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1.
Clin Transl Sci ; 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-33650314

RESUMO

In this paper, we review the management of neonatal opioid withdrawal syndrome (NOWS) and clinical pharmacology of primary treatment agents in NOWS, including morphine, methadone, buprenorphine, clonidine, and phenobarbital. Pharmacologic treatment strategies in NOWS have been mostly empirical, and heterogeneity in dosing regimens adds to the difficulty of extrapolating study results to broader patient populations. As population pharmacokinetics of pharmacologic agents in NOWS become more well-defined and knowledge of patient-specific factors affecting treatment outcomes continues to accumulate, pharmacokinetic/pharmacodynamic modeling and simulation will be powerful tools to aid the design of optimal dosing regimens at the patient level. Though there is an increasing number of clinical trials on the comparative efficacy of treatment agents in NOWS, here we also draw attention to the importance of optimizing the dosing regimen, which can be arguably equally important as identifying the optimal treatment agent.

2.
Clin Res Hepatol Gastroenterol ; : 101649, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33601064

RESUMO

OBJECTIVE: To investigate the efficacy and safety of anticoagulants in liver cirrhosis patients with portal vein thrombosis (PVT). METHODS: PubMed, BioMed Central, Cochrane Library and Web of Science were retrieved to identify relevant literature. Forest plots were applied to display the results of the meta-analysis. The odds ratios (ORs) were used as the effect index for the enumeration data, and the effect size was expressed as 95% confidence intervals (CIs). Publication bias was evaluated by funnel plots and Egger's test. RESULTS: Eight articles included 225 patients with liver cirrhosis and PVT receiving anticoagulants and 232 not receiving anticoagulants. The data demonstrated that the recanalization rate of PVT was significantly higher in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=5.60; 95% CI: 3.40-9.22; P<0.001). The exacerbation risk of PVT was significantly lower in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=0.15; 95% CI: 0.04-0.54; P<0.001). A significantly lower portal hypertension bleeding effect was observed in patients with anticoagulant treatment than in patients without anticoagulant treatment (OR=0.21; 95% CI: 0.10-0.45; P<0.001). Low molecular weight heparins (LMWH) were more effective in preventing the PVT exacerbation in liver cirrhosis patients with PVT than warfarin (OR=0.16; 95% CI: 0.08-0.35). CONCLUSIONS: Anticoagulants were effective and safe in treating patients with liver cirrhosis and PVT as they could increase the PVT recanalization rate and decrease the risks of PVT exacerbation and portal hypertension bleeding.

3.
Cell Mol Immunol ; 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33408344

RESUMO

Haploidentical stem cell transplantation (haplo-SCT) achieves superior or at least comparable clinical outcomes to HLA-matched sibling donor transplantation (MSDT) in treating hematological malignancies. To define the underlying regulatory dynamics, we analyzed time courses of leukemia burden and immune abundance of haplo-SCT or MSDT from multiple dimension. First, we employed two nonirradiated leukemia mouse models which carried human AML-ETO or MLL-AF9 fusion gene to establish haplo-identical and major histocompatibility (MHC)-matched transplantation models and investigated the immune cell dynamic response during leukemia development in vivo. We found that haplo-matching the MHCs of leukemia cells with recipient mouse T cells prolonged leukemic mice survival and reduced leukemia burden. The stronger graft-versus-leukemia activity in haplo-SCT group mainly induced by decreased apoptosis and increased cytotoxic cytokine secretion including tumor necrosis factor-α, interferon-γ, pore-forming proteins and CD107a secreted by T cells or natural killer cells. Furthermore, we conducted a prospective clinical trial which enrolled 135 patients with t(8;21) acute myeloid leukemia that displayed minimal residual disease before transplantation and underwent either haplo-SCT or MSDT. The results showed that the haplo-SCT slowed the kinetics of the leukemia burden in vivo and reduced the cumulative incidence of relapse compared with MSDT. Ex vivo experiments showed that, 1 year after transplantation, cytotoxic T lymphocytes from the haplo-SCT group had higher cytotoxicity than those from the MSDT group during the same period. Our results unraveled the role of immune cells in superior antileukemia effects of haplo-SCT compared with MSDT.

4.
Anal Chem ; 93(4): 2114-2124, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33445862

RESUMO

Lipid imaging plays an important role in the research of some diseases, such as cancers. Unsaturated lipids are often present as isomers that can have different functions; however, traditional tandem mass spectrometry imaging (MSI) cannot differentiate between different isomers, which presents difficulties for the pathological study of lipids. Herein, we propose a method for the MSI of the C═C double-bond isomers of unsaturated lipids based on oxidative reactions coupled with air flow-assisted desorption electrospray ionization, which can conveniently achieve rapid MSI of unsaturated lipids at an isomeric level. Using this method, tissue sections can be scanned directly with MSI after only 10 min of accelerated oxidation. This method was used for the imaging of mouse lung cancer tissues, revealing a distributional difference in the unsaturated lipid isomers of normal and pathological regions. Through the MSI of unsaturated lipids at an isomeric level in tissues infected with cancer cells, the regions where the isomers were enriched were exhibited, indicating that these regions were the most concentrated regions of cancer cells. This method provides a convenient platform for studying the functional effects of the isomers of unsaturated lipids in pathological tissues.

5.
Artigo em Inglês | MEDLINE | ID: mdl-33482392

RESUMO

BACKGROUND AND AIMS: TRIM21 is a ubiquitin E3 ligase that is implicated in numerous biological processes including immune response, cell metabolism, redox homeostasis, and cancer development. We recently reported that TRIM21 can negatively regulate the p62-Keap1-Nrf2 antioxidant pathway by ubiquitylating p62 and prevents its oligomerization and protein sequestration function. As redox homeostasis plays a pivotal role in many cancers including liver cancer, we sought to determine the role of TRIM21 in hepatocarcinogenesis. METHODS: We examined the correlation between TRIM21 expression and the disease using publicly available data sets and 49 cases of HCC clinical samples. We used TRIM21 genetic knockout mice to determine how TRIM21 ablation impact HCC induced by the carcinogen DEN plus phenobarbital (PB). We explored the mechanism that loss of TRIM21 protects cells from DEN-induced oxidative damage and cell death. RESULTS: There is a positive correlation between TRIM21 expression and HCC. Consistently, TRIM21-knockout mice are resistant to DEN-induced hepatocarcinogenesis. This is accompanied by decreased cell death and tissue damage upon DEN treatment, hence reduced hepatic tissue repair response and compensatory proliferation. Cells deficient in TRIM21 display enhanced p62 sequestration of Keap1 and are protected from DEN-induced ROS induction and cell death. Reconstitution of wild-type but not the E3 ligase-dead and the p62 binding-deficient mutant TRIM21 impedes the protection from DEN-induced oxidative damage and cell death in TRIM21-deficient cells. CONCLUSIONS: Increased TRIM21 expression is associated with human HCC. Genetic ablation of TRIM21 leads to protection against oxidative hepatic damage and decreased hepatocarcinogenesis, suggesting TRIM21 as a preventive and therapeutic target.

6.
Neurosci Bull ; 2021 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-33512634
7.
Bioorg Chem ; 107: 104523, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33339668

RESUMO

Chuanxiongdiolides R4-R6 (1-3), three novel phthalide dimers featuring two classes of unreported monomeric units (ligustilide/senkyunolide A and ligustilide/neocnidilide) with an unprecedented linkage style (3a,7'/7a,7'a), were isolated from the aerial parts of Ligusticum chuanxiong, together with three pairs of enantiomeric phthalide dimers [(-)/(+)-4a/4b, 5a/5b, and 6a/6b]. The bioassays revealed that compounds 1, 3, 4, 5, and 6 showed significant vasodilation effects, and the mechanism may be attributed to Cav1.2 activation blockade. Based on the established compounds library, the structure activity relationship of the phthalides was proposed. Our findings afford possible leads for developing new vasodilator against cardiovascular and cerebrovascular diseases such as hypertension and ischemic stroke.

8.
Drug Alcohol Depend ; 219: 108485, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33360853

RESUMO

INTRODUCTION: The striatum mediates reward processing in addiction, and previous fMRI (functional Magnetic Resonance Imaging) studies have revealed abnormal striatofrontal functional connectivity in heroin addiction. However, little is known about whether there is abnormal structural connectivity of the striatal circuit in heroin addiction. This study investigated the structural connectivity of striatal circuits in abstinent heroin-dependent individuals (HDIs) without methadone treatment. METHODS: Forty-three (age: 38.8 ± 7.1) male HDIs and twenty-one (age: 42.4 ± 7.9) matched healthy controls underwent high-resolution T1 and whole-brain diffusion tensor imaging (64 directions) magnetic resonance imaging. Connectivity-based seed classification probabilistic tractography was used to detect the tract strengths of striatal circuits with 10 a priori target masks. Tract strengths were compared between groups and correlated with impulsivity behavior, evaluated using the Barratt Impulsivity Scale (BIS), and craving, measured on visual analogue scale (VAS). RESULTS: HDIs showed significantly weaker tract strength of the left striatum-medial orbitofrontal cortex (mOFC) (Bonferroni corrected, p < 0.05/20 = 0.0025) and significantly higher BIS total, attention, motor, and non-planning scores (Bonferroni corrected, p < 0.05/4 = 0.0125) than controls. In HDIs, negative correlations were observed between the left striatum- mOFC tract strengths and the BIS total, attention and non-planning scores (r1=-0.410, p1 = 0.005; r2=-0.432, p2 = 0.003; r3=-0.506, p3<0.001) and between the right striatum-posterior cingulate cortex (PCC) tract strengths and craving scores (r=-0.433, p = 0.009) in HDIs. CONCLUSION: HDIs displayed decreased structural connectivity of the striatum-mOFC circuit and higher impulsivity. Higher impulsive behavior was associated with decreased left striatal circuit connectivity. These findings suggest that the striatal circuit tract strengths might be a novel potential biomarker in heroin and, potentially, general opioid addiction.

9.
Iran J Kidney Dis ; 14(6): 454-462, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33277449

RESUMO

INTRODUCTION: To investigate the relationship between serum IgG (sIgG) concentration and the prognosis of IgA nephropathy (IgAN). METHODS: A total of 309 patients with biopsy-proven IgAN in the Second Referral Hospital of Shenzhen were enrolled between 2010/01 and 2017/06. Patients were divided into 3 groups on the basis of sIgG tertiles: < 8.99 g/L (Group G1), 8.99 to 11.17 g/L (Group G2), and > 11.17 g/L (Group G3). RESULTS: As the level of sIgG increased, there was a decrease in DBP, serum creatinine, 24h urine proteinuria and an increase in serum albumin (all P < .05). In terms of pathological manifestations, with increasing sIgG levels, there was a tendency of decline in the Lee's grading system or high-grade tubular atrophy/interstitial fibrosis or in the proportion of glomerular sclerosis and the ratio of crescent (all P < .05). Kaplan-Meier analysis indicated that the cumulative renal survivals rates were significantly higher in patients with elevated sIgG (P < .05). Cox regression analysis showed that after adjusting for gender, age, BMI, and clinical indicators (BP, 24h urine proteinuria, eGFR, M, E, S, T, and the ratio of crescent), decreased sIgG level at the time of renal biopsy is an independent risk factor for unfavorable outcomes in IgAN. Furthmore, every 1 g/L decrease in sIgG level was associated with a 1.74-fold (95% CI: 1.30 to 5.38) increased risk of the incidence of composite renal outcomes. CONCLUSIONS: Decreased serum IgG level at baseline might be a kind of predictive marker for the poor prognosis of IgAN.

10.
Clin Transplant ; : e14160, 2020 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-33222318

RESUMO

OBJECTIVES: The aim of our study was to determine possible predictors and clinical course of mixed chimerism (MC) in aplastic anemia after transplantation. METHODS: A total of 207 transplants were obtained from haploidentical donors (HID) using busulfan (Bu), cyclophosphamide (Cy) and anti-thymocyte globulin (ATG) regimens, and 69 transplants from matched related donors (MRD) and 29 transplants from unrelated donors (URD) using Cy/ATG regimens were obtained. RESULTS: Incidences of MC were 1.93±0.01%, 20.29±0.01%, and 35.71±0.01% in HID, MRD and URD transplantation (P<0.001). In multivariate analysis, incidence of MC was significantly higher in patients without adding Bu in conditioning (P<0.001) and receiving a lower number of CD3+ cells in graft (P = 0.042). MC was associated with significantly lower II-IV aGvHD (3.70% vs. 27.7%, P = 0.007), but higher secondary graft rejection rates (14.8% vs. 0.4%, P<0.001) and poorer overall survival (72.7±8.9% vs. 89.6±2.0%, P = 0.011) than those of donor chimerism cohort. CONCLUSIONS: MC was an unsettling status even in non-malignancy. Haploidentical transplantation with more intense regimen by adding Bu to Cy and ATG was associated with reduced MC following HSCT for SAA. An intensified regimen should be explored in matched related or unrelated donors.

11.
Artigo em Inglês | MEDLINE | ID: mdl-33248966

RESUMO

OBJECTIVES: This study investigated the prognosis of coronary microvascular disease (CMD) as determined by stress perfusion cardiac magnetic resonance (CMR) in patients with ischemic symptoms but without significant coronary artery disease (CAD). BACKGROUND: Patients with CMD have poorer prognosis with various cardiac diseases. The myocardial perfusion reserve index (MPRI) derived from noninvasive stress perfusion CMR has been established to diagnose microvascular angina with a threshold MPRI <1.4. The prognosis of CMD as determined by MPRI is unknown. METHODS: Chest pain patients without epicardial CAD or myocardial disease from January 2009 to December 2017 were retrospectively included from 3 imaging centers in Hong Kong (HK). Stress perfusion CMR examinations were performed using either adenosine or adenosine triphosphate. Adequate stress was assessed by achieving splenic switch-off sign. Measurement of MPRI was performed in all stress perfusion CMR scans. Patients were followed for major adverse cardiovascular events defined as all-cause death, acute coronary syndrome (ACS), epicardial CAD development, heart failure hospitalization and non-fatal stroke. RESULTS: A total of 218 patients were studied (mean age 59 ± 12 years; 49.5% male) and the average MPRI of that cohort was 1.56 ± 0.33. Females and a history of hyperlipidemia were predictors of lower MPRI. Major adverse cardiovascular events (MACE) occurred in 15.6% of patients during a median follow-up of 5.5 years (interquartile range: 4.6 to 6.8 years). The optimal cutoff value of MPRI in predicting MACE was found with a threshold MPRI ≤1.47. Patients with MPRI ≤1.47 had three-fold increased risk of MACE compared with those with MPRI >1.47 (hazard ratio [HR]: 3.14; 95% confidence interval [CI]: 1.58 to 6.25; p = 0.001). Multivariate Cox regression after adjusting for age and hypertension demonstrated that MPRI was an independent predictor of MACE (HR: 0.10; 95% CI: 0.03 to 0.34; p < 0.001). CONCLUSION: Stress perfusion CMR-derived MPRI is an independent imaging marker that predicts MACE in patients with ischemic symptom and no overt CAD over the medium term.

12.
J Am Med Dir Assoc ; 2020 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-33234447

RESUMO

OBJECTIVES: Determine the incidence rates of frailty among community-dwelling older veterans. DESIGN: Population-based retrospective cohort study. SETTING AND PARTICIPANTS: Veterans Health Administration Medical Center study included community-dwelling veterans 60 years and older with determinations of frailty from 2013 to 2014 and followed until September 2019. METHODS: A 31-item frailty index was generated at baseline and during each subsequent primary care encounters as a proportion of potential variables from electronic health record data. Period prevalence was calculated by dividing total number of cases of frailty during the baseline period. After adjusting for covariates, the association of frailty with mortality was determined using a multivariate Cox regression model. Using baseline and follow-up data, incidence rates of frailty per 1000 person/years based on event rates and mean duration of follow-up were calculated, including survivor and entire cohorts. RESULTS: Patients in this cohort were 16,761 veterans, mean age 72.18 (9.32) years, 74.00% Caucasian, 90.75% non-Hispanic, and 97.78% male. The period prevalence of frailty in this cohort was 20.84%. Over a median follow-up of 3.96 (interquartile range = 3.73) years, 25.86% of the baseline population died during follow up. Veterans with frailty had a higher all-cause mortality during follow up, adjusted hazard ratio = 3.12 (95% confidence interval 2.87-3.38), P value of < .0005. Among 10,513 veterans who survived a median follow-up of 4.81 (interquartile range = 3.12) years, 29.84% became frail. The incidence rate of frailty was 75.05 cases per 1000 person-years. Among the entire cohort of 13,268 nonfrail veterans, 29.93% became frail. The incidence rate of frailty was 84.03 cases per 1000 person-years. CONCLUSIONS AND IMPLICATIONS: This study shows high incidence of frailty in community dwelling older US veterans. Future studies should be done for identification, implementation of adequate interventions aimed at preventing frailty or reducing frailty-related complications in community dwelling older individuals.

13.
Am J Manag Care ; 26(10): e312-e318, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-33094943

RESUMO

OBJECTIVES: Cardiovascular disease (CVD) continues to disproportionately affect disadvantaged populations, leading to calls to address social determinants of health (SDOH) as a preventive strategy. Our aim is to create a weighed SDOH score and to test the impact of each SDOH factor on the Framingham risk score (FRS) and on individual traditional CVD risk factors. STUDY DESIGN: We conducted a retrospective cohort study. METHODS: We included patients seen at a primary care clinic at UHealth/University of Miami Health System who answered a SDOH survey between September 16, 2016, and September 10, 2017. The survey included SDOH domains recommended by the American Heart Association position statement and by the National Academy of Medicine. We selected the FRS as well as all traditional CVD risk factors as our outcome metrics. RESULTS: We included 2876 patients. The mean (SD) age of our cohort was 53.8 (15.8) years, 61% were female, 9% were Black, 38% were Hispanic, and 87% reported speaking English. The statistically significant ß coefficients in the FRS model corresponded to being born outside of the United States, being a racial minority, living alone, having a high social isolation score, and having a low geocoded median household income (P < .01). Increasing quartile of SDOH score was significantly associated with higher systolic blood pressure, FRS, glycated hemoglobin, and smoking pack-years (P < .05). It was also associated with fewer minutes spent exercising weekly (P < .01). CONCLUSIONS: The addition of self-reported SDOH data has a dose effect on CVD risk factors. Future studies should address how to intervene to address social factors.

14.
Front Oncol ; 10: 577452, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072609

RESUMO

Orbital cavernous hemangioma is the most common primary tumor in the orbit. With the development of histopathology, it has been confirmed that cavernous hemangioma is not a real tumor, but a special type of vascular malformation. Cavernous hemangioma malformation(CVM) is a more appropriate way to name it. At present, surgical resection is the main treatment for CVMs. The prognosis of the surgery mainly depends on the location and the size of the lesion as well as its relationship with the optic nerve. Therefore, effective imaging information is of great importance. This paper analyzes the radiological imaging characteristics and the advantages and disadvantages between them, including ultrasound, CT, MRI, and SPECT/CT imaging of CVMs, hoping to help improve our understanding of CVMs.

15.
Clin Lab ; 66(10)2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33073949

RESUMO

BACKGROUND: Cases of duodenal variceal hemorrhage after cirrhosis are rare, but patients have a higher mortality rate. There is currently no clinical guideline to address how such patients should choose preferred treatment. METHODS: We retrospectively evaluated the clinical information of a 65-year-old male admitted to the Gastroenterology Department with gastrointestinal bleeding. RESULTS: The patient was eventually diagnosed with duodenal variceal bleeding after cirrhosis. We performed TIPS on the patients after the vital signs were stable. No varicose veins were seen by endoscopy during the 2-year follow-up. CONCLUSIONS: TIPS treatment is a good choice for patients with severe duodenal varices after cirrhosis.

16.
Opt Lett ; 45(20): 5712-5715, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33057272

RESUMO

Transparent ceramics (TCs) represent a new family of functional hard materials. In this Letter, steady-state and time-resolved upconversion photoluminescence in Yb3+-Er3+ co-doped TC of yttrium aluminum garnet (TC-YAG) are reported for the first time, to the best of our knowledge. Under the excitation of near-infrared 940 nm laser at room temperature, the Yb3+-Er3+ co-doped TC-YAG emits intense multi-color luminescence consisting of cyan, green, and red groups of sharp lines. More excitingly, the green group of luminescence due to the transitions from 4S3/2 to 4I15/2 states of Er3+ are the prominent components with the average lifetime of ∼0.3ms. The internal quantum efficiency of the green luminescence is estimated to be 32.8%. A unique dual-resonance energy transfer from Yb3+ to Er3+ via the excited-state vibronic transitions is proposed as the principal mechanism of the strongest green luminescence of Er3+ ions in TC-YAG.

17.
J Clin Psychiatry ; 81(5)2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32936543

RESUMO

OBJECTIVE: This study examined a cohort of 15,520 inpatient psychiatric discharges to determine associations between scheduling an outpatient mental health appointment as part of discharge planning and attending outpatient care following discharge after control for patient, hospital, and system characteristics. METHODS: 2012-2013 New York State Medicaid and other administrative databases were used to examine patients who were aged under 65 years, admitted to an inpatient psychiatric unit, and discharged to the community. Outcomes included attending an outpatient mental health service within 7 and 30 days following inpatient discharge. Scheduling a mental health outpatient appointment as part of the discharge plan was the primary predictor variable, and potentially confounding covariates were addressed by adjusting for propensity scores estimating the likelihood of having an outpatient appointment scheduled. RESULTS: Among 15,520 discharged patients, 11,945 (77%) had an outpatient appointment scheduled with a mental health provider as part of their discharge planning. After adjustment for propensity scores, patients who had an outpatient appointment scheduled were significantly more likely to attend an outpatient mental health service within 7 (OR = 1.69; 95% CI, 1.48-1.94) and 30 days (OR = 1.65; 95% CI, 1.42-1.93) compared to patients who did not have an appointment scheduled. Even among those with a low propensity to have an appointment scheduled, scheduling an outpatient appointment was associated with attending outpatient services. CONCLUSIONS: Scheduling an outpatient mental health appointment is an effective and low-resource discharge planning practice that should be an important target for inpatient psychiatric clinical quality measurement and improvement.


Assuntos
Assistência Ambulatorial , Continuidade da Assistência ao Paciente , Transtornos Mentais/terapia , Alta do Paciente , Adolescente , Adulto , Assistência Ambulatorial/métodos , Agendamento de Consultas , Criança , Pré-Escolar , Serviços Comunitários de Saúde Mental/métodos , Serviços Comunitários de Saúde Mental/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , New York , Pontuação de Propensão , Adulto Jovem
18.
Front Psychiatry ; 11: 643, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32760297

RESUMO

Understanding the brain mechanisms of heroin dependence is invaluable for developing effective treatment. Measurement of regional cerebral blood flow (CBF) provides a method to visualize brain circuits that are functionally impaired by heroin dependence. This study examined regional CBF alterations and their clinical associations in unmedicated heroin-dependent individuals (HDIs) using a relatively large sample. Sixty-eight (42 males, 26 females; age: 40.9 ± 7.3 years) HDIs and forty-seven (34 males, 13 females; age: 39.3 ± 9.2 years) matched healthy controls (HCs) underwent high-resolution T1 and whole-brain arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) scans. Additionally, clinical characteristics were collected for neurocognitive assessments. HDIs showed worse neuropsychological performance than HCs and had decreased relative CBF (rCBF) in the bilateral middle frontal gyrus (MFG), inferior temporal gyrus, precuneus, posterior cerebellar lobe, cerebellar vermis, and the midbrain adjacent to the ventral tegmental area; right posterior cingulate gyrus, thalamus, and calcarine. rCBF in the bilateral MFG was negatively correlated with Trail Making Test time in HDIs. HDIs had limbic, frontal, and parietal hypoperfusion areas. Low CBF in the MFG indicated cognitive impairment in HDIs. Together, these findings suggest the MFG as a critical region in HDIs and suggest ASL-derived CBF as a potential marker for use in heroin addiction studies.

19.
Medicine (Baltimore) ; 99(30): e21335, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791731

RESUMO

RATIONALE: Since the end of December 2019, the outbreak of coronavirus disease 2019 (COVID-19) epidemic has occurred and spread rapidly throughout China. At present, China's epidemic situation has been basically controlled, but the number of cases worldwide is increasing day by day. On March 11, the WHO officially announced that the COVID-19 had become a global pandemic. However, there are currently limited data on pregnant women with COVID-19 pneumonia and their infants. In this paper, a case of a pregnant woman infected with COVID-19 pneumonia is reported. PATIENT CONCERNS: We report a clinically confirmed COVID-19 pregnant woman. The patient was tested negative 4 times in nucleic acid test, but immunoglobulin G was positive and immunoglobulin M was negative before delivery, suggesting a previous infection. DIAGNOSES: The pregnant woman underwent a computed tomography scan of both lungs at 29 + 2 weeks of pregnancy, and scattered stiffness and frosted glass shadows of both lungs were observed. According to the diagnostic criteria for COVID-19 pneumonia in the "New Coronavirus Prevention and Control Plan Fifth Edition" of the National Health Commission of China, she was diagnosed as a clinically confirmed case. INTERVENTIONS: The pregnant women received nebulized inhalation and oral cephalosporin treatment in a community hospital and was discharged after the symptoms disappeared. After that, she was isolated at home. OUTCOMES: The pregnant woman gave birth to a healthy baby after being cured from COVID-19 infection. The nucleic acid test of the neonatal pharyngeal swab was negative, and the neonatal serum test showed positive for immunoglobulin G and negative for immunoglobulin M. LESSONS SUBSECTIONS: The findings of this case report are useful for understanding the possible clinical features of COVID-19 infection in pregnant women, the duration of the antibody, and passive immunity of the fetus.


Assuntos
Betacoronavirus , Infecções por Coronavirus/patologia , Pneumonia Viral/patologia , Complicações Infecciosas na Gravidez/virologia , Adulto , Betacoronavirus/imunologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Imunidade Materno-Adquirida , Transmissão Vertical de Doença Infecciosa , Nascimento Vivo , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Gravidez
20.
Pediatr Transplant ; 24(7): e13793, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32741088

RESUMO

The specific description, risk factors, and outcomes of aGVHD in pediatric haplo-HSCT using TCR protocols without PT-Cy have not been well described previously. We evaluated the incidence, risk factors, and outcomes of aGVHD in 350 consecutive pediatric patients receiving TCR haplo-HSCT without PT-Cy according to the Glucksberg and NIH aGVHD classifications between January 2015 and December 2017 at Peking University Institute of Hematology. The cumulative incidences of grade I, II, III, and IV aGVHD were 28%, 29.7%, 8.3%, and 5.1%, respectively. The type of aGVHD onset was classic in 243 patients (97.2%), and persistent/recurrent/late-onset aGVHD was in seven patients (2.8%). None of the considered variables significantly influenced the incidence of grade III-IV aGVHD. The 3-year OS, DFS, cumulative incidence of NRM, and relapse in malignant disease between severe aGVHD (III-IV) group and grade 0-II aGVHD group were 61.5% vs 77.2% (P = .027), 58.6% vs 75.1% (P = .014), 19.8% vs 5.3% (P = .002), and 21.6% vs 19.6% (P = .59), respectively; in non-malignant diseases, the 3-year OS, DFS, and NRM were 81.8% vs 97.4% (P = .05), 81.8% vs 97.4% (P = .05), and 18.2% vs 2.6% (P = .05), respectively. Under the protocol of pediatric TCR haplo-HSCT without PT-Cy, the persistent/recurrent/late-onset aGVHD was rare, and the incidence of severe aGVHD was acceptable and significantly contributed to NRM and lower survival in both malignant disease and non-malignant diseases.

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