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1.
Zhonghua Xin Xue Guan Bing Za Zhi ; 49(6): 572-579, 2021 Jun 24.
Artigo em Chinês | MEDLINE | ID: mdl-34126724

RESUMO

Objective: This study intends to explore the difference in the efficacy of PCSK9 inhibitors in patients with different FH phenotypes by analyzing the level of blood lipids before and after treatment with PCSK9 inhibitors in patients with familial hypercholesterolemia (FH) with different allele grades. Methods: Patients with FH phenotype, who admitted to Beijing Anzhen Hospital from January 2019 to October 2020, were enrolled. Age, sex and other clinical information were collected from enrolled, and the pathogenic genes were detected by the second generation sequencing technique. The patients were divided into five groups according to the number of alleles involved and the degree of gene damage: single allele-null mutation group, single allele-defect mutation group, multi-allele-null mutation group, multi-allele-defect mutation group and no major pathogenic gene mutation group. The results of blood lipids were collected before medication, 4-6 weeks of intensive statin treatment and one month after combined treatment with PCSK9 inhibitor (PCSK9i). The LDL-C level were compared among groups. ASCVD risk stratification was performed in all patients, and the proportion of LDL-C level reaching the corresponding risk stratification target value of each genotype group after treatment was analyzed. Results: A total of 66 patients with FH phenotype were included, including 47 males (71.2%) and 19 females (28.8%),the mean age was(43.1±13.4 years). There were 7 cases in single allele-null mutation group (10.6%), 25 cases in single allele-defect mutation group (37.9%), 8 cases in multi-allele-null mutation group (12.1%), 18 cases in multi-allele-defect mutation group (27.3%) and 8 cases in no major pathogenic mutation group (12.1%). The degree of LDL-C reduction post combined PCSK9 inhibitor therapy was as follows: single allele mutation group>no major pathogenic mutation group>multi-allele mutation group, general distribution was in the range of 0-90.0%. Two groups of single allele mutation and no major pathogenic mutation group>50.0%>multi-allele mutation group. Under the combined treatment of PCSK9 inhibitors, the further decrease of LDL-C was in the order of single allele mutation group>non-major pathogenic mutant group>multi-allele mutation group. The efficacy of combined therapy on reducing LDL-C at 1 month after treatment decreased with the increase of baseline LDL-C level (r = 0.46, P<0.001) in patients with FH phenotype. In addition, the further decrease of LDL-C level post high-intensity statin therapy combined with PCSK9 inhibitors decreased with the increase of baseline LDL-C levels (r = 0.40, P<0.001). The degree of LDL-C decrease was high and stable by statin combined with PCSK9 inhibitor therapy in single allele mutation group. In the single allele-defect mutant group, the decrease of LDL-C increased with the increase of baseline LDL-C level post intensive statin treatment and combined PCSK9 inhibitor treatment ((r=0.54, P=0.009); r=0.45,P=0.030), and the further decrease of LDL-C level decreased with the increase of baseline LDL-C level in single allele-defect mutant group post combined therapy with PCSK9 inhibitor (r=0.43, P=0.040). The decrease of LDL-C in patients with the multi-allele mutation group varied with different pathogenic gene loci and combinations post combined therapy with PCSK9 inhibitor. There was no significant difference in the level of blood lipids between the group without major pathogenic gene mutation and the group with single allele mutation before and after treatment. The percentage of patients achieving LDL-C goals with different genotypes of phenotypic FH were as follows: single allele mutation group (86.7%), non-major pathogenic mutant group (75.0%) and multi-allele mutation grou (<5.0%). Conclusions: All patients with different FH phenotypes could benefit from the intensive lipid-lowering therapy with statins and PCSK9 inhibitors, however, there are significant differences in the efficacy of lowering LDL-C in Chinese patients with FH phenotype with different molecular etiologies. Therefore, the pathogenic gene analysis may suggest the lipid-lowering effect of PCSK9 inhibitors in patients with FH.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases , Hiperlipoproteinemia Tipo II , Adulto , Feminino , Genótipo , Humanos , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Hiperlipoproteinemia Tipo II/genética , Masculino , Pessoa de Meia-Idade , Pró-Proteína Convertase 9/genética
3.
Artigo em Chinês | MEDLINE | ID: mdl-33832190

RESUMO

Objective: To investigate the clinical effects of single-stage auricular reconstruction and hearing rehabilitation in children with microtia and external auditory canal atresia. Methods: Sixty eight cases of microtia with external auditory canal atresia (53 males and 15 females, age from 7 to 12 years, with a median age of 8.8 years), who received operations in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine from July 2017 to December 2019 were collected.A total of 28 cases received auricle reconstruction with high-density polyethylene (Medpor) framework and hearing reconstructions, among which 20 patients received the traditional external auditory canal and middle ear repair (EACR), and eight patients were implanted bone conduction device bone bridge(BB) simultaneously.In the control group, 40 patients only received Medpor frame implantation for auricle plasty. Postoperative changes in auricle morphology and auditory function and postoperative complications were evaluated. Results: After three to thirty months follow-ups, the auricles shape recovered well in all three groups. The average scores of 14 fine structures in the auricles were 9.43(EACR) and 10.67(BB) points. The average score of auricle symmetry were 6.83(EACR) and 6.00(BB) points. There was no significant difference compared to the auricle reconstruction group (8.23/6.20 points). P>0.05. After surgery, the average hearing improvement in the BB group was 43.33 dB HL and the average speech recognition threshold declined 42.28 dB HL. In the EACR group, the average hearing improvement was 4.13 dB HL and the average speech recognition threshold declined 11.36 dB HL. No vertigo, tinnitus, cerebrospinal fluid leakage and other complications occurred in all the patients. In the EACR group, sensorial hearing loss, auricle stent fracture, ear canal restenosis and ear canal atresia occurred in one patient respectively. In the auricle group, one auricle stent exposure and one facial branch nerve injury occurred. Nearly ten patients had difficulty in hair growth at scalp incisions. Conclusions: The operation of single-stage auricular reconstruction and hearing rehabilitation for microtia is feasible. The methods of hearing reconstruction should be determined by evaluating the development of the inner and middle ear of the patients. For those with poor mastoid development, bone bridge implantation is recommended to achieve a stable and significant hearing effect.


Assuntos
Microtia Congênita , Perda Auditiva , Procedimentos Cirúrgicos Reconstrutivos , Criança , China , Microtia Congênita/cirurgia , Feminino , Audição , Perda Auditiva/reabilitação , Humanos , Masculino , Polietilenos
4.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(5): 404-409, 2021 May 09.
Artigo em Chinês | MEDLINE | ID: mdl-33904272

RESUMO

Osteoradionecrosis of the jaw (ORNJ) and bisphosphonate-related osteonecrosis of the jaw (BRONJ) are usually caused by head and neck radio-therapy and by the usage of bisphosphonate, respectively. These diseases can lead to facial deformity and dysfunction of the mandible, and may cause severe chronic facial pain. The pathogenesis of ORNJ and BRONJ are complex, and the therapy of which is still challenged. The present article reviewed the latest literature about the pathogenesis and treatment of ORNJ and BRONJ were reviewed for update. The irradiation may damage the endothelia cells and microvessels in jaw bone, which leads to the termination of the bone remodeling 15 days after irradiation. Mesenchymal stem cells based bio-therapy can assist the recovery of mandibular circulation and the reconstruction of the bone, showing therapeutic potential for ORNJ clinical treatment. Bisphosphonate can induce the dysfunction of bone marrow mesenchymal stem cells and the immune imbalance of the body. Allogeneic mesenchymal stem cells transplantation can rebuild the jaw bone and rebalance the immune of the recipient, demonstrating the ideally potential for the treatment of BRONJ. Taking together, although it would be complicated and winding, the improvement of biotech and the usage of mesenchymal stem cells shed a light on the way of ORNJ and BRONJ treatments.

5.
Poult Sci ; 100(4): 100983, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33610902

RESUMO

This study was aimed at studying use of reduced dietary crude protein (CP) level supplemented with additional amino acids in laying ducks. A total of 720 Jingjiang ducks (50 wk) were randomly assigned to 5 treatments and fed 5 basal diets with CP levels at 17.5, 16.5, 15.5, 14.5, or 13.5%, with additional amino acids added to each diet for 12 wk. Each treatment had 6 replicates of 24 ducks each. Dietary CP levels affected (P < 0.05) egg production and mass of laying ducks, and there was a linear and quadratic decrease with decreasing CP levels (P < 0.05). Dietary CP levels did not affect egg weight and feed conversion ratio (FCR), but egg weight decreased linearly (P < 0.05); FCR increased linearly and quadratically (P < 0.05) with decreasing CP levels. There were no significant differences in egg quality among the different CP levels (P > 0.05). Ovarian weight, total and mean weight of preovulatory follicles, and total weight of small yellow follicles (SYF) were decreased by dietary CP levels (linear, P < 0.01 and quadratic, P < 0.05). The oviductal weight decreased linearly (P < 0.05), and the number of SYF decreased linearly and quadratically with decreasing CP levels (P < 0.05). The serum estradiol content decreased linearly with dietary CP levels (P < 0.05). The serum contents of luteinizing hormone, prolactin, and progesterone decreased (P < 0.05), linearly and quadratically (both P < 0.01) with decreasing CP levels. The serum contents of creatinine (CRE), triglycerides (TG), total cholesterol (TC), and alanine aminotransferase (ALT) activity were affected (P < 0.05) by different dietary CP levels. The total protein content increased linearly (P < 0.05), TC content increased quadratically (P < 0.05), and contents of albumin, CRE, TG, and phosphorus, and activities of aspartate aminotransferase and ALT increased linearly and quadratically (both P < 0.05) with decreasing CP levels. Overall, reduced dietary CP levels with addition of amino acids affected the laying performance, the development of reproductive organs and ovarian follicles, serum hormones, and biochemical indices of laying ducks. Dietary CP levels can be reduced to 14.5% with additional amino acid supplementation for 12 wk in laying ducks without negative effect on laying performance and egg quality.


Assuntos
Ração Animal , Patos , Aminoácidos , Ração Animal/análise , Animais , Galinhas , Dieta/veterinária , Suplementos Nutricionais , Feminino , Reprodução
6.
Eur Rev Med Pharmacol Sci ; 25(3): 1455-1461, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33629315

RESUMO

OBJECTIVE: The purpose of this study was to establish a nomogram for predicting the severity of acute pancreatitis (AP) and verify its predictive value. PATIENTS AND METHODS: A total of 571 AP patients received by Ordos Central Hospital from January 2015 to December 2018 were included in this study. According to the 2012 Revised Atlanta classification, the included subjects were classified into severe AP (SAP) group and non-severe AP (NSAP) group [including patient with mild AP (MAP) and moderately SAP (MSAP)]. The baseline characteristics, imageological data and pathological data within 24 h after the disease onset between the two groups were analyzed using One-way analysis of variance (one-way ANOVA). R language was used for establishing a predictive nomogram, whose performance was verified by clinical data of 150 AP cases collected from December 2018 to December 2019. RESULTS: One-way ANOVA shows that SAP and NSAP patients show significant differences in sex, calcium ions, creatinine, neutrophils ratio, lymphocytes ratio and eosinophils ratio (p<0.05). A predictive nomogram was accordingly established using the six indicators. Validation on this predictive nomogram showed high internal validation concordance index (C-index) of 0.69 (95% CI, 0.64-0.74), and high external validation C-index of 0.71 (95% CI, 0.67-0.76). CONCLUSIONS: This nomogram can be used as a clinical tool to predict the severity of SAP.

7.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(11): 1888-1893, 2020 Nov 10.
Artigo em Chinês | MEDLINE | ID: mdl-33297656

RESUMO

Objective: To analyze the immunological failure of antiretroviral therapy (ART), its association with baseline anemia and related factors in HIV/AIDS patients in Taizhou prefecture, during 2006-2019. Methods: A retrospective cohort study was conducted among HIV/AIDS patients under ART. Cox regression model was used to analyze predictors of immunological failure and logistic regression model was used to analyze factors of baseline anemia. Results: A total of 2 904 HIV/AIDS patients were enrolled with a median time of 28 (P(25)-P(75):12-53) months follow-up of ART, in which 177 cases (6.1%) were identified as immunological failure with a failure rate of 2.17 per 100 person-years. The cumulative incidence rates of immunological failure in the first, third, fifth, and tenth years were 5.49%, 6.94%, 7.30% and 8.82%, respectively. Results of multivariate logistic regression analysis showed that for the risk of baseline anemia, ≥66 years old group had 4.17 times higher risk than 18-25 years old group (95%CI: 1.68-10.33), males had 0.67 times higher risk than females (95%CI: 0.50-0.89), and CD(4)(+)T cell counts (CD(4))<200 cells/µl group had 4.35 times higher risk than CD(4)≥350 cells/µl group (95%CI: 2.81-6.72), baseline white blood cells<4.0×10(9) cells/L group had 1.73 times higher risk than 4.0×10(9) cells/L-9.9×10(9) cells/L group (95%CI: 1.31-2.29), baseline platelet counts <100×10(9) cells/L and >300×10(9) cells/L groups had 2.02 times and 4.45 times higher risk than 100×10(9) cells/L-299×10(9) cells/L group (95%CI: 1.36-3.01, 95%CI: 3.05-6.50), respectively. WHO classified stage Ⅲ/Ⅳ group had 2.15 times higher risk than WHO classified stageⅠ/Ⅱ group (95%CI: 1.61-2.87), while heterosexual transmission group had 2.03 times higher risk than homosexual transmission group (95%CI: 1.42-2.92). Results of multivariate cox proportional risk regression showed that for the risk of immunological failure, baseline anemia group had 1.77 times higher risk than no anemia group (95%CI: 1.20-2.60), WHO classified stage Ⅲ/Ⅳ group had 1.66 times higher risk than WHO classified stage Ⅰ/Ⅱ group (95%CI: 1.10-2.48), and withdrawal of follow up and death groups had 3.18 times and 4.61 times higher risks than treatment group (95%CI: 1.96-5.19, 95%CI: 2.98-7.13), respectively. Conclusions: The immunological effect of ART among HIV/AIDS patients in Taizhou prefecture was affected by multiple factors, including anemia, clinical stage and follow-up status. Enhancing surveillance of baseline anemia and timely correction of anemia in elder group can help improve treatment outcome of HIV/AIDS patients.

8.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(12): 2093-2097, 2020 Dec 10.
Artigo em Chinês | MEDLINE | ID: mdl-33378822

RESUMO

Objective: To analyze influencing factors of instant antiretroviral therapy (ART) and explore associution between strategies of ART and immunological effects among HIV/AIDS patients in Taizhou city during 2006-2019. Methods: A retrospective cohort study was conducted on HIV/AIDS patients under ART, and a logistic regression model was used to analyze factors of instant ART. The student t-test and chi-square test were used to compare immunological effect of different ART strategies while the Kaplan-Meier method was used to generate a survival curve. Results: A total of 2 971 HIV/AIDS patients were enrolled with 1 786 cases (60.1%) having instant ART strategy. The proportion of instant ART were 77.8% (1 170/1 504) during 2016 to 2019. The treatment success rate of the instant ART group (87.4%, 1 561/1 786) were higher than the delayed ART group (84.4%, 1 000/1 185). The results of multivariate logistic regression model indicated that male (aOR=1.28, 95%CI: 1.03-1.59), married (aOR=1.71, 95%CI: 1.33-2.19) and baseline CD(4)(+)T lymphocyte cells (CD(4)) counts ≤200 cells/µl (aOR=1.60, 95%CI: 1.27-2.02) were factors positively related to instant ART while 31-40 years old (aOR=0.63, 95%CI: 0.48-0.84), infected through heterosexual transmission(aOR=0.60, 95%CI: 0.49-0.74) and diagnosed before 2015 (aOR=0.20, 95%CI: 0.17-0.23) were inversely related to instant ART. The increase of the CD(4)/CD(8) ratio was greater, and the cumulative ART success rate was higher each year in the instant ART group than in the delayed ART group (P<0.05). Conclusions: The instant ART strategy has been well implemented in Taizhou city during 2006-2019, and the immunological effect was better in instant ART group. The proportion of instant ART were more than 60.0% among HIV/AIDS patients. Instant ART strategy needs to be strengthened for those who are 31-40 years old, women, unmarried, and infected through heterosexual transmission in an attempt to further increase treatment level and improve treatment effect.


Assuntos
Síndrome de Imunodeficiência Adquirida , Antirretrovirais , Infecções por HIV , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida/epidemiologia , Síndrome de Imunodeficiência Adquirida/imunologia , Adulto , Antirretrovirais/uso terapêutico , Contagem de Linfócito CD4/estatística & dados numéricos , China/epidemiologia , Cidades/epidemiologia , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Infecções por HIV/imunologia , Humanos , Masculino , Estudos Retrospectivos , Fatores Socioeconômicos , Resultado do Tratamento
9.
Poult Sci ; 99(11): 5752-5762, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33142493

RESUMO

This study was aimed at estimating the dietary manganese (Mn) requirement for laying duck breeders. A total of 504 Longyan duck breeders (body weight: 1.20 ± 0.02 kg) aged 17 wk were randomly allocated to 6 treatments. The birds were fed with a basal diet (Mn, 17.5 mg/kg) or diets supplemented with 20, 40, 80, 120, or 160 mg/kg of Mn (as MnSO4·H2O) for 18 wk. Each treatment had 6 replicates of 14 ducks each. As a result of this study, dietary Mn supplementation did not affect the productive performance of laying duck breeders in the early laying period (17-18 wk), but affected egg production, egg mass, and feed conversion ratio (FCR) from 19 to 34 wk (P < 0.05), and there was a linear and quadratic effect of supplement level (P < 0.05). The proportion of preovulatory ovarian follicles increased (P < 0.01) linearly and quadratically, and atretic follicles (weight and percentage) decreased (P < 0.05) quadratically with dietary Mn supplementation. The density and breaking strength of tibias increased (quadratic; P < 0.05), the calcium content of tibias decreased (linear, quadratic; P < 0.01), and Mn content increased (linear, quadratic; P < 0.001) with increase in Mn. The addition of Mn had a quadratic effect on serum contents of estradiol, prolactin, progesterone, luteinizing hormone, and follicle-stimulating hormone (P < 0.001). Dietary Mn supplementation decreased serum contents of total protein (linear, P < 0.05), glucose (quadratic, P < 0.05), total bilirubin, triglycerides, total cholesterol, low-density lipoprotein cholesterol, and calcium (linear, quadratic; P < 0.05). The serum total antioxidant capacity and total and Mn-containing superoxide dismutase activities increased (linear, quadratic; P < 0.001), and malondialdehyde content decreased (linear, quadratic; P < 0.001) in response to Mn supplemental levels. The dietary Mn requirements, in milligram per kilogram for a basal diet containing 17.5 mg/kg of Mn, for Longyan duck breeders from 19 to 34 wk of age were estimated to be 84.2 for optimizing egg production, 85.8 for egg mass, and 95.0 for FCR. Overall, dietary Mn supplementation, up to 160 mg/kg of feed, affected productive performance, tibial characteristics, and serum biochemical and antioxidant status of layer duck breeders. Supplementing this basal diet (17.5 mg/kg of Mn) with 85 to 95 mg/kg of additional Mn was adequate for laying duck breeders during the laying period.

10.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1324-1327, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867444

RESUMO

Objective: To analyze the predictive ability of HIV infection risk assessment tool for men who have sex with men (MSM). Sentinel surveillance data of MSM in Taizhou prefecture of Zhejiang province was used. Methods: MSM involved in AIDS sentinel surveillance program in Taizhou from 2013 to 2017 were included in the study and items listed in the HIV infection risk assessment tool for MSM was revised. Related data on questions and options involved in sentinel surveillance was collected and individual risk scores were calculated. We determined the predictive ability of this tool by comprehensive analyzing the HIV infection status and individual risk scores. Results: A total of 1 944 MSM were included in the study, with an average age of (35.04±13.28)years old. Most of them were recruited from the venues (55.7%) and 48.2% were never married. Among these MSM, HIV infection rate was 12.6%(245/1 944) with the median of risk score as 23.99, versus 20.36 from the HIV negative ones. Significant differences appeared on the risk scores between the target populations that with different HIV status (Mann-Whitney test, P=0.007). According to the principle of decision tree, MSM were divided into two groups according to risk scores: ≤18.66 and >18.66. It appeared that the risk scores were in parallel with the rates of HIV infection (χ(2)=13.102, P<0.001). Results from the multivariate analysis showed that MSM with higher risk score were more likely to be infected with HIV (>18.66 vs. ≤18.66: aOR=1.72, 95%CI: 1.27-2.32, P<0.001). Area under the ROC curve (AUC) for HIV infection was 0.553 (95%CI: 0.516-0.590, P=0.007). At the point of risk score 19.01, Youden's index appeared the maximum, with sensitivity as 0.69 and specificity as 0.43, of this tool. Conclusions: The HIV infection risk assessment tool for MSM developed based on Delphi method can predict the risk of HIV infection in MSM to some extent. MSM with higher risk score seemed likely to be infected with HIV. Items of this tool need to be adjusted for the verification of the tool through cohort studies in the near future.


Assuntos
Infecções por HIV/epidemiologia , Homossexualidade Masculina/estatística & dados numéricos , Medição de Risco/métodos , Vigilância de Evento Sentinela , Adulto , China/epidemiologia , Técnica Delfos , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Adulto Jovem
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1328-1334, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867445

RESUMO

Objective: To understand the characteristics and differences of diarrhea-related symptoms caused by different pathogens, and the clinical features of various pathogens causing diarrhea. Methods: Etiology surveillance program was conducted among 20 provinces of China from 2010 to 2016. The acute diarrhea outpatients were collected from clinics or hospitals. A questionnaire was used to survey demographics and clinical features. VFeces samples were taken for laboratory detection of 22 common diarrhea pathogens, to detect and analyze the clinical symptom pattern characteristics of the patient's. Results: A total of 38 950 outpatients were enrolled from 20 provinces of China. The positive rates of Rotavirus and Norovirus were the highest among the five diarrhea-causing viruses (Rotavirus: 18.29%, Norovirus: 13.06%). In the isolation and culture of 17 diarrhea-causing bacterial, Escherichia coli showed the highest positive rates (6.25%). The clinical features of bacterial diarrhea and viral diarrhea were mainly reflected in the results of fecal traits and routine examination, but pathogenic Vibrio infection was similar to viral diarrhea. Conclusion: Infectious diarrhea presents different characteristics due to various symptoms which can provide a basis for clinical diagnosis.


Assuntos
Disenteria/microbiologia , Disenteria/virologia , Vigilância da População , China/epidemiologia , Disenteria/epidemiologia , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Fezes/virologia , Humanos , Norovirus/isolamento & purificação , Rotavirus/isolamento & purificação
12.
Zhonghua Zhong Liu Za Zhi ; 42(8): 653-659, 2020 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-32867457

RESUMO

Objective: To identify the risk factors of non-sentinel lymph node (nSLN) metastasis in breast cancer patients with 1~2 positive axillary sentinel lymph node (SLN) and construct an accurate prediction model. Methods: Retrospective chart review was performed in 917 breast cancer patients who underwent surgery treatment between 2002 and 2017 and pathologically confirmed 1-2 positive SLNs. According to the date of surgery, patients were divided into training group (497 cases) and validation group (420 cases). A nomogram was built to predict nSLN metastasis and the accuracy of the model was validated. Results: Among the 917 patients, 251 (27.4%) had nSLN metastasis. Univariate analysis showed tumor grade, lymphovascular invasion (LVI), extra-capsular extension (ECE), the number of positive and negative SLN and macro-metastasis of SLN were associated with nSLN metastasis (all P<0.05). Multivariate Logistic regression analysis showed the numbers of positive SLN, negative SLN and macro-metastasis of SLN were independent predictors of nSLN metastasis (all P<0.05). A nomogram was constructed based on the 6 factors. The area under the receiver operating characteristic curve was 0.718 for the training group and 0.742 for the validation group. Conclusion: We have developed a nomogram that uses 6 risk factors commonly available to accurately estimate the likelihood of nSLN metastasis for individual patient, which might be helpful for radiation oncologists to make a decision on regional nodal irradiation.


Assuntos
Neoplasias da Mama/patologia , Excisão de Linfonodo , Metástase Linfática/diagnóstico , Nomogramas , Biópsia de Linfonodo Sentinela , Linfonodo Sentinela/patologia , Axila , Humanos , Linfonodos/patologia , Estudos Retrospectivos
13.
Eur Rev Med Pharmacol Sci ; 24(14): 7621-7633, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32744688

RESUMO

OBJECTIVE: The competing endogenous RNA (ceRNA) presents a comprehensive regulatory network among lncRNAs, miRNAs and mRNA. The ceRNA provides significant information in understanding the pathology of cancer. This study aimed to explore a lncRNA-associated ceRNA network for predicting the overall survival of patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: In this study, RNA-sequencing data of HCC were downloaded from The Cancer Genomes Atlas (TCGA) database. The module-trait relationship was analyzed with Weighted gene co-expression network analysis (WGCNA). The key module associated with tumor was identified, as well as the involved lncRNAs, mRNAs and miRNAs. The preliminary ceRNA network was constructed with Cytoscape. The survival analysis was further performed to screen survival-relevant lncRNAs, mRNAs and miRNAs, and then the survival-associated ceRNA network was reconstructed. RESULTS: Eventually, 5 lncRNAs, 10 miRNAs, and 25 mRNAs were included in the reconstructed ceRNA network. CONCLUSIONS: The identified lncRNAs were promising candidate biomarkers in HCC diagnosis and therapeutics. This analysis process was effective to construct ceRNA network. The result will be conductive to explore the significant lncRNAs and regulatory mechanism.

14.
Zhonghua Yi Xue Za Zhi ; 100(29): 2293-2296, 2020 Aug 04.
Artigo em Chinês | MEDLINE | ID: mdl-32746601

RESUMO

Objective: To investigate the efficacy of percutaneous extensor tendon reconstruction in treating spastic hammery deformity. Methods: From February 2009 to July 2018, the clinicaldata of 36 patients with fresh sputum hammer fingers treated in Jinan People's Hospital were analyzed retrospectively. The tendon was percutaneously sutured with PDS Ⅱmonofilament suture and the distal end of the tendon was fixed to the base of the distal phalanx through the bone hole. Removal of the K-wire 6 weeks after the operation, the brace was used to fix the affected finger in the dorsal extension. For 8-10 weeks, only the brace was worn at night and the flexion and extension of the affected finger was gradually strengthened.The extension and flexion function of the interphalangeal joint of the finger was compared pre and post the operation with t test. Results: A total of 36 patients were enrolled but only 33 patientswere followed up for 6 to 15 months. The hammer-shaped deformity was corrected and there was no pain when moving fingers after the operation.The straightening angle of the interphalangeal joint of the finger improved from 46.2°±6.3° before surgery to 7.5°±0.6° after (t=35.12, P<0.05). The passive straightening angle decreased from 3.2°±0.3° before surgery to 0.9°±0.2° after (t=37.11, P<0.05). According to the Crawford functional assessment: excellent in 19 fingers, good in 10 fingers, can be in 4 fingers. The excellent rate was 87.9%. There was no knot exposure, skin necrosis and other complications. Conclusions: Percutaneous resection of the extensor tendon is fixed in the basal phalanx. It is a simple and feasible minimally invasive surgery for hammer-shaped deformity. It can obviously correct the hammer-shaped deformity and has fewer complications.


Assuntos
Traumatismos dos Dedos , Deformidades Adquiridas da Mão , Humanos , Espasticidade Muscular , Amplitude de Movimento Articular , Estudos Retrospectivos , Tendões , Resultado do Tratamento
15.
Zhonghua Shao Shang Za Zhi ; 36(8): 722-725, 2020 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-32829612

RESUMO

Objective: To explore the effects of ilioinguinal composite tissue flaps in repairing skin and soft tissue defects on hand or foot and reconstructing the flexion and extension functions of wrist, finger, ankle, and toe. Methods: From February 2012 to March 2018, 4, 5, and 3 patients (11 males and 1 female, 23-62 years old) with skin and soft tissue defects on hand or foot were admitted to Traditional Chinese Medicine Hospital of Zhongmu County of Henan Province, Henan Armed Police Corps Hospital, and the Affiliated Jiangyin Hospital of Medical College of Southeast University, respectively. Five patients had hand defects, and 7 patients had foot defects. The areas of skin and soft tissue defects after debridement were 10 cm×8 cm-15 cm×10 cm. The ilioinguinal composite tissue flaps were designed and resected according to the wound area and the length of tendon defects, and the areas of flaps were 10 cm×8 cm-15 cm×12 cm. According to the specific condition of the recipient area, the superficial iliac circumflex artery in the tissue flap was reconstructed by end-to-side anastomosis in 2 patients and end-to-end anastomosis in 1 patient with ulnar artery, end-to-side anastomosis in 4 patients with the dorsal foot artery, end-to-side anastomosis in 2 patients with the posterior tibial artery, and end-to-end anastomosis in 1 patient with the external tarsal foot artery in the recipient area, and the superficial epigastric artery in the tissue flap was reconstructed by end-to-side anastomosis in 1 patient with the radial artery and end-to-end anastomosis in 1 patient with the ulnar artery in the recipient area. The donor sites were sutured directly or repaired with medium split-thickness skin grafts. The survival of tissue flap after the operation and the appearance, texture, and the two-point discrimination distance of the tissue flaps during follow-up were observed. The hand function and foot function were evaluated by the total active movement standard of hand and the Maryland foot score standard, respectively. Results: All the tissue flaps in 12 patients survived. During follow-up of 6-36 months after operation, the tissue flaps were slightly bloated, with linear scars at the junction site in the recipient area, and the two-point discrimination distances of the tissue flaps were 15-22 mm. The hand function was excellent in 3 cases, good in 1 case, and fair in 1 case, and the foot function was excellent in 4 cases, good in 2 cases, and fair in 1 case, and all the patients were satisfied with the function and appearance of hand or foot. Conclusions: The ilioinguinal composite tissue flaps can repair the hand and foot wounds and reconstruct the flexion and extension functions of wrist, finger, ankle, and toe at the same time, which is an effective method to repair this kind of defects.


Assuntos
Retalhos Cirúrgicos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Reconstrutivos , Transplante de Pele , Lesões dos Tecidos Moles , Resultado do Tratamento , Cicatrização , Adulto Jovem
16.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 433-438, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634879

RESUMO

Dietary nitrate which mainly comes from green leafy vegetables, is absorbed into blood circulation by the intestinal mucosa. Parotid gland is an important organ for transporting nitrate. Nitrate in blood is taken up by sialin, a nitrate transporter and concentrated in salivary glands and secreted into saliva. The salivary nitrate is partially reduced to nitrite and nitric oxide by oral bacteria, and then salivary nitrate and nitrite return into blood circulation with swallowing and intestinal mucosal absorption. As a non-classic source of nitric oxide, nitrate-nitrite-nitric oxide pathway plays an important role on physiological and pathological conditions, especially on the condition of hypoxia and ischemia. These functions include body protection, such as gastrointestinal tract, cardiovascular system, anti-inflammation, regulation of glucose/lipid metabolism, improvement of sport ability, maintaining gut microbiome hemostasis, and alleviating senility. The traditional view on nitrate as a harmful substance to human body has been proved to be lack of scientific evidence. With further research and application, as a pioneer from the mouth to the whole body, nitrate is expected to play a crucial part in human health, and prevention and treatment of systemic diseases.


Assuntos
Boca , Nitratos , Humanos , Óxido Nítrico , Nitritos , Saliva
17.
Eur Rev Med Pharmacol Sci ; 24(12): 6726-6734, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32633363

RESUMO

OBJECTIVE: The aim of this study was to investigate the mechanism of simvastatin-induced apoptosis in nasopharyngeal carcinoma (NPC) cells. MATERIALS AND METHODS: CNE1 and HK1 cell lines were treated with different concentrations of simvastatin for different time course. Subsequently, Cell Counting Kit-8 (CCK-8), colony formation assay, and flow cytometry were conducted to evaluate cell activity, colony formation ability, as well as cell cycle of NPC cells, respectively. The mRNA expressions of p21, Bim, and cyclin D1 were examined by qPCR. Meanwhile, the protein expression levels of apoptosis-related proteins (including caspase-3, Bax, Bcl-2) were detected by Western blot. Caspase-3 activity was determined to estimate cell apoptosis. An NPC xenotransplantation model was constructed to further determine the role of simvastatin in vivo. In addition, NF-κB activity was assessed through Luciferase reporter gene assay and Western blot. RESULTS: Simvastatin treatment lead to significantly reduced viability of NPC cells and the number of cell colonies dose-dependently and time-dependently. Meanwhile, simvastatin treatment caused cell cycle arrest in G0/G1 phase, remarkably downregulated expression of cyclin D1, and upregulated expressions of p21 and Bim. In addition, simvastatin induced apoptosis of NPC cells and enhanced the Luciferase activity of caspase-3. Western blot results indicated that simvastatin promoted the protein level of Bax and caspase-3, whereas suppressed the protein expression of Bcl-2. In vivo experiments showed that simvastatin was able to suppress the growth of NPC cells. Further studies demonstrated that simvastatin remarkably attenuated the Luciferase activity of pNF-κB-Luc, thereby specifically inhibiting the NF-κB signaling pathway. CONCLUSIONS: Simvastatin inhibits proliferation and promotes apoptosis of NPC cells by inhibiting the NF-κB pathway.

18.
Zhonghua Zhong Liu Za Zhi ; 42(6): 456-462, 2020 Jun 23.
Artigo em Chinês | MEDLINE | ID: mdl-32575940

RESUMO

Objective: To evaluate the incidence of early cardiac injury in patients with left-sided breast cancer receiving hypofractionated radiotherapy after breast conserving surgery, and to investigate the correlation between cardiac injury and hypofractionated radiotherapy dose. Methods: We prospectively enrolled 103 breast cancer patients who received whole breast with or without regional nodal irradiation after breast conserving surgery using either deep inspiration breath-hold (DIBH) or free breathing (FB) radiotherapy technique. Cardiac examinations that included N-terminal pro-B-type natriuretic peptide (NT-proBNP), electrocardiogram, and myocardial perfusion imaging were performed routinely before and after radiotherapy. The effects of heart dose, systemic therapy and individual factors (Framingham score) on the incidence of cardiac events were analyzed. Results: The median age was 48 years. The mean dose (Dmean) of the heart, left anterior descending coronary artery (LAD), left ventricular (LV), and right ventricular (RV) were 4.0, 16.9, 6.3, and 4.4 Gy, respectively. With a median follow-up of 13.4 months, no patient had clinical cardiac abnormalities. The incidence rates of subclinical cardiac events at 1- 6- and 12-month were 23.5%, 31.6%, and 41.3%, respectively. The DIBH group had a lower mean dose, maximum dose, and V5-V40 in the heart, LAD, LV, and RV than the FB group (P<0.001). Univariate analysis showed an increased incidence of subclinical cardiac events with heart Dmean >4 Gy, LAD V40 > 20%, LV Dmean >6 Gy, RV Dmean >7 Gy, or cumulative doses of anthracycline or taxane > 300 mg/m(2) (All P<0.05). Anti-HER2 targeted therapy, endocrine therapy and Framingham score were not associated with the incidence of subclinical cardiac events (all P>0.05). Multivariate analysis demonstrated that Dmean of LV and RV were independently associated with the increased incidence of subclinical cardiac events. Conclusions: Early subclinical heart injury are found in patients with left-sided breast cancer after hypofractionated radiotherapy. The increased incidence of subclinical cardiac events after radiotherapy is positively associated with the cardiac radiation doses.


Assuntos
Neoplasias da Mama/radioterapia , Traumatismos Cardíacos/etiologia , Coração/efeitos da radiação , Mastectomia Segmentar , Neoplasias Unilaterais da Mama/radioterapia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Suspensão da Respiração , Coração/diagnóstico por imagem , Ventrículos do Coração/efeitos da radiação , Humanos , Mastectomia Segmentar/efeitos adversos , Pessoa de Meia-Idade , Estudos Prospectivos , Hipofracionamento da Dose de Radiação , Lesões por Radiação , Resultado do Tratamento , Neoplasias Unilaterais da Mama/patologia
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(6): 367-372, 2020 Jun 09.
Artigo em Chinês | MEDLINE | ID: mdl-32486564

RESUMO

Although the dental lamina of permanent teeth in human being has been developed as early as the embryo stage, the replacement of the deciduous teeth by permanent teeth does not take place untill the age of 6 to 12 years old. The molecular mechanism of the initiation of permanent teeth is still unclear. The rodent species are usually used for the tooth development research in the past. However, this animal model is not suitable for the tooth replacement study because of the absence of tooth replacement in rodents. After 10 years of efforts, our team has established the animal model of miniature pig for tooth replacement research. Using this model, we firstly defined the spatiotemporal pattern of teeth replacement. In the further mechanism research, results showed that the growing rate of the deciduous teeth was faster than that of the surrounding alveolar bone, and biomechanical stress inside mandible was generated due to the fast growth of deciduous teeth. The stress might up-regulate the signal of Runt-related transcription factor 2 (RUNX2)-Wnt pathway in the mesenchyme between the deciduous and permanent teeth, sustain the successional dental lamina at the resting stage and inhibit the development of permanent teeth. A similar expression pattern was also found in the mesenchyme between the deciduous and permanent teeth in human. Our findings demonstrated that the eruption of deciduous tooth released the stress inside mandible, thus induced the "Wnt translocation" from the mesenchyme into the epithelium of permanent counterpart and therefore initiated the development of permanent teeth. The underlying mechanism of the replacement of deciduous teeth by permanent teeth is the regulation of biomechanical stress throughout the initiation process. Based on the findings, we proposed the theory of "biomechanical stress regulation of the tooth replacement" . The replacement pattern and regulatory mechanism provide a scientific foundation for the organ development and regeneration by regulating the biomechanical stress and Wnt pathway in the future.


Assuntos
Odontogênese , Dente , Animais , Criança , Dentição Permanente , Humanos , Suínos , Erupção Dentária , Dente Decíduo , Via de Sinalização Wnt
20.
Poult Sci ; 99(1): 454-462, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32416830

RESUMO

This study evaluated the effects of different dietary zinc (Zn) levels on productive and reproductive performance, egg quality, tibial characteristics, plasma biochemical and antioxidant indices, and zinc deposition in laying duck breeders. A total of 504 Longyan duck breeders aged 21 wk were randomly allocated to 6 treatments and fed a basal diet (Zn, 27.7 mg/kg) or that basal diet supplemented with Zn (as ZnSO4·H2 O) at 10, 20, 40, 80, or 160 mg Zn per kg of feed for 20 wk. Each group had 6 replicates of 14 ducks each. Dietary Zn supplementation affected (P < 0.05) the egg production, FCR, and shell thickness of laying duck breeders from 21 to 40 wk, and there was a quadratic (P < 0.05) effect between them. Dietary Zn supplementation affected (P < 0.05) and quadratically (P < 0.001) increased the breaking strength, density, and dry defatted weight of tibias. Alkaline phosphatase, calcium, phosphorus, total superoxide dismutase, glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) activities or content in plasma were affected (P < 0.05), and quadratically (P < 0.01) changed by dietary Zn levels. Dietary Zn supplementation affected (P < 0.01) and increased the Zn deposition in egg yolk (linear, P < 0.05; quadratic, P < 0.001) and tibia (linear, P < 0.05). The dietary Zn requirements, in mg/kg for a basal diet containing 27.7 mg/kg Zn, for Longyan duck breeders from 21 to 40 wk of age were estimated to be 65.4 for optimizing egg production, 68.6 for FCR, 102 for hatchling BW, 94.7 for eggshell thickness, 77.2 for tibial breaking strength, 81.4 for tibial density, 78.9 for tibial dry defatted weight, 69.5 for plasma GSH-Px activity, 72.4 for plasma MDA content, and 94.6 for Zn content in tibia. Overall, dietary Zn supplementation, up to 160 mg/kg feed, affected the productive performance, eggshell thickness, tibial characteristics, plasma antioxidant status, and Zn deposition of layer duck breeders. Supplementing this basal diet (27.7 mg/kg Zn) with 70 to 80 mg/kg additional Zn was adequate for laying duck breeders during the laying period.

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