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1.
BMC Musculoskelet Disord ; 22(1): 28, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407335

RESUMO

BACKGROUND: To evaluate the clinical outcomes of arthroscopic tight fibrous band release in the treatment of adult moderate-to-severe gluteal fibrosis using anterior and posterior portals during mid-term follow-up. METHODS: The data of 138 patients (58 males, 80 females) aged between 18 and 42 years (mean, 28.6 years), presenting with bilateral moderate-to-severe gluteal fibrosis (GF) from October 2013 to August 2019, was retrospectively analyzed. All patients underwent arthroscopic tight fibrous band release using anterior and posterior portals with radiofrequency energy. Under arthroscopic guidance through the posterior portal, we debrided the fatty tissue overlying the contracted band of the gluteal muscle and excised the contracted bands using a radiofrequency device introduced through the anterior portal. The pre- and post-operative gluteal muscle contracture disability (GD) scale and the patient satisfaction rate were compared to evaluate the curative effect of the operation. RESULTS: The average operation time was 18 min (range, 10-30 min) and the average blood loss was 4 ml (range, 2-10 ml) for unilateral arthroscopic release. Two cases of post-operative minimal hematomas, 2 cases of bruising and 2 cases of local subcutaneous edema were observed as early complications and were cured by conservative treatment. After surgery, all incisions healed in stage I, and no other complications such as wound infection, nerve and blood vessel injury were detected. One hundred eighteen patients were followed up for 6 to 72 months (mean, 36 months). No lateral instability of the hip was observed and all patients returned to normal gait. The degree of adduction of the hip joint in all these 118 patients was significantly improved relative to their pre-operative conditions. One hundred fifteen patients (97.5%) were able to crouch with knees close to each other after surgery. One hundred fourteen patients (96.6%) were able to cross the affected leg completely without any support. The GD scale was improved from 55.5 ± 10.6 before operation to 90.1 ± 5.2 at the last follow-up (p < 0.05). The patient satisfaction rate was 95.8%. CONCLUSION: Arthroscopic tight fibrous band release using anterior and posterior portals is minimally invasive for adult moderate-to-severe gluteal fibrosis, with a high success rate, quick recovery after surgery and reliable medium-term effect.

2.
BMJ Open Qual ; 10(1)2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33408099

RESUMO

Patients admitted to the isolation ward during the COVID-19 outbreak face multiple psychosocial stressors including the disruptive experience of being in quarantine, anxiety over contracting a newly emerging infectious disease and limited access to their healthcare team. This quality improvement project aims to leverage on technology to improve patients' access to, and experience of, care while in isolation.Patients admitted to two isolation wards in Singapore General Hospital (SGH) between 28 February and 19 March 2020 were each provided an iPad loaded with the MyCare application (app), curated materials and mobile games. During this period, 83 of them accessed the device and the app. MyCare app is an app developed by the nursing team in SGH as part of an existing interprofessional collaboration to help patients navigate their care during their inpatient stay. In response to COVID-19, MyCare app was supplemented with materials to address affected patients' informational and psychosocial needs. These materials included an information sheet on COVID-19, interviews with previous severe acute respiratory syndrome survivors, psychosocial support materials, and uplifting literature, illustrated storybooks and artwork.This paper describes the process of planning for, and executing, the intervention and reports the initial results of its effect. Initial feedback indicated a positive response to the intervention. 9 out of 10 respondents (90%) rated their hospital experience with a maximum of five stars and all 10 respondents (100%) rated the psychosocial support materials with five stars. Doctors managing the patients also observed a reduction in the number of commonly asked questions following the deployment of the iPad.This quality improvement project is ongoing with plans for further research to determine how to better support the psychosocial needs of patients in isolation during a novel disease outbreak. This report is written based on the Standards for Quality Improvement Reporting Excellence guidelines.


Assuntos
Acesso à Informação , Comportamento do Consumidor , Acesso aos Serviços de Saúde , Hospitalização , Aplicativos Móveis , Quarentena/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Surtos de Doenças , Empoderamento , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Singapura , Estresse Psicológico/etiologia , Estresse Psicológico/prevenção & controle , Adulto Jovem
3.
Chem Commun (Camb) ; 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33399146

RESUMO

Vanadium-doped cobalt oxide materials have emerged as a promising class of catalysts for the oxygen evolution reaction. Previous studies suggest vanadium doping in crystalline Co spinel materials tunes the electronic structure and stabilizes surface intermediates. We report a CoV2O4 material that shows good activity for the oxygen evolution reaction. However, postmortem characterization of the catalyst material shows dissolution of vanadium resulting in an amorphous CoOx material, suggesting that this vanadium-free material, and not CoV2O4, is the active catalyst. This study highlights the importance of postmortem characterization prior to mechanistic and computational analysis for this class of materials.

4.
Int Urol Nephrol ; 2021 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-33389462

RESUMO

PURPOSE: Bruton's tyrosine kinase (BTK) is a vital biological molecule that contributes to immune regulation. Previous studies have showed that BTK can be detected in patients with lupus nephritis and rheumatoid arthritis. However, the role of BTK in IgA nephropathy (IgAN) has not yet been elucidated. The purpose of this research was to investigate the role of BTK activation in macrophages in IgAN. METHODS: Peripheral blood and renal tissue samples were collected from 63 patients with IgAN, and peritumoral normal tissues were collected from 20 patients after surgical resection of renal tumor for use as control. Additionally, 20 healthy volunteers were recruited as control. The levels of BTK, CD68, phosphorylated BTK (pBTK), phosphorylated NF-κB (p-NF-κB p65), tumor necrosis factor (TNF)-α, interleukin (IL)-1ß, and monocyte chemotactic protein (MCP)-1 were measured by immunohistochemistry (IHC), real-time polymerase chain reaction (RT-PCR), western blotting, and enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared to peritumoral normal tissues, the expression levels of CD68 and BTK were significantly increased in IgAN group (p < 0.001) and the differences between M0 and M1, E0 and E1, S0 and S1, T0 and T1-2, C0 and C1-2 were statistically significant in the updated Oxford Classification (p < 0.05). Also, CD68 and BTK were positively correlated with Katafuchi semi-quantitative glomerular and tubulointerstitial scores (r = 0.580, 0.637 and 0.442, 0.489, respectively, p < 0.05). The expression of BTK was significantly higher in C3b- and C4d-positive renal tissues of patients with IgAN (p < 0.05). In addition, BTK was positively correlated with 24-h urine protein, serum creatinine levels (r = 0.456 and 0.453, respectively, p < 0.001), and negatively correlated with serum albumin (r = 0.357, p < 0.05). The intensity of expression of pBTK and p-NF-κB p65 was observably increased in renal tissues and monocytes of patients with IgAN compared to the control group. The results of IHC, RT-PCR, and ELISA indicated that the levels of TNF-ɑ, IL-1ß, and MCP-1 were markedly increased in the IgAN group (p < 0.05). CONCLUSION: The results of this study indicate that activation of BTK in macrophages may play an important role in promoting the progression of renal inflammation in IgAN.

5.
Hypertension ; 77(2): 617-631, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33356397

RESUMO

Pulmonary hypertension (PH) is characterized by profound vascular remodeling and altered Ca2+ homeostasis in pulmonary arterial smooth muscle cells (PASMCs). Magnesium ion (Mg2+), a natural Ca2+ antagonist and a cofactor for numerous enzymes, is crucial for regulating diverse cellular functions, but its roles in PH remains unclear. Here, we examined the roles of Mg2+ and its transporters in PH development. Chronic hypoxia and monocrotaline induced significant PH in adult male rats. It was associated with a reduction of [Mg2+]i in PASMCs, a significant increase in gene expressions of Cnnm2, Hip14, Hip14l, Magt1, Mmgt1, Mrs2, Nipa1, Nipa2, Slc41a1, Slc41a2 and Trpm7; upregulation of SLC41A1, SLC41A2, CNNM2, and TRPM7 proteins; and downregulation of SLC41A3 mRNA and protein. Mg2+ supplement attenuated pulmonary arterial pressure, right heart hypertrophy, and medial wall thickening of pulmonary arteries, and reversed the changes in the expression of Mg2+ transporters. Incubation of PASMCs with a high concentration of Mg2+ markedly inhibited PASMC proliferation and migration, and increased apoptosis, whereas a low level of Mg2+ produced the opposite effects. siRNA targeting Slc41a1/2, Cnnm2, and Trpm7 attenuated PASMC proliferation and migration, but promoted apoptosis; and Slc41a3 overexpression also caused similar effects. Moreover, siRNA targeting Slc41a1 or high [Mg2+] incubation inhibited hypoxia-induced upregulation and nuclear translocation of NFATc3 in PASMCs. The results, for the first time, provide the supportive evidence that Mg2+ transporters participate in the development of PH by modulating PASMC proliferation, migration, and apoptosis; and Mg2+ supplementation attenuates PH through regulation of Mg2+ transporters involving the NFATc3 signaling pathway.

6.
Huan Jing Ke Xue ; 42(1): 343-352, 2021 Jan 08.
Artigo em Chinês | MEDLINE | ID: mdl-33372486

RESUMO

Mastering the spatial distribution of heavy metals in the soil plays an important supporting role in the scientific formulation of soil pollution risk management and control strategies. Few factors were considered and multiple collinearity between parallel variables existed,resulting in low prediction accuracy. OK (common Kriging method), NRK (regressive Kriging method based on natural factors only), and NARK (regressive Kriging based on natural-human factors)were used to simulate the spatial distribution of soil Cd by selecting 23 natural-artificial influencing factors. The prediction accuracy was evaluated based on an empirical study of the area around Shaoguan Qujiang smelter. The results showed that the above-standard rate of soil cadmium in this area reached 85.93%, and the effect on the spatial heterogeneity of soil cadmium was shown as air emissions from smelters > air emissions from steel plants > pH > organic matter > Euclidean distance to road > Euclidean distance to river. The root-mean-square error and average absolute error of NARK's prediction results for soil cadmium were 26.86% and 30.56% lower than that of the OK method, respectively. The model determination coefficient R2 increased from 0.78 to 0.88. Compared with that of NRK, it was reduced by 24.15% and 24.23% and R2 increased from 0.81 to 0.88. The NRK combining natural and human factors significantly improved the simulation accuracy of the spatial distribution of soil cadmium, and the addition of human factors as auxiliary variables, especially atmospheric point source pollution emissions, greatly contributed to the improvement of the model accuracy.


Assuntos
Metais Pesados , Poluentes do Solo , Cádmio , China , Monitoramento Ambiental , Humanos , Metais Pesados/análise , Solo , Poluentes do Solo/análise , Análise Espacial
7.
Biomater Sci ; 9(1): 167-185, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33165465

RESUMO

Nanoporous tantalum pentoxide (NTP) particles with a pore size of about 10 nm were synthesized and blended with polyetheretherketone (PEEK) to fabricate a PEEK/NTP composite (PN). Subsequently, PN was treated by concentrated sulfuric acid to create a microporous surface (pore size of around 2 µm) on sulfonated PN (SPN), which formed a hierarchical micro & nanoporous surface. Compared with PN, the porous surface of SPN exhibited higher roughness, hydrophilicity, and surface energy. In addition, genistein (GT) was loaded into the porous surface of SPN (SPNG), which showed high GT loading capacity and sustained release of GT into phosphate buffered saline (PBS). Moreover, SPNG revealed excellent antibacterial activity, which inhibited bacterial (E. coli and S. aureus) growth in vitro due to the synergistic effects of both sulfonic acid (SO3H) groups and the sustained release of GT. Compared with PN, SPN significantly improved the adhesion, proliferation, and osteogenic differentiation of bone mesenchymal stem cells in vitro. Moreover, compared with SPN, SPNG further enhances the cell responses. Compared with PN, SPN remarkably improved bone formation and osteointegration in vivo. Furthermore, compared with SPN, SPNG further enhanced the osteointegration. In short, SPNG with a micro & nanoporous surface, SO3H groups, and the sustained release of GT exhibited antibacterial activity and accelerated osteointegration, which would have tremendous potential as drug-loaded implants for bone substitute.

8.
Rheumatology (Oxford) ; 60(1): 147-159, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-32594175

RESUMO

OBJECTIVES: To examine trends in the initial prescription of commonly-prescribed analgesics and patient- as well as practice-level factors related to their selection in incident OA. METHODS: Patients consulting with incident clinical OA between 2000-2016 were identified within The Health Improvement Network in the United Kingdom (UK) general practice. Excluded were patients who had history of cancer or were prescribed the analgesics of interest within 6 months before diagnosis of OA. Initial analgesic prescription included oral non-selective NSAID, oral selective cyclooxygenase-2 inhibitor, topical NSAID, paracetamol, topical salicylate or oral/transdermal opioid within 1 month after OA diagnosis. RESULTS: ∼44% of patients with incident OA (n = 125 696) were prescribed one of these analgesics. Incidence of oral NSAID prescriptions decreased whereas other analgesic prescriptions, including oral opioid prescriptions, increased (all P-for-trend < 0.001). Patients with a history of gastrointestinal disease were more likely to receive topical NSAIDs, paracetamol or oral/transdermal opioids. Only 38% of patients with history of gastrointestinal disease and 21% of patients without it had co-prescription of gastroprotective agent with oral NSAIDs. Oral/transdermal opioid prescription was higher among the elderly (≥65 years), women, obesity, current smoker, and patients with gastrointestinal, cardiovascular or chronic kidney disease. Prescription of oral opioids increased with social deprivation (P-for-trend < 0.05) and was highest in Scotland, whereas transdermal opioid prescription was highest in Northern Ireland (all P-for-homogeneity-test < 0.05). CONCLUSION: The initial prescription pattern of analgesics for OA has changed over time in the UK. Co-prescription of gastroprotective agents with oral NSAIDs remains suboptimal, even among those with prior gastrointestinal disease.

9.
JAMA Intern Med ; 181(1): 71-78, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-32910179

RESUMO

Importance: Lymphopenia is common and correlates with poor clinical outcomes in patients with coronavirus disease 2019 (COVID-19). Objective: To determine whether a therapy that increases peripheral blood leukocyte and lymphocyte cell counts leads to clinical improvement in patients with COVID-19. Design, Setting and Participants: Between February 18 and April 10, 2020, we conducted an open-label, multicenter, randomized clinical trial at 3 participating centers in China. The main eligibility criteria were pneumonia, a blood lymphocyte cell count of 800 per µL (to convert to ×109/L, multiply by 0.001) or lower, and no comorbidities. Severe acute respiratory syndrome coronavirus 2 infection was confirmed with reverse-transcription polymerase chain reaction testing. Exposures: Usual care alone, or usual care plus 3 doses of recombinant human granulocyte colony-stimulating factor (rhG-CSF, 5 µg/kg, subcutaneously at days 0-2). Main Outcomes and Measures: The primary end point was the time from randomization to improvement of at least 1 point on a 7-category disease severity score. Results: Of 200 participants, 112 (56%) were men and the median (interquartile range [IQR]) age was 45 (40-55) years. There was random assignment of 100 patients (50%) to the rhG-CSF group and 100 (50%) to the usual care group. Time to clinical improvement was similar between groups (rhG-CSF group median of 12 days (IQR, 10-16 days) vs usual care group median of 13 days (IQR, 11-17 days); hazard ratio, 1.28; 95% CI, 0.95-1.71; P = .06). For secondary end points, the proportion of patients progressing to acute respiratory distress syndrome, sepsis, or septic shock was lower in the rhG-CSF group (rhG-CSF group, 2% vs usual care group, 15%; difference, -13%; 95%CI, -21.4% to -5.4%). At 21 days, 2 patients (2%) had died in the rhG-CSF group compared with 10 patients (10%) in the usual care group (hazard ratio, 0.19; 95%CI, 0.04-0.88). At day 5, the lymphocyte cell count was higher in the rhG-CSF group (rhG-CSF group median of 1050/µL vs usual care group median of 620/µL; Hodges-Lehmann estimate of the difference in medians, 440; 95% CI, 380-490). Serious adverse events, such as sepsis or septic shock, respiratory failure, and acute respiratory distress syndrome, occurred in 29 patients (14.5%) in the rhG-CSF group and 42 patients (21%) in the usual care group. Conclusion and Relevance: In preliminary findings from a randomized clinical trial, rhG-CSF treatment for patients with COVID-19 with lymphopenia but no comorbidities did not accelerate clinical improvement, but the number of patients developing critical illness or dying may have been reduced. Larger studies that include a broader range of patients with COVID-19 should be conducted. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2000030007.


Assuntos
/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Fármacos Hematológicos/uso terapêutico , Mortalidade Hospitalar , Linfopenia/tratamento farmacológico , Corticosteroides/uso terapêutico , Adulto , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Linfócitos B , Contagem de Linfócito CD4 , /complicações , China , Progressão da Doença , Feminino , Humanos , Células Matadoras Naturais , Contagem de Leucócitos , Contagem de Linfócitos , Linfopenia/sangue , Linfopenia/complicações , Masculino , Pessoa de Meia-Idade , Mortalidade , Ventilação não Invasiva , Oxigenoterapia , Proteínas Recombinantes , Insuficiência Respiratória/fisiopatologia , Sepse/fisiopatologia , Choque Séptico/fisiopatologia , Fatores de Tempo
10.
J Ethnopharmacol ; 264: 113247, 2021 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-32800929

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Tetrastigma hemsleyanum Diels et Gilg (T.hemsleyanum), a rare herbal plant distributed in subtropical areas of mainland China, has become a focus of scientific attention in recent years because of its high traditional value, including uses for treatment of children with fever, pneumonia, asthma, rheumatism, hepatitis, menstrual disorders, scrofula, and pharynx pain. AIM: This systematic review aims to provide an insightful understanding of traditional uses, chemical composition, pharmacological effect and clinical application of T. hemsleyanum, and lay a foundation for the further study and for the utilization of T. hemsleyanum resource. MATERIALS AND METHODS: A domestic and overseas literature search in known databases was conducted for published articles using the relevant keywords. RESULTS: One hundred and forty-two chemical constituents identified from T. hemsleyanum have been reported, including flavonoids, phenolic acids, polysaccharide, organic acids, fatty acids, terpenoids, steroids, amino acid and others. Among these components, flavonoids and polysaccharides were the representative active ingredients of T. hemsleyanum, which have been widely investigated. Modern pharmacological studies have shown that these components exhibited various pharmacological activities, such as anti-inflammatory, antioxidant, antivirus, antitumor, antipyretic, anti-hepatic injury, immunomodulatory, antibacterial etc. Moreover, different toxicological studies indicated that the clinical dosage of T. hemsleyanum was safe and reliable. CONCLUSIONS: Modern pharmacological studies have well supported and clarified some traditional uses, and T. hemsleyanum has a good prospect for the development of new drugs due to these outstanding properties. However, the present findings did not provide an in-depth evaluation of bioactivity of the extracts, the composition of its active extracts was not clear. Moreover, they were insufficient to satisfactorily explain some mechanisms of action. Data regarding many aspects of T. hemsleyanum, such as links between the traditional uses and bioactivities, pharmacokinetics, quality control standard and the clinical value of active compositions is still limited which need more attention.

11.
Int J Eat Disord ; 54(1): 95-101, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33159492

RESUMO

OBJECTIVE: This study aims to compare the outcomes of higher calorie refeeding (HCR) and a lower calorie refeeding (LCR) methods among a diverse sample of young Asian adolescents admitted to a tertiary institution in Asia for management of anorexia nervosa (AN). METHOD: This is a retrospective case control study of Asian adolescents who were managed using an inpatient HCR protocol (2016-2017) and an LCR protocol (2010-2014). Baseline characteristics, daily change in percent median body mass index (%mBMI), and rates of refeeding hypophosphatemia were analyzed between groups. RESULTS: A total of 125 adolescents with AN were analyzed with 61 (52%) patients in the HCR group. Mean age was 14.0 years (SD =1.5) and mean presenting %mBMI was 73.2 (SD =6.9) with mean length of stay of 11.9 days (SD = 6.6). Patients in the HCR group had significantly increased rate of change of %mBMI (M = 0.39, SD = 0.31) than patients in the LCR group (M = 0.12, SD = 0.43) (p < .001). There was an increased rate of mild hypophosphatemia in the HCR group (HCR: 46%, LCR: 22%, p = .007) but no difference in rates of moderate hypophosphatemia and no cases of severe hypophosphataemia. Lower presenting %mBMI significantly predicted the phosphate levels (p = .004). DISCUSSION: In a sample of Asian adolescents with AN, use of an HCR protocol was associated with improved rate of inpatient weight gain. There was increased risk of mild hypophosphataemia, but not moderate to severe hypophosphataemia, suggesting that an HCR protocol can be used safely with close monitoring of phosphate levels.

12.
Metabolism ; 115: 154433, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33212070

RESUMO

BACKGROUND/AIMS: Whereas nonalcoholic fatty liver disease (NAFLD) is a multisystem disease, the association between metabolic dysfunction-associated fatty liver disease (MAFLD) and extra-hepatic diseases is not known. The aim of this cross-sectional study was to compare the prevalence of chronic kidney disease (CKD) in patients with either MAFLD or NAFLD, and then to examine the association between the presence and severity of MAFLD and CKD and abnormal albuminuria. METHODS: A total of 12,571 individuals with complete biochemical and liver ultrasonography data from the Third National Health and Nutrition Examination Survey (1988-1994) were included in the analysis. Multivariable logistic regression analyses were performed to test the independence of associations between MAFLD or MAFLD severity as the key exposures and CKD (defined as either CKD stage ≥1 or stage ≥3) or abnormal albuminuria (urinary albumin-to-creatinine ratio ≥ 3 mg/mmol) as the outcomes. RESULTS: The prevalence of MAFLD and NAFLD was 30.2% (n = 3794) and 36.2% (n = 4552), respectively. MAFLD individuals had a lower eGFR (74.96 ±â€¯18.21 vs. 76.46 ±â€¯18.24 ml/min/1.73 m2, P < 0.001) and a greater prevalence of CKD (29.60% vs. 26.56%, P < 0.05) than NAFLD individuals. Similarly, there was a higher prevalence CKD in MAFLD than in non-metabolic dysfunction-associated NAFLD (P < 0.05). Notably, after adjustment for sex, age, ethnicity, alcohol intake and diabetes, the severity of MAFLD (i.e. NAFLD fibrosis score ≥ 0.676) was associated with 1.34-fold higher risk of prevalent CKD (P < 0.05). CONCLUSIONS: MAFLD identifies patients with CKD better than NAFLD. MAFLD and MAFLD with increased liver fibrosis score are strongly and independently associated with CKD and abnormal albuminuria.

13.
Clin Rheumatol ; 40(1): 295-301, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32519053

RESUMO

OBJECTIVES: Pain catastrophizing impacts symptoms and outcomes for knee osteoarthritis (OA). We evaluated the internal consistency, content, construct and structure validity of the Pain Catastrophizing Scale (PCS) in patients with knee OA. METHODS: We evaluated content validity of PCS via cognitive interviews. We then recruited patients with knee OA enlisted for knee replacement (KR) surgery in a Singapore tertiary referral hospital for cross-sectional validation evaluation of PCS. Data was collected 2 weeks prior to KR. Analyses was guided by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) framework for internal consistency, construct validity and structure validity. RESULTS: Adequate content validity was confirmed from 10 patients in cognitive interviews. 675 (70.4% female, mean (standard deviation, SD) age = 65.52 (6.84) years) were included (91.7% total KR, 8.3% unicompartmental KR) in the cross-sectional study. The mean (SD) PCS score was 12.65 (10.55), with 0.14% and 8.63% ceiling and floor effects, respectively. PCS demonstrates high internal consistency (Cronbach's alpha = 0.94). Construct validity was demonstrated by fulfilment of seven out of seven (100%) a priori hypotheses. PCS was strongly correlated with anxiety and depression, and moderately correlated with physical functioning and mental health domains of the short form 36 health survey (SF-36). Sensitivity analyses between Chinese and non-Chinese subgroups are generally consistent. From confirmatory factor analysis, the PCS model showed good fit for a second-order, three-factor structure (CFI = 0.965, TLI = 0.950, SRMR = 0.031). CONCLUSIONS: This study supports internal consistency, construct validity and structural validity of PCS as a measure of pain catastrophizing in knee OA patients. Key points • The PCS is validated for measuring pain catastrophizing in knee OA patients, for evaluation of possible link to post-KR surgery satisfaction outcomes and other purposes.

14.
Artigo em Inglês | MEDLINE | ID: mdl-33360415

RESUMO

Charge variants are the most commonly observed sources of heterogeneity in the routine manufacturing of monoclonal antibodies. To gain further insight into the structural foundation of charge heterogeneity and its influence on biological functions, an infliximab biosimilar HS626 from a biopharmaceutical facility was isolated by semipreparative cation exchange chromatography (CEX) to obtain fractions of acidic and basic charge variants and determine the main species. It was assessed again by CEX to ensure purities. Through a series of structural and physicochemical characterizations, we concluded that the acidic variants were caused by fragments, Met oxidation, Asn deamidation, higher levels of sialylation and galactosylation of N-linked glycans, and less high mannose. The basic variants resulted mainly from aggregates, fragments, and Met oxidation. Through further analysis of antigen binding affinity, cell death inhibitory activity, ADCC, and CDC, as well as FcRn, FcγRIIIa, and C1q affinity, we demonstrated that the charge heterogeneity did not affect biological functions. This research enhances the understanding of charge variants, which are usually effective components that should not be intentionally reduced unless biological functions are affected.

15.
Cell Discov ; 6(1): 77, 2020 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-33298897

RESUMO

The novel coronavirus (CoV) severe acute respiratory syndrome (SARS)-CoV-2 outbreak began at the end of 2019 in Wuhan, China, and has spread to over 200 countries. In this multicenter retrospective study, we identified 2190 adult patients admitted for laboratory-confirmed COVID-19 in three participating centers. Multivariate logistic regression was conducted in patients with comorbid hypertension to examine the potential association between clinical outcomes, disease severity, and clinical characteristics with the use of ACEI, ARB, calcium-channel blockers (CCB), beta-blockers (BB), and thiazide diuretics. The clinical outcome, dyspnea, and fatigue were significantly improved in patients, especially elderly patients who were older than 65 years, who took ARB drugs prior to hospitalization compared to patients who took no drugs. The reduction of disease severity of elderly COVID-19 patients was associated with CCB and ACEI users. Clinical indices, including CRP, lymphocyte count, procalcitonin D dimer, and hemoglobin, were significantly improved in elderly ARB users. In addition, the clinical outcomes were statistically significantly improved in patients who took antihypertension drugs ARB, BB, and CCB after statistical adjustment by all ages, gender, baseline of blood pressures, and coexisting medical conditions. Our data indicate that hypertension drugs ARB, ACEI, CCB, and BB might be beneficial for COVID-19 patients.

16.
Sci Rep ; 10(1): 22369, 2020 12 22.
Artigo em Inglês | MEDLINE | ID: mdl-33353956

RESUMO

We aimed to analyse clinical characteristics and identify risk factors predicting all-cause mortality in older patients with severe coronavirus disease 2019 (COVID-19). A total of 281 older patients with severe COVID-19 were categorized into two age groups (60-79 years and ≥ 80 years). Epidemiological, clinical, and laboratory data, and outcome were obtained. Patients aged ≥ 80 years had higher mortality (63.6%) than those aged 60-79 years (33.5%). Anorexia and comorbidities including hypertension, diabetes and COPD, higher levels of lactate dehydrogenase (LDH), osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I and procalcitonin, and higher SOFA scores were more common in patients aged > 80 years than those aged 60-79 years and also more common and higher in non-survivors than survivors. LDH, osmotic pressure, C-reactive protein, D-dimer, high-sensitivity troponin I, and procalcitonin were positively correlated with age and sequential organ failure assessment (SOFA), whereas CD8+ and lymphocyte counts were negatively correlated with age and SOFA. Anorexia, comorbidities including hypertension, diabetes, and chronic obstructive pulmonary disease (COPD), LDH, osmotic pressure, and SOFA were significantly associated with 28-day all-cause mortality. LDH, osmotic pressure and SOFA were valuable for predicting 28-day all-cause mortality, whereas the area under the receiver operating characteristic curve of LDH was the largest, with sensitivity of 86.0% and specificity of 80.8%. Therefore, patients with severe COVID-19 aged ≥ 80 years had worse condition and higher mortality than did those aged 60-79 years, and anorexia and comorbidities including hypertension, diabetes, COPD, elevated plasma osmotic pressure, LDH, and high SOFA were independent risk factors associated with 28-day all-cause mortality in older patients with severe COVID-19. LDH may have the highest predictive value for 28-day all-cause mortality in all examined factors.


Assuntos
/epidemiologia , Escores de Disfunção Orgânica , /genética , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anorexia , Relação CD4-CD8 , /virologia , China/epidemiologia , Comorbidade , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Prognóstico , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Fatores de Risco
17.
Gene ; 770: 145344, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33333221

RESUMO

Differences in the gene mutation spectra of younger and older Chinese adult AML patients and the prognostic significance of these differentially presented gene mutations are rarely reported. One hundred and thirteen newly diagnosed Chinese adults with AML, divided into groups of younger and older patients, were enrolled in this study. Bone marrow samples from the patients were analyzed using targeted next-generation sequencing with a panel of 141 genes. Ninety-eight mutated genes were detected and the top 10 mutated genes were KMT2D, FLT3, FAT1, ASXL1, NRAS, DNMT3A, RELN, TET2, JAK2, and KRAS. The top five functional groups were the tyrosine kinase pathway, transcription factors, DNA methylation, chromatin modifiers, and the JAK-STAT signaling pathway. Younger patients exhibited higher incidences of KMT2D (33.8% vs 10.4%, P = 0.004) and KRAS (15.4% vs 2.1%, P = 0.042) mutations than older patients; whereas, older patients harbored more SRSF2 (20.8% vs 0%, P = 0.002), transcription factor (85.4% vs 67.7%, P = 0.031), DNA methylation (58.3% vs 36.9%, P = 0.024), and RNA splicing (31.3% vs 12.3%, P = 0.013) mutations than younger patients. Moreover, patients with SRSF2 mutations exhibited a lower rate of overall survival (P < 0.001) and relapse-free survival (P < 0.001) than patients carrying wild-type SRSF2. In conclusion, rarely reported KMT2D, FAT1, and RELN mutations were detected at high frequencies in our cohort. The gene mutation spectrum of older patients was different to that of younger patients. Moreover, older patients harbored more SRSF2 mutations, which predicted lower rates of overall and relapse-free survival.

18.
Ying Yong Sheng Tai Xue Bao ; 31(9): 3093-3100, 2020 Sep 15.
Artigo em Chinês | MEDLINE | ID: mdl-33345511

RESUMO

We investigated the effects of dicyandiamide (DCD) on the growth and Cd concentrations in pakchoi cultivated under different instant soluble N fertilizers [ammonium sulfate, ammonium sulfate and sodium nitrate (1:1, ammonium/nitrate), and urea] in Cd-contaminated soils. The results showed that the fresh weight of the edible parts of Cd-stressed pakchoi were increased by 583.3%, 41.5%, and 206.8% under ammonium, ammonium/nitrate, and urea treatments in the presence of DCD, respectively compared with control, and the tolerance index and photosynthetic rate significantly increased, whereas no significant changes were observed under nitrate supply. Under all N treatments with DCD, the MDA and H2O2 contents and the superoxide radical production rate in the leaves of pakchoi were decreased, with the highest reduction occurred in ammonium and urea treatments. Cd concentrations in the leaves of pakchoi fertilized with ammonium, ammonium/nitrate, and urea were lowered by 58.3%, 34.0%, and 44.5% and those in the petioles were lowered by 61.8%, 29.4%, and 55.6%, respectively. Cd concentration in the leaves and petioles of pakchoi in the nitrate treatment did not differ significantly from control. These changes could be attributable to the reduction in the acidification of rhizosphere soil in response to the combined application of N fertilizer and DCD. Accordingly, in Cd-contaminated soils with a low buffering capacity, the application of DCD combined with ammonium, ammonium/nitrate, or urea N fertili-zers could alleviate Cd-induced growth stress and inhibit photosynthesis in pakchoi plants and effectively minimize the Cd accumulation.


Assuntos
Fertilizantes , Poluentes do Solo , Cádmio/análise , Fertilizantes/análise , Guanidinas , Peróxido de Hidrogênio , Nitrogênio , Solo , Poluentes do Solo/análise
19.
J Clin Neurosci ; 82(Pt A): 71-75, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33317742

RESUMO

PURPOSE: To introduce a tooth-supported personalized template-assisted foramen ovale (FO) puncture system for trigeminal neuralgia (TN) treatment, analyze its advantages, and review other previously reported methods. METHODS: Sixty-seven patients were included. According to the preoperative digital design, the personalized puncture path was determined. Then, a tooth-supported personalized template was designed and manufactured. Finally, surgery (radiofrequency thermocoagulation or balloon compression) was carried out with the assistance of the template. The puncture effect and puncture-associated complications were evaluated, and the related literature was reviewed. RESULTS: The FO was successfully punctured in one attempt in all patients. The procedure was completed in 15 s in 35 (52.24%) patients and in 15-30 s in 28 (41.79%) patients. The required position was accurately reached in all patients, and the center point error range was within 1 mm. No complications associated with puncture occurred. CONCLUSION: The tooth-supported personalized template-assisted FO puncture system reported in this paper is an exceedingly simple, highly effective and safe FO puncture method that is worth popularizing.

20.
Front Psychol ; 11: 590844, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33192931

RESUMO

Introduction: A qualitative evaluation of mental illness stigma experienced by people with mental illness (PMI) is currently lacking in Singapore. This study aims to employ qualitative methods to identify the common encounters of mental illness stigma experienced by PMI in Singapore and uncover their individual strategies and efforts to reduce mental illness stigma. Methods: This study is part of a larger research project that explores the concept of mental illness stigma among different stakeholders in Singapore. Focus group discussions (FGDs) were conducted with 42 PMI to collect qualitative data on their experience with mental illness stigma, including encounters of stigma and individual strategies to reduce stigma. The inductive thematic analysis method was employed to analyze the data. Results: The eight emergent themes associated with encountering stigma in PMI's everyday life were categorized into two over-arching themes, public stigma (i.e., negative beliefs and attitudes, subjected to contemptuous treatment, social exclusion, over-scrutinizing, and receiving excessive care and concern) and structural stigma (i.e., the requirement to declare psychiatric conditions during job interviews, excluded from consideration after the declaration, and requirement of medical endorsements for employment). Four themes regarding PMI's individual strategies to reduce stigma were also identified (i.e., non-disclosure of condition, standing up for themselves, individual efforts in raising awareness, improving themselves, and living life as per normal). Limitations: Participants may be influenced by social desirability bias due to the presence of other participants in an FGD setting. Also, those who agreed to participate in the study may possess strong views or beliefs about mental illness stigma and may therefore be inherently different from those who refused to participate. Conclusion: Our findings on instances of public and structural stigma encountered by PMI in Singapore can guide policymakers with the development of future policies and strategies to reduce mental illness stigma in the Singapore society. Furthermore, our study also identified individual strategies that PMI employed to reduce mental illness stigma. However, the effectiveness of these strategies was unclear and little is known of their effect on PMI themselves. Hence, there is a need for future studies to examine these strategies.

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