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1.
J Nanosci Nanotechnol ; 20(2): 934-940, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31383089

RESUMO

Precise thermodynamic relations to describe the size-dependent integral melting enthalpy and entropy of nanoparticles were deduced by virtue of designing a thermochemical cycle. The differences between integral and differential melting enthalpy and integral and differential melting entropy of nanoparticles were discussed. Nano-Sn of different sizes was prepared by means of chemical reduction, and differential scanning calorimetry (DSC) was utilized to obtain the melting temperature, melting enthalpy, and melting entropy. The experimental results agree with the theoretical predictions and literature results, demonstrating that the melting temperature, enthalpy, and entropy decrease with decreasing particle size and linearly vary with the reciprocal of particle size within the experimental size range. The variations of melting enthalpy and entropy with particle size mainly depend on the molar surface area, the interfacial tension, and the temperature coefficient of interfacial tension. These findings offer a better understanding of the effect of particle size on the melting thermodynamic behaviors of nanoparticles at different melting stages.

2.
J Nanosci Nanotechnol ; 20(2): 1066-1073, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31383106

RESUMO

Novozym435-gold nanoparticles biohybrids (NAuB) were synthesized and characterized in this work, with subsequent investigations on their catalytic activities and stability in compared with the initial form of Novozym435. This is a new way to modify immobilized enzyme by physical means. The elemental analysis of NAuB showed that Au was also the major element except C and O. The results of TEM and EDX demonstrated that gold nanoparticles (AuNPs) could be formed in the protein molecular network structure or on the surface of protein in the pores of Novozym435. The optimal process parameters for synthesis NAuB: synthesis temperature of 35 °C, HAuCl4 concentration of 0.02 mg/mL, synthesis time of 24 h. Using the transesterification of starch with ferulic acid ethyl ester as the reaction model, preliminary results pointed to excellent stabilities, solvent tolerance and activities as compared with Novozym435. As for a isooctane:dimethyl sulfoxide system, transesterification of starch with ferulic acid ethyl ester was carried out at 6% (w/w) NAuB and 60 °C for 24 h, a maximum DS of 0.2650 was obtained.

3.
Chemosphere ; 240: 124875, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31541899

RESUMO

Adsorptive removal of phthalate esters from wastewater combined with their persulfate (PS) catalytic degradation has attracted the attention of many researchers. In this study, the adsorptive and catalytic properties of an MIL100 material obtained by a green synthetic route have been optimized by a surface molecular imprinting technique. Results have shown that there are two steps in the molecular imprinting process. A polymerization is first carried out in the internal channels of the material and the imprinting layer is then formed on the surface. The relative proportions of the starting materials for the synthesis have been optimized through the design of a three-dimensional response surface. The amount of pollutant adsorbed was increased fourfold after surface imprinting, reaching 13.6 mg g-1. The homogeneity of the recognition sites has been evaluated by dynamics calculations and the Freundlich equation. The selective adsorption ability of the material for diethyl phthalate was improved, and the process involved chemical adsorption. The catalytic properties of the material after imprinting were increased about 1.5-fold, indicating that selective adsorption is important. Such molecularly imprinted polymers may potentially serve as good functional materials for the removal of phthalate esters from wastewater.

4.
Chemosphere ; 240: 124846, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31550594

RESUMO

Cadmium (Cd) precipitation and dissolution in pore water is associated with dissolved organic carbon (DOC)-induced reduction-oxidation of sulfur (S) under waterlogging and is vital for controlling the bioavailability in paddy soil. A 120-day soil incubation experiment, including application of sulfur (S, 30 mg kg-1) and wheat straw (W, 1.0%) alone or in combination (W + S) into Cd-contaminated paddy soil under waterlogging, was conducted to investigate the dynamic of dissolved Cd and its relationship with DOC, S2-, Fe2+, pH, Eh and pe + pH in soil pore water. The results showed that the lowest dissolved Cd concentration was observed in the W + S-treated soil pore water among all treatments when the soil Eh remained at lower values during the period of 15-60 days of incubation, which could be attributed to CdS precipitation and/or co-precipitation of Cd absorbed by FeS2 because of the reduction in sulfur. The application of S resulted in a Cd rebound in the pore water irrespective of W addition when the Eh began to increase from its lowest values during the period of 45-75 days of incubation, and SOB genera were observed in the S added soil. This could be attributed to re-dissolution of the precipitated Cd in soils under the SOB-driven oxidation of sulfide such as CdS and FeS2. In conclusion, DOC-driven reduction-oxidation of sulfur controls Cd dissolution in the pore water of Cd-contaminated paddy soil under waterlogging conditions. Further studies are required to investigate the interaction of sulfur and SOM-induced DOC on Cd bioavailability in rice-planted paddy soils.

5.
Chemosphere ; 240: 124849, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31561166

RESUMO

In this work, reduced graphene oxide/metal organic framework composites (RGO/MOF) have been fabricated for the purpose of activating persulfate (PS) successfully first time. Benefiting from the abundant active sites of composites and the excellent electron conductivity arising from repaired large π conjugate plane structure, RGO/MIL-101(Fe) performed better than RGO and MIL-101(Fe) for PS activation and organic compounds degradation from aqueous. The physical-chemical properties of composite catalysts were fully characterized and the applications to the catalytic degradation of trichlorophenol (TCP) were evaluated. The results showed that RGO/MIL-101(Fe) could effectively degrade TCP, under the reaction conditions of pH 3.0, 20 mg/L TCP, 20 mM PS, 0.5 g/L catalyst, and the removal efficiency is 92% in 180 min. Furthermore, chemical reduction and thermal process played key role in regulating defect levels and electron transfer channels. The obtained adsorptive and conductive graphene allow rapid electron transport between free radicals and enriched contaminants. These advancements of the structure and chemical properties were beneficial to improve the catalytic activity in the activation of PS. Finally, a possible activation mechanism was also investigated, which involved the prevailing free radical pathway and recessive non-radical pathway.

6.
Water Res ; 168: 115200, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31655440

RESUMO

H2-based autotrophic denitrification is promising to remove nitrate from water or wastewater lacking organic carbon sources, and pH is one of its most important process parameters. HCl and CO2 addition are known as adequate pH control methods for practical purposes. However, because of H2, added CO2 may participate in microbial metabolisms and affect denitrification mechanisms. Here, a combined micro-electrolysis and autotrophic denitrification (CEAD) reactor, in which H2 is generated based on galvanic-cell reactions between zero-valent iron and carbon, was optimized and continuously operated for 233 days by adding HCl or CO2 to control pH in the range of 7.2-8.2. Microbial communities were compared between the two pH-control methods through high-throughput sequencing of 16S rRNA, nirS, and nirK genes. Under a low COD/N ratio of 0.5 in the influent (with ∼36 mgNO3--N/L), when adding HCl, the total nitrogen (TN) removal efficiency reached 91.4% ±â€¯0.9% with a 28-h hydraulic retention time (HRT). When adding CO2, the TN removal efficiency was improved to 96.5% ±â€¯1.7% with 24-h HRT. Significant differences of 16S rRNA and nirS genes between the two pH-control stages indicated the variation of microbial communities and nirS-type denitrifiers. With HCl addition, Thiobacillus, unclassified Comamonadaceae, Arenimonas, Limnobacter, and Thermomonas, which were reported previously as likely autotrophic or heterotrophic denitrifiers, were most dominant in the biofilms. With CO2 addition, the biofilms became dominated by Anaerolineaceae and Methylocystaceae (related to organic carbon metabolism), Denitratisoma (likely heterotrophic denitrifier), and uncultured bacteria TK10 and AKYG587. The results suggest that the added CO2 not only contributed to pH control but also participated in microbial metabolisms. This study provides useful insights into microbial mechanisms and further optimization of H2-based autotrophic denitrification in water and wastewater treatment.


Assuntos
Desnitrificação , Microbiota , Processos Autotróficos , Reatores Biológicos , Dióxido de Carbono , Concentração de Íons de Hidrogênio , Nitratos , Nitrogênio , RNA Ribossômico 16S , Águas Residuárias
7.
J Endocrinol ; 244(1): 25-40, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31539873

RESUMO

Recent studies raise the possibility that eukaryotic translation elongation factor 1 alpha (eEF1A) may play a role in metabolism. One isoform, eEF1A2, is specifically expressed in skeletal muscle, heart and brain. It regulates translation elongation and signal transduction. Nonetheless, eEF1A2's function in skeletal muscle glucose metabolism remains unclear. In the present study, suppression subtractive hybridisation showed a decrease in Eef1a2 transcripts in the skeletal muscle of diabetic Mongolian gerbils. This was confirmed at mRNA and protein levels in hyperglycaemic gerbils, and in db/db and high-fat diet-fed mice. Further, this downregulation was independent of Eef1a2 promoter methylation. Interestingly, adeno-associated virus-mediated eEF1A2 overexpression in skeletal muscle aggravated fasting hyperglycaemia, hyperinsulinaemia and glucose intolerance in male diabetic gerbils but not in female gerbil models. The overexpression of eEF1A2 in skeletal muscle also resulted in promoted serum glucose levels and insulin resistance in male db/db mice. Up- and downregulation of eEF1A2 by lentiviral vector transfection confirmed its inhibitory effect on insulin-stimulated glucose uptake and signalling transduction in C2C12 myotubes with palmitate (PA)-induced insulin resistance. Furthermore, eEF1A2 bound PKCß and increased its activation in the cytoplasm, whereas suppression of PKCß by an inhibitor attenuated eEF1A2-mediated impairment of insulin sensitivity in insulin-resistant myotubes. Endoplasmic reticulum (ER) stress was elevated by eEF1A2, whereas suppression of ER stress or JNK partially restored insulin sensitivity in PA-treated myotubes. Additionally, eEF1A2 inhibited lipogenesis and lipid utilisation in insulin-resistant skeletal muscle. Collectively, we demonstrated that eEF1A2 exacerbates insulin resistance in male murine skeletal muscle via PKCß and ER stress.

8.
J Affect Disord ; 260: 334-341, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-31521871

RESUMO

BACKGROUND: To investigate mental and physical health comorbidity with chronic back or neck pain in the Chinese population, and assess the level of disability associated with chronic back or neck pain. METHODS: Data were derived from a large-scale and nationally representative community survey of adult respondents on mental health disorders in China (n = 28,140). Chronic back or neck pain, other chronic pain conditions and chronic physical conditions were assessed by self-report. Mental disorders were assessed by the Composite International Diagnostic Interview (CIDI). Role disability during the past 30 days was assessed with the World Health Organization Disability Assessment Schedule (WHO-DAS-II). RESULTS: The 12-month prevalence of chronic back or neck pain was 10.8%. Most of respondents with chronic back or neck pain (71.2%) reported at least one other comorbid condition, including other chronic pain conditions (53.4%), chronic physical conditions (37.9%), and mental disorders (23.9%). It was found by logistic regression that mood disorders (OR = 3.7, 95%CI:2.8-4.8) showed stronger association with chronic back or neck pain than anxiety disorders and substance disorders. Most common chronic pains and physical conditions were significantly associated with chronic back or neck pain. Chronic back or neck pain was associated with role disability after controlling for demographics and for comorbidities. Physical and mental comorbidities explained 0.7% of the association between chronic back or neck pain and role disability. CONCLUSIONS: Chronic back or neck pain and physical-mental comorbidity is very common in China and chronic back or neck pain may increase the likelihood of other physical and mental diseases. This presents a great challenge for both clinical treatment and public health education. We believe that further study needs to be conducted to improve the diagnostic and management skills for comorbidity conditions.

9.
Carbohydr Polym ; 228: 115385, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31635747

RESUMO

A novel copper(II)-ß-cyclodextrin and CuO functionalized graphene oxide composite (CD-CuO/NH2-GO) was successfully synthesized by reacting mono-6-O-toluenesulfonyl-copper(II)-ß-cyclodextrin with amino and CuO functionalized graphene oxide. The characterization results showed that the CD-CuO/NH2-GO was well-characterized and has a BET surface area of 746.5 m2 g-1 and good thermal stability, and CD and CuO were uniformly dispersed. The unique structure of CD-CuO/NH2-GO is conducive to the synergistic effect of the different components, especially for the inclusion ability of CD. Benefiting from that, CD-CuO/NH2-GO could quickly and efficiently remove the thiophenic sulfides, which are difficult to be economically removed by hydrodesulfurization. The removal efficiency for the three sulfides was in the order of benzothiophene > dibenzothiophene > thiophene. The desulfurization process of benzothiophene has the fastest desulfurization rate (0.121 g mg-1 min-1) and maximum sulfur capacity (12.75 mg S g-1). The different molecular inclusion ability of CD for the thiophenic sulfides demonstrates the difference in the desulfurization of CD-CuO/NH2-GO. The work highlights the synthesis and the potential application in fuel desulfurization of supramolecular GO composite nanomaterials.

10.
IEEE Trans Cybern ; 50(1): 338-350, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30561356

RESUMO

This paper is concerned with the optimal decentralized output-feedback control of the large-scale systems. A random information pattern is considered, where the information is transmitted among the subsystems with random communication delays. For the random information pattern, the optimal LQG problems for both global estimation case and local estimation case are studied. It is difficult to derive the optimal controller under random framework, because the gains of the controller must be designed to satisfy the random sparse structure constraints. In this paper, we design the optimal controller by Hadamard product method. For global estimation case, the gains of the controller are obtained by solving linear matrix equation. For local estimation case, an iterative algorithm is exploited to compute the gains. In addition, the value of the cost function achieved by the designed controller is found and shown to monotonically increase with the increase of the delay probability for both global and local estimation cases. Finally, the theoretical results are illustrated by two numerical examples.

11.
J Cell Biochem ; 121(1): 713-722, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31385350

RESUMO

Small for gestational age (SGA) has a high risk of mortality and morbidity and is common in obstetrics. To date, no effective prediction and treatment tools are available. Acting as microRNA (miRNA) sponges and disease biomarkers are clear functions of circular RNAs (circRNAs). However, it is still unknown what role circRNAs act in SGA. To explore the role of circRNAs in SGA, circRNA expression patterns of the umbilical cord and maternal plasma in SGA was assessed. We first evaluated circRNAs in umbilical cord blood of the SGA and appropriate for gestational age (AGA) groups by microarray sequencing. In total, 170 340 circRNAs were sequenced, and 144 circRNAs were significantly upregulated while 977 were markedly downregulated. Has_circRNA15994-13, has_circ_0001359, and has_circ_0001360 were abundant and differentially expressed between the SGA and AGA groups, and confirmed in the umbilical cord and maternal blood specimens by reverse transcription polymerase chain reaction. By combining miRNA microarray data of the SGA placenta tissue in NCBI, it was found that two miRNAs were both hsa_circRNA15994-13 targets and differentially expressed, including hsa-miR-3619-5p and hsa-miR-4741. Further KEEG analysis revealed that the most significant pathway enriched by hsa-miR-3619-5p was Wnt signaling that is closely related to SGA; meanwhile, previous reports demonstrated that hsa-miR-3619-5p directly binds to ß-catenin to accommodate the Wnt/ß-catenin pathway, whereby the suggestive hsa_circRNA15994-13 → hsa-miR-3619-5p → ß-catenin signaling pathway may play an important part in SGA.

12.
J Pharm Biomed Anal ; 177: 112843, 2020 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-31509788

RESUMO

An UHPLC method was developed for the determination of 15 prenylflavonoids from aerial parts of Epimedium grandiflorum and related species (Berberidaceae). The separation was achieved using a reverse phased column and water/acetonitrile gradient as a mobile phase at a temperature of 40°C. The developed analytical method was validated for linearity, limits of detection (LOD) and limits of quantification (LOQ), stability and repeatability. The LOD and LOQ were found to be in the range from 0.1-0.5 µg/mL and 0.3-1 µg/mL, respectively. The wavelength used for quantification with the photodiode array detector was 269 nm. The total content of 15 prenylflavonoids was 9.1-20.6 mg/g for E. grandiflorum (except for sample #2899 and #20862), 5.6-35.4 mg/g for E. brevicornu and 10.8-30.5 mg/g for E. sagittatum. Twenty dietary supplements contained in the range from 0.1 to 81.7 mg/day. The developed method is simple, rapid and especially suitable for quality assessment of E. grandiflorum and dietary supplements containing E. grandiflorum. Liquid chromatography quadrupole time-of-flight-mass spectrometry (LC-QToF) is described for the identification and confirmation of compounds in plant samples and dietary supplements. This technique is also used for chemical profiling of Epimedium samples. This method involved the use of protonated ions in the positive ion mode and deprotonated ions in the negative ion mode with extracted ion chromatogram (EIC). Chemometric analytical tools for visualizing the plant and commercial samples quality were used for discriminating between Epimedium species and dietary supplements with regards to the relative content or presence of components. A HPTLC method was also developed for the fast chemical fingerprint analysis of Epimedium species.

13.
J Cell Physiol ; 235(2): 1025-1035, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31240705

RESUMO

Cutaneous malignant melanoma (hereafter called melanoma) is one of the most aggressive cancers with increasing incidence and mortality rates worldwide. In this study, we performed a systematic investigation of the tumor microenvironmental and genetic factors associated with melanoma to identify prognostic biomarkers for melanoma. We calculated the immune and stromal scores of melanoma patients from the Cancer Genome Atlas (TCGA) using the ESTIMATE algorithm and found that they were closely associated with patients' prognosis. Then the differentially expressed genes were obtained based on the immune and stromal scores, and prognostic immune-related genes further identified. Functional analysis and the protein-protein interaction network further revealed that these genes enriched in many immune-related biological processes. In addition, the abundance of six infiltrating immune cells was analyzed using prognostic immune-related genes by TIMER algorithm. The unsupervised clustering analysis using immune-cell proportions revealed eight clusters with distinct survival patterns, suggesting that dendritic cells were most abundant in the microenvironment and CD8+ T cells and neutrophils were significantly related to patients' prognosis. Finally, we validated these genes in three independent cohorts from the Gene Expression Omnibus database. In conclusion, this study comprehensively analyzed the tumor microenvironment and identified prognostic immune-related biomarkers for melanoma.

14.
J Cell Physiol ; 235(2): 1090-1102, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31256427

RESUMO

Long noncoding RNAs (lncRNAs) regulate tumor development and progression by promoting proliferation, invasion, and metastasis. The oncogenic role of lncRNA SNHG16 in hepatocellular carcinoma (HCC) has not been revealed. LncRNA SNHG16 is upregulated in HCC and correlates with poorer prognosis. Patients with high SNHG16 expression showed lower rates of overall and disease-free survival than patients with low SNHG16 expression. Multivariate Cox regression revealed that SNHG16 expression was an independent predictor of poor overall and disease-free survival. In vitro, SNHG16 promoted HCC cell proliferation, migration, and invasion while inhibiting apoptosis; in vivo, it accelerated tumor development. Altering SNHG16 expression altered levels of miR-17-5p, which in turn modified expression of p62, which has been shown to regulate the mTOR and NF-κB pathways. Indeed, altering SNHG16 expression in HCC cells activated mTOR and NF-κB signaling. These results reveal a potential mechanism for the oncogenic role of SNHG16 in HCC. SNHG16 may therefore be a promising diagnostic marker as well as therapeutic target in HCC.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31683465

RESUMO

PURPOSE: The aim of this study was to evaluate the diagnostic value of conventional sonography and ultrasound elastography for thyroid nodules of each Bethesda category and to analyze their potential role in the corresponding management decision. METHODS: This retrospective study included 557 thyroid nodules diagnosed by conventional ultrasound (US) and real-time ultrasound elastography (RTE) before fine-needle aspiration (FNA) from 458 patients. The US, RTE, and cytological results were collected and analyzed according to different Bethesda categories. Differences in the distribution of sonographic features between groups were evaluated by the Chi-square test or Fisher exact test. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of conventional US and RTE for the diagnosis of malignant nodules in each category were then calculated and analyzed. RESULTS: The diagnostic accuracy of the comprehensive US diagnosis in all categories stayed at a relatively high level from 78.4% to 88.6%, and good specificities ranging from 77.3% to 100% were revealed in all Bethesda categories. As to RTE, the diagnostic accuracies in categories I-IV stayed at a relatively low level ranging from 44.6% to 65.6% except for better performance in categories V and VI (85.2%, 89.1%). Besides, the accuracies of comprehensive US (85.2%, 88.6%) and RTE (85.2%, 89.1%) is relatively low compared to the corresponding cytological diagnoses in categories V and VI. CONCLUSIONS: Conventional US is complementary to FNA for providing additional hints especially in categories I-IV for further clinical managements, while RTE failed to provide useful diagnostic information in general.

16.
Toxins (Basel) ; 11(11)2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31683906

RESUMO

Lactobacillus plantarum, as a natural bio-preservative, has attracted a great deal of attention in recent years. In this study, 22 L. plantarum strains were tested against the aflatoxin-producing fungus, Aspergillus flavus; strain IAMU80070 showed the highest antifungal activity. At a concentration of 5 × 105 colony-forming units (CFU) mL-1, it completely inhibited A. flavus growth and decreased aflatoxin production by 93%. Furthermore, ultrastructural examination showed that IAMU80070 destroyed the cellular structure of hyphae and spores. To explore the inhibitory effect of IAMU80070 on A. flavus at the transcriptional level, transcriptome data were obtained and subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. The aflatoxin biosynthetic process was the most significantly downregulated functional category, while genes implicated in the synthesis and organization of cell wall polysaccharides were upregulated. Quantitative real-time PCR results verified the credibility and reliability of the RNA sequencing data. These results provided insight into the transcriptome of A. flavus in response to the antagonistic effects of L. plantarum IAMU80070.

17.
Cells ; 8(11)2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31683987

RESUMO

Ectopic lipid accumulation in muscle is important not only for obesity and myopathy treatment, but also for meat quality improvement in farm animals. However, the molecular mechanisms involved in lipid metabolism in muscle satellite cells are still elusive. In this study, SB216763 reduced GSK3ß activation by increasing the level of pGSK3ß (Ser9) and decreasing the level of total GSK3ß protein. GSK3ß inhibition decreased lipid accumulation and downregulated the expression level of lipogenesis-related genes in the adipogenic differentiation of goat muscle satellite cells. Furthermore, SB216763 treatment increased the levels of pAMPKα (T172) and pACC (Ser79). Further, we found that GSK3ß inhibition promoted levels of LC3B-II and reduced the protein levels of p62 to induce the autophagy in muscle satellite cells. Taken together, our results provide new insight into a critical function for GSK3ß: modulating lipid accumulation in goat muscle satellite cells through activating the AMPK pathway.

18.
Artigo em Inglês | MEDLINE | ID: mdl-31688674

RESUMO

OBJECTIVES: In adult in-hospital cardiac arrest, pulmonary hypertension is associated with worse outcomes, but pulmonary hypertension-associated in-hospital cardiac arrest has not been well studied in children. The objective of this study was to determine the prevalence of pulmonary hypertension among children with in-hospital cardiac arrest and its impact on outcomes. DESIGN: Retrospective single-center cohort study. SETTING: PICU of a quaternary care, academic children's hospital. PATIENTS: Children (<18 yr old) receiving greater than or equal to 1 minute of cardiopulmonary resuscitation (cardiopulmonary resuscitation) for an index in-hospital cardiac arrest with an echocardiogram in the 48 hours preceding in-hospital cardiac arrest, excluding those with cyanotic congenital heart disease. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 284 in-hospital cardiac arrest subjects, 57 (20%) had evaluable echocardiograms, which were analyzed by a cardiologist blinded to patient characteristics. Pulmonary hypertension was present in 20 of 57 (35%); nine of 20 (45%) had no prior pulmonary hypertension history. Children with pulmonary hypertension had worse right ventricular systolic function, measured by fractional area change (p = 0.005) and right ventricular global longitudinal strain (p = 0.046); more right ventricular dilation (p = 0.010); and better left ventricular systolic function (p = 0.001). Children with pulmonary hypertension were more likely to have abnormal baseline functional status and a history of chronic lung disease or acyanotic congenital heart disease and less likely to have sepsis or acute kidney injury. Children with pulmonary hypertension were more likely to have an initial rhythm of pulseless electrical activity or asystole and were more frequently treated with inhaled nitric oxide (80% vs 32%; p < 0.001) at the time of cardiopulmonary resuscitation. On multivariable analysis, pulmonary hypertension was not associated with event survival (14/20 [70%] vs 24/37 [65%]; adjusted odds ratio, 1.30 [CI95, 0.25-6.69]; p = 0.77) or survival to discharge (8/20 [40%] vs 10/37 [27%]; adjusted odds ratio, 1.17 [CI95, 0.22-6.44]; p = 0.85). CONCLUSIONS: Pulmonary hypertension physiology preceding pediatric in-hospital cardiac arrest may be more common than previously described. Among this cohort with a high frequency of inhaled nitric oxide treatment during cardiopulmonary resuscitation, pulmonary hypertension was not associated with survival outcomes.

19.
Ultrasound Med Biol ; 2019 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-31718811

RESUMO

Both ischemic cardiomyopathy (ICM) and non-ischemic cardiomyopathy (NICM) are characterized by left ventricular (LV) dysfunction and dilation. Differentiation between ICM and NICM using non-invasive image modalities is a clinical challenge. This study compared the myocardial deformation patterns of ICM and NICM using 2-D speckle tracking echocardiography (2-D STE) and sought to find parameters valuable in the diagnosis and management of dilated cardiomyopathy. The study population comprised 84 consecutive patients with LV end-diastolic dimension >55 mm and ejection fraction (EF) <45 %. Of these patients, 41 were diagnosed with ICM and 43 with NICM by coronary angiography. 2-D STE was performed in all patients. The LV dimension did not differ between ICM and NICM. Compared with patients with ICM, patients with NICM had lower EF (29.0% vs. 33.0%, p = 0.024), lower global longitudinal strain (-5.4 ± 2.6% vs. -7.0 ± 2.5%, p = 0.006) and lower global radial strain (7.5 ± 4.5% vs. 10.7 ± 4.7%, p = 0.019). In contrast, global longitudinal strains did not differ significantly. However, NICM patients had higher apical and lower basal longitudinal strains compared with those with ICM. The ratio of basal to sum of mid- and apical longitudinal strains could predict NICM with a sensitivity of 63.4% and specificity of 88.4% by receiver operating characteristic curve analysis (cutoff value: 0.47, area under the curve: 0.792). Moreover, the concomitant presence of non-significant coronary artery stenosis (>50% and <70%) had no significant influence on global longitudinal strain in NICM. In conclusion, LV dilation and systolic dysfunction, relative apical sparing and a basal worsening pattern of LV longitudinal strain by 2-D STE were observed in patients with NICM but not ICM. The ratio of basal to sum of mid- and apical longitudinal strains could help differentiate NICM from ICM.

20.
Bone Joint J ; 101-B(11): 1438-1446, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31674243

RESUMO

AIMS: This study aimed to explore whether intraoperative nerve monitoring can identify risk factors and reduce the incidence of nerve injury in patients with high-riding developmental dysplasia. PATIENTS AND METHODS: We conducted a historical controlled study of patients with unilateral Crowe IV developmental dysplasia of the hip (DDH). Between October 2016 and October 2017, intraoperative nerve monitoring of the femoral and sciatic nerves was applied in total hip arthroplasty (THA). A neuromonitoring technician was employed to monitor nerve function and inform the surgeon of ongoing changes in a timely manner. Patients who did not have intraoperative nerve monitoring between September 2015 and October 2016 were selected as the control group. All the surgeries were performed by one surgeon. Demographics and clinical data were analyzed. A total of 35 patients in the monitoring group (ten male, 25 female; mean age 37.1 years (20 to 46)) and 56 patients in the control group (13 male, 43 female; mean age 37.9 years (23 to 52)) were enrolled. The mean follow-up of all patients was 13.1 months (10 to 15). RESULTS: The two groups had no significant differences in preoperative data. In the monitoring group, ten nerve alerts occurred intraoperatively, and no neural complications were detected postoperatively. In the control group, six patients had neural complications. The rate of nerve injury was lower in the monitoring group than in the control group, but this did not achieve statistical significance. The degree of leg lengthening was significantly greater in the monitoring group than in the control group. In further analyses, patients who had previous hip surgery were more likely to have intraoperative nerve alerts and postoperative nerve injury. CONCLUSION: Nerve injury usually occurred during the processes of exposure and reduction. The use of intraoperative nerve monitoring showed a trend towards reduced nerve injury in THA for Crowe IV DDH patients. Hence, we recommend its routine use in patients undergoing leg lengthening, especially in those with previous hip surgery. Cite this article: Bone Joint J 2019;101-B:1438-1446.


Assuntos
Artroplastia de Quadril/métodos , Nervo Femoral/fisiologia , Luxação Congênita de Quadril/cirurgia , Tratamentos com Preservação do Órgão/métodos , Nervo Isquiático/fisiologia , Adulto , Feminino , Nervo Femoral/lesões , Humanos , Masculino , Pessoa de Meia-Idade , Monitorização Intraoperatória/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Nervo Isquiático/lesões , Traumatismos do Sistema Nervoso/prevenção & controle , Adulto Jovem
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