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1.
Clin Radiol ; 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34857380

RESUMO

AIM: To explore the utility of multiple energy spectrum computed tomography (CT) parameters in distinguishing thymic epithelial tumours (TETs) from thymic cysts among lesions <5 cm in diameter. MATERIALS AND METHODS: Data pertaining to 56 patients with TETs and thymic cysts <5 cm in diameter were assessed retrospectively. All patients underwent surgical resection and the diagnosis was confirmed histopathologically. Thirty-five patients with TETs (average age, 51.97 years) and 21 patients with thymic cysts (average age, 50.54 years) were included. The region of interest for the lesion on the energy spectrum CT was delineated on the post-processing workstation, and multiple parameters of the energy spectrum CT were obtained. The diagnostic efficacies of the parameters were analysed using receiver operating characteristic (ROC) curves. RESULTS: To distinguish small TETs from thymic cysts, a single-energy CT value of 60 keV showed good differential diagnostic performance in the arterial phase (cut-off value = 68.42 HU; area under the curve [AUC] = 0.978), a single-energy CT value of 70 keV showed good differential diagnostic performance in the venous phase (cut-off value = 59.77 HU; AUC = 0.956). In the arterial and venous phases, effective atomic numbers of 8.065 and 8.175, respectively, were used as cut-off values to distinguish small TETs from thymic cysts (AUC = 0.972 and AUC = 0.961, respectively). Iodine concentrations of 10.99 and 11.05 were used as cut-off values to distinguish small TETs from thymic cysts (AUC = 0.956 and AUC = 0.924, respectively). CONCLUSION: According to the present study, energy spectrum CT parameters may have clinical value in the differential diagnosis of TETs and thymic cysts.

2.
Zhonghua Yi Shi Za Zhi ; 51(5): 313-320, 2021 Sep 28.
Artigo em Chinês | MEDLINE | ID: mdl-34794272

RESUMO

The historical artifacts displayed in the Museum of Western study on Chinese Medicine at Yunnan University of Chinese Medicine came from a variety of Chinese medical schools in America and European countries. They are in the memorial galleries for some well-known figures, such as George Soulié de Morant (Su Lie), Jacques-André Lavier (La Wei Ai), Felix Mann (Man Fu Li) and Manfred Porkert (Man Xi Bo), representing the development and status of respective Chinese medical schools in America and European countries. The displayed artifacts are nearly 3,000 photos, manuscripts, documents and more than 500 hours of audiovisual materials, including instruments for acupuncture and moxibustion, books, passports, letters and even supplies for their life. The displayed artifacts demonstrate the process and the access of people in the western societies to know, learn and take use of Chinese medicine.


Assuntos
Terapia por Acupuntura , Acupuntura , Moxibustão , China , Humanos , Medicina Tradicional Chinesa , Museus
3.
Lett Appl Microbiol ; 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34822727

RESUMO

Cinnamomum camphora chvar. Borneol essential oil (BEO) was efficiently extracted by using pilot-plant neutral cellulase-assisted steam distillation (NCSD). Borneol, ß-cadinene and α-caryophyllene were identified as major components. Bacillus subtilis was the most sensitive bacteria to BEO with the lowest minimal inhibition concentration (MIC) and minimal bactericial concentration (MBC) at 1·75 and 3·50 mg ml-1 , respectively. Antimicrobial activity of the BEO was also reasonably high against Salmonella typhimurium, Escherichia coli and Staphylococcus aureus, but not sensitive against two fungi, i.e. Aspergillus niger and Penicillium aurantiogriseum. Changes in permeability and integrity of cell membrane, damage of cell wall and further leakage out of metabolites and ions were determined as bactericidal mechanisms of BEO against the two gram-positive bacteria. The BEO showed a reasonably high repelling activity of dust mite, which achieved higher than 95% repelling dust mite activity after the treatment of BEO solution at 0·50 mg ml-1 . When the concentration of BEO was higher than 0·50 mg ml-1 , it was B-grade miticide with miticidal activity higher than 95%. Miticidal procedures were characterized as excitation, contraction, relaxation and lastly leading to the death of dust mite. It is speculated that the BEO would cause dehydration and death of dust mite as neuromuscular toxicity.

5.
Int J Radiat Oncol Biol Phys ; 111(3S): e241, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34700994

RESUMO

PURPOSE/OBJECTIVE(S): To explore the impact of dose distribution on the parameter and predictive ability of equivalent uniform dose (EUD) model. MATERIALS/METHODS: The brains of 103 nasopharyngeal carcinoma patients receiving IMRT were divided into left and right half-brains to create small-size virtual brains with similar dose distribution to brains. Difference of relative VD between brain and half-brain was analyzed by independent sample t-test. EUDs for different dose distributions were calculated in different VD (EUDVD). Predictive ability of EUDVD for radiation-induced brain injury was assessed by receiver operating characteristics curve (ROC) and area under the curve (AUC). The optimal volume-effect parameter a of EUD was selected when AUC was maximal (mAUC). The correlations between mAUC, a and D (specific dose of VD) were analyzed by Pearson correlation analysis and linear regression analysis to evaluate the impact of dose distribution. Paired samples t-test was used for comparisons of both mAUCs and parameters between brain and half-brain to evaluate the role of size. The optimal DV and VD points were calculated for a simple comparison. RESULTS: Average-DVH curves of left half-brains, right half-brains and brains overlapped almost exactly, and the differences of relative VD were less than 0.01% (P > 0.5). The mAUC of EUDVD increased with D, and reached maximum when D was around 55 Gy. When D≤55 Gy, mAUC was linearly dependent on D. The optimal a was correlated with D strongly, and it decreased from 22 to 1 as D increased. The difference of mAUC/a between brain and half-brain was not significant. In the a range of 1 to 22, AUCs of EUDV55 Gy in brain/half-brain (0.830-0.857/0.830-0.845) were always larger than those of whole-volume EUD (0.681-0.819/0.691-0.821). AUCs of EUDV55 Gy (a = 1, equal to mean dose) and DV55 Gy/2 (dose delivered to V55 Gy/2, equal to median dose,) were larger than those of DV and VD (0.845/0.844 vs. 0.818/0.827 in half-brain). CONCLUSION: Volume-effect parameter of EUD is variable and depends on dose distribution rather than volume size. Before using an empirical parameter, dose distributions (especially the gradients) should be similar. Critical-dose-volume EUD could improve the predictive ability (no matter what the a is) and has a stable volume-effect parameter. Mean dose may be the case in which critical-dose-volume EUD has the best predictive ability, while median dose, as a simple dose/volume point, is a convenient alternative.

6.
Int J Radiat Oncol Biol Phys ; 111(3S): e557, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701742

RESUMO

PURPOSE/OBJECTIVE(S): To compare dosimetric results of two beam arrangement strategies and their robustness to setup uncertainties in fractionated thoracic spine Stereotactic Body Radiotherapy (SBRT) MATERIALS/METHODS: Fifteen patients who received fractionated thoracic spine SBRT were retrospectively studied. All patients received simulation CT scans in body vacuum bag immobilization and multiparametric MRI exams. Clinical target volumes (CTVs) included single vertebral bodies with possible paraspinal space inclusion. Planning target volumes (PTVs) were expanded from CTVs with a 2mm margin but were cropped from spinal cord defined by MRI with a 2mm margin. Two different beam arrangement strategies of volumetric modulated arc therapy planning were studied: 1) 5 full arcs (FA) (360° each arc) with different collimator angles; and 2) 6 partial arcs (PA) (90° each arc) divided into two groups (3 arcs in each group) covering patient left-posterior-oblique (LPO) and right-posterior-oblique (RPO) regions, respectively, with orthogonal collimator angles. Both plans (PlanFA and PlanPA) were calculated as 24 Gy in 3 fractions using 6xFFF photon energy and a high-definition MLC model. During the inverse optimization of each plan for same patient, a same set of dose-volume constraints and optimization settings was used to exhaust parameter space search. Key dosimetric results of PTV as well as dose-volume parameters of relevant organs-at-risk (OARs) including spinal cord, esophagus, heart, lung and liver were evaluated. Dosimetric impact of on-board patient setup uncertainties to both plans were also simulated. All comparison results were analyzed by Wilcoxon signed-rank tests when the statistical power was sufficient. RESULTS: Both PlanFA and PlanPA achieved satisfactory spatial dose distribution. After PTV coverage normalization, PlanPA had better PTV dose uniformity (P = 0.026) and PlanFA had better dose fall-off gradient outside PTV. PlanPA had slightly better (18.1 ± 0.8 Gy vs 18.3 ± 0.9 Gy) cord max dose (D0.035cc) results (P = 0.213) and better cord low dose sparing V12 Gy (P = 0.013) results. PlanPA also achieved lower max dose (D0.035cc) of esophagus (P = 0.003) and heart, and improved low dose sparing (V5 Gy) of lung (P = 0.002) and liver. In plan parameter comparisons, PlanFA demonstrated stronger beam modulation effect (P < 0.001) but PlanPA had smaller MLC apertures (P < 0.001). In the simulated on-board scenarios with setup uncertainties, while both PlanFA and PlanPA had similar cord max dose increases with simulated pitch and/or roll in setup (< 0.1 Gy differences), PlanPA had minimal cord max dose increase (P < 0.001) with simulated anterior body weight loss. CONCLUSION: For thoracic spine SBRT plans, the beam arrangement in PlanPA might be favored dosimetrically with better OAR sparing results and could be less sensitive to certain patient uncertainties, while the PlanFA could be acceptable with satisfactory dosimetry results. AUTHOR DISCLOSURE: C. Wang: None. Y. Xie: None. Z. Hu: None. F. Yin: Research Grant; Varian Medical Systems. Teaching and mentoring graduate students. Administration of graduate program activities; Duke Kunshan University. Board of Directors Member at Large Members; AAPM. organize activities of the SANTRO; SANTRO.Z. Reitman: None. Y. Cui: None.

7.
Int J Radiat Oncol Biol Phys ; 111(3S): e91, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34701997

RESUMO

PURPOSE/OBJECTIVE(S): Artificial intelligence (AI) driven tools have been maturing in automating the radiation treatment planning process. To prepare for clinical deployment of these tools, it is essential to understand their robustness in clinical scenarios. This study works to fill the existing gap between research initiated and clinically ready AI tools by investigating a clinical assessment approach based on phantom design and planning complexity simulation. The hypothesis is that AI tool assessment program provides more clinically relevant and comprehensive evaluations beyond typical model validation studies. MATERIALS/METHODS: A cylindrical digital phantom was designed in the treatment planning system with an axial diameter of 30 cm and length of 18 cm. The phantom contains key structures involved in pancreas SBRT including the PTV25Gy, PTV33Gy, C-loop, stomach, bowel and liver with their base shape and volume representing the average of 100 clinical SBRT patients. Phantom cases were synthesized to mimic real-life anatomical variations and overlaps through displacement, expansion, and rotation of PTVs and OARs. This study involved a total of 32 simulated cases to test a broad range of planning scenarios. A previously developed deep learning based automatic planning tool was assessed in this study. This AI tool is composed of two deep neural networks (NNs) which predict beam dose and fluence maps sequentially. The goal of treatment planning was to deliver 25 Gy to PTV25 and 33 Gy to PTV33 in 5 fractions via simultaneous integral boost (SIB) while limiting luminal OAR max dose to below 29 Gy. The AI-plan's quality was analyzed against the clinical evaluation criteria, which include PTV V100%, luminal OAR max dose using Dmax and D0.03cc. The passing rate of key clinical criteria were collected to quantify overall robustness. RESULTS: For all scenarios, the mean PTV25 V25Gy of the AI plans was 96.7% while mean PTV33 V33 Gy was 82.2%. Large variation (16.3%) in PTV33 V33 Gy was observed due to anatomical variations, i.e., proximity of luminal structures to PTV33. Mean max dose was 28.55, 27.68, and 24.63 Gy for the C-loop, bowel and stomach respectively. Using D0.03cc as a surrogate for max dose, the value was 28.03, 27.12, and 23.84 Gy for the same respective structures. A max dose constraint of 29 Gy was achieved for 81.3% cases for the C-loop and stomach, and 78.1% for the bowel. Using D0.03cc as a surrogate for max dose, the passing rate was 90.6% for the C-loop and 81.3% for both the bowel and stomach. CONCLUSION: The results showed promising robustness of AI planning tool for pancreas SBRT, providing important evidence of its readiness for clinical implementation. The established approach could guide the robustness testing and other clinical assessments of AI based treatment planning tools in general, which is an important component for safe clinical implementation.

8.
Int J Radiat Oncol Biol Phys ; 111(3S): e94-e95, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34702004

RESUMO

PURPOSE/OBJECTIVE(S): To evaluate a regional deformable model based on deep unsupervised learning framework for automated contour propagation in breast Cone Beam Computed Tomography (CBCT) guided radiation therapy. MATERIALS/METHODS: We introduce an unsupervised learning framework to map the breast tumor bed, clinical target volume (CTV), heart, left lung, right lung, and spinal cord from planning CT (pCT) to daily CBCT. To improve the performance of the traditional deformable image registration method, the proposed unsupervised learning method uses a regional deformable model based on the narrow band mapping, which can mitigate the effect of the image artifacts. We retrospectively selected 380 anonymized CBCT volumes from 107 patients with breast cancer. The CBCTs are divided into three sets. 311 / 20 / 49 CBCTs were used for training, validation, and testing. For the testing set, one physician-generated contours were generated as the references. Through the Dice similarity coefficients (DSC), the Hausdorff distances, and the distances of the center-of-mass, the results were compared between the proposed model and physician-generated contours. RESULTS: The mean DSC between the proposed segmentations and the physician-generated segmentations for breast tumor bed, clinical target volume (CTV), heart, left lung, right lung, and spinal cord were 0.79 ± 0.09, 0.89 ± 0.08, 0.90 ± 0.08, 0.93 ± 0.03, 0.94 ± 0.04, and 0.76 ± 0.13, respectively. The average distances of the center-of-mass for the whole testing images were less than 4 mm. The proposed regional deformable model's performance was better than the traditional global deformable model, especially in the CBCT image with severe image artifacts. CONCLUSION: This novel deep learning-based regional deformable model technique can automatically propagate contours for breast cancer patient radiotherapy. The proposed approach shows that the deep learning technique can accomplish highly precise contour propagation for breast CBCT-guided adaptive radiotherapy.

9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 266-270, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645191

RESUMO

To establish reference intervals for thyroid functional indicators in early (T1), mid-term (T2), and late stage (T3) pregnancy in a population of women in Northwestern China. A cross-sectional study was conducted on 620 pregnant women. Subjects were recruited through a questionnaire where apparently healthy women were selected. Serum thyroid stimulating hormone (TSH3), total triiodothyronine (TT3), total thyroid hormone (TT4), free triiodothyronine (FT3), and free thyroid hormone (FT4) were detected using the Beckman Unicel DXI 800 automatic chemiluminescence analyzer (the third-generation TSH detection reagent for TSH3),and the reference intervals of different gestation periods were established. The results showed that the reference intervals of TSH3 in T1, T2, and T3 were 0.05-4.59, 0.61-6.01, and 0.63-4.78 mIU/L, respectively; TT3 were 1.62-2.97 nmol/L, 1.59-2.95 nmol/L, and 1.45-2.70 nmol/L, respectively; TT4 were 95.49-185.00 nmol/L, 92.70-181.54 nmol/L, and 77.93-155.09 nmol/L, respectively; FT3 were 3.18-5.22 pmol/L, 2.78-4.67 pmol/L, and 2.51-4.18 pmol/L, respectively; and FT4 were 7.72-12.97 pmol/L, 6.90-1.09 pmol/L, and 5.63-9.85 pmol/L, respectively. All thyroid function indexes had statistically significant differences between the three stages of pregnancy (TSH:H=30.879,P<0.01;FT3:H =153.827,P<0.01;FT4:H =229.967,P<0.01;TT3:H =36.484,P<0.01;TT4:H =58.531,P<0.01). 20 independent samples were collected to verify the reference intervals of TSH, FT3, FT4, TT3 and TT4 for three trimesters of pregnancy, and all of them passed.


Assuntos
Glândula Tireoide , Tiroxina , Estudos Transversais , Feminino , Humanos , Gravidez , Valores de Referência , Testes de Função Tireóidea , Tireotropina , Tri-Iodotironina
10.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(10): 978-982, 2021 Oct 09.
Artigo em Chinês | MEDLINE | ID: mdl-34619890

RESUMO

Orthodontic tooth movement inevitably affects adjacent periodontal tissue. The labiobuccal alveolar bone is generally thin, and patients with dental crowding often present alveolar dehiscence and fenestration. These may lead to prolonged treatment time, even gingival atrophy, tooth loosening and other complications in the orthodontic tooth movement. Periodontally accelerated osteogenic orthodontics (PAOO) could accelerate the orthodontic tooth movement and promote the formation of new bone by using corticotomy and bone grafting. This article, starting from the influence of orthodontic treatment on periodontal hard tissue, describes the application of PAOO in orthodontic treatment.


Assuntos
Ortodontia , Transplante Ósseo , Assistência Odontológica , Humanos , Osteogênese , Técnicas de Movimentação Dentária
12.
Zhonghua Yi Xue Za Zhi ; 101(34): 2649-2652, 2021 Sep 14.
Artigo em Chinês | MEDLINE | ID: mdl-34510869

RESUMO

Gastric cancer (GC) is one of the malignant tumors with both high morbidity and mortality in China. Immunotherapy is expected to improve its prognosis. Molecular classification of GC based on multiple levels of assessment such as genes and tumor immune microenvironment (TiME), which can precisely screen the population with potential benefit from immunotherapy. It is helpful to make the treatment decision-making, and to further improve the efficacy of immunotherapy.


Assuntos
Neoplasias Gástricas , China , Humanos , Imunoterapia , Prognóstico , Neoplasias Gástricas/genética , Neoplasias Gástricas/terapia , Microambiente Tumoral
13.
Phys Rev E ; 104(2-2): 025204, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34525564

RESUMO

Inverse magnetic energy transfer from small to large scales is a key physical process for the origin of large-scale strong magnetic fields in the universe. However, so far, from the magnetohydrodynamic perspective, the onset of inverse transfer is still not fully understood, especially the underlying dynamics. Here, we use both two-dimensional and three-dimensional particle-in-cell simulations to show the self-consistent dynamics of inverse transfer in collisionless decaying turbulent plasmas. Using the space filtering technique in theory and numerical analyses, we identify magnetic reconnection as the onset and fundamental drive for inverse transfer, where, specifically, the subscale electromotive force driven by magnetic reconnection do work on the large-scale magnetic field, resulting in energy transfer from small to large scales. The mechanism is also verified by the strong correlations in locations and characteristic scales between inverse transfer and magnetic reconnection.

14.
Eur J Paediatr Dent ; 22(3): 207-214, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34544249

RESUMO

AIM: Immature necrotic teeth are frequent findings in adolescents that may lead to thin root walls and open apexes. The absence of an apical stop becomes a challenge for endodontic treatment because it is difficult or impossible to seal the immature root canal with conventional endodontic techniques. Revascularisation therapy (RET) may be more suitable for the treatment of immature necrotic teeth. However, clinicians are still more inclined to choose apexification (AP) when considering the predictability of treatment results. METHODS: The literature was searched via PubMed/MEDLINE and the Cochrane Library, Web of Science data from June, 2001 to September, 2020 and randomised clinical trials were selected that compared RET with AP for the treatment of immature necrotic teeth assessing clinical and radiographic results. RESULTS: A total of 556 articles were retrieved, though only five studies were included. There were no differences in the periapical healing rate, overall effective rate/invalid rate, or apical closure rate between RET and AP. The root length was significantly increased in the RET group compared with the AP group quantitatively (pooled difference in means=1.28, 95% CI: [1.08, 1.48], Z=12.69, P<0.00001) and qualitatively (pooled RR=4.12, 95% CI: [2.44, 6.97]), Z=5.28, P<0.00001). The effective rate of root thickness was significantly increased in the RET group compared with the AP group (pooled RR=22.63, 95% CI: [6.08, 84.26]), Z=4.65, P<0.00001). CONCLUSIONS: Both RET and AP were effective options regarding the healing of periapical periodontitis or the closure of open apices. Pulp revascularisation is more effective for root elongation and thickening without higher risk of overall invalid treatment.


Assuntos
Apexificação , Periodontite Periapical , Adolescente , Necrose da Polpa Dentária/terapia , Humanos , Tratamento do Canal Radicular , Ápice Dentário
15.
Br Poult Sci ; : 1-8, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34477026

RESUMO

1. The aim of this study was to explore the effects of acute heat stress on serum hormone levels and the expression of genes and proteins related to the unfolded protein response (UPR) pathway and apoptotic process in the liver of broilers.2. A total of 144 Arbor Acres broilers (35-d-old) were randomly allocated to 4 different environmental-controlled chambers for acute heat exposure. The temperature of the 4 environmental chambers was adjusted to 26°C (control), 29°C, 32°C, and 35°C within 1 h, respectively. The blood and liver samples were collected after 6 h of constant heat exposure at set temperatures.3. The results showed that 6 h of acute heat stress increased serum hormone levels and up-regulated the expression of heat shock protein. The endoplasmic reticulum (ER) stress markers, GRP78 and GRP94, in the liver of broilers were significantly upregulated at the mRNA and protein levels. The PERK, IRE1, and XBP1 genes, which are involved in the unfolded protein response signalling, were significantly up-regulated at the mRNA levels. However, other pro-apoptotic genes showed no significant changes in the liver of broiler chickens in all groups except for upregulation of the anti-apoptotic gene BCL-xl.4. The results suggested that broilers have tolerance to acute heat stress to a certain extent. The UPR activation can alleviate ER stress and further prevent apoptosis in the liver of broilers under short-term exposure to high ambient temperatures.

16.
Zhonghua Yi Xue Za Zhi ; 101(30): 2382-2386, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34404131

RESUMO

Objective: To investigate the effect of axillary lymph node status on the prognosis of different types of invasive breast cancer. Methods: Patients with invasive breast cancer of different molecular subtypes diagnosed in the breast cancer prevention and treatment center of Beijing Cancer Hospital from January 2000 to July 2011 were collected as a historical cohort, and the influence of lymph node status on the prognosis of different types of breast cancer was analyzed. Results: A total of 4 269 female breast cancer patients with molecular subtypes [aged (50.8±11.2) years] information and 3 824 female breast cancer patients with complete axillary lymph node status information [aged (50.5±10.9) years] were included in the study, including 3 135 cases with both molecular subtypes and lymph node status information. The 10-year event free survival (EFS) rates of hormone receptor (HR)+/human epidermal growth factor receptor-2(HER2)-, HR-/HER2-and HER2+were 82.2%, 79.0% and 76.8%, respectively; the 10-year overall survival (OS) rates were 88.1%, 83.1% and 84.4%, respectively, and the differences of 3 molecular subtypes in EFS and OS were statistically significant (both P<0.001). The 10-year EFS rate of lymph node positive and negative patients was 68.8% and 88.2%, respectively; the 10-year OS rate was 76.7% and 92.5%, respectively, and the differences of lymph node status in EFS and OS were statistically significant (both P<0.001). In lymph node negative subgroup, 3 subtypes showed similar EFS and OS rate (both P>0.05); In lymph node positive subgroup, 3 subtypes showed significantly different EFS and OS (both P<0.05). No modification effect was detected of lymph node status on the correlation of molecular subtypes and EFS, DDFS and OS(all Pinteractive>0.1). Conclusions: Different molecular subtypes of breast cancer have different prognosis. Compared with molecular subtype, lymph node status may be a more important prognostic factor.


Assuntos
Neoplasias da Mama , Axila , Intervalo Livre de Doença , Feminino , Humanos , Linfonodos , Prognóstico , Receptor ErbB-2
18.
Niger J Clin Pract ; 24(8): 1133-1137, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34397020

RESUMO

Aims: To investigate alteration of intestinal microflora in uremia patients with or without blood purification treatments. Methods: The present study included a total of 109 adult patients who were administered in our hospital during 2014 August to 2015 December, 85 cases had already received hemodialysis treatment and 24 cases had not received any renal transplantation treatments. Serum levels of hemoglobin, albumin, creatinine, hypersensitive C reactive protein, and cystatin C, as well as blood urea nitrogen and estimated glomerular filtration rate were determined. 16S rRNA sequencing was conducted to determine the levels of Bifidobacterium, Lactobacillus acidophilus, Escherichia coli, and Enterococcus faecalis. Results: The hemoglobin level in the hemodialysis group was significantly higher than that of the non-hemodialysis patients. The levels of Bifidobacterium and Lactobacillus acidophilus were significantly lower while the levels of Escherichia coli and Enterococcus faecalis were significantly higher in both of the patient groups compared with the healthy control. In all treatment groups, levels of Bifidobacterium and Lactobacillus acidophilus were significantly higher and levels of Escherichia coli and Enterococcus faecalis were significantly lower compared with the non-blood purification treatment group. Conclusions: The intestinal microflora might be influenced by uremia and might also be affected by blood purification treatments.


Assuntos
Microbioma Gastrointestinal , Uremia , Adulto , Bifidobacterium , Humanos , Lactobacillus acidophilus , RNA Ribossômico 16S , Uremia/terapia
19.
Zhonghua Nei Ke Za Zhi ; 60(9): 827-830, 2021 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-34445820

RESUMO

The 17α-hydroxylase/17, 20-lyase deficiency (17-OHD) is a rare disease. The clinical characteristics and gene mutation of 2 late-diagnosed 17-OHD patients with testicular tumor admitted to our hospital from March 2018 to February 2019 were analyzed retrospectively. The two 17-OHD patients were female (46, XY). Laparoscopic abdominal exploration found undeveloped testicles in grey-yellow or grey-red in the groin and iliac fossa. The testicles were removed and showed malignancy in pathology study. Sequencing of the CYP17A1 gene identified c.1247G>A/c.1427T>C and c.985_987delTACinsAA/c.1306G>A complex heterozygous mutations. Taking together, the possibility of 17-OHD should be considered in patients with hypertension, hypokalemia, adrenal adenomatoid hyperplasia together with 46, XY gonadal dysplasia, so as to make early diagnosis and treatment, and avoid dysplastic testicular turning to malignancy.


Assuntos
Hiperplasia Suprarrenal Congênita , Liases , Neoplasias Testiculares , Hiperplasia Suprarrenal Congênita/genética , Feminino , Humanos , Masculino , Oxigenases de Função Mista , Mutação , Estudos Retrospectivos , Esteroide 17-alfa-Hidroxilase/genética , Neoplasias Testiculares/genética
20.
Zhonghua Wai Ke Za Zhi ; 59(9): 785-792, 2021 Sep 01.
Artigo em Chinês | MEDLINE | ID: mdl-34404178

RESUMO

Objective: To evaluate the classification of petroclival meningiomas(PCM), proposed selection of microsurgical approach and therapeutic outcomes. Methods: Retrospectively analyzed clinical data of 179 cases of PCM from Department of Neurosurgery, Xiangya Hospital, Central South University between January 2011 and November 2020. There were 28 males and 151 females with an age of(49.9±10.2) years(range: 22 to 75 years) and the tumor size of(44.8±10.3)mm(range: 15 to 80 mm). The mean duration of symptom(M(QR)) was 18.0(40.6)months(range:1 week to 320 months) and the mean preoperative Karnofsky performance scale(KPS) was 78.6±13.3(range: 40 to 100). The PCM were classified into 5 types according to the difference in the origin of dural attachment, involvement of adjacent structures and growth patterns through preoperative MRI. The surgical approaches were selected based on the proposed classification, and the clinical characteristics, surgical record, and follow-up data of each type were reviewed. Results: The PCM were divided into clivus type(CV, 4 cases), petroclival type(PC, 60 cases), petroclivosphenoidal type(PC-S, 62 cases), sphenopetroclival type with 2 subtypes(S-PC, 50 cases) and central skull base type(CSB, 3 cases). All of 176 cases were obtained microsurgical treatment except CSB type. The gross total resection reached in 124 cases(70.5%) with 112 cases of retrosigmoid approach(RSA), 27 cases of subtemporal transtentorial transpetrosal approach, 13 cases of pretemporal trancavernous anterior transpetrosal approach(PTCA), 12 cases of extended pterional transtentorial approach(EPTA) and presigmoid combined supra-infratentorial approach, respectively. The RSA could be adopted in both of CV type and PC type and most of PC-S type(71.0%). S-PC subtype Ⅰ and subtype Ⅱ were mainly underwent EPTA(40.8%) and PTCA(52.2%), respectively. Seventy-two cases(40.9%) gained new neurological dysfunctions mainly with the cranial nerve paralysis. The postoperative morbidity and complications were recovered or improved with conservative and positive symptomatic and supportive treatment. There was no intraoperative and postoperative death case. One hundred and sixty four cases(93.2%) of operative patients were followed with the duration of 24(48)months(range:3 to 108 months). Tumor recurrence and progress were identified in 14 cases(10.4%) and 14 cases(28.6%), respectively. Compared with postoperative neurological status, 89 patients(54.3%) had improved and 38 patients(23.2%) were still suffering various degrees of neurological dysfunctions during the follow-up. The recent KPS was 84.2±11.4(range: 50 to 100) without statistical difference from preoperative KPS(t=-1.356,P=0.125). As for each type, there were statistically significant differences in brain stem edema(χ2=3.482,P=0.038), gross total resection(χ2=9.127,P=0.001), surgical duration(F=8.954, P=0.013), postoperative length of stay(F=3.652, P=0.025), postoperative complications(χ2=1.550,P=0.024), postoperative KPS(F=2.856, P=0.042) and tumor recurrence/progress(χ2=4.824,P=0.013). Conclusion: The precise and comprehensive classification of PCM and specific individual treatment strategy are benefit to evaluate the diverse clinical prognosis, choose optimal surgical approaches, elevate gross total resection, diminish neurological dysfunctions and restraint tumor recurrence, so as to improve the quality of life for patients.

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