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1.
Eur J Hosp Pharm ; 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472817

RESUMO

BACKGROUND: In the neonatal population, individual calculation and adjustment of vancomycin (VCM) doses has been recommended based on population pharmacokinetics (PPK) methods. OBJECTIVE: Our previous study established a Chinese neonatal VCM PPK model. The main goal of this study was to evaluate the predictive performance of this PPK model for VCM trough concentration. METHODS: The data on neonatal severe infection patients treated with VCM were retrospectively collected. The predictive performance of this PPK model was expressed using mean prediction error (MPE), mean absolute prediction error (MAPE), sensitivity and specificity. Linear regression analysis was used to compare predicted and measured VCM concentrations. We drew the receiver operating characteristic (ROC) curve to evaluate the predictive efficacy of the ratio of area under the concentration-time curve over 24 hours to minimum inhibitory concentration (AUC0-24/MIC) and trough concentration for clinical efficacy. RESULTS: A total of 40 neonates with Gram-positive bacterial sepsis were included. After VCM treatment, 32 (80%) neonates were clinically cured. Eight cases were a clinical failure: the trough concentrations and AUC0-24 were lower than that of the clinical cure patients (8.70±4.30 vs 14.30±4.50 mg/L, p=0.003; 404.30±122.80 vs 515.40±131.70, p=0.037). The measured and predicted trough concentration were 11.16 (5.96, 16.53) mg/L and 10.13 (6.61, 15.73) mg/L, respectively. The MPE and MAPE were 4.62% and 13.26% (5.30%, 25.88%), respectively. The proportion of MAPE <30% in the adjusted regimen was higher than the initial regimen (89.66% vs 65.00%, p=0.039). Predictions of sensitivity and specificity by this PPK model were 88.24% and 94.29%, respectively. The coefficients of determination of linear regression analysis were 0.9171 and 0.9009 for the initial and adjusted regimen, respectively. The AUC0-24 was correlated with the trough concentration (r=0.587, p<0.001). The ROC curve indicated that the optimal cut-off points for predicting clinical efficacy were AUC0-24/MIC >425.47 and trough concentration >9.45 mg/L. CONCLUSION: This PPK model has good predictive performance in Chinese neonatal patients. Both AUC0-24/MIC and trough concentration can predict the clinical efficacy of antibacterial treatment.

2.
Eur J Hosp Pharm ; 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33414258

RESUMO

BACKGROUND: There is a significant correlation between augmented renal clearance (ARC) and lower serum trough concentrations of vancomycin (VCM) during therapy. There is a need to evaluate the predictive performance of the population pharmacokinetic (PPK) model used for individual calculation of dosage regimens in ARC patients. OBJECTIVE: Our study aimed to estimate the predictive performance differences of the reported VCM PPK software JPKD-vancomycin and SmartDose in patients with varying renal function status, especially those with ARC. METHODS: Patients receiving VCM treatment from May 2014 to December 2019 were enrolled, and divided into the ARC group, the normal renal function (NRF) group, and the impaired renal function (IRF) group. VCM dosage, trough concentration, area under the curve (AUC) and pharmacokinetic parameters were compared among the three groups. The predictive performance of PPK software was expressed using absolute prediction error (APE), sensitivity, specificity, and regression coefficient (r2) of linear regression analysis between the measured VCM trough concentration and the predicted trough concentration. RESULTS: A total of 388 patients were included: 86 patients in the ARC group, 241 patients in the NRF group, and 61 patients in the IRF group. The daily dose of the adjusted regimen in the ARC group was higher than in the NRF group, but the trough concentration was significantly lower than in the NRF group (2.8±0.6 g vs 1.9±0.6 g, p<0.001; 10.5±5.1 mg/L vs 12.9±6.8 mg/L, p=0.030). The percentage of trough concentrations lower than 10 mg/L was 84.9% in the ARC group. Compared with the APE of the initial dosage regimen, the APE of the adjusted regimen calculated by JPKD was lower in the ARC group (p=0.041) and the NRF group (p<0.001). Specificity of JPKD and SmartDose in the ARC group was higher than in the NRF group (p<0.001; p<0.001). According to the linear regression analysis, the coefficients of determination (r2) were all >0.6 for the initial regimen and adjusted regimen of VCM in the ARC and NRF groups, and the r2 of the adjusted regimen of JPKD was >0.8 in the ARC and NRF groups. In the IRF group, 31.1% of patients had a change in serum creatinine (Scr) level of >50%. The r2 increased from 0.527 to 0.7347 in SmartDose and from 0.55 to 0.7802 in JPKD when using Scr at the sampling time. The ARC group showed a significant decrease in AUC (p<0.001) and an increase in clearance rate (p<0.001) when compared to the NRF group. CONCLUSION: ARC was significantly associated with subtherapeutic serum VCM concentration. The pharmacokinetic parameters of VCM were diverse in patients with different renal function status. The PPK model JPKD and SmartDose had a good predictive performance for predicting VCM trough concentrations of the ARC and NRF patients, especially using JPKD for prediction of the adjusted regimen. The change of Scr is a main factor affecting the accuracy of software prediction.

3.
Bioengineered ; 12(1): 162-171, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33356805

RESUMO

Long non-coding RNA (LncRNA) contributes to the occurrence and development of osteosarcoma (OS), although the underlying mechanism is not clear. In the present study, we showed that lncRNA MRPL23-AS1 was remarkably increased in OS tissues and cell lines. Stable knockdown of MRPL23-AS1 evidently attenuated cell viability and invasive ability, meanwhile inhibited in vivo tumor growth and dissemination. In terms of mechanism, luciferase reporter, RNA pull-down and fluorescence in situ hybridization (FISH) assays showed that MRPL23-AS1 competitively interacted with miR-30b, increasing myosin heavy chain 9 (MYH9) expression, a trans- activator of ß-catenin, resulting in the activation of Wnt/ß-catenin pathway, thereby promoting OS tumorigenesis and metastasis. Importantly, high MRPL23-AS1 was positively correlated with MYH9, while conversely correlated with miR-30b, suggesting that the regulatory axis of MRPL23-AS1/miR-30b/MYH9 does exist in OS. Clinically, OS patients with high MRPL23-AS1 had larger tumor size, higher stage and easier metastasis than those with low MRPL23-AS1, moreover, MRPL23-AS1 was identified as an adverse prognostic factor for OS survival. In conclusion, our results show that MRPL23-AS1 is a key oncogenic lncRNA in OS, targeting of MRPL23-AS1 may be a promising treatment for OS patients.

4.
Gen Physiol Biophys ; 39(5): 407-417, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33084595

RESUMO

We analyzed the role of the RhoA/ROCK pathway in regulating endothelial dysfunction triggered by LPS and the protective effects of TSG (2, 3, 5, 4'-tetrahydroxystilbene-2-O-ß-D-glucoside). Human umbilical vein endothelial cells (HUVECs) were treated with LPS at different concentrations or at different time points. Cells were also pretreated with 30 µM ROCK inhibitor Y27632 for 30 min or different concentrations of TSG for 24 h and then were incubated with 100 µg/ml LPS for another 24 h. The results showed that LPS treatment significantly reduced endothelial cell viability, increased LDH release, and promoted cell necrosis in a dose- and time-dependent manner, which was dramatically inhibited by TSG pretreatment. Furthermore, LPS induction significantly enhanced the expression of RhoA, ROCK1, and ROCK2 and the activation of ROCK; these effects were reduced by TSG pretreatment. The suppression of either RhoA or ROCK significantly improved LPS-induced endothelial cell viability, and reduced cell necrosis and LDH release. In addition, LPS treatment promoted F-actin skeleton rearrangement and contraction ring formation around the plasma membrane, which was greatly inhibited by the suppression of the RhoA/ROCK pathway or TSG pretreatment. In conclusion, TSG may inhibit F-actin cytoskeletal remodeling by blocking RhoA/ROCK signaling and thus reduce LPS-induced endothelial cell toxicity.

5.
BMC Pregnancy Childbirth ; 20(1): 578, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33004015

RESUMO

BACKGROUND: Magnesium sulfate (MgSO4) is the standard drug for eclampsia prophylaxis and treatment. In China, the effective therapeutic serum magnesium level is 1.8-3.0 mmol/L. There is little information on how to achieve and maintain effective therapeutic concentrations. This study aimed to investigate risk factors for sub-therapeutic serum concentrations of MgSO4 in patients with severe preeclampsia. METHODS: Patients with severe preeclampsia who received MgSO4 intravenous infusion were retrospectively reviewed. The maternal demographic characteristics, regimens for the administration of MgSO4, and lab test results of patients were collected. Multivariate logistic regression analysis and receiver operating characteristic (ROC) curve analysis were conducted for the risk factors influencing the serum magnesium concentration. RESULTS: A total of 93 patients with severe preeclampsia were included in the study. 52 (55.91%) patients did not attain therapeutic serum magnesium levels. A multivariate logistic regression analysis identified creatinine clearance (Ccr), whether the loading dose was given, and measurement time of serum magnesium concentration (referring to the time from start of MgSO4 infusion to blood draw for serum sampling) as independent risk factors for sub-therapeutic serum magnesium concentration (P < 0.05). ROC curve analysis indicated that the continuous variable Ccr had a significant predictive value for the serum magnesium concentration, which resulted in a cutoff point of 133 mL/min; while measurement time had limited predictive value, with cutoff point of 2.375 h. CONCLUSIONS: Ccr, whether the loading dose was given, and measurement time were independent risk factors for sub-therapeutic serum magnesium concentration. A loading dose of MgSO4 everytime before the maintenance dose, as well as the duration of MgSO4 maintenance dose of more than 2.375 h are recommended for all the patients with severe PE. Routine evaluation of serum magnesium levels is a recommended practice for women with severe PE and whose Ccr is ≥133 mL/min.

6.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(7): 1056-1061, 2020 Jul 30.
Artigo em Chinês | MEDLINE | ID: mdl-32895150

RESUMO

OBJECTIVE: To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data. METHODS: MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model. RESULTS: The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm). CONCLUSIONS: Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.


Assuntos
Imagem por Ressonância Magnética , Tomografia Computadorizada por Raios X , Uretra , Bexiga Urinária , Feminino , Humanos , Modelos Anatômicos
7.
Aging (Albany NY) ; 12(16): 16410-16419, 2020 08 29.
Artigo em Inglês | MEDLINE | ID: mdl-32862152

RESUMO

Although it is known that inflammation is involved in Parkinson's disease (PD) pathogenesis and vitamin K2 (VK2) has anti-inflammatory effects, to date few studies have been reported on the relationship between VK2 and PD development. Herein we presented a case-control study involving 93 PD patients and 95 healthy controls. Overall, the serum VK2 level of PD patients (3.49 ± 1.68 ng/ml) was significantly lower than that of healthy controls (5.77 ± 2.71 ng/ml). When the PD patients were stratified by disease progression, we observed that the serum VK2 level of late stage patients was further decreased to 3.15 ± 1.18 ng/ml while the serum VK2 level of early stage patients was 3.92 ± 2.09 ng/ml. Furthermore, the curve analysis showed that the serum VK2 level decreased gradually with the increment of PD Hoehn-Yahr (H-Y) stage. We also confirmed the dysregulated inflammatory responses and coagulation cascades in PD patients by public dataset, which are associated to the decreased VK2 level. In summary, we found the serum VK2 level in PD patients is lower than that in healthy controls. The decrease of VK2 level may be related to the occurrence and progression of PD by loosening the regulation of inflammatory responses and coagulation cascades signal.

8.
Zhejiang Da Xue Xue Bao Yi Xue Ban ; 40(7): 1056-1061, 2020 May 25.
Artigo em Chinês | MEDLINE | ID: mdl-32701229

RESUMO

OBJECTIVE: To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data. METHODS: MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model. RESULTS: The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm). CONCLUSIONS: Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.


Assuntos
Imagem por Ressonância Magnética , Modelos Anatômicos , Tomografia Computadorizada por Raios X , Uretra , Bexiga Urinária , Feminino , Humanos , Imageamento Tridimensional , Músculo Esquelético , Uretra/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem
9.
Int J Clin Pharmacol Ther ; 58(7): 408-414, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32352368

RESUMO

OBJECTIVE: The objective of this study was to use LC-MS/MS to compare the pharmacodynamic properties and bioequivalence of two 200-mg formulations of racecadotril: suspension formulation (test) and granule formulation (reference) in healthy Chinese subjects. MATERIALS AND METHODS: A single-dose, randomized, two-period crossover study was conducted in fasted healthy Chinese subjects, who received a single oral dose of the test or reference formulation, followed by a 7-day washout period and administration of the alternate formulation. RESULTS: The rapid and highly sensitive LC-MS/MS method exhibited a reasonable linearity range (2.324 - 952.000 ng/mL) and high sensitivity (LLOQ of 2.324 ng/mL). The within- and between-run precision, accuracy, and stability results were within the acceptable limits, and no matrix effect was observed. The 90% CI of the ratio of geometric means for AUC0-t, AUC0-∞, and Cmax were 88.1 - 102.3%, 87.9 - 101.5% and 99.5 - 113%, respectively, which met the regulatory criteria for bioequivalence. CONCLUSION: The method is suitable for quantification of thiorphan in human plasma. In addition, the results indicated that the test and reference formulations were bioequivalent in terms of both rate and extent of absorption.


Assuntos
Inibidores de Proteases , Espectrometria de Massas em Tandem , Tiorfano/análogos & derivados , Área Sob a Curva , Disponibilidade Biológica , Cromatografia Líquida , Estudos Cross-Over , Humanos , Inibidores de Proteases/sangue , Comprimidos , Equivalência Terapêutica , Tiorfano/sangue
10.
J Pain Symptom Manage ; 60(3): 559-567, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32276100

RESUMO

CONTEXT: Limited studies have identified symptom clusters (SCs) and their risk factors and the relationships with inflammatory biomarkers in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: In this study, we aimed to investigate SCs in patients with AECOPD and explore their influencing factors and relationships with inflammatory biomarkers. METHODS: Data were collected with sociodemographic and disease information questionnaires, and symptoms were measured with the revised Memorial Symptom Assessment Scale. SCs were extracted through exploratory factor analysis. Logistic regression analysis was conducted to explore the risk factors of SCs. RESULTS: A total of 151 patients were recruited. Two SCs, namely, emotional and respiratory functional SCs, were identified. Logistic regression analysis showed that individuals with high C-reactive protein level, Charlson Comorbidity Index score, and high modified Medical Research Council Dyspnea Scale score were more likely to belong to the high-severity symptom subgroup than to the low-severity symptom group in the emotional SC. The patients with a low body mass index and without or lax inhaled drug therapy exhibited highly prominent predictors of membership in the high-severity symptom group of the respiratory functional SC. CONCLUSION: Symptoms experienced by patients with AECOPD were grouped into specific clusters. Targeted interventions should be performed based on SCs, and influencing factors and biological mechanisms should be considered when providing individualized approaches and interventions.

11.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 32(1): 50-55, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-32148231

RESUMO

OBJECTIVE: To estimate the predictive performance of the population pharmacokinetics software JPKD-vancomycin on predicting the vancomycin steady-state trough concentration, and to analyze the related factors affecting the predictive performance. METHODS: The clinical data of patients who were treated with vancomycin and received therapeutic drug monitoring (TDM) admitted to Suzhou Hospital Affiliated to Nanjing Medical University from July 2013 to December 2018 were enrolled. All patients were designed an empirical vancomycin regimen (initial regimen) according to vancomycin medication guidelines. Steady-state trough concentrations of vancomycin were determined at 48 hours after the first dose and 0.5 hour before the next dose. Dosage regimen was adjusted when steady-state trough concentration was not in 10-20 mg/L (adjustment regimen), and then the steady-state trough concentration was determined again 48 hours after adjustment. First, the JPKD-vancomycin software was used to calculate the initial regimen and predict the steady-state trough concentration according to the results calculated by classic pharmacokinetic software Vancomycin Calculator. Second, the JPKD-vancomycin software was used to adjust the vancomycin dosage regime and predict the steady-state trough concentration of adjustment regimen. The weight residual (WRES) between the predicted steady-state trough concentration (Cpre) and the measured steady-state trough concentration (Creal) was used to evaluate the ability of the JPKD-vancomycin software for predicting the vancomycin steady-state trough concentration. The TDM results of initial regimen were divided into accurate prediction group (WRES < 30%) and the inaccurate prediction group (WRES ≥ 30%) according to the WRES value. Patient and disease characteristics including gender, age, weight, height, the length of hospital stay, comorbidities, vasoactive agent, mechanical ventilation, smoking history, postoperative, obstetric patients, trauma, laboratory indicators, vancomycin therapy and TDM results were collected from electronic medical records. Univariate and multivariate Logistic regression analysis was used to screen the related factors that influence the predictive performance of JPKD-vancomycin software, and the receiver operating characteristic (ROC) curve was drawn to evaluate its predictive value. RESULTS: A total of 310 patients were enrolled, and 467 steady-state trough concentrations of vancomycin were collected, including 310 concentrations of initial regimen and 157 concentrations of adjustment regimen. Compared with the initial regimen, the WRES of adjusted regimen was significantly reduced [14.84 (6.05,22.89)% vs. 20.41 (11.06,45.76)%, P < 0.01], and the proportion of WRES < 30% increased significantly [82.80% (130/157) vs. 63.87% (198/310), P < 0.01]. These results indicated that JPKD-vancomycin software had a better accuracy prediction for steady-state trough concentration of the adjusted regimen than the initial regimen. There were 198 concentrations in the accurate prediction group and 112 in the inaccurate prediction group. Univariate Logistic regression analysis showed that women [odds ratio (OR) = 0.466, 95% confidence interval (95%CI) was 0.290-0.746, P = 0.002], low body weight (OR = 0.974, 95%CI was 0.953-0.996, P = 0.022), short height (OR = 0.963, 95%CI was 0.935-0.992, P = 0.014), low vancomycin clearance (CLVan; OR < 0.001, 95%CI was 0.000-0.231, P = 0.023) and postoperative patients (OR = 1.695, 95%CI was 1.063-2.702, P = 0.027) were related factors affecting the predictive performance of JPKD-vancomycin software. Multivariate Logistic regression analysis indicated that women (OR = 0.449, 95%CI was 0.205-0.986, P = 0.046), low CLVan (OR < 0.001, 95%CI was 0.000-0.081, P = 0.015) and postoperative patients (OR = 2.493, 95%CI was 1.455-4.272, P = 0.001) were independent risk factors for inaccurate prediction of JPKD-vancomycin software. The ROC analysis indicated that the area under ROC curve (AUC) of the CLVan for evaluating the accuracy of JPKD-vancomycin software in predicting vancomycin steady-state trough concentration was 0.571, the sensitivity was 56.3%, and the specificity was 57.1%. The predictive performance of JPKD-vancomycin software was decreased when CLVan was lower than 0.065 L×h-1×kg-1. CONCLUSIONS: JPKD-vancomycin software had a better predictive performance for the vancomycin steady-state trough concentrations of adjustment regimen than initial regimen. JPKD-vancomycin software had a poor predictive performance when the patient was female, having low CLVan, and was postoperative. The predictive performance of JPKD-vancomycin software was decreased when CLVan was lower than 0.065 L×h-1×kg-1.


Assuntos
Antibacterianos/farmacocinética , Monitoramento de Medicamentos , Software , Vancomicina/farmacocinética , Feminino , Humanos , Masculino , Estudos Retrospectivos
12.
Yi Chuan ; 42(3): 236-249, 2020 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-32217510

RESUMO

The emergence of the gene editing technology, especial CRISPR-Cas (clustered regularly intersected short palindromic repeats and CRISPR associated proteins), has greatly promoted the ability of human beings to transform natural species. It has been widely harnessed for the engineering in the medical, industrial, agricultural and other fields. The key component of the CRISPR-Cas system, the Cas protein, possesses its specific features, including self-activity, recognition site, cutting end and guide RNA. PAM (protein assistant motif) is a number of nucleotides adjacent to the target site, which is very important for the Cas protein to recognize the target sequence and is also the key characteristic of CRISPR-Cas. There are several reported methods for identification of PAM. In this review, we summarize the searching for the Cas protein, the identification of Cas mutants with desired traits and the mapping of the PAM (including the extending of PAM spectrum), in order to provide a reference for the development and optimization of next-generation gene editing tools.


Assuntos
Motivos de Aminoácidos , Proteínas Associadas a CRISPR/genética , Sistemas CRISPR-Cas , Edição de Genes , RNA Guia/genética , Humanos
13.
ACS Appl Mater Interfaces ; 12(8): 9775-9781, 2020 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-32011857

RESUMO

The extraction of lithium from seawater has attracted much interest as a means to meet increasing demand for lithium with the rapid expansion of the electric vehicle and electronics markets. Herein, a renewable and recyclable hydrogen manganese oxide (HMO)-modified cellulose film was developed and investigated toward the extraction of lithium from lithium-containing aqueous solutions. The porous film was characterized, and its extraction efficacy and selectivity toward lithium from an aqueous solution (ppm level) and seawater (ppb level) were investigated. The HMO/cellulose film exhibited a higher Li+ adsorption capacity (21.6 mg g-1 HMO) than HMO/polymer (e.g., poly(vinyl chloride) or poly(vinylidene fluoride)) films, which have been examined in the literature for lithium extraction, because of its multidimensional porosity and hydrophilicity. The kinetics analysis based on a pseudo-second-order model indicated that the Li+ extraction rate of the HMO/cellulose film was 3 times higher than that achieved by the HMO particle alone (i.e., 0.075; cf. 0.023 g mg-1 h-1). Furthermore, the HMO/cellulose film displayed high selectivity for Li+ when exposed to seawater-the extraction of Li+ reached 99%, whereas that of the other ions present in seawater (i.e., Sr2+, K+, and Ca2+) was <4%. In addition, the adsorption capacity and mechanical strength of the HMO/cellulose film remained stable even after eight adsorption-desorption cycles. The present findings demonstrate the potential of the present HMO/cellulose film for the recovery of Li+ from seawater or wastewater.

14.
Int J Clin Oncol ; 25(5): 937-947, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32062731

RESUMO

BACKGROUND: To investigate the survival outcomes of stage IB1 cervical cancer patients with tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy. METHODS: We retrospectively analyzed stage IB1 cervical cancer patients with a tumor size ≤ 2 cm who underwent laparoscopic or abdominal radical hysterectomy in China between 2004 and 2016. A real-world study (RWS) and 1:1 matching was used in the study. RESULTS: After 1:1 matching, laparoscopic (n = 926) and abdominal radical hysterectomy (n = 926) had similar 5-year overall survival and disease-free survival rates in stage IB1 cervical cancer with a tumor size ≤ 2 cm. Subsequently, in cervical squamous carcinoma with tumor size ≤ 2 cm, the laparoscopic and abdominal groups (724 cases, respectively) showed comparable 5-year overall survival and disease-free survival rates. Finally, in cervical adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm, the laparoscopic group (n = 174) had a similar 5-year overall survival rate but a lower disease-free survival rate compared to those of the abdominal group (disease-free survival: 89.9% vs. 98.0%, respectively, P = 0.006; hazard ratio (HR), 5.094; 95% confidence interval (CI), 1.400-18.535; P = 0.013; n = 174). The RWS results were similar to the 1:1 matching results. CONCLUSIONS: Patients with squamous cell carcinoma in stage IB1 cervical cancer with tumor size ≤ 2 cm might be suitable for laparoscopic surgery, while patients with adenocarcinoma or adenosquamous carcinoma with tumor size ≤ 2 cm are not candidates for laparoscopic surgery.


Assuntos
Histerectomia/métodos , Laparoscopia/métodos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Abdome/cirurgia , Adenocarcinoma/patologia , Adulto , Carcinoma Adenoescamoso/mortalidade , Carcinoma Adenoescamoso/patologia , Carcinoma Adenoescamoso/cirurgia , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/cirurgia , Estudos de Casos e Controles , China , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias do Colo do Útero/mortalidade
15.
Eur J Obstet Gynecol Reprod Biol ; 244: 76-80, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31760266

RESUMO

OBJECTIVE: To investigate the relationship between the cervical length evaluated by Pelvic Organ Prolapse Quantification (POP-Q) point C minus D (C-D; ECL) and the magnetic resonance imaging (MRI)-based cervical length (MCL). STUDY DESIGN: This was a retrospective study of patients with POP II-IV who underwent MRI. The ECL was calculated based on the absolute value of C-D according to POP-Q. The MCL was defined as the distance between the internal and external cervical os on MRI. Intraobserver reliability using the Bland-Altman method. Continuous variables were compared by paired 2-tailed t-tests. Multiple linear regression analysis was used to analyse the factors influencing differences between the ECL and MCL. RESULTS: Among 105 eligible patients, 89 patients were eventually included in the study. The Bland-Altman scatter plots show that the intraobserver reliability of MCL was excellent. Furthermore, the mean ECL was significantly longer than the mean MCL (48.15 mm ±â€¯27.46 vs. 28.25 mm ±â€¯10.27, P = 0.000).Body mass index, parity, menopausal status or total vaginal length did not affect the difference between ECL and MCL. However, The larger the point Ba, the larger the difference between the ECL and MCL. The larger the point Bp, the smaller the difference between the ECL and MCL. CONCLUSION: In general, POP-Q C-D was longer than the cervical length measured by MRI. Deep analysis found that when uterine prolapse is combined with larger anterior vaginal wall prolapse, the difference between ECL and MCL is greater; when uterine prolapse with larger posterior vaginal wall prolapse, the difference between ECL and MCL is smaller.


Assuntos
Colo do Útero/diagnóstico por imagem , Imagem por Ressonância Magnética , Prolapso de Órgão Pélvico/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Medida do Comprimento Cervical , Feminino , Humanos , Pessoa de Meia-Idade
16.
Asian J Androl ; 22(2): 217-221, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31210148

RESUMO

Biochemical recurrence (BCR) is important for measuring the oncological outcomes of patients who undergo radical prostatectomy (RP). Whether transurethral resection of the prostate (TURP) has negative postoperative effects on oncological outcomes remains controversial. The primary aim of our retrospective study was to determine whether a history of TURP could affect the postoperative BCR rate. We retrospectively reviewed patients with prostate cancer (PCa) who had undergone RP between January 2009 and October 2017. Clinical data on age, prostate volume, serum prostate-specific antigen levels (PSA), biopsy Gleason score (GS), metastasis stage (TNM), D'Amico classification, and American Society of Anesthesiologists (ASA) classification were collected. Statistical analyses including Cox proportional hazard models and sensitivity analyses which included propensity score matching, were performed, and the inverse-probability-of-treatment-weighted estimator and standardized mortality ratio-weighted estimator were determined. We included 1083 patients, of which 118 had a history of TURP. Before matching, the non-TURP group differed from the TURP group with respect to GS (P= 0.047), prostate volume (mean: 45.19 vs 36.00 ml, P < 0.001), and PSA level (mean: 29.41 vs 15.11 ng ml-1, P= 0.001). After adjusting for age, PSA level, T stage, N stage, M stage, and GS, the TURP group showed higher risk of BCR (hazard ratio [HR]: 2.27, 95% confidence interval [CI]: 1.13-3.94, P= 0.004). After matching (ratio 1:4), patients who underwent TURP were still more likely to develop BCR according to the adjusted propensity score (HR: 2.00, 95% CI: 1.05-3.79, P= 0.034). Among patients with PCa, those with a history of TURP were more likely to develop BCR after RP.

17.
Eur J Radiol ; 121: 108596, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31623899

RESUMO

PURPOSE: To develop and evaluate new formulas to determine the magnetic resonance imaging (MRI)-based estimated foetal weight (EFW) more than a week before delivery. METHODS: The study included 153 women with singleton pregnancies who gave birth to live, normal neonates within 15-21 days of the MRI examination for whom foetal body volume biometry data were available at term. All foetuses were randomly divided into a testing group (102) and a validation group (51). Regression analysis was used to determine the single volume or the combination of volume and MRI-to-delivery interval that determined the EFW. The accuracy of the two new models and the primary existing model developed by Baker et al. were evaluated in validation group. RESULTS: The two new models had similar mean percentage errors (MPEs) (3.9% vs 3.9%) and proportions of pregnancies with an MPE < 10% (92.2% vs 90.2%); the model incorporating volume and MRI-to-delivery had relatively higher proportions of pregnancies with an MPE < 5% (72.5% vs 64.7%) and EFWs in agreement with the birth weights. The error in the Baker model was almost twice that in the new models. CONCLUSION: The accuracy of foetal weight estimation more than one week before delivery using the model developed by Baker et al. was poor and was significantly improved by the new models. A combination of the foetal body volume and MRI-to-delivery interval will enable the more accurate determination of the EFWs.


Assuntos
Peso Fetal/fisiologia , Processamento de Imagem Assistida por Computador/métodos , Imagem por Ressonância Magnética/métodos , Cuidado Pré-Natal/métodos , Adulto , Feminino , Humanos , Gravidez , Estudos Prospectivos , Análise de Regressão , Reprodutibilidade dos Testes , Ultrassonografia Pré-Natal/métodos
18.
Orthop Surg ; 11(4): 679-689, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31385411

RESUMO

OBJECTIVE: To determine the safety and effectiveness of a cross-linked sodium hyaluronate (CHA) scaffold in cartilage repair. METHODS: Physicochemical properties of the scaffold were determined. The safety and effectiveness of the scaffold for cartilage repair were evaluated in a minipig model of a full-thickness cartilage defect with microfracture surgery. Postoperative observation and hematological examination were used to evaluate the safety of the CHA scaffold implantation. Pathological examination as well as biomechanical testing, including Young's modulus, stress relaxation time, and creep time, were conducted at 6 and 12 months postsurgery to assess the effectiveness of the scaffold for cartilage repair. Furthermore, type II collagen and glycosaminoglycan content were determined to confirm the influence of the scaffold in the damaged cartilage tissue. RESULTS: The results showed that the routine hematological indexes of the experimental animals were within the normal physiological ranges, which confirmed the safety of CHA scaffold implantation. Based on macroscopic observation, it was evident that repair of the defective cartilage in the animal knee joint began during the 6 months postoperation and was gradually enhanced from the central to the surrounding region. The repair smoothness and color of the 12-month cartilage samples from the operation area were better than those of the 6-month samples, and the results for the CHA scaffold implantation group were better than the control group. Greater cell degeneration and degeneration of the adjacent cartilage was found in the implantation group compared with the control group at both 6 and 12 months postoperation, evaluated by O'Driscoll Articular Cartilage Histology Scoring. Implantation with the CHA scaffold matrix promoted cartilage repair and improved its compression capacity. The type II collagen level in the CHA scaffold implantation group tended to be higher than that in the control group at 6 months (2.33 ± 1.50 vs 1.68 ± 0.56) and 12 months postsurgery (3.37 ± 1.70 vs 2.06 ± 0.63). The GAG content in the cartilage of the control group was significantly lower than that of the experimental group (2.17 ± 0.43 vs 3.64 ± 1.17, P = 0.002 at 6 months and 2.27 ± 0.38 vs 4.12 ± 1.02, P = 0.002 at 12 months). Type II collagen and glycosaminoglycan content also demonstrated that CHA was beneficial for the accumulation of both these vital substances in the cartilage tissue. CONCLUSIONS: The CHA scaffold displayed the ability to promote cartilage repair when applied in microfracture surgery, which makes it a promising material for application in the area of cartilage tissue engineering.


Assuntos
Cartilagem Articular/efeitos dos fármacos , Fêmur/cirurgia , Ácido Hialurônico/farmacologia , Engenharia Tecidual/métodos , Tecidos Suporte/química , Animais , Colágeno Tipo II/metabolismo , Modelos Animais de Doenças , Glicosaminoglicanos/metabolismo , Suínos , Porco Miniatura
19.
Gen Physiol Biophys ; 38(4): 271-280, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31219429

RESUMO

The aim of this study was to investigate the effects of the Rho GDP dissociation inhibitor (RhoGDI) on TGFß1-mediated vascular adventitia myofibroblast transdifferentiation and on the inhibition of ROCK inhibitors. Myofibroblast transdifferentiation and vascular remodeling model were induced by TGFß1 in vitro and by balloon injury in vivo. H&E (Hematoxylin & Eosin) and PSR (Picrosirius Red) staining were used to observe vascular morphology while immunofluorescence, immunohistochemistry, and Western blotting were used to measure protein expression. Fasudil treatment reduced the expression of TGFß1, RhoGDI1, and RhoGDI2 in addition to vascular remodeling in the rat balloon injury model. TGFß1 induced the expression of α-SMA, TGFßRI, phospho-TGFßRI, RhoGDI1, RhoGDI2, and collagen secretion in human aortic adventitial fibroblasts (HAAFs). These effects were diminished after treatment with Y27632. Suppressing both RhoGDI1 and RhoGDI2 expression also blocked TGFß1-induced α-SMA expression and collagen secretion in HAAFs. Moreover, TGFßR inhibition blocked TGFß1-mediated collagen secretion and the expression of α-SMA, RhoGDI1, and RhoGDI2. These data suggested that ROCK inhibitors alleviate myofibroblast transdifferentiation and vascular remodeling by decreasing TGFß1-mediated expression of RhoGDI.


Assuntos
Transdiferenciação Celular/efeitos dos fármacos , Miofibroblastos/citologia , Miofibroblastos/efeitos dos fármacos , Inibidores de Proteínas Quinases/farmacologia , Fator de Crescimento Transformador beta1/metabolismo , Remodelação Vascular/efeitos dos fármacos , Quinases Associadas a rho/antagonistas & inibidores , Inibidores da Dissociação do Nucleotídeo Guanina rho-Específico/biossíntese , Animais , Humanos , Ratos
20.
Polymers (Basel) ; 11(6)2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31163667

RESUMO

In the polymerization of caprolactam, the stoichiometry of carboxyl groups and amine groups in the process of melt polycondensation needs to be balanced, which greatly limits the copolymerization modification of polyamide 6. In this paper, by combining the characteristics of the polyester polymerization process, a simple and flexible synthetic route is proposed. A polyamide 6-based polymer can be prepared by combining caprolactam hydrolysis polymerization with transesterification. First, a carboxyl-terminated polyamide 6-based prepolymer is obtained by a caprolactam hydrolysis polymerization process using a dibasic acid as a blocking agent. Subsequently, ethylene glycol is added for esterification to form a glycol-terminated polyamide 6-based prepolymer. Finally, a transesterification reaction is carried out to prepare a polyamide 6-based polymer. In this paper, a series of polyamide 6-based polymers with different molecular weight blocks were prepared by adjusting the amount and type of dibasic acid added, and the effects of different control methods on the structural properties of the final product are analyzed. The results showed that compared with the traditional polymerization method of polyamide 6, the novel synthetic strategy developed in this paper can flexibly design prepolymers with different molecular weights and end groups to meet different application requirements. In addition, the polyamide 6-based polymer maintains excellent mechanical and hygroscopic properties. Furthermore, the molecular weight increase in the polyamide 6 polymer is no longer dependent on the metering balance of the end groups, providing a new synthetic route for the copolymerization of polyamide 6 copolymer.

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