Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 569
Filtrar
1.
Adv Ther ; 2020 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-32172510

RESUMO

INTRODUCTION: Claims data (IBM MarketScan Commercial and MarketScan Medicare Supplemental databases) from June 30, 2011 to September 30, 2017 were used to evaluate the cost impact of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC) in this retrospective cohort study. METHODS: The primary analysis compared short-term costs for patients diagnosed with HER2+ MBC at least 180 days after the end of first HER2-targeted treatment (MBC+ cohort) versus a propensity score matched cohort of patients with breast cancer who did not develop MBC (MBC- cohort). A pseudo-post period for patients in the HER2+ MBC- cohort was defined by indexing to the HER2+ treatment completion-MBC diagnosis time interval of the matched pair in the HER2+ MBC+ cohort; we then compared average monthly cost differences between these groups for the year preceding and following MBC diagnosis. In secondary analyses, we estimated medium-term aggregate and categorical healthcare costs for patients with HER2+ MBC up to 3 years post-diagnosis. RESULTS: In the short-term primary analysis, costs for the HER2+ MBC+ and HER2+ MBC- cohorts were largely comparable in the year preceding MBC diagnosis. Monthly direct costs were significantly higher for the HER2+ MBC+ cohort in the months immediately preceding MBC diagnosis, with differences in the range of $500-5000. Following diagnosis, total monthly costs were $13,000-34,000 higher for patients in the HER2+ MBC+ cohort vs. the HER2+ MBC- cohort. In the medium-term secondary analysis, mean per patient total costs were $218,171 [standard error (SE) $5450] in the first year following MBC diagnosis and $412,903 (SE $13,034) cumulatively over 3 years following diagnosis (among patients with complete follow-up). Primary cost contributors were outpatient visits ($195,162; SE $8043) and HER2-targeted therapy drug costs ($177,489; SE $8120). CONCLUSIONS: HER2+ MBC is associated with high short-term and medium-term direct healthcare costs. These could be alleviated with early diagnosis and optimal standard-of-care treatment for early breast cancer, which can significantly reduce the risk of recurrence.

2.
Mar Drugs ; 18(3)2020 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-32120786

RESUMO

Nephrotic syndrome (NS) is a clinical syndrome with a variety of causes, mainly characterized by heavy proteinuria, hypoalbuminemia, and edema. At present, identification of effective and less toxic therapeutic interventions for nephrotic syndrome remains to be an important issue. In this study, we isolated fucoidan from Saccharina japonica and prepared its depolymerized fragment by oxidant degradation. Fucoidan and its depolymerized fragment had similar chemical constituents. Their average molecular weights were 136 and 9.5 kDa respectively. The effect of fucoidan and its depolymerized fragment on adriamycin-induced nephrotic syndrome were investigated in a rat model. The results showed that adriamycin-treated rats had heavy proteinuria and increased blood urea nitrogen (BUN), serum creatinine (SCr), total cholesterol (TC), and total triglyceride (TG) levels. Oral administration of fucoidan or low-molecular-weight fucoidan for 30 days could significantly inhibit proteinuria and decrease the elevated BUN, SCr, TG, and TC level in a dose-dependent manner. At the same dose (100 mg/kg), low-molecular-weight fucoidan had higher renoprotective activity than fucoidan. Their protective effect on nephrotic syndrome was partly related to their antioxidant activity. The results suggested that both fucoidan and its depolymerized fragment had excellent protective effect on adriamycin-induced nephrotic syndrome, and might have potential for the treatment of nephrotic syndrome.

3.
J Thorac Oncol ; 2020 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-32036071

RESUMO

INTRODUCTION: Programmed death receptor-1 (PD-1) inhibitors have shown efficacy in first-line treatment of NSCLC; however, evidence of PD-1 inhibitor as neoadjuvant treatment is limited. This is a phase 1b study to evaluate the safety and outcome of PD-1 inhibitor in neoadjuvant setting. METHODS: Treatment-naive patients with resectable NSCLC (stage IA-IIIB) received two cycles of sintilimab (200 mg, intravenously, day 1 out of 22). Operation was performed between day 29 and 43. Positron emission tomography-computed tomography scans were obtained at baseline and before the operation. The primary end point was safety. Efficacy end points included rate of major pathologic response (MPR) and objective response rate. Expression of programmed cell death ligand 1 was also evaluated (registration number: ChiCTR-OIC-17013726). RESULTS: A total of 40 patients enrolled, all of whom received two doses of sintilimab and 37 underwent radical resection. A total of 21 patients (52.5%) experienced neoadjuvant treatment-related adverse events (TRAEs). Four patients (10.0%) experienced grade 3 or higher neoadjuvant TRAEs, and one patient had grade 5 TRAE. Eight patients achieved radiological partial response, resulting in an objective response rate of 20.0%. Among 37 patients, 15 (40.5%) achieved MPR, including six (16.2%) with a pathologic complete response in primary tumor and three (8.1%) in lymph nodes as well. Squamous cell NSCLC exhibited superior response compared with adenocarcinoma (MPR: 48.4% versus 0%). Decrease of maximum standardized uptake values after sintilimab treatment correlated with pathologic remission (p < 0.00001). Baseline programmed cell death ligand 1 expression of stromal cells instead of tumor cells was correlated with pathologic regression (p = 0.0471). CONCLUSIONS: Neoadjuvant sintilimab was tolerable for patients with NSCLC, and 40.5% MPR rate is encouraging. The decrease of maximum standardized uptake values after sintilimab might predict pathologic response.

4.
JCO Clin Cancer Inform ; 4: 89-99, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32027538

RESUMO

PURPOSE: To improve outcomes for lung cancer through low-dose computed tomography (LDCT) early lung cancer detection. The International Association for the Study of Lung Cancer is developing the Early Lung Imaging Confederation (ELIC) to serve as an open-source, international, universally accessible environment to analyze large collections of quality-controlled LDCT images and associated biomedical data for research and routine screening care. METHODS: ELIC is an international confederation that allows access to efficiently analyze large numbers of high-quality computed tomography (CT) images with associated de-identified clinical information without moving primary imaging/clinical or imaging data from its local or regional site of origin. Rather, ELIC uses a cloud-based infrastructure to distribute analysis tools to the local site of the stored imaging and clinical data, thereby allowing for research and quality studies to proceed in a vendor-neutral, collaborative environment. ELIC's hub-and-spoke architecture will be deployed to permit analysis of CT images and associated data in a secure environment, without any requirement to reveal the data itself (ie, privacy protecting). Identifiable data remain under local control, so the resulting environment complies with national regulations and mitigates against privacy or data disclosure risk. RESULTS: The goal of pilot experiments is to connect image collections of LDCT scans that can be accurately analyzed in a fashion to support a global network using methodologies that can be readily scaled to accrued databases of sufficient size to develop and validate robust quantitative imaging tools. CONCLUSION: This initiative can rapidly accelerate improvements to the multidisciplinary management of early, curable lung cancer and other major thoracic diseases (eg, coronary artery disease and chronic obstructive pulmonary disease) visualized on a screening LDCT scan. The addition of a facile, quantitative CT scanner image quality conformance process is a unique step toward improving the reliability of clinical decision support with CT screening worldwide.

5.
Int J Biol Macromol ; 151: 545-553, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32057857

RESUMO

In order to investigate the anti-fibrotic effect of different molecular weight (Mw) fucoidans on TGF-ß1-induced mouse renal tubular epithelial cell (MTEC) mode. Oxidative degradation method was used to obtain fucoidans with different molecular weights and the reaction time, reaction temperature and the concentration of oxidants were investigated. Cell viability was detected by CCK-8, and EMT markers expression was detected by Western-bolt and Cell immunofluorescence assay. As a result, after chemical analysis of three independent batches of prepared samples, one batch of fucoidan sample (LHX 1-9) which chemical contents are similar but Mw ranging from 3.3 KDa to 49.3 KDa were selected to do further research. We found LHX1 (Mw = 3.3 KDa) and LHX 3-9 (Mw = 6.6 KDa, 8.3 KDa, 11.3 KDa, 14.9 KDa, 25.2 KDa, 35.4 KDa, 49.3 KDa) could resist the TGF-ß1-induced depithelial-mesenchymal transition (EMT) by decreased expression of Fn and CTGF and maintained epithelial cell morphology in MTEC. However, the relationship between the Mw of fucoidans and their anti-EMT effect is not simply linear. Among the samples, LHX 1, 5 and 8 showed significant anti-EMT effects than others by de-regulated Fn and CTGF expression on MTEC cells.

6.
Artigo em Inglês | MEDLINE | ID: mdl-32043180

RESUMO

PURPOSE: Investigate whether 18F-FDG PET-CT has the potential to predict the major pathologic response (MPR) to neoadjuvant sintilimab in resectable NSCLC patients, and the potential of sifting patients who probably benefit from immunotherapy. METHODS: Treatment-naive patients with resectable NSCLC (stage IA-IIIB) received two cycles of sintilimab (200 mg, intravenously, day 1 and 22). Surgery was performed between day 29 and 43. PET-CT was obtained at baseline and prior to surgery. The following lean body mass-corrected metabolic parameters were calculated by PET VCAR: SULmax, SULpeak, MTV, TLG, ΔSULmax%, ΔSULpeak%, ΔMTV%, ΔTLG%. PET responses were classified using PERCIST. The above metabolic information on FDG-PET was correlated with the surgical pathology. (Registration Number: ChiCTR-OIC-17013726). RESULTS: Thirty-six patients received 2 doses of sintilimab, all of whom underwent PET-CT twice and had radical resection (35) or biopsy (1). MPR occurred in 13 of 36 resected tumors (36.1%, 13/36). The degree of pathological regression was positively correlated with SULmax (p = 0.036) of scan-1, and was negatively correlated with all metabolic parameters of scan-2, and the percentage changes of the metabolic parameters after neoadjuvant therapy (p < 0.05). According to PERCIST, 13 patients (36.1%, 13/36) showed partial metabolic response (PMR), 21 (58.3%, 21/36) had stable metabolic disease, and 2 (5.6%, 2/36) had progressive metabolic disease (PMD). There was a significant correlation between the pathological response and the PET responses which were classified using PERCIST. All (100.0%) the PMR (ΔSULpeak% < - 30.0%) tumors showed MPR. CONCLUSIONS: 18F-FDG PET-CT can predict MPR to neoadjuvant sintilimab in resectable non-small cell lung cancer.

7.
Artigo em Inglês | MEDLINE | ID: mdl-32034805

RESUMO

The aim of this study was to estimate whether methotrexate (MTX) promotes cognitive impairment via increased ER stress and disrupted H2 S signaling in the hippocampus and whether H2 S may alleviate MTX-induced cognitive impairment by inhibiting ER stress through CHOP and caspase-12. Cognitive impairment behaviors were observed by Morris water maze test, and the apoptosis of neurons was assessed by TUNEL assay. The production of neurons was analyzed by DCX and Ki67 immunohistochemistry. The expressions of CHOP and caspase-12 in the hippocampus were determined by Western blot and immunohistochemistry. MTX increased the expression of CHOP and caspase-12 and the number of TUNEL-positive cells in the hippocampus by inhibiting endogenous H2 S-induced neuronal pyknosis in the hippocampal DG region. MTX decreased the number of DCX- and Ki67-positive cells in the hippocampus in the hippocampal DG region. The results of Morris water maze showed that MTX could damage the spatial memory of rats. The changes of MTX-induced Morris water maze test in mice and H2 S levels in serum and hippocampus, as well as the expression of CHOP and caspase-12 and the number of CHOP and caspase-12-positive neurons in the hippocampus, indicated that H2 S could alleviate the cognitive impairment induced by methotrexate through CHOP and caspase-12.

8.
Cell Rep ; 30(4): 1129-1140.e5, 2020 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-31995754

RESUMO

Plasma membrane damage and cell death during processes such as necroptosis and apoptosis result from cues originating intracellularly. However, death caused by pore-forming agents, like bacterial toxins or complement, is due to direct external injury to the plasma membrane. To prevent death, the plasma membrane has an intrinsic repair ability. Here, we found that repair triggered by pore-forming agents involved TMEM16F, a calcium-activated lipid scramblase also mutated in Scott's syndrome. Upon pore formation and the subsequent influx of intracellular calcium, TMEM16F induced rapid "lipid scrambling" in the plasma membrane. This response was accompanied by membrane blebbing, extracellular vesicle release, preserved membrane integrity, and increased cell viability. TMEM16F-deficient mice exhibited compromised control of infection by Listeria monocytogenes associated with a greater sensitivity of neutrophils to the pore-forming Listeria toxin listeriolysin O (LLO). Thus, the lipid scramblase TMEM16F is critical for plasma membrane repair after injury by pore-forming agents.

9.
J Hazard Mater ; 386: 121965, 2020 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-31896002

RESUMO

To deal with regeneration of nuclear-waste-contaminated soil, it is important to develop new materials and techniques for effective removal of radioactive cesium ions from clay. We report herein a synergistic remediation method for cleaning cesium-contaminated clay by Prussian blue analogue-functionalized magnetic microgel along with ionized chitosan. The magnetic microgels were prepared by surface polymerization of 4-vinyl pyridine and styrene on magnetite nanoparticles and attachment of Prussian blue analogues by ligand exchange reaction. The adsorption of cesium ions by magnetic microgels in aqueous solution follows the second-order kinetics process. And the maximum adsorption capacity was determined to be 149.70 mg/g by Langmuir adsorption model. When ionized chitosan hydrochloride was mixed with cesium-contaminated clay, we found that 200 mg/g clay of chitosan hydrochloride can realize 87.6 % of cesium release from clay within 2 h. Further use of magnetic microgel adsorbents can adsorb 95.5 % free cesium ions in solution, achieving an overall 83.7 % cleaning efficiency from cesium-contaminated clays. The microgels can be regenerated effectively and recycled magnetically while keeping the adsorption capacity constant after multiple times of use. The underlying principle demonstrated in this work can be extended to remediation of other types of radionuclides or heavy-metal ions in contaminated soil.

10.
Lancet Respir Med ; 8(1): 45-53, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31628085

RESUMO

BACKGROUND: Ensartinib is a potent new-generation ALK inhibitor with high activity against a broad range of known crizotinib-resistant ALK mutations and CNS metastases. We aimed to assess the efficacy and safety of ensartinib in ALK-positive patients with non-small-cell lung cancer (NSCLC), in whom crizotinib therapy was unsuccessful. The associations between ensartinib efficacy and crizotinib-resistant mutations were also explored. METHODS: We did a single-arm, open-label, phase 2 study at 27 centres in China. Patients were aged 18 years or older, had stage IIIb or stage IV ALK-positive NSCLC that had progressed while they were on crizotinib therapy, an Eastern Cooperative Oncology Group performance status of 2 or less, had measurable disease, and had received fewer than three previous treatments. Patients with CNS metastases were included if these metastases were asymptomatic and did not require steroid therapy. All patients received 225 mg ensartinib orally once daily on a continuous dosing schedule. The primary outcome was the proportion of patients with an objective response according to the Response Evaluation Criteria in Solid Tumors (version 1.1), as assessed by an independent review committee in all patients who received at least one dose of ensartinib with no major violations of the inclusion criteria (ie, the full analysis set). Safety was assessed in all enrolled patients who received at least one dose of ensartinib. This trial was registered with ClinicalTrials.gov, NCT03215693. FINDINGS: Between Sept 28, 2017, and April 11, 2018, 160 patients were enrolled and had at least one dose of ensartinib (safety analysis set). Four patients had inclusion violations and were excluded from the efficacy analysis, which thus included 156 patients (full analysis set). 97 (62%) patients in the full analysis set had brain metastases. 76 (52% [95% CI 43-60]) of 147 patients in the full analysis set, with responses that could be assessed by the independent review committee, had an objective response. 28 (70% [53-83]) of 40 patients with measurable brain metastases as assessed by the independent review committee had an intracranial objective response. 145 (91%) of 160 patients had at least one treatment-related adverse event, which were mostly grade 1 or 2. The most common treatment-related adverse events were rash (89 [56%]), increased alanine aminotransferase concentrations (74 [46%]), and increased aspartate aminotransferase concentrations (65 [41%]). INTERPRETATION: Ensartinib has activity and is well tolerated in patients with crizotinib-refractory, ALK-positive NSCLC, including those with brain metastases. The role of ensartinib in patients in whom other second-generation ALK inhibitors have been unsuccessful warrants further studies. FUNDING: Betta Pharmaceuticals.

11.
Eur Radiol ; 30(2): 744-755, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31485837

RESUMO

OBJECTIVE: To investigate the natural history of persistent pulmonary pure ground-glass nodules (pGGNs) with deep learning-assisted nodule segmentation. METHODS: Between January 2007 and October 2018, 110 pGGNs from 110 patients with 573 follow-up CT scans were included in this retrospective study. pGGN automatic segmentation was performed on initial and all follow-up CT scans using the Dr. Wise system based on convolution neural networks. Subsequently, pGGN diameter, density, volume, mass, volume doubling time (VDT), and mass doubling time (MDT) were calculated automatically. Enrolled pGGNs were categorized into growth, 52 (47.3%), and non-growth, 58 (52.7%), groups according to volume growth. Kaplan-Meier analyses with the log-rank test and Cox proportional hazards regression analysis were conducted to analyze the cumulative percentages of pGGN growth and identify risk factors for growth. RESULTS: The mean follow-up period of the enrolled pGGNs was 48.7 ± 23.8 months. The median VDT of the 52 pGGNs having grown was 1448 (range, 339-8640) days, and their median MDT was 1332 (range, 290-38,912) days. The 12-month, 24.7-month, and 60.8-month cumulative percentages of pGGN growth were 10%, 25.5%, and 51.1%, respectively, and they significantly differed among the initial diameter, volume, and mass subgroups (all p < 0.001). The growth pattern of pGGNs may conform to the exponential model. Lobulated sign (p = 0.044), initial mean diameter (p < 0.001), volume (p = 0.003), and mass (p = 0.023) predicted pGGN growth. CONCLUSIONS: Persistent pGGNs showed an indolent course. Deep learning can assist in accurately elucidating the natural history of pGGNs. pGGNs with lobulated sign and larger initial diameter, volume, and mass are more likely to grow. KEY POINTS: • The pure ground-glass nodule (pGGN) segmentation accuracy of the Dr. Wise system based on convolution neural networks (CNNs) was 96.5% (573/594). • The median volume doubling time (VDT) of 52 pure ground-glass nodules (pGGNs) having grown was 1448 days (range, 339-8640 days), and their median mass doubling time (MDT) was 1332 days (range, 290-38,912 days). The mean time to growth in volume was 854 ± 675 days (range, 116-2856 days). • The 12-month, 24.7-month, and 60.8-month cumulative percentages of pGGN growth were 10%, 25.5%, and 51.1%, respectively, and they significantly differed among the initial diameter, volume, and mass subgroups (all p values < 0.001). The growth pattern of pure ground-glass nodules may conform to exponential model.

12.
Tob Control ; 29(2): 191-199, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31073096

RESUMO

BACKGROUND: Lung cancer is substantially attributable to smoking, but detailed related estimates on smoking-attributable expenditure (SAE) in China are not available yet, which could inform tobacco control and cancer prevention initiatives. METHODS: A prevalence-based approach was adopted to estimate the total SAE, including direct expenditure (medical and non-medical) and indirect cost (disability and premature death). Detailed per-patient data on direct expenditure and work-loss days were acquired from a unique multicentre survey in China. Other parameters were from literatures and official reports. RESULTS: The total estimated SAE of lung cancer was US$5249 million in China in 2015 (0.05 % of gross domestic product for China). The estimated direct SAE was US$1937 million (36.9 % of the total SAE), accounting for 0.29 % of total healthcare expenditure for China. The medical and non-medical direct expenditures were US$1749 million and US$188 million, respectively. The estimated indirect cost was US$3312 million (63.1 % of the total SAE), including US$377 million due to disability and US$2935 million due to premature death. The SAE increased with age, peaking at 60-64 years (US$1004 million), and was higher among men, in urban areas and in eastern China. If smoking prevalence was reduced to 20%, as is the goal of Healthy China 2030, the total SAE would be decreased by 4.9 %. CONCLUSIONS: Smoking-attributable economic burden caused by lung cancer was substantial in China in 2015, and will continue increasing given current trends in lung cancer. However, future economic burden can be prevented with implementation of effective tobacco control and other interventions.

13.
Int J Biol Macromol ; 145: 154-164, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31866539

RESUMO

Glioblastoma (GBM) represents the most common, aggressive and deadliest primary tumors with poor prognosis as available therapeutic approaches fail to control its aberrant proliferation and high invasiveness. Thus, the therapeutic agents targeting these two characteristics will be more effective. In present study, a novel polypeptide (MM15), which was originally purified from Meretrix meretrix Linnaeus and has been proven to possess potent antitumor activity by our laboratory, was recombinant expressed and identified as a tropomyosin homologous protein. The recombinant polypeptide (re-MM15) could induce the U87 cell cycle arrest in G2/M phase and cell apoptosis by inducing tubulin polymerization. Additionally, re-MM15 displayed the significant inhibition to the migration and invasion of U87 cells through downregulating FAK/Akt/MMPs signaling. Furthermore, the in vivo analysis suggested that re-MM15 significantly blocked tumor growth in U87 xenograft model. Collectively, our results indicated that re-MM15, with anti-GBM properties in vitro and in vivo, has promising potential as a new anticancer candidate for GBM.

14.
Artigo em Inglês | MEDLINE | ID: mdl-31817855

RESUMO

Our aim is to examine the associations between long working hours and depression and mental well-being among the working population in Shanghai, as well as to identify the impact of having hobbies on these relationships. A cross-sectional study was conducted in Shanghai, with depression assessed by the Patient Health Questionnaire-9 (PHQ-9) scale and mental well-being assessed by the World Health Organization five-item Well-Being Index (WHO-5) scale. The phenomenon of long working hours (69.3%) was quite common among employees in Shanghai, and the rate of working over 60 h was 19.3%. Those who worked over 60 h had the highest prevalence of poorer mental health compared with individuals working ≤40 h per week. After adjustment in the logistic regression model, those who reported weekly working time over 60 h were 1.40 (95%CI: 1.03-1.90) and 1.66 (95%CI: 1.26-2.18) times more likely to have depression and poor mental well-being (PMWB), respectively. Adjusted ORs for having hobbies were 0.78 (95%CI: 0.62-0.97) and 0.62 (95%CI: 0.51-0.75), respectively. Meanwhile, having hobbies could significantly lower the mean score on the PHQ-9 and elevate the mean score on the WHO-5 in each working time group, with no interaction effect. Long working hours could have a significantly negative impact on workers' psychological health. Importantly, having hobbies in their daily lives might help to mitigate the adverse effects of long working hours on workers' depression and mental well-being.

15.
Cancer Imaging ; 19(1): 77, 2019 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-31783917

RESUMO

BACKGROUND: Kirsten rat sarcoma viral oncogene homolog (KRAS) and epidermal growth factor receptor (EGFR) are the two most frequent and well-known oncogene of lung adenocarcinoma. The purpose of this study is to compare the characteristics measured with dual-energy spectral computed tomography (DESCT) in lung adenocarcinoma patients who have KRAS and EGFR gene mutations. METHODS: Patients with surgically resected lung adenocarcinoma (n = 72) were enrolled, including 12 patients with KRAS mutations and 60 patients with EGFR mutations. DESCT quantitative parameters, including the CT number at 70 keV, the slopes of the spectral attenuation curves (slope λ HU), normalized iodine concentration (NIC), normalized water concentration (NWC), and effective atomic number (effective Z), were analyzed. A multiple logistic regression model was applied to discriminate clinical and DESCT characteristics between the types of mutations. RESULTS: The KRAS mutation was more common in people who smoked than the EGFR mutation. Nodule type differed significantly between the KRAS and EGFR groups (P = 0.035), and all KRAS mutation adenocarcinomas were solid nodules. Most DESCT quantitative parameters differed significantly between solid nodules and subsolid nodules. CT number at 70 keV, slope λ HU, NIC, and effective Z differed significantly between the KRAS and EGFR groups (P = 0.006, 0.017, 0.013 and 0.010) with solid lung adenocarcinoma. Multivariate logistic analysis of DESCT and clinical features indicated that besides smoking history, the CT value at 70 keV (OR = 0.938, P = 0.009) was significant independent factor that could be used to differentiate KRAS and EGFR mutations in solid lung adenocarcinoma. CONCLUSIONS: DESCT would be a potential tool to differentiate lung adenocarcinoma patients with a KRAS mutation from those with an EGFR mutation.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/genética , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Tomografia Computadorizada com Tomografia Computadorizada de Emissão de Fóton Único/métodos , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/cirurgia , Adulto , Idoso , Animais , Receptores ErbB/genética , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Mutação , Ratos , Estudos Retrospectivos
17.
Int Health ; 11(S1): S55-S63, 2019 10 31.
Artigo em Inglês | MEDLINE | ID: mdl-31670817

RESUMO

BACKGROUND: Migrant workers worldwide commonly are susceptible to mental disorders. Since the 1980s, there has been a large-scale increase in the number of migrant workers in China; this development parallels the acceleration of socio-economic transformation. Studies addressing this population rarely focus on workers' mental health or psychological well-being, yet it is imperative to understand the mental health status of rural-to-urban migrant workers and study the relationship between migration and mental health. METHODS: A cross-sectional survey of 3286 participants (response rate 85.4%) was conducted among different work units in Shanghai. All of the variables of this survey were assessed by a self-administered questionnaire, with depression measured by the Patient Health Questionnaire-9 (PHQ-9) scale and poor mental health (PMH) measured by the World Health Organization 5-Item Well-Being Index (WHO-5) scale. Pearson's χ2 test and logistic regression were used to compare migrants with urbanites, and to identify factors related to mental health outcomes. RESULTS: Migrant workers (15.3%) had a slightly higher prevalence of depression than non-migrant (12.0%) workers, with notable PMH (26.9%) among participants >45 y of age. In the logistic regression models, those who reported low job satisfaction, unhealthy organizations, poor physical health (self-rated) and long working hours were 2.86 (95% CI 2.14 to 3.84), 1.42 (95% CI 1.06 to 1.91), 1.89 (95% CI 1.41 to 2.55) and 1.48 (95% CI 1.08 to 2.03) times more likely to have depression, respectively. Similarly, workers >45 y of age were 2.92 (95% CI 1.65 to 5.16) and 1.80 (95% CI 1.01 to 3.21) times more likely to have PMH for low job satisfaction and unhealthy organizations, respectively. CONCLUSIONS: There are numerous potential causes affecting the mental health of Chinese internal migrant workers. Strengthening the construction of healthy organizations and enhancing workers' job satisfaction may improve the mental health status or psychological well-being of this group.


Assuntos
Nível de Saúde , Transtornos Mentais/epidemiologia , Saúde Mental/estatística & dados numéricos , População Rural/estatística & dados numéricos , Migrantes/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , Adulto Jovem
18.
Transl Lung Cancer Res ; 8(5): 649-657, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31737500

RESUMO

Background: Multifocal ground glass nodules (GGNs) represent a special radiological pattern indicative of synchronous multiple lung cancers (SMLCs), especially adenocarcinoma. However, the necessity of performing whole-body positron emission tomography/computed tomography (PET-CT) scanning and brain enhanced magnetic resonance imaging (MRI) as a staging workup for multifocal pure GGN (pGGN) patients remains unclear. The purpose of this study was to determine the utility of these two imaging scans for patients with multifocal pGGNs. Methods: This retrospective study was reviewed and approved by the ethics committee of the Cancer Hospital of the Chinese Academy of Medical Sciences. The study cohort was retrospectively selected from patients with multifocal pGGNs who underwent whole-body PET-CT examinations and/or brain enhanced MRIs between January 2010 and February 2019 at our institution. The additional value of the two exams for detecting nodal and distant metastases was evaluated. Results: In total, 73 patients (male-to-female ratio, 20:53; median age, 57 years) with multifocal pGGNs who underwent whole-body PET-CT (55 patients) and/or brain enhanced MRI (25 patients) were enrolled. No clearly metastatic lesions were detected. Among the enrolled patients, 53 (128 pGGNs) underwent complete surgical resection. All pGGNs were adenocarcinomas and/or preneoplasias, and no lymph node metastases were found on final pathology. Whole-body PET-CT and brain enhanced MRI added no definite benefit compared with chest CT alone before surgery. Conclusions: Whole-body PET-CT scans and brain enhanced MRIs are not necessary for patients with multifocal pGGNs.

19.
J Immunol Res ; 2019: 7616509, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31737688
20.
Cell Stem Cell ; 25(6): 754-767.e9, 2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31761722

RESUMO

Increased understanding of the functions of lactate has suggested a close relationship between lactate homeostasis and normal brain activity because of its importance as an energy source and signaling molecule. Here we show that lactate levels affect adult hippocampal neurogenesis. Cerebrovascular-specific deletion of PTEN causes learning and memory deficits and disrupts adult neurogenesis with accompanying lactate accumulation. Consistently, administering lactate to wild-type animals impairs adult hippocampal neurogenesis. The endothelial PTEN/Akt pathway increases monocarboxylic acid transporter 1 (MCT1) expression to enhance lactate transport across the brain endothelium. Moreover, cerebrovascular overexpression of MCT1 or deletion of Akt1 restores MCT1 expression, decreases lactate levels, and normalizes hippocampal neurogenesis and cognitive function in PTEN mutant mice. Together, these findings delineate how the brain endothelium maintains lactate homeostasis and contributes to adult hippocampal neurogenesis and cognitive functions.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA