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1.
J Surg Oncol ; 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34617593

RESUMO

BACKGROUND: Patients with distal cholangiocarcinoma (DCC) are prone to relapse even after radical pancreaticoduodenectomy. In this study, we sought to create an online nomogram calculator to accurately predict the recurrence risk of DCC. METHODS: A total of 184 patients were included. Multivariate Cox regression analysis was used to identify independent prognosis factors for recurrence-free survival and overall survival. A nomogram was constructed according to the prognostic factors in the training cohort and then tested in the validation cohort. RESULTS: Multivariate Cox analysis showed preoperative carbohydrate antigen 19-9 (p < 0.001), maximum tumor size (p = 0.076), perineural invasion (p = 0.044), and N stage (p = 0.076) were independent prognostic factors for DCC relapse. We then constructed a nomogram with these four factors. The consistency index (C-index) of the nomogram in the training and validation cohorts were 0.703 and 0.665, respectively. Time-dependent receiver operating characteristic and decision curve analyses revealed that the nomogram provided higher diagnostic power and net benefit compared with other staging systems. CONCLUSION: In this study, we developed an online nomogram calculator that can accurately predict the recurrence risk of DCC and identify patients with a high risk of recurrence in a simple and convenient manner.

2.
Artigo em Inglês | MEDLINE | ID: mdl-34471952

RESUMO

PURPOSE: Robotic surgery has been increasingly applied in pancreatic surgery and showed many advantages over conventional open surgery. The robotic pancreaticoduodenectomy (RPD) is a surgical option for primary nonampullary duodenal adenocarcinoma (PNDA). However, whether RPD is superior to open pancreaticoduodenectomy (OPD) for PNDA has not been reported. The comparative study was designed to analyze the short- and long-term outcomes of RPD versus OPD on patients with PNDA. METHODS: Demographics, perioperative, and survival outcomes among patients who underwent RPD (n = 49) versus OPD (n = 43) for PNDAs between January 2013 and March 2018 were collected and analyzed RESULTS: Demographic characteristics were comparable between the RPD group and the OPD group. The RPD group demonstrated a decreased estimated blood loss (100 vs. 200 ml, p < 0.001), time to oral intake (4.0 vs. 4.0 days, p = 0.04), and postoperative hospital stay (12.9 vs. 15.0 days, p = 0.01) compared with the OPD group. However, no differences were observed between the two groups in terms of operative time and the rates of major complications, grade B and C POPF, PPH, grade B and C DGE, biliary fistular, reoperation, and 90-day readmission. No patient died within 90 days. There were no significant differences in tumor size, differentiation, TNM stage, number of harvested lymph nodes, and the rates of nerve invasion, lymph node invasion, R0 resection, and the median overall survival between the two groups (p > 0.05) CONCLUSIONS: RPD is a safe, feasible, and effective treatment for PNDA compared with OPD and can be used as an alternative for surgeons in the treatment of PNDA. Further multicenter randomized controlled trials are needed to evaluate the effectiveness of RPD in patients with PNDA.

3.
Trials ; 22(1): 545, 2021 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-34407832

RESUMO

BACKGROUND: Proton pump inhibitor (PPI) is effective for the treatment of nonerosive gastroesophageal reflux (NERD), but long-term use of PPI is prone to have complications and recurrence after withdrawal. Traditional Chinese medicine (TCM) can relieve the symptoms of reflux and improve the quality of life. The purpose of this study is to evaluate the safety and efficacy of Hewei Jiangni recipe (HWJNR) in the treatment of NERD with cold-heat complex syndrome, and clarify the mechanism of HWJNR on NERD based on the correlation analysis of intestinal flora and metabolites. METHODS: This is a single-center, randomized controlled, double-blind, placebo-controlled clinical trial in which 72 eligible participants with NERD and TCM syndrome of intermingled heat and cold will be randomly allocated in the ratio of 1:1 to two groups: TCM group and western medicine group. The TCM group will receive HWJNR with omeprazole enteric-coated tablets placebo, while the western medicine group will receive omeprazole enteric-coated tablets with HWJNR placebo. Each group will be treated for 8 weeks. The primary outcome is the score of gastroesophageal reflux disease (GERD) health-related quality of life questionnaire (GERD-Q). Secondary outcomes include SF-36 quality of life scale (SF-36), patient-reported outcomes (PRO) self-rating scale score, syndrome score of TCM, and adverse events. Mechanistic outcome is the correlation analysis of intestinal flora and metabolites from healthy individuals and NERD participants before and after the treatment respectively. DISCUSSION: The goal of this trial is to investigate the efficacy and safety of HWJNR in the treatment of NERD with cold-heat complex syndrome, and to study the composition structure and metabolite expression profile of intestinal flora in patients with NERD through 16SrRNA sequencing and metabolomic correlation analysis of fecal flora, which makes us identify the dominant links of treatment and reveal the potential mechanism of HWJNR. ChiCTR2000041225 . Registered on 22 December 2020.


Assuntos
Medicamentos de Ervas Chinesas , Qualidade de Vida , China , Método Duplo-Cego , Medicamentos de Ervas Chinesas/efeitos adversos , Temperatura Alta , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
4.
Turk J Gastroenterol ; 32(5): 422-430, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34231471

RESUMO

BACKGROUND: This systematic review and meta-analysis were carried out on well-conducted and adequately powered studies to explore whether arterial stiffness was associated with inflammatory bowel disease (IBD). METHODS: The search for potential literature was conducted on PubMed, MEDLINE, Cochrane Library, and Embase from inception to February 15, 2020. The studies assessing arterial stiffness in IBD were reviewed and included. RESULTS: Conclusively, 17 eligible trials with a total of 2188 participants were in compliance with the inclusion criteria. Of the included 2188 participants, the cases for ulcerative colitis (UC) and Crohn's disease (CD) were 558 and 693, respectively. Altogether 10 studies were conducted to evaluate the carotid-femoral pulse wave velocity (CPWV) in overall IBD patients, which was significantly increased with the mean difference (MD) and 95% CI as 0.70 (0.48-0.92, P < .01). The pooled results for CPWV in patients with CD and UC were also faster than that of control groups with MD and 95% CI as 1.09 (0.45-1.72) and 0.57 (0.57-1.24), respectively. The CPWV in CD and UC groups was comparable with a MD of 0.07 (P = .74, 95% CI: -0.32 to 0.45). CONCLUSION: Arterial stiffness had associations with the overall IBD, UC, and CD with a similar strength of association between UC and CD.

5.
Artigo em Inglês | MEDLINE | ID: mdl-34264489

RESUMO

Dissimilatory nitrate reduction processes, including denitrification, anaerobic ammonium oxidation (anammox), and dissimilatory nitrate reduction to ammonium (DNRA), are important pathways of nitrate transformation in the aquatic environments. In this study, we investigated potential rates of denitrification, anammox, and DNRA in the sediments of two subtropical rivers, Jinshui River and Qi River, with different intensities of human activities in their respective catchment, China. Our objectives were to assess the seasonality of dissimilatory nitrate reduction rates, quantify their respective contributions to nitrate reduction, and reveal the relationship between dissimilatory nitrate reduction rates, functional gene abundances, and physicochemicals in the river ecosystems. Our results showed higher rates of denitrification and anammox in the intensively disturbed areas in autumn and spring, and higher potential DNRA in the slightly disturbed areas in summer. Generally, denitrification, anammox, and DNRA were higher in summer, autumn, and spring, respectively. Relative contributions of nitrate reduction from denitrification, anammox, and DNRA were quite different in different seasons. Dissimilatory nitrate reduction rates and gene abundances correlated significantly with water temperature, dissolved organic carbon (DOC), sediment total organic carbon (SOC), NO3-, NH4+, DOC/NO3-, iron ions, and sulfide. Understanding dissimilatory nitrate reduction is essential for restoring nitrate reduction capacity and improving and sustaining ecohealth of the river ecosystems.

6.
Sci Total Environ ; 778: 146347, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34030388

RESUMO

As a quorum sensing signal molecule, N-(3-oxododecanoyl)-homoserine lactone (3OC12) regulate the population behavior of microorganisms. Many studies have proved that 3OC12 harm the physiological function of host intestinal epithelial cells. However, the detrimental effects of 3OC12 on intestinal health need verification in animals. Besides, the role of gut microbiome in 3OC12-induced intestinal damage also needs further understanding. In our study, 3OC12 was first administered to specific pathogen-free (SPF) mice, then the fecal microbiome of SPF mice was transplanted into germ-free (GF) mice to reveal the effects of 3OC12 on intestinal health and regulatory mechanisms of the intestinal microbiome. 3OC12 treatment significantly decreased body weight, shortened colonic length, disrupted the morphology of the colonic epithelium and increased the histopathological score of the colon in SPF mice. The levels of diamine peroxidase, d-lactate, TNF-α, IL-1ß, and IL-8 were found to be significantly elevated in the serum of 3OC12 mice, while the levels of IL-10 were significantly reduced. Besides, the fecal microbial community of mice was also altered in the 3OC12-treated SPF mice. The results of fecal microbial transplantation (FMT) experiment showed that the phenotypes in SPF mice were almost reproduced in GF mice, manifested by body weight loss, colon damage and changed in serum chemical markers. More importantly, a joint analysis of fecal microbes in SPF and GF mice revealed Feature14_Elizabethkingia spp. was common differential bacteria in the feces of two kinds of mice treated with and without FMT. Our results demonstrated that 3OC12 challenge led to systemic inflammation and body weight loss in mice by disrupting intestinal barrier function, in which gut microbiome played a key role. These findings increased our understanding of the mechanism of intestinal injury caused by 3CO12, providing new ideas for the prevention and therapy of diseases caused by bacterial infection from the perspective of intestinal microbiome.


Assuntos
Microbioma Gastrointestinal , 4-Butirolactona/análogos & derivados , Animais , Homosserina/análogos & derivados , Inflamação , Camundongos , Percepção de Quorum
7.
Environ Sci Pollut Res Int ; 28(32): 44339-44353, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33847890

RESUMO

Expansion of agricultural and urban areas and intensification of catchment land-use increasingly affect different facets of biodiversity in aquatic communities. However, understanding the responses of taxonomic and functional diversity to specific conversion from natural forest to agriculture and urban land-use remains limited, especially in subtropical streams where biomonitoring programs and using functional traits are still under development. Here, we conducted research in a subtropical stream network to examine the responses of macroinvertebrate taxonomic and functional diversity to different types of land-use in central China. Our results showed that medium body size, univoltine, gill respiration, and slow seasonal development were much higher in natural forest sites, while certain traits related to strong resilience and resistance (e.g., small body size, fast seasonal development, bi-or multivoltine, abundant occurrence in drift, sprawler) dominated in high-intensity agriculture and urbanization sites. We further found that land-use compromised water quality (e.g., increases in total phosphate, conductivity and water temperature) and habitat conditions (e.g., high proportion of sand and silt, gravel, and channel width) accounted for the changes in trait composition based on a combination of RLQ and fourth-corner analysis. Moreover, natural forest sites presented relatively high values of functional richness than other land-use, demonstrating the importance of natural forest maintenance to promote high levels of functional diversity. However, taxonomic diversity indexes showed higher sensitivity to distinguish different types of land-use compared to functional diversity measures. Even so, given that certain trait categories showed significant relationships with specific local environmental stressors, trait-based approaches can provide reliable evidence to diagnose the cause of impairment and complement the results of the taxonomic-based approaches. Our findings support the idea that taxonomic and functional approaches should be integrated in river restoration and land-use management.


Assuntos
Invertebrados , Rios , Animais , Biodiversidade , Ecossistema , Monitoramento Ambiental
8.
Updates Surg ; 73(3): 967-975, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33797734

RESUMO

Robotic central pancreatectomy has been applied for 20 years with the advantage of minimally invasive surgery. The general pancreatic reconstruction approaches include pancreaticojejunostomy and pancreaticogastrostomy. Recently, our group reported a few preliminary cases of application of end-to-end pancreatic anastomosis in robotic central pancreatectomy. This novel approach has not been compared with the conventional approach on a large scale. The objective of this study is to compare end-to-end pancreatic anastomosis with pancreaticojejunostomy after robotic central pancreatectomy based on the perioperative and long-term outcomes. Clinical data consist of demographics, clinicopathologic characteristics, perioperative and long-term outcomes of patients who underwent robotic central pancreatectomy from March 2015 to December 2019 were collected and analyzed. Seventy-four patients received a robotic central pancreatectomy with either end-to-end pancreatic anastomosis (n = 52) or pancreaticojejunostomy (n = 22). End-to-end pancreatic anastomosis was associated with shorter operative time and reduced blood loss. Despite a higher incidence of clinically relevant postoperative pancreatic fistula (69.2% vs. 36.4%, p = 0.009), the newer anastomotic technique was also associated with earlier removal of nasogastric tube and resumption of oral intake. Long-term results, in terms of either endocrine or exocrine function, were not affected by the anastomotic technique. We have shown the feasibility of robotic central pancreatectomy with end-to-end pancreatic anastomosis. Despite streamlined technique, the newer anastomosis appears to improve early post-operative results while preserving endocrine and exocrine functions in the long-term period. Evaluation of the true potential of robotic central pancreatectomy with end-to-end pancreatic anastomosis requires a prospective and randomized study enrolling a large number of patients.

9.
Dis Esophagus ; 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33884417

RESUMO

Feeding jejunostomy (FJ) is a routine procedure at the time of esophagectomy in some centers. With the widespread popularization of enhanced recovery after surgery, the necessity of FJ has been increasingly questioned. This study aims to analyze the differences in safety and effectiveness between with (FJ group) or without (no-FJ group) performing FJ at the time of esophagectomy. PubMed, Embase, Web of Science, and Cochrane Library were comprehensively searched for relevant studies, including randomized controlled trials and cohort studies. The primary outcome was the length of hospital stay (LOS). Secondary outcomes were overall postoperative complications, postoperative pneumonia, intestinal obstruction, and weight loss at 3 and 6 months after esophagectomy. Weighted mean differences (WMD) and odds ratios (OR) were calculated for statistical analysis. About 12 studies comprising 2,173 patients were included. The FJ group had a longer LOS (WMD = 2.05, P = 0.01) and a higher incidence of intestinal obstruction (OR = 11.67, P < 0.001) than the no-FJ group. The incidence of overall postoperative complications (OR = 1.24, P = 0.31) and postoperative pneumonia (OR = 1.43, P = 0.13) were not significantly different, nor the weight loss at 3 months (WMD = 0.58, P = 0.24) and 6 months (P > 0.05) after esophagectomy. Current evidence suggests that routinely performing FJ at the time of esophagectomy appears not to generate better postoperative outcomes. FJ may need to be performed selectively rather than routinely. More studies are required to further verify.

10.
Huan Jing Ke Xue ; 42(4): 1879-1888, 2021 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-33742823

RESUMO

In order to explore the characteristics and driving factors of the epilithic algae community in the middle and lower reaches of the Lhasa River, epilithic algae was collected and identified in September 2019, the species composition and spatial distribution were analyzed, and the key environmental factors affecting the epilithic algae community were identified through redundancy analysis. The results indicated that 31 genera of epilithic algae belonging to six phyla were identified, and the average cell density of the epilithic algae was 1.92×106 cells·m-2. The number of species and cell density of the diatom phylum were the largest at each sampling point. The species number and cell density of the epilithic algae were significantly different between the main stream and tributaries. The main stream and tributaries contained relatively small differences in the dominant algae genera, which were Gomphonema, Fragilaria, Cymbella, and Planktolyngbya in the main stream and Gomphonema, Fragilaria, Cymbella, and Oscillatoria in the tributaries. The redundancy analysis revealed that temperature, pH, and dissolved oxygen were the main driving factors affecting the community structure of the dominant genus in the main stream, while HCO3- and flow velocity controlled the community structure of the dominant genus in the tributaries. This study provides basic data and the theoretical basis for the conservation of aquatic ecosystems and water quality management in the middle and lower reaches of the Lhasa River.


Assuntos
Ecossistema , Rios , Monitoramento Ambiental , Tibet , Qualidade da Água
11.
Medicine (Baltimore) ; 100(9): e24604, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33655925

RESUMO

ABSTRACT: Mortality of critically ill patients with coronavirus disease 2019 (COVID-19) was high. Aims to examine whether time from symptoms onset to intensive care unit (ICU) admission affects incidence of extra-pulmonary complications and prognosis in order to provide a new insight for reducing the mortality. A single-centered, retrospective, observational study investigated 45 critically ill patients with COVID-19 hospitalized in ICU of The Third People's Hospital of Yichang from January 17 to March 29, 2020. Patients were divided into 2 groups according to time from symptoms onset to ICU admission (>7 and ≤7 days) and into 2 groups according to prognosis (survivors and non-survivors). Epidemiological, clinical, laboratory, radiological characteristics and treatment data were studied. Compared with patients who admitted to the ICU since symptoms onset ≤7 days (55.6%), patients who admitted to the ICU since symptoms onset >7 days (44.4%) were more likely to have extra-pulmonary complications (19 [95.0%] vs 16 [64.0%], P = .034), including acute kidney injury, cardiac injury, acute heart failure, liver dysfunction, gastrointestinal hemorrhage, hyperamylasemia, and hypernatremia. The incidence rates of acute respiratory distress syndrome, pneumothorax, and hospital-acquired pneumonia had no difference between the 2 groups. Except activated partial thromboplastin and Na+ concentration, the laboratory findings were worse in group of time from symptoms onset to ICU admission >7 days. There was no difference in mortality between the 2 groups. Of the 45 cases in the ICU, 19 (42.2%) were non-survivors, and 16 (35.6%) were with hospital-acquired pneumonia. Among these non-survivors, hospital-acquired pneumonia was up to 12 (63.2%) besides higher incidence of extra-pulmonary complications. However, hospital-acquired pneumonia occurred in only 4 (15.4%) survivors. Critically ill patients with COVID-19 who admitted to ICU at once might get benefit from intensive care via lower rate of extra-pulmonary complications.


Assuntos
COVID-19 , Cuidados Críticos , Estado Terminal , Avaliação de Sintomas , Tempo para o Tratamento/estatística & dados numéricos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/mortalidade , COVID-19/fisiopatologia , China/epidemiologia , Cuidados Críticos/métodos , Cuidados Críticos/estatística & dados numéricos , Estado Terminal/mortalidade , Estado Terminal/terapia , Doenças do Sistema Digestório/diagnóstico , Doenças do Sistema Digestório/etiologia , Feminino , Pneumonia Associada a Assistência à Saúde/diagnóstico , Pneumonia Associada a Assistência à Saúde/mortalidade , Cardiopatias/diagnóstico , Humanos , Hiperamilassemia/diagnóstico , Hiperamilassemia/etiologia , Hipernatremia/diagnóstico , Hipernatremia/etiologia , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Prognóstico , SARS-CoV-2/isolamento & purificação , Análise de Sobrevida , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
12.
Gut ; 2021 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-33692094

RESUMO

OBJECTIVE: Solid tumours respond poorly to immune checkpoint inhibitor (ICI) therapies. One major therapeutic obstacle is the immunosuppressive tumour microenvironment (TME). Cancer-associated fibroblasts (CAFs) are a key component of the TME and negatively regulate antitumour T-cell response. Here, we aimed to uncover the mechanism underlying CAFs-mediated tumour immune evasion and to develop novel therapeutic strategies targeting CAFs for enhancing ICI efficacy in oesophageal squamous cell carcinoma (OSCC) and colorectal cancer (CRC). DESIGN: Anti-WNT2 monoclonal antibody (mAb) was used to treat immunocompetent C57BL/6 mice bearing subcutaneously grafted mEC25 or CMT93 alone or combined with anti-programmed cell death protein 1 (PD-1), and the antitumour efficiency and immune response were assessed. CAFs-induced suppression of dendritic cell (DC)-differentiation and DC-mediated antitumour immunity were analysed by interfering with CAFs-derived WNT2, either by anti-WNT2 mAb or with short hairpin RNA-mediated knockdown. The molecular mechanism underlying CAFs-induced DC suppression was further explored by RNA-sequencing and western blot analyses. RESULTS: A negative correlation between WNT2+ CAFs and active CD8+ T cells was detected in primary OSCC tumours. Anti-WNT2 mAb significantly restored antitumour T-cell responses within tumours and enhanced the efficacy of anti-PD-1 by increasing active DC in both mouse OSCC and CRC syngeneic tumour models. Directly interfering with CAFs-derived WNT2 restored DC differentiation and DC-mediated antitumour T-cell responses. Mechanistic analyses further demonstrated that CAFs-secreted WNT2 suppresses the DC-mediated antitumour T-cell response via the SOCS3/p-JAK2/p-STAT3 signalling cascades. CONCLUSIONS: CAFs could suppress antitumour immunity through WNT2 secretion. Targeting WNT2 might enhance the ICI efficacy and represent a new anticancer immunotherapy.

13.
J Sci Med Sport ; 24(8): 806-810, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33573872

RESUMO

OBJECTIVES: The ACSM recommends drinking to avoid loss of body mass >2% during exercise to avert compromised performance. Our study aimed to assess the level of dehydration in elite runners following a city marathon in a tropical environment. DESIGN: Prospective cohort design. METHODS: Twelve elite runners (6 males, 6 females; age 24-41 y) had body mass measured to the nearest 0.01kg in their race attire immediately before and after the 2017 Standard Chartered Singapore Marathon 2017. Body mass change was corrected for respiratory water loss, gas exchange, and sweat retained in clothing, and expressed as % of pre-race mass (i.e. % dehydration). RESULTS: Data are expressed as means±SD (range). Dry bulb temperature and humidity were 27.9±0.1°C (27.4-28.3°C) and 79±2% (73-82%). Finish time was 155±10min (143-172min). Male runners finishing positions ranged from 2-12 out of 7627 finishers, whilst female runners placed 1-8 out of 1754 finishers. Body mass change (loss) and % dehydration for all runners were 2.5±0.5kg (1.8-3.5kg) and 4.6±0.9% (3.6-6.8%). Male runners experienced body mass loss of 2.8±0.5kg and 4.9±1.2% while females experienced body mass loss of 2.1±0.2kg and 4.3±0.6%. CONCLUSIONS: Despite experiencing dehydration (4.6% body mass loss) two-fold higher than current fluid replacement guidelines recommend (≤2%), elite male and female runners performed successfully and without medical complication in a hot weather marathon.


Assuntos
Índice de Massa Corporal , Desidratação/diagnóstico , Corrida de Maratona/fisiologia , Clima Tropical , Adulto , Ingestão de Líquidos , Feminino , Hidratação , Resposta ao Choque Térmico , Temperatura Alta , Humanos , Umidade , Masculino , Estudos Prospectivos , Singapura , Adulto Jovem
14.
Phytochemistry ; 185: 112701, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33607578

RESUMO

Globosumin, an undescribed chromene-4,7(4aH)-dione-tetramic acid PKS-PKS-NRPS hybrid, and globosumone, an undescribed azaphilone, together with ten known metabolites, were isolated from the desert plant-associated endophytic fungus Chaetomium globosum (Chaetomiaceae). The planar structures and relative configurations of globosumin and globosumone were determined by high-resolution ESI-MS and NMR data, and the absolute configurations of these two metabolites were determined by electronic circular dichroism (ECD) and circular dichroism (CD) combined with time-dependent density functional theory (TDDFT)-based quantum-chemical calculations. Chaetoglobosin A displayed biological effects against the seedling growth of Arabidopsis thaliana (Brassicaceae) in a dose-dependent manner, and this compound also exhibited biological activity against two cancer cell lines, A549 and HepG2, with IC50 values of 6.82 ± 2.34 and 38.62 ± 7.44 µM, respectively.


Assuntos
Chaetomium , Dicroísmo Circular , Espectroscopia de Ressonância Magnética , Plantas
15.
Acad Radiol ; 2021 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-33504445

RESUMO

RATIONALE AND OBJECTIVES: The purpose of this study was to explore conventional MRI features that can accurately differentiate central nervous system embryonal tumor, not otherwise specified (CNS ETNOS) from glioblastoma (GBM) in adults. MATERIALS AND METHODS: Preoperative conventional MRI images of 30 CNS ETNOS and 98 GBMs were analyzed by neuroradiologists retrospectively to identify valuable MRI features. Five blinded neuroradiologists independently reviewed all these MRI images, and scored MRI features on a five-point scale. Kendall's coefficient of concordance was used to measure inter-rater agreement. Diagnostic value was assessed by the area under the curve (AUC) of receiver operating curve, and sensitivity and specificity were also calculated. RESULTS: Seven MRI features, including isointensity on T1WI, T2WI, and FLAIR, ill-defined margin, severe peritumoral edema, ring enhancement, and broad-based attachment sign, were helpful for the differential diagnosis of these two entities. Among these features, ring enhancement showed the highest inter-rater concordance (0.80). Ring enhancement showed the highest AUC value (0.79), followed by severe peritumoral edema (0.67). The combination of seven features showed the highest AUC value (0.86), followed by that of three features (ill-defined margin, severe peritumoral edema, and ring enhancement) (0.83). CONCLUSION: Enhancement pattern, peritumoral edema, and margin are valuable for the discrimination between CNS ETNOS and GBM in adults.

16.
Asian J Surg ; 44(1): 269-274, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32747143

RESUMO

BACKGROUND: To demonstrate the surgical procedures and techniques of the robotic anatomical isolated complete caudate lobectomy. METHODS: A retrospective analysis was performed on the demographic, operative, postoperative outcomes of seven patients who underwent robotic anatomical isolated complete caudate lobectomy at our department from January 2018 to November 2019. Mobilization of the left lateral and Spiegel lobe, dissection of the short hepatic veins and liver parenchyma transection from the dorsal plane of middle and right hepatic vein were crucial procedures for the robotic left-side approach. Anatomic complete caudate lobectomy was defined as total removal of the caudate lobe, in which the dorsal middle and right hepatic vein, the inferior vena cava and its right side were fully exposed on the raw surface. RESULTS: All patients successfully underwent the robotic anatomical isolated caudate lobectomy with a left-side approach without conversion to laparotomy, and without Clavien-Dindo Grade III or higher complications. The average tumor diameter was 65.00 ± 10.61 mm, the average operation time was 212.00 ± 74.53 min, the median bleeding loss was 100 mL, and the average postoperative hospital stay was 8.71 ± 4.89 d, respectively. There were four patients with primary hepatocellular carcinoma, one with tumor recurrence five months after surgery and three patients were free of recurrence. All patients survived at the last follow-up. CONCLUSION: Robotic anatomical isolated complete caudate lobectomy with a left-sided approach is safe and feasible for selected patients.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Fígado/anatomia & histologia , Fígado/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Adulto , Idoso , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Carcinoma Hepatocelular/patologia , Feminino , Veias Hepáticas/cirurgia , Humanos , Fígado/irrigação sanguínea , Neoplasias Hepáticas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Duração da Cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Veia Cava Inferior/cirurgia
17.
Dig Dis Sci ; 66(1): 19-28, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32095968

RESUMO

BACKGROUND: Gastroesophageal reflux disease (GERD) is a common disorder, and is typically treated with proton-pump inhibitors (PPIs) as the recommended first-line therapy. Recently, a new potassium-competitive acid blocker, vonoprazan, was launched in Japan. It is uncertain whether the standard dose of vonoprazan 20 mg is superior to that of PPIs for GERD, so a direct comparison of the therapeutic effects and adverse events between vonoprazan 20 mg and PPIs is needed. METHODS: MEDLINE, the Cochrane Central Register of Controlled Trials, and Embase were chosen as the literature sources. Randomized controlled trials for vonoprazan 20 mg and PPIs published in English were searched. Data from studies meeting the eligibility criteria were extracted individually by two researchers and compared to maintain consistency. RESULTS: Fifty-six articles were identified in the databases, and one study was manually searched and added to the analysis, ultimately yielding six eligible studies. For the main analysis, the risk ratios (RR) of efficacy and adverse events between vonoprazan and PPIs were 1.06 (0.99-1.13) and 1.08 (0.96-1.22), respectively. Subgroup analysis for patients with severe esophagitis at baseline showed significantly higher results for vonoprazan than lansoprazole, with an RR of 1.14 (1.06-1.22). CONCLUSIONS: Our findings suggest that vonoprazan is non-inferior to PPIs as therapy for patients with GERD. Subgroup analysis indicates that vonoprazan is more effective than PPIs for patients with severe erosive esophagitis. The safety outcomes for vonoprazan are similar to those for PPIs.


Assuntos
Refluxo Gastroesofágico/diagnóstico , Refluxo Gastroesofágico/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Pirróis/uso terapêutico , Sulfonamidas/uso terapêutico , Refluxo Gastroesofágico/complicações , Azia/diagnóstico , Azia/tratamento farmacológico , Azia/etiologia , Humanos , Inibidores da Bomba de Prótons/efeitos adversos , Pirróis/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Sulfonamidas/efeitos adversos , Resultado do Tratamento
18.
Ther Innov Regul Sci ; 55(2): 454-461, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33165761

RESUMO

BACKGROUND: An important component of a systematic strategy for safety surveillance is prospective identification of anticipated serious adverse events (SAEs). Developing a structured approach to identify anticipated events and estimating their incidence can help align the safety strategy and the safety surveillance efforts. METHODS: We developed a novel approach to identify anticipated events for a hypothetical randomized, double-blind, controlled trial in subjects with bipolar disorder using the adverse events reported in the placebo arm of trials from the ClinicalTrials.gov database. We searched the ClinicalTrials.gov database for all trials on bipolar depression with similar inclusion/exclusion criteria and study duration as our hypothetical study. The frequencies of anticipated events in placebo arms were abstracted from each trial and 95% confidence intervals (CI) were calculated using the Clopper-Pearson method. Meta-analysis with a random effects model was performed to obtain a summary estimate and 95% CI for the events identified in more than one trial. RESULTS: A total of 129 clinical trials were initially identified, and 18 were ultimately selected as they met all the selection criteria. There were 69 unique anticipated SAEs identified, and 13 out of 69 were reported in at least 2 clinical trials. The top 5 anticipated SAEs for our study were: (1) hospitalization, psychiatric symptom (3.57%); (2) suicidal behavior, overdose (3.57%), (3) cholecystitis (2.86%); (4) fall (2.86%); (5) road traffic accident, injury (2.86%). CONCLUSION: We successfully identified the anticipated events from registered trials that included a population similar to our trial. This method for identifying anticipated events could be applied to other disease areas.


Assuntos
Hospitalização , Método Duplo-Cego , Humanos , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
Artigo em Inglês | MEDLINE | ID: mdl-33281910

RESUMO

Aim: This study aims to uncover the pharmacological mechanism of Tongxie Anchang Decoction (TXACD), a new and effective traditional Chinese medicine (TCM) prescription, for treating irritable bowel syndrome with diarrhea predominant (IBS-D) using network pharmacology. Methods: The active compounds and putative targets of TXACD were retrieved from TCMSP database and published literature; related target genes of IBS-D were retrieved from GeneCards; PPI network of the common target hub gene was constructed by STRING. Furthermore, these hub genes were analyzed using gene ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Results: A total of 54 active compounds and 639 targets were identified through a database search. The compound-target network was constructed, and the key compounds were screened out according to the degree. By using the PPI and GO and KEGG enrichment analyses, the pharmacological mechanism network of TXACD in the treatment of IBS-D was constructed. Conclusions: This study revealed the possible mechanisms by which TXACD treatment alleviated IBS-D involvement in the modulation of multiple targets and multiple pathways, including the immune regulation, inflammatory response, and oxidative stress. These findings provide novel insights into the regulatory role of TXACD in the prevention and treatment of IBS-D and hold promise for herb-based complementary and alternative therapy.

20.
Medicine (Baltimore) ; 99(52): e23868, 2020 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-33350782

RESUMO

BACKGROUND: Diarrhea-predominant irritable bowel syndrome (IBS-D) is a kind of functional gastrointestinal disorder with obscure pathogenesis, and exploration about differential gene expression and cell heterogeneity of T lymphocytes in peripheral blood in IBS-D patients still remains unknown. Clinicians tend to use symptomatic treatment, but the efficacy is unstable and symptoms are prone to relapse. Traditional Chinese Medicine (TCM) is used frequently in IBS-D with stable and lower adverse effects. Tong-Xie-An-Chang Decoction (TXACD) has been proven to be effective in the treatment of IBS-D. However, the underlying therapeutic mechanism remains unclear. This trial aims to evaluate the clinical efficacy and safety of TXACD in IBS-D and elucidate the gene-level mechanism of IBS-D and therapeutic targets of TXACD based on single-cell sequencing technology. METHODS/DESIGN: This is a randomized controlled, double-blind, double-simulation clinical trial in which 72 eligible participants with IBS-D and TCM syndrome of liver depression and spleen deficiency will be randomly allocated in the ratio of 1:1 to two groups: the experimental group and the control group. The experimental group receives Tong-Xie-An-Chang Decoction (TXACD) and Pinaverium bromide tablets placebo; the control group receives pinaverium bromide tablets and TXACD placebo. Each group will be treated for 4 weeks. The primary outcome: the rate of IBS-Symptom Severity Score (IBS-SSS). The secondary outcomes: TCM syndrome score, adequate relief and IBS-Quality of Life Questionnaire (IBS-QOL). Mechanistic outcome is the single-cell sequencing profiling of the T lymphocytes in peripheral blood from IBS-D participants before and after the treatment and healthy individuals. DISCUSSION: This trial will prove the efficacy and safety of TXACD with high-quality evidence and provide a comprehensive perspective on the molecular mechanism of IBS-D by single-cell sequencing profiling, which makes us pinpoint specific biomarkers of IBS-D and therapeutic targets of TXACD.


Assuntos
Diarreia , Medicamentos de Ervas Chinesas , Síndrome do Intestino Irritável , Qualidade de Vida , Adulto , Misturas Complexas/administração & dosagem , Misturas Complexas/efeitos adversos , Diarreia/tratamento farmacológico , Diarreia/etiologia , Diarreia/psicologia , Método Duplo-Cego , Monitoramento de Medicamentos/métodos , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Perfilação da Expressão Gênica/métodos , Humanos , Síndrome do Intestino Irritável/sangue , Síndrome do Intestino Irritável/complicações , Síndrome do Intestino Irritável/tratamento farmacológico , Síndrome do Intestino Irritável/fisiopatologia , Masculino , Medicina Tradicional Chinesa/métodos , Extratos Vegetais/administração & dosagem , Extratos Vegetais/efeitos adversos , Avaliação de Sintomas , Linfócitos T , Resultado do Tratamento
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