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1.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 226-232, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645184

RESUMO

Objective: To investigate the correlation between serum CCL20 level and disease severity in patients with rheumatoid arthritis (RA). Methods: From July 2018 to July 2019, a cross-sectional study was conducted in the Department of Rheumatology and Immunology, the Third Affiliated Hospital of Southern Medical University. The observation group consisted of 105 outpatients and inpatients diagnosed with RA, while the control group was 90 healthy people with age and gender matched physical examination in the Third Affiliated Hospital of Southern Medical University. According to Steinbroker classification, RA patients were divided into Steinbroker grade 2 group (n=35), Steinbroker grade 3 group (n=38) and steinbroker grade 4 group (n=32); according to DAS28 score, RA patients were divided into remission group (DAS28<2.6)(n=39), mild active group (DAS28 2.6-3.2)(n=25), moderate active stage group (DAS28 3.2-5.1)(n=20) and severe active stage group (DAS28 ≥ 5.1)(n=21). The levels of chemokine ligand 20 (CCL20), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were detected by ELISA. The levels of CCL20 in each group were compared, and the correlation between CCL20 and other indicators was analyzed. The receiver operating characteristic (ROC) curve of CCL20 in diagnosis of RA was analyzed to explore the correlation between CCL20 and disease severity of RA patients. Results: Compared with the normal control group, the serum CCL20 level in RA patients was significantly increased [(48.1±16.7) pg/ml vs (17.6±5.9) pg/ml, t=19.39, P<0.001]. In addition, serum CCL20 in steinbroker grade 4 group was significantly higher than that in Steinbroker grade 3 group [(59.5±10.1) pg/ml vs (47.4±17.5) pg/ml, t=3.472, P<0.001], and the serum CCL20 level in steinbroker grade 3 group was significantly higher than that in steinbroker grade 2 group [(47.4±17.5) pg/ml vs (38.4±14.6) pg/ml, t=2.370, P<0.001], CCL20 level in steinbroker grade 2 group was significantly higher than that in normal control group [(38.4±14.6) pg/ml vs (17.6±5.9) pg/ml, t=7.738, P<0.001]. In addition, serum CCL20 level was significantly positively correlated with steinbroker score (r=0.505, P<0.001); CCL20 level in active RA patients was significantly higher than that in remission RA patients [(57.2±13.2) pg/ml vs (32.7±8.9) pg/ml, t=10.31, P<0.001]. The serum CCL20 level in severe activity group was significantly higher than that in moderate activity group [(60.6±10.9) pg/ml vs (51.7±16.2) pg/ml, t=0.212, P=0.040], and the serum CCL20 level in moderate activity group was significantly higher than that in mild activity group [(51.7±16.2) pg/ml vs (40.5±18.6) pg/ml, t=0.217, P=0.037]. In addition, there was a significant positive correlation between serum CCL20 level and DAS28 score (r=0.451, P<0.001). In addition, serum CCL20 level was positively correlated with serum CRP (r=0.332, P<0.001). According to the ROC curve, the specificity of steinbroker grade 2 group was 0.53, and the sensitivity was 0.74, AUC was 0.659; the sensitivity of steinbroker grade 3 group was 0.78, and the specificity was 0.69, AUC was 0.734; the sensitivity of mild vs medium stage was 0.64, and the specificity was 0.70, AUC was 0.699; the sensitivity of medium stage vs severe stage was 0.57, and the specificity was 0.68,AUC was 0.678. Conclusion: Serum CCL20 level in RA patients is significantly increased and positively correlated with disease severity, which may be used as a marker to observe and evaluate the progression of RA.

2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(9): 1114-1122, 2021 Sep 06.
Artigo em Chinês | MEDLINE | ID: mdl-34619930

RESUMO

Objective: To explore the relationship between alcohol consumption and insomnia among 18-59 years old employed floating population in mainland China, and provide scientific basis for the relevant policies to improve the sleep status of employed floating population from the perspective of alcohol consumption. Methods: Data were from Chinese Floating Population Chronic Disease Surveillance (2012). Floating population were selected from industries in 170 counties and districts of 31 provinces/autonomous regions, and Xinjiang Construction Corps in mainland China by using the stratified multistage cluster sampling. Demographic information, behavioral risk factors, insomnia, social pressure and chronic diseases were collected through using the face-to-face questionnaire. After complex weighting of the data, a multivariable logistic regression was used to explore the sleep status and its influencing factors among the employed floating population. Results: A total of 48 499 subjects were included in the analysis. The proportions of the employed floating population who never drank alcohol, drank small amount, and drank excessively were 48.3%, 41.8% and 9.9%, respectively. The prevalence of insomnia among the general, male and female employed floating population was 28.6%, 25.8% and 32.3%, respectively. The prevalence of insomnia among the employed floating population aged between 45 and 59 years old (32.2%) was higher than that in the population aged between 18 and 44 years old (28.2%). The multivariable logistic regression analysis showed that after adjusting confounding factors, compared with the employed floating population who never consumed alcohol as the reference group, the OR values of insomnia for the employed floating population with moderate drinking and excessive drinking were 1.40 and 1.53, respectively. The OR values of insomnia for the male and female employed floating population with moderate drinking were 1.28 and 1.53. The OR values of insomnia for the male and female employed floating population with excessive drinking were both 1.46. The OR values of insomnia for the population aged 18-44 years and 45-59 years with excessive drinking were 1.41 and 1.27. The OR values of insomnia for the population aged 18-44 years and 45-59 years with excessive drinking were 1.55 and 1.37. Conclusion: Small amount of drinking and excessive drinking are associated with insomnia among the employed floating population in mainland China. The association between excessive drinking and insomnia is stronger than that between small amount of drinking and insomnia.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adulto Jovem
3.
J Infect ; 2021 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-34614399

RESUMO

OBJECTIVES: We aim to study the viral kinetics and host inflammatory response of RSV infection in older adults, and their correlation with disease severity. METHODS: We performed a prospective observational study in adults with RSV infection. We serially collected nasal-throat swabs for quantification of RSV-A and RSV-B viral load, and peripheral blood samples for measurement of cytokine/chemokine concentrations. The study endpoints were (i) requiring supplemental oxygen therapy, and (ii) non-invasive ventilation, intensive care, or died within 30 days of admission. We performed multivariable logistic regression models to identify independent variables for severe disease. RESULTS: We enrolled 71 hospitalized patients and 10 outpatients treated for RSV infection (median age 75 years, 51% male, and 74% with comorbidities). Among hospitalized patients, 61% required supplemental oxygen therapy, and 18% had severe disease requiring non-invasive ventilation or intensive care, or died within 30 days. Inflammatory cytokine/chemokines IL-6, CXCL8/IL-8, CXCL9/MIG and CXCL10/IP-10 increased significantly during the acute phase of illness. IL-6 concentration was independently associated with severe disease after adjusting for confounding factors. RSV viral load was not associated with disease severity throughout the course of illness. CONCLUSION: Host inflammatory response is a major marker of severe disease in older adults with RSV infection.

4.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(5): 915-920, 2021 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-34650294

RESUMO

OBJECTIVE: To investigate the clinical features and prognosis of acute myeloid leukemia (AML) patients with the mixed lineage leukemia (MLL) gene rearrangements AF6 (MLL-AF6) positive. METHODS: In the study, 11 patients who were newly diagnosed with MLL-AF6 positive AML were analyzed retrospectively, related literature was reviewed to clarify the clinical features and prognosis of MLL-AF6 positive patients. RESULTS: Among the 11 patients, there were 6 males and 5 females, with a median age of 36 years. Six patients were diagnosed with AML M5 and five with M4 according to FAB classification (French-American-British classification systems). Gingival swelling and pain occurred in 6 cases and fever occurred in 5 cases. At first diagnosis, the median white blood cells were 55.5×109/L. Immunotype showed the expression of myeloid/monocyte and early stem cell series antigens. The expression level of MLL-AF6 fusion gene (real-time quantitative PCR) was 14.2%-214.5%, and 6/11 cases (54.5%) were associated with high EVI1 gene expression. Mutations of KRAS, TET2, ASXL1, TP53, DNMT3A, and FLT3-ITD were detected by next generation sequencing (NGS) in 4 patients. Chromosome G banding examination showed that 2 cases were t(6;11)(q27, q23) with complex karyotype abnormality, 4 cases with +8 abnormality and 2 cases with normal karyotype. Hematological complete remission (CR) was achieved in 8/11 patients (72.7%) after conventional induction chemotherapy, and primary drug resistance was observed in 3 patients. Two of the eight patients with CR were negative for minimal residual disease (MRD), with a median CR duration of 4.5 months. Two patients with positive MRD and three patients with refractory recurrence underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), but all died due to leukemia progression. At the end of follow-up on December 1, 2019, 2 patients were alive and 9 died, with median survival time of 9 months. CONCLUSION: The AML patients with MLL-AF6 positive were mostly young, the majority of FAB types were M4 and M5, and most of the patients often had fever as the first symptom, with increased white blood cells, accompanied by organ infiltration, and high EVI1 gene expression. The hematological remission rate of routine chemotherapy is not low, but it is difficult to achieve molecular remission, most of which have early recurrence. Early allo-HSCT in a molecular negative state may prolong the CR duration.

6.
Zhonghua Bing Li Xue Za Zhi ; 50(9): 1098-1102, 2021 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-34496513
7.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 33(4): 387-395, 2021 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-34505446

RESUMO

OBJECTIVE: To analyze the changes of small molecular metabolites in the larvae of a deltamethrin-sensitive strain of Anopheles sinensis following exposure to deltamethrin, so as to provide the scientific basis for investigating the metabolic pathway and screening metabolic markers of deltamethrin in An. sinensis. METHODS: The 50% and 75% lethal concentrations (LC50 and LC75) of deltamethrin against the larvae of a deltamethrin-sensitive strain of An. sinensis were calculated in laboratory. The type and content of An. sinensis larvae metabolites were detected using high performance liquid chromatography and mass spectrometry (LC-MS/MS) following exposure to deltamethrin at LC50 and LC75 for 30 min and 24 h, and the changes of metabolites were analyzed. RESULTS: The LC50 and LC75 values of deltamethrin were 4.36 × 10-3 µg/mL and 1.12 × 10-2 µg/mL against thelarvae of a deltamethrin-sensitive strain of An. sinensis. Following exposure of the larvae of a deltamethrin-sensitive strain of An. sinensis to deltamethrin at LC50 and LC75 for 30 min, the differential metabolites mainly included organic oxygen compounds, carboxylic acid and its derivatives, fatty acyl and pyrimidine nucleotides, with reduced glucose levels. Following exposure for 24 h, the differential metabolites mainly included organic oxygen compounds, carboxylic acid and its derivatives, aliphatic acyl and purine nucleotides, with increased glucose level detected. CONCLUSIONS: Carbohydrate, carboxylic acid and its derivatives, fatty acyls, amino acids and their derivatives may play important roles in deltamethrin metabolism in the larvae of a deltamethrin-sensitive strain of An. sinensis.


Assuntos
Anopheles , Inseticidas , Animais , Cromatografia Líquida , Larva , Nitrilas , Piretrinas , Espectrometria de Massas em Tandem
8.
Artigo em Chinês | MEDLINE | ID: mdl-34521172

RESUMO

Objective: To investigate the sonographic features of primary thyroid lymphoma (PTL) and to evaluate the clinical significance of ultrasound-guided core needle biopsy (US-CNB) in PTL. Methods: A total of 24 patients with suspected PTL in Sir Run Run Shaw Hospital from January 2013 to June 2018 were analyzed retrospectively. All cases were confirmed by pathology, of them 23 patients received US-CNB and 1 patient chose operation without US-CNB, including 5 males and 19 females, aged from 39 to 75 years old. The effectiveness and safety of 23 patients with US-CNB were evaluated, and the sonographic features of 20 patients with PTL diagnosed by pathology were analyzed. Descriptive statistical methods were used in the study. Results: In the 23 patients with suspected PTL underwent US-CNB, 18 patients were diagnosed as PTL, 4 patients were respectively diagnosed as subacute thyroiditis, anaplastic carcinoma, Hashimoto's thyroiditis, and fibro thyroiditis, and the another patient was hard to diagnose by US-CNB and then was diagnosed as PTL by surgical biopsy. The success rate of US-CNB for diagnosis of PTL was 18/19, and no severe complications occurred in the patients with US-CNB. The other case was diagnosed as PTL by surgical biopsy without US-CNB. Sonographic features of 20 cases with PTL (18 cases diagnosed by US-CNB and 2 cases by surgery or surgery biopsy) were as follows: (1) Most nodules had irregular shapes and unsmooth margins; (2) Hypoechoic or markedly hypoechoic nodules with honeycombed or cord structures were observed in most cases; (3) Calcification was rare; (4) Multiple lesions were common; (5) Abundant intralesional vascularization was commonly observed; (6) Most cases had intensification of posterior acoustic enhancement; (7) Thyroid gland enlargement or with irregular shape; and (8) PTL often accompanied with lymph nodes enlargement in lateral neck or central region. Conclusion: PTL has certain sonographic features, with assistance of US-CNB, more accurate diagnosis of PTL can be obtained.


Assuntos
Linfoma , Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Adulto , Idoso , Biópsia com Agulha de Grande Calibre , Feminino , Humanos , Biópsia Guiada por Imagem , Linfoma/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Glândula Tireoide , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Ultrassonografia de Intervenção
9.
Zhonghua Xue Ye Xue Za Zhi ; 42(8): 666-672, 2021 Aug 14.
Artigo em Chinês | MEDLINE | ID: mdl-34547873

RESUMO

Objective: To investigate risk factors for early mortality (EM) in patients with newly diagnosed multiple myeloma (NDMM) and to build an EM-predictive model. Methods: In a cohort of 275 patients with NDMM, risk factors for EM at 6, 12, and 24 months after diagnosis (EM6, EM12, and EM24, respectively) were determined to establish a model to predict EM. Results: The rates of EM6, EM12, and EM24 were 5.5% , 12.7% , and 30.2% , respectively. The most common cause for EM was disease progression/relapse, accounting for 60.0% , 77.1% , and 84.3% of EM6, EM12, and EM24, respectively. EM6 was associated with corrected serum calcium >2.75 mmol/L and platelet count <100×10(9)/L, whereas risk factors for EM12 included age >75 years, ISS Ⅲ, R-ISS Ⅲ, corrected serum calcium >2.75 mmol/L, serum creatinine >177 µmol/L, platelet count <100×10(9)/L, and bone marrow plasma cell ratio ≥ 60% . In addition to the risk factors for EM12, EM24 was also associated with male sex and 1q21 gain. By multivariate analysis, age >75 years, platelet count <100×10(9)/L, and 1q21 gain were independent risk factors for EM24 but there were no independent risk factors significantly associated with EM6 and EM12. Using a scoring system including these three risk factors, a Cox model for EM24 was generated to distinguish patients with low (score<3) and high (score ≥ 3) risk. The sensitivity and specificity of the model were 20.7% and 99.2% , respectively. Further, an internal validation performed in a cohort of 183 patients with NDMM revealed that the probability of EM24 in high-risk patients was 26 times higher than that in low-risk patients. Moreover, this model was also able to predict overall survival. The median overall survival of patients with scores of 0, 1, 2, 3, 4, and 5 were 59, 41, 22, 17.5, and 16 months, respectively. Conclusion: In the study cohort, the EM6, EM12, and EM24 rates were 5.5% , 12.7% , and 30.2% , respectively, and disease progression or relapse were main causes of EM. An EM24-predictive model built on three independent risk factors for EM24 (age>75 years, platelet count<100×10(9)/L, and 1q21 gain) might predict EM risk and overall survival.


Assuntos
Mieloma Múltiplo , Idoso , Humanos , Masculino , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos , Fatores de Risco
10.
Zhonghua Er Ke Za Zhi ; 59(10): 853-858, 2021 Oct 02.
Artigo em Chinês | MEDLINE | ID: mdl-34587682

RESUMO

Objective: To summarize the clinical features and therapeutic outcomes of patients with hyperinsulinemic hypoglycemia (HH) auxiliarily diagnosed by 18F-DOPA positron emission tomography (PET) CT scanning. Methods: The clinical data of 123 patients who were diagnosed with hyperinsulinemic hypoglycemia by comprehensive clinical diagnostic procedures in the Department of Pediatric Endocrinology and Inherited Metabolic Diseases, Children's Hospital of Fudan University between January 2016 and December 2020 were retrospectively analyzed. Clinical data such as gender, age of onset, province, concurrent serum insulin level measured during hypoglycemia, lesion type of pancreas by 18F-DOPA-PET CT scanning, genetic test results, and treatment were collected successively. The clinical features and therapeutic outcomes were compared between patients with focal and diffuse pancreatic lesions. T test, Rank sum test, and χ² test were used for comparison between groups. Results: A total of 123 patients with hyperinsulinemic hypoglycemia (72 males and 51 females), whose average age of onset was 3 days (ranging from 1 day to 4 860 days), were recruited from 24 provinces. The concurrent serum insulin level was 7.1 (0.4-303.0) mU/L during hypoglycemia. 18F-DOPA-PET CT scanning identified focal lesions in 25.2% (31/123) and diffuse lesions in 74.8% (92/123) of the patients; 64.2% (79/123) of the HH cases were found to have pathogenic gene variants, in which 88.6% (70/79) were found to have KATP channel related genes (61 in ABCC8 and 9 in KCNJ11 mutations). Thirty-seven patients (17 focal and 20 diffuse) received surgical treatment with a success rate of 67.6% (25/37). The effective rate of diazoxide for children with diffuse type was significantly higher than that of children with focal group (28.3% (26/92) vs. 9.7% (3/31), χ²=10.31, P=0.001). Conclusions: 18F-DOPA-PET CT scan can improve the success rate of surgery. Comprehensive diagnosis of the etiology of hyperinsulinemic hypoglycemia by genetic analysis and 18F-DOPA-PET CT scanning can result in better treatment and prognosis.


Assuntos
Hiperinsulinismo Congênito , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Criança , Hiperinsulinismo Congênito/diagnóstico por imagem , Hiperinsulinismo Congênito/tratamento farmacológico , Hiperinsulinismo Congênito/genética , Di-Hidroxifenilalanina/análogos & derivados , Feminino , Humanos , Masculino , Tomografia por Emissão de Pósitrons , Estudos Retrospectivos
11.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(8): 1226-1233, 2021 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-34549715

RESUMO

OBJECTIVE: We propose an efficient method to reduce the noise in low-dose cerebral perfusion CT images using prior image constrained diffusion tensor to reduce the radiation dose in brain CT examination. METHODS: By utilizing the redundant information in cerebral perfusion CT images, we embedded the complementary structure information in prior images into lowdose cerebral perfusion CT image restoration process to suppress the image noise and artifacts.We first calculated the diffusion tensor for the low-dose cerebral perfusion CT image and prior image separately and then constructed a prior image constrained diffusion tensor (PICDT) to incorporate the structure information from the prior image into low-dose image restoration process. RESULTS: In experiments with the Shepp-Logan phantom, the SSIM value of CBF map obtained by the proposed algorithm was increased by 63% as compared with that of the FBP algorithm.In analysis of the clinical dataset, the SSIM value of CBF map obtained by the proposed algorithm was increased by 45% as compared with that of FBP algorithm. CONCLUSION: The proposed method can effectively reduce noises and artifacts of low-dose cerebral perfusion CT images while maintaining the structural details to obtain accurate cerebral hemodynamic maps.


Assuntos
Algoritmos , Tomografia Computadorizada por Raios X , Artefatos , Circulação Cerebrovascular , Processamento de Imagem Assistida por Computador , Imagens de Fantasmas , Doses de Radiação
12.
Zhonghua Jie He He Hu Xi Za Zhi ; 44(10): 902-908, 2021 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-34565118

RESUMO

Objective: To investigate the clinical features and pathogenesis of spontaneous regression of lymphoma involving the respiratory system. Methods: Two cases of pulmonary lymphoma which regressed spontaneously were reported. Literatures with"spontaneous regression, lymphoma""spontaneous remission, lymphoma"published before February 2020 were searched in Wanfang, CNKI and Pubmed database. And cases with respiratory system involvement of lymphoma which regressed spontaneously were analyzed. A total of 22 cases were finally retrieved. There were 6 males and 16 females, with an average age of (62.5±16.8) years. Results: Common symptoms included dyspnea, cough, expectoration, fever and weakness. Imaging examination showed that any parts in respiratory system could be involved. The proportion of invasive and indolent lymphomas was approximately similar. The time interval between diagnosis of lymphoma and first sign of spontaneous regression of the disease was from 2 weeks to 1 year. Spontaneous regression of the disease could sustain from 50 days to 60 months. Moreover, 78.6% of patients achieved complete remission in their courses of treatment, and some patients showed wax and wane phenomena. Conclusions: Spontaneous regression of lymphoma may occur in any part of the respiratory system. When a patient exhibits spontaneous regression of pulmonary lesions, lymphoma should be considered in the differential diagnoses. Pathology study is needed to achieve a definitive diagnosis. Misdiagnosis and delayed diagnosis related to empirical treatment of antibiotics and corticosteroid should be avoided.


Assuntos
Neoplasias Pulmonares , Linfoma , Idoso , Tosse , Dispneia , Feminino , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade
13.
Zhonghua Bing Li Xue Za Zhi ; 50(7): 734-739, 2021 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-34405606

RESUMO

Objective: To analyze the clinicopathological and molecular features and prognostic implications of adult isocitrate dehydrogenase wild type (IDH-wt) diffuse gliomas. Methods: A total of 87 cases of adult IDH-wt diffuse gliomas from 2016 to 2020 in Xuanwu Hospital of Capital Medical University were retrospectively collected. The clinicopathological characteristics and prognosis were analyzed. Molecular characteristics were also analyzed using Sanger sequencing and next generation sequencing. Results: There were 53 males and 34 females, aged from 19 to 78 years (mean 53 years). Histopathologically, there were 63 (72.4%) glioblastomas, 16 (18.4%) anaplastic astrocytomas, six (6.9%) diffuse astrocytomas, and one (1.1%) each of anaplastic oligodendrocytoma, and anaplastic oligodendroglioma. Common molecular genetic changes in IDH-wt gliomas included TERT promoter mutation which was found in 60 cases (69.0%); MGMT promoter methylation in 43 cases (49.4%); EGFR mutation in 38 cases (43.7%); PTEN mutation in 35 cases (40.2%) and TP53 mutation in 32 cases (36.8%). In addition, PDGFRA mutation was detected in 17 cases (19.5%), CDK4 amplification in 15 cases (17.2%) and MDM2 amplification in 11 cases (12.6%). In IDH-wt diffuse gliomas, there was no significant difference in the overall survival between TERT promoter, EGFR, PTEN, TP53, PDGFRA, CDK4, MDM2 mutations and the wild-type, since these gene mutations could co-occur in any case (P>0.05). Also there was no significant difference in the overall survival between the WHO grade Ⅱ/Ⅲ gliomas and glioblastoma patients with these gene mutations (P>0.05). Conclusions: TERT promoter, EGFR, PTEN, TP53, PDGFRA, CDK4 and MDM2 gene mutations are common molecular genetic changes in adult IDH-wt gliomas, and are associated with poor prognosis. It is suggested that these genes are potentially useful for predicting the prognosis and should be tested in adult IDH-wt gliomas.


Assuntos
Neoplasias Encefálicas , Glioma , Telomerase , Adulto , Neoplasias Encefálicas/genética , Feminino , Glioma/genética , Humanos , Isocitrato Desidrogenase/genética , Masculino , Biologia Molecular , Mutação , Prognóstico , Estudos Retrospectivos , Telomerase/genética
14.
Zhonghua Bing Li Xue Za Zhi ; 50(7): 745-750, 2021 Jul 08.
Artigo em Chinês | MEDLINE | ID: mdl-34405608

RESUMO

Objective: To unravel the CIC rearrangement sarcomas and BCOR-CCNB3 sarcomas from EWSR1 rearrangement-negative undifferentiated round cell sarcomas in the bone and soft tissues. Methods: Twenty-eight cases of EWSR1 rearrangement-negative undifferentiated round cell sarcomas of bone and soft tissues, tested for CIC rearrangement and BCOR rearrangement by fluorescence in situ hybridization and related immunostaining were analyzed, and some of the BCOR rearrangement cases were verified by reverse transcription-polymerase chain reaction. Results: Five of 28 (17.9%) tested cases were positive for CIC rearrangement and six (21.4%) for BCOR rearrangement. Histopathologically, CIC rearrangement sarcomas comprised nodular aggregates of round to polygonal cells, containing hyperchromatic nuclei, prominent nucleoli and moderate cytoplasm, with focal variable necrosis and myxoid stroma. BCOR-CCNB3 sarcomas mostly comprised diffusely arranged, round to oval to short spindly cells with angulated nuclei, vesicular chromatin, inconspicuous nucleoli and interspersed vessels. Immunohistochemically, five of six BCOR-CCNB3 sarcomas showed CCNB3 immunostaining, which could be helpful for diagnosis. Two patients with CIC rearrangement sarcoma died of the diseases in seven months and twenty-two months. One patient with BCOR-CCNB3 sarcoma died of the diseases in forty-six months. Conclusions: Overall, 39.3% of the EWSR1 rearrangement-negative undifferentiated round cell sarcomas are CIC rearrangement sarcomas and BCOR-CCNB3 sarcomas. Molecular testing is helpful for diagnosis.


Assuntos
Biomarcadores Tumorais , Sarcoma , Biomarcadores Tumorais/genética , Rearranjo Gênico , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Proteínas de Fusão Oncogênica/genética , Proteínas Proto-Oncogênicas/genética , Proteína EWS de Ligação a RNA/genética , Proteínas Repressoras/genética , Sarcoma/genética
15.
Zhonghua Yi Xue Za Zhi ; 101(30): 2400-2404, 2021 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-34404134

RESUMO

Objective: To investigate the value of serum cystatin C for the evaluation of renal function damage in patients with proliferative diabetic retinopathy (PDR). Methods: The clinical data of PDR patients treated in ophthalmic wards of Beijing Tongren Hospital from July 2019 to January 2021 were retrospectively analyzed. The estimated glomerular filtration rate (eGFR) was calculated by the abbreviated Modification of Diet in Renal Disease (MDRD) study equation. Based on the eGFR level, the patients were divided into no obvious renal function damage group [≥ 60 ml·min⁻¹·(1.73 m2)⁻1] and renal inadequacy group [<60 ml·min⁻¹·(1.73 m2)⁻1]. The clinical characteristics between the two groups were compared. Multivariate logistic regression analysis was performed to identify the relevant factors of renal inadequacy. The value of cystatin C to predict the renal inadequacy was calculated by the receiver operating characteristic (ROC) curves. Results: A total of 1 009 patients [593 males and 416 females; mean age: (52±12) years] were finally included in the study, with 192 cases (19.0%) and 817 cases (81.0%) in renal inadequacy group and no obvious renal function damage group, respectively. There were no significant statistically differences in gender, age, diastolic blood pressure, body mass index, fasting blood glucose and low-density lipoprotein between the two groups (all P>0.05). The systolic blood pressure, blood urea nitrogen, creatinine, uric acid, triglyceride, cholesterol and cystatin C were higher in the renal inadequacy group than those of no obvious renal function damage group (all P<0.05). However, the glycosylated hemoglobin, albumin and high-density lipoprotein were lower in the renal inadequacy group (all P<0.05). Multivariate logistic regression analysis showed that serum creatinine (OR=1.189, 95%CI: 1.101-1.284, P<0.001) and cystatin C (OR=3.175, 95%CI: 1.272-7.923, P=0.013) were independent risk factors for renal inadequacy in PDR patients. The ROC curve showed that cystatin C had a predictive value for renal inadequacy, with an area under the curve (AUC) of 0.966 (95%CI: 0.952-0.979). Meanwhile, the cutoff value was 1.315 mg/L, and the Youden index was 0.826, with the sensitivity of 94.3% and specificity of 88.4%. Conclusion: Serum cystatin C can be used as an important laboratory indicator to evaluate the renal impairment in PDR patients.


Assuntos
Diabetes Mellitus , Retinopatia Diabética , Adulto , Biomarcadores , Creatinina , Cistatina C , Feminino , Taxa de Filtração Glomerular , Humanos , Rim/fisiologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos
16.
Am J Hypertens ; 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34424290

RESUMO

BACKGROUND: The in utero pathologies underlying the link between preterm birth and offspring high blood pressure (BP) are still unknown. We investigated the prospective association of placental histopathological findings among preterm births with childhood BP. METHODS: Our prospective birth cohort included 546 mother-child pairs with preterm birth enrolled from 1999 to 2013 at the Boston Medical Center. Early preterm birth was defined as gestational age between 23 and 34 weeks. We histologically classified maternal placental pathology using the latest recommended categories: no placental complications, histologic chorioamnionitis, maternal vascular malperfusion, and other placental complications. We calculated age-, sex- and height-specific systolic BP (SBP) percentiles for children using the 2017 American Academy of Pediatrics Hypertension guideline US reference. We used linear regression models with generalized estimating equations (GEE) to examine the associations. RESULTS: The mean (SD) postnatal follow-up of the study children was 9.29 (4.1) years. After adjusting for potential confounders, histologic chorioamnionitis was associated with 5.42 percentile higher childhood SBP (95% CI: 0.32, 10.52) compared to no placental pathologic findings. This association was stronger among early preterm children. Maternal vascular malperfusion was associated with 8.44 percentile higher childhood SBP among early preterm children (95% CI: 1.54, 15.34) but the association was attenuated [6.25 higher SBP percentile (-0.76, 13.26)] after additional adjustment for child standardized birthweight, a potential mediator of the association. CONCLUSIONS: These findings suggest that among children born preterm, especially those born early preterm, both placental histologic chorioamnionitis and vascular malperfusion may further modify a child's risk of high BP.

17.
Beijing Da Xue Xue Bao Yi Xue Ban ; 53(4): 697-703, 2021 Aug 18.
Artigo em Chinês | MEDLINE | ID: mdl-34393231

RESUMO

OBJECTIVE: To evaluate urinary continence recovery time and risk factors of urinary continence recovery after robot-assisted laparoscopic radical prostatectomy (RARP). METHODS: From January 2019 to January 2021, a consecutive series of patients with localized prostate cancer (cT1-T3, cN0, cM0) were prospectively collected. RARP with total anatomical reconstruction was performed in all the cases by an experienced surgeon. Lymph node dissection was performed if the patient was in high-risk group according to the D'Amico risk classification. The primary endpoint was urinary continence recovery time after catheter removal. Postoperative and pathological variables were analyzed. Continence was rigo-rously analyzed 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after catheter removal. Continence was evaluated by recording diaper pads used per day, and all the patients were instructed to perform the 24-hour pad weight test until full recovery of urinary continence. The patient was defined as continent if no more than one safety pad were needed per day, or no more than 20-gram urine leakage on the 24-hour pad weight test. Time from catheter removal to full recovery of urinary continence was recorded, and risk factors influencing continence recovery time evaluated. RESULTS: In total, 166 patients were analyzed. The mean age of the enrolled patients was 66.2 years, and the median prostate specific antigen (PSA) was 8.51 µg/L. A total of 59 patients (35.5%) had bilateral lymphatic dissection, and 28 (16.9%) underwent neurovascular bundle (NVB) preservation surgery. Postoperative pathology results showed that stage pT1 in 1 case (0.6%), stage pT2 in 77 cases (46.4%), stage pT3 in 86 cases (51.8%), and positive margins in 28 patients (16.9%). Among patients who underwent lymph node dissection, lymph node metastasis was found in 7 cases (11.9%). Median continence recovery time was one week. The number of the continent patients at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 65 (39.2%), 32 (19.3%), 34 (20.5%), 24 (14.5%), and 9 (5.4%). Two patients remained incontinent 24 weeks after catheter removal. The continence rates after catheter removal at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 39.2%, 58.4%, 78.9%, 93.4%, and 98.8%, respectively. Univariate COX analysis revealed that diabetes appeared to influence continence recovery time (OR=1.589, 95%CI: 1.025-2.462, P=0.038). At the end of 48 hours, 4 weeks, 12 weeks, and 24 weeks after catheter removal, the mean OABSS score of the continent group was significantly lower than that of the incontinent group. CONCLUSION: RARP showed promising results in the recovery of urinary continence. Diabetes was a risk factor influencing continence recovery time. Bladder overactive symptoms play an important role in the recovery of continence after RARP.


Assuntos
Neoplasias da Próstata , Robótica , Incontinência Urinária , Idoso , Humanos , Masculino , Prostatectomia , Neoplasias da Próstata/cirurgia , Recuperação de Função Fisiológica , Resultado do Tratamento , Incontinência Urinária/epidemiologia , Incontinência Urinária/etiologia
18.
Zhonghua Er Ke Za Zhi ; 59(8): 684-688, 2021 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-34333922

RESUMO

Objective: To explore the clinical value of sacral magnetic stimulation (SMS) combined with rehabilitation training in the treatment of primary nocturnal enuresis (PNE) in children. Methods: The clinical data of 57 children with PNE admitted to the Department of Rehabilitation Xuzhou Rehabilitation Hospital, Xuzhou Central Hospital and Xuzhou Children's Hospital from October 2019 to September 2020 were collected and analyzed. The children were divided prospectively into observation group and control group by using random number table method. Bladder function training, awakening training and life and psychological intervention were performed in both groups, while the observation group was treated with SMS based on the above treatment methods. Before and after treatment, the degree and the frequency of enuresis (normal, mild, moderate, severe), therapeutic evaluation and bladder volume were compared. Chi-square test and T test were used for comparison between the two groups. Results: Finally, 28 cases in the observation group and 29 cases in the control group were included. There was no significant difference in age, sex, degree and of frequency enuresis of children between the two groups (all P>0.05).The degree of enuresis in the observation group after 1 month of treatment was better than that in the control group (12 vs. 7 cases, 8 vs. 8 cases, 5 vs. 9 cases, 3 vs. 5 cases, χ2=-2.269, P=0.030). Enuresis times in observation group was lower than that in the control group [(4.2±1.8) vs. (8.1±2.0), t=4.475, P<0.01). The total effective rate and bladder capacity of efficacy evaluation were higher than those of control group [82%(23/28) vs. 48%(14/29), (225±25) vs. (199±21) ml, Z=11.238, t=-2.249, both P<0.05]. Conclusions: SMS is an effective method for the treatment of PNE in children, which can reduce the degree and frequency of enuresis in children, increase the bladder volume and improve the total effective rate of treatment. It is worthy of clinical promotion and application.


Assuntos
Enurese Noturna , Criança , Humanos , Fenômenos Magnéticos , Enurese Noturna/terapia
20.
Zhonghua Yi Xue Za Zhi ; 101(32): 2544-2551, 2021 Aug 24.
Artigo em Chinês | MEDLINE | ID: mdl-34407581

RESUMO

Objective: To evaluate the cost-effectiveness of anti-tumor associated antigen autoantibody (TAAb) for hepatocellular carcinoma (HCC) screening in cirrhosis population with chronic hepatitis B (CHB). Methods: A simulated cohort of 40-year-old patients with CHB cirrhosis was established with a sample size of 10 000. Using TAAb screening alone or TAAb and AFP screening in parallel (TAAb + AFP) as the research strategy, and liver ultrasound and AFP screening in parallel (liver ultrasound + AFP) as the control strategy, the decision analysis Markov model was constructed and the model validity was evaluated. The 6-month cycle was simulated using TreeAge Pro 2020 software. Cost and quality-adjusted life years (QALY) were calculated. Incremental cost-effectiveness ratio (ICER) was used to compare the two strategies, and sensitivity analysis was used to evaluate the uncertainty of results. Results: The Markov model had a total of 11 outcomes, of which 7 were natural outcomes and 4 wereclinical intervention outcomes, and the goodness of fit was 0.969. The lifetime screening cost of TAAb+AFP strategy for HCC screening was 249 612 yuan/case, and the QALY per capita was 7.704 years. Compared with liver ultrasound +AFP strategy (247 805 yuan/case), the total health cost increased by 1 807 yuan/case, and the QALY obtained was 0.014. The ICER was 127 635 yuan /QALY. When the TAAb screening fee was higher than 889.552 yuan, or the discount rate was higher than 0.068, or the antiviral treatment compliance was lower than 45.1%, ICER > 212 676 yuan /QALY. When the single TAAb screening fee was 400-600 yuan, the TAAB+AFP strategy had cost effective value. When the willingness to pay was 70 892, 141 784 and 212 676 yuan /QALY, the probability of cost-effectiveness of TAAb+AFP strategy was 70.6%, 75.3% and 77.8%, respectively. Conclusion: It is cost-effective to use TAAb+AFP for early screening of liver cancer in Chinese population with CHB cirrhosis.


Assuntos
Carcinoma Hepatocelular , Hepatite B Crônica , Neoplasias Hepáticas , Adulto , Análise Custo-Benefício , Hepatite B Crônica/complicações , Humanos , Cirrose Hepática , Neoplasias Hepáticas/diagnóstico
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