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1.
BMC Cancer ; 22(1): 335, 2022 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-35346114

RESUMO

OBJECTIVE: The purpose of this study was to explore the efficacy and safety of transarterial chemoembolization (TACE) combined with apatinib and camrelizumab (TACE + AC) for unresectable hepatocellular carcinoma (HCC), and the impact of the timing of the combination on it. METHODS: In this single-arm retrospective study, consecutive data of patients with unresectable HCC treated to our hospital from March 2017 to September 2021 were collected. These patients were treated with TACE and started on camrelizumab and apatinib within one week of TACE. Camrelizumab 200 mg intravenously once every three weeks and apatinib 250 mg orally once daily. Repeat TACE treatment was available on an on-demand basis. The primary endpoints were overall survival (OS) and progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), and safety. The univariate and multivariate Cox regression analyses were used to assess the effect of early and late combination on OS and PFS. RESULTS: A total of 80 patients were enrolled in this study. The median OS was 22.1 months (95% confidence interval [CI]: 13.8-30.5 months) and the median PFS was 15.7 months (95% CI: 14.7-16.6 months). The ORR was 58.8% (95% CI: 47.2-69.6) and DCR reached 81.2% (95% CI: 71.0-89.1). Multivariable Cox proportional hazard regression analyses showed that TACE late combined with apatinib and camrelizumab provided better OS than early combination (HR = 0.175, 95% CI:0.060-0.509, P = 0.001), as did PFS (HR = 0.422, 95% CI:0.184-0.967, P = 0.041). All treatment-related adverse events were tolerable, and no serious adverse events were observed. CONCLUSION: TACE combined with apatinib plus camrelizumab for patients with unresectable HCC has promising antitumor activity and a manageable safety profile. For unresectable HCC with large tumor burden, late combination provides better OS and PFS compared to early combination.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Anticorpos Monoclonais Humanizados , Carcinoma Hepatocelular/tratamento farmacológico , Quimioembolização Terapêutica/efeitos adversos , Terapia Combinada , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Piridinas , Estudos Retrospectivos
2.
Int J Mol Sci ; 23(21)2022 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-36362395

RESUMO

Tanshinones are the bioactive constituents of Danshen (Salvia miltiorrhiza Bunge), which is used in Traditional Chinese Medicine to treat cardiovascular and other diseases, and they synthesize and accumulate in the root periderm of S. miltiorrhiza. However, there is no relevant report on the initial stage of tanshinone synthesis, as well as the root structure and gene expression characteristics. The present study aims to provide new insights into how these bioactive principles begin to synthesize by characterizing possible differences in their biosynthesis and accumulation during early root development from both spatial and temporal aspects. The morphological characteristics and the content of tanshinones in roots of S. miltiorrhiza were investigated in detail by monitoring the seedlings within 65 days after germination (DAGs). The ONT transcriptome sequencing was applied to investigate gene expression patterns. The periderm of the S. miltiorrhiza storage taproot initially synthesized tanshinone on about 30 DAGs. Three critical stages of tanshinone synthesis were preliminarily determined: preparation, the initial synthesis, and the continuous rapid synthesis. The difference of taproots in the first two stages was the smallest, and the differentially expressed genes (DEGs) were mainly enriched in terpene synthesis. Most genes involved in tanshinone synthesis were up regulated during the gradual formation of the red taproot. Plant hormone signal transduction and ABC transport pathways were widely involved in S. miltiorrhiza taproot development. Five candidate genes that may participate in or regulate tanshinone synthesis were screened according to the co-expression pattern. Moreover, photosynthetic ferredoxin (FD), cytochrome P450 reductase (CPR), and CCAAT binding transcription factor (CBF) were predicted to interact with the known downstream essential enzyme genes directly. The above results provide a necessary basis for analyzing the initial synthesis and regulation mechanism of Tanshinones.


Assuntos
Salvia miltiorrhiza , Salvia miltiorrhiza/genética , Salvia miltiorrhiza/metabolismo , Regulação da Expressão Gênica de Plantas , Raízes de Plantas , Abietanos , Proteínas de Plantas/metabolismo
3.
Medicine (Baltimore) ; 101(46): e31668, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401440

RESUMO

Erectile dysfunction (ED) is a male disease, which is easy to cause disharmony in sexual life. However, at present, there are few drugs with small side effects in clinic. Jin Gui Shen Qi Pill (JGSQP) is a traditional Chinese medicine compound with obvious clinical effect in treating ED. Therefore, it is imperative to explore clinical drugs based on inhibiting the pathological characteristics of ED. First, the active ingredients and action targets in JGSQP were screened by applying Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SWISS Target Prediction. Further, a systematic pharmacological analysis platform for traditional Chinese medicine, and the ED targets were screened by applying Gene Cards and Online Mendelian Inheritance in Man databases to construct drug active ingredient-target-disease mapping, followed by gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and protein-protein interaction (PPI) network analysis. Finally, Molecular docking and molecular dynamics simulations were used to screen the active ingredients of JGSQP acting on PDE-5, and analyze the ligand-receptor interaction relationship and binding free energy. The results showed that there were 212 potential targets of JGSQP for ED disease, and GO analysis revealed that the main pathways were positive regulation of DNA-binding transcription factor activity, regulation of vascular diameter, and negative regulation of vascular diameter, etc. KEGG analysis revealed that the main pathways were HIF-1 signaling pathway, prolactin signaling pathway, fluid shear stress, and atherosclerosis, etc. PPI network analysis revealed that the core targets TGFB1 and EGFR have important roles. Molecular docking and molecular dynamics simulations showed that the main components acting on PDE-5 were MOL000546, MOL011169, MOL000279, MOL000273 and Sildenafil. MOL000546 was able to bind stably to PDE-5. The multi-component, multi-target, and multi-pathway action characteristics of JGSQP were confirmed by network pharmacology, which predicted the possible mechanism of action of JGSQP in the treatment of ED and provided a theoretical reference for further experimental validation.


Assuntos
Medicamentos de Ervas Chinesas , Disfunção Erétil , Humanos , Masculino , Biologia Computacional/métodos , Simulação de Acoplamento Molecular , Disfunção Erétil/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/química , Medicina Tradicional Chinesa
4.
Opt Express ; 30(17): 31396-31406, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-36242222

RESUMO

Femtosecond lasers have been widely employed in scientific and industrial applications, including the study of material properties, fabrication of structures on the sub-micrometer scale, surgical and medical treatment, etc. In these applications, the ultrafast laser is implemented either in free space or via an optical fiber-based channel. To investigate the light-matter interaction on a chip-based dimension, laser pulses with extremely high peak power need to be injected into an integrated optical waveguide. This requires the waveguide to be transparent and linear at this power, but also capable of providing a highly efficient and reliable interface for fiber-chip coupling. Contrary to the common belief that polymer materials may suffer from stability issues, we show that a polymer waveguide fabricated under simple and low-cost technology using only commercial materials can indeed transmit femtosecond laser pulses with similar characteristics as low-power continuous-wave laser. The coupling efficiency with a lensed fiber is ∼76% per facet. The pulse broadening effect in the polymer waveguide is also well fitted by the material and waveguide dispersion without nonlinear behavior. This study paves the way for developing a low-cost, highly efficient, polymer-based waveguide platform for the investigation of ultrafast phenomena on a chip.

5.
Opt Express ; 30(10): 17529-17540, 2022 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-36221573

RESUMO

Laser transmission induced transparency (LTIT) has been observed in a polymer waveguide using commercial perfluorinated acrylate-based materials when a continuous-wave laser at 635 nm is injected. The transmitted optical power increases continuously and follows a non-linear curve with respect to the laser injection time. Loss reduction over 13 dB is observed within 60 min at a moderate laser power of 5 mW. While higher injection power leads to a quicker change of the waveguide transparency, this loss reduction tends to saturate at a level irrelevant to the injection power. Further experiments demonstrate that a laser injection at 635 nm can also slightly improve the transparency at near-infrared wavelengths from 1500 nm to 1600 nm which is also the target wavelength range for this material. The state after a certain laser injection dose of 635 nm proves to be stable and the transmission characteristics of the polymer waveguide can be maintained and will continue after being stored at room temperature over a long period of time. By baking the waveguide at 200 °C for 20 min, the transparency property can be reset and the waveguide will return to the original high-loss state of 635 nm. These unique properties can be attributed to the photo-induced generation and thermally induced recombination of free radicals in the organic material. Our discovery may trigger interesting applications of polymer waveguides in the development of optical memory, clock, and encryption devices, beyond their target applications in optical communication.

6.
Cell Death Discov ; 8(1): 411, 2022 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-36202781

RESUMO

Transcatheter arterial chemoembolization (TACE) has become the preferred therapy for unresectable advanced hepatocellular carcinoma (HCC). However, the embolization of tumor-feeding arteries by TACE always leads to hypoxia-related tumor angiogenesis, which limited the therapeutic effect for HCC. In this paper, we used a VEGFR targeting peptide VEGF125 - 136 (QKRKRKKSRYKS) to conjugate with a lytic peptide (KLUKLUKKLUKLUK) to form a peptide-drug conjugate (PDC). We used cell affinity assay to detect the peptide binding ability to VEGFR highly expressed cell lines, and CCK8, cell apoptosis to confirm the cellular toxicity for different cell lines. Meanwhile, we created a VX2 tumor-bearing rabbit model to assess the in vivo anti-tumor effect of the peptide conjugate in combination with TAE. HE staining was used to verify the in vivo safety of the peptide conjugate. IHC was used to assess the anti-angiogenesis and cell toxicity of the peptide conjugate in tumor tissues. The peptide conjugate could not only target VEGFR in cell surface and inhibit VEGFR function, but also have potent anti-cancer effect. We luckily found the peptide conjugate showed potent cytotoxicity for liver cancer cell Huh7 (IC50 7.3 ± 0.74 µM) and endothelial cell HUVEC (IC50 10.7 ± 0.292 µM) and induced cell apoptosis of these two cell lines. We also found the peptide conjugate inhibited cell migration of HUVEC through wound healing assay. Besides, these peptides also showed better in vivo anti-tumor effect than traditional drug DOX through TACE in VX2 rabbit tumor model, and efficiently inhibit angiogenesis in tumor tissues with good safety. In conclusion, our work may provide an alternative option for clinical HCC therapy via TACE combination.

7.
Int J Infect Dis ; 124: 212-223, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36241168

RESUMO

OBJECTIVES: Available data show that COVID-19 vaccines may be less effective in people living with HIV (PLWH) who are at increased risk for severe COVID-19. This meta-analysis aimed to compare the immunogenicity and efficacy of COVID-19 vaccines in PLWH with healthy individuals. METHODS: Pubmed/Medline, EMBASE, and the Cochrane Library were searched. Risk ratios of seroconversion were separately pooled using random-effects meta-analysis, and a systematic review without meta-analysis of SARS-CoV-2 antibody titer levels was performed after the first and second doses of a COVID-19 vaccine. RESULTS: A total of 22 studies with 6522 subjects met the inclusion criteria. After the first vaccine dose, seroconversion in PLWH was comparable to that in healthy individuals. After a second dose, seroconversion was slightly lower in PLWH compared with healthy controls, and antibody titers did not seem to be significantly affected or reduced among participants of both groups. CONCLUSION: COVID-19 vaccines show favorable immunogenicity and efficacy in PLWH. A second dose is associated with consistently improved seroconversion, although it is slightly lower in PLWH than in healthy individuals. Additional strategies, such as a booster vaccination with messenger RNA COVID-19 vaccines, might improve seroprotection for these patients.


Assuntos
COVID-19 , Infecções por HIV , Humanos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , SARS-CoV-2 , Soroconversão , Anticorpos Antivirais , Vacinação
8.
Nature ; 611(7936): 485-490, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36224388

RESUMO

Lithium-ion batteries with nickel-rich layered oxide cathodes and graphite anodes have reached specific energies of 250-300 Wh kg-1 (refs. 1,2), and it is now possible to build a 90 kWh electric vehicle (EV) pack with a 300-mile cruise range. Unfortunately, using such massive batteries to alleviate range anxiety is ineffective for mainstream EV adoption owing to the limited raw resource supply and prohibitively high cost. Ten-minute fast charging enables downsizing of EV batteries for both affordability and sustainability, without causing range anxiety. However, fast charging of energy-dense batteries (more than 250 Wh kg-1 or higher than 4 mAh cm-2) remains a great challenge3,4. Here we combine a material-agnostic approach based on asymmetric temperature modulation with a thermally stable dual-salt electrolyte to achieve charging of a 265 Wh kg-1 battery to 75% (or 70%) state of charge in 12 (or 11) minutes for more than 900 (or 2,000) cycles. This is equivalent to a half million mile range in which every charge is a fast charge. Further, we build a digital twin of such a battery pack to assess its cooling and safety and demonstrate that thermally modulated 4C charging only requires air convection. This offers a compact and intrinsically safe route to cell-to-pack development. The rapid thermal modulation method to yield highly active electrochemical interfaces only during fast charging has important potential to realize both stability and fast charging of next-generation materials, including anodes like silicon and lithium metal.

9.
Acta Biomater ; 2022 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-36241014

RESUMO

Transcatheter arterial chemoembolization (TACE) is extensively used in the treatment of hepatocellular carcinoma (HCC), but its efficacy is usually limited to secondary tumor hypoxia and other progressive exacerbation of the abnormal tumor microenvironment (TME). Herein, we synthesized polyvinyl pyrrolidone (PVP)-coated CaO2 nanoparticles (CaO2 NPs) and applied them as a synergistic agent to improve the antitumor efficacy of TACE. After injection into the tumor, CaO2 NPs reacted with water to generate abundant oxygen, hydroxyl ions (OH-), and calcium ions (Ca2+), thereby relieving tumor hypoxia, neutralizing acid, and overloading Ca2+ to mediate antitumor effects. Moreover, the effect of chemotherapeutic drugs within the TACE was improved due to the modulated TME. CaO2 NPs efficiently regulated the TME and improved the antitumor effect of doxorubicin under hypoxia conditions in vitro. Compared to other groups, the TACE+CaO2 NPs group achieved the lowest tumor growth rate, highest tumor necrosis rate, lowest expression of histological markers associated with hypoxia and angiogenesis (HIF-α, VEGF, and CD31), and highest CD8+ T cell recruitment in vivo. Thus, these findings demonstrated that CaO2 NPs provide synergy for TACE therapy in the VX2 orthotopic rabbit liver cancer model, suggesting that they have a potential broad clinical application. STATEMENT OF SIGNIFICANCE: The efficacy of transcatheter arterial chemoembolization (TACE) for treatment of hepatocellular carcinoma is usually limited to secondary tumor hypoxia and other progressive exacerbation of the abnormal tumor microenvironment (TME). To address this issue, we synthesized CaO2 nanoparticles (CaO2 NPS) which would react with water to generate abundant oxygen, hydroxyl ions (OH-), and calcium ions (Ca2+), thereby relieving tumor hypoxia, neutralizing the acidic TME, and inducing Ca2+ overloading. The efficacy of CaO2 NPs in combination with TACE was investigated in an orthotopic rabbit liver cancer model, and the results showed the great synergetic antitumor effect of TACE and CaO2 NPs.

10.
Phys Chem Chem Phys ; 24(41): 25420-25425, 2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36250547

RESUMO

The exploration of mandrel materials with superior degradation performance to the traditionally adopted hydrocarbon polymer of poly-α-methylstyrene (PAMS), has always been an important pursuit for fabricating high-quality inertial confinement fusion (ICF) targets. Here, we propose a method to enhance the degradation performance of mandrel material based on side-chain engineering. A series of hydrocarbon cyclic functional groups, including cyclopentane, cyclopentadiene, naphthalene and azulene, are used to replace the benzene ring on the side chain of PAMS to form new polymer structures. The results show that the degradation performance of structures can be largely regulated by different side chains. In particular, one of the naphthalene-substituted structures has similar properties to PAMS, but the required degradation condition is lower. Furthermore, the reaction rate calculations indicate that this structure is expected to be synthesized experimentally. This work provides a direction for side-chain engineering for research into the key technology of ICF target fabrication in the future.

11.
Eur J Gastroenterol Hepatol ; 34(10): 1090-1097, 2022 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-36062499

RESUMO

BACKGROUND AND AIM: The aim of this study was to evaluate the efficacy and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of portal hypertension caused by schistosomiasis. METHODS: This study included 43 patients with schistosomiasis-induced portal hypertension treated with TIPS in our institution from December 2015 to May 2021. The demographic, imaging, clinical and follow-up data of patients were recorded retrospectively to evaluate the efficacy and safety of the procedure. RESULTS: All patients were successfully implanted with stents to establish shunt, and 90.7% of the patients were in good postoperative condition with no complications. After TIPS, the Yerdel grade of portal vein thrombosis decreased, and the portal pressure gradient decreased from 27.0 ± 4.9 mmHg to 11.3 ± 3.8 mmHg (P < 0.001). Bleeding was effectively controlled, with a postoperative rebleeding rate of 9.3%, which was an 87.9% reduction from the preoperative rate. The cumulative incidence of postoperative refractory ascites, shunt dysfunction, overt hepatic encephalopathy (OHE) and death were all similar to those of TIPS for nonschistosomiasis portal hypertension. There were no differences in liver and kidney function and blood coagulation indexes before and 3 months after TIPS. Albumin was identified as an independent risk factor for mortality after TIPS for schistosomal liver fibrosis. CONCLUSION: TIPS can be used as a well-tolerated and effective treatment for schistosomiasis-induced portal hypertension, effectively reduce portal pressure gradient and improve portal vein thrombosis.


Assuntos
Varizes Esofágicas e Gástricas , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Esquistossomose , Trombose Venosa , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/cirurgia , Hemorragia Gastrointestinal/etiologia , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Estudos Retrospectivos , Esquistossomose/complicações , Esquistossomose/diagnóstico , Esquistossomose/cirurgia , Resultado do Tratamento , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia , Trombose Venosa/cirurgia
12.
Hum Vaccin Immunother ; : 2119763, 2022 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-36161976

RESUMO

Patients with solid cancer have an increased risk of severe coronavirus disease 2019 (COVID-19) and associated mortality than the general population. This meta-analysis aimed to investigate the currently available evidence about the efficacy of COVID-19 vaccines in patients with solid cancer. We included prospective studies comparing the immunogenicity and efficacy of COVID-19 vaccines between patients with solid cancer and healthy individuals. Relative risks of seroconversion after the first and second dose of a COVID-19 vaccine were separately pooled with the use of random effects meta-analysis. Thirty studies with 11,245 subjects met the inclusion criteria. After first vaccine dose, the pooled RR of seroconversion in patients with solid cancer vs healthy individuals was 0.54 (95% CI 0.38-0.78, I2 = 94%). After a second dose, the pooled RR of seroconversion in patients with solid cancer vs healthy controls was 0.87 (0.86-0.88, I2 = 87%). Our review suggests that, compared with healthy individuals, COVID-19 vaccines show favorable immunogenicity and efficacy in patients with solid cancer. A second dose is associated with significantly improved seroconversion, although it is slightly lower in patients with solid cancer compared with healthy individuals.

13.
Eur J Med Res ; 27(1): 190, 2022 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-36175983

RESUMO

PURPOSE: A large number of people with Crohn's disease (CD) fail to recover from conventional therapy or biological therapy. Some studies showed that adalimumab (ADA) may be an effective alternative therapy for these patients. The aim of this study was to evaluate the efficacy and safety of ADA in inducing CD remission. METHODS: We performed search of Pubmed/MEDLINE, Embase, CENTRAL, the Cochrane IBD Group Specialized Register, and several other databases. Randomized controlled trials (RCTs) comparing any dose of ADA with controls (placebo or active) in participants with active CD were included. The primary outcome was the failure to achieve clinical response/remission at 4 weeks. Several subgroup and sensitivity analyses were performed. Review Manager Software v5.3 was used. RESULTS: Four RCTs were included (n = 919), in which 553 participants received ADA and 366 participants received placebo. A meta-analysis of four studies showed that at 4 weeks, there were more people in the ADA group with clinical response/remission or symptom improvement compared with the placebo group. The rates of side effects, serious side effects, and study withdrawals due to side effects were lower in ADA participants than placebo ones. CONCLUSION: This meta-analysis shows that ADA is superior to placebo in induction of clinical response/remission of CD patients, but no firm conclusions can be drawn on the safety of ADA in CD due to the low number of events.


Assuntos
Doença de Crohn , Adalimumab/uso terapêutico , Doença de Crohn/tratamento farmacológico , Humanos , Indução de Remissão
14.
Phys Rev Lett ; 129(5): 050503, 2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35960556

RESUMO

Quantum internet gives the promise of getting all quantum resources connected, and it will enable applications far beyond a localized scenario. A prototype is a network of quantum memories that are entangled and well separated. In this Letter, we report the establishment of postselected entanglement between two atomic quantum memories physically separated by 12.5 km directly. We create atom-photon entanglement in one node and send the photon to a second node for storage via electromagnetically induced transparency. We harness low-loss transmission through a field-deployed fiber of 20.5 km by making use of frequency down-conversion and up-conversion. The final memory-memory entanglement is verified to have a fidelity of 90% via retrieving to photons. Our experiment makes a significant step forward toward the realization of a practical metropolitan-scale quantum network.

15.
Adv Mater ; 34(38): e2205677, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35924314

RESUMO

The lithium (Li)-metal anode offers a promising solution for high-energy-density lithium-metal batteries (LMBs). However, the significant volume expansion of the Li metal during charging results in poor cycling stability as a result of the dendritic deposition and broken solid electrolyte interphase. Herein, a facile one-step roll-to-roll fabrication of a zero-volume-expansion Li-metal-composite anode (zeroVE-Li) is proposed to realize high-energy-density LMBs with outstanding electrochemical and mechanical stability. The zeroVE-Li possesses a sandwich-like trilayer structure, which consists of an upper electron-insulating layer and a bottom lithiophilic layer that synergistically guides the Li deposition from the bottom up, and a middle porous layer that eliminates volume expansion. This sandwich structure eliminates dendrite formation, prevents volume change during cycling, and provides outstanding flexibility to the Li-metal anode even at a practical areal capacity over 3.0 mAh cm-2 . Pairing zeroVE-Li with a commercial NMC811 or LCO cathode, flexible LMBs that offer a record-breaking figure of merit (FOM, 45.6), large whole-cell energy density (375 Wh L-1 , based on the volume of the anode, separator, cathode, and package), high-capacity retention (> 99.8% per cycle), and remarkable mechanical robustness under practical conditions are demonstrated.

16.
Artigo em Inglês | MEDLINE | ID: mdl-35845574

RESUMO

Objective: The study aimed to assess the clinical efficacy of Huangkui capsule plus methylprednisolone in the treatment of nephropathy and the effect on urinary protein and serum inflammatory factors in patients. Methods: Between June 2017 and July 2020, 90 patients with nephropathy admitted to our hospital were recruited after assessment of eligibility and assigned via the random number table method (1 : 1) to receive either methylprednisolone tablets (observation group) or methylprednisolone tablets plus Huangkui capsules (experimental group). All eligible patients were also given dipyridamole and valsartan. Outcome measures included clinical efficacy, urine protein, hematuria, serum inflammatory factor levels, and adverse reactions. Results: A higher clinical efficacy was observed in the experimental group versus the observation group (P < 0.05). Huangkui capsules resulted in significantly lower levels of urine protein and hematuria in the experimental group versus the observation group after treatment (P < 0.05). The serum tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and monocyte chemoattractant protein-1 (MCP-1) levels in the experimental group were significantly lower than those in the observation group after treatment (P < 0.05). Huangkui capsules plus methylprednisolone were associated with a lower incidence of adverse events versus methylprednisolone (P < 0.05). Conclusion: The clinical efficacy of Huangkui capsule plus methylprednisolone in the treatment of patients with nephropathy is remarkable. It can effectively mitigate the inflammatory responses and enhance renal function, with reliable clinical safety, so it is worthy of clinical application.

17.
BMC Gastroenterol ; 22(1): 363, 2022 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-35906529

RESUMO

BACKGROUND: Targeted puncture of an appropriate portal venous branch during transjugular intrahepatic portosystemic shunt (TIPS) procedure may reduce the risk of postprocedural overt hepatic encephalopathy (HE). This study aimed to describe blood distribution under portography and combined it with puncture site to determine portal flow diversion, and to evaluate its prognostic value in predicting post-TIPS overt HE. METHODS: In this retrospective analysis of patients with cirrhosis undergoing TIPS, we included 252 patients to describe blood distribution under portography and 243 patients to assess the association between portal flow diversion and post-TIPS overt HE. RESULTS: At the first stage, 51 (20.2%) patients were identified as type A (unilateral type with the right portal branch receives blood from splenic vein [SV]), 16 (6.4%) as type B (unilateral type with the right branch receives blood from superior mesenteric vein [SMV]) and 185 (73.4%) as type C (fully mixed type). At the second stage, 40 patients were divided into the SV group, 25 into the SMV group and 178 into the mixed group. Compared with the mixed group, the risk of post-TIPS overt HE was significantly higher in the SMV group (adjusted HR 3.70 [95% CI 2.01-6.80]; p < 0.001), whereas the SV group showed a non-significantly decreased risk (adjusted HR 0.57 [95% CI 0.22-1.48]; p = 0.25). Additionally, the SMV group showed a substantial increase in ammonia level at 3 days and 1 month after procedure. CONCLUSIONS: Our results support the clinical use of portal flow diversion for risk stratification and decision-making in the management of post-TIPS overt HE.

18.
Abdom Radiol (NY) ; 47(10): 3615-3627, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35821274

RESUMO

PURPOSE: This study aimed to investigate whether underdilated transjugular intrahepatic portosystemic shunt (TIPS) could reduce the risk of hepatic encephalopathy (HE) and ameliorate impaired hepatic function in patients with a history of splenectomy. METHODS: A retrospective case-control study was conducted with 96 patients who had prior splenectomy and TIPS placement from August 2016 to May 2022. All patients were divided into two groups based on the diameter of expansion balloon catheters, the underdilated group (6-mm balloon catheter, n = 60) and a control group (8-mm balloon catheter, n = 36). Following the 1:1 propensity score matching (PSM), 33 patients in the underdilated group and 33 patients in the control group were included. RESULTS: During a median follow-up of 36 months, a quicker recovery in liver function after TIPS placement was showed in the underdilated group. The mean TBIL content (16.562 ± 6.549 µmol/L vs 23.871 ± 11.609 µmol/L, P = 0.019) and the mean CLIF-C AD score (41.108 ± 5.223 vs 45.100 ± 4.429, P = 0.033) in the underdilated group were significantly lower than those in the control group during 6 to 12 months after the procedure. In line with the control group, the ability to reduce portal pressure gradient (PPG) and achieve a significantly clinical remission of PVT and ascites severity was showed in the underdilated group 3 months after TIPS creation (P < 0.001). The Kaplan-Meier analysis demonstrated that no statistically significant differences were found in the cumulative incidence of no overt HE (OHE) (log-rank P = 0.383), cumulative incidence without shunt dysfunction (log-rank P = 0.283), cumulative incidence of no variceal rebleeding (log-rank P = 0.696), and survival (log-rank P = 0.341) (log-rank P = 0.341) between the two groups during the follow-up period. CONCLUSION: For patients with prior splenectomy, it is safe to employ underdilated TIPS, as the stents will eventually self-expand to 8 mm. The present study has shown some degree of liver function preservation in the underdilated group, which may be related to slower progressive changes in the portal hemodynamics.


Assuntos
Varizes Esofágicas e Gástricas , Encefalopatia Hepática , Hipertensão Portal , Derivação Portossistêmica Transjugular Intra-Hepática , Estudos de Casos e Controles , Encefalopatia Hepática/complicações , Encefalopatia Hepática/epidemiologia , Humanos , Hipertensão Portal/cirurgia , Cirrose Hepática/complicações , Derivação Portossistêmica Transjugular Intra-Hepática/métodos , Prognóstico , Pontuação de Propensão , Estudos Retrospectivos , Esplenectomia/efeitos adversos , Resultado do Tratamento
19.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 36(5): 540-547, 2022 May 15.
Artigo em Chinês | MEDLINE | ID: mdl-35570626

RESUMO

Objective: To validate the use of key point matrix technology based contactless automatic measurement for evaluation of joint motion of hand. Methods: Thirty-three volunteers were enrolled to evaluate the extension and flexion of hand joints between May 2021 and November 2021. There were 20 males and 13 females, the age ranged from 16 to 70 years with an average of 30.2 years. The extension angles of 14 joints of 5 fingers (including hyperextension) and the flexion angles of 12 joints of 4 fingers (excluding thumb) of volunteers were measured by key point matrix technology and manual goniometer, respectively. Then 5 participants and repeated measurement experiment were employed to test the system repeatability and accuracy; 28 participants and paired measurement experiment were employed to test the system accuracy. Results: The average repeatability of finger joint motion measured by the key point matrix technology was 1.801° (extension) and 7.823° (flexion), respectively. Compared with manual measurement, the average differences of each finger joint measured by the key point matrix technology were 3.225° in extension and 14.145° in flexion, respectively. The key point matrix technology based contactless automatic evaluation system offered excellent consistency with the manual goniometers ( ICC=0.875). While most of the consistency with manual goniometer of individual joints were at moderate levels (median of ICC, 0.440). The correlation coefficients between the measurement results of the two methods were mainly positive in the extension of the joint ( P<0.05) and negative in the flexion of the joints ( P<0.05). Conclusion: The key point matrix technology based contactless automatic evaluation provides sufficient measurement repeatability and accuracy in evaluation for the joint motion of hand.


Assuntos
Dedos , Mãos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Tecnologia , Polegar , Adulto Jovem
20.
Eur J Gastroenterol Hepatol ; 34(9): 948-955, 2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-35594511

RESUMO

OBJECTIVE: To explore the predictive value of model for end-stage liver disease (MELD)-Sarcopenia score for survival of cirrhotic patients after transjugular intrahepatic portosystemic shunt (TIPS) placement. METHODS: 289 patients who underwent TIPS between February 2016 and December 2020 were included, they were divided into the sarcopenia group ( n = 138) and non-sarcopenia group ( n = 151) according to whether they were complicated with sarcopenia. Kaplan-Meier curve was used to analyze and compare the prognosis of the above two groups and multivariate Cox regression analysis was used to identify the independent prognostic factors. The performance of different predictive models was compared using C-index. RESULTS: During the follow-up, Kaplan-Meier analyses indicated that cumulative survival was significantly lower in sarcopenia group than that in non-sarcopenia group [74.6% vs. 92.7%, HR, 0.24 (95% confidence interval (CI), 0.12-0.46), Log-rank P < 0.001]. After multivariate Cox analysis, age [HR, 1.040 (95% CI, 1.015-1.065), P = 0.002], sarcopenia [HR, 3.948 (95% CI, 1.989-7.838), P < 0.001], albumin [HR, 0.945 (95% CI, 0.897-0.997), P = 0.037], and MELD score [HR, 1.156 (95% CI, 1.097-1.217), P < 0.001] were identified as the independent risk factors for mortality after TIPS. The C-indexes of MELD-Sarcopenia, Child-Pugh, MELD, MELD-Na, and the Freiburg index of post-TIPS survival (FIPS) scores were 0.782, 0.688, 0.719, 0.734, and 0.770, respectively. CONCLUSION: Sarcopenia is independently correlated with post-TIPS mortality, and MELD-Sarcopenia score showed the best performance in predicting post-TIPS mortality than the traditional predictive models.


Assuntos
Doença Hepática Terminal , Derivação Portossistêmica Transjugular Intra-Hepática , Sarcopenia , Doença Hepática Terminal/complicações , Doença Hepática Terminal/diagnóstico , Doença Hepática Terminal/cirurgia , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/diagnóstico , Cirrose Hepática/cirurgia , Derivação Portossistêmica Transjugular Intra-Hepática/efeitos adversos , Prognóstico , Estudos Retrospectivos , Sarcopenia/diagnóstico , Sarcopenia/etiologia , Índice de Gravidade de Doença , Resultado do Tratamento
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