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1.
Environ Int ; 140: 105636, 2020 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-32474218

RESUMO

BACKGROUND: Exposure to per-/polyfluoroalkyl substances (PFASs) can disrupt endocrine hormones in humans. Prior studies have focused on the harmful effects of the two traditional per-/polyfluoroalkyl substances (PFASs), perfluorooctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA). Other PFASs, used as the replacements of PFOS and PFOA, are widely and increasingly detected in humans. Whether these replacements influence glucocorticoids and progestogens in newborns remains unknown. OBJECTIVE: To investigate the associations between exposures of PFOS, PFOA and their replacements and glucocorticoids and progestogens in newborns. METHODS: We measured the concentrations of 13 PFASs, 3 glucocorticoids (11-deoxycortisol, cortisol and cortisone) and 2 progestogens [progesterone, 17-hydroxyprogesterone (17OHP)] in the cord sera of 374 neonates in a birth cohort from Wuhan, China, between 2013 and 2014. We evaluated the associations of each PFAS with glucocorticoids and progestogens using multiple linear regression models, and multiple comparisons were additionally corrected via false discovery rates (FDR). RESULTS: Out of the 13 PFASs, 9 were detected in over 95% of cord sera. The Chinese specific PFOS replacement - 6:2 chlorinated polyfluorinated ether sulfonate (6:2 Cl-PFESA, trade name F-53B) was positively associated with 13.13% change in cortisol in girls (95% CI = 4.47%, 22.52%, for each IQR increase in 6:2 Cl-PFESA). Seven PFASs had positive associations with the precursor of cortisol, namely 11-deoxycortisol (percent change ranged from 6.41% to 11.24%, for each IQR increase in PFASs). Perfluorobutane sulfonate (PFBS) in cord sera was positively associated with progesterone in the linear model, whereas PFOS and perfluorohexane sulfonate (PFHxS) levels were associated with progesterone in the quartile models. No PFASs were related to 17OHP or cortisone. CONCLUSIONS: In this study, PFOS, PFOA and/or their replacements were positively associated with progesterone, cortisol and 11-deoxycortisol in newborns. These results suggested that not only PFOS and PFOA, but also other PFASs have potential impacts on glucocorticoids and progestogens in newborns.

2.
Value Health Reg Issues ; 21: 272-279, 2020 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-32402819

RESUMO

OBJECTIVES: To analyze the cost-effectiveness of prostate cancer screening among Chinese men. METHODS: A cost-effectiveness analysis was performed from a societal perspective using a Markov model to compare 2 strategies: the population-based screening strategy and the current clinical diagnostic strategy. Relevant parameters were retrieved from published literature data and surveys, and univariate sensitivity analysis was used to assess the robustness of the model. We simulated the health outcomes for the next 25 years for 100 000 men and calculated the incremental cost-effectiveness ratio (ICER). RESULTS: This study found that the population-based screening strategy, compared with the clinical diagnostic strategy, could save 756.61 quality-adjusted life-years (QALYs) for the hypothetical population. The ICER for the population-based screening strategy was ¥14 747.11/QALY, and this value was less than the willingness-to-pay threshold of ¥64 520. With life-year gains (LYGs) as the model output, the population-based screening strategy yielded an ICER of ¥16 470.45/LYG. The univariate sensitivity analyses showed that the ICER was sensitive to the prostate-specific antigen (PSA) test fee, the proportion diagnosed with low-grade prostate cancer (PC) in the population-based strategy, and the proportion diagnosed with intermediate-grade PC in the population-based strategy. CONCLUSIONS: Prostate cancer screening based on PSA test results appears to be cost-effective for Chinese men who are in good health and have a life expectancy of more than 10 years. Nevertheless, this finding needs to be further studied with more treatment cost parameters (treatment costs related to impotence and urinary incontinence) and using local utility value information.

3.
Cancer ; 2020 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-32396242

RESUMO

BACKGROUND: The purpose of this study was to estimate the proportion of Chinese cancer survivors experiencing financial hardship and then examine the relationship between material and behavioral financial hardship. METHODS: This study surveyed 964 cancer survivors who were 30 to 64 years old and 644 survivors who were 65 years old or older during 2015-2016 (1608 survivors in all). Material financial hardship was measured by whether they had borrowed money because of cancer, its treatment, or the lasting effects of treatment, and behavioral financial hardship was measured by whether they had forgone some cancer-related medical care because of cost. Multivariable logistic regression models were used to examine factors associated with material financial hardship by age group. RESULTS: Approximately 44% of the cancer survivors who were 65 years old or older borrowed money or went into debt because of cancer, and 54% of younger patients (P < .01) reported cancer-related debts. Among these survivors with cancer care debt, survivors aged 65 years old or older had a lower proportion of borrowing more than 50,000 Chinese yuan (CNY; approximately US $7700) than survivors aged 30 to 64 years (14% vs 20%). In both age groups, approximately 10% of cancer survivors reported that they had experienced behavioral financial hardship. After adjustments for covariates, cancer survivors who reported material financial problems were more likely to report behavioral financial hardship (odds ratio [OR] for those aged 30-64 years, 3.72; 95% confidence interval [CI], 2.13-6.50; OR for those aged 65 years or older, 5.48; 95% CI, 2.69-11.15). CONCLUSIONS: Older cancer survivors in China experience significant material financial hardship, but it is not as noticeable as younger patients' hardship. The results highlight the importance of identifying cancer survivors who are more likely to experience financial hardship and improving the affordability of cancer care in China.

4.
Chemosphere ; 253: 126592, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32289600

RESUMO

Prenatal exposure to particulate matter (PM) in ambient air has been linked to changes in newborn mitochondrial DNA copy number (mtDNAcn), but the effects of exposure are inconsistent. We aimed to investigate the effect of weekly PM exposure during pregnancy on newborn mtDNAcn. The present study included 762 mother-infant pairs who were recruited in a birth cohort established between November 2013 and March 2015 in Wuhan, China. Mother's prenatal daily exposure to PM2.5 and PM10 was calculated using a spatial-temporal land use regression model. Relative mtDNAcn in cord blood leukocytes was determined by quantitative real-time polymerase chain reaction. Distributive lag regression models (DLMs) were applied to estimate the association between PM exposure and newborn mtDNAcn. In the adjusted models, prenatal PM2.5 exposure during 25-32 weeks and PM10 exposure during 25-31weeks were significantly associated with decreased cord blood mtDNAcn. PM2.5 exposure during the third trimester was related to decreased mtDNAcn (cumulative percent change: -8.55%, 95% CI: -13.32%, -3.51%). We also identified other exposure windows (17-22 and 11-22 weeks) in which PM exposure was positively associated with mtDNAcn. Overall, exposure to particulate air pollution during mid-to-late gestation is significantly associated with alterations in newborn mtDNAcn, potentially suggesting an enhanced sensitivity to PM exposure during this period.

6.
Thorac Cancer ; 11(4): 1076-1089, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32130756

RESUMO

BACKGROUND: We aimed to obtain a set of health state utility scores of patients with esophageal cancer (EC) and precancerous lesions in China, and to explore the influencing factors of health-related quality of life (HRQoL). METHODS: A hospital-based multicenter cross-sectional study was conducted. From 2013 to 2014, patients with EC or precancerous lesions were enrolled. HRQoL was assessed using a European quality of life-5 dimension (EQ-5D-3L) instrument. Multivariable linear regression analysis was performed to explore the influencing factors of the EQ-5D utility scores. RESULTS: A total of 2090 EC patients and 156 precancer patients were included in the study. The dimension of pain/discomfort had the highest rate of self-reported problems, 60.5% in EC and 51.3% in precancer patients. The mean visual analog scale (VAS) score for EC and precancer patients were 68.4 ± 0.7 and 64.5 ± 3.1, respectively. The EQ-5D utility scores for EC and precancer patients were estimated as 0.748 ± 0.009 and 0.852 ± 0.022, and the scores of EC at stage I, stage II, stage III, and stage IV were 0.693 ± 0.031, 0.747 ± 0.014, 0.762 ± 0.015, and 0.750 ± 0.023, respectively. According to the multivariable analyses, the factors of region, occupation, household income in 2012, health care insurance type, pathological type, type of therapy, and time points of the survey were statistically associated with the EQ-5D utility scores of EC patients. CONCLUSIONS: There were remarkable decrements of utility scores among esophageal cancer patients, compared with precancer patients. The specific utility scores of EC would support further cost-utility analysis in populations in China.

7.
Carbohydr Polym ; 236: 116051, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32172865

RESUMO

Effective bleeding control is critical first step in current civilian and military trauma treatment, however commercially available hemostatic materials are difficult to achieve expected effects. In this study, a composite sponge (H-D) based on hydroxybutyl chitosan (HBC) and diatom-biosilica (DB) was designed for hemorrhage control. H-D exhibited hierarchical porous structure, favorable biocompatibility (hemolysis ratio < 5 %, no cytotoxicity), along with high and fast fluid absorbability (11-16 times than that of weight), given effective hemostasis effect (clotting time shortened by 70 % than that of control). In vitro coagulation tests demonstrated that H-D could provide strong interface effect to induce erythrocyte absorption and aggregation, as well as activating the intrinsic coagulation pathway and thus accelerated blood coagulation. These results proved that H-D composite sponge has great potential for hemorrhage control.

8.
J Hazard Mater ; 388: 121774, 2020 04 15.
Artigo em Inglês | MEDLINE | ID: mdl-32001102

RESUMO

While increasing evidence has shown that prenatal bisphenol A (BPA) exposure is adversely associated with child neurodevelopment, little is known about the neurodevelopmental effects of BPA alternatives, such as bisphenol S (BPS) and bisphenol F (BPF). We aimed to evaluate the relationships of repeated measurements of bisphenol exposure during pregnancy with child neurodevelopment. From 2014-2015, 456 mother-child pairs were included in the present study. Each had a spot urine sample in the first, second, and third trimester, respectively, during pregnancy for BPA, BPS, and BPF measurements. Children's neurodevelopment was assessed using the Bayley Scales of Infant Development at 2 years. In adjusted models, children's psychomotor development index scores decreased across quartiles of BPS concentrations [-5.52 (95 % CI: -10.06, -0.99) in the 4th quartile vs. 1 st quartile, P-trend = 0.01]. Each 10-fold increase in BPA concentrations was related to lower mental development index scores only in the second trimester [-2.87 (95 % CI: -4.98, -0.75), Ptrimester-int = 0.04]. However, prenatal BPF exposure was not significantly associated with child neurodevelopment. We provide evidence that prenatal exposure to BPA and BPS may affect child neurodevelopment.

9.
Cancer Med ; 9(4): 1544-1552, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31899608

RESUMO

As a prevalent tumor among women, breast cancer is still an incurable disease due to drug resistance. In this study, we report microRNA-221 to have a significant effect on breast cancer resistance to adriamycin. The microRNA-221 is elevated in tumor tissue compared with nearby nontumor samples, as well as in breast cancer cell line with adriamycin resistance (MCF-7/ADR) compared to its parental line (MCF-7) and the normal breast epithelial cell line (MCF-10A). Enforced level of microRNA-221 promotes cancer resistance to adriamycin, which in turn sustains cell survival and exacerbates malignant formation. Reciprocally, the silence of microRNA-221 in cancer cells augments the sensitivity to chemotherapy, thereby resulting in enhanced apoptosis of MCF-7/ADR cells. Mechanistically, we identify PTEN as a direct target of microRNA-221, which was conversely associated with a microRNA-221 level in breast tumors. The knock-down of PTEN partially reversed the stimulatory role of microRNA-221 in the modulation of the Akt/mTOR signaling. Taken together, these findings suggest microRNA-221 suppresses PTEN transcription and activates Akt/mTOR pathway, which in turn enhances breast cancer resistance to adriamycin and promotes cancer development. Our data thus illuminate the microRNA-221/PTEN axis may act as a promising strategy for the treatment of chemotherapy-resistant breast tumors.

10.
J Chromatogr A ; 1617: 460830, 2020 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31902577

RESUMO

There is an urgent need for the development of efficient and comprehensive analytical methods for organic chemical compounds due to their increasing number and diversity in children's toy products. The presence of these chemicals in toys poses an extreme risk for the health and development of children. In this study, an analytical methodology has been developed using ultra-high-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry (UHPLC-Q-TOF-MS). This hybrid instrumentation together with an in-house accurate-mass database and a mass spectral library, allows for wide-scope screening and identification of hazardous substances in plastic toys. A total number of 200 compounds belonging to eight chemical families were investigated, such as coloring agents, plasticizers, fragrance allergens, nitrosamines, primary aromatic amines, flame retardants, perfluorinated compounds, and endocrine disruptors. Following a straightforward and efficient dissolution/precipitation method for sample preparation, chemical screening and confirmation were conducted by comparing the experimentally measured exact mass, retention time, and isotopic pattern with the accurate-mass database and by matching the acquired MS/MS spectra against the mass spectral library. The matrix effect, linearity, sensitivity, precision, and recovery of the proposed method were properly evaluated. The obtained limits of detection (LODs) and quantitation (LOQs) were in the range of 0.01-0.98 mg kg-1 and 0.03-2.99 mg kg-1, respectively. The applicability of the developed protocol was verified through the analysis of 55 real plastic toy products.

11.
Environ Int ; 136: 105491, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31991237

RESUMO

BACKGROUND: Evidence from animal and in vitro studies suggest that some metals interfere with normal platelet counts (PLT). However, limited human studies have investigated the association of metals and PLT, a marker of hematologic and hemostatic, particularly in susceptible populations such as pregnant women. OBJECTIVES: Our purpose was to investigate the associations of repeated measures of 13 urinary metals with PLT during pregnancy. METHODS: The present study involved 3911 pregnant women participating in a prospective cohort study in Wuhan, China, from 2013 to 2016. We measured 13 metals in urine and PLT in blood samples collected in the first, second, and third trimester (median = 13, 24, and 35 weeks of gestation, respectively). Mixed linear models and general linear models were applied to analyze the associations between multiple metals and PLT during pregnancy. The odds ratio (OR) for gestational thrombocytopenia was examined using generalized estimating equations. RESULTS: After adjusting for other metals and covariates, the repeated measure analyses showed that decreased levels of PLT were associated with a 10-fold increase in urinary concentration of cadmium (Cd) [percent difference (%Δ) = -5.02, 95%CI = -9.53, -0.29], manganese (Mn) [percent difference (%Δ) = -4.63, 95%CI = -7.50, -1.67], and arsenic (As) [percent difference (%Δ) = -4.56, 95%CI = -8.11, -0.86]. Cross-sectional analyses by trimesters revealed that Cd was inversely associated with PLT through the three trimesters. In addition, Cd was associated with an increased OR of 1.80 (95%CI: 1.26, 2.56), 1.65 (95%CI: 1.05, 2.59), 1.54 (95%CI: 1.02, 2.33) for gestational thrombocytopenia in the first, second, and third trimester, respectively. CONCLUSIONS: Our study suggested an association of Cd, Mn, and As with decreased PLT during pregnancy. Particularly, Cd may increase the risk of gestational thrombocytopenia.

12.
Environ Pollut ; 258: 113657, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31812528

RESUMO

Microplastics are a growing problem in marine environments due to their ubiquitous occurrence and affinity for chemical pollutants. However, the influence of microplastics on the uptake, depuration and toxicity of decabromodiphenyl ether (BDE-209) in marine organisms is unclear. We exposed the marine scallop Chlamys farreri to polystyrene microplastics (PS; 125 µg/L) combined with BDE-209 (10 and 100 µg/L) to determine their toxicokinetics, cellular toxicity and histopathological effects. The results showed that PS acted as both a carrier and a scavenger for the bioaccumulation of BDE-209. Importantly, the carrier role of PS was greater than scavenger one. PS increased the negative effect of BDE-209 (100 µg/L) on hemocyte phagocytosis, and ultrastructural changes in gills and digestive gland of scallops due to their carrier role for the bioaccumulation of BDE-209. However, PS did not increase the DNA damage of BDE-209 on the hemocytes. These findings are evidence of microplastics transferring adsorbed pollutants to marine organisms, and increasing their toxicity.

13.
Environ Int ; 135: 105360, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31830730

RESUMO

BACKGROUND: Benzotriazoles (BTRs) and benzothiazoles (BTHs) are emerging contaminants with potential insulin modulation activities. Pregnancy exposure to BTs (BTRs and BTHs) may be a risk factor for the development of gestational diabetes mellitus (GDM). However, epidemiological studies are limited. OBJECTIVES: We prospectively investigated the associations of exposure to BTs at early pregnancy with the blood glucose levels and the risks of GDM. METHODS: A prospective cohort of 1770 pregnant women who were free of diabetes at baseline was established between 2013 and 2015 in Wuhan, China. Urine samples collected at 13.1 ± 1.1 weeks of gestation were analyzed to estimate the exposure level of BTs. The diagnosis of GDM was based on a 75 g oral glucose tolerance test (OGTT) conducted at 26.4 ± 2.4 weeks of gestation. We examined the associations between urinary concentration of BTs and blood glucose levels by linear regression models. The associations of urinary BTs concentrations with the relative risk (RR) of GDM were evaluated by generalized estimating equations with Poisson regression. Effect modifications by fetus sex and pre-pregnancy body mass index (BMI) were further evaluated in the sensitivity analysis. RESULTS: A total of 147 (8.31%) pregnant women were diagnosed with GDM. Median concentrations of urinary BTs did not differ significantly between pregnant women with and without GDM. It was found that urinary levels of benzothiazole and 2-hydroxy-benzothiazole (2-OH-BTH) were positively associated with 2-hour blood glucose (p for trend < 0.050). Comparing the high exposure group with the low exposure group of 2-OH-BTH, the adjusted RR of GDM was 1.79 (95% CI = 1.18 to 2.69, p for trend = 0.012). Sensitivity analysis indicated that the positive association of the urinary 2-OH-BTH level with the RR of GDM remained significant among pregnant women who had a male fetus (RR = 1.76, 95% CI = 1.02 to 3.03, p for trend = 0.041) and those with a normal pre-pregnancy BMI (RR = 1.85, 95% CI = 1.09 to 3.11, p for trend = 0.034). CONCLUSIONS: These findings suggested that higher urinary level of 2-OH-BTH in early pregnancy was associated with impaired glucose homeostasis and the increased risk of GDM. The results underscore the need of follow-up studies to validate the findings and elucidate the underlying biological mechanism.

14.
Chin J Cancer Res ; 31(5): 825-837, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31814686

RESUMO

Objective: Colorectal cancer (CRC) causes a substantial burden of disease in China and the evidence of economic burden triggered is fundamental for priority setting. The aim of this survey was to quantify medical expenditures and the time trends for CRC diagnosis and treatment in China. Methods: From 2012 to 2014, a hospital-based multicenter retrospective survey was conducted in 13 provinces across China. For each eligible CRC patient diagnosed from 2002 to 2011, clinical information and expenditure data were extracted using a uniform questionnaire. All expenditure data were reported in Chinese Yuan (CNY) using 2011 values. Results: Of the 14,536 CRC patients included, the average age at diagnosis was 58.2 years and 15.8% were stage-I cases. The average medical expenditure per patient was estimated at 37,902 CNY [95 % confidence interval (95% CI): 37,282-38,522], and the annual average increase rate was 9.2% from 2002 to 2011 (P for trend <0.001), with a cumulative increase of 2.4 times (from 23,275 CNY to 56,010 CNY). The expenditure per patient in stages I, II, III and IV were 31,698 CNY, 37,067 CNY, 38,918 CNY and 42,614 CNY, respectively (P<0.001). Expenditure significantly differed within various subgroups. Expenses for drugs contributed the largest proportion (52.6%). Conclusions: These conservative estimates illustrated that medical expenditures for CRC diagnosis and treatment in tertiary hospitals in China were substantial and increased rapidly over the 10 years, with drugs continually being the main expense by 2011. Relatively, medical expenditures are lower for CRC in the earlier stages. These findings will facilitate the economic evaluation of CRC prevention and control in China.

15.
Medicine (Baltimore) ; 98(51): e18336, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860987

RESUMO

BACKGROUND: This systematic review program is designed to provide an assessment of the effectiveness and safety of needle-knife therapy for the treatment of carpal tunnel syndrome (CTS). METHODS: A cumulative search till October 2018 will be conducted in the following 8 databases: PubMed, EMBASE, Cochrane Controlled Trials Register, MEDLINE, China National Knowledge Infrastructure, China Biomedical Literature Database, VIP Database, and Wanfang Database, with no language or Publication status restrictions. All randomized controlled trials (RCT) for carpal tunnel syndrome will be considered eligible. The primary outcomes will include changes in the Boston carpal tunnel questionnaire (BCTQ) and visual analogue score (VAS), as well as safety and adverse events. Study inclusion, data extraction, and quality assessment will be done independently by 2 reviewers. If no substantial heterogeneity is detected, a meta-analysis will be performed. Continuous results will be expressed as mean differences or standard average differences, while binary data will be expressed as relative risks. The deviation risk and data synthesis will be assessed using the Review Manager software. RESULTS: This study will provide a high-quality synthesis of BCTQ and VAS to assess the effectiveness and safety of acupotomy for carpal tunnel syndrome patients. CONCLUSION: This systematic review will provide evidence to judge whether acupotomy is an effective intervention for patients with carpal tunnel syndrome. PROSPERO REGISTRATION NUMBER: CRD42018108787.


Assuntos
Terapia por Acupuntura , Síndrome do Túnel Carpal/terapia , Humanos , Avaliação de Resultados em Cuidados de Saúde , Projetos de Pesquisa , Revisões Sistemáticas como Assunto
16.
Medicine (Baltimore) ; 98(46): e17765, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725617

RESUMO

BACKGROUND: De Quervain disease (dQD) is a painful condition of the wrist that affects patients' quality of life and work ability. Acupotomy has been widely used in the treatment of dQD. It has been reported in many articles that acupotomy can improve the clinical symptoms of dQD. However, the efficacy has not been evaluated scientifically and systematically. The aim of this systematic review protocol is to evaluate the efficacy and safety of acupotomy treatment compared with local steroid injection in patients with de Quervain disease. METHODS: Relevant randomized controlled trials will be identified by searching 9 databases (PubMed, EMBASE, Cochrane Library, Chinese literature databases, the Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI], SinoMed, Technology Journal [VIP], and the Wanfang Database). Randomized controlled trials (RCTs) of Acupotomy for dQD patients will be identified independently by 2 reviewers by searching the databases from inception to October 2018. Clinical effects will be evaluated as the primary outcome. The VAS (visual analog scale) score will be assessed as a secondary outcome. RevMan V.5.3 will be used to perform a fixed effect meta-analysis, and the evidence level will be evaluated by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. Continuous outcomes will be presented as the mean differences or standard mean differences, while dichotomous data will be expressed as relative risks. RESULTS: This study will evaluate the effectiveness and safety of acupotomy in the treatment of de Quervain disease in RCTs with high-quality VAS and RM. CONCLUSION: This systematic review will provide evidence to judge whether acupotomy is an effective intervention for patients with de Quervain disease. PROSPERO REGISTRATION NUMBER: CRD42018108786.


Assuntos
Terapia por Acupuntura/estatística & dados numéricos , Doença de De Quervain/terapia , Esteroides/administração & dosagem , Terapia por Acupuntura/métodos , Humanos , Injeções Intra-Articulares , Medição da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento , Articulação do Punho
17.
Medicine (Baltimore) ; 98(42): e17398, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626093

RESUMO

BACKGROUND: Acupotomy is a miniature surgery instrument. It can cut and detach the abnormal, cicatricial, and contractured tissues by causing only microtrauma. Acupotomy has been widely used clinically with a satisfactory efficacy. With the development of ultrasound technology, ultrasound-guided acupotomy has shown great value in clinical practice. But it is not yet clear that ultrasound-guided acupotomy is very effective and safe. Therefore, it is important to re-evaluate the available evidence to reach a relatively convincing conclusion that acupotomy by ultrasound-guided technique is a better choice than traditional acupotomy. The purpose of this systematic review is to provide a method for evaluating the effectiveness and safety of acupotomy by ultrasound-guided technique. METHODS: This systematic review will be performed by searching relevant randomized controlled trials (RCTs) without any language or publication status restriction from inception to December 2019 by 2 researchers in nine databases (PubMed, Medline, Embase, Cochrane Library, Chinese literature databases, Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI], China Science and Journal Database [CSJD], and Wanfang Database). All RCTs evaluating acupotomy by the ultrasound-guided technique will be included in this study. Visual analog scale (VAS) and change of symptom will be assessed as the primary outcomes. The change in the ultrasound image, safety and adverse events, and acceptability will be assessed as secondary outcomes. The selection of study, data collection and analysis, and assessment of the study quality will be completed independently by 2 researchers. RevMan v.5.3 will be used for meta-analysis if no significant heterogeneity is detected. Continuous outcomes will be presented as the mean difference (MD) or standardized MD, while dichotomous data will be expressed as the relative risk. RESULTS: This study will provide a high-quality synthesis of QL and AR to assess the effectiveness and safety of acupotomy by ultrasound-guided technique. CONCLUSION: This systematic review will provide evidence to judge whether acupotomy by ultrasound-guided technique is an effective the efficacy and safety intervention. PROSPERO REGISTRATION NUMBER: CRD42018109070.


Assuntos
Terapia por Acupuntura/métodos , Ultrassonografia de Intervenção/métodos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto
18.
Medicine (Baltimore) ; 98(42): e17402, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626094

RESUMO

BACKGROUND: Trigger finger is thought to be caused by aseptic inflammation of the A1 pulley and subsequent thickening and narrowing of the fibrous sheath. Acupotomy has been an important treatment for trigger finger. But an updated systematic review about this issue has not yet been released. This systematic review protocol is aimed at providing a higher quality method used to evaluate the efficacy and safety of acupotomy treatment for trigger finger. METHODS: The following databases will be searched from the study inception to July 2019: the Cochrane Central Register of Controlled Trials (Cochrane Library), MEDLINE, EMBASE, PubMed, China National Knowledge Infrastructure, Wan-Fang Data, and Chinese Biomedical Literature Database. All English or Chinese randomized controlled trials related to acupotomy for trigger finger will be included. Two reviewers will independently perform the processes of study inclusion, data extraction, and quality assessment. The primary outcome will be assessed by improvement of the pain symptoms and finger activity. Secondary outcomes will be assessed through Safety assessment. Meta-analysis will be completed by RevMan V.5.3 software. RESULTS: This systematic review will provide an assessment of the current state of acupotomy for trigger finger, aiming to show the efficacy and safety of treatment. CONCLUSION: This systematic review will re-evaluate a higher-quality systematic review to obtain a relatively convincing conclusion that finds acupotomy to be a better choice for trigger finger patients. PROSPERO REGISTRATION NUMBER: CRD42018118663.


Assuntos
Terapia por Acupuntura/métodos , Dedo em Gatilho/terapia , Humanos , Revisões Sistemáticas como Assunto , Resultado do Tratamento
19.
Cancer Med ; 8(18): 7859-7868, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31650699

RESUMO

BACKGROUND: The present study aimed to first describe the work-related outcomes of cancer survivors and to then identify those characteristics that influenced the decision to stop working in rural China. METHODS: We assessed 752 cancer survivors (residents of rural areas, working at the time of diagnosis, >1 year since completing treatment) from the cross-sectional study "China Survey of Experiences with Cancer". Participants reported changes in employment status, income, and the ability to perform physical jobs due to cancer, as well as the work-related outcomes of their informal caregivers. Logistic regression analyses were used to examine the association between sociodemographic characteristics, cancer characteristics, and changes in work (ie, continue to work vs not working). RESULTS: The participants were largely farmers (96%), women (56%), younger than 65 years old (69%), and diagnosed with colorectal (31%) and breast cancer (31%). Thirty-nine percent reported reducing working hours, and 40% reported stopping work altogether. Approximately 7% of informal caregivers also stopped working in order to take care of those diagnosed with cancer. Thirty-three percent of cancer survivors and 5% of their informal caregivers had no source of income following treatment. Controlling for other variables, lower educational attainment, physical limitations in work, and different cancer sites were significantly associated with ending employment in both men and women, while among men specifically, we observed that older age, being unmarried, and being diagnosed at later stages were significantly associated with an end to working. CONCLUSION: Rural cancer survivors are at a high risk for stopping work after completing treatment, and many survivors and their caregivers experience poor work-related outcomes and economic hardship. These results highlight the importance of paying attention to the work experiences of cancer survivors in rural China.

20.
Ecotoxicol Environ Saf ; 185: 109700, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31557569

RESUMO

In this study, heavy metals including Cd, Pb, Zn, Mn, Cu, Ni, Cr, As, and Hg, in the surface sediment (0-10 cm) of the Huixian wetland in a karst region were investigated in terms of their spatial distribution, ecological risks, and possible sources. Samples were collected from 13 typical sites throughout the Huixian wetland and were analyzed via inductively coupled plasma-mass spectrometry. The results revealed that the mean concentrations of Cd, Pb, Mn, Cr, As, and Hg were higher than the background and Chinese safe standard values. Based on spatial distribution and ecological risk, the study area was differentiated into three groups of sites with the following order of risk: group 3 > group 2 > group 1. The observed concentrations fluctuated slightly with depth. However, an irregular decreasing trend in the concentration with soil depth was observed among the groups. Multivariate statistical analyses showed that the high accumulation of Cd, Pb, Zn and Cu in the sediments of group 3 sites is due to the natural ancient deposition of minerals rich in heavy metals, while the accumulation of Mn, Cr, As, and Hg is attributed to an anthropogenic origin. Agricultural activities, the use of fertilizers and, pesticides, and local automobile repair stations most probably enriched these heavy metals in the Huixian wetland sediments. Hg and Cd have the highest potential ecological risk, which follows the order Hg > Cd > Pb > As > Ni > Cu > Cr > Mn > Zn. The mean geoaccumulation index (Igeo) values of Pb (0.48) and Hg (1.12) suggested moderate contamination in the study area.


Assuntos
Monitoramento Ambiental/métodos , Sedimentos Geológicos/química , Metais Pesados/análise , Poluentes Químicos da Água/análise , Áreas Alagadas , China , Ecologia , Análise Multivariada , Medição de Risco , Solo/química
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