Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 84
Filtrar
1.
Asian J Surg ; 2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33341336

RESUMO

OBJECTIVE: To compare the operation complexity and prognosis of completely laparoscopic versus open radical nephrectomy and infrahepatic tumor thrombectomy. METHODS: We reviewed and analyzed the clinical data of 87 patients with infrahepatic tumor thrombus from January 2015 to April 2019 retrospectively. Completely laparoscopic infrahepatic tumor thrombectomy was completed in 41 cases, and open surgery was completed in 46 cases. RESULTS: All 41 patients successfully completed laparoscopic operation, and there were no cases of death during the operation. The completely laparoscopic group were older, had smaller renal tumor diameter, shorter median operation time, lower median intraoperative hemorrhage volume, and lower median transfusion volume of suspended red blood cells compared with open surgeries. The proportion of low-level tumor thrombus (Mayo I) in the completely laparoscopic group was higher (63.4%), while the proportion of low-level tumor thrombus in the open surgery group was lower (30.4%) (P = 0.002). The postoperative complications incidence of laparoscopic surgery was 19.5%, which was lower than that of open surgery (47.8%) (P = 0.004). The mean cancer-specific survival time of the laparoscopic surgery group was 36.6 ± 2.5 months, while that of the open surgery group was 32.3 ± 2.7 months (P = 0.277). There was no statistical difference between the two groups. CONCLUSION: Although completely laparoscopic radical nephrectomy and infrahepatic tumor thrombectomy is a challenging operation, it could be feasible and safely performed, especially in the hands of highly-experienced laparoscopic urologists for well selected cases.

3.
Front Cell Infect Microbiol ; 10: 581639, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33117735

RESUMO

Leishmaniasis is still a serious neglected tropical disease that may cause death in infected individuals. At present, the clinical diagnosis and treatment monitoring still rely on parasitological culture and microscopy that needs experienced technicians. The low sensitivity and inconvenience of microscopic examination could cause misdiagnosis and relapse of leishmaniasis. There is an urgent need for developing a sensitive and easily operated diagnostic method for the diagnosis and disease management of leishmaniasis. Thus, a quantitative real-time PCR (qPCR) based on the conversed regions of kinetoplast minicircle DNA (mkDNA) of Leishmania spp. was developed to detect different species of Leishmania. The designed mkDNA-based qPCR was able to detect as low as one copy of Leishmania mkDNA or DNA from single parasite. It also detected Pan-Leishmania protozoa including Leishmania donovani, Leishmania infantum and Leishmania major without cross-reaction with other pathogen DNAs available in our lab. This method was clinically applied to quantitatively detect skin lesion samples from 20 cutaneous leishmaniasis (CL) and bone marrow and/or PBMC samples from 30 current and cured visceral leishmaniasis (VL) patients, and blood samples from 11 patients with other infections and 5 normal donors as well. Total 20 skin lesion samples from current CL patients and 20 bone marrow and/or PBMC samples from current VL patients were all detected as positive with qPCR without cross-reaction with samples from patients with malaria, brucellosis and dengue or normal donors. Two VL patients with parasite converted to microscopically negative after treatment were detected positive with qPCR. The patients with bigger skin lesion in CL and higher level of immunoglobulin or splenomegaly in VL, had the higher parasite load detected by qPCR. The parasite load was significantly reduced after treatment. In conclusion, the mkDNA-based qPCR assay that we developed in this study can be used not only for diagnosis of both cutaneous and visceral leishmaniasis with high sensitivity and specificity, but also for evaluating the severity and treatment efficacy of this disease, presenting a rapid and accurate tool for clinical surveillance, treatment monitoring and the end point determination of leishmaniasis.

4.
BMC Surg ; 20(1): 185, 2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32792015

RESUMO

BACKGROUND: We aimed to explore the causal analysis, clinical characteristics and treatment strategies of laparoscopic conversion to open approach (LCTOA) in radical nephrectomy and tumor thrombectomy. METHODS: We included all patients with Mayo level I-III renal tumors with inferior vena cava (IVC) tumor thrombus who underwent laparoscopic radical nephrectomy and tumor thrombectomy as the first choice from May 2015 to July 2019. RESULTS: There were 70 cases of renal tumor with IVC tumor thrombus treated with a laparoscopic approach as the first choice; 31 Mayo level I, 30 Mayo level II, and 9 Mayo level III. A completely laparoscopic approach was performed in 51 cases (72.9%), and 19 cases (27.1%) underwent active or passive LCTOA. The LCTOA group had higher median preoperative serum creatinine (110.0 µmol/L vs 92.0 µmol/L; P = 0.026), longer postoperative hospital stay (9 days vs 7 days; P = 0.008), longer median operation time (374 min vs 311 min; P = 0.017), higher median intraoperative hemorrhage volume (1300 vs 600 ml; P = 0.020), and higher proportion of male patients (94.7% vs 66.7%; P = 0.016) vs the completely laparoscopic group, respectively. Although preoperative serum creatinine and gender were risk factors in the univariate analysis, multivariate analysis revealed no independent risk factors for LCTOA. We divided the reasons for LCTOA into active conversion and passive conversion; 4 (21.1%) cases underwent active conversion, and 15 (78.9%) underwent passive conversion. Most of the patients undergoing passive conversion had multiple concurrent risk factors, among which perirenal adhesion (30.9%), organ invasion (16.4%), and IVC adhesion (25.5%) were the most common. Fourteen (73.7%) cases underwent renal treatment, and 5 (26.3%) cases underwent tumor thrombus treatment. CONCLUSIONS: The LCTOA group had a higher median preoperative serum creatinine concentration, longer hospital stay, longer median operation time, and higher median intraoperative hemorrhage volume. However, none of the predictors in our study was an independent risk factor for LCTOA. Perirenal adhesion, organ invasion, and IVC adhesion were the most common causes of LCTOA. Considering the limitations of this study, studies with large sample sizes are required to validate our conclusions.


Assuntos
Carcinoma de Células Renais , Conversão para Cirurgia Aberta , Neoplasias Renais , Nefrectomia/métodos , Trombectomia/métodos , Neoplasias Vasculares/cirurgia , Idoso , Carcinoma de Células Renais/secundário , Carcinoma de Células Renais/cirurgia , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Laparoscopia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Vasculares/complicações , Neoplasias Vasculares/secundário , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgia , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
5.
Cancer Med ; 9(16): 5860-5868, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32627973

RESUMO

OBJECTIVE: To describe the clinical characteristics of renal cell carcinoma (RCC) with venous tumor thrombus (VTT) and bland thrombus (BT), and to evaluate the influence of BT on surgical treatment and cancer-specific survival (CSS) of RCC with VTT. METHODS: We retrospectively reviewed clinical data of 123 patients with RCC and VTT, who underwent surgical treatment in our center between February 2015 and May 2018. Patients were divided into the BT group (21 patients) and non-BT group (102 patients). Chi-square and Mann-Whitney U test were used for categorical and continuous variables respectively. Univariable log-rank tests and multivariable Cox regressions were conducted to evaluate the prognostic significance of each variable. Kaplan-Meier plots were performed to evaluate the influence of BT. RESULTS: In the delayed phase of enhanced magnetic resonance imaging (MRI), BT and VTT had difference. Patients were divided according to the relative position of BT: proximal end BT (one patients), contralateral renal vein BT (two patients), distal end BT (12 patients), and multiple BT (six patients). The average length of BT was 8.4 ± 5.8 cm (range: 0.6-20.0 cm). Patients with BT had longer operative time (P = .001), more surgical blood loss (P = .004), higher proportion of open surgery (P = .006), more postoperative complications (P = .011). BT (hazard ratio [HR] = 3.323, P = .007) were independent risk factors for poor prognosis. CONCLUSIONS: In the delayed phase of enhanced MRI, BT showed no obvious enhancement, while VTT usually showed enhancement. This was an important basis for preoperative imaging diagnosis of BT. The presence of BT increases the difficulty of surgery, and is correlated with adverse survival outcomes in patients with RCC and VTT.

6.
Oncol Lett ; 20(1): 201-208, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32565947

RESUMO

The present study aimed to develop an accurate preoperative scoring system to predict the probability of using laparoscopic surgery in radical nephrectomy and thrombectomy. The clinical data of 123 patients with renal cell carcinoma with renal vein or inferior vena cava tumour thrombus admitted to the Department of Urology at Peking University Third Hospital between January 2015 and May 2018 were retrospectively analysed. Univariate and multivariate regression analyses were used to create the scoring system with an emphasis on the area improvement under the receiver operating characteristic curve. A total of 58 (47.2%) patients underwent complete laparoscopic surgery, 56 (45.5%) underwent complete open surgery and 9 (7.3%) underwent laparoscopic conversion to open surgery. The final multivariable model included the following three factors: Clinical node stage (P=0.030), Mayo classification (P<0.001) and tumour diameter (P=0.001). These three variables were then used to construct the score system named Peking University Third Hospital Laparoscopic Probability (PKUTHLP), which ranges from 0-5. The proportion of patients undergoing laparoscopic surgery for each level of the PKUTHLP score were as follows: 0 (n=20), 100%; 1 (n=34), 67.6%; 2 (n=21), 33.3%; 3 (n=21), 19.0%; 4 (n=23), 17.4%; and 5 (n=4), 0.0%. Overall, the PKUTHLP score accurately predicted the probability of using laparoscopic surgery in radical nephrectomy and thrombectomy; however, prospective validation of the PKUTHLP scoring system is required.

7.
Biol Methods Protoc ; 5(1): bpaa006, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32411820

RESUMO

Clustered regularly interspaced short palindromic repeats (CRISPR)-based gene editing techniques find applications in many fields, such as molecular biology, cancer biology, and disease modeling. In contrast to the knock-out procedure, a key step of CRISPR knock-in experiments is the homology-directed repair process that requires donor constructs as repair templates. Therefore, it is desirable to generate a series of donor templates efficiently and cost-effectively. In this study, we developed a new strategy that combines (i) Gibson assembly reaction, (ii) a linker pair composed of eight in silico screened restriction enzyme sites, and (iii) a hierarchical framework, to remarkably improve the efficiency of producing donor constructs for common genes as well as for the genes containing unbalanced guanine-cytosine content and requiring a selectable marker. Furthermore, the approach provides the ability of inserting additional elements into the donor templates, such as single guide RNA recognition sites that have been reported to enhance the efficiency of homology-directed repair. Conclusively, our modularized process is simple, fast, and cost-effective for making donor constructs and benefits the application of CRISPR knock-in methods.

8.
Chin Med J (Engl) ; 133(10): 1166-1174, 2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32433048

RESUMO

BACKGROUND: Radical nephrectomy and thrombectomy is the standard surgical procedure for the treatment of renal cell carcinoma (RCC) with tumor thrombus (TT). But the estimation of intra-operative blood loss is only based on the surgeon's experience. Therefore, our study aimed to develop Peking University Third Hospital score (PKUTH score) for the prediction of intra-operative blood loss volume in radical nephrectomy and thrombectomy. METHODS: The clinical data of 153 cases of renal mass with renal vein (RV) or inferior vena cava tumor thrombus admitted to Department of Urology, Peking University Third Hospital from January 2015 to May 2018 were retrospectively analyzed. The total amount of blood loss during operation is equal to the amount of blood sucked out by the aspirator plus the amount of blood in the blood-soaked gauze. Univariate linear analysis was used to analyze risk factors for intra-operative blood loss, then significant factors were included in subsequent multivariable linear regression analysis. RESULTS: The final multivariable model included the following three factors: open operative approach (P < 0.001), Neves classification IV (P < 0.001), inferior vena cava resection (P = 0.001). The PKUTH score (0-3) was calculated according to the number of aforementioned risk factors. A significant increase of blood loss was noticed along with higher risk score. The estimated median blood loss from PKUTH score 0 to 3 was 280 mL (interquartile range [IQR] 100-600 mL), 1250 mL (IQR 575-2700 mL), 2000 mL (IQR 1250-2900 mL), and 5000 mL (IQR 4250-8000 mL), respectively. Meanwhile, the higher PKUTH score was, the more chance of post-operative complications (P = 0.004) occurred. A tendency but not significant overall survival difference was found between PKUTH risk score 0 vs. 1 to 3 (P = 0.098). CONCLUSION: We present a structured and quantitative scoring system, PKUTH score, to predict intra-operative blood loss volume in radical nephrectomy and thrombectomy.

9.
Nat Chem Biol ; 16(6): 695-701, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32251409

RESUMO

Growth-mediated feedback between synthetic gene circuits and host organisms leads to diverse emerged behaviors, including growth bistability and enhanced ultrasensitivity. However, the range of possible impacts of growth feedback on gene circuits remains underexplored. Here we mathematically and experimentally demonstrated that growth feedback affects the functions of memory circuits in a network topology-dependent way. Specifically, the memory of the self-activation switch is quickly lost due to the growth-mediated dilution of the circuit products. Decoupling of growth feedback reveals its memory, manifested by its hysteresis property across a broad range of inducer concentration. On the contrary, the toggle switch is more refractory to growth-mediated dilution and can retrieve its memory after the fast-growth phase. The underlying principle lies in the different dependence of active and repressive regulations in these circuits on the growth-mediated dilution. Our results unveil the topology-dependent mechanism on how growth-mediated feedback influences the behaviors of gene circuits.


Assuntos
Proteínas de Escherichia coli/genética , Redes Reguladoras de Genes/genética , Genes Sintéticos/genética , Simulação por Computador , Escherichia coli/genética , Escherichia coli/metabolismo , Regulação Bacteriana da Expressão Gênica , Proteínas de Fluorescência Verde/genética , Proteínas de Fluorescência Verde/metabolismo , Cinética , Modelos Genéticos , Imagem Óptica
10.
iScience ; 23(5): 101047, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32339988

RESUMO

Tissue fibrosis compromises organ function and occurs as a potential long-term outcome in response to acute tissue injuries. Currently, lack of mechanistic understanding prevents effective prevention and treatment of the progression from acute injury to fibrosis. Here, we combined quantitative experimental studies with a mouse kidney injury model and a computational approach to determine how the physiological consequences are determined by the severity of ischemia injury and to identify how to manipulate Wnt signaling to accelerate repair of ischemic tissue damage while minimizing fibrosis. The study reveals that memory of prior injury contributes to fibrosis progression and ischemic preconditioning reduces the risk of death but increases the risk of fibrosis. Furthermore, we validated the prediction that sequential combination therapy of initial treatment with a Wnt agonist followed by treatment with a Wnt antagonist can reduce both the risk of death and fibrosis in response to acute injuries.

11.
Cancer ; 126 Suppl 9: 2073-2078, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32293727

RESUMO

BACKGROUND: The surgical treatment of patients with renal cell carcinoma (RCC) with venous tumor thrombus (VTT) is challenging. In the current study, the authors have reported their surgical outcomes and experience with en bloc retroperitoneal laparoscopic radical nephrectomy (LRN) with inferior vena cava (IVC) thrombectomy for patients with RCC with level 0 to II VTT. METHODS: A retrospective review of the clinical records of 78 patients who underwent retroperitoneal LRN with IVC thrombectomy from March 2015 to September 2018 was performed. The surgical procedures included establishing the retroperitoneal space, ligating and severing the renal artery, clamping the renal vein and IVC, incising the IVC, and placing the renal and tumor thrombus en bloc into a retrieval bag. RESULTS: According to the Mayo classification, the tumor thrombus was level 0, I, and II, respectively, in 28 patients, 27 patients, and 23 patients. The median operative time, estimated blood loss, and postoperative hospital stay were 256 minutes, 400 mL, and 8 days, respectively. A total of 67 patients were not converted to open surgery. No patient died during surgery, and no tumor embolization occurred. Thirteen patients experienced complications. The pathological reports indicated clear cell RCC in 70 patients and other RCC in 8 patients. The median follow-up was 14.5 months, and 61 patients were alive at the time of last follow-up. CONCLUSIONS: En bloc retroperitoneal LRN with IVC thrombectomy is a challenging but feasible procedure for experienced surgeons in patients with RCC with level 0 to II VTT.

12.
PLoS Comput Biol ; 16(3): e1007682, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32155144

RESUMO

Epithelial-to-mesenchymal transition (EMT) is a fundamental cellular process and plays an essential role in development, tissue regeneration, and cancer metastasis. Interestingly, EMT is not a binary process but instead proceeds with multiple partial intermediate states. However, the functions of these intermediate states are not fully understood. Here, we focus on a general question about how the number of partial EMT states affects cell transformation. First, by fitting a hidden Markov model of EMT with experimental data, we propose a statistical mechanism for EMT in which many unobservable microstates may exist within one of the observable macrostates. Furthermore, we find that increasing the number of intermediate states can accelerate the EMT process and that adding parallel paths or transition layers may accelerate the process even further. Last, a stabilized intermediate state traps cells in one partial EMT state. This work advances our understanding of the dynamics and functions of EMT plasticity during cancer metastasis.


Assuntos
Transição Epitelial-Mesenquimal/fisiologia , Modelos Biológicos , Metástase Neoplásica , Animais , Biologia Computacional , Metabolismo Energético , Humanos , Cadeias de Markov , Camundongos , Metástase Neoplásica/patologia , Metástase Neoplásica/fisiopatologia , Neoplasias/patologia , Neoplasias/fisiopatologia
13.
Aging (Albany NY) ; 12(3): 2030-2048, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32007952

RESUMO

The AKT/mTOR pathway is critical for bladder cancer (BC) pathogenesis and is hyper-activated during BC progression. In the present study, we identified a novel positive feedback loop involving oncogenic factors histone methyltransferase SMYD3, insulin-like growth factor-1 receptor (IGF-1R), AKT, and E2F-1. SMYD3 expression was significantly up-regulated in BC tumors and positively associated with histological grade, lymph node metastasis, and shorter patient survival. Depletion of SMYD3 inhibited BC cell proliferation, colony formation, migration, invasion, and xenograft tumor growth. Mechanistically, SMYD3 inhibition led to the diminished AKT/mTOR signaling activity, thereby triggering deleterious effects on BC cells. Furthermore, SMYD3 directly activates the expression of IGF-1R, a critical activator of AKT in BC, by inducing hyper-methylation of histone H3-K4 and subsequent chromatin remodeling in the IGF-1R promoter region. On the other hand, E2F-1, a downstream factor of the AKT pathway, binds to the E2F-1 binding motifs at the SMYD3 promoter and consequently induces SMYD3 transcription and expression. Thus, SMYD3/IGF-1R/AKT/E2F-1 forms a positive feedback loop leading to the hyper-activated AKT signaling. Our findings provide not only profound insights into SMYD3-mediated oncogenic activity but also present a unique avenue for treating BC by directly disrupting this signaling circuit.


Assuntos
Carcinoma de Células de Transição/genética , Fator de Transcrição E2F1/metabolismo , Histona-Lisina N-Metiltransferase/genética , Proteínas Proto-Oncogênicas c-akt/genética , Proteínas Proto-Oncogênicas c-akt/metabolismo , Receptor IGF Tipo 1/metabolismo , Neoplasias da Bexiga Urinária/genética , Idoso , Animais , Carcinoma de Células de Transição/metabolismo , Carcinoma de Células de Transição/patologia , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Progressão da Doença , Retroalimentação Fisiológica , Feminino , Técnicas de Silenciamento de Genes , Histona-Lisina N-Metiltransferase/metabolismo , Humanos , Linfonodos/patologia , Metástase Linfática , Masculino , Camundongos Nus , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica/genética , Estadiamento de Neoplasias , Transplante de Neoplasias , Prognóstico , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/metabolismo , Neoplasias da Bexiga Urinária/patologia
14.
BMC Cancer ; 20(1): 61, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992244

RESUMO

BACKGROUND: To explore the influencing factors of perioperative renal function change and their relationship with prognosis on renal cell carcinoma (RCC) patients with tumor thrombus after nephrectomy and thrombectomy. METHODS: The clinical and pathological data of 135 patients with RCC and tumor thrombus, who underwent nephrectomy and thrombectomy at Peking University Third Hospital from May 2015 to July 2018, was retrospectively analyzed. Absolute change in estimated glomerular filtration rate (eGFR) (ACE) and percent change in eGFR (PCE) were calculated by preoperative and postoperative renal function. Linear regression analysis was used to explore the influencing factors of ACE and PCE, and logistic regression analysis was used to explore the influencing factors of worse postoperative renal function [eGFR≤60 mL/(min × 1.73 m^2)]. Cancer-specific survival (CSS) was estimated by Kaplan-Meier method and multivariate Cox regression, which were used to explore the effect of ACE and PCE on prognosis. RESULTS: Of all the 135 patients, 101 patients (74.8%) were male and 34 patients (25.2%) were female. The mean preoperative eGFR was 73.9 ± 21.8 mL/(min × 1.73 m^2) and postoperative eGFR was 69.5 ± 25.2 mL/(min × 1.73 m^2). In multivariate linear regression analysis, preoperative eGFR (P < 0.001) and pathological type (P = 0.038) were significant predictive factors of ACE. In aspect of PCE, preoperative eGFR (P < 0.001) and pathological type (P = 0.002) were significant predictors. In multivariate logistic regression analysis, preoperative eGFR (P = 0.016) was the only risk factor of predicting worse postoperative renal function. During follow-up, 22 patients (16.3%) were dead due to RCC. According to ROC analysis, the cut off value of ACE and PCE was 13.9 and 0.16, respectively. ACE> 13.9 and PCE > 0.16 indicated worse CSS (P = 0.006 and P = 0.047, respectively). However, in multivariate Cox regression analysis of several related factors, perinephric tissues invasion (P = 0.001), sarcomatoid differentiation (P = 0.001) and ACE> 13.9 (P = 0.002) were significant prognostic factors for CSS. PCE > 0.16 seemed to be not (P = 0.055). CONCLUSION: We explored several clinicopathological risk factors of predicting renal function change and their relationship with prognosis of RCC patients with tumor thrombus after nephrectomy and thrombectomy. The renal function change, which was associated with preoperative eGFR and pathological type, was prognostic risk factor for CSS and ACE> 13.9 indicated the worse prognosis.


Assuntos
Carcinoma de Células Renais/fisiopatologia , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/fisiopatologia , Neoplasias Renais/cirurgia , Trombose/cirurgia , Idoso , Carcinoma de Células Renais/patologia , China , Feminino , Taxa de Filtração Glomerular , Humanos , Testes de Função Renal , Neoplasias Renais/patologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nefrectomia , Período Perioperatório , Prognóstico , Análise de Regressão , Estudos Retrospectivos , Análise de Sobrevida , Trombectomia , Trombose/fisiopatologia
15.
Mol Metab ; 30: 250-263, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31767176

RESUMO

BACKGROUND: Globally, diabetic kidney disease (DKD) is the leading cause of end-stage renal disease. As the most common microvascular complication of diabetes, DKD is a thorny, clinical problem in terms of its diagnosis and management. Intensive glucose control in DKD could slow down but not significantly halt disease progression. Revisiting the tremendous advances that have occurred in the field would enhance recognition of DKD pathogenesis as well as improve our understanding of translational science in DKD in this new era. SCOPE OF REVIEW: In this review, we summarize advances in the understanding of the local microenvironmental changes in diabetic kidneys and discuss the involvement of genetic and epigenetic factors in the pathogenesis of DKD. We also review DKD prevalence changes and analyze the challenges in optimizing the diagnostic approaches and management strategies for DKD in the clinic. As we enter the era of 'big data', we also explore the possibility of linking systems biology with translational medicine in DKD in the current healthcare system. MAJOR CONCLUSION: Newer understanding of the structural changes of diabetic kidneys and mechanisms of DKD pathogenesis, as well as emergent research technologies will shed light on new methods of dealing with the existing clinical challenges of DKD.


Assuntos
Nefropatias Diabéticas/genética , Nefropatias Diabéticas/metabolismo , Nefropatias Diabéticas/fisiopatologia , Complicações do Diabetes/metabolismo , Diabetes Mellitus/metabolismo , Epigenômica/métodos , Genética , Humanos , Rim/metabolismo , Rim/patologia , Biologia de Sistemas/métodos
16.
ACS Appl Mater Interfaces ; 11(42): 39088-39099, 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31566951

RESUMO

To date, various electronic devices have been strategically fabricated, and simultaneous realization of high electrical conductivity, sensing property, and heat-conducting property by a simple, efficient, and accurate approach is significant but still challenging. Here, cellulosic fiber supported 3D interconnected silver nanowire (AgNW) networks with hierarchical structures are rationally designed to achieve excellent electrical conductivity and superior thermal dispersion capability. In particular, thermal annealing at the junctions enables both phonon and electron transfer as well as impedes interfacial slippage. In the current study, the AgNW/cellulosic paper with the low Ag content (1.55 wt %) exhibits a low sheet resistance of 0.51 Ω sq-1. More importantly, the AgNW/cellulosic paper-based flexible strain sensor has been reasonably developed, which can be applied to monitor various microstructural changes and human motions with high sensitivity and robust stability (fast response/relaxation time of ∼100 ms and high stability >2000 bending-stretching cycles). The AgNW/cellulosic paper-based device also displays efficient thermal dispersion property, which offers exciting opportunities for thermal management application. Furthermore, the obtained hybrid paper exhibits superior heat dispersion capacity for thermal management devices. Overall, uniform dispersion and 3D interconnected junctions of AgNW among the fibers inside the cellulosic papers lead to the combination of high mechanical strength, highly efficient electrical conductivity, and ultrahigh heat dispersion property. The AgNW/cellulosic paper has promising potentials in the flexible and wearable sensing elements, thermal management materials, and artificial intelligence devices.

17.
Medicine (Baltimore) ; 98(37): e17172, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517871

RESUMO

The aim of the study was to report the experience and outcomes of Xp11.2 translocation renal cell carcinoma (tRCC) patients with tumor thrombus undergoing radical nephrectomy and thrombectomy.Between January 2017 and December 2017, 66 consecutive patients with RCC and venous thrombus involvement received surgical treatment at Peking University Third Hospital. Of which, 5 patients were confirmed of Xp11.2 tRCC, 61 patients were diagnosed of non-tRCC subtypes including 45 ccRCCs, 10 pRCCs, and 6 other subtypes. Demographic, clinical, operation, pathological and follow-up data were extracted for analysis. Prognostic factors were identified by Cox regression analysis.All the patients received radical nephrectomy and thrombectomy successfully. During a median follow-up of 18 months, 5 patients in non-tRCC group and 1 patient in tRCC group died of disease progression. Survival analysis revealed that Xp11.2 tRCC patients experienced shorter DFS than non-tRCC patients, however, there is no significant difference in OS between two groups. Xp11.2 tRCC histological subtype and presence of metastasis at diagnosis were identified as independent negative factors of DFS by multivariate analysis.Radical nephrectomy with thrombectomy provides an acceptable efficacy for tRCC patients with tumor thrombus extending into the venous system. In addition, multimodality treatment should be considered for advanced Xp11.2 RCCs as this subtype was a negative prognostic factor of DFS.


Assuntos
Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/cirurgia , Neoplasias Renais/complicações , Neoplasias Renais/cirurgia , Trombose Venosa/complicações , Trombose Venosa/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/genética , Carcinoma de Células Renais/mortalidade , Feminino , Seguimentos , Humanos , Neoplasias Renais/genética , Neoplasias Renais/mortalidade , Masculino , Pessoa de Meia-Idade , Nefrectomia , Análise de Sobrevida , Trombectomia , Trombose Venosa/mortalidade , Adulto Jovem
18.
Water Sci Technol ; 79(12): 2345-2356, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31411589

RESUMO

Heterogeneous Fenton oxidation has become a very important wastewater-treatment method and its catalyst is crucial for good treatment effect. In order to improve the catalytic properties, the Cu and Mn elements were doped for CuxMnxFe3-2xO4/multi-walled carbon nanotubes (CuxMnxFe3-2xO4/MWCNTs) nanocomposites (0 ≤ x ≤ 0.1) by co-precipitation method. The structure, morphology and surface properties of the nanocomposites were characterized by X-ray powder diffractometer (XRD), N2-physisorption analysis, transmission electron microscope (TEM), and X-ray photoelectron spectroscopy (XPS). The CuxMnxFe3-2xO4/MWCNTs nanocomposites were used as heterogeneous Fenton catalysts for p-nitrophenol (p-NP) degradation. The catalytic performances of the Cu and/or Mn doped nanocomposites have remarkable improvement compared with Fe3O4/MWCNTs nanocomposite, especially for both Cu and Mn doped catalyst. For CuxMnxFe3-2xO4/MWCNTs nanocomposites, the catalytic performance increases with increasing x value and reaches a maximum at 0.075 of x value. At optimal condition, the p-NP conversion rate reaches 96.4% in 10 min for Cu0.075Mn0.075Fe2.85O4/MWCNTs nanocomposite. However, the mentioned rate for Fe3O4/MWCNTs catalyst is only 14.5%. The chemical oxygen demand (COD) removal rates in 120 min for Cu0.075Mn0.075Fe2.85O4/MWCNTs and Fe3O4/MWCNTs catalysts are 82.7% and 67.3%, respectively. Furthermore, the p-NP conversion and COD removal rates of Cu0.075Mn0.075Fe2.85O4/MWCNTs nanocomposite still keep at 94.4% and 70.3% after five-time reuse, respectively. This catalyst shows good reusability for p-NP degradation and is very easy to recover from the treated water.


Assuntos
Nanocompostos , Nanotubos de Carbono , Catálise , Peróxido de Hidrogênio , Nitrofenóis
19.
Phys Rev Lett ; 122(23): 233901, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31298910

RESUMO

We demonstrate single-photon superradiance from artificially constructed nonbonded zinc-phthalocyanine molecular chains of up to 12 molecules. We excite the system via electron tunneling in a plasmonic nanocavity and quantitatively investigate the interaction of the localized plasmon with single-exciton superradiant states resulting from dipole-dipole coupling. Dumbbell-like patterns obtained by subnanometer resolved spectroscopic imaging disclose the coherent nature of the coupling associated with superradiant states while second-order photon correlation measurements demonstrate single-photon emission. The combination of spatially resolved spectral measurements with theoretical considerations reveals that nanocavity plasmons dramatically modify the linewidth and intensity of emission from the molecular chains, but they do not dictate the intrinsic coherence of the superradiant states. Our studies shed light on the optical properties of molecular collective states and their interaction with nanoscopically localized plasmons.

20.
Chin Med J (Engl) ; 132(15): 1780-1787, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31306232

RESUMO

BACKGROUND: Radical nephrectomy with thrombectomy is one of the most difficult and complicated urological operations. But the roles of renal tumor volume and thrombus level in surgical complexity and prognostic outcome are not clear. This study aimed to evaluate the surgical complexity and prognostic outcome between the volume of renal cell carcinoma (RCC) and the level of venous tumor thrombus. METHODS: The clinical data of 67 RCC cases with renal vein or inferior vena cava (IVC) tumor thrombus from January 2015 to May 2018 were retrospectively analyzed. Among these 67 cases, 21 (31.3%) were small tumors with high-level thrombus (tumor ≤7 cm in diameter and thrombus Neves Level II-IV), while 46 (68.7%) were large tumors with low-level thrombus group (tumor >7 cm in diameter and thrombus Level 0-I). Clinical features, operation details, and pathology data were collected. Univariable and multivariable logistic regression analyses were applied to evaluate the risk factors for small tumor with high-level thrombus. RESULTS: Patients with small tumors and high-level thrombus were more likely to have longer operative time (421.9 ±â€Š135.1 min vs. 282.2 ±â€Š101.9 min, t = 4.685, P < 0.001), more surgical bleeding volume (1200 [325, 2900] mL vs. 500 [180, 1000] mL, U = 270.000, P = 0.004), more surgical blood transfusion volume (800 [0, 1400] mL vs. 0 [0, 800] mL, U = 287.500, P = 0.004), more plasma transfusion volume (0 [0, 800] mL vs. 0 [0, 0] mL, U = 319.000, P = 0.004), higher percentage of open operative approach (76.2% vs. 32.6%, χ = 11.015, P = 0.001), higher percentage of IVC resection (33.3% vs. 0%, χ = 17.122, P < 0.001), and higher percentage of post-operative complications (52.4% vs. 19.6%, χ = 7.415, P = 0.010) than patients with large tumors and low-level thrombus. In multivariate analysis, decreased hemoglobin (Hb) (odds ratio [OR]: 0.956, 95% confidence interval [CI]: 0.926-0.986, P = 0.005) and non-sarcomatoid differentiation (OR: 0.050, 95% CI: 0.004-0.664, P = 0.023) were more likely to form small tumors with high-level tumor thrombus rather than large tumor with small tumor thrombus. The estimated mean cancer-specific survival times of small tumor with high-level thrombus and large tumor with low-level thrombus were 31.6 ±â€Š3.8 months and 32.5 ±â€Š2.9 months, without statistical significance (P = 0.955). After univariate and multivariate Cox proportional hazard survival regression analyses, only distant metastasis (hazard ratio [HR]: 3.839, P = 0.002), sarcomatoid differentiation (HR: 7.923, P < 0.001), alkaline phosphatase (HR: 2.661, P = 0.025), and severe post-operative complications (HR: 10.326, P = 0.001) were independent predictors of prognosis. CONCLUSIONS: The level of the tumor thrombus was more important than the diameter of the primary kidney tumor in affecting the complexity of surgery. In the same T3 stage, neither the renal tumor diameter nor the tumor thrombus level was an independent risk factor for prognosis.


Assuntos
Carcinoma de Células Renais/patologia , Carcinoma de Células Renais/cirurgia , Trombose/patologia , Trombose/cirurgia , Idoso , Feminino , Humanos , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA