Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 194
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
J Environ Sci (China) ; 86: 107-119, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31787175

RESUMO

Phthalate esters (PAEs), typical pollutants widely used as plasticizers, are ubiquitous in various indoor and outdoor environments. PAEs exist in both gas and particle phases, posing risks to human health. In the present study, we chose four typical kinds of indoor and outdoor environments with the longest average human residence times to assess the human exposure in Hangzhou, including newly decorated residences, ordinary residences, offices and outdoor air. In order to analyze the pollution levels and characteristics of 15 gas- and particle-phase PAEs in indoor and outdoor environments, air and particulate samples were collected simultaneously. The total PAEs concentrations in the four types of environments were 25,396, 25,466.8, 15,388.8 and 3616.2 ng/m3, respectively. DEHP and DEP were the most abundant, and DMPP was at the lowest level. Distinct variations in the distributions of indoor/outdoor, gas/particle-phase and different molecular weights of PAEs were observed, showing that indoor environments were the main sources of PAEs pollution. While most PAEs tended to exsit in indoor sites and gas-phase, the high-molecular-weight chemicals tended to exist in the particle-phase and were mainly found in PM2.5. PAEs were more likely adsorbed by small particles, especially for the indoor environments. There existed a good correlation between the particle matter concentrations and the PAEs levels. In addition, neither temperature nor humidity had obvious effects on the distributions of the PAEs concentrations.

2.
J Bone Joint Surg Am ; 2019 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-31855868

RESUMO

BACKGROUND: The association between tibial plateau fracture morphology and injury force mechanism has not been well described. The aim of this study was to characterize 3-dimensional fracture patterns associated with hypothesized injury force mechanisms. METHODS: Tibial plateau fractures treated in a large trauma center were retrospectively reviewed. Three experienced surgeons divided fractures independently into 6 groups associated with injury force mechanisms proposed from an analysis of computed tomographic (CT) imaging: flexion varus, extension varus, hyperextension varus, flexion valgus, extension valgus, and hyperextension valgus. The fracture lines and comminution zones of each fracture were graphically superimposed onto a 3-dimensional template of the proximal part of the tibia. Fracture characteristics were then summarized on the basis of the fracture maps. The association between injury force mechanism and ligament avulsions was calculated. RESULTS: In total, 353 tibial plateau fractures were included. The flexion varus type pattern was seen in 67 fractures characterized by a primary fracture apex located posteromedially and was frequently associated with concomitant anterior cruciate ligament (ACL) avulsion (44.8%). The extension varus pattern was noted in 60 fractures with a characteristic medial fragment apex at the posteromedial crest or multiple apices symmetrically around the crest and was commonly completely articular in nature (65%). The hyperextension varus pattern was seen in 47 fractures as noted by anteromedial articular impaction, 51% with a fibular avulsion and 60% with posterior tension failure fragments. The flexion valgus pattern was observed in 51 fractures characterized by articular depression posterolaterally, often (58.9%) with severe comminution of the posterolateral cortical rim. The extension valgus patterns in 116 fractures only involved the lateral plateau, with central articular depression and/or a pure split. The hyperextension valgus pattern occurred in 12 fractures denoted by anterolateral articular depression. A moderate positive association was found between flexion varus fractures and ACL avulsions and between hyperextension varus fractures and fibular avulsions. CONCLUSIONS: Tibial plateau fractures demonstrate distinct, mechanism-associated 3-dimensional pattern characteristics. Further research is needed to validate the classification reliability among other surgeons and to determine the potential value in the diagnosis and formulation of surgical protocols.

3.
Huan Jing Ke Xue ; 40(7): 3304-3312, 2019 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-31854732

RESUMO

Phosphorus is an essential life element, which can affect the activities and functions of denitrifiers. Both nirK and nirS genes can code nitrite reductase; however, it remains unclear whether nirK- and nirS-containing denitrifers respond differentially to changes in the availability of phosphorus in paddy soil. In this study, P-deficient paddy soil was used to grow rice plants. Three phosphorus levels established by applying P fertilizer at a rate of 0 mg·kg-1 (CK), 15 mg·kg-1 (P1), and 30 mg·kg-1(P2), respectively. The abundance and community structure of nirK- and nirS- containing denitrifers were determined using quantitative PCR and high-throughput sequencing techniques. Results indicated that nirK- and nirS-containing communities responded differentially to changes in the P levels. The nirS-containing communities are more sensitive to the changes in P in both rhizosphere and bulk soil samples. In addition, the abundance of nirS genes was 2-3 times higher in the P2 treatment than in the CK treatment. Furthermore, the nirS community structure is also clearly differed from the CK treatment. However, P addition only induced partial modification of the community structure and abundance of nirK-containing denitrifiers. Moreover, compared to the bulk soil with each phosphorus level, the nirS community structure in the rhizosphere soil changed significantly; however, only the P2 treatment induced significant increases in the abundance of the nirS gene. In contrast, no significant differences in the abundance and composition of nirK-containing denitrifers were detected between rhizosphere and bulk soils under different phosphorus levels. Collectively, application of phosphate fertilizer in P-deficient paddy soil could significantly increase the abundance of nirK- and nirS-containing denitrifiers, changing their community structures, with nirS-type showing a greater sensitivity than nirK-type denitrifiers. In comparison, the denitrifying communities in the rhizosphere were more sensitive to variable P levels than that in the bulk soil. Compared to bulk soils, rice growth shifted the community structure of nirS- and nirK-containing denitrifiers in rhizosphere soils at each level of P, but failed to induce significant changes in their abundance (except for P2) that could cause a significant increase in nirS abundance. These results could provide a theoretical basis for exploring the effects of fertilization on soil denitrification.


Assuntos
Bactérias/classificação , Desnitrificação , Fósforo/análise , Microbiologia do Solo , Solo/química , Genes Bacterianos , Nitrito Redutases/genética
4.
Mol Biol Evol ; 2019 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-31589316

RESUMO

Ribosomal protein (RP) genes encode structural components of ribosomes, the cellular machinery for protein synthesis. A single functional copy has been maintained in most of 78-80 RP families in animals due to evolutionary constraints imposed by gene dosage balance. Some fungal species have maintained duplicate copies in most RP families. The mechanisms by which the RP genes were duplicated and maintained and their functional significance are poorly understood. To address these questions, we identified all RP genes from 295 fungi and inferred the timing and nature of gene duplication events for all RP families. We found that massive duplications of RP genes have independently occurred by different mechanisms in three distantly related lineages: budding yeasts, fission yeasts, and Mucoromycota. The RP gene duplicates in budding yeasts and Mucoromycota were mainly created by whole genome duplication (WGD) events. However, duplicate RP genes in fission yeasts were likely generated by retroposition, which is unexpected considering their dosage sensitivity. The sequences of most RP paralogs have been homogenized by repeated gene conversion in each species, demonstrating parallel concerted evolution, which might have facilitated the retention of their duplicates. Transcriptomic data suggest that the duplication and retention of RP genes increased their transcript abundance. Physiological data indicate that increased ribosome biogenesis allowed these organisms to rapidly consume sugars through fermentation while maintaining high growth rates, providing selective advantages to these species in sugar-rich environments.

5.
Plant Cell ; 31(12): 3057-3072, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31591163

RESUMO

Intracellular processes can be localized for efficiency or regulation. For example, localized mRNA translation by chloroplastic ribosomes occurs in the biogenesis of PSII, one of the two photosystems of the photosynthetic electron transport chain in the chloroplasts of plants and algae. The biogenesis of PSI and PSII requires the synthesis and assembly of their constituent polypeptide subunits, pigments, and cofactors. Although these biosynthetic pathways are well characterized, less is known about when and where they occur in developing chloroplasts. Here, we used fluorescence microscopy in the unicellular alga Chlamydomonas reinhardtii to reveal spatiotemporal organization in photosystem biogenesis. We focused on translation by chloroplastic ribosomes and chlorophyll biosynthesis in two developmental contexts of active photosystem biogenesis: (1) growth of the mature chloroplast and (2) greening of a nonphotosynthetic chloroplast. The results reveal that a translation zone is the primary location of the biogenesis of PSI and PSII. This discretely localized region within the chloroplast contrasts with the distributions of photosystems throughout this organelle and, therefore, is likely a hub where anabolic pathways converge for photosystem biogenesis.plantcell;31/12/3057/FX1F1fx1.

6.
Environ Res ; 179(Pt A): 108795, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31605867

RESUMO

Multiyear spatiotemporal distributions of daily ambient sulfur dioxide (SO2) are essential for evaluating management effectiveness and assessing human health risk. In this study, we estimate the daily SO2 levels across China on 0.1o grid from 2013 to 2016 by assimilating satellite- and ground-based SO2 observations using the random-forest spatiotemporal kriging (RF-STK) model. The cross-validation R2 is 0.64 and 0.81 for predicting the daily and multiyear averages, respectively. The multiyear population-weighted average of SO2 for China is 28.1 ±â€¯14.0 µg/m3, and the severest SO2 pollution occurs in the northern China (45.1 ±â€¯14.7 µg/m3). The SO2 concentration shows a strong seasonality, i.e., highest in winter (41.6 ±â€¯26.4 µg/m3) and lowest in summer (19.6 ±â€¯8.3 µg/m3). During 2013-2016, the annual SO2 decreases from 34.4 ±â€¯18.2 to 22.7 ±â€¯11.1 µg/m3, and the population% exposed for more than 100 nonattainment days (SO2 > 20 µg/m3) drops from 86% to 48%. While the seasonality of SO2 is mainly determined by the meteorological variation, the substantial decrease attributes to the reduced emissions such as from coal consumption. The effectiveness of SO2 emission reduction varies widely in different prefectures of China. In Shandong province, the SO2 concentration decreases by -45% while the coal consumption increases by 9%. In Shanxi province, the SO2 concentration decreases by -15% while the coal consumption decreases by -3%. The contrasting effectiveness between these two provinces is associated with the much fewer waste gas disposal facilities in Shanxi than Shandong. Stricter regulation is required to further lower the SO2 concentration in order to protect the public health, especially in the northern China.

7.
World J Clin Cases ; 7(19): 2916-2929, 2019 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-31624740

RESUMO

Colorectal cancer (CRC) remains a major contributor to the number of cancer-related deaths that occur annually worldwide. With the development of molecular biology methods, an increasing number of molecular biomarkers have been identified and investigated. CRC is believed to result from an accumulation of epigenetic changes, and detecting aberrant DNA methylation patterns is useful for both the early diagnosis and prognosis of CRC. Numerous studies are focusing on the development of DNA methylation detection methods or DNA methylation panels. Thus, this review will discuss the commonly used techniques and technologies to evaluate DNA methylation, their merits and deficiencies as well as the prospects for new methods.

8.
Nat Commun ; 10(1): 4593, 2019 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-31597916

RESUMO

Charged defects at the surface of the organic-inorganic perovskite active layer are detrimental to solar cells due to exacerbated charge carrier recombination. Here we show that charged surface defects can be benign after passivation and further exploited for reconfiguration of interfacial energy band structure. Based on the electrostatic interaction between oppositely charged ions, Lewis-acid-featured fullerene skeleton after iodide ionization (PCBB-3N-3I) not only efficiently passivates positively charged surface defects but also assembles on top of the perovskite active layer with preferred orientation. Consequently, PCBB-3N-3I with a strong molecular electric dipole forms a dipole interlayer to reconfigure interfacial energy band structure, leading to enhanced built-in potential and charge collection. As a result, inverted structure planar heterojunction perovskite solar cells exhibit the promising power conversion efficiency of 21.1% and robust ambient stability. This work opens up a new window to boost perovskite solar cells via rational exploitation of charged defects beyond passivation.

9.
Sci Rep ; 9(1): 12532, 2019 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-31467342

RESUMO

A gradient boosting machine (GBM) was developed to model the susceptibility of debris flow in Sichuan, Southwest China for risk management. A total of 3839 events of debris flow during 1949-2017 were compiled from the Sichuan Geo-Environment Monitoring program, field surveys, and satellite imagery interpretation. In the cross-validation, the GBM showed better performance, with the prediction accuracy of 82.0% and area under curve of 0.88, than the benchmark models, including the Logistic Regression, the K-Nearest Neighbor, the Support Vector Machine, and the Artificial Neural Network. The elevation range, precipitation, and aridity index played the most important role in determining the susceptibility. In addition, the water erosion intensity, road construction, channel gradient, and human settlement sites also largely contributed to the formation of debris flow. The susceptibility map produced by the GBM shows that the spatial distributions of high-susceptibility watersheds were highly coupled with the locations of the topographical extreme belt, fault zone, seismic belt, and dry valleys. This study provides critical information for risk mitigating and prevention of debris flow.

10.
J Cancer Res Ther ; 15(4): 836-841, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31436240

RESUMO

Background: Apatinib has been approved for the treatment of advanced gastric adenocarcinoma and gastric-esophageal junctional adenocarcinoma, but its efficacy is unknown for other advanced solid tumors. Aims and Objectives: We retrospectively reviewed the use of apatinib for multiple advanced-stage non-gastric cancers. Ninety-two patients from 7 hospitals who received additional treatment except apatinib more than once were enrolled. Materials and Methods: The primary end-point was the overall response rate (ORR), and the secondary end-points included progression-free survival (PFS), disease control rate (DCR), overall survival, and adverse reactions. We categorized all the patients into six groups according to their cancer type. Results: In the lung cancer group, the ORR was 9% (95% confidence interval [CI], 3%-23%), DCR was 88% (95% CI, 74%-96%), and median PFS was 3 months (95% CI, 1.9-5.4 months). In the cervical cancer group, the ORR was 25% (95% CI, 3%-65%), DCR reached 100%, and median PFS was 3.5 months (95% CI, 0.6-9.0 months). There were different ORRs between the other cancer groups. In addition, the most common adverse effect of apatinib was palmar-plantar erythrodysesthesia syndrome (37%), followed by proteinuria (14%) and hypertension (13%). Conclusion: These results suggest that apatinib might be effective for not only gastric cancer but also other carcinomas including lung cancer, colorectal cancer, cervical cancer, liver cancer, breast cancer, and nasopharyngeal cancer. Thus, apatinib is a promising targeted drug for multiple types of cancer.

11.
Trials ; 20(1): 403, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31277678

RESUMO

BACKGROUND: Lymphedema is the most common complication after breast cancer treatment, but management of lymphedema remains a clinical challenge. Several studies have reported the beneficial effect of acupuncture for treating breast cancer-related lymphedema (BCRL). Our objective is to verify the effectiveness of warm acupuncture on BCRL and compare the effectiveness of a local distribution acupoint combination with a local-distal acupoint combination for BCRL. METHODS: This is a study protocol for a multicenter, three-arm parallel, assessor blinded, randomized controlled trial. A total of 108 participants diagnosed as BCRL will be randomly allocated in equal proportions to a local distribution acupoint (LA) group, a local-distal acupoint (LDA) group, or a waiting-list (WL) group. The LA and LDA groups will receive 20 acupuncture treatment over 8 weeks with local distribution acupoint combination and local-distal acupoint combination, respectively. The WL group will receive acupuncture treatment after the study is concluded. The primary outcome is the mean change in inter-limb circumference difference from baseline to week 8. The secondary outcomes include volume measurement, skin hardness, common terminology criteria for adverse events 4.03 (edema limbs criteria), stages of lymphedema from the International Society of Lymphology, Disabilities of the Arm, Shoulder and Hand questionnaire, and the Medical Outcome Study 36-item Short-form Health Survey. DISCUSSION: This study aims to provide data on warm acupuncture as an effective treatment for BCRL and at the same time compare the effectiveness of different acupoint combinations. TRIAL REGISTRATION: ClinicalTrials.gov: Identifier NCT03373474 . Registered on 14th December 2017.

12.
Nat Commun ; 10(1): 2935, 2019 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-31270335

RESUMO

Trace elements play important roles in human health, but little is known about their functions in humoral immunity. Here, we show an important role for iron in inducing cyclin E and B cell proliferation. We find that iron-deficient individuals exhibit a significantly reduced antibody response to the measles vaccine when compared to iron-normal controls. Mice with iron deficiency also exhibit attenuated T-dependent or T-independent antigen-specific antibody responses. We show that iron is essential for B cell proliferation; both iron deficiency and α-ketoglutarate inhibition could suppress cyclin E1 induction and S phase entry of B cells upon activation. Finally, we demonstrate that three demethylases, KDM2B, KDM3B and KDM4C, are responsible for histone 3 lysine 9 (H3K9) demethylation at the cyclin E1 promoter, cyclin E1 induction and B cell proliferation. Thus, our data reveal a crucial role of H3K9 demethylation in B cell proliferation, and the importance of iron in humoral immunity.


Assuntos
Linfócitos B/imunologia , Proliferação de Células , Histonas/química , Histonas/imunologia , Imunidade Humoral , Lisina/imunologia , Animais , Linfócitos B/química , Linfócitos B/citologia , Ciclo Celular , Células Cultivadas , Ciclina E/genética , Ciclina E/imunologia , Desmetilação , Proteínas F-Box/genética , Proteínas F-Box/imunologia , Histonas/genética , Ferro/metabolismo , Histona Desmetilases com o Domínio Jumonji/genética , Histona Desmetilases com o Domínio Jumonji/imunologia , Ativação Linfocitária , Lisina/genética , Camundongos , Camundongos Endogâmicos C57BL , Proteínas Oncogênicas/genética , Proteínas Oncogênicas/imunologia , Regiões Promotoras Genéticas , Linfócitos T/citologia , Linfócitos T/imunologia
13.
Acta Pharmacol Sin ; 2019 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-31316178

RESUMO

Chronic myeloid leukemia (CML) is a clonal hematopoietic stem cell neoplasm characterized by an uncontrolled proliferation of moderately and well differentiated cells of the granulocytic lineage. LW-213, a newly synthesized flavonoid compound, was found to exert antitumor effects against breast cancer through inducing G2/M phase arrest. We investigated whether LW-213 exerted anti-CML effects and the underlying mechanisms. We showed that LW-213 inhibited the growth of human CML cell lines K562 and imatinid-resistant K562 (K562r) in dose- and time-dependent manners with IC50 values at the low µmol/L levels. LW-213 (5, 10, 15 µM) caused G2/M phase arrest of K562 and K562r cells via reducing the activity of G2/M phase transition-related proteins Cyclin B1/CDC2 complex. LW-213 treatment induced apoptosis of K562 and K562r cells via inhibiting the expression of CDK9 through lysosome degradation, thus leading to the suppression of RNAPII phosphorylation, down-regulation of a short-lived anti-apoptic protein MCL-1. The lysosome inhibitor, NH4Cl, could reverse the anti-CML effects of LW-213 including CDK9 degradation and apoptosis. LW-213 treatment also degraded the downstream proteins of BCR-ABL1, such as oncoproteins AKT, STAT3/5 in CML cells, which was blocked by NH4Cl. In primary CML cells and CD34+ stem cells, LW-213 maintained its pro-apoptotic activity. In a K562 cells-bearing mice model, administration of LW-213 (2.5, 5.0 mg/kg, ip, every other day for 4 weeks) dose-dependently prolonged the survival duration, and significantly suppressed huCD45+ cell infiltration and expression of MCL-1 in spleens. Taken together, our results demonstrate that LW-213 may be an efficient agent for CML treatment.

14.
Front Neurosci ; 13: 701, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354412

RESUMO

Xiaoshuan enteric-coated capsule (XSEC) is a Chinese medicinal compound widely used for treatment of ischemic cerebrovascular diseases. Enriched environment (EE) is an effective rehabilitative protocol designed to enhance sensorimotor, cognitive and social stimulation. This study aimed to apply magnetic resonance imaging (MRI) to non-invasively assess whether EE could augment the therapeutic benefits of XSEC on post-ischemic neurovascular remodeling. Male Sprague-Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO) and treated with XSEC and EE alone or combination for 30 consecutive days. Beam walking test and Morris water maze (MWM) test were performed to evaluate motor and cognitive function, respectively. Multimodal MRI was applied to examine alterations to brain structures, intracranial vessels, and cerebral perfusion on the 31st day after MCAO. Double-immunofluorescent staining was used to evaluate neurogenesis and angiogenesis. Western blot and RT-PCR were used to detect the expressions of vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and the axon guidance molecules. Combination therapy with XSEC and EE significantly reduced cystic volume compared with XSEC and EE monotherapies. In line with this, combination treated rats performed better in the beam walking test and exhibited improved spatial memory in the probe trial of the MWM. Moreover, XSEC and EE combination treatment improved cerebral blood flow (CBF), amplified angiogenesis and upregulated VEGF protein levels. This proangiogenic effect was consistent with the increased progenitor cell proliferation and neuronal differentiation in the peri-infarct cortex and striatum. Specifically, the combined therapy of XSEC and EE markedly increased the Netrin-1 and Robo-1 protein expression levels compared with vehicle group, while no difference was observed between XSEC or EE monotherapy and vehicle group. Together, these findings indicate that the combination of XSEC and EE benefits neurovascular reorganization. This correlates with restoration of CBF, promotion of neurogenesis and angiogenesis, and activation of the intrinsic axonal guidance molecules, thereby facilitating greater physical rehabilitation after ischemic stroke.

15.
J Clin Nurs ; 28(13-14): 2599-2612, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30830708

RESUMO

AIMS AND OBJECTIVES: To develop and validate an instrument to measure nurses' empathy motivation in China (See Supporting Information Appendix S1). BACKGROUND: Nurses are increasingly expected to empathise with patients in clinical settings. However, research investigating nurses' empathy motivation in China is lacking, and no specific instrument exists worldwide. DESIGN: Two-stage cross-sectional study, which follows the STROBE guidelines. Instrument development and psychometric evaluation were used (See Supporting Information Appendix S1). METHODS: A literature review and qualitative interviews with nurses were conducted to generate the initial items. Convenience samples of 340 (for item analysis) and 640 (for psychometric evaluation) clinical nurses working at four tertiary hospitals in Anhui Province were recruited. The scale was validated by content validity, surface validity and item analysis. A total of 640 participants were randomly divided into two equal groups. Exploratory factor analysis (EFA) was used with varimax rotation, confirmatory factor analysis (CFA) and internal consistency reliability to analyse the psychometric properties of the scale (See Supporting Information Appendix S1). RESULTS: From the initial 90-item pool, 27 items were retained by the item analysis. The EFA (N = 290) showed the following six factors on the scale explained 71.266% of the overall variance: amotivation, external regulation, introjected regulation, identified regulation, integrative regulation and intrinsic motivation. Furthermore, when limited to three factors, that is autonomy motivation, controlled motivation and amotivation, 56.578% of the variance was explained. The findings showed high internal consistency. The six-factor solution and three-factor solution of the scale, including 27 items, were both confirmed by the CFA, for example χ2 /df = 1.744, 2.261; RMSEA = 0.051, 0.066; GFI = 0.882, 0.847; TLI = 0.942, 0.902; and RMR = 0.039, 0.049, respectively. CONCLUSIONS: The nurses' empathy motivation scale presents good psychometric properties and can be used to explore nurses' empathy motivation in China (See Supporting Information Appendix S1). RELEVANCE TO CLINICAL PRACTICE: This study offers insight into nurses' complicated reasons for exhibiting empathy.


Assuntos
Empatia , Relações Enfermeiro-Paciente , Recursos Humanos de Enfermagem no Hospital/psicologia , Inquéritos e Questionários/normas , Adulto , China , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Motivação , Psicometria , Reprodutibilidade dos Testes , Adulto Jovem
16.
Kaohsiung J Med Sci ; 35(2): 102-110, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30848027

RESUMO

This study intends to investigate the predictive values of plasma Vitamin D-binding protein (VDBP), 25-hydroxyvitamin D [25(OH)D], and glutathione (GSH) levels in the outcome of cervical spondylotic myelopathy (CSM) surgery. Surgery outcomes of 236 CSM patients were determined. Recovery rate was calculated according to Japanese Orthopaedic Association (JOA) scores during follow-up. CSM patients with a recovery rate >50% were assigned with good prognosis and the rest were with fair prognosis. Preoperative and postoperative neurologic function scores were compared among groups. Plasma VDBP and 25(OH)D levels, as well as GSH levels were measured by ELISA and glutathione reductase recycling assay, respectively. Pearson's correlation coefficient was performed to analyze the correlation among plasma VDBP, 25(OH)D, and GSH levels. Receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of plasma VDBP, 25(OH)D, and GSH levels for surgical outcome. Logistic regression model was used to analyze risk factors for surgical outcome. Compared with those with fair prognosis, CSM patients with good prognosis group exhibited higher postoperative neurologic function scores, plasma VDBP, 25(OH)D, and GSH levels, and better improvements in spinal cord compression and motions of the cervical vertebra. Plasma VDBP, 25(OH)D, and GSH levels were favorable prognostic factors for CSM surgical outcome. The sensitivity and specificity of plasma VDBP, plasma 25(OH)D, and plasma GSH were 89.8% and 91.7%, 85.8% and 84.4%, and 79.5% and 91.7%, respectively. Our study provides evidence that higher plasma VDBP, 25(OH)D, and GSH levels may predict better surgical outcome in CSM patients.


Assuntos
Vértebras Cervicais/patologia , Glutationa/sangue , Espondilose/sangue , Proteína de Ligação a Vitamina D/sangue , Vitamina D/análogos & derivados , Estudos de Casos e Controles , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/fisiopatologia , Vértebras Cervicais/cirurgia , Feminino , Humanos , Modelos Logísticos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Amplitude de Movimento Articular , Fatores de Risco , Espondilose/diagnóstico por imagem , Espondilose/fisiopatologia , Espondilose/cirurgia , Vitamina D/sangue
17.
Orthop Surg ; 11(1): 82-90, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30724021

RESUMO

OBJECTIVE: To present our clinical experience of treating varus malunion of the distal femur through a medial open-wedge osteotomy with double-plate fixation. METHODS: A prospective cohort study was performed. From January 2005 to February 2015, 15 consecutive patients with varus malunion following distal femur fractures were surgically treated at a single level I trauma center. The coronal and sagittal deformity were corrected by a medial open-wedge osteotomy of the distal femur. A medial buttress plate was used to maintain the realignment. A lateral locking plate was additionally used as a protection plate. The mean age of patients at the time of the surgery was 35.5 years (range, 22-58 years). The radiographical evaluation included the mechanical femorotibial angle, the mechanical lateral distal femoral angle, the anatomic posterior distal femoral angle, and the leg length discrepancy. Clinical outcome evaluation consisted of the range of motion (ROM) and Hospital for Special Surgery (HSS) score. RESULTS: Mean follow-up was 7.4 years (range, 4-11.5 years). Varus and flexion malalignment and limb discrepancy were adequately corrected in all patients. The mechanical femorotibial angle, the mechanical lateral distal femoral angle, and the anatomic posterior distal femoral angle were restored from 17.5° (range, 13°-25°) to 2.3° (range, - 2°-7°), 102.3° (range, 95°-112°) to 85.2° (range, 81°-92°), and 77.1° (range, 65°-87°) to 82.7° (range, 76°-88°), respectively. The leg length discrepancy was diminished from 3.4 cm (range, 2.4-4.5 cm) to 0.8 cm (range, 0-1.7 cm). The average bone healing time was 4.1 months (range, 2.5-6 months). The average ROM of the affected knees at 24-month follow-up was 3.4°-112.55°. The score of HSS at 4-years follow-up was 76.1 (range, 64-88). No internal fixation failure or secondary operation was noted until the last follow-up. CONCLUSION: Medial open-wedge osteotomy can adequately correct the posttraumatic varus malunion of the distal femur. With fixation of the double plate, non-displaced bone healing and good functional outcome are expected.


Assuntos
Placas Ósseas , Fraturas do Fêmur/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Mal-Unidas/cirurgia , Osteotomia/métodos , Adulto , Feminino , Fraturas do Fêmur/diagnóstico por imagem , Seguimentos , Fixação Interna de Fraturas/instrumentação , Consolidação da Fratura , Fraturas Mal-Unidas/diagnóstico por imagem , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Fraturas Intra-Articulares/cirurgia , Deformidades Articulares Adquiridas/diagnóstico por imagem , Deformidades Articulares Adquiridas/cirurgia , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/cirurgia , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Osteotomia/efeitos adversos , Estudos Prospectivos , Radiografia , Amplitude de Movimento Articular , Resultado do Tratamento , Adulto Jovem
18.
EBioMedicine ; 40: 643-654, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30612943

RESUMO

BACKGROUND: Genetic overexpression or pharmacological activation of heme oxygenase (HO) are identified as potential therapeutic target for spinal cord injury (SCI); however, the role of carbon monoxide (CO), which is a major product of haem degenerated by HO, in SCI remains unknown. Applying hemin or chemicals which may regulate HO expression or activity to increase CO production are inadequate to elaborate the direct role of CO. Here, we assessed the effect of CO releasing molecule-3 (CORM-3), the classical donor of CO, in SCI and explained its possible protective mechanism. METHODS: Rat SCI model was performed with a vascular clip (30 g) compressing at T9 vertebral level for 1 min and CO was delivered immediately after SCI by CORM-3. The neurological deficits and neuron survival were assessed. Inflammasome and inositol-requiring enzyme 1 (IRE1) pathway were measured by western blot and immunofluorescence. For in vitro study, oxygen glucose deprivation (OGD) simulated the SCI-inflammasome change in cultured the primary neurons. FINDINGS: CORM-3 suppressed inflammasome signaling and pyroptosis occurrence, which consequently alleviated neuron death and improved motor functional recovery following SCI. As a pivotal sensor involving in endoplasmic reticulum stress-medicated inflammasome signaling, IRE1 and its downstream X-box binding protein 1 (XBP1) were activated in SCI tissues as well as in OGD neurons; while inhibition of IRE1 by STF-083010 in SCI rats or by si-RNA in OGD neurons suppressed inflammasome signaling and pyroptosis. Interestingly, the SCI/OGD-stimulated IRE1 activation was attenuated by CORM-3 treatment. INTERPRETATIONS: CO may alleviate neuron death and improve motor functional recovery in SCI through IRE1 regulation, and administration of CO could be a promising therapeutic strategy for SCI.


Assuntos
Inflamassomos/metabolismo , Neurônios/metabolismo , Compostos Organometálicos/metabolismo , Traumatismos da Medula Espinal/metabolismo , Animais , Biomarcadores , Monóxido de Carbono/metabolismo , Contagem de Células , Morte Celular , Modelos Animais de Doenças , Feminino , Neurônios/efeitos dos fármacos , Neurônios/patologia , Compostos Organometálicos/farmacologia , Fosforilação , Interferência de RNA , Ratos , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/patologia
19.
Arch Orthop Trauma Surg ; 139(6): 743-750, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30673869

RESUMO

PURPOSE: Varus deformity of knee osteoarthritis was formed by both intra-articular and extra-articular pathologies. Such intra-articular deformities could not be fully corrected by a medial open-wedge high tibial osteotomy (HTO), which was performed as an extra-articular procedure. Therefore, the purpose of this study was to investigate whether any residual varus was left inside the joint after HTO in the patients with knee osteoarthritis, and a correlation of the residual varus could be traced. METHODS: This study involved 66 patients (66 knees) undergoing HTO for medial knee osteoarthritis. The percentage of mechanical axis (%MA), mechanical femorotibial angle (mFTA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA) and joint line convergence angle (JLCA) were measured on radiographs of the full-length legs preoperatively and 6 months postoperatively. The relationship between changes in the JLCA and alignment correction was assessed. The postoperative residual JLCA was categorized as the optimal (postoperative JLCA ≤ 2°), the acceptable (2° < postoperative JLCA ≤ 5°), and the unacceptable (postoperative JLCA > 5°) to analyze its correlation with pre- or intra-operative factors. RESULTS: Average %MA and mFTA were improved from 5.5 to 60% and from 190.2° to 176.4°, respectively. There was no change in mLDFA, whereas mMPTA changed from 80.3° to 91.8°. JLCA changed from 4.2° to 2.7°. The analyses of multiple linear regression showed that the preoperative JLCA and postoperative changes in mechanical alignment (%MA, mFTA and mMPTA) were two important variables dependently associated with differences in JLCAs postoperatively. However, postoperative JLCAs showed a stronger correlation to preoperative JLCAs than to changes in mechanical alignment postoperatively. A Chi-square analysis showed a significantly higher percentage of patients achieved acceptable postoperative JLCAs in the preoperative JLCA ≤ 6° group (78.8%) compared to the preoperative JLCA > 6° group (6.1%). Therefore, 6° of JLCA was suggested to be a tipping point. CONCLUSIONS: The capability of HTO to correct intra-articular varus deformities, which was represented by JLCAs, is limited. Postoperative residual JLCAs were correlated primarily to preoperative JLCA values and total alignment correction, while the former accounted for most. A preoperative JLCA of 6° was suggested to be a tipping point, and a larger value indicated more than 5° residual JLCA after the HTO.


Assuntos
Osteoartrite do Joelho , Osteotomia , Tíbia/cirurgia , Estudos de Coortes , Humanos , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/cirurgia , Osteotomia/efeitos adversos , Osteotomia/métodos , Osteotomia/estatística & dados numéricos , Complicações Pós-Operatórias
20.
Int Orthop ; 43(2): 411-416, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29744649

RESUMO

BACKGROUND: Metaphyseal-diaphyseal junction (MDJ) fractures of the distal humerus are problematic to reduce and more susceptible to post-operative complications. This biomechanical study was designed to compare Kirschner wires (KW), lateral external fixation, and elastic stable intramedullary nails (ESIN) in simulated transverse MDJ fractures of various heights. METHOD: Sagittally oblique, transverse MDJ fractures were created in fourth-generation composite bone models at three levels: high, mid, and low fractures, respectively, and then fixed with either Kirschner wires, lateral external fixation (EF), or ESIN respectively and tested in extension, flexion, valgus, varus, internal, and external rotations. RESULTS: In the high fractures, ESIN had better overall stiffness than the other techniques. In the mid groups, three crossed pinning (1-medial and 2-lateral pins) had the best overall stiffness, followed by two crossed pinning (1-medial and 1-lateral pins). In the low fractures, three crossed pinning was superior to all other techniques. Two crossed pinning and three -lateral pinning techniques yielded comparable stiffness in the low fracture model. CONCLUSIONS: From a biomechanical perspective, ESIN provides the best overall stability for fractures located in the upper region of the MDJ, while percutaneous pinning is superior in stabilizing fractures of the lower region. Two lateral and one medial pins make the most stable crossed pinning construct for these fractures.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA