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1.
Zhonghua Nei Ke Za Zhi ; 59(3): 250-252, 2020 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-32146758

RESUMO

The 21-year-old male patient was admitted to the Department of Rheumatology and Immunology at Peking Union Medical College Hospital with chief complaints of "skin rash for 1 year and edema for 2 months". He was diagnosed with systemic lupus erythematosus (SLE) with renal, cardiac and hematological involvement. Remission was not achieved after glucocorticoid pulse treatment. The patient experienced oliguria, malignant hypertension, accompanied by thrombocytopenia and low serum complements, and elevated lactate dehydrogenase and serum creatinine. Schistocytes were seen in the peripheral blood smear. Thrombotic microangiopathy (TMA) secondary to SLE was diagnosed. Though plasma exchange was partially effective, TMA could not be controlled yet. The activity of serum von Willebrand factor -cleaving protease (ADAMTS 13) was 100%, and ADAMTS 13 inhibitor was negative. Finally, remission of the disease was achieved after second glucocorticoid pulse therapy and rituximab treatment. At the 3-month follow-up, the patient's condition was stable with mild anemia and normal platelet count. Patients with TMA secondary to SLE are heterogenous, while normal ADAMT 13 activity indicates poor prognosis. Early and aggressive treatment is important for disease control, and plasma exchange is helpful as a supportive care.

2.
Artigo em Chinês | MEDLINE | ID: mdl-32186171

RESUMO

Objective: Analyzing the symptom characteristics of Coronavirus Disease 2019(COVID-19) to improve its prevention. Methods: Using Baidu Index Platform (http://index.baidu.com) and the website of Chinese Center for Disease Control and Prevention as data resources to obtain the search volume (SV) of keywords for symptoms associated with COVID-19 from January 1 to February 20 in each year from 2017 to 2020, in Hubei province and other top 10 impacted provinces in China and the epidemic data. Data of 2020 were compared with the previous three years. Data of Hubei province were compared with confirmed cases. The differences and characteristics of the SV of COVID-19-related symptoms, and the correlation between the SV of COVID-19 and new confirmed or suspected cases were analyzed and the hysteresis effects were discussed. Results: Compared the data from January 1 to February 20, 2020, with the SV for the same period of previous three years, Hubei's SV for cough, fever, diarrhea, chest tightness, dyspnea and other symptoms were significantly increased. The total SV of lower respiratory symptoms was significantly higher than that of upper respiratory symptoms (P<0.001). The SV of COVID-19 in Hubei province was significantly correlated with new confirmed or suspected cases (R(confirmed) = 0.723, R(suspected) = 0.863, all P < 0.001). The results of the distributed lag model suggested that the patients who retrieved relevant symptoms on the Internet may begin to see a doctor in 2-3 days later and be diagnosed in 3-4 days later. Conclusions: The total SV of lower respiratory symptoms is higher than that of upper respiratory symptoms, and the SV of diarrhea also increased significantly. It warns us to pay attention to not only the symptoms of lower respiratory tract, but also the gastrointestinal symptoms, especially diarrhea in patients with COVID-19. There is a relationship between Internet retrieval behavior and the number of new confirmed or suspected cases. Big data has a certain role in the early warning of infectious diseases.

3.
Zhonghua Yi Xue Za Zhi ; 100(6): 430-436, 2020 Feb 18.
Artigo em Chinês | MEDLINE | ID: mdl-32146765

RESUMO

Objective: To investigate the effect and specific mechanism of heat shock protein 47 (HSP47) on streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM). Methods: A mouse model of type 1 diabetic cardiomyopathy was established by intraperitoneal injection of STZ. After 8 weeks of successful modeling, HSP47 was overexpressed by tail vein injection, and the heart of the mouse was harvested after 6 weeks. Hematoxylin-eosin (HE) staining and Sirius red (PSR) staining were used to detect the cross-sectional area of myocardial cells and myocardial fibrosis, respectively. Immunofluorescence staining with α-smooth muscle actin (α-SMA) and collagen Ⅰ was used to detect the degree of fibrosis activation. The expression level of fibrosis-related proteins was determined by Western blot. Results: The expression level of HSP47 in the myocardium of the diabetic group up-regulated (2.014±0.264 vs 1.004±0.064, P<0.001). The area of myocardial cells in the diabetic group was increased compared with the control group [(235.3±20.7) µm(2) vs (172.8±13.6) µm(2), P<0.001] and the cross-sectional area of myocardial cells in the HSP47 overexpression-diabetes group was further increased [(302.2±41.0) µm(2) vs (235.3±20.7) µm(2), P=0.009], while the mRNA levels of mouse cardiac hypertrophic markers atrial natriuretic peptide (ANP), type B brain natriuretic peptide (BNP), myosin heavy chain ß (ß-MHC) further upregulated (all P<0.001). Compared with the control group, the myocardial fibrosis content in the diabetic group increased [(7.333±1.127)% vs (4.837±0.775)%, P=0.002] and the left ventricular fibrosis content of the HSP47 overexpressing diabetic group further increased [(9.175±1.008)% vs (7.333±1.127)%, P=0.025] and the mRNA levels of fibrosis index collagenⅠ, collagen Ⅲ, connective tissue growth factor (CTGF) and transforming growth factor ß (TGFß) further up-regulated (all P<0.001). Immunofluorescence results showed that compared with the control group, the expression of collagenⅠ up-regulated in the endothelial stroma of the diabetic group and the content of collagenⅠ in the HSP47 over-expressing diabetic group was higher (P<0.001). Western blot results indicated that the phosphorylation level of Smad3 and the protein levels of α-SMA and TGFß in HSP47 overexpressing diabetic group increased, compared with those of diabetic group (all P<0.001). Conclusion: HSP47 ameliorates STZ-induced diabetic myocardial fibrosis by activating the TGFß/Smad3 signaling pathway.


Assuntos
Cardiomiopatias Diabéticas , Animais , Fibrose , Proteínas de Choque Térmico HSP47 , Camundongos , Miocárdio , Estreptozocina
4.
Clin Lab ; 66(3)2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32162863

RESUMO

BACKGROUND: Hepatitis B virus (HBV)-associated decompensated cirrhosis (HBV-DeCi) has a high mortality rate if liver transplantation is not performed. The study aimed to evaluate the association between the mean platelet volume to platelet count ratio (MPR) and outcomes of HBV-DeCi patients. METHODS: This was a retrospective study of 109 patients newly diagnosed with HBV-DeCi. Univariate and multivariate regression models were used to determine risk factors for 90-day mortality. RESULTS: The MPR was observed to be higher in nonsurvivors than in survivors. Multivariate analysis suggested that the model for end-stage liver disease score and MPR were independent predictors in HBV-DeCi patients. CONCLUSIONS: This study demonstrated that the MPR can serve as a potential predictor of 3-month mortality in HBV-DeCi patients.

5.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(2): 236-243, 2020 Feb 10.
Artigo em Chinês | MEDLINE | ID: mdl-32164136

RESUMO

Objective: To understand the types and distribution of Arboviruses in Hainan province. Methods: Blood-sucking insects were collected in Hainan province from 2017 to 2018. After laboratory treatment, BHK-21 cells and C6/36 cells were inoculated with grinding supernatant of all blood-sucking insects to isolate all of involving virus. Arbovirus genes in blood-sucking insects were detected in parallel by RT-PCR method. Results: A total of 15 062 mosquitoes were classified into four genera (Culex, Armigeres, Aedes, Anopheles) and 11 360 midges were collected. Culex tritaeniorhynchus was in the majority and accounted for 92.88% (13 990/15 062) of all the mosquitoes collected. Four strains of virus isolates were notified by tissue culture method. Three strains of viruses belonged to Japanese encephalitis virus (JEV), with the other one as Getah virus (GETV). Five pools of JEV gene amplification were positive, from Culex tritaeniorhynchus. Results from the phylogenetic analysis showed that they belonged to genotype JEV-Ⅰ. The minimum infection rate of JEV was 0.57‰ (8/13 990). A total of 5 pools of Akabane virus (AKV) gene amplification were positive. The minimum infection rate of AKV was 0.44‰ (5/11 360). Based on the S gene and M gene sequences of the virus, data from the phylogenetic analysis showed that the five AKV strains carried by midges in Hainan province were in a separate evolutionary branch and with formed unique geographical distribution. Conclusions: JEV and GETV had been isolated again from the mosquito specimens in this survey, since the 1980s. AKV was detected from the midge specimens in Hainan province. These results showed the needs of strengthening the programs on detection and monitor of JEV, GETV and AKV that were related to animal and human diseases in order to reduce the risks of related diseases in this area.

6.
Eur Rev Med Pharmacol Sci ; 24(5): 2539-2547, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32196604

RESUMO

OBJECTIVE: Lung cancer has an unfavorable prognosis due to the lack of efficient diagnostic and therapeutic strategies. Therefore, this study sought to figure out the effect of long non-coding RNA (lncRNA) DANCR on lung cancer progression. PATIENTS AND METHODS: LncRNA DANCR and miR-214-5p expressions in non-small cell lung cancer (NSCLC) were detected by Real Time-quantitative Polymerase Chain Reaction (RT-qPCR). Function assays, including Cell Counting Kit-8 (CCK-8) and flow cytometric analysis were conducted to clarify the role of DANCR and miR-214-5p in the progression of NSCLC. Western blot, Dual-Luciferase reporter assay, and RNA immunoprecipitation assay (RIP) were performed to elucidate the underlying mechanism. RESULTS: LncRNA DANCR was upregulated in NSCLC. The knockdown of lncRNA DANCR inhibited cell proliferation and accelerated cell apoptosis in NSCLC. LncRNA DANCR interacted with miR-214-5p. MiR-214-5p over-expression partially reversed the regulatory effects of DANCR on proliferation and apoptosis in NSCLC. In addition, CIZ1 was the downstream gene binding miR-214-5p. LncRNA DANCR could regulate the miR-214-5p/CIZ1 axis. CONCLUSIONS: Downregulation of lncRNA DANCR inhibited cell proliferation and induced cell apoptosis in NSCLC by regulating the miR-214-5p/CIZ1 axis. LncRNA DANCR may act as an oncogene and promote the progression of NSCLC.

7.
ISA Trans ; 2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32111406

RESUMO

Student's t distribution is a useful tool that can model heavy-tailed noises appearing in many practical systems. Although t distribution based filter has been derived, the information filter form is not presented and the data fusion algorithms for dynamic systems disturbed by heavy-tailed noises are rarely concerned. In this paper, based on multivariate t distribution and variational Bayesian estimation, the information filter, the centralized batch fusion, the distributed fusion, and the suboptimal distributed fusion algorithms are derived, respectively. The centralized fusion is given in two forms, namely, from t distribution based filter and the proposed t distribution based information filter, respectively. The distributed fusion is deduced by the use of the newly derived information filter, and it has been demonstrated to be equivalent to the centralized batch fusion. The suboptimal distributed fusion is obtained by a parameter approximation from the derived distributed fusion to decrease the computation complexity. The presented algorithms are shown to be the generalization of the classical Kalman filter based traditional algorithms. Theoretical analysis and exhaustive experimental analysis by a target tracking example show that the proposed algorithms are feasible and effective.

8.
Acta Virol ; 64(1): 59-66, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32180419

RESUMO

Novel duck reovirus (NDRV), the prototype strain of avian orthoreoviruses, continues to circulate among ducks. Analysis of its genome suggested that a putative second open reading frame in the S1 segment encodes a 162-amino acid nonstructural protein with size of 18 kDa, provisionally designated P18. This protein is different from the 17 kDa nonstructural protein encoded in the same open reading frame in other avian orthoreoviruses, which is designated P17 and consists of 146 amino acids. There is no corresponding protein in Muscovy duck reovirus. Antibodies raised to the purified recombinant protein reacted with viral P18 both in vitro and in vivo. In cells, P18 was located predominantly in the nucleus at 6-12 h post-infection, with negligible levels in the cytoplasm. However, the protein accumulated both in the nucleus and cytoplasm at 24 to 36 h post-infection. Immunohistochemistry indicated that P18 strongly accumulates in spleen tissues of infected ducklings. Collectively, the data provide the direct experimental evidence that P18 is expressed by novel duck reovirus both in vivo and in vitro. Keywords: duck reovirus; expression; characterization; novel P18 protein.

9.
Rev Sci Instrum ; 91(1): 015003, 2020 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32012593

RESUMO

Variable-capacitance electrostatic motors are ideal for driving the test mass in ultra-low-noise electrostatic accelerometers. Such devices are essential for testing the new equivalence principle (NEP) with rotating extended masses. However, as the air-film damping is greatly reduced by placing the sensor core assembly in a high-vacuum housing, this synchronous motor may easily fall out of step and suffer spin-up failures with traditional open-loop excitation. In this study, a synchronous electronic phase commutation scheme is proposed by sensing the three-phase position change of the rotor poles and activating the stator electrodes in careful correlation with the instantaneous rotor position. Experiments on a ground-test NEP instrument prototype show that the proposed closed-loop excitation scheme can spin-up the rotor synchronously and maintain stable constant-speed operation of this macroscale variable capacitance motor operated in a high-vacuum environment. This rotation control method is also applicable to the synchronous operation of micromachined variable-capacitance electrostatic motors.

10.
Eur Rev Med Pharmacol Sci ; 24(1): 11-17, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31957813

RESUMO

OBJECTIVE: The aim of this study was to investigate the therapeutic effect of microRNA-7a (miR-7a) on spinal cord injured rats and to explore its underlying mechanism in vivo. MATERIALS AND METHODS: The spinal cord injury (SCI) model was first established in adult rats. The epicenter of the lesion was treated with miR-7a mimics via intrathecal injection. The Basso-Beattie-Bresnahan (BBB) locomotor rating scale was used to evaluate the functional recovery of hindlimbs in rats within 4 weeks following SCI. Western blotting and qPCR were utilized to detect the apoptosis and oxidative stress in rats treated with or without miR-7a. In addition, the neuron survival and neuro-filament amount were determined using immunofluorescence. RESULTS: After SCI and miR-7a treatment, the locomotor recovery of treated rats was significantly improved when compared with rats without treatment. The mitochondrial disorder and cell death were significantly reduced in miR-7a treated rats. Meanwhile, the nuclear transcription factor-κB (NF-κB) pathway was significantly reduced as well. Contrarily, the expression of anti-apoptotic protein Bcl-2 and NF-κB inhibitor I-κB was remarkably elevated in miR-7a treated rats. In addition, up-regulation of miR-7a rescued neurons and maintained the neural structure. CONCLUSIONS: The up-regulation of miR-7a alleviated the injury-induced oxidative stress and inhibited apoptosis by down-regulating NF-κB pathway in SCI rats.

11.
Int J Radiat Oncol Biol Phys ; 106(5): 1095-1103, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31982497

RESUMO

PURPOSE: To develop a tradeoff hyperplane model to facilitate tradeoff decision-making before inverse planning. METHODS AND MATERIALS: We propose a model-based approach to determine the tradeoff hyperplanes that allow physicians to navigate the clinically viable space of plans with best achievable dose-volume parameters before planning. For a given case, a case reference set (CRS) is selected using a novel anatomic similarity metric from a large reference plan pool. Then, a regression model is built on the CRS to estimate the expected dose-volume histograms (DVHs) for the current case. This model also predicts the DVHs for all CRS cases and captures the variation from the corresponding DVHs in the clinical plans. Finally, these DVH variations are analyzed using the principal component analysis to determine the tradeoff hyperplane for the current case. To evaluate the effectiveness of the proposed approach, 244 head and neck cases were randomly partitioned into reference (214) and validation (30) sets. A tradeoff hyperplane was built for each validation case and evenly sampled for 12 tradeoff predictions. Each prediction yielded a tradeoff plan. The root-mean-square errors of the predicted and the realized plan DVHs were computed for prediction achievability evaluation. RESULTS: The tradeoff hyperplane with 3 principal directions accounts for 57.8% ± 3.6% of variations in the validation cases, suggesting the hyperplanes capture a significant portion of the clinical tradeoff space. The average root-mean-square errors in 3 tradeoff directions are 5.23 ± 2.46, 5.20 ± 2.52, and 5.19 ± 2.49, compared with 4.96 ± 2.48 of the knowledge-based planning predictions, indicating that the tradeoff predictions are comparably achievable. CONCLUSIONS: Clinically relevant tradeoffs can be effectively extracted from existing plans and characterized by a tradeoff hyperplane model. The hyperplane allows physicians and planners to explore the best clinically achievable plans with different organ-at-risk sparing goals before inverse planning and is a natural extension of the current knowledge-based planning framework.

12.
J Chem Phys ; 152(2): 024118, 2020 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-31941306

RESUMO

It is believed that the density functional theory (DFT) describes most elements with s, p, and d orbitals very well, except some materials that have strongly localized and correlated valence electrons. In this work, we find that the widely employed exchange-correlation (XC) functionals, including local-density approximation (LDA), generalized gradient approximation (GGA), and meta-GGA, underestimate the shear modulus and phase stability of V and Nb greatly. The advanced hybrid functional that is usually better for correlated systems, on the other hand, completely fails in these two simple metals. This striking failure is revealed due to the orbital localization error in GGA, which is further deteriorated by hybrid functionals. This observation is corroborated by a similar failure of DFT+U and van der Waals functionals when applied to V and Nb. To remedy this problem, a semiempirical approach of DFT+J is proposed, which can delocalize electrons by facilitating the on-site exchange. Furthermore, it is observed that including density derivatives slightly improves the performance of the semilocal functionals, with meta-GGA outperforms GGA, and the latter is better than LDA. This discovery indicates the possibility and necessity to include higher-order density derivatives beyond the Laplacian level for the purpose of removing the orbital localization error (mainly from d orbitals) and delocalization error (mainly from s and p orbitals) completely in V and Nb so that a better description of their electronic structures is achieved. The same strategy can be applied to the other d electron system and f electron system.

13.
J Appl Microbiol ; 128(3): 840-852, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31671233

RESUMO

AIMS: This study was conducted to assess the effects of acute heat stress (HS) on intestinal microbiota, and the associations with the changes in feed intake (FI) and serum profile. METHODS AND RESULTS: Twenty four individually housed pigs (Duroc × Large White × Landrace, 30 ± 1 kg body weight) were randomly assigned to receive one of three treatments (8 pigs/treatment): (i) thermal neutral (TN) conditions (25 ± 1°C), (ii) HS conditions (35 ± 1°C), (iii) pair-feeding (PF) with HS under TN conditions. After 24-h treatment, pigs were monitored to assess FI, and samples of serum and faeces were collected to investigate serum profile, microbial composition and short chain fatty acids (SCFAs). The results showed that HS decreased (P < 0·05) FI compared with the TN group. Compared with TN group, HS changed the serum profile by affecting biochemical parameters and hormones related with energy metabolism and stress response; immune indicators were also altered in HS group. Most of changes in serum profile were independent of FI reduction. Additionally, HS shifted the diversity and composition of faecal microbial community by increasing (P < 0·05) Proteobacteria and decreasing (P < 0·05) Bacteroidetes. Moreover, HS decreased (P < 0·05) the concentrations of propionate, butyrate, valerate, iso-valerate and total SCFAs in faeces in an FI-independent manner. Furthermore, the Spearman correlation analysis implied that changes of serum profile have potential correlation with alterations of faecal microbiota and their SCFAs metabolites in acute HS-treated grow-finishing pigs. CONCLUSIONS: Metabolism disorders caused by 24-h acute HS associated with changes of faecal microbiota and their SCFAs metabolites in an FI-independent manner in grow-finishing pigs. SIGNIFICANCE AND IMPACT OF THE STUDY: These results give us a new insight of the intestinal damage caused by acute HS and the underlying mechanisms.

14.
J Mater Chem B ; 8(1): 27-37, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31746932

RESUMO

Resveratrol (RES) is a naturally occurring and effective drug for tumor prevention and treatment. However, its low levels of aqueous solubility, stability, and poor bioavailability limit its application, especially when used as a free drug. In this study, RES was loaded into peptide and sucrose liposomes (PSL) to enhance the physico-chemical properties of RES and exploit RES delivery mediated by liposomes to effectively treat breast cancer. RES loaded PSL (the complex: PSL@RES) were stable, had a good RES encapsulation efficiency, and prolonged RES-release in vitro. PSL@RES was exceptionally efficient for inhibiting the growth of cancer cells, as the IC50 of PSL@RES in MCF-7 cells was found to be only 20.89 µmol L-1. The therapeutic efficacy of PSL@RES was evaluated in mice bearing breast cancer. The results showed that PSL@RES at a dosage of 5 mg kg-1 was more effective than 10 mg kg-1 free RES, and PSL@RES inhibited tumor growth completely at a dosage of 10 mg kg-1. PSL@RES induced apoptosis in breast tumor by upregulation of p53 expression. This then downregulated Bcl-2 and upregulated Bax, thereby inducing Caspase-3 activation. More importantly, encapsulation of RES within peptide liposomes greatly reduced the toxicity of free RES to mice. Overall, the simple formulation of liposomal nanocarriers of RES developed in this study produces satisfactory outcomes to encourage further applications of liposomal carriers for the treatment of breast cancer.

15.
Clin Transl Oncol ; 22(1): 103-110, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31062173

RESUMO

PURPOSE: The aim of the study was to evaluate the cost-effectiveness of capecitabine plus bevacizumab compared with capecitabine alone in elderly patients with metastatic colorectal cancer (CRC) from a Chinese societal perspective. METHODS: A decision-analytic Markov model was conducted to simulate the process of metastatic CRC. Three distinct health states: progression-free survival (PFS), progressive disease and death were included. Clinical data were derived from the AVEX trial. Health effectiveness was denoted in quality-adjusted life years (QALYs) and health utilities were derived from previously published studies. Incremental cost-effectiveness ratio (ICER) was regarded as the primary endpoint and willingness-to-pay (WTP) threshold was set at $26,753.37/QALY (3 × per capita GDP of China, 2017). One-way sensitivity analyses and probabilistic sensitivity analysis were also performed to explore the parameters uncertainty in the study. RESULTS: Over a 10-year life horizon, capecitabine plus bevacizumab gained 1.14 QALYs at an average cost of $21,609.48, while the effectiveness and cost of capecitabine group were 0.99 QALYs and $7274.83, respectively. The ICER between the two groups was $95,564.33/QALY. Parameters that mostly influenced the results of the model were utility of PFS state, duration of PFS state for capecitabine plus bevacizumab, total cost of PFS state for capecitabine plus bevacizumab and price of bevacizumab. The probabilities of capecitabine plus bevacizumab and capecitabine as the dominant option were 0% and 100% at the WTP threshold of $26,753.37/QALY. CONCLUSIONS: The results of the study showed that capecitabine plus bevacizumab is unlikely to be a cost-effective treatment option for elderly patients with metastatic CRC.

16.
Osteoporos Int ; 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31786628

RESUMO

Genetic risk of low BMD in African American women remains unclear. Based on SNPs discovered from a predominantly Caucasian sample, genetic profile was summarized and was found to be significantly associated with BMD variation in African American women. INTRODUCTION: Osteoporosis is largely under-recognized and undertreated in African-American women, the post-fracture morbidity and mortality rates in this racial group is rather high. Since BMD was proved to be highly heritable, based on a comprehensive genome-wide meta-analysis that reported 63 BMD-related single nucleotide polymorphisms (SNPs), we aim to unravel the overall genetic risk for decreased BMD and osteoporosis in African-American women. METHODS: Genotype data of 842 African American women in a Women's Health Initiative cohort were analyzed. Comprehensive genotype imputation was conducted at the Sanger Imputation Server. Multi-locus genetic risk scores (GRSs) based on 62 BMD-related single-nucleotide polymorphisms (SNPs) were calculated. The association between GRS and BMD was assessed by regression analysis. Longitudinal data was further analyzed using a generalized estimating equation, which helps achieve more efficient and unbiased regression parameters by accounting for the within-subject correlation of responses on dependent variables. RESULTS: After adjusting for age, body weight, hormone use, and previous fracture, for every unit increase of GRS.FN and GRS.LS, BMD at hip and lumbar spine decreased 0.124 g/cm2 and 0.086 g/cm2, respectively. Collectively, the model accounted for 34.95% of the femoral neck BMD variation and 25.79% of lumbar spine BMD variation. Notably, GRS.FN and GRS.LS accounted for 2.03% and 2.39% of the total explained variance, respectively. The proportion of BMD variation can be explained by GRSs increasing as participants aged. CONCLUSIONS: Genetic risk score was significantly associated with lower BMD in the current study, suggesting that SNPs discovered from prior meta-analysis based on primarily Caucasian population can also explain a considerable proportion of BMD variation in African Americans.

17.
Dis Esophagus ; 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31863099

RESUMO

Esophageal cancer has a high incidence among malignancies in China, but a comprehensive picture of the status of its surgical management in China has hitherto not been available. A nationwide database has recently been established to address this issue. METHOD: A National Database was setup through a network platform, and data was collected from 70 high-volume centers (>100 esophagectomies/per year) across China. Data was entered between January 2009 and December 2014, and was analyzed in June 2015 after a minimal follow-up of 6 months for all patients. 8181 patients with complete data who received surgery for primary esophageal cancer on the Database were included in the analysis. RESULT: In this series, there were 6052 males and 2129 females, with a mean age of 60.5 years (range: 22-90 years). The pathology in 95.5% of patients was squamous cell carcinoma. The pathological stage distribution was 1.2% in stage 0, 2.5% in Ia, 11.5% in Ib, 14.8% in IIa, 36.1% in IIb, 19.3% in IIIa, 8.3% in IIIb, 6.2% in IIIc. 1800 patients (22.0%) with locally advanced disease received preoperative neoadjuvant therapy and 3592 patients (43.9%) underwent postoperative adjuvant chemotherapy and/or radiotherapy. The esophagectomies were performed through left thoracotomy approach in 5870 cases (72.6%), through right chest approach in 2215 cases (27.4%) including right thoracotomy (21.3%) and VATS (6.1%). The 30-day postoperative mortality rate was 0.6% (43 patients), and the overall postoperative complication rate was 11.6% (951 patients). The 1-, 3-, and 5-year overall survival rates were 82.6%, 61.6%, and 52.9%, respectively. CONCLUSION: This National Registry Database from high-volume centers provides a comprehensive picture of surgical management for esophageal cancer in China for the first time. Squamous cell carcinoma predominates, but there is heterogeneity with respect to the surgical approach and perioperative oncologic management. Overall, surgical mortality and morbidity rates are low, and good survival rates have been achieved due to improvement of surgical treatment technology in recent years.

18.
Lupus ; 28(13): 1558-1565, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31635555

RESUMO

OBJECTIVES: The objective of this study was to investigate risk factors of microvascular involvement and survival in Chinese patients with primary antiphospholipid syndrome. METHODS: In this single-center, retrospective study, we enrolled 112 patients with a confirmed diagnosis of primary antiphospholipid syndrome who were admitted to Peking Union Medical College Hospital from January 2004 to December 2016. Demographic data, clinical characteristics, laboratory results, and follow-up records were collected. RESULTS: A total of 112 patients with primary antiphospholipid syndrome were studied. Microvascular involvement was identified in 21 patients (18.75%). Patients with microvascular involvement experienced fewer episodes of arterial or venous thrombosis (28.6% vs. 84.6%) and a higher incidence of thrombocytopenia (85.7% vs. 54.9%), respectively. Low complement and elevated high-sensitivity CRP levels were observed more frequently in the microvascular group compared with the non-microvascular group (complement 38.1% vs. 18.7%; high-sensitivity CRP 71.4% vs. 31.9%, respectively). Anti-ß2-glycoprotein I antibodies were more prevalent in patients with microvascular involvement than in patients without (66.7% vs. 33.0%, respectively). Multivariate logistic regression analysis revealed that thrombocytopenia (odds ratio = 4.523, 95% confidence interval 1.139-17.962), elevated high-sensitivity CRP levels (odds ratio = 6.385, 95% confidence interval 1.969-20.704), and anti-ß2-glycoprotein I antibody positivity (odds ratio = 5.042, 95% confidence interval 1.555-16.352) were independent risk factors for microvascular involvement. A Kaplan-Meier analysis revealed that survival was significantly poorer in patients with microvascular involvement compared with patients without (p = 0.0278). CONCLUSIONS: In addition to arterial and venous thrombosis, antiphospholipid syndrome can affect the microvasculature of select organs. It is thus important for clinicians to be aware that antiphospholipid syndrome-associated microvascular involvement has a unique pathogenesis and can be a life-threatening condition.

19.
Artigo em Inglês | MEDLINE | ID: mdl-31576022

RESUMO

SERIES EDITORS' NOTE: We are pleased to add this typescript to the Bone Marrow Transplantation Statistics Series. We realize the term cubic splines may be a bit off-putting to some readers, but stay with us and don't get lost in polynomial equations. What the authors describe is important conceptually and in practice. Have you ever tried to buy a new pair of hiking boots? Getting the correct fit is critical; shoes that are too small or too large will get you in big trouble! Now imagine if hiking shoes came in only 2 sizes, small and large, and your foot size was somewhere in between. You are in trouble. Sailing perhaps?Transplant physicians are often interested in the association between two variables, say pre-transplant measurable residual disease (MRD) test state and an outcome, say cumulative incidence of relapse (CIR). We typically reduce the results of an MRD test to a binary, negative or positive, often defined by an arbitrary cut-point. However, MRD state is a continuous biological variable, and reducing it to a binary discards what may be important, useful data when we try to correlate it with CIR. Put otherwise, we may miss the trees from the forest.Another way to look at splines is a technique to make smooth curves out of irregular data points. Consider, for example, trying to describe the surface of an egg. You could do it with a series of straight lines connecting points on the egg surface but a much better representation would be combining groups of points into curves and then combining the curves. To prove this try drawing an egg using the draw feature in Microsoft Powerpoint; you are making splines.Gauthier and co-workers show us how to use cubic splines to get the maximum information from data points, which may, unkindly, not lend themselves to dichotomization or a best fit line. Please read on. We hope readers will find their typescript interesting and exciting, and that it will give them a new way to think about how to analyse data. And no, a spline is not a bunch of cactus spines. Robert Peter Gale, Imperial College London, and Mei-Jie Zhang, Medical College of Wisconsin and CIBMTR.

20.
Lupus ; 28(13): 1541-1548, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31615325

RESUMO

Recently, exposure to air pollutants has been associated with the development and progression of systemic lupus erythematosus (SLE). The current study aims to evaluate the effects of air pollutants on SLE hospital admissions in Bengbu, China. We performed distributed lag non-linear model combined with quasi-Poisson generalized linear regression to assess the impacts of air pollutants on SLE admissions from 2015 to 2017. Subgroup analyses by admission status (first admission or readmission) were also evaluated. A total of 546 hospital admissions during 2015-2017 were included. For single-day lag structures, the risk effects occurred from lag 2 to lag 9 for the 75th percentile particulate matter (PM)2.5, lag 3 to lag 9 for the 80th percentile PM2.5. For cumulative lag structures, the risk effects occurred from lag 0-5 to lag 0-14 for both 75th PM2.5 and 80th PM2.5, and no significant effect was observed for 90th PM2.5. In addition, the adverse effects on SLE first admissions occurred from lag 0 to lag 1 for NO2, lag 1 to lag 2 for SO2. The maximum effect of PM2.5 on SLE was 4.27 (95% confidence interval: 1.34-13.59) at lag 0-13 day, the minimum effect value was 1.12 (95% confidence interval: 1.03-1.23) at lag 9 day. These findings demonstrate that high PM2.5, NO2 and SO2 are associated with SLE hospital admissions. In addition, this study further revealed that exposure to high concentration of PM2.5 increased the risk of SLE relapse, while high levels of NO2 and SO2 increased the risk of SLE first admissions.

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