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1.
Artigo em Inglês | MEDLINE | ID: mdl-32006087

RESUMO

Results of a preclinical study suggested that the anticonvulsant drug ethosuximide may elicit ketamine-like rapid-acting antidepressant actions. We evaluated the antidepressant efficacy of ethosuximide versus placebo in non-medicated adult patients with major depressive disorder (MDD). This randomized, double-blind, placebo-controlled trial included patients at three mental health centers in China. Eighty eligible adults (aged 18-65 years) met the DSM-5 criteria for MDD. Patients in the acute single study received three doses (500, 1000, or 1500 mg) of ethosuximide or placebo. Patients in the repeated study received ethosuximide (1500 mg/day) or placebo for 2 weeks. The Hamilton Depression Rating Scale (HAM-D), the Montgomery-Åsberg Depression Rating Scale (MADRS), and the Hamilton Anxiety Rating Scale were used to assess antidepressant and antianxiety responses to ethosuximide. No significant reductions in depression and anxiety rating scale scores were observed after a single oral administration of ethosuximide, in comparison with placebo. Furthermore, patients receiving ethosuximide for 2 weeks did not show reductions in depression and anxiety rating scale scores. There were no serious adverse events. Responses to the study's primary and secondary outcome measures, the clinician-rated HAM-D and MADRS, showed no change from baseline to the end of treatment, with either ethosuximide or placebo. These results suggest that ethosuximide does not produce ketamine-like robust antidepressant actions in adult patients with MDD.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32049934

RESUMO

STUDY DESIGN: Retrospective analysis. OBJECTIVE: The aim of this study was to develop and validate a nomogram for the prediction of lung metastasis in patients with malignant primary spinal tumors. SUMMARY OF BACKGROUND DATA: In patients with malignant primary spinal tumors, lung metastasis is usually found by computed tomography (CT) and is considered to be an essential factor affecting the prognosis and survival. METHODS: We retrospectively collected 580 malignant primary osseous spinal neoplasms patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The least absolute shrinkage and selection operator (LASSO) and multivariate logistic analysis were used to identify independent factors. These prognostic factors were included in the nomograms. The nomograms were validated based on its calibration, discrimination, and clinical utility. The overall survival of the patients was analyzed using the Kaplan-Meier method and the survival differences were tested by the log-rank test. RESULTS: We randomly divided all these patients (n = 580) into a training cohort (n = 408) and a validation cohort (n = 172). The results showed that the risk of lung metastasis was independently influenced by histologic type, use of surgery, clinical T stage, clinical N stage, and tumor extension (all P < 0.05). The nomogram consisted of five clinical features and provided good calibration and discrimination in the training and validation cohort, with an area under the curve of 0.858 and 0.811, respectively. Decision curve analysis showed that the nomogram was clinically useful. The Kaplan-Meier curves showed a significant difference between the higher and lower risk of lung metastasis groups (P < 0.001). CONCLUSION: Nomograms were developed to predict the risk of lung metastasis in patients with malignant primary spinal tumors. The nomogram showed favorable discrimination and calibration values, which may help optimize treatment decision-making for patients. LEVEL OF EVIDENCE: 4.

3.
World Neurosurg ; 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-32001394

RESUMO

OBJECTIVE: To assess the role of the difference between the proximal junctional angle (PJA) and rod contouring angle (RCA) (PJA-RCA) in the development of postoperative proximal junctional angle (PJK) in Lenke I and II AIS patients. METHODS: We performed a retrospective analysis of 84 Lenke I and II AIS patients who underwent posterior segmental spinal instrumentation and fusion between 2012 and 2018 (minimum follow-up of 1.5 years and an average follow-up of 2 years) at a single institution. The full-spine X-rays taken at the preoperative, postoperative and final follow-ups were measured for each patient. The radiographic parameters were compared between the PJK and non-PJK groups, and binary logistic regression with forward elimination (Conditional) was also performed to identify the risk factors for the occurrence of PJK. RESULTS: Among the 84 patients, who had a mean age of 14.63 years (± 1.33), the overall incidence of PJK was 23.81%. The PJK group showed a larger preoperative pelvic incidence (PI) (55.66° ± 8.66° vs. 50.29°±8.27°, P = 0.045), thoracic kyphosis (TK) (32.44° ± 5.60° vs. 27.19° ± 5.14°, P = 0.007) and sagittal vertical axis (SVA) (40.99 mm ± 21.82 mm vs. 18.13 mm ± 28.64 mm, P = 0.013) than the non-PJK group. Postoperatively, the PJK group showed a larger decrease in the TK (-10.62° ± 3.19° vs. -5.56° ± 1.17°, P < 0.001) and SVA (-24.28 mm ± 18.22 mm vs. -10.83 mm ± 15.02 mm, P = 0.007). In addition, the PJK group had significantly larger postoperative PJA (9.83° ± 2.64° vs. 5.77° ± 3.06°, P < 0.001) and postoperative PJA-RCA (6.56° ± 3.69° vs. 1.55° ±3.32°, P < 0.001). The proportion of patients with a PJA-RCA value greater than 5° was significantly larger in the PJK group (65.00% vs. 18.75%, P < 0.001). At the last follow-up, the PJK patients had significantly larger TK (35.11° ± 5.51° vs. 26.53° ± 4.71°, P < 0.001) and SVA (22.83 mm±23.12 mm vs. 3.46 mm±26.24 mm, P = 0.038). Binary logistic regression analysis showed that decreases in TK and postoperative PJA-RCA were the primary contributors to PJK in patients with AIS. CONCLUSIONS: Large postoperative PJA-RCA and decreased TK are risk factors for PJK in Lenke I and II AIS patients, especially those with PJA-RCA greater than 5°, and the occurrence of PJK should be highly considered.

4.
Biomed Pharmacother ; 124: 109863, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31986411

RESUMO

The cyclic adenosine monophosphate (cAMP)-activated protein kinase A (PKA) pathway is profoundly implicated in Prostate cancer (PCa) progression. Previously, we showed that PRKAR2B, the type II-beta regulatory subunit of PKA, is highly expressed in castration-resistant prostate cancer (CRPC) and can induce epithelial-mesenchymal transition by activating Wnt/ß-catenin signaling in PCa cells. However, the molecular mechanism of dysregulated PRKAR2B expression pattern is still largely unknown. In this study, we found that the mutation, copy number alteration, and methylation status of PRKAR2B gene have no correlation with its expression level in PCa. Then, we identified two microRNAs (miR-200b-3p and miR-200c-3p) to be critical regulators of PRKAR2B expression in PCa. Notably, miR-200b-3p and miR-200c-3p expression were significantly downregulated in metastatic CRPC and negatively correlated with the expression level of PRKAR2B in PCa tissues. Moreover, we characterized X-Box Binding Protein 1 (XBP1) as a key transcription factor responsible for PRKAR2B expression in PCa. Importantly, miR-200b-3p/200c-3p or XBP1 knockdown inhibited PCa cell proliferation and promoted cell apoptosis and these inhibitory roles could be largely restored by PRKAR2B, suggesting that PRKAR2B is a functional mediator of miR-200b-3p, miR-200c-3p, and XBP1 in PCa. Collectively, our study firstly identified miR-200b-3p/200c-3p and XBP1 as the critical upstream regulators of PRKAR2B in PCa and provided novel insights to PRKAR2B-driven PCa progression.

5.
J Dig Dis ; 2020 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-31953907

RESUMO

OBJECTIVE: We aimed to evaluate the efficacy of living-donor liver transplantation (LDLT) in children with tyrosinemia type I. METHODS: Ten patients were diagnosed with tyrosinemia type I and underwent LDLT between June 2013 and April 2019 at Ren-Ji Hospital. Cirrhosis was the transplantation indication in all 10 patients, and HCC was suspected in 9 patients. Outcomes, including liver function, metabolism restoration, life quality and physical development, were analyzed after LDLT. RESULTS: All recipients were alive with normal liver function after a median follow-up of 49-month. Pathological examination indicated HCC in 1 patient, dysplasia in 5 patients, and cirrhosis in all. The median AFP level dropped from 2520ng/mL to a normal level after LDLT, and no recurrence of HCC was detected during follow-up. Tyrosine metabolism was restored to its normal level with normalized plasma tyrosine and succinylacetone concentration. Besides, urinary succinylacetone excretion decreased significantly during the follow-up. Furthermore, LDLT improved the renal tubular function, as evidenced by the normalized plasma phosphate concentration and by improved eGFR. Severe rickets symptoms, including spontaneous fractures and bone pain, were also ameliorated. Improved motor function was reported by all patients' parents during the follow-up period. Dietary restriction and supplementary medicine were no longer required, associated with favorable catch-up growth and improved life quality. Complete resolution of hypertrophic cardiomyopathy was observed one-year after LDLT in one patient. All donors survived the operation without any complications or compromised working ability. CONCLUSION: LDLT is a safe and effective treatment for tyrosinemia type I patients with end-stage liver disease. This article is protected by copyright. All rights reserved.

6.
Chin Med J (Engl) ; 133(2): 183-189, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31929368

RESUMO

BACKGROUND: Obstetric hemorrhage is a major cause of maternal death during cesarean delivery. The objective of this retrospective observational study was to evaluate the efficacy and safety of intra-operative cell salvage (IOCS) in cesarean section. METHODS: We included a total of 361 patients diagnosed with central placenta previa who underwent cesarean section from May 2016 to December 2018. In this study, 196 patients received autologous transfusion using IOCS (IOCS group) and 165 patients accepted allogeneic blood transfusion (ABT group). Propensity score matched analysis was performed to balance differences in the baseline variables between the IOCS group and ABT group. Patients in the IOCS group were matched 1:1 to patients in the ABT group. RESULTS: After propensity score matching, 137 pairs of cases between the two groups were successfully matched and no significant differences in baseline characteristics were found between the IOCS group and ABT group. Patients in the IOCS group were associated with significantly shorter length of hospital stay, compared with ABT group (8.9 ±â€Š4.1 days vs. 10.3 ±â€Š5.2 days, t = -2.506, P = 0.013). The postoperative length of hospital stay was 5.3 ±â€Š1.4 days for patients in the IOCS group and 6.6 ±â€Š3.6 days for those in the ABT group (t = -4.056, P < 0.001). The post-operative hemoglobin level in the IOCS group and ABT group was 101.3 ±â€Š15.4 and 96.3 ±â€Š16.6 g/L, respectively, which were significantly different (t = 2.615, P = 0.009). Allogeneic red blood cell transfusion was significantly lower at 0 unit (range: 0-11.5 units) in the IOCS group when compared with 2 units (range: 1-20 units) in the ABT group (P < 0.001). CONCLUSIONS: This retrospective observational study using propensity score matched analysis suggested that IOCS was associated with shorter length of postoperative hospital stay and higher post-operative hemoglobin levels during cesarean delivery.

7.
J Steroid Biochem Mol Biol ; 196: 105491, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31586638

RESUMO

Vitamin D is very important for children's health. Previous studies have shown that vitamin D deficiency leads to a series of diseases in adults. However, pediatricians are mostly aware of rickets caused by vitamin D deficiency in children and poorly aware of other symptoms. This study aimed to retrospectively analyze the different clinical features of vitamin D deficiency to enhance identification by pediatricians, thus minimizing misdiagnosis. In this study, we retrospectively analyzed the clinical features of vitamin D deficiency in 268 children aged 0-14 years from June 2016 to May 2018 in the Third Affiliated Hospital of Zhengzhou University. Serum 25-hydroxy vitamin D [25(OH)D] levels were determined using the chemiluminescence method. Of the 268 cases, 101 cases showed movement disorder (37.7%) and 167 nervous system abnormalities (62.3%). Among all cases, 6 were misdiagnosed as febrile seizures (2.23%), 5 as epilepsy (1.86%), 2 as Tourette syndrome (0.74%), and 2 as developmental retardation (0.74%). There were significant differences in patients with clinical characteristics of movement disorder and nervous system abnormalities partly between Pre-and post-vitamin D treatment. This analysis revealed that vitamin D deficiency occurs not only in children but also in adolescents, with diverse clinical features. Therefore, pediatricians should pay more attention to clinical different signs and symptoms, and future studies should be conducted to confirm the mechanisms of these processes.

8.
J Cell Biochem ; 121(1): 524-533, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31318098

RESUMO

Renal ischemia-reperfusion injury (IRI) is one of the most common causes of acute kidney injury (AKI), which is closely related to high morbidity and mortality. However, the pathogenesis underlying renal IRI is complex and not fully defined. N6-methyladenosine (m6A) was recently found to be an abundant modification in mammalian messenger RNAs. It is implicated in various biological processes, while the role of m6A in IRI is not illustrated. Here we show that the m6A-methylated RNA level and its methyltransferase METTL14 are elevated in human AKI renal tissues and IRI HK-2 cells. Moreover, METTL14 knockdown protects the kidney against IRI in vitro and in vivo. Mechanistically, we identified that YAP1 is a direct target of METTL14 in AKI progression. Inhibition of YAP1-TEAD signaling by peptide 17 abrogates the protective effect of METTL14 against IRI in vitro and in vivo. Taken together, these results reveal that the N6-methyladenosine mRNA methylase METTL14 promotes the renal IRI via suppressing YAP1. The discovery of the METTL14-YAP1 pathway provides an important new perspective for understanding AKI and is conducive to revealing new therapeutic strategies and targets.

9.
Front Oncol ; 9: 1319, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31828041

RESUMO

Background: ALK and ROS1 rearrangement accounts for 3-6% and 1-3% of non-small cell lung cancers, respectively, while coexistence of them in the same patient is extremely rare. Only three cases have ever been reported with concurrent ALK/ROS1 fusions in the same tumor indicating tumor heterogeneity. Therefore, comprehensive genetic profiling via next-generation sequencing (NGS) is needed to provide fully molecular diagnosis. Case Presentation: A 50-year old Chinese female with resectable stage IB bilateral lung adenocarcinomas (ADCs) harbored EML4 exon 6-ALK exon 19 and TPM3 exon 8-ROS1 exon 35 fusions in the right lower and the left upper tumors, respectively, identified by clinical NGS test targeting 425 cancer-relevant genes. The results were further confirmed at RNA level using RNA-seq. Genomic evolution analysis reveals that these bilateral tumors are synchronous multiple primary lung cancers with no shared somatic alterations for both genes and arm-level copy number variations (CNVs). No recurrence was observed during 12 months of post-surgery follow-up. Conclusions: Our case is the first report of concurrent ALK/ROS1 fusions as distinct driver events of synchronous multiple primary lung cancers, and highlights the importance of individual genetic testing for each of the multiple primary tumors for fully molecular diagnosis and precise treatment decision-making.

10.
Animals (Basel) ; 9(12)2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31757039

RESUMO

The purpose of this study is to investigate the effect of probiotics L. casei YYL3 (Lc) and L. plantarum YYL5 (Lp) on growth performance, innate immunity, disease resistance and intestinal microbiota of channel catfish. A total of 252 catfish (67.20 ± 1.46 g) were randomly divided into 3 groups which were fed with basal diet, Lc-added (3.0 × 108 cfu/g) or Lp-added (3.0 × 108 cfu/g) diets, respectively. After 4 weeks of feeding, Lc significantly enhanced the growth and feed utilization of channel catfish compared with the control group (CG). Following that, the catfish were challenged with an intraperitoneal injection of 200 µL of the pathogenic E.ictaluri (2.0 × 106 cfu/mL), the relative percent survival of Lc and Lp were 38.28% and 12.76%, respectively. High-throughput sequencing indicated Lc and Lp reduced the alpha diversity of the intestinal microbiota in channel catfish. Lactobacillus were overwhelming in the guts during probiotics treatment, but almost vanished away after 2 weeks post-cessation of probiotics administration. Compared to CG, Lc and Lp resulted in an increased abundance of Pseudomonas and decreased amount of Aeromonas. Functional analysis revealed that Lc treatment upregulated the relative abundance of Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways including lipid metabolism, metabolism of other amino acids, metabolism of terpenoids and polyketides, xenobiotics biodegradation and metabolism, and nucleotide metabolism. Combined, our data revealed that Lc, as a feed additive at 3.0 × 108 cfu/g, could promote the growth performance, disease resistance and dramatically change the composition of intestinal microbiota of channel catfish.

11.
Front Cell Neurosci ; 13: 494, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31749688

RESUMO

Cerebral palsy (CP) is a group of non-progressive motor impairment syndromes that are secondary to brain injury in the early stages of brain development. Numerous etiologies and risk factors of CP have been reported, and genetic contributions have recently been identified. Autophagy has an important role in brain development and pathological process, and autophagy-related gene 7 (ATG7) is essential for autophagosome biogenesis. The purpose of this study was to investigate the genetic association between ATG7 gene single nucleotide polymorphisms (SNPs) and CP in Han Chinese children. Six SNPs (rs346078, rs1470612, rs11706903, rs2606750, rs2594972, and rs4684787) were genotyped in 715 CP patients and 658 healthy controls using the MassArray platform. Plasma ATG7 protein was determined in 73 CP patients and 79 healthy controls. The differences in the allele and genotype frequencies of the rs1470612 and rs2594972 SNPs were determined between the CP patients and controls (p allele = 0.02 and 0.0004, p genotype = 0.044 and 0.0012, respectively). Subgroup analysis revealed a more significant association of rs1470612 (p allele = 0.004, p genotype = 0.0036) and rs2594972 (p allele = 0.0004, p genotype < 0.0001) with male CP, and more significant differences in allele and genotype frequencies were also noticed between CP patients with spastic diplegia and controls for rs1470612 (p allele = 0.0024, p genotype = 0.008) and rs2594972 (p allele < 0.0001, p genotype = 0.006). The plasma ATG7 level was higher in CP patients compared to the controls (10.58 ± 0.85 vs. 8.18 ± 0.64 pg/mL, p = 0.024). The luciferase reporter gene assay showed that the T allele of rs2594972 SNP could significantly increase transcriptional activity of the ATG7 promoter compared to the C allele (p = 0.009). These findings suggest that an association exists between genetic variants of ATG7 and susceptibility to CP, which provides novel evidence for the role of ATG7 in CP and contributes to our understanding of the molecular mechanisms of this neurodevelopmental disorder.

12.
Medicine (Baltimore) ; 98(44): e17661, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689777

RESUMO

RATIONALE: Primary Extranodal Natural Killer/T-Cell Nasal-Type Lymphoma (ENKTCL) of spine is rarely reported. This case study presents a rare case of ENKTCL originating from the sixth thoracic vertebra. PATIENT CONCERNS: Here, we present a case of 49-year-old Asian male with chest and back pain. Physical examination revealed the myodynamia of both lower limbs decreased from IV degree to 0 degree, reflexes of both lower limbs and a large area of cutaneous sensation below xiphoid process disappeared in 3 days. DIAGNOSES: In immunophenotype analysis, CD2, CD3, CD7, and CD68 were positive and CD56 was suspiciously positive. Granzyme B and T-cell intracellular antigen (TIA-1) were also positive and in situ hybridization was positive for Epstein-Barr virus-encoded mRNA (EBER). Ki-67 was 60%+. Nuclide bone scan showed that the nuclide was unusually concentrated in the sixth thoracic vertebra which considered extremely active and slightly concentrated in the right sacrolilac joint. Magnetic resonance imaging detected an abnormal signal in the sixth thoracic vertebra with corresponding paravertebral and intraspinal occupying lesion. Based on the above features, a diagnosis of ENKTCL was made. INTERVENTIONS: This patient was treated with surgery and symptomatic supportive treatment. OUTCOMES: The myodynamia of patient's both lower limbs were elevated to I degree after the operation with chest and back pain partly relieved. However, the patient died about 3 months later. LESSONS: ENKTCL could originate from spine. Clinicians should be alert for early stage diagnose and distinguish it from some common spinal tumor such as neurofibroma and hemangioma.


Assuntos
Linfoma Extranodal de Células T-NK/diagnóstico , Linfoma Extranodal de Células T-NK/patologia , Vértebras Torácicas/patologia , Humanos , Linfoma Extranodal de Células T-NK/diagnóstico por imagem , Linfoma Extranodal de Células T-NK/cirurgia , Masculino , Pessoa de Meia-Idade
13.
World Neurosurg ; 2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31634621

RESUMO

OBJECTIVE: To perform a meta-analysis exploring the correlation between cervical lordosis (CL) and sagittal spine alignment in patients with adolescent idiopathic scoliosis (AIS) after surgery for determining a surgical strategy. METHODS: We searched 3 electronic databases for studies discussing the correlation between CL and spine sagittal alignment in patients with AIS. Studies reported from the inception of the database to June 2019 were retrieved without any language restrictions. Summary correlation coefficient (r) values were extracted from each study, and 95% confidence intervals (CIs) were calculated. In addition, we conducted subgroup analyses in different curve type subgroups with at least 2 studies. RESULTS: Ten relevant studies involving 539 patients were evaluated in this meta-analysis. The Pearson correlation (r) for CL and the T1 slope was -0.69; (95% CI, -0.79 to -0.54). The fixed-effects summary correlation between CL and thoracic kyphosis in patients was moderate (r = -0.40; 95% CI, -0.48 to -0.31). In addition, the fixed-effects summary correlations between CL and lumbar lordosis (r = 0.19; 95% CI, 0.07-0.30), pelvic incidence (r = -0.08; 95% CI, -0.20 to 0.04), pelvic tilt (r = -0.06; 95% CI, -0.18 to 0.06), and sacral slope (r = -0.06; 95% CI, -0.18 to 0.06) in patients were weak. CONCLUSIONS: There is a strong negative correlation between CL and the T1 slope in patients with AIS. Given the lack of robust clinical evidence, these findings warrant verification by large prospective registries and randomized trials with long follow-up periods.

14.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 27(5): 1654-1663, 2019 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-31607328

RESUMO

OBJECTIVE: To compare the effects of intravenous and subcutaneous injection of bortezomib on incidence and relative risk of peripheral neuropathy in patients with multiple myeloma(MM). METHODS: The electronic database of PubMed, Embase, Cochrance library, CNKI and related meeting records were searched by computers. The data were derived all from a matched randomized controlled studies. The incidence, relative risk(RR) and 95% confidence interval of peripheral neuropathy caused by intravenous and subcustaneous injections were calculated by the statistical methods. RESULTS: Four RCT studies were selected for meta-analysis, with a total of 911 patients (479 cases and 432 cases in the subcutaneous injection and intravenous injection groups, respectively). The incidence of peripheral neuropathy in the intravenous injection group was 41.4% (95% CI=0.137-0.692, P=0.003), and the incidence of >2 grade of peripheral neuropathy was 15.6% (95% CI=0.005-0.308, P=0.043). The corresponding incidence rates of the subcutaneous injection group were 16% (95% CI=0.021-0.299, P=0.024) and 3.4% (95% CI=-0.011-0.080, P=0.141) respectively. Compared with the intravenous injection group, the RR of peripheral neuropathy and the relative risk of peripheral neuropathy above grade 2 were 0.525, 95% CI=0.297-0.928 (P=0.027) and 0.376, 95% CI=0.196-0.722 (P=0.003) respectively. CONCLUSION: Subcutaneous injection of bortezomib at therapeutic doses significantly reduces the incidence of peripheral neuropathy compared with intravenous injection.


Assuntos
Bortezomib/efeitos adversos , Mieloma Múltiplo , Doenças do Sistema Nervoso Periférico , Antineoplásicos , Humanos , Incidência , Injeções Subcutâneas , Doenças do Sistema Nervoso Periférico/induzido quimicamente
15.
Medicine (Baltimore) ; 98(39): e16774, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574793

RESUMO

BACKGROUND: Total hip arthroplasty (THA) relieves pain and restores function in patients with severe rheumatoid arthritis and osteoarthritis. Over the past few decades, several authors have attempted to assess the efficacy and safety of simultaneous bilateral THA compared with staged bilateral THA. The purpose of this meta-analysis is to compare the mortalities and complications between simultaneous bilateral THA and staged bilateral THA. METHODS: A literature search to identify eligible studies was undertaken to identify all relevant articles published until August 2018. We included studies that compared simultaneous bilateral THA and staged bilateral THA and their effects on mortality and complications. The outcomes included mortality, the occurrence of deep venous thrombosis (DVT), the occurrence of pulmonary embolism (PE), respiratory complications, cardiovascular complications, digestive system complications and the occurrence of dislocation. Stata 12.0 was used for the meta-analysis. RESULTS: Nineteen studies involving 59,257 patients were identified; among them, 16,758 patients were selected for treatment with simultaneous bilateral THA, and 42,499 patients were chosen for the purpose of staged bilateral THA. The meta-analysis results demonstrated that there was no significant difference between simultaneous bilateral THA and staged bilateral THA in terms of mortality (risk ratio [RR] = 1.15, 95% CI = 0.76, 1.74; P = .520). Compared with staged bilateral THA, simultaneous bilateral THA was associated with a reduction in the occurrence of DVT, PE and respiratory complications (P < .05). There were no significant differences in the cardiovascular complications, digestive system complications or the occurrence of dislocation and infection (P = .057). CONCLUSIONS: We observed that the prevalence of DVT, PE and respiratory complications was considerably lower with the use of simultaneous bilateral THA than with the use of staged bilateral THA. Thus, simultaneous bilateral THA is a considerably safer procedure than staged bilateral THA in selected THA patients.


Assuntos
Artrite Reumatoide/cirurgia , Artroplastia de Quadril/efeitos adversos , Artroplastia de Quadril/métodos , Osteoartrite do Quadril/cirurgia , Complicações Pós-Operatórias/epidemiologia , Artroplastia de Quadril/mortalidade , Doenças do Sistema Digestório/epidemiologia , Cardiopatias/epidemiologia , Humanos , Luxações Articulares/epidemiologia , Prevalência , Embolia Pulmonar/epidemiologia , Transtornos Respiratórios/epidemiologia , Trombose Venosa/epidemiologia
16.
Ann Hepatol ; 18(6): 790-795, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558419

RESUMO

Prohibitin (PHB) 1 is involved in multiple regulatory pathways in liver disease to protect hepatocytes, and its function is associated with subcellular localization. PHB1 located in the nucleus, cytoplasm and the mitochondrial inner membrane has anti-oxidative stress and anti-inflammatory effects in hepatitis and cirrhosis, which can protect liver cells from damage caused by inflammatory factors and reactive oxygen species (ROS) stimulation. The low expression of PHB1 located in the nucleus of liver cancer cells inhibits the proliferation and metastasis of liver cancer; thus, PHB1 exhibits the function of a tumor suppressor gene. Understanding the mechanisms of PHB1 in liver diseases may be useful for further research on the disease and may provide new ideas for the development of targeted therapeutic drugs in the future. Therefore, this review puts forward an overview of the role of PHB1 and its protective mechanism in liver diseases.

17.
Brain Behav ; 9(10): e01409, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31541518

RESUMO

BACKGROUND: Although recent studies have shown that botulinum toxin-A (BTX-A) has a good analgesic effect on trigeminal neuralgia (TN) and peripheral neuropathic pain (PNP), the quality of evidence is low due to limited data. This meta-analysis is used to synthesize existing evidence for the treatment of these conditions with BTX-A. METHODS: Relevant trials were accessed by using an electronic search in databases (Web of Science, PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov). Data from included randomized controlled trials (RCTs) on the efficacy and safety of BTX-A in treating TN and PNP were extracted for meta-analysis. RESULTS: Finally, 10 RCTs (n = 391) were included in this meta-analysis. The pooled effect of BTX-A was superior to placebo based on pain intensity (SMD = -0.48, 95% CI [-0.74, 0.23] at 1 month, SMD = -0.58, 95% CI [-0.91, -0.24] at 2 months, and SMD = -0.55, 95% CI [-0.87, -0.22] at 3 months). Number needed to treat (NNT) for 50% pain intensity reduction showed better effect of BTX-A on TN and postherpetic neuralgia (PN). Adverse events associated with BTX-A were similar to placebo (OR = 1.58, 95% CI [0.51, 4.87], p = .424). CONCLUSION: Pooled data from our meta-analysis suggest that BTX-A is efficacious and safe in treating TN and PNP. However, due to the limited sample size and heterogeneity, further larger and well-designed RCTs are imperative to validate these findings.

18.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(9): 881-885, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31506146

RESUMO

OBJECTIVE: To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis). RESULTS: There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05). CONCLUSIONS: Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.


Assuntos
Sepse , Enterocolite Necrosante , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Estudos Retrospectivos , Streptococcus agalactiae
19.
Polymers (Basel) ; 11(10)2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547582

RESUMO

In this work, a polyethylene terephthalate (PET) nonwoven support was prepared by wet-laid and hot-press technology and used as support for separation membranes. The properties of the PET nonwoven support were studied to determine the effect of hot-pressing parameters and PET fiber ratio, and were optimized by response surface methodology. Result showed that the PET nonwoven support with 62% low melting point PET (LPET-180) fibers obtained satisfactory properties and structure after hot pressing at 220 °C under the pressure of 9 MPa for 20 s. The response surface analysis indicated that the temperature and time of hot pressing and the fiber ratio were the most important factors affecting the strength and air permeability of the PET nonwoven support. After hot pressing, the PET nonwoven support exhibited interconnected structure, small pore size, low porosity, and high strength. Then phase inversion technique was applied to prepare a polysulfone (PSF) layer on the PET nonwoven support and an ultra-thin polyamide (PA) active layer was prepared by interfacial polymerization on the PSF layer. The practicality of PET nonwoven support was verified by testing the pure water flux and retention of the PA composite membrane and the structural change of the PA composite membrane before and after use. The results proved the feasibility and remarkable application prospects of hot-pressed wet-laid PET nonwoven support as support for separation membranes.

20.
Cell Mol Immunol ; 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481754

RESUMO

Despite the diverse etiologies of drug-induced liver injury (DILI), innate immunity activation is a common feature involved in DILI progression. However, the involvement of innate immunity regulation in inflammation resolution and liver regeneration in DILI remains obscure. Herein, we identified the chemokine CCL5 as a central mediator of innate immunity regulation in the pathogenesis of DILI. First, we showed that serum and hepatic CCL5 levels are elevated in both DILI patients and an APAP-induced liver injury (AILI) mouse model. Interestingly, both nonparenchymal cells and stressed hepatocytes are cell sources of CCL5 induction in response to liver injury. Functional experiments showed that CCL5 deficiency has no effect on the early phase of AILI but promotes liver repair in the late phase mainly by promoting inflammation resolution and liver regeneration, which are associated with an increased number of hepatic M2 macrophages. Mechanistically, CCL5 can directly activate M1 polarization and impede M2 polarization through the CCR1- and CCR5-mediated activation of the MAPK and NF-κB pathways. We then showed that CCL5 inhibition mediated by either a CCL5-neutralizing antibody or the antagonist Met-CCL5 can greatly alleviate liver injury and improve survival in an AILI mouse model. Our data demonstrate CCL5 induction during DILI, identify CCL5 as a novel innate immunity regulator in macrophage polarization, and suggest that CCL5 blockage is a promising therapeutic strategy for the treatment of DILI.

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