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1.
Nat Metab ; 5(1): 61-79, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36593272

RESUMO

Enhanced glycolysis and accumulation of lactate is a common feature in various types of cancer. Intracellular lactate drives a recently described type of posttranslational modification, lysine lactylation (Kla), on core histones. However, the impact of lactylation on biological processes of tumour cells remains largely unknown. Here we show a global lactylome profiling on a prospectively collected hepatitis B virus-related hepatocellular carcinoma (HCC) cohort. Integrative lactylome and proteome analysis of the tumours and adjacent livers identifies 9,275 Kla sites, with 9,256 sites on non-histone proteins, indicating that Kla is a prevalent modification beyond histone proteins and transcriptional regulation. Notably, Kla preferentially affects enzymes involved in metabolic pathways, including the tricarboxylic acid cycle, and carbohydrate, amino acid, fatty acid and nucleotide metabolism. We further verify that lactylation at K28 inhibits the function of adenylate kinase 2, facilitating the proliferation and metastasis of HCC cells. Our study therefore reveals that Kla plays an important role in regulating cellular metabolism and may contribute to HCC progression.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/metabolismo , Neoplasias Hepáticas/metabolismo , Histonas/metabolismo , Lactatos
2.
Carbohydr Polym ; 303: 120439, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36657834

RESUMO

A glycyrrhetinic acid-modified carboxymethyl chitosan-thioketal-rhein (GCTR) conjugate was designed and synthesized for the in vivo delivery of celastrol (Cela). Cela was encapsulated into polymeric micelles (PMs) formed by GCTR conjugates self-assembly in water to form Cela/GCTR PMs with high drug loading capacity and small particle size. Cela/GCTR PMs had a sustained-release characteristic in the blood environment and a rapid-release feature in the tumor microenvironment. Cela/GCTR PMs had a significant proliferation inhibitory effect on HepG2 and BEL-7402 cells, but a negligible impact on L-02 cells at low concentrations. Cela/GCTR PMs possessed reactive oxygen species (ROS)-responsive properties in vitro and in cells, could improve the bioavailability of Cela, and exert remarkable hepatoma-targeting properties. Cela/GCTR PMs could also effectively inhibit tumor growth with no apparent damage to different organs. In summary, GCTR PMs with good ROS-responsive and hepatoma-targeting properties are expected to be possible delivery carriers for hydrophobic antineoplastic drugs for hepatocellular carcinoma therapy.


Assuntos
Antineoplásicos , Carcinoma Hepatocelular , Quitosana , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Micelas , Espécies Reativas de Oxigênio , Quitosana/química , Antineoplásicos/farmacologia , Polímeros/química , Neoplasias Hepáticas/tratamento farmacológico , Portadores de Fármacos/química , Linhagem Celular Tumoral , Microambiente Tumoral
3.
Anal Chem ; 95(4): 2496-2503, 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36639744

RESUMO

Hematogenous metastasis is the main route of cancer spreading, causing majority death of cancer patients. During this process, platelets in the blood are found increasingly essential to promote hematogenous metastasis by forming platelet-interacted circulating tumor cells (CTCs). Hence, we aim to fabricate an integrated method for the availability of capture and detection of such invasive CTCs. Specifically, a new form of channeled and conductive three-dimensional (3D) electrode is constructed by modifying a conductive layer and capture antibody on the templated and channeled poly(dimethylsiloxane) scaffold. The modified antibody enables the capture of the platelet-interacted CTC hybrid, while the conductive layer significantly facilitates electron transfer from electro-active signal molecules that are targeting platelets. Therefore, sensitive electrochemical detection of platelet-interacted CTCs has been realized. Efficient capture and sensitive detection have been demonstrated by this work. Additionally, dynamic analysis of patients' CTCs has also been conducted to provide accurate information about disease assessment and efficacy evaluation. The cut-off line was set as 5.15 nA based on the sample signals from healthy volunteers. Thus, stage III cancer patients with high risk of hematogenous metastasis have been identified. Together, this work shows the development of a new strategy for simultaneous capture and detection of the invasive CTC subtype form patient blood, which favors precise monitoring of hematogenous metastasis.


Assuntos
Células Neoplásicas Circulantes , Humanos , Células Neoplásicas Circulantes/patologia , Anticorpos
4.
Orthop Surg ; 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-36718651

RESUMO

OBJECTIVE: New vertebral compression fracture (NVCF) occurring after bone cement injection in middle-aged and elderly patients with vertebral compression fracture is very common. Preoperative baseline characteristics and surgical treatment parameters have been widely studied as a risk factor, but the importance of the patients' laboratory indicators has not been thoroughly explored. We aimed to explore the relationship between laboratory indicators and NVCF, and attempt to construct a clinical prediction model of NVCF together with other risk factors. METHODS: Retrospective analysis was performed for 200 patients who underwent bone cement injection (percutaneous kyphoplasty or vertebroplasty) for vertebral compression fractures between January 2019 and January 2020. We consulted the relevant literature and collated the factors affecting the occurrence of NVCF. Feature selection of patients with NVCF was optimized using the least absolute shrinkage and selection operator regression model, which was used to conduct multivariable logistic regression analysis, to create a predictive model incorporating the selected features. The discrimination, calibration, and clinical feasibility of the predictive model were assessed using the concordance index (C-index), calibration plots, and decision curve analysis. Internal validation was performed using Bootstrap resampling verification. RESULTS: Time from injury to surgery exceeding 7 days, low osteocalcin levels, elevated homocysteine levels, osteoporosis, mode of operation (percutaneous vertebroplasty), lack of postoperative anti-osteoporosis treatment, and poor diffusion of bone cement were independent risk factors for NVCF in middle-aged and elderly patients with vertebral compression fracture after bone cement injection. The C-index of the nomogram constructed using these seven factors was 0.895, indicating good discriminatory ability. The calibration plot showed that the model was well calibrated. Bootstrap resampling verification yielded a significant C-index of 0.866. Decision curve analysis demonstrated that the greatest clinical net benefit for predicting NVCF after bone cement injection could be achieved with a threshold of 1%-91%. CONCLUSION: This nomogram can effectively predict NVCF incidence after bone cement injection in middle-aged and elderly patients with vertebral compression fracture, thus aiding clinical decision-making and postoperative management, promoting effective postoperative rehabilitation, and improving the quality of life.

5.
HIV AIDS (Auckl) ; 15: 1-9, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36628326

RESUMO

Introduction: We aimed to investigate whether there were changes in fundus picture and retinal microvascularity of patients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) who were treated with highly active antiretroviral therapy (HAART). Methods: From July 2015 to November 2016, 130 HIV/AIDS patients were collected by the Yunnan Institute of Traditional Chinese Medicine, including 63 treatment-naïve patients and 67 that received HAART for 12 months. Fundus picture lesions, retinal microvascular diameters, CD4+ T lymphocyte count and HIV-1 plasma viral loads were compared between the two groups. The recruited patients were mainly young and middle-aged, with more males than females. There were no significant differences in smoking history, comorbidities and opportunistic infections between the two groups. Results: According to the analysis results from SPSS 20.0 software, the number of CD4+ T lymphocytes in the treated patients (563.34±2.56 cells/µL) increased significantly (P=0.009) as compared with untreated patients (451.37±2.10 cells/µL), and the HIV-1 plasma viral load reduced considerably (4794 vs 0 copy/mL, P=0.000). No significant differences were observed from the fundus picture of patients after effective HAART therapy, including the retinal artery diameter, venous diameter and arteriovenous diameter ratio.

6.
Cancer Imaging ; 23(1): 7, 2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36650584

RESUMO

BACKGROUND: The evaluation of treatment response according to METastasis Reporting and Data System for Prostate Cancer (MET-RADS-P) criteria is an important but time-consuming task for patients with advanced prostate cancer (APC). A deep learning-based algorithm has the potential to assist with this assessment. OBJECTIVE: To develop and evaluate a deep learning-based algorithm for semiautomated treatment response assessment of pelvic lymph nodes. METHODS: A total of 162 patients who had undergone at least two scans for follow-up assessment after APC metastasis treatment were enrolled. A previously reported deep learning model was used to perform automated segmentation of pelvic lymph nodes. The performance of the deep learning algorithm was evaluated using the Dice similarity coefficient (DSC) and volumetric similarity (VS). The consistency of the short diameter measurement with the radiologist was evaluated using Bland-Altman plotting. Based on the segmentation of lymph nodes, the treatment response was assessed automatically with a rule-based program according to the MET-RADS-P criteria. Kappa statistics were used to assess the accuracy and consistency of the treatment response assessment by the deep learning model and two radiologists [attending radiologist (R1) and fellow radiologist (R2)]. RESULTS: The mean DSC and VS of the pelvic lymph node segmentation were 0.82 ± 0.09 and 0.88 ± 0.12, respectively. Bland-Altman plotting showed that most of the lymph node measurements were within the upper and lower limits of agreement (LOA). The accuracies of automated segmentation-based assessment were 0.92 (95% CI: 0.85-0.96), 0.91 (95% CI: 0.86-0.95) and 75% (95% CI: 0.46-0.92) for target lesions, nontarget lesions and nonpathological lesions, respectively. The consistency of treatment response assessment based on automated segmentation and manual segmentation was excellent for target lesions [K value: 0.92 (0.86-0.98)], good for nontarget lesions [0.82 (0.74-0.90)] and moderate for nonpathological lesions [0.71 (0.50-0.92)]. CONCLUSION: The deep learning-based semiautomated algorithm showed high accuracy for the treatment response assessment of pelvic lymph nodes and demonstrated comparable performance with radiologists.


Assuntos
Neoplasias da Próstata , Masculino , Humanos , Neoplasias da Próstata/diagnóstico por imagem , Algoritmos , Linfonodos/diagnóstico por imagem , Pelve/diagnóstico por imagem
7.
Pain Res Manag ; 2023: 1157611, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36643939

RESUMO

Objective: To explore the influence and potential factors of the bone cement dispersion state on residual pain after vertebral augmentation. Methods: The cases included in this retrospective cohort study were patients treated with vertebral augmentation (VA) for osteoporotic vertebral compression fractures (OVCFs) between July 2018 and June 2021. According to the type of cement diffusion distribution, the patients were divided into a sufficient diffusion group (Group A) and an insufficient diffusion group (Group B). The differences in the baseline data, visual analog scale (VAS), Oswestry disability index score (ODI), injured vertebral height (IVH), and local kyphosis angle (LKA) between the two groups were analyzed. Assessments were performed preoperatively on the 2nd day postoperation and at the last follow-up. The imaging data of injured vertebrae were accurately reconstructed by a GE AW4.7 workstation, and the differences in the vertebral body volume, bone cement volume, and bone cement volume ratio were compared between the groups. Result: After screening, 36 patients were included. (1) The postoperative VAS and ODI scores of the two groups were significantly improved compared with the preoperative scores. (2) On the 2nd day postoperation and the last follow-up, the VAS and ODI scores of Group A were significantly different from those of Group B, and Group A outperformed Group B. (3) The IVH and LKA of the two groups were improved after the operation, and no significant difference was found between the groups. (4) Significant differences were found in the bone cement volume and bone cement volume ratio between the groups, and Group A was larger than Group B. Conclusions: Sufficient bone cement diffusion can reduce residual pain after vertebral augmentation.


Assuntos
Fraturas por Compressão , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Vertebroplastia , Humanos , Cimentos Ósseos/uso terapêutico , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/cirurgia , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/cirurgia , Coluna Vertebral , Dor
8.
Hum Mol Genet ; 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36617157

RESUMO

As the auditory and balance receptor cells in the inner ear, hair cells are responsible for converting mechanical stimuli into electrical signals, a process referred to as mechano-electrical transduction (MET). Hair cell development and function are tightly regulated, and hair cell deficits are the main reasons for hearing loss and balance disorders. TMCC2 is an endoplasmic reticulum (ER)-residing transmembrane protein whose physiological function largely remains unknown. In the present work, we show that Tmcc2 is specifically expressed in the auditory hair cells of mouse inner ear. Tmcc2 knockout mice were then established to investigate its physiological role in hearing. Auditory brainstem responses (ABR) measurements show that Tmcc2 knockout mice suffer from congenital hearing loss. Further investigations reveal progressive auditory hair cell loss in Tmcc2 knockout mice. The general morphology and function of ER is unaffected in Tmcc2 knockout hair cells. However, increased ER stress was observed in Tmcc2 knockout mice and knockdown cells, suggesting that loss of TMCC2 leads to auditory hair cell death through elevated ER stress.

9.
J Neurosci ; 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36596697

RESUMO

Distributed cortical regions show differential responses to visual objects belonging to different domains varying by animacy (e.g., animals vs tools), yet it remains unclear whether this is an organization principle also applying to the subcortical structures. Combining multiple fMRI activation experiments (two main experiments and six validation datasets; 12 females and 9 males in the main Experiment 1; 10 females and 10 males in the main Experiment 2), resting-state functional connectivity, and task-based dynamic causal modeling analysis in human subjects, we found that visual processing of images of animals and tools elicited different patterns of response in the pulvinar, with robust left lateralization for tools, and distinct, bilateral (with rightward tendency) clusters for animals. Such domain-preferring activity distribution in the pulvinar was associated with the magnitude with which the voxels were intrinsically connected with the corresponding domain-preferring regions in the cortex. The pulvinar-to-right-amygdala path showed a one-way shortcut supporting the perception of animals, and the modulation connection from pulvinar to parietal showed an advantage to the perception of tools. These results incorporate the subcortical regions into the object processing network and highlight that domain organization appears to be an overarching principle across various processing stages in the brain.Significance Statement:Viewing objects belonging to different domains elicited different cortical regions, but whether the domain organization applied to the subcortical structures (e.g., pulvinar) was unknown. Multiple fMRI activation experiments revealed that object pictures belonging to different domains elicited differential patterns of response in the pulvinar, with robust left lateralization for tool pictures, and distinct, bilateral (with rightward tendency) clusters for animals. Combining the resting-state functional connectivity and dynamic causal modeling analysis on task-based fMRI data, we found domain-preferring activity distribution in the pulvinar aligned with that in cortical regions. These results highlight the need for coherent visual theories that explain the mechanisms underlying the domain organization across various processing stages.

10.
Toxicology ; 484: 153406, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36549504

RESUMO

Environmental pollutants fine particulate matter and di-(2-ethylhexyl) phthalate (DEHP) are believed to be the risk factors for childhood asthma. Allergic asthma is basically an immediate hypersensitivity mediated by IgE, the product of humoral immune response. T follicular helper cells (Tfh) have been newly identified as the crucial T helper cells for supporting B cells to produce immunoglobulins in humoral immunity. Tfh cells are therefore potentially to serve as the diagnostic marker and therapeutic target of immune diseases. In this study, we examined the joint effects of fine particulate matter and DEHP on the initiation and progression of asthma and explored the fundamental role of Tfh cells during the process. Weanling C57BL/6 mice (both sexes) were concurrently exposed to DEHP (intragastric administration at 300 µg/kg) and fine atmospheric particulate matter (mean particle diameter < 4 µm, PM4) (oropharyngeal instillation at 2 mg/kg) once every three days for 30 days (10 times). We found that DEHP displayed adjuvant effects to potentiate PM4 allergen-induced expansion of Tfh and plasma cells, production of serum IgE and IgG1, and occurrence of airway hyper-responsiveness and inflammation. Then PM4 and DEHP co-exposure was performed to Cd4 knock-out mice reconstituted with normal wild-type adoptive Tfh cells or non-Tfh cells. The results of immune adoptive transfusion indicated that the joint immunotoxic effects of PM4 and DEHP were dependent on Tfh cells. We further proved that DEHP could adjuvantly boost PM4-induced expression of BCL-6 and c-MAF and secretion of IL-13 and IL-4 in Tfh cells. In conclusion, these data suggest that DEHP metabolites act in an adjuvant-like manner to aggravate PM4 allergen-induced asthma based on anaphylactic IgE response, resulting from excessive IL-13 and IL-4 synthesized by abnormally differentiated Tfh cells.


Assuntos
Asma , Dietilexilftalato , Masculino , Feminino , Animais , Camundongos , Dietilexilftalato/toxicidade , Células T Auxiliares Foliculares/metabolismo , Interleucina-4/metabolismo , Interleucina-4/farmacologia , Interleucina-13/toxicidade , Interleucina-13/metabolismo , Material Particulado/toxicidade , Camundongos Endogâmicos C57BL , Asma/induzido quimicamente , Asma/metabolismo , Linfócitos T Auxiliares-Indutores , Adjuvantes Imunológicos/farmacologia , Alérgenos/toxicidade , Imunoglobulina E
11.
Crit Rev Food Sci Nutr ; : 1-29, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36503364

RESUMO

Epidemiological data suggest that regular intake of soy isoflavones may reduce the incidence of estrogen-dependent and aging-associated disorders. Equol is a metabolite of soy isoflavone (SI) produced by specific gut microbiota and has many beneficial effects on human health due to its higher biological activity compared to SI. However, only 1/3 to 1/2 of humans are able to produce equol in the body, which means that not many people can fully benefit from SI. This review summarizes the recent advances in equol research, focusing on the chemical properties, physiological functions, conversion mechanisms in vitro and vivo, and metabolic regulatory pathways affecting S-equol production. Advanced experimental designs and possible techniques in future research plan are also fully discussed. Furthermore, this review provides a fundamental basis for researchers in the field to understand individual differences in S-equol production, the efficiency of metabolic conversion of S-equol, and fermentation production of S-equol in vitro.

12.
Front Pharmacol ; 13: 1005301, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36506507

RESUMO

Bai-Mi-Decoction (BMD), which is composed of Eugenia caryophyllata, Myristica fragrans, Moschus berezovskii, and Crocus sativu, is a characteristic TCM multi-herb formula for brain disease. However, the mechanism of protective effects of BMD on ischemic stroke (IS) still has not been clarified. Our study is designed to elucidate the protective effects and underlying mechanisms of BMD on IS by employing pharmacodynamic and serum and brain metabolomic methods. In this experiment, 90 adult male Sprague-Dawley rats were randomly divided into the sham operation group (SHAM, vehicle), middle cerebral artery occlusion-reperfusion injury model group (MCAO/R, vehicle), positive control group (NMDP, 36 mg/kg/day nimodipine), and low (BMDL, 0.805 g/kg/day), moderate (BMDM, 1.61 g/kg/day), and high (BMDH, 3.22 g/kg/day) dosage of BMD prophylactic administration groups. The drugs were dissolved in 0.5% CMC-Na and orally administered to rats with equal volumes (100 g/ml body weight) once a day for 14 consecutive days. Neurological deficit score, cerebral infarct volume, change in body weight, and serum NO, SOD, MDA, GSH, and GSSG levels were determined. Pathological abnormalities using hematoxylin and eosin staining and the expression of VEGF, caspase-3, and NF-κB were analyzed. Furthermore, serum and brain metabolic profiles were explored to reveal the underlying mechanism using UHPLC-QTOF-MS/MS technology. BMD exhibited significant neuroprotective effects on MCAO/R rats. As compared to the MCAO/R model group, it could reduce the neurological deficit score and cerebral infarct volume, increase body weight, enhance GSH, SOD, and GSSG activities, and decrease NO and MDA contents of MCAO/R rats. Meanwhile, BMD could ameliorate pathological abnormalities of MCAO/R rats through reducing neuronal loss, vacuolated spaces, shrunken neurons, and destructed neuron structure, as well as regulating the expression of VEGF, caspase-3, and NF-κB. UHPLC-QTOF-MS/MS-based serum and brain metabolomics analysis found a total of 53 differential metabolites between MCAO/R and SHAM groups, of which 30 were significantly regulated by BMD intervention, and further metabolic pathway analysis implied that the protective effects were mainly associated with amino acid and glycerophospholipid metabolisms. Our pharmacodynamic and metabolomic results revealed the neuroprotective effects of BMD on MCAO/R rats, and the underlying mechanisms were probably related to amino acid and glycerophospholipid metabolisms.

13.
Foods ; 11(23)2022 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-36496717

RESUMO

Multiplex polymerase chain reaction (PCR) assays are mainly used to simultaneously detect or identify multiple pathogenic microorganisms. To achieve high specificity for detecting foodborne pathogenic bacteria, specific primers need to be designed for the target strains. In this study, we designed and achieved a multiplex PCR system for detecting eight foodborne pathogenic bacteria using specific genes: toxS for Vibrio parahaemolyticus, virR for Listeria monocytogenes, recN for Cronobacter sakazakii, ipaH for Shigella flexneri, CarA for Pseudomonas putida, rfbE for Escherichia coli, vvhA for Vibrio vulnificus, and gyrB for Vibrio alginolyticus. The sensitivity of the single system in this study was found to be 20, 1.5, 15, 15, 13, 14, 17, and 1.8 pg for V. parahaemolyticus, L. monocytogenes, E. coli O157:H7, C. sakazakii, S. flexneri, P. putida, V. vulnificus, and V. alginolyticus, respectively. The minimum detection limit of the multiplex system reaches pg/µL detection level; in addition, the multiplex system exhibited good specificity and stability. Finally, the assays maintained good specificity and sensitivity of 104 CFU/mL for most of the samples and we used 176 samples of eight aquatic foods, which were artificially contaminated to simulate the detection of real samples. In conclusion, the multiplex PCR method is stable, specific, sensitive, and time-efficient. Moreover, the method is well suited for contamination detection in these eight aquatic foods and can rapidly detect pathogenic microorganisms.

14.
Eur Radiol ; 2022 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-36543903

RESUMO

OBJECTIVES: To compare the image quality of breath-hold magnetic resonance cholangiopancreatography (BH-MRCP) and respiratory-gating MRCP (RG-MRCP), and to explore breathing curve-based factors and patient-related data affecting image quality. METHODS: A total of 126 participants who underwent RG-MRCP and BH-MRCP on a 3-T magnetic resonance (MR) scanner were enrolled from May to December 2021. The images were evaluated by three radiologists on a 5-point scale. Respiratory parameters were extracted from the breathing curves. The Wilcoxon test was used to compare the image quality between the two MRCPs. Logistic regression analyzes were performed to identify age, sex, abdominal pain, and breathing predictor variables of better image quality. RESULTS: BH-MRCP performed better in visualizing intrahepatic bile ducts and overall image quality than RG-MRCP (p < 0.01). Factors predicting relatively good image quality included lower standard deviation of the respiratory amplitude (SDamp)-minimum-peak (odds ratio = 0.16, p < 0.01) for RG-MRCP and lower SDamp (OR = 0.69, p < 0.01) for BH-MRCP. CONCLUSIONS: BH-MRCP had significantly better overall image quality than RG-MRCP. Respiratory conditions exerted a significant impact on MRCP image quality, and parameters derived from the breathing curve could help predict the image quality of both sequences. KEY POINTS: • Both breath-hold (BH) and respiratory-gating (RG) MRCP demonstrate satisfying image quality. • BH-GRASE-MRCP is significantly better than RG-MRCP at the group level, but not for every individual. • Respiratory conditions exert a significant impact on the image quality, and the breathing curve can help predict the image quality.

15.
Surg Endosc ; 2022 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-36542135

RESUMO

BACKGROUND: Left lateral sectionectomy (LLS) is one of the most commonly performed minimally invasive liver resections. While laparoscopic (L)-LLS is a well-established technique, over traditional open resection, it remains controversial if robotic (R)-LLS provides any advantages of L-LLS. METHODS: A post hoc analysis of 997 patients from 21 international centres undergoing L-LLS or R-LLS from 2006 to 2020 was conducted. A total of 886 cases (214 R-LLS, 672 L-LLS) met study criteria. 1:1 and 1:2 propensity score matched (PSM) comparison was performed between R-LLS & L-LLS. Further subset analysis by Iwate difficulty was also performed. Outcomes measured include operating time, blood loss, open conversion, readmission rates, morbidity and mortality. RESULTS: Comparison between R-LLS and L-LLS after PSM 1:2 demonstrated statistically significantly lower open conversion rate in R-LLS than L-LLS (0.6% versus 5%, p = 0.009) and median blood loss was also statistically significantly lower in R-LLS at 50 (80) versus 100 (170) in L-LLS (p = 0.011) after PSM 1:1 although there was no difference in the blood transfusion rate. Pringle manoeuvre was also found to be used more frequently in R-LLS, with 53(24.8%) cases versus to 84(12.5%) L-LLS cases (p < 0.001). There was no significant difference in the other key perioperative outcomes such as operating time, length of stay, postoperative morbidity, major morbidity and 90-day mortality between both groups. CONCLUSION: R-LLS was associated with similar key perioperative outcomes compared to L-LLS. It was also associated with significantly lower blood loss and open conversion rates compared to L-LLS.

16.
Urol Oncol ; 2022 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-36526525

RESUMO

PURPOSE: To develop predictive models based on the integration of radiomics with the Vesical Imaging-Reporting and Data System (VI-RADS) for determining muscle invasion of bladder cancer. MATERIALS AND METHODS: One hundred ninety-one patients were retrospectively included in this study from January 2015 to March 2022. Of these, 121 data were randomly divided into training and validation sets at a ratio of 7:3. The remaining data (n = 70) served as the independent testing set. The radiomics features were extracted from bladder cancer on high-b-value DWI images. The pipelines of radiomics models were trained in the training set. One optimal model was selected based on the performance in the validation set. Then, the selected model was tested in the independent testing set. Two radiologists evaluated the VI-RADS based on T2WI and DWI. Reader 1 was an experienced reader, and Reader 2 was an inexperienced reader. A clinical-radiomics model was built by integrating the radiomics signature and VI-RADS. The performance was assessed using receiver operating characteristic curve analysis. The histopathological results were used as the standard reference to assess the diagnostic accuracy of muscle invasion. RESULTS: The radiomics model had area under the curve (AUC) values of 0.801, 0.867, and 0.806 in the training, validation, and testing sets, respectively. The VI-RADS scores of Readers 1/2 yielded AUC values of 0.831/0.781, 0.909/0.815, and 0.871/0.776 in the training, validation, and testing sets, respectively. The clinical-radiomics model for Readers 1/2 revealed AUC values of 0.889/0.854, 0.961/0.919, and 0.881/0.844 in the training, validation, and testing sets, respectively. The performance of the clinical-radiomics model was improved compared to the VI-RADS score for inexperienced Reader 2 (P < 0.05). CONCLUSION: The radiomics model was useful in the diagnosis of muscle invasion of bladder cancer. The clinical-radiomics model integrating radiomics and VI-RADS further improved the performance compared to VI-RADS alone, which was helpful for readers with less diagnostic experience.

17.
Artigo em Inglês | MEDLINE | ID: mdl-36527496

RESUMO

PURPOSE: To compare school-age children's objective and subjective refraction using a binocular wavefront optometer (BWFOM) with autorefraction and retinoscopy before and after cycloplegia. METHODS: Eighty-six eyes from 86 children (6-15 years old) were enrolled in this cross-sectional study. BWFOM objective and subjective refractions were compared with autorefraction and retinoscopy under cycloplegia. BWFOM refraction was evaluated before and after cycloplegia. Measurements were compared using a paired t-test; agreement was assessed using Bland-Altman plots. RESULTS: Under cycloplegia, the sphere, spherical equivalence, and J45 were significantly more negative on BWFOM objective refraction than autorefraction (- 1.39 ± 2.20 D vs. - 1.28 ± 2.23 D, P = 0.003; - 1.84 ± 2.38 D vs. - 1.72 ± 2.43 D, P = 0.001; - 0.02 ± 0.17 D vs. 0.03 ± 0.21 D, P = 0.004). The subjective sphere of BWFOM was less myopic, and the cylinder and the J45 were more negative than those with retinoscopy (- 1.17 ± 2.09 D vs. - 1.25 ± 2.20 D, P = 0.02; - 0.91 ± 0.92 D vs. - 0.76 ± 0.92 D, P < 0.001; - 0.01 ± 0.15 D vs. 0.03 ± 0.21 D, P = 0.028). For both BWFOM objective and subjective refraction, sphere and spherical equivalence with noncycloplegia were more myopic than those with cycloplegia (objective: - 1.76 ± 2.10 D vs. - 1.39 ± 2.20 D, - 2.21 ± 2.30 D vs. - 1.84 ± 2.38 D, P < 0.001; subjective: - 1.57 ± 1.92 D vs. - 1.17 ± 2.09 D, - 2.01 ± 2.13 D vs. - 1.62 ± 2.27 D, P < 0.001). Bland-Altman plots showed good agreement in spherical equivalence between BWFOM objective refraction and autorefraction (mean difference = 0.12 D, 95% confidence interval [CI] - 0.52 to 0.76), subjective refraction with retinoscopy (mean difference = - 0.01 D, 95% CI - 0.65 to 0.64), and BWFOM refractions with or without cycloplegia (objective: mean difference = - 0.37 D, 95% CI - 1.31 to 0.57; subjective: mean difference = - 0.39 D, 95% CI - 1.30 to 0.51). The time cost by BWFOM was significantly less than the total time of autorefraction and retinoscopy (264.88 ± 90.67 s vs. 315.89 ± 95.31 s, P < 0.001). CONCLUSION: BWFOM is a new device that realizes both objective and subjective refraction. For children's refractive errors, it is more convenient and quicker to obtain the proper prescription at a 0.05-D interval, and it is more accurate than autorefraction and retinoscopy under cycloplegia.

18.
Inorg Chem ; 61(51): 21004-21010, 2022 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-36520116

RESUMO

Manageable thermal expansion (MTE) of metal trifluorides can be achieved by introducing local structure distortion (LSD) in the negative thermal expansion ScF3. However, an open issue is why isostructural TiF3, free of LSD, exhibits positive thermal expansion. Herein, a combined analysis of synchrotron X-ray diffraction, X-ray pair distribution function, and rigorous first-principles calculations was performed to reveal the important role of itinerant electrons in mediating soft phonons and lattice dynamics. Metallic TiF3 demonstrates itinerant electrons and a suppressed Grüneisen parameter γ ≈ -20, while insulating ScF3 absence of itinerant electrons has a considerable γ ≈ -120. With increasing electron doping concentrations in ScF3, soft phonons become hardened and the γ is repressed significantly, identical to TiF3. The presented results update the thermal expansion transition mechanism in framework structure analogues and provide a practical approach to obtaining MTE without inducing sizable structure distortion.

19.
BMC Cancer ; 22(1): 1285, 2022 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-36476181

RESUMO

BACKGROUND: Evaluation of treated tumors according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria is an important but time-consuming task in medical imaging. Deep learning methods are expected to automate the evaluation process and improve the efficiency of imaging interpretation. OBJECTIVE: To develop an automated algorithm for segmentation of liver metastases based on a deep learning method and assess its efficacy for treatment response assessment according to the RECIST 1.1 criteria. METHODS: One hundred and sixteen treated patients with clinically confirmed liver metastases were enrolled. All patients had baseline and post-treatment MR images. They were divided into an initial (n = 86) and validation cohort (n = 30) according to the examined time. The metastatic foci on DWI images were annotated by two researchers in consensus. Then the treatment responses were assessed by the two researchers according to RECIST 1.1 criteria. A 3D U-Net algorithm was trained for automated liver metastases segmentation using the initial cohort. Based on the segmentation of liver metastases, the treatment response was assessed automatically with a rule-based program according to the RECIST 1.1 criteria. The segmentation performance was evaluated using the Dice similarity coefficient (DSC), volumetric similarity (VS), and Hausdorff distance (HD). The area under the curve (AUC) and Kappa statistics were used to assess the accuracy and consistency of the treatment response assessment by the deep learning model and compared with two radiologists [attending radiologist (R1) and fellow radiologist (R2)] in the validation cohort. RESULTS: In the validation cohort, the mean DSC, VS, and HD were 0.85 ± 0.08, 0.89 ± 0.09, and 25.53 ± 12.11 mm for the liver metastases segmentation. The accuracies of R1, R2 and automated segmentation-based assessment were 0.77, 0.65, and 0.74, respectively, and the AUC values were 0.81, 0.73, and 0.83, respectively. The consistency of treatment response assessment based on automated segmentation and manual annotation was moderate [K value: 0.60 (0.34-0.84)]. CONCLUSION: The deep learning-based liver metastases segmentation was capable of evaluating treatment response according to RECIST 1.1 criteria, with comparable results to the junior radiologist and superior to that of the fellow radiologist.


Assuntos
Aprendizado Profundo , Neoplasias Hepáticas , Humanos , Critérios de Avaliação de Resposta em Tumores Sólidos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia
20.
J Anesth ; 2022 Dec 24.
Artigo em Inglês | MEDLINE | ID: mdl-36565365

RESUMO

PURPOSE: Orthopedic hip, knee, and spinal surgeries have a relatively high incidence of persistent postoperative pain, with the highest risk observed in Asian ethnicity. This study aimed to investigate the distribution of persistent pain at 1 year after surgery and its associated factors and effects on functional disability. METHODS: This secondary analysis of a prospective observational study included 297 patients aged ≥ 55 years who underwent elective total hip arthroplasty, total knee arthroplasty, and spine and spinal cord surgeries under general anesthesia. Data were collected perioperatively and at 3 months and 1 year postoperatively to assess persistent postoperative pain on a numerical rating scale. RESULTS: At 1 year postoperatively, 34.6% (103/297) of patients reported pain, with a score of ≥ 1 and a mean score of 1.2. Multivariable negative binomial regression analysis revealed that less preoperative bodily pain (risk ratio [RR], 0.97; 95% confidence interval [CI] 0.94-0.99), preoperative C-reactive protein (CRP) level (RR, 1.19; 95% CI 1.01-1.39), and spine and spinal cord surgeries (RR, 2.48; 95% CI 1.30-4.75) increased the risk of persistent pain at 1 year after surgery, which was a significant factor for predicting the 12-item World Health Organization Disability Assessment Schedule 2.0 score (p < 0.001). CONCLUSION: The mean score for persistent pain at 1 year after surgery on the numerical rating scale was 1.2. Worse preoperative bodily pain, higher preoperative serum CRP level, and spine and spinal cord surgeries increased the persistent pain score at 1 year after surgery, which was associated with functional disability CLINICAL TRIAL REGISTRATION: This prospective observational study was registered on the University Hospital Medical Information Network (31 December 2015; UMIN000021671).

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