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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(4): 683-689, 2021 Apr 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814451

RESUMO

Objective: To study the prevalence and correlations of HIV infection among cross-border couples in the Dehong prefecture. Methods: A cross-sectional mass screening study with questionnaire interview and HIV testing was conducted among 17 594 registered cross-border couples from May 2017 through June 2018. Results: Among 32 400 participants, the overall prevalence of HIV infection was 2.27% (736/32 400), 2.44% (375/15 372) for Chinese citizens, and 2.12% (361/17 028) for foreign spouses. Among all the 13 853 couples with both spouses receiving HIV testing, 13 415(96.84%) were seroconcordant-negative couples, 142(1.03%) were serocondordant-positive couples, and 296(2.13%) were serodiscordant couples, including 167(1.20%) couples with positive husband and negative wife and 129(0.93%) couples with positive wife and negative husband. Multiple logistic regression analyses indicated that HIV infection was associated with drug use and risky sexual behaviors for male spouses. In contrast, HIV infection was associated with risky sexual behaviors for female spouses. Conclusion: The prevalence of HIV among cross-border couples in Dehong prefecture is high, underscoring the urgent need to scale up HIV testing, prevention, and behavioral intervention.


Assuntos
Infecções por HIV , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Prevalência , Comportamento Sexual , Cônjuges
2.
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(8): 1518-1522, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34814577

RESUMO

HIV infection among foreign personnel is one of the nonnegligible issues to control the epidemic of HIV/AIDS in China. It is necessary for HIV infection among foreign personnel to be taken effective measures in China. This paper consists of information about epidemic characteristics among foreign personnel with HIV in China, including influence on the overall infection, geographical distribution, and prevention status, referencing more effective AIDS knowledge and health education and behavior intervention.


Assuntos
Síndrome de Imunodeficiência Adquirida , Emigrantes e Imigrantes , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/prevenção & controle , China/epidemiologia , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Educação em Saúde , Humanos
3.
Zhonghua Yan Ke Za Zhi ; 57(11): 861-864, 2021 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-34743473

RESUMO

Primary orbital melanoma (POM) is a sort of extremely rare orbital malignancy. It often associates with melanin lesion such as congenital ocular melanocytosis and blue nevus. The most common clinical manifestation of POM is progressive painless proptosis. There are some difficulties in diagnosing this disease. MRI shows characteristic expression of this disease as an important way to diagnose POM, while pathology is the gold standard. Surgery is the mainstay of treatment in patients with POM. In addition, adjuvant radiotherapy and chemotherapy should be considered. This article systematically reviews the research progress of pathogenesis, clinical manifestation, auxiliary examination, differential diagnosis and treatment of POM, in order to provide some thoughts for the future study of the rare malignancy. (Chin J Ophthalmol, 2021, 57: 861-864).


Assuntos
Melanoma , Neoplasias Orbitárias , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Melanoma/diagnóstico , Melanoma/terapia , Neoplasias Orbitárias/diagnóstico por imagem , Neoplasias Orbitárias/terapia
4.
J Dairy Sci ; 104(12): 12496-12507, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34593232

RESUMO

This study evaluated the effects of incremental tributyrin supplementation in pasteurized waste milk on growth performance, health, and blood metabolism of dairy calves before and after weaning. Forty-eight newborn female Holstein dairy calves (39.6 ± 2.75 kg; mean ± standard deviation) were blocked by age and randomly assigned to 3 treatments: pasteurized waste milk (1) without supplementation, (2) with 1 g/L of tributyrin products (unprotected solid powder; containing 35% tributyrin), or (3) with 2 g/L of tributyrin products. The calves were weaned on d 56 and were raised until d 77. Data were analyzed for the preweaning, postweaning, and overall periods. The results showed that starter intake and hay intake were not different among treatments in any period of the trial, but the crude protein intake tended to increase linearly with tributyrin supplementation during the overall period. Although tributyrin supplementation had no effects on body weight during preweaning and overall periods, body weight increased linearly with tributyrin supplementation postweaning. The average daily gain tended to increase linearly during postweaning and overall periods. No effects were observed on feed efficiency in any period. A positive linear relationship between body length and tributyrin supplementation was observed during the postweaning period, but no differences were found for the other body structural measurements in any period. The results of diarrhea showed that tributyrin concentration had a negative linear relationship with diarrhea frequency during preweaning and overall periods. The rectal temperature did not differ among treatments in any period, but a treatment × week effect for rectal body temperature was observed. For blood metabolism, tributyrin supplementation had no effects on insulin, growth hormone, total protein, albumin, or globulin. No differences were found in serum amyloid A concentration in any of the periods, yet haptoglobin concentration decreased linearly with increasing tributyrin concentration during postweaning and overall periods. Endothelin concentration showed a tendency to decrease linearly during preweaning and postweaning periods and decreased linearly with tributyrin supplementation during the overall period. An increasing tributyrin concentration was associated with a negative linear relationship with IL-1ß concentration during the preweaning period, and no differences were found in the other periods. The concentration of IL-6 and tumor necrosis factor α were not different among treatments in any of the periods. These data suggest that increasing the concentration of tributyrin in pasteurized waste milk could increase growth performance and health of dairy calves, and incremental tributyrin supplementation could linearly reduce haptoglobin, endothelin, and IL-1ß concentrations, indicating a positive effect of tributyrin on alleviating oxidative stress and inflammatory status of dairy calves. Calves fed pasteurized waste milk supplemented with tributyrin products (containing 35% tributyrin) at 2 g/L compared with 1 g/L of milk had more improved growth and health.


Assuntos
Ração Animal , Leite , Ração Animal/análise , Animais , Peso Corporal , Bovinos , Dieta , Suplementos Nutricionais , Feminino , Triglicerídeos , Desmame
5.
Int J Radiat Oncol Biol Phys ; 111(3S): e304, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701136

RESUMO

PURPOSE/OBJECTIVE(S): Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL) is characterized with Epstein-Barr virus (EBV) infection and often presence of B symptoms (including fever, night sweat, and weight loss), but the mechanisms of B symptoms remain unclear. We sought to identify the association of B symptoms with plasma EBV-DNA copy number and cytokine profiles in patients with ENKTL to provide some explanation as well as prognostic analyses. MATERIALS/METHODS: We retrospectively analyzed data from 681 newly diagnosed patients with ENKTL at our institution from April 2007 to December 2019. Plasma EBV-DNA copy levels at presentation were divided into 4 groups: group A (EBV-DNA = 0 copies/ml), group B (0 < EBV-DNA < 103 copies/ml), group C (103 ≤ EBV-DNA < 106 copies/ml), and group D (EBV-DNA ≥ 106 copies/ml). In the subgroup of 167 patients with detailed data of cytokines (including IFN, IL-10 and IL-6), patients were divided into three tertiles based on individual cytokines. We explored the association between EBV-DNA levels, cytokines tertiles, and B symptoms via Cochran-Armitage trend test and Goodman-Kruskal Gamma test. Univariate and multivariate analysis for PFS and OS were performed. RESULTS: The median age of all the 681 patients was 44 years (range 9-83 years). There were 467 males, and 321 patients had B symptoms. The majority of patients were those aged ≤60 years (84.9%), presented with early-stage disease (Ann-Arbor I or II) (79.3%), and with tumor originating from the upper aerodigestive tract (UADT, 84.7%). There were 158 (23.2%), 143 (20.1%), 284 (41.7%), and 96 (14.1%) patients in EBV-DNA group A, B, C, and D, respectively. The Cochran-Armitage trend test demonstrated an upward trend in the incidence of B symptoms from 25.9%, 36.4%, 53.2%, to 80.2%, in EBV-DNA groups with increasing copy number (P < 0.0001). Among 321 patients with B symptoms, 82.6% had a fever with significance. Similarly, the incidence of fever also increased over the four EBV-DNA load groups, which were 15.8%, 31.5%, 45.4%, and 68.8%, respectively (P<0.0001). Further analysis of 167 patients with cytokines data demonstrated IFN, IL-10, IL-6 were correlated with EBV-DNA load (P < 0.0001 for all). In addition, the tertiles level of IFN, IL-10 and IL-6 were significantly associated with the presence of B symptoms (P < 0.0001, P = 0.0001, P = 0.0001, respectively) and fever (P = 0.0002, P = 0.0003, P = 0.0005, respectively). In univariate analysis, EBV-DNA load and B symptoms were significant predictor of PFS (P < 0.0001 for both) and OS (P < 0.0001 for both). Multivariate Cox regression analysis showed B symptoms (P = 0.026), primary tumor location (P = 0.019), and Ann-Arbor stage (P = 0.032) as predictive factors of OS. CONCLUSION: This exploratory study provided more evidence for a potential association and mechanism, that the massive replication of EBV in vivo could trigger cytokinemia, which may lead to B symptoms and poor prognosis in patients with ENKTL.

6.
Int J Radiat Oncol Biol Phys ; 111(3S): e86, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701985

RESUMO

PURPOSE/OBJECTIVE(S): to investigate the clinical and dose-volume factors of radiation-induced liver disease (RILD) during preoperative chemoradiotherapy for local advanced gastric adenocarcinoma, and provide a reference for optimization of the radiation plans. MATERIALS/METHODS: We retrospectively observed the clinical characteristics as well as dose-volume factors in a cohort of 190 patients with local advanced gastric adenocarcinoma in our hospital, including gender, age, treatment group, clinical TNM classification, primary tumor site, hepatitis, body mass index (BMI), alanine aminotransferase (ALT), alkaline phosphatase (ALP), serum albumin (ALB), total bilirubin (TBIL), activated partial thromboplastin time (APTT) from June 2013 to November 2020, based on an ongoing multicentric randomized phase III clinical trial (NCT01815853). There are 98 patients receiving chemotherapy (ChT, 3 cycles of XELOX regimen), and 99 patients receiving chemoradiation therapy (CRT, 1 cycle of induced XELOX regimen and 4500cGy/25f IMRT radiotherapy plus concurrent extenuated 2 cycles of XELOX regimen) before radical gastrectomy. The evaluation of RILD was performed based on clinical symptoms, Child-Pugh score system, Common Terminology Criteria of Adverse Event (CTCAE) 5.0 during preoperative treatment. ROC curves were used for appropriate cut-off values. Univariant and multivariant analysis were performed in dose-volume factors to find significant variables. RESULTS: In all of the patients, the incidence rate of RILD is 7.3%. With aid of supportive and symptom-eliminating treatments, all but one patient completed the assigned preoperative treatment. The RILD rate in the CRT group was higher than in ChT group (12.1% vs 2.2%, P = 0.009). As for the patients in CRT group, there were significant discrepancies in V3.5Gy (P = 0.017), V5Gy (P = 0.018), V10Gy (P = 0.033), V15Gy (P = 0.019), and borderline significance in the maximum dose (Dmax, P = 0.078) of liver between RILD patients and non-RILD patients in CRT group. Subsequent analysis showed that patients with the liver V3.5Gy (%) > 99.975%, liver V15Gy (%) > 66.470% had higher risk of RILD (OR: 5.797, P = 0.016; OR: 6.601, P = 0.023; respectively). However, V5Gy and V10Gy couldn't be considered as independent factors based on multivariant analysis (P = 0.757, P = 0.219, respectively), and the value of Dmax as independent prognostic factor was borderline significant (P = 0.050). There were no significant association between RILD and other clinical characteristics. CONCLUSION: Compared to chemotherapy, chemoradiation can increase the risk of RILD during preoperative treatment, but it's safe with regularly monitoring and appropriate treatment. Under the condition of the present liver-dose limitation, reduction of liver radiated volume in low dose (< = 15Gy) can eliminate the incidence rate of RILD. Besides, further studies are in need for the improvement for radiation plans of preoperative chemoradiation.

7.
AJNR Am J Neuroradiol ; 42(10): 1798-1806, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34385142

RESUMO

BACKGROUND AND PURPOSE: Delays to reperfusion negatively impact outcomes of patients with ischemic stroke, yet current guidelines recommend selective sequential imaging for thrombectomy candidates. We aimed to quantify and analyze time delays associated with rescanning in sequential acute stroke imaging. MATERIALS AND METHODS: This was a retrospective cohort study of consecutive patients with acute ischemic stroke who underwent imaging for treatment decision-making from January 1, 2017, to June 30, 2020. Rescan time delay was defined as ≥10-minute difference between initial NCCT and CTA ± CTP. Mean rescan time delays in comprehensive and primary stroke centers were compared. Bivariate and multivariable regression analyses assessed clinical and imaging factors associated with rescanning time delays and early outcomes. RESULTS: A total of 588 patients with acute ischemic were included in statistical analyses. Rescanning occurred in 27.9% (164/588 patients), with a mean time delay of 53.7 (SD, 43.4) minutes. For patients presenting at primary compared with comprehensive stroke centers, rescan time delays were more common (59.6% versus 11.8%, P < .001), with longer delays (65.4 [SD, 45.4] minutes versus 23.6 [SD, 14.0] minutes, P < .001). Independent predictors of rescan time delays included primary stroke center presentation, intravenous thrombolysis administration, black race, admission NIHSS ≥10, baseline independent ambulation, and onset-to-comprehensive stroke center arrival in ≥6 hours. Protocols for early simultaneous comprehensive CT (NCCT + CTA + CTP) were associated with lower odds of time delays (OR = 0.34; 95% CI, 0.21-0.55). Rescanning was associated with lower odds of home discharge (OR = 0.53; 95% CI, 0.30-0.95). CONCLUSIONS: A sequential approach to CT-based imaging may be significantly associated with prolonged acute stroke evaluations. Adoption of early simultaneous comprehensive CT could minimize treatment delays and improve outcomes.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Isquemia Encefálica/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico por imagem , Trombectomia , Resultado do Tratamento
8.
Zhonghua Er Ke Za Zhi ; 59(7): 563-569, 2021 Jul 02.
Artigo em Chinês | MEDLINE | ID: mdl-34405638

RESUMO

Objective: To evaluate the relationship between the timing of complementary feeding for infants and the occurrence of food allergy. Methods: The PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), and WanFang Data database were searched for randomized controlled trials (RCTs) about the effects of early introduction of complementary foods in infants on the occurrence of food allergy. Papers published from the establishment of the databases to December 31, 2019 were extracted. The quality of the selected literature was evaluated using the risk-of-bias (ROB) tools in the Cochrane Handbook, and the RevMan 5.3 software was used for meta-analysis. For the complementary food analyzed in a few reports in literature, a systematic review was conducted. Results: A total of 8 RCTs were extracted, and the systematic review and Meta-analysis were carried out according to food types. The results of Meta-analysis showed that compared with late introduction (after 6 months of age), early introduction (before 6 months of age) of eggs (RR=0.60, 95%CI 0.46-0.79) could reduce the risk of egg allergy in infants. The subgroup analysis of the six studies about eggs demonstrated that in infants with a prior or family history of allergic diseases, the introduction of eggs before 6 months of age was associated with reduced risk of egg allergy (RR=0.55, 95%CI 0.40-0.75), and the introduction of raw eggs (RR=0.67, 95%CI 0.49-0.93) and small amount of eggs (equivalent to weekly protein 0-4 g) (RR=0.55, 95%CI 0.36-0.85) before 6 months of age were also associated with reduced risk of egg allergy. In addition, egg supplementation during 4-6 months of age reduced the occurrence of egg allergy compared with supplementation before 4 months of age (RR=0.58, 95%CI 0.43-0.78). The systematic review found no conclusive relationship between early peanut introduction and peanut allergy, nor the correlation between early cow's milk protein introduction and cow's milk protein allergy (P>0.05). Conclusion: Early introduction (before 6 months of age) of eggs in infants' complementary foods can prevent infant egg allergy, but the limitations of the study need to be considered.


Assuntos
Hipersensibilidade Alimentar , Hipersensibilidade a Leite , Animais , Bovinos , Dieta , Feminino , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/prevenção & controle , Humanos , Lactente , Alimentos Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido
9.
Artigo em Chinês | MEDLINE | ID: mdl-34256485

RESUMO

Objective: We conducted a Meta-analysis to investigate the necessity of postural restrictions after manual reduction in the treatment of posterior canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We searched PubMed, EBSCO, Proquest, Web of Science databases, Ovid, and screened eligible studies that investigated the effect of post-maneuver postural restriction in treating patients with PC-BPPV. Outcomes included the efficacy of treatment and recurrence. Meta-analysis was performed using Stata 15.0 software. Results: Studies of the single visit efficiency included 11 references, with a sample size of 1 733 cases. The Meta-analysis results showed that the difference in the efficacy between the postural restricted group and the non-postural restricted group in PC-BPPV patients was statistically significant(RR=1.12, 95%CI=1.07-1.18, P<0.001). There were 12 references included in the study on the total efficiency, with a cumulative sample size of 1763 cases. There was no statistically significant difference between the effect of postural restriction after manipulative reduction and that of simple manipulative reduction (RR=1.03, 95%CI=0.99-1.08, P=0.118). There were 5 references included in the study of recurrence rate, and the cumulative sample size was 659 cases. There was no statistically significant difference in the recurrence rate between the postural restricted group and the non-postural restricted group(RR=0.98, 95%CI=0.62-1.54, P=0.937). Conclusions: In comparison with non-postural restriction group, post-maneuver postural restriction after a single visit can improve the treatment effective rate of PC-BPPV and contribute to the improvement in the symptoms of patients in a short term. However, postural restrictions has no significant effect on the final prognosis of PC-BPPV, and it also has no significant effect on the recurrence.


Assuntos
Vertigem Posicional Paroxística Benigna , Posicionamento do Paciente , Vertigem Posicional Paroxística Benigna/terapia , Meio Ambiente , Humanos , Recidiva , Canais Semicirculares , Resultado do Tratamento
10.
Insect Mol Biol ; 30(6): 605-614, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34318563

RESUMO

Long non-coding RNAs (lncRNAs) generally display tissue-specific distributions, and testis-specific lncRNAs form the highest proportion of lncRNAs in many species. Here, we presented a detailed analysis of testis-specific lncRNAs in the melon fly, Zeugodacus cucurbitae, a highly destructive insect pest of cucurbitaceous and other related crops. Most testis-specific lncRNAs were found to be long intergenic non-coding RNAs (lincRNA). The size distribution of these lncRNAs ranged between 600 and 1000 nucleotides. Testis-specific lncRNAs that harboured one isoform number and two exons were the most abundant. Compared to other male tissues, the testis had more highly expressed lncRNAs. The quantitative real-time polymerase chain reaction results of 10 randomly selected testis-specific lncRNAs showed expression patterns consistent with RNA-seq data. Further analysis of the most highly expressed testis-specific lncRNA, lnc94638, was undertaken. Fluorescent in situ hybridization assays localized lnc94638 to the apical region of the testis that contains mature spermatozoa. RNA interference-mediated knockdown of lnc94638 expression reduced spermatozoa numbers and impaired the fertility of Z. cucurbitae male. This study provides a catalogue of testis-specific lncRNAs, shows that the testis-specific lnc94638 is involved in spermatogenesis and has the potential to be used for treating male sterility.

11.
Zhonghua Yi Xue Za Zhi ; 101(21): 1583-1591, 2021 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-34098685

RESUMO

Objective: Investigate the current situation of lung cancer cough diagnosis and treatment and the awareness of related issues among Chinese medical providers. Methods: Doctors, nurses, pharmacists from the oncology department, respiratory department, or general department were investigated using an electronic questionnaire from January 29 to March 29, 2021. There were 25 questions about lung cancer in the questionnaire. The questionnaire was including the most common accompanying symptoms in patients with lung cancer, the incidence of lung cancer-related cough, the assessment of the proportion of central antitussive drugs, and the commonly used central antitussives. Results: Questionnaires from 2 424 medical providers were collected from 402 hospitals in 21 provincial administrative units. Cough was the most common symptom in lung cancer. Most physicians believed that the incidence of lung cancer-related cough was 51%~75%, while the proportion of patients satisfied with the treatment was only 11%~20%. The evaluation of lung cancer-related cough was seriously insufficient. The leading cause of lung cancer-related cough was tumors. And the main problem was the inadequate antitussive effect of drugs in lung cancer-related cough management. The proportion of central antitussive medication usage in the secondary and tertiary hospitals was 93.9% and 92.0%, significantly higher than 75.0% in Primary hospitals (χ²=8.390, P=0.015). The proportion of the physicians who underhanded that codeine is at risk of addiction was 76.6% and 72.0% in the secondary and tertiary hospitals, which were significantly higher than 53.9% in Primary hospitals (χ²=9.240, P=0.010). In different occupations, the proportions of doctors and pharmacists who knew the risk of addicting to codeine were 73.0% and 82.6%, which were significantly higher than the 66.4% of nurses (χ²=21.200, P<0.001). The Chinese medical providers were lack of training about the basic knowledge of using central antitussive medication. Conclusions: The proportion of patients who were satisfied with the effect of cough treatment is low. The medical staff did not have enough awareness of this. There was an urgent need to develop a consensus and standardize lung cancer cough diagnosis and treatment in China.


Assuntos
Antitussígenos , Neoplasias Pulmonares , Antitussígenos/uso terapêutico , China/epidemiologia , Tosse/tratamento farmacológico , Tosse/etiologia , Humanos , Neoplasias Pulmonares/complicações , Inquéritos e Questionários
12.
Zhonghua Gan Zang Bing Za Zhi ; 29(4): 326-331, 2021 Apr 20.
Artigo em Chinês | MEDLINE | ID: mdl-33979958

RESUMO

Objective: To analyze the clinical efficacy and safety of camrelizumab combined with apatinib as a second-line therapy for unresectable hepatocellular carcinoma (HCC). Methods: Ninety-four cases with mid-and advanced-stage HCC who received camrelizumab combined with apatinib as second-line treatment were enrolled. Routine blood test, blood biochemical indexes, tumor stage, tumor imaging characteristics, previous treatment strategies and other clinical data before treatment were documented. Imaging examination follow-up results and adverse reactions during treatment were followed up until the end of follow-up or loss of follow-up or death. Kaplan-Meier method was used to analyze the clinical efficacy. Results: As of the last follow-up, 94 cases with mid-and advanced-stage HCC had received camrelizumab combined with apatinib as second-line treatment. Among them, 15 cases were lost to follow-up, 31 cases died, and 48 cases survived. The overall remission rate was 31.9%. The overall disease control rate was 71.3%. The median time to disease-free progression was 6.6 months. The median time to disease progression was not yet available. The 1-year cumulative survival rate was 62.3%. Grade 3 and above adverse reactions mainly included were thrombocytopenia (7.4%), abdominal pain (4.3%), active hepatitis (4.3%), leukopenia (4.3%), diarrhea (3.2%), hand-foot syndrome (3.2%). All adverse reactions were effectively controlled. Conclusion: Camrelizumab combined with apatinib can effectively prolong the survival period of patients with mid-and advanced-stage HCC, and it is well tolerated.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Anticorpos Monoclonais Humanizados , Carcinoma Hepatocelular/tratamento farmacológico , Humanos , Neoplasias Hepáticas/tratamento farmacológico , Piridinas , Estudos Retrospectivos , Resultado do Tratamento
13.
Zhonghua Yan Ke Za Zhi ; 57(4): 261-267, 2021 Apr 11.
Artigo em Chinês | MEDLINE | ID: mdl-33832050

RESUMO

Objective: To predict the prevalence of myopia among Chinese students aged 6-18 years under different intervention scenarios from 2021 to 2030. Methods: The multi-state Markov model was developed based on the transition process of study stages and myopia statuses. The development of myopia was simplified into two statuses: non-myopia and myopia. Students aged 6-18 years were also divided according to their study stages including senior kindergarten, primary school (from Grade 1 to 6), junior school (from Grade 1 to 3) and high school (from Grade 1 to 3). The parameters were extracted from the National Myopia Investigation in 2018 and published articles of cohort studies. The transition probability was applied to simulate the intervention scenarios, and sensitivity analysis was carried out. Results: The cumulative incidence of myopia among Chinese school-aged children and adolescents would increase consistently. It would be 91.3% (min to max: 83.7% to 96.7%) upon graduation from high school. Without any intervention, the myopia prevalence would increase to 61.8% (min to max: 55.4% to 69.5%) by 2030 among Chinese school-aged children and adolescents. And the myopia prevalence among students in primary schools, junior schools and high schools would be 45.6% (min to max: 40.2% to 54.3%), 81.3% (min to max: 72.6% to 91.0%) and 90.5% (min to max: 82.4% to 96.7%), respectively, all higher than the national target. If the interventions could achieve 70% of the desired effect, the myopia prevalence would be lower than the national target at each stage. Conclusions: Without effective interventions, the prevalence of myopia among students aged 6-18 years may keep increasing in the next ten years. If the interventions achieve the desired effect, the national target for myopia prevention and control could be reached. It is urgent to identify more effective interventions and call on the whole society to participate in the myopia prevention action to achieve the national goal by 2030. (Chin J Ophthalmol, 2021, 57: 261-267).


Assuntos
Miopia , Adolescente , Criança , China/epidemiologia , Humanos , Miopia/epidemiologia , Prevalência , Instituições Acadêmicas , Estudantes
14.
Zhonghua Er Ke Za Zhi ; 59(4): 322-326, 2021 Apr 02.
Artigo em Chinês | MEDLINE | ID: mdl-33775053

RESUMO

Objective: To analyze the clinical features and efficacy of enzyme replacement therapy in 4 children with Fabry disease. Methods: A retrospective analysis of the clinical manifestations, laboratory findings, genetic variations and treatment were conducted in 4 children with Fabry disease in Children's Hospital of Zhejiang University School of Medicine from January 2014 to July 2020. Results: All four children (2 males, 2 females) with onset age of 12.4 (6.0-16.8) years were diagnosed based on clinical features, α-Gal A enzyme activity, genetic analysis and family history. The clinical manifestations varied in 4 children. All patients had left ventricular hypertrophy and abnormal urinalysis results, 1 case of neuropathic pain, 2 cases of hypohidrosis, 1 case of insipidus, but no angiokeratomas or hearing abnormalities were found. Three missense mutations of GLA gene were identified: c.424T>C (p.C142R), C.335G>A (p.R112H) and c.644A>G (p.N215S). The first two gene mutations were classical phenotypes, and the last one had also been reported in a classic case. In Case 1, no severe adverse events were reported in the first two months of agalsidase beta treatment. The dosage was 1 mg/kg once every 2 weeks. Symptoms of pain intensity and hypohidrosis were improved. Transiently elevated proteinuria was observed but it returned to normal after a week without any treatment. Conclusions: Clinical manifestations of Fabry disease varied in childhood. Multidisciplinary collaboration is required for its early diagnosis and treatment. Severe adverse events are rare in children with short-term therapy of agalsidase beta.


Assuntos
Doença de Fabry , Adolescente , Idade de Início , Criança , Terapia de Reposição de Enzimas , Doença de Fabry/tratamento farmacológico , Doença de Fabry/genética , Feminino , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento
15.
AJNR Am J Neuroradiol ; 42(6): 1017-1022, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33541898

RESUMO

BACKGROUND AND PURPOSE: Indirect consequences of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) pandemic include those related to failure of patients to seek or receive timely medical attention for seemingly unrelated disease. We report our experience with stroke code imaging during the early pandemic months of 2020. MATERIALS AND METHODS: Retrospective review of stroke codes during the 2020 pandemic and both 2020 and matched 2019 prepandemic months was performed. Patient variables were age, sex, hospital location, and severity of symptoms based on the NIHSS. We reviewed the results of CT of the head, CTA, CTP, and MR imaging examinations and classified a case as imaging-positive if any of the imaging studies yielded a result that related to the clinical indication for the study. Both year-to-year and sequential comparisons were performed between pandemic and prepandemic months. RESULTS: A statistically significant decrease was observed in monthly stroke code volumes accompanied by a statistically significant increased proportion of positive imaging findings during the pandemic compared with the same months in the prior year (P < .001) and prepandemic months in the same year (P < .001). We also observed statistically significant increases in average NIHSS scores (P = .045 and P = .03) and the proportion of inpatient stroke codes (P = .003 and P = .03). CONCLUSIONS: During our pandemic period, there was a significantly decreased number of stroke codes but simultaneous increases in positivity rates, symptom severity, and inpatient codes. We postulate that this finding reflects the documented reluctance of patients to seek medical care during the pandemic, with the shift toward a greater proportion of inpatient stroke codes potentially reflecting the neurologic complications of the virus itself.


Assuntos
COVID-19/diagnóstico , Admissão do Paciente/estatística & dados numéricos , Índice de Gravidade de Doença , Acidente Vascular Cerebral/diagnóstico , Tempo para o Tratamento/estatística & dados numéricos , Distribuição por Idade , Idoso , COVID-19/epidemiologia , COVID-19/terapia , Diagnóstico por Imagem , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Hemorragias Intracranianas/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapia
16.
Zhonghua Yan Ke Za Zhi ; 57(1): 34-40, 2021 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-33412640

RESUMO

Objective: To investigate the changes of axial length, corneal refractive power, and refractive state in infants with congenital cataract surgery. Methods: Retrospective cohort study. Medical records of 103 patients who underwent congenital cataract surgery in the Eye Hospital of Wenzhou Medical University Hangzhou Branch from January 1, 2015 to December 31, 2018 were reviewed. There were 61 boys and 42 girls in the study. The mean age at the surgery of 103 congenital cataract patients was (3.95±1.94) months. In patients receiving bilateral cataract surgery, only the left eye was selected for analysis. The patients were followed up for at least 1 year. The patients were divided into the groups of <4 months old and 4-12 months old according to the age at cataract surgery. The change in the axial length, corneal refractive power, and refractive state of each patient at 1 year after surgery was analyzed. Independent sample t-test, one way variance analysis and simple linear regression were used for statistical analysis. Results: There were 71 cases of bilateral cataract, including 33 in the group of <4 months old and 38 in the group of 4-12 months old, and 32 cases of unilateral cataract, including 17 in the group of <4 months old and 15 in the group of 4-12 months old. The change in the axial length of bilateral cataract children in the <4-month-old group was (2.46±1.33) mm at 1 year after surgery, which was greater than (1.52± 1.00) mm in the group of 4-12 months old (t=3.21; P<0.01). In the same surgery age group, there was no significant difference in the change of axial length among bilateral cataract eyes, unilateral cataract eyes and the contralateral eyes at 1 year after surgery (both P>0.05). One year after surgery, the axial length of the eyes in patients with bilateral cataract, the affected eyes and the fellow eyes in patients with unilateral cataract all was highly correlated with the logarithm of the actual age (r=0.68, 0.52, 0.73; all P<0.01). The corneal refractive power showed a decreased trend with the increase of age. The change in the corneal refractive power of the bilateral cataract children in the <4-month-old group at 1 year after surgery was (1.43±2.87) D, and in the group of 4-12 months old was (0.68±2.10) D, but the difference was not statistically significant (P>0.05). The chang in spherical equivalent of bilateral cataract children was (2.02±2.60) D in the <4-month-old group, greater than that in the group of 4-12 months old [(0.69±1.89) D; t=2.15; P<0.05]. The change of spherical equivalent one year after surgery in 4-12 months group, unilateral cataract eyes was significantly greater than that of bilateral cataract eyes [(2.05±0.95) D vs. (0.69±1.89) D; t=2.49; P<0.05]. The spherical equivalent of both bilateral and unilateral cataract children was highly correlated with the actual age (r=-0.51, -0.54; both P<0.01). Conclusions: The axial length is increased, the corneal refractive power is decreased, and the spherical equivalent is decreased at 1 year after surgery for congenital cataract in infants. The younger the age at cataract surgery, the greater the change in the axial length, myopia drift, and corneal refractive power. (Chin J Ophthalmol, 2021, 57: 34-40).


Assuntos
Extração de Catarata , Catarata , Criança , Feminino , Seguimentos , Humanos , Lactente , Implante de Lente Intraocular , Masculino , Refração Ocular , Estudos Retrospectivos
17.
Zhonghua Zhong Liu Za Zhi ; 43(1): 155-159, 2021 Jan 23.
Artigo em Chinês | MEDLINE | ID: mdl-33472330

RESUMO

Objective: To investigate the effect of six degree of freedom (6-DOF) bed combined with cone beam computed tomography (CBCT) in the on-line correction of setup errors in patients with primary rectal cancer. Methods: The clinicopathological data of 17 patients with primary rectal cancer in Department of Radiotherapy, Third Hospital of Peking University from July 2013 to January 2014 were collected. There were 14 males and 3 females, a median age of 65 years. The difference of CBCT and 6-DOF bed combined with CBCT online correction of patients with positioning error were retrospectively analyzed. Results: Before position correction, the first CBCT verification of setup errors in the three translation directions including X (left and right), Y (in and out) and Z (up and down) directions were (0.06±0.25) cm, (0.13±0.40) cm and (-0.28±0.31) cm, respectively. The setup errors of RX (rotation pitch), RY(rolling) and RZ (left and right rotation) directions were (0.62±1.15)°, (-0.19±0.99)°, and (-0.34 ± 0.84)°, respectively . After correction of IGRT combined with six freedom of bed, the setup errors of translation X, Y and Z were (0.01±0.09) cm, (-0.01±0.05) cm and (-0.03±0.08) cm, respectively, and the setup errors of rotation RX, RY and RZ directions were (-0.16±0.40)°, (0.36±0.31)°and (-0.01±0.25)°, respectively. There were significant differences in translation direction (X, Y and Z direction) and rotation direction (Rx, RY and RZ) before and after 6-DOF bed combined with CBCT correction (all P<0.05). In the translation direction, the higher frequency range of Z-direction error value was 0.20-0.79 cm. In the rotation direction, the frequency range of error in Rx direction was 0.20°-2.99°. There was no significant difference between bone mode and gray scale model registration (P>0.05). With the progress of radiotherapy, the setup errors of X, Z, Rx, RY and RZ directions increased except Y direction. Conclusions: In radiotherapy, six freedom bed combined with CBCT is helpful to correct the setup errors of patients with primary rectal cancer. Six freedom bed may be used to correct the setup errors of patients with primary rectal cancer online. Image-guided radiation therapy (IGRT) is recommended for bone pattern registration in patients with rectal cancer.


Assuntos
Radioterapia Guiada por Imagem , Neoplasias Retais , Idoso , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Planejamento da Radioterapia Assistida por Computador , Erros de Configuração em Radioterapia , Neoplasias Retais/diagnóstico por imagem , Neoplasias Retais/radioterapia , Estudos Retrospectivos
18.
AJNR Am J Neuroradiol ; 42(2): 257-261, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33122216

RESUMO

BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) appears to be an independent risk factor for stroke. We hypothesize that patients who develop stroke while hospitalized for severe COVID-19 will have higher inflammatory markers and distinct stroke imaging patterns compared with patients positive for COVID-19 with out-of-hospital stroke onset and milder or no COVID-19 symptoms. MATERIALS AND METHODS: This is a retrospective case series of patients positive for COVID-19 on polymerase chain reaction testing with imaging-confirmed stroke treated within a large health care network in New York City and Long Island between March 14 and April 26, 2020. Clinical and laboratory data collected retrospectively included complete blood counts and creatinine, alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer levels. All CT and MR imaging studies were independently reviewed by 2 neuroradiologists who recorded stroke subtype and patterns of infarction and intracranial hemorrhage. RESULTS: Compared with patients with COVID-19 with outside-of-hospital stroke onset and milder or no COVID-19 symptoms (n = 45, 52.3%), patients with stroke already hospitalized for severe COVID-19 (n = 41, 47.7%) had significantly more frequent infarctions (95.1% versus 73.3%, P = .006), with multivascular distributions (56.4% versus 33.3%, P = .022) and associated hemorrhage (31.7% versus 4.4%, P = .001). Patients with stroke admitted with more severe COVID-19 had significantly higher C-reactive protein and ferritin levels, elevated D-dimer levels, and more frequent lymphopenia and renal and hepatic injury (all, P < .003). CONCLUSIONS: Patients with stroke hospitalized with severe COVID-19 are characterized by higher inflammatory, coagulopathy, and tissue-damage biomarkers, supporting proposed pathogenic mechanisms of hyperinflammation activating a prothrombotic state. Cautious balancing of thrombosis and the risk of hemorrhagic transformation is warranted when considering anticoagulation.


Assuntos
Biomarcadores , COVID-19/complicações , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos da Coagulação Sanguínea/etiologia , COVID-19/diagnóstico por imagem , Infarto Cerebral/complicações , Infarto Cerebral/diagnóstico por imagem , Feminino , Hospitalização , Humanos , Hepatopatias/etiologia , Linfopenia/sangue , Linfopenia/etiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Acidente Vascular Cerebral/diagnóstico por imagem , Trombose/complicações , Tomografia Computadorizada por Raios X
19.
Tech Coloproctol ; 25(6): 683-691, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32572664

RESUMO

BACKGROUND: Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to be an effective treatment for peritoneal tumors; whether preventive HIPEC after radical resection for T4 stage colon adenocarcinoma could decrease peritoneal recurrence remains unknown. The aim of the present study was to compare peritoneal recurrence and short-term survival in patients with T4 stage colon adenocarcinoma undergoing HIPEC plus adjuvant chemotherapy or adjuvant chemotherapy alone following surgery. METHODS: We retrospectively reviewed T4 stage colon adenocarcinoma patients who had radical tumor resection at our institution between January 2014 and January 2019. Clinical data were extracted from the database at our institution, and patient survival and long-term complications were assessed through repeated outpatient examinations and telephone interviews. RESULTS: A total of 352 patients were included in this study; 157 patients received postoperative HIPEC plus adjuvant chemotherapy (HIPEC group), 195 patients received adjuvant chemotherapy alone (conventional chemotherapy group). Forty-one (26.1%) patients in the HIPEC group had a peritoneal recurrence and the peritoneum was the first site of tumor recurrence in 6 (14.6%) of them. However, 73 (37.4%) patients experienced peritoneal recurrence in the conventional group, and the peritoneum was the first site of tumor recurrence in 25 (34.2%) (p = 0.019). Disease-free survival in the HIPEC group at 1 and 3 years was 93.3% and 61.1%, respectively, versus 89.3% and 51.7% in the conventional chemotherapy group (p = 0.038). Overall survival in the HIPEC group at 1 and 3 years was 100.0% and 82.7%, respectively, versus 100.0% and 76.9% in the conventional chemotherapy group (p = 0.420). The two groups did not differ with respect to severe complications. CONCLUSIONS: Preventive HIPEC after radical surgery may decrease peritoneal recurrence and promote disease-free survival for T4 stage colon adenocarcinoma. Large-scale randomized controlled studies are needed to confirm the results of our study.


Assuntos
Adenocarcinoma , Hipertermia Induzida , Adenocarcinoma/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Colo , Terapia Combinada , Humanos , Recidiva Local de Neoplasia/prevenção & controle , Perfusão , Estudos Retrospectivos , Taxa de Sobrevida
20.
Clin Exp Immunol ; 203(1): 13-21, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32852779

RESUMO

Anti-Ro60 is one of the most common and clinically important serum autoantibodies that has a number of diagnostic and predictive capabilities. Most diagnostic laboratories report this simply as a qualitative positive/negative result. The objective of this study was to examine the clinical and serological relevance of a novel subset of anti-Ro60 in patients who display low levels of anti-Ro60 (anti-Ro60low ). We retrospectively identified anti-Ro60 sera during a 12-month period at a major immunopathology diagnostic laboratory in Australia. These all were anti-Ro60-precipitin-positive on the diagnostic gold standard counter-immuno-electrophoresis (CIEP). Lineblot immunoassay was used to stratify patients into either anti-Ro60low or anti-Ro60high subsets. We compared the medical and laboratory parameters associated with each group. Enzyme-linked immunosorbent assay (ELISA) and mass spectrometry techniques were used to analyse the serological and molecular basis behind the two subsets. Anti-Ro60low patients displayed less serological activity than anti-Ro60high patients with less intermolecular spreading, hypergammaglobulinaemia and less tendency to undergo anti-Ro60 isotype-switching than anti-Ro60high patients. Mass spectrometric typing of the anti-Ro60low subset showed restricted variable heavy chain subfamily usage and amino acid point mutations. This subset also displayed clinical relevance, being present in a number of patients with systemic autoimmune rheumatic diseases (SARD). We identify a novel anti-Ro60low patient subset that is distinct from anti-Ro60high patients serologically and molecularly. It is not clear whether they arise from common or separate origins; however, they probably have different developmental pathways to account for the stark difference in immunological maturity. We hence demonstrate significance to anti-Ro60low and justify accurate detection in the diagnostic laboratory.


Assuntos
Anticorpos Antinucleares , Autoantígenos , Doenças Autoimunes , RNA Citoplasmático Pequeno , Ribonucleoproteínas , Anticorpos Antinucleares/sangue , Anticorpos Antinucleares/imunologia , Austrália , Autoantígenos/sangue , Autoantígenos/imunologia , Doenças Autoimunes/sangue , Doenças Autoimunes/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , Células K562 , RNA Citoplasmático Pequeno/sangue , RNA Citoplasmático Pequeno/imunologia , Ribonucleoproteínas/sangue , Ribonucleoproteínas/imunologia
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