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1.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(2): 469-473, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-33812417

RESUMO

OBJECTIVE: To investigate the efficacy, safety and prognosis of auto-HSCT between classical and modified conditioning regimen in patients with B-cell non-Hodgkin lymphoma. METHODS: 36 patients diagnosed as B-cell non-Hodgkin lymphoma treated with autologous hematopoietic stem cell transplantation from January 2015 to June 2018 in Tianjin Cancer Hospital were retrospectively analyzed. The patients were divided into two groups: Idarubicin group and non-Idarubicin group. The overall survival (OS), progression-free survival (PFS), adverse reactions and hematopoietic reconstitution time between the two groups were compared. Survival analysis was performed by using the Kaplan-Meier method. Log-rank test was used for comparison between groups, and Cox regression was used for multivariate analysis. RESULTS: The median follow-up time was 29 months. Among these 36 patients with B-cell non-Hodgkin lymphoma before transplantation, 21 patients achieved CR and 15 patients achieved PR. The reconstitution time of neutrophil (P>0.05) and platelet (P>0.05) was not significantly different between Idarubicin and non-Idarubicin group. Also, the adverse reactions were not significantly different between two groups. The addition of idarubicin showed not aggravate the adverse reactions of patients. The OS and PFS of patients with idarubicin was longer than that of patients without idarubicin. The multivariate analysis showed that, the modified conditioning regimen and the remission state before transplantation were closely associated with prognosis. CONCLUSION: The above-mentioned results indicated that the combination of modified conditioning regimen with idarubicin can lengthen the OS and PFS of the patients significantly, and show not aggravate of bone marrow inhibition, moreover, the hematopoietic reconsititution time show not lengthen, which means that it can be a safe and effective choice for autologous HSCT in the patients with B cell non-Hodgkin lymphoma.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Linfoma não Hodgkin , Protocolos de Quimioterapia Combinada Antineoplásica , Linfócitos B , Intervalo Livre de Doença , Humanos , Linfoma não Hodgkin/terapia , Estudos Retrospectivos , Condicionamento Pré-Transplante , Transplante Autólogo , Resultado do Tratamento
2.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(2): 643-647, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-33812445

RESUMO

Sickle cell disease (SCD) is a single gene genetic disease, which seriously threatens the life span and quality of patients. On the basis of the pathogenesis of SCD and the alternative therapy based on fetal hemoglobin F (HbF), the research progress of transcription factors involved in the regulation of HbF gene expression, such as BCL11A, ZBTB7A, KLF-1, c-MYB and SOX6, as well as the application of CRISPR / Cas9, TALEN, zinc finger nuclease and other gene editing technologies in this field has been made, providing a solid theoretical basis for the exploration of new treatment schemes for ß- like hemoglobin diseases, such as sickle cell disease and ß- thalassemia.


Assuntos
Anemia Falciforme , Hemoglobina Fetal , Anemia Falciforme/genética , Anemia Falciforme/terapia , Linhagem Celular Tumoral , Proteínas de Ligação a DNA , Hemoglobina Fetal/genética , Terapia Genética , Humanos , Proteínas Repressoras/genética , Fatores de Transcrição
3.
J Nat Prod ; 2021 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-33822610

RESUMO

Three new tyramine-type alkamides (1-3), three new natural products (4-6), five new N-acylated/formylated aporphine alkamides with different ratios of rotational isomers (7-11), and 20 known alkamides (12-31) were isolated from an EtOH extract of the stems and leaves of Piper puberulum. The absolute configurations of compounds 7, 8, and 10 were determined by single-crystal X-ray diffraction analysis. In the biological activity assay, compounds 3, 5, and 10-23 displayed inhibitory effects against lipopolysaccharide-induced NO release in BV-2 microglial cells, exhibiting IC50 values of 0.93-45 µM.

4.
J Int Med Res ; 49(4): 3000605211004520, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33823641

RESUMO

OBJECTIVE: To investigate the effect of psychological intervention on the prognosis of patients with C4 dislocation and spinal cord injury. METHODS: We investigated target patients admitted between 2010 and 2018. Patients' mental state, quality of life and neurological function at different time points were evaluated to examine the relationship between psychological intervention and recovery and prognosis of acute and critical spinal cord injury. RESULTS: All patients showed improvements in clinical symptoms, neurological function and quality of life. Psychological intervention significantly improved Zung Self-Rating Anxiety Scale score, Zung Self-Rating Depression Scale score and SF-36 Mental Component Summary score within 3 months. Japanese Orthopaedic Association neurological function score and SF-36 Physical Component Summary score were significantly improved after 1-year follow-up. Psychological intervention did not improve 2-year survival. CONCLUSION: Timely and professional psychological intervention can eliminate the psychological disorders of C4 dislocation patients with spinal cord injury. This has a positive effect on their quality of life and prognosis.

5.
Med Sci Monit ; 27: e929280, 2021 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-33824264

RESUMO

BACKGROUND In addition to sociodemographic and COVID-19- related factors, the needs of school support, including material, psychological and information support, have seldom been discussed as factors influencing anxiety and depression among college students during the COVID-19 pandemic. MATERIAL AND METHODS In this cross-sectional study, 3351 college students from China were surveyed through questionnaires about their sociodemographic and COVID-19 characteristics, the needs of school support, and their experiences with anxiety and depression. RESULTS Anxiety and depression were reported by 6.88% and 10.50% of students, respectively. Married, higher education, non-medical, and urban students had significantly higher risks of anxiety or depression. Additionally, symptoms such as cough and fever, especially when following a possible contact with suspected individuals, quarantine history of a personal contact, going out 1-3 times a week, not wearing a mask, and spending 2-3 hours browsing COVID-19-related information were significantly associated with the occurrence of anxiety or depression. Those who used methods to regulate their emotional state, used a psychological hotline, and who had visited a psychiatrist showed higher anxiety or depression. Those who used online curricula and books, used preventive methods for COVID-19, and who had real-time information about the epidemic situation of the school showed lower anxiety and depression. CONCLUSIONS In addition to sociodemographic and COVID-19-related aspects, students' needs for psychological assistance and information from schools were also associated with anxiety and depression among college students.

6.
Adv Physiol Educ ; 45(2): 269-275, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33825525

RESUMO

Basic medical laboratory courses (BMLCs) play an important role in medical educational courses helping the student acquire three important skills of surgical operating, collaborative learning, and problem solving. The outcome-based student assessment (OBSA) is a learning evaluation method that establishes specific evaluation points based on performance of students in three aspects: surgical operating, collaborative learning, and problem solving in the BMLC curriculum practices. The purpose of the present randomized controlled trial study is to explore the efficiency of OBSA program in BMLCs. The 233 students attending BMLCs were randomly divided into 2 groups, 118 in the OBSA group and 115 in the control group. We conducted multiple-choice examination questions (MCQs) test and two questionnaires with the method of two-sample t test for statistics. The results of MCQs in total eight BMLC blocks showed that the academic performance of the OBSA group was significantly better than that of the control group (P < 0.05). In addition, the average scores of direct observation of procedural skills (DOPS) and mini-experimental evaluation exercise in OBSA group were significantly higher than those in control group (P < 0.05). The majority of the medical students preferred the OBSA and considered OBSA could effectively improve their surgical operating skills (83.9%), collaborative learning skills (92.1%), and problem-solving skills (91.1%). From the above, OBSA is an effective evaluation method for the implementation of the BMLC curriculum.

7.
Molecules ; 26(6)2021 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-33805809

RESUMO

Crataegi folium have been used as medicinal and food materials worldwide due to its pharmacological activities. Although the leaves of Crataegus songorica (CS), Crataegus altaica (CA) and Crataegus kansuensis (CK) have rich resources in Xinjiang, China, they can not provide insights into edible and medicinal aspects. Few reports are available on the qualitative and quantitative analysis of flavonoids compounds of their leaves. Therefore, it is necessary to develop efficient methods to determine qualitative and quantitative flavonoids compounds in leaves of CS, CA and CK. In the study, 28 unique compounds were identified in CS versus CK by qualitative analysis. The validated quantitative method was employed to determine the content of eight flavonoids of the leaves of CS, CA and CK within 6 min. The total content of eight flavonoids was 7.8-15.1 mg/g, 0.1-9.1 mg/g and 4.8-10.7 mg/g in the leaves of CS, CA and CK respectively. Besides, the best harvesting periods of the three species were from 17th to 26th September for CS, from 30th September to 15th October for CA and CK. The validated and time-saving method was successfully implemented for the analysis of the content of eight flavonoids compounds in CS, CA and CK for the first time.

8.
J Environ Sci Health B ; : 1-10, 2021 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-33818270

RESUMO

Controlled-release formulations (CRFs) have potential applications in modern agriculture, for it can not only prolong the duration of agrochemicals but also alleviate the adverse effect on non-target organism. In this study, we constructed pyraclostrobin@SiO2@polydopamine microcapsule (Pyr@SiO2@PDA MC). The resulting microcapsule is a near-rod shape (about 1.15 µm), which has a drug-loading efficiency of 55%. Fourier transform infrared (FTIR) and thermogravimetric analysis (TG) revealed the successful entrapment of the pesticide. The coating of polydopamine (PDA) endowing the microcapsule with superior UV-shielding properties than pyraclostrobin@SiO2 microcapsule (Pyr@SiO2 MC). Compared with pyraclostrobin emulsifiable concentrate (EC), the Pyr@SiO2@PDA MC exhibited 9.07-, 5.50-, 4.93- and 4.16-fold higher fungicidal activity against Rice blast fungus (Pyricularia oryzae) at concentrations of 0.5, 1, 2 and 4 mg/L. Moreover, acute toxicity tests demonstrated that the sample on zebrafish with lower toxicity on the first day. These results showed that the obtained microcapsule may process broader application potential in agriculture.

9.
ACS Nano ; 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33792288

RESUMO

Electronic devices with high heat flux are currently facing heat dissipation problems. Heat pipes can be used as efficient heat spreaders to address this critical problem. However, as electronic devices become smaller, the space for heat dissipation is becoming ever so limited; hence, ultrathin heat pipes are desired. This study proposes a biomimetic copper forest wick for an ultrathin heat pipe (UTHP). It is made by a simple one-step electrodeposition process and appears as a natural forest structure with abundant Ω-like grooves. Capillary rise tests with ethanol were performed to characterize the capillary force of the wick structure. Compared to traditional sintered particles, this wick structure has a much higher capillary performance parameter, K/Reff. The biomimetic copper forest wick was used to fabricate a 0.6 mm thick UTHP. The UTHP was tested at different filling ratios; the optimum filling ratio was found to be about 71%. At a heating power of 6 W, the temperature difference between the condenser and evaporator was only 1.2 °C, with an effective thermal conductivity, λeff, up to 1.26 × 104 W m-1 K-1.

10.
Int J Biol Macromol ; 179: 485-499, 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33684430

RESUMO

Melatonin (MT) is a bioactive molecule that can regulate various developmental processes. Changes in lignin content play important roles in plant growth and development. Herein, quantitative analysis and histochemical staining showed that lignin content significantly increased over time, and melatonin treatment triggered the lignification at 8 and 16 d in tea leaves. The POD activity participated in lignin formation had also been significantly improved. The effect of melatonin on the increase of lignin content was attenuation over time. Sequencing results based on transcriptome at 8 and 16 d showed that 5273 and 3019 differentially expressed genes (DEGs) were identified in CK1 vs. MT1 and CK2 vs. MT2, respectively. A total of 67 DEGs were annotated to lignin biosynthesis, and 38 and 9 genes were significantly up-regulated under melatonin treatment, respectively. Some transcription factor genes such as MYB were also identified among the two pairwise comparisons, which might relate to lignin metabolism. Melatonin increased the degree of lignification in tea leaves by modifying the enzyme genes expression involved in lignin synthesis pathway. These results provide a reference for further study on the molecular mechanism of the dynamic changes of lignin content induced by melatonin treatment in tea plants.

11.
J Int Med Res ; 49(3): 300060521996911, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33779362

RESUMO

OBJECTIVE: A meta-analysis to investigate the risk factors for postoperative hypocalcaemia after thyroidectomy in adult patients. METHODS: A systematic search of publications in the electronic databases (PubMed®, The Cochrane Library, Web of Science, OVID and Embase®) from inception to June 2020 was conducted. Screening of titles, abstracts and full texts and data extraction were independently performed by two authors. The OR was selected as the pooled estimate. RESULTS: The analysis included 23 studies. Twelve significant risk factors for postoperative hypocalcaemia were identified: hypoparathyroidism, OR 5.58; total thyroidectomy, OR 3.59; hypomagnesaemia, OR 2.85; preoperative vitamin D deficiency, OR 2.32; female sex, OR 1.49; thyroid malignancy, OR 1.85; thyroiditis, OR 1.48; substernal multinodular goitres, OR 1.70; parathyroidectomy, OR 1.58; central compartment neck dissection, OR 1.17; modified radical neck dissection, OR 1.57; and central neck dissection, OR 1.54. CONCLUSIONS: This meta-analysis provides moderate-to-high quality evidence that the 12 risk factors were predictive of postoperative hypocalcaemia, which should be monitored closely before thyroidectomy.

12.
Artigo em Inglês | MEDLINE | ID: mdl-33782006

RESUMO

BackgroundThe Clinical and Laboratory Standards Institute (CLSI) revised the fluoroquinolone minimal inhibitory concentration (MIC) breakpoints for Enterobacterales in 2019, based on pharmacokinetic/pharmacodynamic analyses. However, clinical evidence supporting these breakpoints revision is limited.MethodsA retrospective cohort was conducted at 3 hospitals in Taiwan between January 2017 and March 2019. Patients treated with levofloxacin for Enterobacterales bacteremia with high-MIC (1 or 2 µg/mL; levofloxacin-susceptible by pre-2019 CLSI breakpoints) were compared with those with low-MIC (≤0.5 µg/mL; levofloxacin-susceptible by 2019 CLSI breakpoints) to assess therapeutic effectiveness in multivariable logistic regression. The primary outcome was 30-day mortality and the secondary outcome was the emergence of levofloxacin-resistant isolates within 90 days after levofloxacin initiation.ResultsA total of 308 patients were eligible in the study. Kaplan-Meier analysis showed that patients infected with high-MIC isolates (n=63) had a significantly lower survival rate compared with those infected with low-MIC isolates (n=245) (p=0.001). Multivariable logistic regression revealed high levofloxacin MIC was a predictor of 30-day mortality [odds ratio (OR) 6.05, 95% confidence interval (CI) 1.51-24.18, p=0.011]. We consistently found similar result in propensity-score matched cohort (OR 5.38, 95%CI 1.06-27.39, p=0.043). The emergence of levofloxacin-resistant isolates was likely more common in the high-MIC group compared to the low-MIC group (7.5% vs. 25.0%, p=0.065). An estimated AUC/MIC ratio≥ 87 was significantly associated with better survival (p=0.002).ConclusionsPatients with high levofloxacin MICs within the pre-2019 CLSI susceptible range of 1 or 2 µg/mL were associated with higher mortality compared to those with MICs ≤0.5 µg/mL.

13.
Accid Anal Prev ; 154: 106092, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33765495

RESUMO

Whether the public feels psychologically safe about intelligent connected vehicles (ICVs) is crucial for this new technology to prevail. While researchers have realized the importance of perceived safety, a direct and psychometrically sound measure is still needed. This paper aimed to develop and validate a scale to measure the perceived safety of ICVs. In Study 1, an 8-item scale of the perceived safety was developed based on a literature review and used with a sample from Beijing (n = 373), among the people who are very likely to be the first wave of users. Exploratory factor analysis retained six items and found that a two-dimensional model (three items for cognitive safety and three items for emotional safety) best suited the data. Correlational analyses suggested that the two components may have unique causes and consequences. In Study 2, using a different sample from Shenzhen (n = 352), confirmatory factor analysis consolidated the two-factor model. Further correlational analyses showed that the scale had good criterion-related validity. Across two studies, cognitive safety was related to perceived controllability, the tendency to seek new technologies, ICV driving experience, perceived government support, drive intention and intention to be other road users. Emotional safety was correlated with social support, familiarity, benefit perception, purchase and recommend intention. These results suggest that the scale developed in this study is a useful and reliable tool to measure perceived safety. Implications for future studies and relevant policies are discussed.

14.
J Colloid Interface Sci ; 594: 658-668, 2021 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-33780769

RESUMO

The photoreduction of the green-house gas CO2 into carbon monoxide (CO) is a growing process due to the use of CO for the production of methanol in the Fischer-Tropsch process and the synthesis of many of the bulk chemicals. Here, we have synthesized phosphorous doped graphitic carbon nitride (P-g-C3N4) sensitized by the cobalt phthalocyanine complex for the molecular reduction of CO2 into CO under visible-light irradiation-the doping of phosphorous improved the stability as well as the harvesting of the visible region. The CoPc@P-g-C3N4 hybrid photocatalyst exhibited the highest efficiency for the photoreduction of CO2 with a high yield of 295 µmol-g-1 for CO under the experimental conditions. Also, hydrogen with low concentration was identified as a by-product under the experimental conditions. The photocatalyst had stability for six consecutive runs with negligible loss of the activity and no leaching of the cobalt content at the end of the sixth run of the photoreduction experiment. The stability of the photocatalysts is an advantage, which made it a suitable candidate for the current reaction system.

15.
Asia Pac J Clin Nutr ; 30(1): 22-29, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33787037

RESUMO

BACKGROUND AND OBJECTIVES: Stress hyperglycemia is a common condition in critically ill patients. Inappropriate nutritional supplementation may worsen blood glucose control in these patients. The present study aimed to investigate the outcome of blood glucose control status when using various enteral formulas. METHODS AND STUDY DESIGN: This retrospective study was conducted at the intensive care unit of a tertiary medical center in central Taiwan. Patients meeting the following inclusion criteria were enrolled in the study: age ≥20 years, respiratory failure requiring mechanical ventilation, and two consecutive blood glucose concentration measurements of ≥180 mg/dL. Demographic data, blood glucose samples, and hospital mortality were collected for analysis. RESULTS: A total of 4,604 blood glucose samples from 48 patients were analyzed. Results demonstrated no significant difference in mortality rate or blood glucose control between patients fed semi-elemental formulas and those fed polymer formulas. Serum HbA1C of <7.5% was a risk factor for hospital mortality (OR: 0.18, 95% CI: 0.04-0.89). Enteral formulas containing less carbohydrate were associated with better blood glucose control. CONCLUSIONS: No significant difference in the outcome of blood glucose control was observed between patients fed semi-elemental formula and those fed polymer formula. To achieve better blood glucose control in critically ill patients, formulas with lower carbohydrate content should be considered.

16.
Bioorg Med Chem Lett ; 40: 127913, 2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33705905

RESUMO

Resveratrol is a natural polyhydroxy trans-stilbene product with many biological activities. One of the most striking biological activities of it is its anti-aging potential. Resveratrol can exhibit anti-aging activity via a variety of signaling pathways, however, the repair effect of it on kidney and brain injury in aging mice induced by d-galactose and its regulation on klotho gene expression have not been reported. Herein, the anti-aging activity of resveratrol and its effect on the repair of kidney and brain injuries in d-galactose-induced aging mice, as well as its regulation of klotho gene expression in these two tissues were investigated. The results indicated that resveratrol could significantly increase the aged cell viability and improve the pathological status of aging mice via inhibiting the formation of malondialdehyde and enhancing the activities of superoxide dismutase and catalase. The histological analysis suggested that resveratrol could remarkably repair the damages of kidney and brain tissues in aging mice. Moreover, PCR and western blot have shown that resveratrol could obviously increase the anti-aging klotho gene expression in the above tissues. The data in this paper further revealed and enriched the anti-aging mechanism of resveratrol, and the methods established in this study can be used as a tool to evaluate the anti-aging activity of drugs to a certain extent.

17.
Huan Jing Ke Xue ; 42(4): 1668-1678, 2021 Apr 08.
Artigo em Chinês | MEDLINE | ID: mdl-33742802

RESUMO

The aim of this study was to analyze the differences in the concentration, particle size, and bacterial community structure of microbial aerosols and further investigated the effects of meteorological conditions and air pollutants on microbial aerosol distribution at different periods during spring in Lanzhou. The results showed that the average aerosol concentrations of total microbes, bacteria, fungi, and actinomycetes in the air environment of Lanzhou were (2730±376), (2243±354), (349±38), and (138±22) CFU·m-3, respectively. The contribution rate of bacteria was 82.16%, which was significantly higher than that of fungi and actinomycetes (P<0.05). The concentrations of total microorganisms, bacteria, and actinomycetes during 08:00-09:00 were significantly higher than those sampled during 18:00-19:00, indicating that meteorological conditions and air pollutants have a remarkable influence on the concentration of microbial aerosols. Aerosol particles of bacteria and fungi were primarily distributed at the first four levels (>2.1 µm), accounting for 85.13% and 83.26%, respectively, while 73.15% of the actinomycetes aerosol particles focused largely on the latter four stages (<4.7 µm). Illumina MiSeq sequencing results indicated that there was no significant difference in the composition of the bacterial community (P>0.05) during the periods of 08:00-09:00 and 18:00-19:00. Lactococcus and Bacillus were the dominant bacteria genus. Enterococcus, Staphylococcus, Pseudomonas, Acinetobacter, Klebsiella, Erwinia, Bacillus cereus, Streptococcus agalactiae, and Clostridium perfringens were potential pathogens detected in the air environment of Lanzhou in the spring. The results could provide fundamental data for further revealing the contamination status of microbial aerosols and the potential harm of the related pathogenic bacteria to human health during the spring in Lanzhou.


Assuntos
Microbiologia do Ar , Poluentes Atmosféricos , Aerossóis/análise , Poluentes Atmosféricos/análise , China , Cidades , Monitoramento Ambiental , Fungos , Humanos , Tamanho da Partícula
18.
Aging (Albany NY) ; 13(5): 7147-7165, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33658397

RESUMO

Whether tenofovir disoproxil fumarate (TDF) is superior to entecavir in reducing hepatocellular carcinoma (HCC) risk among treatment-naïve chronic hepatitis B (CHB) patients remains controversial. We aimed to clarify this controversy. Several databases, including PubMed and Embase, were retrieved through November 2020. Cohort studies comparing the effectiveness of TDF and entecavir in reducing HCC incidence among treatment-naïve CHB patients were included if they reported multivariable-adjusted or propensity-score-matched risk estimates. A random-effects model was used to pool hazard ratios (HRs). Thirteen cohort studies, involving 4097 HCC cases and 80202 CHB patients, were included. Multivariable-adjusted meta-analysis revealed no significant difference in HCC incidence between TDF and entecavir groups (HR 0.86, 95% confidence interval 0.72-1.04), which was consistent with propensity-score-matched meta-analysis (HR 0.83, 95% confidence interval 0.66-1.03). Subgroup analysis showed that the observed similarity of TDF to entecavir for HCC prevention persisted in studies with follow-up length of ≥4 years but not in those with follow-up length of <4 years (Pinteraction<0.01). In conclusion, TDF is similar to entecavir in reducing HCC incidence among treatment-naïve CHB patients. Heterogeneous results of included studies may result from their disparity in follow-up length. Our findings should be treated with caution and need to be further confirmed.

19.
Fitoterapia ; 151: 104877, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33667564

RESUMO

Five new flavonol glycosides (1-5), one new phenylpropanoid glycoside (6), and nine known glycosides (7-15) were isolated from the stems and leaves of Neoshirakia japonica. The structures of the new compounds were determined by detailed analysis of spectroscopic data (HRESIMS, 1D and 2D NMR) and acid hydrolysis experiment. The antineuroinflammatory effects of all the isolates were evaluated by inhibiting NO production against LPS-induced BV-2 microglial cells. Compounds 1, 8, and 9 showed more potent inhibitory activities with IC50 values of 2.7, 5.5, and 4.1 µM, respectively, than that of the positive control minocycline (IC50 = 15.6 µM), while compounds 7 (IC50 = 17.0 µM) and 10 (IC50 = 24.3 µM) also displayed inhibitory activities to a certain degree.

20.
Artigo em Inglês | MEDLINE | ID: mdl-33787525

RESUMO

BACKGROUND: Teleradiology has become one of the most important approaches to virtual clinical diagnosis; its importance has only grown during the coronavirus 2019 pandemic. In developing countries, asking patients to take photographs of their images using a smartphone can facilitate the process and help keep its costs down. However, the images taken by patients with smartphones often are of poor quality, and there is no regulation or standard instruction about how to use smartphones to take photographs of medical examination images effectively. These problems limit the use of smartphones in remote diagnosis and treatment. QUESTIONS/PURPOSES: To formulate a set of guidelines for the most appropriate and effective use of smartphones to capture images (radiographs, CT images, and MR images), and to determine whether these guidelines are more effectively adopted by patients of differing ages and genders. METHODS: In this prospective study, a set of step-by-step instructions was created with the goal of helping patients take better smartphone photographs of orthopaedic diagnostic images for transfer to telemedicine services. Following the advice of surgeons, experts in smartphone technology, imaging experts, and suggestions from patients, the instructions were modified based on clinical experience and finalized with the goals of simplicity, clarity, and convenience. Potentially eligible patients were older than 18 years, had no cognitive impairment, and used smart phones. Based on that, 256 participants (patients or their relatives and friends) who visited the orthopaedic department of our hospital from June to October 2020 potentially qualified for this study. A total of 11% (29) declined to participate, leaving 89% (227) for analysis here. Their mean age was 36 ± 11 years, 50% were women (113 of 227), and the patient himself/herself represented in 34% (78 of 227) of participants while relatives or friends of patients made up 66% (149 of 227) of the group. In this study, the diagnoses included spinal stenosis (47% [107 of 227]), disc herniation without spinal stenosis (31% [71 of 227]), vertebral fractures (14% [32 of 227]), and other (7% [17 of 227]). Each study participant first took photographs of their original medical images based on their own knowledge of how to use the smartphone camera function; each participant then took pictures of their original images again after receiving our instructional guidance. Three senior spine surgeons (YZ, TQL, TCM) in our hospital analyzed, in a blinded manner, the instructed and uninstructed imaging files based on image clarity (the content of the image is complete, the text information in the image is clearly visible, there is neither reflection nor shadow in the image) and image position (it is not tilted, curled, inverted, or reversed). If either of these conditions was not satisfied, the picture quality was deemed unacceptable; two of three judges' votes determined the outcome. Interobserver reliability with kappa values for the three judges were 0.89 (YZ versus TQL), 0.92 (YZ versus TCM), and 0.90 (TQL versus TCM). RESULTS: In this study, the overall proportion of smartphone medical images deemed satisfactory increased from 40% (91 of 227) for uninstructed participants to 86% (196 of 227) for instructed participants (risk ratio 2.15 [95% CI 1.82 to 2.55]; p<0.001). The proportion of acceptable-quality images in different age groups improved after instruction, except for in patients aged 51 years or older (3 of 17 uninstructed participants versus 8 of 17 instructed participants; RR 2.67 [95% CI 0.85 to 8.37]; p = 0.07). The proportion of acceptable-quality images in both genders improved after instruction, but there was no difference between the genders. CONCLUSION: We believe our guidelines for patients who wish to take smartphone photographs of their medical images will decrease image transmission cost and facilitate orthopaedic telemedicine consultations. However, it appears that patients older than 50 years are more likely to have difficulty with this approach, and if so, they may benefit from more hands-on assistance from clinic staff or younger relatives or friends. The degree to which our findings are culture-specific should be verified by other studies in other settings, but on the face of it, there is little reason to believe our findings would not generalize to a reasonable degree. Other studies in more heterogeneous populations should also evaluate factors related to levels of educational attainment and wealth differences, but in the meantime, our findings can give clinical teams an idea of which patients may need a little extra assistance. LEVEL OF EVIDENCE: Level II, therapeutic study.

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