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1.
Eur Rev Med Pharmacol Sci ; 24(9): 4793-4802, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32432742

RESUMO

OBJECTIVE: Increasing evidence has shown that autophagy related proteins and hypoxia-inducible factor-1α (HIF-1α) are both involved in the malignant progress of nasopharyngeal carcinoma (NPC), and HIF-1α plays an emerging role in the chemosensitivity of NPC cells. However, it is still unknown whether autophagy related proteins are associated with HIF-1α in regulating the chemosensitivity of NPC cells. MATERIALS AND METHODS: Quantitative Real-time PCR (qPCR) was applied to determine mRNA levels of HIF-1α and the autophagy related proteins, such as ATG3, ATG4B, ATG5, Beclin1, ATG7, ATG10, ATG12 and ATG16L1. Western blot was applied to determine protein levels of HIF-1α, ATG4B and cleaved Caspase-3. Cell viability and death were investigated by cell counting kit-8 and trypan blue exclusion assay. In addition, Caspase-3 activity was detected to reflect apoptosis. Furthermore, Luciferase reporter assay was applied to explore the mechanism by which HIF-1α transcriptionally upregulated ATG4B expression. RESULTS: Our study reveals that HIF-1α increased ATG4B expression in NPC cells, and in turn upregulated the cisplatin (DDP)-induced protective autophagy, resulting in enhanced killing effect of DDP to NPC cells. In mechanism, reporter assay showed that HIF-1α upregulated ATG4B expression by activating its gene promoter region. The binding site (-225 to -216) was required for HIF-1α-induced increase of ATG4B gene promoter activity. CONCLUSIONS: These results indicate that HIF-1α elevates ATG4B via promoting its transcription, which alleviates the sensitivity of DDP in NPC cells through enhancing protective autophagy, suggesting that ATG4B, upregulated by HIF-1α, may be a novel target for DDP sensitization in the treatment of NPC in clinic.

2.
Artigo em Inglês | MEDLINE | ID: mdl-32449023

RESUMO

PURPOSE: To identify patient factors that influence response to therapy in patients with vestibular migraines. METHODS: A retrospective cohort study was performed at a university-based tertiary medical center. PATIENTS: 47 patients evaluated for treatment of definite vestibular migraine, per the Barany Society criteria, from 2015 to 2019. INTERVENTIONS: A protocol of antidepressants, antiepileptics, beta blockers, and vestibular rehabilitation. Patients failing initial therapy received botulinum toxin per the PREEMPT protocol. Vestibular rehabilitation for motion desensitization in case of known vestibular dysfunction. OUTCOME MEASURES: Quality of life measured per the dizziness handicap inventory (DHI). Pre- and post-treatment DHI scores (total and domain scores) and change in DHI were correlated against patient-specific variables to determine factors associated with change in response to therapy. Patient factors included demographic variables, medical comorbidities, comorbid otologic or pain symptoms, treatment modality, and initial DHI scores. RESULTS: 47 patients underwent therapy for vestibular migraine. This population had a significant DHI reduction of 17.3 ± 25.2 (p < 0.001) with therapy. Univariate analysis showed that female gender, comorbid benign paroxysmal positional vertigo, and high initial DHI were significantly associated with greater reduction in DHI scores (ß = - 7.92, p = 0.033; ß = - 18.65, p = 0.028; ß = - 0.458, p = 0.016, respectively). Conversely, cervicalgia and oscillopsia were significantly associated with a lower reduction in DHI scores (ß = 5.525, p = 0.024 and ß = 21.48, p = 0.027, respectively). CONCLUSIONS: Vestibular migraine is a complex disorder with heterogeneous response to therapy. This study shows that patient-specific factors of gender, cervicalgia, oscillopsia, BPPV, and high DHI scores on presentation may influence response to common vestibular migraine therapy.

4.
Otol Neurotol ; 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32271263

RESUMO

OBJECTIVE: To explore the usefulness of vestibular evoked myogenic potentials (VEMPs) in the diagnosis of Menière's disease (MD) and vestibular migraine (VM). STUDY DESIGN: Retrospective cohort. SETTING: Multidisciplinary neurotology clinic. PATIENTS: Definite MD and definite VM patients between January, 2015 and May, 2017, as well as healthy volunteers. INTERVENTIONS: Cervical and ocular VEMP (cVEMP and oVEMP) testing. MAIN OUTCOME MEASURES: VEMP response, amplitude, and latency. RESULTS: Twenty five definite MD, 34 definite VM, and 13 control subjects were analyzed. MD affected ears had significantly lower cVEMP (p = 0.007) and oVEMP (p < 0.001) amplitudes than control ears. VM ears had significantly lower oVEMP (p = 0.001), but not cVEMP (p = 0.198) amplitudes than control ears. MD affected ears, but not VM ears, had significantly more absent cVEMP (25.9% versus 0%, p = 0.005) and oVEMP responses (40.7% versus 0%, p < 0.001) than control ears. oVEMP latency was significantly shorter for both MD affected (p < 0.001) and VM ears (p < 0.001) than control ears. Sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) were calculated using a neurotology clinic MD prevalence of 7.9% in dizzy patients. A present cVEMP or oVEMP both have more than 93% chance of ruling MD out in the tested ear, while a cVEMP amplitude more than 54.9 µV or oVEMP amplitude more than 5.1 µV both have more than 94% of ruling out MD in the tested ear. CONCLUSIONS: Despite some overlap in VEMP results between MD and VM, when the diagnosis is uncertain between the two disorders due to symptomatic overlap and nonspecific audiometric data, VEMPs can be helpful in guiding treatment toward one disease entity or the other until more evidence points to a definitive diagnosis.

5.
Otol Neurotol ; 41(4): 511-521, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32176140

RESUMO

OBJECTIVE: To conduct a systematic review of posterior semicircular canal dehiscence (PSCD) and to present a series of patients with PSCD with and without classic third-window symptoms. DATA SOURCES: PubMed, Scopus, and the Cochrane Library from inception until April 2019. Case series of five patients seen in a multidisciplinary, vestibular-focused, neurotology clinic. STUDY SELECTION: Inclusion criteria: PSCD studies of symptomatology, diagnostic testing, radiology, and histopathology. EXCLUSION CRITERIA: non-English articles, reviews, letters, animal studies. DATA EXTRACTION: Quality evaluated according to Oxford Center for Evidence-Based Medicine criteria and funnel plot via the Stern and Egger method. DATA SYNTHESIS: Two hundred five studies were found, and 58 studies were included. In 47 total patients, sound-induced vertigo, mixed hearing loss, and tinnitus were the most common presenting symptom. A meta-analysis of proportions using eight radiological and histopathological studies revealed an incidence of 0.38% adult ears [95% CI 0.08, 0.89] and 2.16% of adult patients [0.64, 4.54]. The incidence in pediatric patients ranged from 1.3 to 43%. Jugular bulb abnormalities were common. In our case series, four of five patients presented without third-window symptoms, while one had sound- and pressure-induced vertigo. Hearing loss in these patients was not salvageable. CONCLUSIONS: PSCD is a rare phenomenon most commonly presenting with third-window type symptoms. However, PSCD might also present with dizziness and hearing loss inconsistent with third-window symptomatology. One should be conscious of potentially poorer prognosis for hearing recovery in these patients.

6.
Zhonghua Wai Ke Za Zhi ; 58(3): 213-219, 2020 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-32187925

RESUMO

Objective: To explore the operative effect and treatment strategies for the low distal humerus fracture. Methods: A retrospective analysis was conducted on the clinical data of 16 patients with the low distal humerus fracture between January 2016 and January 2018 at Department of Orthopaedics, Shanghai Tongji Hospital Affiliated to Tongji University.All fractures were coronal fractures of humeral head, partly combined fractures of humeral trochlea or posterior part. Fractures were classified according to Dubberley classification as 9 cases in type Ⅰ, 3 cases in typeⅡ and 4 cases in type Ⅲ.Selection of the kind of operative approach and internal fixation was made according to the fracture type and shape. For simple coronal fractures of humeral head or combining humeral trochlea fractures, which were relatively stable, single or multiple countersunk screws fixation by the lateral approach were chosen.For humeral head coronal fractures, which combining obviously displaced comminuted humeral trochlea factures, posterolateral locking plates and countersunk screws internal fixation by the olecranon osteotomy approach were chosen. The incision and elbow soft tissues were observed within 2 weeks after operation.The radiographic evaluation of fracture reduction, bone healing, internal fixation, arthritis and elbow range of motion were made at 3, 6, 12 months after operation. The Mayo elbow functional scores were documented for analysis of elbow joint function, and compared between different surgery groups by Kruskal-Wallis H test. Results: The follow-up time was (22.1±9.2)months(range: 15 to 39 months). The incisions healed well in 2 weeks after operation without soft tissue infection, necrosis or vascular complications. There was no fracture reduction loss or internal fixation loosening according to radiographic evaluation 3 months after operation. One case of ectopic ossification was observed 6 months after operation and inhibited by the treatment of non steroidal anti-inflammatory drugs.One case of ulnar neuritis occurred after operation and released after removing the long screw and loosing the ulnar.Osteoarthritis images were observed at the end of follow-up.Arc of motion was (120.4±11.2) ° in flexion and (5.5±1.9) ° in extension. The Mayo score was 88.7±9.1, including 11 excellent, 4 good, and 1 fair.The Mayo score was 90.1±3.7 in Dubberley classification type Ⅰcases, 89.7±4.6 in type Ⅱ cases and 84.5±5.8 in type Ⅲ cases. There were no significant differences in Mayo scores between 3 types cases according to Kruskal-Wallis H test. Conclusion: Choosing the appropriate surgical approach and composite internal fixation according to the fracture types and shapes of low distal humerus fracture, anatomic reduction of the articular surface and early functional exercise are the keys to obtain ideal curative effect.


Assuntos
Fixação Interna de Fraturas , Fraturas do Úmero/cirurgia , Placas Ósseas , China , Articulação do Cotovelo/cirurgia , Humanos , Úmero/cirurgia , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento
7.
Br J Surg ; 107(7): 906-916, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32057096

RESUMO

BACKGROUND: Precise classification of the hepatic artery is helpful for preoperative surgical planning in hepatobiliary-pancreatic surgery. However, the anatomy of hepatic arteries is variable. This study investigated anatomical variation using three-dimensional visualization and evaluation (3DVE) to develop a nomenclature system. METHODS: The origin and course of the hepatic artery were tracked and analysed by using three-dimensional visualization of CT images acquired between 2013 and 2017. The new classification and nomenclature system, named CRL, was developed based on the origins of the common, right and left hepatic arteries. RESULTS: Scans from 770 adults were evaluated. Preoperative 3DVE correlated better with surgical findings than the original CT images alone. Using the CRL classification system, hepatic arteries were divided into nine subtypes. Only 87·4-89·2 per cent of the hepatic arteries of 610 living-donor liver transplant donors were depicted in Michels', Hiatt's or Varotti's classification, compared with 100 per cent identified by the CRL classification. The CRL classification was validated against external data sets from previous studies, with 99·6-100·0 per cent of patients classified by the CRL system. CONCLUSION: The CRL classification covers hepatic artery variants and may be used for planning liver surgery.

8.
J Therm Biol ; 87: 102468, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32001017

RESUMO

Preferred temperature (Tpref) has been measured in over 100 species of aquatic and 300 species of terrestrial ectotherms as a metric for assessing behavioural thermoregulation in variable environments and, as such, has been linked to ecological processes ranging from individual behaviour to population and community dynamics. Due to the asymmetric shape of performance curves, Tpref is typically lower than the optimal temperature (Topt, where physiological performance is at its peak), and the degree of this mismatch increases with variability in Tb. Intertidal ectotherms experience huge variability in Tb on a daily basis and therefore provide a good system to test whether the relationship between Tpref and variation in Tb holds in more extreme environments. A review of the literature, however, only revealed comparisons between Tpref and Topt for five intertidal species and measurements of Tpref for 23 species. An analysis of this limited literature for intertidal ectotherms showed a positive relationship between acclimation temperature and Tpref. There was, however, great variation in the methodologies employed to make these assessments. Factors contributing to behavioural thermoregulation in intertidal ectotherms including small body size; low mobility; interactions among individuals; endogenous clocks; metabolic effects; thermal sensitivity; sampling of the thermal environment and recent acclimation history were considered to varying degrees when measuring Tpref, confounding comparisons between species. The methodologies used to measure Tpref in intertidal ectotherms were reviewed in light of each of these factors, and methodologies proposed to standardize approaches. Given the theoretical predictions about the relationships between Tpref and variability in Tb, the spatial and temporal thermal variability experienced by intertidal ectotherms provides numerous opportunities to test these expectations if assessed in a standardized manner, and can potentially provide insights into the value of behavioural thermoregulation in the more thermally variable environments predicted to occur in the near future.

9.
Otol Neurotol ; 2020 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-31977761

RESUMO

OBJECTIVE: To conduct a systematic review of posterior semicircular canal dehiscence (PSCD) and to present a series of patients with PSCD with and without classic third-window symptoms. DATA SOURCES: PubMed, Scopus, and the Cochrane Library from inception until April 2019. Case series of five patients seen in a multidisciplinary, vestibular-focused, neurotology clinic. STUDY SELECTION: Inclusion criteria: PSCD studies of symptomatology, diagnostic testing, radiology, and histopathology. EXCLUSION CRITERIA: non-English articles, reviews, letters, animal studies. DATA EXTRACTION: Quality evaluated according to Oxford Center for Evidence-Based Medicine criteria and funnel plot via the Stern and Egger method. DATA SYNTHESIS: Two hundred five studies were found, and 58 studies were included. In 47 total patients, sound-induced vertigo, mixed hearing loss, and tinnitus were the most common presenting symptom. A meta-analysis of proportions using eight radiological and histopathological studies revealed an incidence of 0.38% adult ears [95% CI 0.08, 0.89] and 2.16% of adult patients [0.64, 4.54]. The incidence in pediatric patients ranged from 1.3 to 43%. Jugular bulb abnormalities were common. In our case series, four of five patients presented without third-window symptoms, while one had sound- and pressure-induced vertigo. Hearing loss in these patients was not salvageable. CONCLUSIONS: PSCD is a rare phenomenon most commonly presenting with third-window type symptoms. However, PSCD might also present with dizziness and hearing loss inconsistent with third-window symptomatology. One should be conscious of potentially poorer prognosis for hearing recovery in these patients.

10.
Zhonghua Yi Xue Za Zhi ; 100(1): 37-41, 2020 Jan 07.
Artigo em Chinês | MEDLINE | ID: mdl-31914556

RESUMO

Objective: To evaluate the effect of dexmedetomidine on lung injury and CCAAT/enhancer-binding protein homologous protein (CHOP) expression in elderly patients with lung cancer undergoing thoracoscopic lobectomy. Methods: A total of 120 elderly patients with lung cancer who underwent elective thoracoscopic lobectomy were selected from the Second Affiliated Hospital of Zhengzhou University from October 2018 to March 2019. The random phenotype was divided into dexmedetomidine group (group D, n=60) and control group (group C, n=60). The elapsed time before postoperative awake and spontaneous breathing recovery and agitation occurrence were recorded. The mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SPO(2)), oxygen partial pressure (PaO(2)), alveolar-arterial oxygen partial pressure difference[P(A-a)O(2)], end-tidal carbon dioxide partial pressure (P(ET)CO(2)), and airway pressure peak (P(peak)) were recorded before the anesthetic induction (T(0)), immediately after tracheal intubation (T(1)), immediately after unilateral pulmonary ventilation(T(2)), 1 hour after unilateral pulmonary ventilation (T(3)), immediately after bilateral pulmonary ventilation (T(4)), and at the end of surgery(T(5)). The levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-8, IL-10, super oxide dismutase (SOD) and malondialdehyde (MDA)were compared at the time of T(0), T(1), T(2), T(3), T(4) and T(5) in two groups. The ratios of alveolar damage (IQA), apoptotic index (AI), and the expression of CHOP mRNA and their protein in lung tissue were detected. Results: The recovery time of conscious and spontaneous breathing in group D were significantly shorter than that in group C (P<0.05). The MAP and HR of the two groups at T(1)-T(5) were significantly lower than those at T(0)(P<0.05).The levels of P(peak) in group C at T(3)-T(5) was significantly higher than those in group D (P<0.05). The SpO(2) values in the group D at T(1)-T(5) were significantly higher than those in group C (P<0.05). The P(A-a)O(2) values in the group D at T(1)-T(5) was significantly lower than those in group C (P<0.05).The levels of IL-6, IL-8 and MDA in group D at T(1)-T(5) were significantly lower than those in group C(P<0.05). The levels of IL-10 and SOD in group D at T(1)-T(5) were significantly higher than those in group C (P<0.05). The values of IQA, AI, and the expression of CHOP mRNA and their protein in the two groups at T(4) were significantly higher than those at T(2) (P<0.05). The values of IQA, AI, and the expression of CHOP mRNA and their protein in group D at T(4) were significantly lower than those in group C (P<0.05). Conclusions: Dexmedetomidine could attenuate the extent of lung injury in elderly patients with lung cancer undergoing thoracoscopic lobectomy. The pulmonary protective mechanism could be related to the inhibition of inflammatory factors in dexmedetomidine, improving oxidative stress and reducing Chop-mediated apoptosis of lung tissue by the protein.


Assuntos
Carcinoma Broncogênico , Neoplasias Pulmonares , Ventilação Monopulmonar , Idoso , Dexmedetomidina , Humanos , Pulmão
11.
Otol Neurotol ; 41(1): 52-59, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31821252

RESUMO

OBJECTIVE: To characterize the relation between protein-calorie malnutrition (PCM) and hearing loss (HL) in children. STUDY DESIGN: Retrospective review. SETTING: Tertiary referral hospital. PATIENTS: Children in the Audiological and Genetic Database with a diagnosis of protein-calorie malnutrition, marasmus, and/or kwashiorkor. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Prevalence, type, severity (4-tone pure-tone average, PTA), and progression of HL. RESULTS: Of 770 children with PCM, 57.8% had HL, compared to 45.5% of children without PCM (p < 0.001). Severely malnourished children had significantly higher odds of moderate-profound HL (aOR 2.27, 95% CI 1.47-3.43), high-frequency HL (aOR 1.82, 95% CI 1.21-2.75), and sensorineural or mixed HL (aOR 1.60, 95% CI 1.05-2.41) compared to children without PCM. Severely malnourished children had significantly worse initial (35.0 dB vs 25.0 dB, p < 0.001), and final median PTA (31.3 dB vs 20.0 dB, p < 0.001) compared to children without PCM. Additionally, HL in children who were moderately and severely malnourished was significantly less likely to improve (aOR 0.47, 95% CI 0.25-0.82 and aOR 0.4, 95% CI 0.2-0.9) when compared to those without PCM. CONCLUSIONS: Given the greater prevalence and severity of hearing loss, children with PCM should be considered an at-risk group for poor audiological outcomes, and clinical practice should focus on early treatment and intervention for malnourished children. Routine audiological evaluation should be considered in this population.

12.
Zhonghua Yi Xue Za Zhi ; 99(40): 3139-3144, 2019 Oct 29.
Artigo em Chinês | MEDLINE | ID: mdl-31694104

RESUMO

Objective: To investigate the efficacy and prognosis of the dynamic monitoring lymphocyte to monocyte ratio (LMR) in patients with diffuse large B-cell lymphoma (DLBCL). Methods: The clinical data of 261 patients with DLBCL in the Affiliated Cancer Hospital of Zhengzhou University between March 2012 to March 2018, were analyzed retrospectively. The optimal cut-off values of LMR was determined using the receiver operating characteristic curve (ROC) method. Patients were divided into low LMR group and high LMR group according to the optimal cut-off value. The changes of LMR before and after treatment in two groups were dynamically monitored, and the relationship between LMR and efficacy and survival were analyzed. Results: Complete remission (CR) rate in patients with high LMR (64.7%) before treatment was significantly higher than that in patients with low LMR (33.3%) (P<0.05). Compared with the 5-year overall survival(OS) and progress free survival(PFS) (56.96% and 43.55%, respectively) in the low LMR group, the 5-year OS and PFS (82.92% and 66.25%, respectively) in the high LMR group were higher, and the difference was statistically significant (all P<0.05). Patients with elevated LMR after treatment in the high or low LMR group had a significant higher 5-year OS and PFS compared with patients with LMR reduction(P<0.05). LMR in both high and low LMR group were significantly lower at the last follow-up than those at the disease recurrence (all P<0.05). Both single and multivariate analyses showed that low LMR was an independent prognostic factor in patients with DLBCL (all P<0.05). Conclusions: LMR can be used as an indicator of risk stratification, efficacy, disease replase and prognosis in patients with DLBCL. Low LMR before and after treatment were poor prognostic factors in patients with DLBCL.


Assuntos
Linfoma Difuso de Grandes Células B , Monócitos , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Linfócitos , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
13.
Zhonghua Xue Ye Xue Za Zhi ; 40(10): 853-855, 2019 Oct 14.
Artigo em Chinês | MEDLINE | ID: mdl-31775486

RESUMO

Objective: To explore the availability and safety of fecal microbiota transplantation for patients with refractory diarrhea after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: Four acute leukemia patients suffered from refractory diarrhea after allo-HSCT. One of them was refractory intestinal infection, the others were intestinal graft versus host disease. One or two doses of fecal microbiota, 3.4-6.0 U for one dose, were infused via nasal-jejunal tube. The curative effect and side effects were reviewed. Results: Three cases achieved complete remission while 1 was stable disease. The side effects included fever, abdominal pain and diarrhea, which all were Ⅰ grade. Conclusion: Fecal microbiota transplantation was effective and safe for refractory diarrhea after allo-HSCT.


Assuntos
Diarreia/terapia , Transplante de Microbiota Fecal , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Leucemia Mieloide Aguda , Diarreia/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos
14.
Artigo em Chinês | MEDLINE | ID: mdl-31594122

RESUMO

Objective: To analyze the prevalence of pneumoconiosis and assistance guarantee of the migrant workers of the district in Chongqing from 2006 to 2017, so as to provide scientific basis for prevention and control of pneumoconiosis of the migrant workers. Methods: The database of new pneumoconiosis cases of the migrant workers and assistance guarantee of the district in Chongqing from 2006 to 2017 were subjected to systematic arrangement. SPSS 18.0 was adopted for statistical description and analysis. Results: From 2006 to 2017 a total of 2188 new cases of pneumoconiosis were diagnosed, including I (917, 41.91%) , II (1003, 45.84%) , III (268, 12.25%) . Most of new cases of pneumoconiosis were silicosis. The median length of seniority was 6 years. The mean diagnostic age was 44.25. Significant difference was found in diagnosis age between different stages (F=3.161, P=0.043) . 98.77% of migrant workers had no units. There were 5.07% of migrant workers who took out industrial injury insurance, 14.58% receiving civil aid, 31.12% receiving aid from poverty alleviation, and 93.46% participating medical insurance. Conclusion: The prevalence of pneumoconiosis of the migrant workers of the district in Chongqing was serious. The prevention and control of pneumoconiosis should be enhanced to reduce the harm of pneumoconiosis of the migrant workers in Chongqing.


Assuntos
Pneumoconiose , Silicose , Migrantes , China , Bases de Dados Factuais , Humanos , Seguro Saúde/estatística & dados numéricos , Prevalência , Assistência Pública/estatística & dados numéricos
15.
Artigo em Chinês | MEDLINE | ID: mdl-31594125

RESUMO

Objective: To analyze the prevalence of pneumoconiosis and civil aid and medical care among Xiangyang-Chongqing railway construction workers in Chongqing from 2011 to 2018, so as to provide scientific basis for prevention and control of pneumoconiosis. Methods: The Chongqing database of Xiangyang-Chongqing railway construction workers cases from 2011 to 2018 were subjected to systematic collected. SPSS 18.0 was adopted for statistical description and analysis. Results: From 2011 to 2018, a total of 7031 silicosis cases were diagnosed, and 5827 cases were existed, including 4056 cases of stage I, 1491 cases of stage II, and 280 cases of stage III. The cases were concentrated in the area along the southwest to northeast of Chongqing. The diagnosis age of silicosis patients was mainly 60~64 years old (69.73%) . Most silicosis cases were the drill workers and the stone workers. The exposure time of silicosis patients was short and concentrated in 3 years. The 5827 cases of pneumoconiosis in the Xiangyang-Chongqing railway were all treated with special civil aid and medical care for pneumoconiosis in the Xiangyang-Chongqing railway. Conclusion: The prevalence of silicosis among workers who participated in Xiangyang-Chongqing railway construction remained serious. Civil aid and medical care covers all silicosis patients. Occupational health surveillance for silicosis and assistance should be carried out in these workers.


Assuntos
Saúde do Trabalhador , Pneumoconiose/epidemiologia , Silicose/epidemiologia , China/epidemiologia , Indústria da Construção , Humanos , Pessoa de Meia-Idade , Prevalência , Ferrovias
16.
Zhonghua Xue Ye Xue Za Zhi ; 40(9): 738-743, 2019 Sep 14.
Artigo em Chinês | MEDLINE | ID: mdl-31648474

RESUMO

Objective: To explore the clinical efficacy and prognostic factors of first-generation and second-generation tyrosine kinase inhibitors (TKI) based regimen in the treatment of patients with BCR-ABL positive acute lymphoblastic leukemia (ALL) . Methods: Retrospectively analyze the clinical characteristics and prognostic factors of 89 patients with BCR-ABL positive ALL from April 2012 to June 2018 in our hospital, the clinical efficacy of first-generation and second-generation TKI was compared. Results: 60 patients were classified into the first-generation TKI (imatinib) group, and 29 patients were in the second-generation TKI (dasatinib) group. There were no significant differences in gender, age, WBC, hemoglobin concentration, PLT, chromosomal karyotype, the types of fusion genes, allogeneic hematopoietic stem cell transplantation (allo-HSCT) and TKI initiation time between the two groups. The first-generation and second-generation TKI groups, for which the complete remission (CR) rate at the fourth week of induction therapy was 83.3% and 89.7% (P=0.637) , respectively, and the complete molecular remission (CMR) was 48.3%and 58.6% (P=0.363) , respectively, the difference was not statistically significant. The 2-year overall survival (OS) rate of first-generation and second-generation TKI group was 34.9% and 64.0% (χ(2)=4.743, P=0.029) , the 2-year relapse free survival (RFS) rate was 17.2% and 55.0% (χ(2)=8.801, P=0.003) , respectively. Multivariate analysis showed that complete molecular remission (HR=0.281, 95%CI 0.151-0.523, P<0.001) was independent favorable prognostic factor for overall survival (OS) , complete molecular remission (HR=0.209, 95%CI 0.112-0.390, P<0.001) and second-generation TKI (HR=0.318, 95%CI 0.158-0.641, P=0.001) were independent favorable prognostic factors for RFS. Conclusion: For TKI-based regimen of BCR-ABL positive ALL, second-generation TKI is superior to first-generation TKI in OS and RFS time.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras , Inibidores de Proteínas Quinases/uso terapêutico , Proteínas de Fusão bcr-abl , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Estudos Retrospectivos , Resultado do Tratamento
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 53(8): 811-816, 2019 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-31378041

RESUMO

Objective: To analyze the infection status and recombination of Norovirus in patients with acute gastroenteritis in Ningxia. Methods: The specimens of 10 sentinel hospitals in Ningxia were collected from 2016 to 2017. Real-time quantitative PCR was used for nucleic acid detection. GⅡ-positive samples were amplified by RT-PCR for the RdRp and Capsid regions, then sequenced and genotyped. Evolution analysis was performed using software such as MEGA-X, and recombination analysis was performed using Simplot 3.5.1 and RDP4. Results: The age of the 2 334 cases was 1.42 (0.68, 7.69) years old, 1 133 cases in 2016 and 1 201 cases in 2017, 1 343 and 991 cases for males and females respectively. The positive rate of Norovirus GⅠ genogroup was 0.86% (20/2 334), and GⅡ genogroup was 14.82% (346/2 334). A total of 78 recombinant strains were sequenced and 12 recombinant types were found. GⅡ.Pe/GⅡ.4Sydney_2012 and GⅡ.P12/GⅡ.3 were the main epidemic strains, accounting for 35.90% (28 strains) and 32.05% (25 strain) respectively, followed by GⅡ.P16/GⅡ.2 accounting for 12.82% (10 strains). Among them,GⅡ.P7/GⅡ.6 (2 strains), GⅡ.P12/GⅡ.3 (6 strains), GⅡ.P16/GⅡ.1 (2 strains), GⅡ.P16/GⅡ.2 (5 strains), GⅡ.Pe/GⅡ.4 (7 strains) were detected for the first time in Ningxia. Recombinant strains were all intergenotype recombination, and the recombination breakpionts were all located within ORF1. Conclusion: Norovirus infection in Ningxia area was mainly in GⅡ genogroup from 2016 to 2017, and most of them were recombinant strains. GⅡ.Pe/GⅡ.4Sydney_2012 and GⅡ.P12/GⅡ.3 were the main epidemic strains, followed by GⅡ.P16/GⅡ. 2.


Assuntos
Infecções por Caliciviridae/epidemiologia , Gastroenterite/virologia , Norovirus/genética , Recombinação Genética , Criança , China , Feminino , Gastroenterite/epidemiologia , Genótipo , Humanos , Masculino , Filogenia
18.
Otol Neurotol ; 40(7): e723-e731, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31295206

RESUMO

OBJECTIVE: Currently available patient reported outcomes questionnaires for dizzy patients give limited insight into the cognitive dysfunction patients often report. Using the newly developed English version of the neuropsychological vertigo inventory (NVI), we aimed to quantify the cognitive impairment of dizzy patients. STUDY DESIGN: Prospective cohort study. SETTING: Tertiary neurotology clinic. PATIENTS: Adults with vestibular diagnoses seen between June 2018 and October 2018. Patients with neurologic disorders affecting cognition were excluded. INTERVENTIONS: None. MAIN OUTCOME MEASURE: NVI score. Secondary measures: dizziness handicap inventory (DHI) score, cognitive failure questionnaire (CFQ) score, 20-item short form health survey scores (SF20). RESULTS: Of 67 subjects, 13 had BPPV, 11 had Menière's disease (MD), and 20 had vestibular migraine (VM). VM patients were significantly younger (43.5 versus 61.1 yrs, p = 0.016), and had significantly higher NVI (67.5 versus 51.0, p = 0.040) scores than BPPV patients. MD patients had significantly higher CFQ scores (44.8 versus 23.4, p = 0.015) than BPPV patients. NVI scores were similar between MD (67.3) and VM (67.5) patients (p = 1.000). DHI scores were similar for all patients (p = 0.102). NVI scores were highly correlated to CFQ scores (r = 0.864, p < 0.001). CONCLUSIONS: VM patients have levels of cognitive dysfunction similar to MD patients, but greater than BPPV patients. A lack of difference in DHI scores among these patients reflects its limitation in assessing the cognitive domain.

20.
Ultrasound Obstet Gynecol ; 54(6): 815-822, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31152572

RESUMO

OBJECTIVE: To evaluate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) Assessment of Different NEoplasias in the adneXa (ADNEX) model in the preoperative diagnosis of adnexal masses using data from a gynecological oncology center in China. METHODS: This was a single-center, retrospective diagnostic accuracy study based on ultrasound data collected prospectively, between May and December 2017, from 278 patients with at least one adnexal (ovarian, paraovarian or tubal) mass. Clinical and pathologic information, serum CA 125 level and ultrasonographic findings were collected. All patients underwent surgery and the histopathological diagnosis was used as reference standard. The final diagnosis was classified into five tumor types according to the ADNEX model: benign ovarian tumor, borderline ovarian tumor (BOT), Stage-I ovarian cancer (OC), Stages-II-IV OC and ovarian metastasis. Receiver-operating characteristics (ROC) curve analysis was used to evaluate the diagnostic accuracy of the ADNEX model, with and without inclusion of CA 125 level in the model. RESULTS: Of the 278 women included, 203 (73.0%) had a benign ovarian tumor and 75 (27.0%) had a malignant ovarian tumor, including 18 (6.5%) with BOT, 17 (6.1%) with Stage-I OC, 32 (11.5%) with Stages-II-IV OC and eight (2.9%) with ovarian metastasis. The performance of the IOTA ADNEX model was good for discriminating between benign and malignant tumors, with an area under the ROC curve (AUC) of 0.94 (95% CI, 0.91-0.97) when CA 125 was included in the model and AUC of 0.93 (95% CI, 0.90-0.96) without CA 125. The AUC values of the model including CA 125 ranged between 0.61 and 0.99 for distinguishing between the different types of tumor, and it showed excellent performance in discriminating between a benign ovarian tumor and Stages-II-IV OC, with an AUC of 0.99 (95% CI, 0.97-1.00). The performance of the model was less effective at distinguishing between BOT and Stage-I OC and between Stages-II-IV OC and ovarian metastasis, with AUC values of 0.61 (95% CI, 0.43-0.77) and 0.78 (95% CI, 0.62-0.90), respectively. Although inclusion of CA 125 did not alter the performance of the ADNEX model in discriminating between benign and malignant lesions (AUC of 0.94 and 0.93 with and without CA 125 level, respectively; P = 0.54), the inclusion of CA 125 in the model improved its performance in discriminating between Stage-I OC and Stages-II-IV OC (AUC increased from 0.81 to 0.92; P = 0.04) and between Stages-II-IV OC and metastatic cancer (AUC increased from 0.58 to 0.78; P = 0.01). CONCLUSIONS: The IOTA ADNEX model showed good to excellent performance in distinguishing between benign and malignant adnexal masses and between the different types of ovarian tumor in a Chinese setting. Based on our findings, the ADNEX model has high value in clinical practice and can aid in the preoperative diagnosis of patients with an adnexal mass. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.

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