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1.
Dis Markers ; 2022: 9934189, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35493302

RESUMO

Background: This research is aimed at establishing a scoring system alpha-fetoprotein+alkaline phosphatase (A-A score) based on preoperative serum alpha-fetoprotein (AFP) and alkaline phosphatase (ALP) levels and to investigate its clinical significance in patients with ruptured hepatocellular carcinoma (rHCC) after hepatectomy. Methods: 175 ruptured hepatocellular carcinoma (HCC) patients treated with hepatectomy were included. Survival analysis was assessed by the Kaplan-Meier method. Prognostic factors were analyzed in a multivariate model. Preoperative serum AFP and ALP values are assigned a score of 1 if they exceed the threshold value and 0 if they are below the threshold value, A-A score is obtained by summing the scores of two variables (AFP, ALP), and the predictive values of AFP, ALP, and A-A score were compared by receiver operating characteristic curve (ROC) analysis, and subgroup analyses were performed to further evaluate the power of A-A scores. Results: Of the 175 patients, 67 (38.3%) had an A-A score of 0, 72 (41.1%) had an A-A score of 1, and 36 (20.6%) had an A-A score of 2. In multivariate analysis, the A-A score, the BCLC stage, and the extent of resection were independent predictors of OS in patients with rHCC. The 1-, 3-, and 5-year OS and RFS in patients with an A-A score of 1 were better than those with an A-A score of 0 and worse than those with an A-A score of 1 (all p < 0.05). Based on the results of ROC analysis, the A-A score is superior to AFP or ALP alone in predicting the prognosis of patients with ruptured HCC. In subgroup analysis, A-A score could accurately predict the prognosis of patients with or without microvascular invasion (MVI) and with different Child-Pugh grades or gender. Conclusions: The A-A score can effectively predict the prognosis of patients after hepatectomy of ruptured hepatocellular carcinoma. At the same time, it also has good evaluation ability in different subgroups.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Fosfatase Alcalina , Carcinoma Hepatocelular/patologia , Hepatectomia , Humanos , Neoplasias Hepáticas/patologia , Prognóstico , alfa-Fetoproteínas
2.
Artigo em Inglês | MEDLINE | ID: mdl-35362393

RESUMO

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death, which can be attributed to the high incidence and first diagnosis at an advanced stage. Tyrosine kinase inhibitors (TKIs), a class of small-molecule targeting drugs, are primarily used for the clinical treatment of HCC after chemotherapy because they show significant clinical efficacy and low incidence of clinical adverse reactions. However, resistance to sorafenib and other TKIs, which can be used to treat advanced HCC, poses a significant challenge. Recent mechanistic studies have shown that epithelial-mesenchymal transition or transformation (EMT), ATP binding cassette (ABC) transporters, hypoxia, autophagy, and angiogenesis are involved in apoptosis, angiogenesis, HCC cell proliferation, and TKI resistance in patients with HCC. Exploring and overcoming such resistance mechanisms is essential to extend the therapeutic benefits of TKIs to patients with TKI-resistant HCC. This review aims to summarize the potential resistance mechanism proposed in recent years and methods to reverse TKI resistance in the context of HCC.

3.
Front Surg ; 9: 832125, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35465422

RESUMO

Background and Aim: To investigate the effect of preoperative circulation tumor cells (CTCs) on postoperative recurrence and overall survival prognosis of pancreatic head cancer after pancreaticoduodenectomy (PD). Methods: From March 2014 to January 2018, 73 patients with pancreatic head cancer underwent radical resection (R0) in Zhongshan People's Hospital. CTCs in peripheral blood of patients with pancreatic head cancer were detected by "Cyttel" method before PD. Seventy-three patients were divided into positive and negative groups according to the positive criteria. To explore the relationship between the clinical data of CTCs and disease-free survival (DFS) and overall survival (OS). Cox proportional hazards model was used to analyzing the risk factors affecting the postoperative recurrence and the survival prognosis of patients. Results: 41 patients (56.2%) were in the CTC-positive group. Preoperative CTCs were correlated with tumor vascular invasion, CA199 level and postoperative liver metastasis (P < 0.05). Preoperative CTC-positive, lymph node metastasis, vascular invasion, and nerve invasion were independent risk factors for DFS (P < 0.05). Preoperative CTC-positive, tumor diameter > 2 cm and vascular invasion were independent risk factors for OS of patients (P < 0.05). Conclusion: The detection of CTCs before PD is an important factor affecting the DFS and OS of pancreatic head cancer, which is significant in guiding clinical work.

4.
JAMA ; 327(15): 1488-1495, 2022 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-35438728

RESUMO

Importance: The racial and ethnic diversity of the US, including among patients receiving their care at the Veterans Health Administration (VHA), is increasing. Dementia is a significant public health challenge and may have greater incidence among older adults from underrepresented racial and ethnic minority groups. Objective: To determine dementia incidence across 5 racial and ethnic groups and by US geographical region within a large, diverse, national cohort of older veterans who received care in the largest integrated health care system in the US. Design, Setting, and Participants: Retrospective cohort study within the VHA of a random sample (5% sample selected for each fiscal year) of 1 869 090 participants aged 55 years or older evaluated from October 1, 1999, to September 30, 2019 (the date of final follow-up). Exposures: Self-reported racial and ethnic data were obtained from the National Patient Care Database. US region was determined using Centers for Disease Control and Prevention (CDC) regions from residential zip codes. Main Outcomes and Measures: Incident diagnosis of dementia (9th and 10th editions of the International Classification of Diseases). Fine-Gray proportional hazards models were used to examine time to diagnosis, with age as the time scale and accounting for competing risk of death. Results: Among the 1 869 090 study participants (mean age, 69.4 [SD, 7.9] years; 42 870 women [2%]; 6865 American Indian or Alaska Native [0.4%], 9391 Asian [0.5%], 176 795 Black [9.5%], 20 663 Hispanic [1.0%], and 1 655 376 White [88.6%]), 13% received a diagnosis of dementia over a mean follow-up of 10.1 years. Age-adjusted incidence of dementia per 1000 person-years was 14.2 (95% CI, 13.3-15.1) for American Indian or Alaska Native participants, 12.4 (95% CI, 11.7-13.1) for Asian participants, 19.4 (95% CI, 19.2-19.6) for Black participants, 20.7 (95% CI, 20.1-21.3) for Hispanic participants, and 11.5 (95% CI, 11.4-11.6) for White participants. Compared with White participants, the fully adjusted hazard ratios were 1.05 (95% CI, 0.98-1.13) for American Indian or Alaska Native participants, 1.20 (95% CI, 1.13-1.28) for Asian participants, 1.54 (95% CI, 1.51-1.57) for Black participants, and 1.92 (95% CI, 1.82-2.02) for Hispanic participants. Across most US regions, age-adjusted dementia incidence rates were highest for Black and Hispanic participants, with rates similar among American Indian or Alaska Native, Asian, and White participants. Conclusions and Relevance: Among older adults who received care at VHA medical centers, there were significant differences in dementia incidence based on race and ethnicity. Further research is needed to understand the mechanisms responsible for these differences.


Assuntos
Demência , Veteranos , Idoso , Demência/epidemiologia , Demência/etnologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Grupos Minoritários/estatística & dados numéricos , Estudos Retrospectivos , Estados Unidos/epidemiologia , Veteranos/estatística & dados numéricos , Serviços de Saúde para Veteranos Militares/estatística & dados numéricos
5.
Front Surg ; 9: 863790, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35392056

RESUMO

Background and Aim: The effect of perioperative blood transfusion (PBT) on the prognosis of patients with ruptured hepatocellular carcinoma (rHCC) with different Barcelona Clinic Liver Cancer (BCLC) stages is not clear. We identified the independent predictors of PBT for postoperative rHCC and investigated the effects of PBT on the prognosis of patients with rHCC at different BCLC stages. Methods: A total of 340 patients who underwent curative hepatectomy for rHCC between January 2010 and March 2018 were abstracted from the databases of two centers. A total of 166 patients underwent PBT. The prognosis of patients who received PBT and those who did not was compared before and after propensity score matching (PSM) in different BCLC stages. Univariate and multivariate Cox regression analyses were also used to identify independent predictors of PBT. Results: We divided the 340 patients into two groups: early tumor stage (BCLC-A) n = 196 and advanced tumor stage (BCLC-B/C) n = 144. Overall, the median survival time of the PBT group was lower than that of the nonPBT group before and after PSM. However, in the BCLC-BC group, the prognosis of patients with PBT was not statistically different from that of patients without blood transfusion. Univariate Cox analysis showed that PBT was a risk factor affecting the overall survival (OS) and recurrence-free survival (RFS) in BCLC-A, and PBT was not a risk factor for poor OS and RFS in BCLC-B/C. Conclusion: Perioperative blood transfusion has a negative impact on the postoperative prognosis of patients with rHCC in the early stage, but has no significant impact on the postoperative prognosis of patients with rHCC in the advanced stage.

7.
Front Oncol ; 12: 848903, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35252016

RESUMO

BACKGROUND: Ruptured hepatocellular carcinoma (rHCC) is considered a rare and life-threatening manifestation; when it happens, it often requires acute and positive intervention. At present, the mechanism of rHCC development is gradually being understood while there are many kinds of rHCC treatment. From our clinical observation, the prognosis of rHCC patients is not as poor as it is currently believed. It may not be appropriate to include all patients with rHCC in T4. MAIN BODY: The incidence of ruptured hepatocellular carcinoma is now rising. Especially in the Asian region, it can even reach 10% - 15%. The most common symptom of HCC rupture is abdominal pain, and there are now a variety of treatments for hepatocellular carcinoma rupture. With aggressive treatment, rHCC patients can also achieve a better prognosis. The patient's condition varies on admission, so the treatment methods will also be different. It is critical to identify prognostic factors simultaneously, and rHCC can be effectively managed by focusing on important prognostic factors. CONCLUSION: A review was carried out to analyze diagnosis, mechanism, treatment, and prognostic risk factors on this disease condition during the current situation; it is hoped that it will provide better guidance for clinicians. Moreover, patients with rHCC were managed hierarchically to prolong their prognosis.

8.
J Oncol ; 2022: 7531452, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35342424

RESUMO

Background and Aims: Conflicting results are often observed in the prognosis of patients with ruptured hepatocellular carcinoma (rHCC), and there are currently very few studies on the long-term postoperative outcomes of ruptured hepatocellular carcinoma patients. This study aimed to distinguish between the postoperative prognosis of rHCC patients with cirrhosis (rHCC-C) and those without cirrhosis (rHCC-NC) using some serum markers. Methods: We collected the data of 151 rHCC patients treated at our centers from January 2010 to March 2021. 62 had no cirrhosis, and 89 had cirrhosis. The prognosis of rHCC-C and rHCC-NC groups was compared using the Kaplan-Meier method. We used multivariate Cox regression to analyze prognostic factors in rHCC patients, and subgroup analysis was performed on the two groups of patients. Results: The long-term prognosis of rHCC-NC patients was better than that of rHCC-C patients. Tumor diameter, Barcelona clinic liver cancer (BCLC) stage, HBsAg, positive Hepatitis C virus (HCV) antibodies, elevated creatinine, and elevated T-bilirubin were prognostic factors for overall survival (OS) in rHCC-C patients. However, only alpha-fetoprotein (AFP) > 92 ng/mL was a prognostic factor for OS in rHCC-NC patients. In noncirrhotic patients, HBsAg positivity was only associated with OS. Similarly, the presence or absence of microvascular invasion (MVI) also had different results in the two groups. Conclusions: There are differences in serum alpha-fetoprotein (AFP) levels, the presence of microvascular invasion (MVI), and HBsAg positivity between rHCC-C and rHCC-NC patients, indicating that the analysis of these prognostic factors may help improve the management of rHCC patients and provide a direction for future treatment options.

9.
BMC Surg ; 22(1): 94, 2022 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-35282826

RESUMO

BACKGROUND AND AIM: It has been previously reported that inflow occlusion does not affect postoperative outcomes in hepatocellular carcinoma patients. However, for patients with ruptured hepatocellular carcinoma(rHCC), the effect of hepatic inflow occlusion and the number of occlusion times on the prognosis is unknown. METHODS: 203 patients with ruptured hepatocellular carcinoma were enrolled in this study. They were first divided into the non-hepatic inflow occlusion (non-HIO) group and the hepatic inflow occlusion (HIO) group. The Kaplan-Meier method was used to compare the recurrence-free survival and overall survival between the two groups. Patients in the HIO group were further divided into one-time HIO and two times HIO groups. KM method was also used to compare the two groups. Finally, independent risk factors affecting RFS and OS were determined by multivariate Cox regression analysis. RESULT: In the non-HIO group, 1-,3- and 5-year OS rates were 67.0%, 41.0%, and 22.0%respectively, and RFS rates were 45.0%, 31.0%, and 20.0% respectively; In the one-HIO group, the 1-,3-, and 5-year OS rates were 55.1%, 32.1%, and 19.2% respectively, and RFS rates were 33.3%, 16.7%, and 7.7% respectively; In the two-HIO group, 1-,3-, and 5-year OS rates were 24.0%, 0.0%, and 0.0% respectively, and RFS rates were 8.0%, 0.0%, and 0.0% respectively. By Cox regression analysis, HIO was an independent risk factor for a poor prognosis in rHCC patients. CONCLUSION: One time hepatic inflow occlusion did not affect postoperative OS, but negatively affected the RFS of rHCC patients; two times hepatic inflow occlusion negatively affected the postoperative OS and RFS in patients with rHCC.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/cirurgia , Hepatectomia/métodos , Humanos , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/cirurgia , Prognóstico , Estudos Retrospectivos
10.
Artigo em Inglês | MEDLINE | ID: mdl-35234840

RESUMO

INTRODUCTION: Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used drugs both prescribed and over the counter. The long-term cardiovascular safety of NSAIDs in patients with arthritis has engendered controversy. Concerns remain regarding the relative incidence and severity of adverse cardiorenal effects, particularly in arthritis patients with established CV disease, or risk factors for disease as illustrated by the PRECISION trial participants (NCT00346216). HYPOTHESIS: The selective COX-2 Inhibitor celecoxib has a superior cardiorenal safety profile when compared to ibuprofen or naproxen in the PRECISION population. METHODS: 24,081 patients who required NSAIDs for osteoarthritis or rheumatoid arthritis and had increased CV risk randomly received celecoxib, ibuprofen or naproxen. The current prespecified secondary analysis assessed the incidence, severity and NSAID-related risk of the pre-specified composite cardiorenal outcome [adjudicated renal event, hospitalization for congestive heart failure (CHF), or hospitalization for hypertension (HTN)] in the intention-to-treat (ITT) population. An on-treatment analysis assessed safety in those taking the study medication. RESULTS: Following a mean treatment duration of 20.3±16.0 months and a mean follow-up of 34.1±13.4 months, the primary cardiorenal composite outcome occurred in 423 patients (1.76%) in the ITT population. Of these 423 patients, 118 (28%) were in the celecoxib, 166 (39%) in the ibuprofen and 139 (33%) in the naproxen group. In a multivariable Cox regression model adjusted for independent clinical variables, celecoxib showed a significantly lower risk compared with ibuprofen (hazard ratio [HR] 0.67, confidence interval [CI] 0.53 - 0.85, p = 0.001) and a trend to lower risk compared to naproxen (HR 0.79, CI 0.61 - 1.00, p = 0.058).In the intention-to-treat analysis, clinically significant renal events occurred in 220 patients with events rates of 0.71%, 1.14% and 0.89% for celecoxib, ibuprofen and naproxen respectively (p = 0.052), while in the on -treatment analysis the rates were 0.52%, 0.91% and 0.78% (p<0.001). CONCLUSION: In the current era, long-term NSAID use was associated with few cardiorenal events in arthritis patients. At the doses studied, celecoxib displayed fewer renal events and hence more favorable cardiovascular safety compared to ibuprofen or naproxen. These results have considerable clinical implications for practitioners managing individuals with chronic arthritis pain and high risk of impaired renal function and/or heart failure. (Funded by Pfizer) Clinical Trial Registration: NCT00346216.

11.
BMC Anesthesiol ; 22(1): 41, 2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35130855

RESUMO

BACKGROUND: Although restricting food intake during labor is recommended by guidelines, intrapartum starvation has not been popular in some regions. We conducted this comparative cross-sectional study to determine the prevalence of risk stomach in non-fasted laboring women compared with fasted non-laboring women using gastric ultrasound. METHODS: Ultrasound examination of the antrum was performed in 50 term fasted non-laboring women before elective cesarean delivery and 50 laboring women allowed to eat and drink during active labor. Examinations consisted of the qualitative (antral grades, 0-3) and quantitative evaluation (antral cross-sectional area and calculated gastric volume) in the supine and right lateral decubitus (RLD) position. A risk stomach was defined as an antral grade ≥ 2 or grade 1 with gastric volume ≥ 1.5 ml· kg- 1. RESULTS: No non-laboring women had grade ≥ 2, while 34 (68%) laboring women had grade ≥ 2. Nine (18%) non-laboring and 40 (80%) laboring women presented risk stomach (P < 0.001) (risk ratio: 4.4, 95% CI 2.4-8.2). Compared with non-laboring women, laboring women had larger antral area at "empty" stomach (grade 0) (437 mm2 vs.350 mm2 in supine, 571 mm2 vs.480 mm2 in RLD, P < 0.05) and cut-off values of antral area to discriminate a risk stomach (510 mm2 vs. 453 mm2 in supine, 670 mm2 vs. 605 mm2 in RLD). CONCLUSIONS: This study confirms a higher prevalence of risk stomach presents in laboring women under a liberal eating policy, gastric ultrasound is therefore useful for this risk population if general anesthesia is required unexpectedly.


Assuntos
Jejum , Conteúdo Gastrointestinal/diagnóstico por imagem , Trabalho de Parto , Ultrassonografia/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Gravidez , Prevalência , Medição de Risco , Estômago/diagnóstico por imagem
12.
Front Pharmacol ; 13: 818877, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35222032

RESUMO

With the wide application of non-steroidal anti-inflammatory drugs (NSAIDs), their gastrointestinal side effects are an urgent health burden. There are currently sound preventive measures for upper gastrointestinal injury, however, there is a lack of effective defense against lower gastrointestinal damage. According to a large number of previous animal experiments, a variety of NSAIDs have been demonstrated to induce small intestinal mucosal injury in vivo. This article reviews the descriptive data on the administration dose, administration method, mucosal injury site, and morphological characteristics of inflammatory sites of various NSAIDs. The cells, cytokines, receptors and ligands, pathways, enzyme inhibition, bacteria, enterohepatic circulation, oxidative stress, and other potential pathogenic factors involved in NSAID-associated enteropathy are also reviewed. We point out the limitations of drug modeling at this stage and are also pleased to discover the application prospects of chemically modified NSAIDs, dietary therapy, and many natural products against intestinal mucosal injury.

13.
Artigo em Inglês | MEDLINE | ID: mdl-35143402

RESUMO

Anomaly detection is one of the most active research areas in various critical domains, such as healthcare, fintech, and public security. However, little attention has been paid to scholarly data, that is, anomaly detection in a citation network. Citation is considered as one of the most crucial metrics to evaluate the impact of scientific research, which may be gamed in multiple ways. Therefore, anomaly detection in citation networks is of significant importance to identify manipulation and inflation of citations. To address this open issue, we propose a novel deep graph learning model, namely graph learning for anomaly detection (GLAD), to identify anomalies in citation networks. GLAD incorporates text semantic mining to network representation learning by adding both node attributes and link attributes via graph neural networks (GNNs). It exploits not only the relevance of citation contents, but also hidden relationships between papers. Within the GLAD framework, we propose an algorithm called Citation PUrpose (CPU) to discover the purpose of citation based on citation context. The performance of GLAD is validated through a simulated anomalous citation dataset. Experimental results demonstrate the effectiveness of GLAD on the anomalous citation detection task.

14.
Artigo em Inglês | MEDLINE | ID: mdl-35134198

RESUMO

BACKGROUND: Studies have demonstrated women to have a higher prevalence of dementia compared to men. However, sex differences in dementia incidence is controversial with conflicting reports showing women with higher, lower, or similar incidence. Source of difference may be due to clinical setting and lack of consideration of competing risk of death. We examined dementia incidence in a sample of the national Veteran population to determine differences by sex. METHODS: We examined data from the Veterans Health Administration (VHA), the largest integrated health care system in the U.S. We studied 947,797 veterans aged ≥55 years (mean age: 69.9±8.4, 3% female) evaluated in the VHA from October 1, 1999 to September 30, 2019. We estimated age-adjusted incidence rates of dementia (International Classification of Diseases, 9  th  and 10  th  Edition codes) by sex, and used Fine-Gray proportional hazards models with age as time scale to examine time to diagnosis, accounting for competing risk of death. RESULTS: During the follow-up (mean 8.4 years), 11.3% (n = 106,977, 11.4 % men and 8.0% women) of Veterans developed dementia. Age-adjusted incidence was 12.6/1000 person-years for men and 12.7/1000 person-years for women. Compared to male Veterans, risk dementia was slightly higher among females (HR=1.15 95% CI 1.10-1.20), and on average, female Veterans developed dementia 0.2 years earlier than male Veterans. After additional adjustment for race, education, medical, and psychiatric conditions, results were similar. CONCLUSIONS: Among older Veterans in a national cohort, women had a slightly increased risk for developing dementia compared to men after accounting for competing risk of death.

15.
Neurology ; 98(10): e1040-e1049, 2022 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-35082172

RESUMO

BACKGROUND AND OBJECTIVE: The goal of this work was to determine whether midlife cardiac structure and function and their 25-year change from early to middle adulthood are associated with lower midlife cognition. METHODS: We studied 2,653 participants from the Coronary Artery Risk Development in Young Adults (CARDIA) study (57% women, 46% Black). Echocardiograms were obtained at year 5, 25, and 30 visits (participant mean age 30, 50, and 55 years) to assess left ventricular (LV) mass (LVM), LV systolic function with LV ejection fraction (LVEF), and LV diastolic function with left atrial volume (LAV) and early peak mitral velocity (E)/early peak mitral annular velocity (e') ratio. LVM and LAV were indexed to body surface area (LVMi and LAVi). At year 30, 5 cognitive domains were measured: global cognition, processing speed, executive function, delayed verbal memory, and verbal fluency. We investigated the association between midlife (year 30) and 25-year change in cardiac structure and function on midlife cognition using linear regressions. RESULTS: Over 25 years, LVMi and LAVi increased with mean change (SD) per year of 0.27 (0.28) g/m2 and 0.42 (0.15) mL/m2, while LVEF decreased by 0.11% (0.02%). After adjustment for demographics and education, 25-year increase (≥1 SD) in LVMi was associated with lower cognition on most tests (p ≤ 0.02); 25-year increase in LAVi was associated with lower global cognition (p = 0.04), but 25-year decrease in LVEF was not associated with cognition. Further adjustment for cardiovascular risk factors led to similar results. In addition, unlike year 30 E/e' ratio and LVEF, higher year 30 LVMi and LAVi were significantly associated with worse cognition on most cognitive tests. DISCUSSION: Midlife cardiac structure and its change from early to middle adulthood are associated with lower midlife cognition even after accounting for confounders. Unlike systolic function, midlife LV diastolic function and its 25-year change were also linked to cognition. Our results provide information linking early to midlife cardiac structure and function to cognition.


Assuntos
Vasos Coronários , Disfunção Ventricular Esquerda , Adulto , Cognição , Feminino , Humanos , Masculino , Volume Sistólico , Sístole , Função Ventricular Esquerda , Adulto Jovem
16.
J Obstet Gynaecol Res ; 48(3): 869-874, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35014127

RESUMO

Obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) is a rare congenital malformation of the female reproductive organs, including uterine dysplasia, blind hemivagina, and ipsilateral renal dysplasia. It has a serious impact on patients' quality of life and fertility. We report a rare case of OHVIRA with a complete septate uterus, ectopic dysplasia of the left kidney, left ectopic ureter, and three oblique vaginal septa. The dysplastic left kidney and the ectopic ureter were removed during laparoscopy. In addition, the two layers of vaginal septa, which were ignored in the past 10 years, were removed by hysteroscopy. As the detection rate of OHVIRA has gradually increased, manifestations that previous classification systems could not recapitulate have emerged. By retrieving the relevant cases, we have tried to propose a new classification system, which would allow clinicians to have a complete understanding of the manifestations of OHVIRA and would be helpful in the treatment of patients.


Assuntos
Nefropatias , Qualidade de Vida , Anormalidades Congênitas , Feminino , Humanos , Rim/anormalidades , Nefropatias/congênito , Útero/anormalidades , Vagina/anormalidades
17.
Sensors (Basel) ; 22(2)2022 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-35062377

RESUMO

A four-loop shaped structure of fiber Bragg grating (FBG) acoustic emission (AE) sensor based on additive manufacturing (AM) technology is proposed in the letter. The finite element analysis (FEA) method was used to model and analyze the sensor structure. We aimed at improving the sensitivity, the static load analysis, and the dynamic response analysis of the normal FBG acoustic emission sensor and the FBG AE sensor with improved structure parameters. We constructed the FBG AE sensor experimental system based on a narrowband laser demodulation method and test on real acoustic emission signals. The results demonstrated that the response sensitivity of the FBG acoustic emission sensor was 1.47 times higher than the sensitivity of the normal FBG sensor. The sensitivity coefficient of PLA-AE-FBG2 sensor was 3.057, and that of PLA-AE-FBG1 was 2.0702. Through structural design and parameter optimization, the sensitivity and stability of the FBG AE sensor are improved. The four-loop shaped sensor is more suitable for the health monitoring in fields such as aero-engine blade, micro-crack of structure, and crack growth in bonded joints. While ensuring the sensing characteristics, sensitivity, and stability of the four-loop shaped sensor have been enhanced. It is possible to apply the FBG AE sensor in some complex engineering environments.


Assuntos
Tecnologia de Fibra Óptica , Fibras Ópticas , Acústica , Análise de Elementos Finitos
18.
Brief Bioinform ; 23(2)2022 03 10.
Artigo em Inglês | MEDLINE | ID: mdl-35043158

RESUMO

Drug-target interactions (DTIs) prediction research presents important significance for promoting the development of modern medicine and pharmacology. Traditional biochemical experiments for DTIs prediction confront the challenges including long time period, high cost and high failure rate, and finally leading to a low-drug productivity. Chemogenomic-based computational methods can realize high-throughput prediction. In this study, we develop a deep collaborative filtering prediction model with multiembeddings, named DCFME (deep collaborative filtering prediction model with multiembeddings), which can jointly utilize multiple feature information from multiembeddings. Two different representation learning algorithms are first employed to extract heterogeneous network features. DCFME uses the generated low-dimensional dense vectors as input, and then simulates the drug-target relationship from the perspective of both couplings and heterogeneity. In addition, the model employs focal loss that concentrates the loss on sparse and hard samples in the training process. Comparative experiments with five baseline methods show that DCFME achieves more significant performance improvement on sparse datasets. Moreover, the model has better robustness and generalization capacity under several harder prediction scenarios.


Assuntos
Algoritmos , Desenvolvimento de Medicamentos , Desenvolvimento de Medicamentos/métodos
19.
BMC Surg ; 22(1): 6, 2022 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-34996410

RESUMO

BACKGROUND: Ingestion of fish bones leading to gastric perforation and inducing abscess formation in the caudate lobe of the liver is very rare. CASE PRESENTATION: A 67-year-old man presented to our hospital with a 2-day history of subxiphoid pain. There were no specific symptoms other than pain. Laboratory tests showed only an increase in the number and percentage of neutrophils. Contrast-enhanced Computerized tomography (CT) of the abdomen showed two linear dense opacities in the gastric cardia, one of which penetrated the stomach and was adjacent to the caudate lobe of the liver, with inflammatory changes in the caudate lobe. We finally diagnosed his condition as a caudate lobe abscess secondary to intestinal perforation caused by a fishbone based on the history and imaging findings. The patient underwent 3D laparoscopic partial caudate lobectomy, incision and drainage of the liver abscess, and fishbone removal. The procedure was successful and we removed the fishbone from the liver. The patient was discharged on the 9th postoperative day without other complications. CONCLUSIONS: Liver abscess caused by foreign bodies requires multidisciplinary treatment. Especially when located in the caudate lobe, we must detect and remove the cause of the abscess as early as possible. Foreign bodies that perforate the gastrointestinal tract can penetrate to the liver and cause abscess formation, as in this case. When exploring the etiology of liver abscesses, we should investigate the general condition, including the whole gastrointestinal tract.


Assuntos
Corpos Estranhos , Migração de Corpo Estranho , Laparoscopia , Abscesso Hepático , Idoso , Animais , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Migração de Corpo Estranho/complicações , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Abscesso Hepático/diagnóstico por imagem , Abscesso Hepático/etiologia , Abscesso Hepático/cirurgia , Masculino
20.
J Invest Surg ; 35(4): 880-887, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34085878

RESUMO

BACKGROUND: No-touch combined directed perfusion radiofrequency ablation (NTDP-RFA) is a new technique for the treatment of hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the short-term efficacy of this new technique for the treatment of small HCC with cirrhosis. METHODS: From January 2017 to March 2018, 56 consecutive patients treated with NTDP-RFA at our center were enrolled in this retrospective study. All NTDP-RFA procedures involved the use of internally cooled wet electrodes with a directional injection function, which can perform both intraelectrode cooling and extraelectrode saline perfusion. Survival curves were analyzed using Kaplan-Meier methods, and Cox proportional hazards regression analyses were used to assess predictors of tumor progression and overall survival. Operative characteristics and complications were also assessed. RESULTS: No technical failure occurred, and the complete ablation rate after single NTDP-RFA treatment was 98.2%. The median tumor diameter and ablation time were 26 (18.0 - 28.0) mm and 8 (6 - 8) min, respectively. Mild complications occurred in five patients (8.9%) postoperatively, and the median hospital stay was 4 (4 - 5) days. In the 18 patients (32.1%) with poor liver function reserve (indocyanine green retention rate at 15 min > 15%, their liver function returned to normal on the third day after the postoperation. The 1- and 2-year local and distant progression rates were 1.7%, 7.1%, 3.5% and 10.7%, respectively. CONCLUSIONS: NTDP-RFA in the treatment of small HCC with cirrhosis has a low incidence of complications and provides a high survival rate without local tumor progression.


Assuntos
Carcinoma Hepatocelular , Ablação por Cateter , Neoplasias Hepáticas , Ablação por Radiofrequência , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/cirurgia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Humanos , Cirrose Hepática/complicações , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/cirurgia , Perfusão , Ablação por Radiofrequência/efeitos adversos , Ablação por Radiofrequência/métodos , Estudos Retrospectivos , Resultado do Tratamento
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