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1.
Medicine (Baltimore) ; 100(20): e25420, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011021

RESUMO

ABSTRACT: This retrospective study investigated the preventive effect of intravenous esomeprazole (IVEO) in the prevention of nonvarices upper gastrointestinal bleeding (NUGIB).This study enrolled 130 patients with NUGIB and all of them underwent successful endoscopic hemostasis, of which 65 cases received routine management and IVEO (Group A) and the other 65 cases received routine management alone (Group B). The primary outcome (recurrent bleeding rate within 72-hour, 7-day, and 30-day), and secondary outcomes ((all-cause mortality, bleeding-related mortality, blood transfused, hospital stay (day), and incidence of adverse events)) were compared between 2 groups.Patients in the group A showed lower recurrent bleeding rate within 72-hour(P < .05), 7-day (P < .05), and 30-day (P < .05), than that of patients in the group B. However, no significant differences were identified in all-cause mortality(P = .26), bleeding-related mortality (P = .57), blood transfused (P = .33), and hospital stay (P = .74) between 2 groups. In addition, both groups had similar safety profile.This study found that routine management and IVEO was superior to the routine management alone for preventing the recurrent bleeding rate after successful endoscopic hemostasis in patients with NUGIB.


Assuntos
Esomeprazol/administração & dosagem , Hemostase Endoscópica/estatística & dados numéricos , Úlcera Péptica Hemorrágica/terapia , Inibidores da Bomba de Prótons/administração & dosagem , Prevenção Secundária/métodos , Adolescente , Adulto , Idoso , Transfusão de Sangue/estatística & dados numéricos , Terapia Combinada/métodos , Terapia Combinada/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Infusões Intravenosas/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Úlcera Péptica Hemorrágica/mortalidade , Recidiva , Estudos Retrospectivos , Prevenção Secundária/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
2.
Quant Imaging Med Surg ; 10(11): 2133-2143, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33139993

RESUMO

Background: Myocarditis does not have typical clinical manifestations and thus is difficult to accurately diagnose by virtue of infection history, and electrocardiogram (EKG) and peripheral blood abnormalities. Endomyocardial biopsy is the gold standard for diagnosis of myocarditis, but is invasive, high risk, and has an observational blind area. Cardiac magnetic resonance imaging (CMRI) is multiparameter and multidirectional with high spatial resolution and high contrast of soft tissue. However, the optimal method of calculating left ventricular (LV) function in patients with apical-segment-injured myocarditis is unresolved. We compared and analyzed the differences between two different methods (Simpson and 4D B-spline surface model (known as the 4D method)) of measuring LV function by CMRI in patients with myocarditis in the 17th segment of the left ventricle. Methods: The basic clinical data of two groups (myocarditis and non-myocarditis) were statistically analyzed, and differences in the LV function parameters by the two imaging methods were compared in the myocarditis group. Receiver-operating characteristic curves of single parameters and combined parameters based on the Simpson and 4D methods were drawn and the area under the curve, diagnostic threshold, maximum sensitivity interval, and maximum specificity interval were calculated. Results: In the myocarditis and non-myocarditis groups the respective number of patients was 22 and 17, the percentage of males was 54.55% and 47.06%, and the average age was 32.20±11.59 and 43.06±11.62 years. The difference in LV ejection fraction (LVEF) (P=0.033) and LV end systolic volume (LVESV) (P=0.030) in the myocarditis group was statistically significant. The respective AUCs based on the Simpson and 4D methods were LVEF 0.602 vs. 0.778, LVESV 0.556 vs. 0.751, LVEF-and-LVESV 0.634 vs. 0.775. Based on the 4D method, the diagnostic thresholds of LVEF and LVESV were 34.965 (sensitivity 0.882, specificity 0.591) and 69.090 (sensitivity 0.727, specificity 0.706), the maximum sensitivity intervals of LVEF and LVESV were (24.610, 27.450) and (35.355, 37.200), and the maximum specificity intervals of LVEF and LVESV were (60.530, 65.625) and (91.625, 95.835), respectively. Conclusions: Compared with the Simpson method, the 4D method might be more effective for CMRI diagnosis of apical-segment-injured myocarditis. When the Simpson method is used, LVEF combined with LVESV is recommended for comprehensive evaluation to improve diagnostic efficiency. When the 4D method is used, LVEF might be the preferred parameter for evaluation of LV function.

3.
Curr Cardiol Rep ; 22(8): 77, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32632670

RESUMO

PURPOSE OF REVIEW: Machine learning (ML) and deep learning (DL) are two important categories of AI algorithms. Nowadays, AI technology has been gradually applied to cardiac magnetic resonance imaging (CMRI), covering the fields of myocardial contrast enhancement (MCE) pattern and automatic ventricular segmentation. This paper mainly discusses the relationship between machine learning and deep learning based on AI and pattern of MCE in CMRI. RECENT FINDINGS: It found that some histogram and GLCM parameters in ML algorithm had significant statistical differences in diagnosis of cardiomyopathy and differentiation of fibrosis and normal myocardial tissue. In the DL algorithm, there was no significant difference between CNN and observers in measuring myocardial fibrosis. The rapid development of texture parameter analysis methods would promote the medical imaging based on AI into a new era. Histogram and GLCM parameters are the research hotspot of unsupervised learning of MCE images. CNN has a great advantage in automatically identifying and quantifying myocardial fibrosis reflected by LGE images.


Assuntos
Inteligência Artificial , Meios de Contraste , Coração , Humanos , Imageamento por Ressonância Magnética , Miocárdio
4.
J Int Med Res ; 48(7): 300060520940158, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32686532

RESUMO

After primary dissemination of Mycobacterium tuberculosis bacillus infection that is localized in liver, disease progression and changes to immune function in the body occur. Various forms of tuberculosis, including granuloma, caseous necrosis, liquefactive necrosis, fibrosis, and calcification, occur that could be presented at different stages, and imaging examination shows findings that are consistent with these stages. Not all liver tuberculosis patients are suitable for liver resection, and preoperative imaging examination and pathological immunohistochemical results could be used to determine whether tuberculosis was active, avoid unnecessary liver resection, and prevent the postoperative spread of tuberculosis. Here, we reported a case of miliary tuberculosis, pelvic tuberculosis, and tuberculous abscess of the thigh muscle in a 51-year-old man after liver lesion resection. The liver lesion was confirmed to be tuberculosis by surgical pathology, which is rare and has not been previously reported. The purpose of this case report is to remind radiologists of the importance of the floral-like enhancement and to estimate whether liver tuberculosis is active. This will help to guide clinicians to determine the timing of surgery, avoid unnecessary liver resection, and avoid hematogenous transmission.


Assuntos
Abscesso Hepático , Tuberculose Miliar , Humanos , Masculino , Pessoa de Meia-Idade , Coxa da Perna
6.
Med Sci Monit ; 26: e923836, 2020 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-32297597

RESUMO

BACKGROUND This study aimed to compare multiple quantitative evaluation indices of levels of theoretical knowledge and clinical practice skills in training medical interns in cardiovascular imaging based on the use of the blended teaching (BT) online artificial intelligence (AI) case resource network platform (CRNP), including time and frequency indices and effectiveness of the CRNP. MATERIAL AND METHODS The study included 110 medical interns who were divided into the routine teaching (RT) group (n=55) and the blended teaching (BT) group (n=55). The two were assessed using the mini-clinical evaluation exercise (mini-CEX) that assessed clinical skills, attitudes, and behaviors and using an objective written questionnaire. The following four indices were compared between the RT and BT groups: the X-ray score (XS), the computed tomography angiography (CTA) score (CS), the cardiac magnetic resonance imaging (CMRI) score (MS), and the average score (AS). Seven assessment indicators included: the imaging description (ID), the qualitative diagnosis (QD), the differential diagnosis (DD), examination preparation (EP), interview skill (IS), position display (PD), and human care (HC). Indicators of CRNP use included: number of times (TN), average duration (AD), single maximum duration (SMD), and total duration (TD). RESULTS AS significantly correlated with AD (rAD=0.761) and TD (rTD=0.754), and showed moderate correlation with TN (rTN=0.595), but weak correlation with SMD (rSMD=0.404). CONCLUSIONS Levels of theoretical knowledge and clinical practice skills during medical intern training in cardiovascular imaging based on BT using the CRNP teaching technology improved theoretical knowledge and practical skills.


Assuntos
Cardiologia/educação , Doenças Cardiovasculares/diagnóstico por imagem , Competência Clínica , Diagnóstico por Imagem/métodos , Educação de Pós-Graduação em Medicina/métodos , Inteligência Artificial , Sistemas Computacionais , Técnicas de Diagnóstico Cardiovascular , Feminino , Humanos , Internato e Residência , Masculino
7.
Med Sci Monit ; 25: 5493-5500, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31378779

RESUMO

BACKGROUND The diagnosis of myocarditis is challenging, and the treatment is generally delayed due to misdiagnosis or missed diagnosis. Endomyocardial biopsy (EMB) is not a specific or sensitive method. A case-controlled observational study was conducted to evaluate early gadolinium enhancement (EGE) and left ventricular functional parameters on Artificial Intelligence in cine-MRI in patients with acute myocarditis. MATERIAL AND METHODS We selected 21 patients with pathologically proven acute myocarditis. We analyzed the EGE findings (total/serial number and location of positive-segments using the 17-segment model according to the American Heart Association) and clinical characteristics (symptoms, arrhythmias in ECG, coronary angiography, and EMB). All patients were divided into positive EGE and negative EGE groups to analyze left ventricular functional parameters (LVEF, FS, LVEDD, LVEDV, LVESV, LVMM, LVSV, CO, and CI) on Artificial Intelligence. RESULTS We enrolled 21 patients (11 males) with a mean age of 32.6±9.8 years (range, 16 to 51 years). Abnormalities on EGE were found in 2/3 of patients, involving 41 segments among multiple locations on the myocardium. The differences in LVEF (40.2±10.2% vs. 51.3±3.6%), LVESV (69.0±16.1ml vs. 52.5±10.6ml) and LVSV (42.6±11.4 vs. 52.8±2.8 ml) on Artificial Intelligence was statistically significant between the positive EGE and negative EGE groups (p<0.05). CONCLUSIONS Our results suggest a significant role of EGE on the basis of Lake Louise criteria in evaluating patients with clinical suspicion of acute myocarditis. Parameters, including LVEF, LVESV, and LVSV, on Artificial Intelligence, may be useful independent predictors for capillary leakage and microcirculatory disturbance in myocarditis.


Assuntos
Miocardite/diagnóstico por imagem , Miocardite/patologia , Adolescente , Adulto , Inteligência Artificial , Estudos de Casos e Controles , Meios de Contraste , Feminino , Gadolínio/análise , Gadolínio DTPA , Coração/fisiopatologia , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Microcirculação , Pessoa de Meia-Idade , Miocárdio/patologia , Valor Preditivo dos Testes , Função Ventricular Esquerda
8.
Curr Med Imaging Rev ; 15(9): 900-905, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32008537

RESUMO

BACKGROUND: The exact morbidity of myocarditis is unknown, as the treatment is generally delayed in virtue of misdiagnosis or missed diagnosis. AIM: The aim of this study was to identify prognostic factors of left-ventricular remodeling on CMRI performed in patients with pathological proven myocarditis. METHODS: Sixty-two cases with various presentations of myocarditis (39 cases with heart failure; 23 cases with arrhythmias) were selected. All patients, who underwent coronary angiography, endomyocardial biopsy, were divided into positive-remodeling and negative-remodelling groups to analyse LGE and cardiac cine parameters at presentation and subsequent to 3 months. RESULTS: Comparison of two subgroups in CMRI is as follows: positive LGE (65.6% vs. 86.7%; p<0.05), LVEF (41.3±14.8% vs. 37.6±10.1%; p=0.62), (25.7±2.0% vs. 24.0±2.5%; p=0.81), (44.5±3.9mm vs. 46.3±5.4mm; p=0.76), (129.1±8.5ml vs. 135.3±12.2ml; p=0.26), (74.8±7.3ml vs. 79.1±10.0ml; p=0.55), (52.0±5.7g vs. 49.6±6.5g; p=0.71), (34.9±3.5ml vs. 32.4±6.2ml; p=0.68), (3.8±0.7L/min vs. 3.1±0.5L/min; p=0.64), (2.9±0.6L/min*m2 vs. 2.7±0.5L/min*m2; p=0.79). CONCLUSION: LGE-MRI is rewarding as an independent predictor in left-ventricular positive and negative remodelling of myocarditis.


Assuntos
Técnicas de Imagem Cardíaca , Imageamento por Ressonância Magnética , Miocardite/diagnóstico por imagem , Miocardite/patologia , Remodelação Ventricular , Adolescente , Adulto , Idoso , Feminino , Gadolínio , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Prognóstico , Adulto Jovem
9.
J Vet Med Sci ; 77(10): 1305-10, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26028021

RESUMO

Fifty-five samples (15.62%) collected from dogs and cats were identified as canine parvovirus (CPV) infection in Beijing during 2010-2013. The nucleotide identities and aa similarities were 98.2-100% and 97.7-100%, respectively, when compared with the reference isolates. Also, several synonymous and non-synonymous mutations were also recorded for the first time. New CPV-2a was dominant, accounting for 90.90% of the samples. Two of the 16 samples collected from cats were identified as new CPV-2a (12.5%), showing nucleotide identities of 100% with those from dogs. Twelve samples (15.78%) collected from completely immunized dogs were found to be new CPV-2a, which means CPV-2 vaccines may not provide sufficient protection for the epidemic strains.


Assuntos
Doenças do Gato/virologia , Doenças do Cão/virologia , Infecções por Parvoviridae/veterinária , Parvovirus Canino/genética , Animais , Doenças do Gato/epidemiologia , Gatos , China , Doenças do Cão/epidemiologia , Cães , Fezes , Epidemiologia Molecular , Infecções por Parvoviridae/sangue , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Parvovirus Canino/isolamento & purificação , Filogenia
10.
Biomed Environ Sci ; 25(5): 509-16, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23122307

RESUMO

OBJECTIVE: This paper aims to investigate the anti-tumor mechanism of inactivated Sendai virus (Hemagglutinating virus of Japan envelope, HVJ-E) for murine melanoma (B16F10). METHODS: The murine dendritic cells (DCs) were treated with HVJ-E, and then the cytokines secreted from DCs and costimulation-related molecules on DCs were measured. Meanwhile, the expression of ß-catenin in HVJ-E treated murine melanoma cells was detected. In addition, HVJ-E was intratumorally injected into the melanoma on C57BL/6 mice, and the immune cells, CTL response and tumor volume were analyzed. RESULTS: HVJ-E injected into B16F10 melanoma obviously inhibited the growth of the tumor and prolonged the survival time of the tumor-bearing mice. Profiles of cytokines secreted by dendritic cells (DCs) after HVJ-E stimulation showed that the number of cytokines released was significantly higher than that elicited by PBS (1P<0.05). The co-stimulation-related molecules on DCs were comparable to those stimulated by LPS. Immunohistochemical examinations demonstrated the repression of ß-catenin in B16F10 melanoma cells after HVJ-E treatment. Meanwhile, real-time reverse transcription PCR revealed that HVJ-E induced a remarkable infiltration of CD11c positive cells, chemokine ligand 10 (CXCL10) molecules, interleukin-2 (IL-2) molecule, CD4(+) and CD8(+) T cells into HVJ-E injected tumors. Furthermore, the mRNA expression level of ß-catenin in the HVJ-E injected tumors was also down-regulated. In addition, B16F10-specific CTLs were induced significantly after HVJ-E was injected into the tumor-bearing mice. CONCLUSION: This is the first report to show the effective inhibition of melanoma tumors by HVJ-E alone and the mechanism through which it induces antitumor immune responses and regulates important signal pathways for melanoma invasion. Therefore, HVJ-E shows its prospect as a novel therapeutic for melanoma therapy.


Assuntos
Citocinas/metabolismo , Melanoma/imunologia , Vírus Sendai/fisiologia , Inativação de Vírus , beta Catenina/metabolismo , Animais , Linhagem Celular Tumoral , Citocinas/genética , Células Dendríticas/imunologia , Células Dendríticas/fisiologia , Células Dendríticas/virologia , Regulação para Baixo , Regulação Neoplásica da Expressão Gênica , Melanoma/patologia , Melanoma/virologia , Camundongos , Camundongos Endogâmicos C57BL , Neoplasias Experimentais , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Replicação Viral , beta Catenina/genética
11.
Zhonghua Jie He He Hu Xi Za Zhi ; 35(6): 435-9, 2012 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-22931725

RESUMO

OBJECTIVE: Acute lung injury (ALI) was associated with excessive inflammation caused by high TNF-α concentration. We hypothesized that anti-TNF-α therapy would have beneficial effects in experimental ALI in mice via oxidative stress inhibition. METHODS: BALB/c mice (8 - 10 week old) were randomly assigned to an LPS group, a TNFR-Fc + LPS group and a control group. LPS (5 mg/kg) was intratracheally administered to the mice. For the TNFR-Fc + LPS group, TNFR-Fc was given intraperitoneally once at a dose of 0.4 mg/kg before LPS treatment, at 0 and 2 h after LPS treatment, the mice were sacrificed. Wet to dry ratio of the lung and the protein concentration in BALF were measured. Lung histology was evaluated for lung injury. TNF-α concentration in serum, MDA and total anti-oxidative stability were assayed. Finally, the transcription level of iNOS, Nox1, Nox2, Nox4, XO and SOD were evaluated by qRT-PCR. RESULTS: TNFR-Fc treatment significantly decreased the serum TNF-α concentration (P < 0.001), reduced the score of lung histology and decreased the protein concentration in BALF (P < 0.001), but did not change the wet to dry ratio of the lung. The ALI mice treated with TNFR-Fc had a lower transcription level of Nox1, Nox2, Nox4 and XO (all P < 0.001). The total anti-oxidative stability of mice treated with TNFR-Fc was preserved better than those treated with LPS alone (P < 0.05). CONCLUSION: Treatment with TNFR-Fc significantly reduced LPS-induced ALI. The transcription level of Nox and XO was down-regulated by anti-TNF-α therapy, followed by oxidative stress attenuation.


Assuntos
Lesão Pulmonar Aguda/metabolismo , Imunoglobulina G/farmacologia , Pulmão/metabolismo , Estresse Oxidativo , Lesão Pulmonar Aguda/patologia , Animais , Etanercepte , Feminino , Inflamação , Lipopolissacarídeos/efeitos adversos , Pulmão/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Receptores do Fator de Necrose Tumoral
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 30(12): 2675-8, 2010 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-21177177

RESUMO

OBJECTIVE: To evaluate the effect of epidermal growth factor receptor tyrosine kinase inhibitor, gefitinib, on the expression of α-smooth muscle actin (α-SMA) in mice with lung fibrosis induced by bleomycin. METHODS: Thirty male BALB/c mice were randomly divided into control, bleomycin, and bleomycin plus gefitinib groups. The mice in the control group were subjected to intratracheal administration of normal saline, those in bleomycin group received bleomycin (3 mg/kg) intratracheally, and those in bleomycin plus gefitinib group received oral gefitinib (20 mg/kg administering) plus intratracheal bleomycin administration. All the mice were sacrificed 14 days after the treatments, and the left lung was examined pathologically with HE staining and Masson staining and also immunohistochemically for assay of the total EGFR, phosphorylated EGFR and α-SMA. The right lungs were sampled for RT-PCR to detect the mRNA levels of α-SMA. RESULTS: Gefitinib administration lessened lung fibrosis induced by bleomycin and significantly reduced lung collagen accumulation. The phosphorylation of EGFR in the pulmonary mesenchymal cells and epithelial cells and the expression levels of α-SMA mRNA and protein were inhibited by gefitinib treatment in mice with intratracheal administration of bleomycin (P<0.05). CONCLUSION: Gefitinib offers protection against lung fibrosis induced by bleomycin in mice probably by inhibiting the downstream signals of EGFR and by downregulating the expression of α-SMA.


Assuntos
Actinas/metabolismo , Fibrose Pulmonar/metabolismo , Quinazolinas/farmacologia , Animais , Bleomicina/efeitos adversos , Receptores ErbB/metabolismo , Gefitinibe , Pulmão/efeitos dos fármacos , Pulmão/metabolismo , Pulmão/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/patologia , RNA Mensageiro/genética
13.
Bing Du Xue Bao ; 23(4): 292-7, 2007 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-17894232

RESUMO

To generate recombinant avian adeno-associated virus (rAAAV) for gene transfer studies in avian cells, the recombinant plasmid containing the whole genome of AAAV was digested with restriction enzymes to remove the Rep and Cap genes, resulting in AAAV transfer vector pAITR. GFP-expressing cassette was amplified by PCR and inserted into the AAAV transfer vector. The Rep-Cap gene of AAAV amplified by high fidelity PCR was subcloned into eukaryotic expression vector pcDNA3, resulting in an AAAV helper vector pcDNA-ARC. The Rep and Cap genes amplified by high fidelity PCR were subcloned separately into the co-expression vector pVITRO2-mcs, resulting in another AAAV helper vector pVITRO2-ARC. Using calcium phosphate precipitation method, rAAAV-GFP was generated by co-transfecting AAV-293 cells with a cocktail of pAITR-GFP, pcDNA-ARC or pVITRO2-ARC, and adenovirus helper vector pHelper. The three structural proteins VP1, VP2 and VP3 of correct molecular masses were detected by SDS-PAGE and the GFP reporter gene was detected by PCR in purified rAAAV-GFP virions. Chicken embryonic fibroblast (CEF) cells and CEL cell line were transduced with the recombinant virus, the GFP-positive cells were easily observed under fluorescent microscope, expression of which lasted for at least two weeks. These data demonstrate that an efficient helper virus-free packaging system has been established for generating recombinant AAAV particles for gene transfer studies in avian cells and for development of recombinant vaccines against avian diseases.


Assuntos
Dependovirus/genética , Proteínas de Fluorescência Verde/genética , Plasmídeos/genética , Animais , Linhagem Celular , Células Cultivadas , Galinhas , Eletroforese em Gel de Poliacrilamida , Proteínas de Fluorescência Verde/metabolismo , Humanos , Microscopia de Fluorescência , Modelos Genéticos , Reação em Cadeia da Polimerase , Proteínas Recombinantes de Fusão/genética , Proteínas Recombinantes de Fusão/metabolismo , Transfecção
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