Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.734
Filtrar
1.
J Orthop Translat ; 30: 70-81, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34611516

RESUMO

Background: In patients with traumatic brain injury (TBI) combined with long bone fracture, the fracture healing is always faster than that of patients with single fracture, which is characterized by more callus growth at the fracture site and even ectopic ossification. Exosomes are nanoscale membrane vesicles secreted by cells, which contain cell-specific proteins, miRNAs, and mRNAs. Methods: In this study, we used exosomes as the entry point to explore the mechanism of brain trauma promoting fracture healing. We established a model of tibia fracture with TBI in mice to observe the callus growth and expression of osteogenic factors at the fracture site. Blood samples of model mice were further collected, exosomes in plasma were extracted by ultra-centrifugation method, and then identified and acted on osteoblasts cultured in vitro. The effects of exosomes on osteoblast differentiation at the cell, protein and gene levels were investigated by Western Blot and q-PCR, respectively. Furthermore, miRNA sequencing of exosomes was performed to identify a pattern of miRNAs that were present at increased or decreased levels. Results: The results suggested that plasma exosomes after TBI had the ability to promote the proliferation and differentiation of osteoblasts, which might be due to the increased expression of osteoblast-related miRNA in exosomes. They were transmitted to the osteoblasts at the fracture site, so as to achieve the role of promoting osteogenic differentiation. Conclusion: The TBI-derived exosomes may have potential applications for promoting fracture healing in future. The Translational Potential of this Article: Plasma exosomes early after TBI have the ability to promote osteoblast proliferation and differentiation. The mechanism may be achieved by miRNA in exosomes. Plasma exosomes may be used as breakthrough clinical treatment for delayed or non-union fractures.

2.
Ultrasound Med Biol ; 2021 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-34598799

RESUMO

This study was aimed at revising the LI-RADS M category (LR-M) criteria to improve the diagnostic performance categories LR-5 and LR-M of the contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System (LI-RADS) Version 2017. We enrolled 264 patients (264 nodules) with a risk for hepatocellular carcinoma (HCC). The nodules were assigned specific CEUS LI-RADS categories. Washout onset times for all nodules were noted. The diagnostic performance of LR-5 and LR-M was analyzed based on the different early washout criterion for the LR-M category. The positive predictive values in LR-5, LR-4 and LR-3 were 98.6%, 72.2% and 16.7%, respectively, and that for non-HCC malignancies in LR-M was 25.0%. Patients in the LR-M category were reclassified using 45 s as the early washout criterion. LR-5 had higher sensitivity (65.5% vs. 76.2%, p = 0.012) and area under the receiver operating characteristic curve (0.80 vs. 0.85, p = 0.001) for HCC diagnosis after reclassification. LR-M also had higher specificity (71.4% vs. 81.3%, p = 0.010) in diagnosing non-HCC malignancies after reclassification. Our findings suggest CEUS LR-5 is effective for HCC diagnosis. The use of 45 s as the time criterion of early washout for LR-M can improve LR-5 and LR-M performance in the diagnosis of HCC and non-HCC malignancies, respectively.

3.
BMC Med Educ ; 21(1): 532, 2021 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-34649532

RESUMO

BACKGROUND: Vertigo and dizziness (VD) are among the most frequently seen symptoms in clinics and are important for medical students, especially for those in Chinese standardized residency training (SRT). The aim of our study was to examine the PAL method's feasibility in the clinical teaching of VD-related diseases for SRT students in China. METHODS: This is a randomized, controlled, multicenter study. A total of 228 residents were invited to participate in this study, of which 198 completed the program. The students were randomized into two groups, and VD-related diseases were taught using lecture-based learning (control group) or peer-assisted learning (PAL). An examination paper and a rating scale were used to evaluate students' performance in the mastery of VD-related theoretical knowledge and clinical skills, meanwhile students' perceptions, satisfaction, and risk of burnout were also analyzed using a questionnaire. Independent-samples t-test and chi-square analysis were performed to evaluate statistical significance for continuous variables and categorical variables, respectively, using SPSS 18.0 software. RESULTS: The PAL group performed better in mastering theoretical knowledge and clinical skills than the control group. And more students believed that PAL could help improve their personal qualities such as teamwork skills. However, more students reported that PAL increased the risk of burnout. CONCLUSIONS: PAL was a suitable and effective method in the clinical teaching of some specialized diseases, especially it was recommended for students who had gained initial knowledge and skills, such as Chinese SRT students. However, we should draw attention to the increased risk of burnout if PAL is intended to be widely used in clinical teaching. TRIAL REGISTRATION: ISRCTN registry, ISRCTN53773239 , 05/07/2021, retrospectively registered.


Assuntos
Educação de Graduação em Medicina , Internato e Residência , Estudantes de Medicina , China , Tontura , Humanos , Grupo Associado , Ensino , Vertigem/diagnóstico
4.
Neuropsychologia ; 162: 108043, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34600892

RESUMO

A fearful face as second visual target (T2) was detected better than a neutral T2 in a Rapid Serial Visual Presentation (RSVP) task. The advantage of fear over neutral emotion was originally attributed to a limited-capacity mechanism, in which fearful stimuli are prioritized for attention over neutral stimuli. However, more recent studies have shown that the prioritization of the processing of fear is strongly dependent on the emotional task relevance. Combining the RSVP task and Garner's paradigm, by varying the expression (fearful and neutral faces) and the emotional task relevance of the T2 (relevance: emotion classification task; irrelevance: gender classification task), this study aims to investigate the role of emotional task relevance on the advantage of fear during an RSVP task in which participants have to identify two visual targets in a stream of distractors. The behavioral results revealed that there was no significant effect of the expression on the task performance in the gender classification task. Fearful faces were easier to detect than neutral faces, but the T2 accuracy of fearful faces was lower than that of neutral faces in the emotion classification task. Furthermore, we found that the vertex positive potential and P100 components were enhanced for fearful faces compared to neutral faces independent of the emotional task relevance. For the P300 component, there was no significant difference in the gender classification task, but fearful faces elicited enhanced P300 amplitudes compared to neutral faces in the emotion classification task. These results indicated that the early processing of fear is automatic, while the late processing of fear is dependent on the emotional task relevance under limited attentional resources.

5.
J Int Med Res ; 49(10): 3000605211052229, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34657512

RESUMO

Peripheral T-cell lymphoma accounts for about 10% of all cases of non-Hodgkin's lymphoma. However, less than 5% of patients with non-Hodgkin's lymphoma present with hypercalcaemia as the initial symptom, and less than 1% present with primary bone lesions. We herein describe a 76-year-old Chinese man who was diagnosed with primary bone adult T-cell lymphoma with extensive osteolysis, including bone loss in the radius, as the initial manifestation. He had developed severe generalised bone pain and an inability to raise his arms. X-ray examination revealed osteolytic destruction of the forearm with loss of the radial diaphysis. The patient was diagnosed with peripheral T-cell lymphoma based on his immunohistochemical results. He began treatment with the CHOPE chemotherapy regimen, which resulted in significant improvement of his bone pain.


Assuntos
Neoplasias Ósseas , Hipercalcemia , Linfoma de Células T Periférico , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/tratamento farmacológico , Osso e Ossos , Humanos , Linfoma de Células T Periférico/diagnóstico por imagem , Linfoma de Células T Periférico/tratamento farmacológico , Masculino , Linfócitos T
6.
Am J Transl Res ; 13(9): 10262-10275, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650695

RESUMO

Breast cancer (BC) is a common malignant tumor in women and exhibits a poor prognosis. This study examined the role and underlying mechanisms of long non-coding RNA (lncRNA), metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in BC pathogenesis. The MALAT1 expression levels in BC cells and tissues were measured using quantitative reverse transcription-polymerase chain reactions. CCK-8 kits and wound healing and transwell assays were used to evaluate the cell growth, invasion, and migration of BC. Bioinformatics and dual-luciferase reporter analyses were conducted to identify MALAT1's potential targets. The protein levels in the mTOR/PKM2 pathway were assessed using Western blot analyses. The MALAT1 overexpressions in the BC tissues and cells were considered to be a predictor of poor prognosis. Therefore, MALAT1 downregulation significantly inhibited BC progression, including cell growth, invasion, and migration. MALAT1 was anticipated to be an miR-101-3p target according to the dual-luciferase reporter gene assay results. The miR-101-3p levels were indirectly proportional to the MALAT1 expressions and the suppressed BC cells. Additionally, the mTOR/PKM2 pathway was directly targeted by miR-101-3p. MALAT1 overexpression significantly decreased the miR-101-3p gene levels and increased the mTOR/PKM2 pathway protein expressions. This miR-101-3p inhibition blocked MALAT1. These findings suggest that lncRNA MALAT1 is related to BC pathogenesis using the miR101-3p/mTOR/PKM2 pathway and is a potential therapeutic target.

7.
Am J Transl Res ; 13(9): 10744-10750, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34650750

RESUMO

OBJECTIVE: To investigate the value of confocal microscopy in determining the morphology of the tarsal gland after cataract phacoemulsification. METHODS: A total of 74 patients (74 eyes) who underwent phacoemulsification for a monocular cataract and intraocular lens implantation (all were single eye surgeries) in our hospital from May 2018 to October 2018 were recruited as the study cohort, with 43 male patients and 31 female patients, and a mean age of (64.8±12.5) years old. All the patients were followed up for 6 months, of whom 25 cases with MGD were included in the MGD group and 49 cases without MGD were included in the control group. All the patients were examined within 30 days and underwent IVCM inspections of the acinar morphology of the tarsal glands (expansion and atrophy), the infiltration of the inflammatory cells in the tarsal gland tissue, and a classification of the fibrosis in the tarsal gland tissue. RESULTS: The longest and shortest acinar diameters in the MGD patients were significantly greater than they were in the control group, but the acinar areas were smaller than they were in the control group. The meibomian glandular vesicle densities, the average opening diameters, the fibrosis, and the inflammatory cell density in the MGD group were significantly increased. CONCLUSION: IVCM plays a vital role in the early diagnosis, in the severity grading, and in the evaluation of the clinical effectiveness of MGD-related diseases, by which the morphological changes of the tarsal gland after phacoemulsification can be observed in a timely manner to predict the occurrence of MGD.

8.
Ann Palliat Med ; 10(9): 9702-9714, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628896

RESUMO

BACKGROUND: Metabolic-associated fatty liver disease (MAFLD) is highly prevalent in type 2 diabetes mellitus (T2DM) patients and can rapidly progress to steatohepatitis, liver fibrosis, and hepatocellular carcinoma (HCC). Accurate evaluation and proper management of MAFLD can help prevent adverse liver outcomes. Here we evaluated the precision of the FibroTouch (FT) in the staging of liver steatosis and fibrosis in patients with MAFLD combined with T2DM using two indicators: controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). METHODS: Eighty-five adult MAFLD combined with T2DM patients were selected at our center from July 2016 to July 2019 and underwent liver puncture biopsy for histopathology and the FT assay simultaneously. Two blinded pathologists independently reviewed the samples. The severity of fatty liver was classified using two scoring systems: the nonalcoholic fatty liver disease activity score (NAS) and the fibrosis score. Scores were then assessed following the Pathology Working Group of the NASH Clinical Research Network of the National Institutes of Health. Similarly, the severity of nonalcoholic steatohepatitis (NASH) was classified using the European Steatosis Activity Fibrosis (SAF) system. The FT assay was applied to obtain the LSM and the CAP. FT accuracy in diagnosing steatosis and fibrosis was determined by the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUROC). RESULTS: Using biopsy analysis as the gold standard, the AUROCs and cutoff values of CAP in diagnosing liver steatosis were as follows: 0.84 (95% CI: 0.67-1.01) and 278 dB/m for S ≥ S1, 0.88 (95% CI: 0.81-0.95) and 305 dB/m for S ≥ S2, 0.89 (95% CI: 0.82-0.95) and 307 dB/m for S ≥ S3. The AUROCs and cutoff values of LSM in diagnosing liver fibrosis were as follows: 0.76 (95% CI: 0.66-0.86) for F ≥ F2, 0.81 (95% CI: 0.71-0.91) and 13.8 kPa for F ≥ F3, 0.92 (95% CI: 0.85-1.00) and 20.1 kPa for F ≥ F4. CONCLUSIONS: In patients of MAFLD with T2DM, CAP and LSM obtained by FT are highly accurate in assess liver steatosis and fibrosis, respectively, with AUROC values ranging from 0.76 to 0.92.


Assuntos
Carcinoma Hepatocelular , Diabetes Mellitus Tipo 2 , Técnicas de Imagem por Elasticidade , Neoplasias Hepáticas , Hepatopatia Gordurosa não Alcoólica , Adulto , Humanos , Cirrose Hepática , Estados Unidos
9.
Small ; : e2103091, 2021 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-34643034

RESUMO

Hydrogel electrolytes have attracted enormous attention in flexible and safe supercapacitors. However, the interfacial contact problem between hydrogel electrolyte and electrodes, and the environmental instability are the key factors restricting the development of hydrogel-based supercapacitors. Here, a nucleotide-tackified adhesive organohydrogel electrolyte is successfully constructed and exhibits freezing resistance and water-holding ability based on the water/glycerol binary solvent system. Adenosine monophosphate enables the organohydrogels to possess outstanding adhesion and mechanical robustness. The robust adhesion can ensure close contact between the organohydrogel electrolyte and electrodes for constructing an all-in-one supercapacitor with low interfacial contact resistance. Impressively, the integrated organohydrogel-based supercapacitors display an areal specific capacitance of 163.6 mF cm-2 . Besides, the supercapacitors feature prominent environmental stability with capacitance retention of 90.6% after 5000 charging/discharging cycles at -20 °C. Furthermore, based on the strong interfacial adhesion, the supercapacitors present excellent electrochemical stability without delamination/displacement between electrolyte and electrodes even under severe deformations such as bending and twisting. It is anticipated that this work will provide an encouraging way for developing flexible energy storage devices with electrochemical stability and environmental adaptability.

10.
Oecologia ; 2021 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-34647165

RESUMO

A shift to higher temperatures has left the Mediterranean Europe and Northern Africa (MENA) region more vulnerable to drought and land degradation. We used MODIS LAI (leaf area index) and GPP (gross primary production) deficits, the differences between actual and historical-maximum values, to describe vegetation structural and functional changes and consequential landcover change in response to changing climate conditions during 2001-2019 in the area (20° W-45° E, 20° N-45° N). We found that 1) the vegetation responses varied significantly among eight landcover types with the decreasing importance: forests, savannas, a mosaic of cropland and natural vegetation (CNV), croplands, permanent wetlands, urban land, grasslands, and shrublands, each with distinctive yet overlapping signatures over the ranges of the climate conditions considered. 2) Forests, occupying the coolest and wettest niche, showed the strongest response to severe drought with a lag of 1-3 years and a legacy effect for 10 years. Shrubs, occupying the hottest and driest niche, were the most resilient under a hotter and drier climate. 3) The total areas of savannas and CNV increased by 394,994 and 404,592 km2, respectively, while that of forests decreased by 33,091 km2. Shrublands extended by 287,134 km2 while grasslands and croplands retreated by 490,644 and 225,263 km2. The area of wetlands increased by 49,192 km2, and that of urban land increased by 39,570 km2. A total of 57,649 km2 of barren land became vegetated over the years. Along with higher temperature and more extended period of drought, MENA has evolved towards a shrubbier landscape.

11.
J Orthop Surg Res ; 16(1): 616, 2021 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-34663366

RESUMO

BACKGROUND: Collagens are important structural components of intervertebral disc. A number of studies have been performed for association between polymorphisms of collagen genes and risk of intervertebral disc degeneration (IVDD) but yielded inconsistent results. Here, we performed a meta-analysis to investigate the association of collagen IX alpha 2 (COL9A2) Trp2, collagen IX alpha 3 (COL9A3) Trp3, collagen I alpha 1 (COL1A1) Sp1 and collagen XI alpha 1 (COL11A1) C4603T polymorphisms with susceptibility to IVDD. METHOD: Eligible studies were retrieved by searching MEDLINE, EMBASE, Web of Science prior to 31 March, 2021. Odds ratio (OR) and corresponding 95% confidence interval (CI) were calculated for association strength. RESULTS: A total of 28 eligible studies (31 datasets comprising 5497 cases and 5335 controls) were included. COL9A2 Trp2 carriers had an increased risk of IVDD than non-carriers in overall population (OR = 1.43, 95% CI 0.99-2.06, P = 0.058), which did not reach statistical significance. However, Trp2 carriers had 2.62-fold (95% CI 1.15-6.01, P = 0.022) risk than non-carriers in Caucasians. COL9A3 Trp3 was not associated with IVDD risk (OR = 1.28, 95% CI 0.81-2.02, P = 0.299). T allele and TT genotype of COL1A1 Sp1 (+ 1245G > T) were correlated with increased risk of IVDD. Significant associations were found between COL11A1 C4603T and IVDD risk under allelic (OR = 1.33, 95% CI 1.20-1.48), dominant (OR = 1.45, 95% CI 1.26-1.67), recessive (OR = 1.55, 95% CI 1.21-1.98) and homozygote model (OR = 1.81, 95% CI 1.40-2.34). CONCLUSIONS: COL1A1 Sp1 and COL11A1 C4603T polymorphism are associated with IVDD risk while the predictive roles of collagen IX gene Trp2/3 need verification in more large-scale studies.

12.
J Glob Health ; 11: 08007, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34671464

RESUMO

Background: China is facing a more severe stroke challenge. In 2017, China fully implemented the zero-margin drug policy (ZMDP), cancelling 15% of drug markups in public hospitals. Based on the "System of Health Accounts 2011" (SHA 2011), this paper explores the changes in the economic burden of stroke in China after implementing ZMDP to provide an accurate reference for policymakers. Methods: Stroke patients from 2016 to 2018 were selected by multistage stratification probability-proportional random sampling in Shanxi Province. A total of 223 187 samples were included. Regression discontinuity design (RDD) was used to measure the change of drug proportion and cost. Sensitivity analysis and subgroup analysis were implied to determine the stability of the results. Results: The current curative expenditure on stroke from 2016 to 2018 was 4374.69, 3727.22, and 3752.52 million Chinese Yuan (CNY). About 90% of the cost occurred during hospitalization, and 60% in general hospitals. After the implementation of ZMDP, the drug proportion from 46.54% (interquartile range (IQR) = 37.10%, 55.14%) in 2016 to 36.40% (IQR = 25.82%, 48.58%) in 2018, and average hospitalization cost per stay was from 7950.02 (IQR = 4938.76, 12 639.90) CNY in 2016 to 7362.08 (IQR = 4892.82, 11 501.40) CNY in 2018. RDD showed the drug proportion decreased by 2.76% (95% confidence interval (CI) = 1.17%, 4.35%, P = 0.001), and the expense decreased by 4698.34 (95% CI = 3047.59, 6349.09, P < 0.001) CNY. Conclusions: The economic burden of stroke patients in China was severe. ZMDP played a noticeable effect in reducing drug proportion and hospitalization costs. The Chinese government should continue to implement relevant policies to control stroke costs according to regional and population characteristics.


Assuntos
Preparações Farmacêuticas , Acidente Vascular Cerebral , China/epidemiologia , Efeitos Psicossociais da Doença , Humanos , Política Pública , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/epidemiologia
13.
Risk Manag Healthc Policy ; 14: 4177-4183, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34675712

RESUMO

Objective: In order to fight against coronavirus disease 2019 (COVID-19) better and to share our experience as a reference for clinical laboratory departments. Methods: This was a retrospective study conducted in the clinical laboratory department of Chengdu Women's and Children's Central Hospital in Chengdu, China, from April 2020 to January 2021. The number of nucleic acid and antibody testing specimens of suspected COVID-19 cases was analyzed. The key points of suspected-case sample processing and detection in the clinical laboratory department were summarized. The laboratory was directly involved in the sample processing and testing of suspected cases, the release of reports, and the transfer of specimens to the fever clinic. Results: The number of COVID-19 nucleic acid test specimens in our laboratory ranged from 102 to 2170 per day, and the number of antibody test specimens ranged from 24 to 391 per day. There were four main considerations in the treatment and detection of suspected-case specimens in the clinical laboratory: biosafety management in clinical laboratory departments, measures to ensure the health of the staff, the eight time points for processing suspected-case samples (turn-around time), and key points for the detection of suspected case specimens. Conclusion: The laboratory developed a protective process for COVID-19 antibody and nucleic acid detection during the pandemic. At present, the detection of COVID-19 antibodies and nucleic acids in the clinical laboratory department is orderly, and there have been no cases of laboratory infection.

14.
Environ Pollut ; 291: 118069, 2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34530243

RESUMO

The on-going and extensive use of neonicotinoids occur in orchards. However, it is still unknown whether and how orchard management affects soil properties, especially the contents and structure of soil organic matter during orchard development, and their further influences on neonicotinoid persistence. Here, surface soil samples were collected from the citrus orchards with different cultivation ages (1, 10, 14, and 20 years), and their physicochemical properties were determined. Changes in the chemical structure of soil organic matter (SOM) were furtherly examined using solid-state CP/TOSS 13C NMR. Then, the sorption isotherms of imidacloprid in these soils were investigated. The sorption coefficient (Kd) of imidacloprid at Ce of 0.05 mg/L in the orchard soils increased by 19.4-23.3%, along a 20-year chronosequence of cultivation, which should be mainly ascribed to the increase of SOM. However, the organic carbon-normalized sorption coefficient (Koc, sorption per unit mass of OM) of imidacloprid declined with increasing cultivation ages. Moreover, the polar and aliphatic domains of SOM had a significantly positive relation to the Koc of imidacloprid, suggesting its key role in governing imidacloprid sorption. The results highlighted that reasonable management measures could be adopted to control the occurrence and fate of neonicotinoids in soils, mainly by affecting the content and quality of SOM.

15.
Front Oncol ; 11: 724722, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34557412

RESUMO

Objective: The advent of immune checkpoint inhibitors (ICIs) has rapidly transformed the treatment paradigm of non-small cell lung cancer (NSCLC). Despite the durability of response to ICIs, the vast majority of patients will later develop progression. However, the failure patterns of ICI treatment are unknown. Here, our study explored the failure patterns in advanced NSCLC patients treated with ICIs. Methods: A cohort of 156 IIIB or IV NSCLC patients treated with first-/second-line ICIs were retrospectively analyzed. Patients who experienced clinical benefit and then developed progression were identified. The disease progression patterns were divided into three categories: progression in new sites, progression in existing sites, and combined progression. The number of progression sites was also recorded. Results: Before the cutoff date, 91 (77.1%) patients had experienced disease progression; 34% of patients had progressed in the last 9 months of the first year. Fifty-three (58.2%) patients had developed progression at existing lesions, and 56 (61.5%) patients had shown ≤2 progression sites (oligo-progression). In patients with oligo-progression, the median time of disease progression was 8.23 months and the counterpart (systemic progression) was 5.97 months. The oligo-progression patients showed prolonged median overall survival (27.23 months) compared with patients with systemic progression (18.87 months). Conclusions: Failure patterns of ICI therapy were predominantly "existing" sites, and the most common lesions of progression were the lung and lymph nodes. Most patients experienced oligo-progression which occurred later than systemic progression and showed prolonged overall survival. The control of the local lesions might be beneficial to improve ICI treatment efficacy.

16.
Front Med (Lausanne) ; 8: 720019, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34568376

RESUMO

Background: Although an increasing number of studies have reported that telemonitoring (TM) in patients with chronic obstructive pulmonary disease (COPD) can be useful and efficacious for hospitalizations and quality of life, its actual utility in detecting and managing acute exacerbation of COPD (AECOPD) is less established. This meta-analysis aimed to identify the best available evidence on the effectiveness of TM targeting the early and optimized management of AECOPD in patients with a history of past AECOPD compared with a control group without TM intervention. Methods: We systematically searched PubMed, Embase, and the Cochrane Library for randomized controlled trials published from 1990 to May 2020. Primary endpoints included emergency room visits and exacerbation-related readmissions. P-values, risk ratios, odds ratios, and mean differences with 95% confidence intervals were calculated. Results: Of 505 identified citations, 17 original articles with both TM intervention and a control group were selected for the final analysis (N = 3,001 participants). TM was found to reduce emergency room visits [mean difference (MD) -0.70, 95% confidence interval (CI) -1.36 to -0.03], exacerbation-related readmissions (risk ratio 0.74, 95% CI 0.60-0.92), exacerbation-related hospital days (MD -0.60, 95% CI -1.06 to -0.13), mortality (odds ratio 0.71, 95% CI 0.54-0.93), and the St. George's Respiratory Questionnaire (SGRQ) score (MD -3.72, 95% CI -7.18 to -0.26) but did not make a difference with respect to all-cause readmissions, the rate of exacerbation-related readmissions, all-cause hospital days, time to first hospital readmission, anxiety and depression, and exercise capacity. Furthermore, the subgroup analysis by observation period showed that longer TM (≥12 months) was more effective in reducing readmissions. Conclusions: TM can reduce emergency room visits and exacerbation-related readmissions, as well as acute exacerbation (AE)-related hospital days, mortality, and the SGRQ score. The implementation of TM intervention is thus a potential protective therapeutic strategy that could facilitate the long-term management of AECOPD. Systematic Review Registration: This systematic review and meta-analysis is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and was registered at International Prospective Register of Systematic Reviews (number: CRD42020181459).

17.
Front Med (Lausanne) ; 8: 682107, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34485328

RESUMO

Background: The Xpert Mycobacterium tuberculosis/rifampin (MTB/RIF) assay has shown good diagnostic efficacy in brushing and biopsy tissue samples from patients with tracheobronchial tuberculosis (TBTB). However, its diagnostic value in bronchoalveolar lavage fluid (BALF) is still unclear. Therefore, the present retrospective study aimed to evaluate the diagnostic value of the Xpert MTB/RIF assay in BALF. Methods: The clinical data of 266 patients with suspected TBTB from January 2018 to October 2020 were pooled with complete details of bronchial brush and bronchoalveolar lavage samples. Smears of the bronchial brushings were stained with Auramine O stain to detect acid-fast bacilli (AFB), and BALF samples were used for culturing MTB with the BACTEC MGIT 960 system and the Xpert MTB/RIF assay. The diagnostic performance of these methods was assessed and compared. Results: A total of 266 patients suspected to have TBTB were enrolled in the final analysis. Of these patients, 179 patients were confirmed to have TBTB and 87 patients were non-TBTB. The sensitivity of the Xpert MTB/RIF assay in BALF (87.2%) was significantly higher than that of the brush smear for AFB (35.2%, p < 0.001). No significant difference was observed between the sensitivities of the Xpert MTB/RIF assay in BALF and MTB culture in BALF (87.2 vs. 84.9%, p = 0.542). The specificities of the Xpert MTB/RIF assay in BALF, MTB culture in BALF, and the bronchial brush smear were 97.7, 97.7, and 98.9%, respectively. The positive predictive value (PPV) and negative predictive value (NPV) of the Xpert MTB/RIF assay in BALF, MTB culture in BALF, and the bronchial brush smear were 98.7 and 78.7%, 98.7 and 75.9%, and 98.4 and 42.6%, respectively. Among the MTB culture-positive patients with TBTB detected by the Xpert assay, 27.0% (20/74) were identified to be resistant to RIF. Conclusions: The Xpert MTB/RIF assay in BALF enables a rapid and accurate diagnosis of TBTB and identification of RIF resistance, which is crucial for timely and proper treatment. Moreover, in patients with TBTB, BALF could be used as an alternative to bronchial brushing and biopsy tissues for the Xpert MTB/RIF assay.

18.
BMC Genomics ; 22(1): 640, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34481473

RESUMO

BACKGROUND: Fatty liver disease prevalently occurs in commercial postpartum dairies, resulting in a worldwide high culling rate because of their subsequent limitations of production and reproduction performance. RESULTS: Fatty liver-specific proteome and acetylome analysis revealed that energy metabolism suppression closely associated with mitochondrial dysfunction and inflammation activation were shown to be remarkable biological processes underlying the development of fatty liver disease, furthermore, acetylation modification of proteins could be one of the main means to modulate these processes. Twenty pivotal genetic factors/genes that differentially expressing and being acetylation modified in liver were identified and proposed to regulate the pathogenesis of fatty liver dairies. These proteins were confirmed to be differentially expressing in individual liver tissue, eight of which being validated via immunohistochemistry assay. CONCLUSIONS: This study provided a comprehensive proteome and acetylome profile of fatty liver of dairy cows, and revealed potential important biological processes and essential regulators in the pathogenesis of fatty liver disease. Expectantly, understanding the molecular mechanisms of the pathogenesis of fatty liver disease in dairies, as an animal model of non-alcoholic fatty liver disease (NAFLD) in human beings, which is a clinico-pathologically defined process associated with metabolic syndrome, could inspire and facilitate the development of efficacious therapeutic drugs on NAFLD.


Assuntos
Hepatopatia Gordurosa não Alcoólica , Proteoma , Animais , Bovinos , Feminino , Humanos , Inflamação , Mitocôndrias , Hepatopatia Gordurosa não Alcoólica/genética
19.
J Transl Int Med ; 9(2): 131-142, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34497752

RESUMO

Background and Objectives: The majority of coronavirus disease 2019 (COVID-19) cases are nonsevere, but severe cases have high mortality and need early detection and treatment. We aimed to develop a nomogram to predict the disease progression of nonsevere COVID-19 based on simple data that can be easily obtained even in primary medical institutions. Methods: In this retrospective, multicenter cohort study, we extracted data from initial simple medical evaluations of 495 COVID-19 patients randomized (2:1) into a development cohort and a validation cohort. The progression of nonsevere COVID-19 was recorded as the primary outcome. We built a nomogram with the development cohort and tested its performance in the validation cohort. Results: The nomogram was developed with the nine factors included in the final model. The area under the curve (AUC) of the nomogram scoring system for predicting the progression of nonsevere COVID-19 into severe COVID-19 was 0.875 and 0.821 in the development cohort and validation cohort, respectively. The nomogram achieved a good concordance index for predicting the progression of nonsevere COVID-19 cases in the development and validation cohorts (concordance index of 0.875 in the development cohort and 0.821 in the validation cohort) and had well-fitted calibration curves showing good agreement between the estimates and the actual endpoint events. Conclusions: The proposed nomogram built with a simplified index might help to predict the progression of nonsevere COVID-19; thus, COVID-19 with a high risk of disease progression could be identified in time, allowing an appropriate therapeutic choice according to the potential disease severity.

20.
Artigo em Inglês | MEDLINE | ID: mdl-34482483

RESUMO

PURPOSE: This study aimed to develop and validate a prognostic model for metastasis-free survival (MFS) based on genes that may functionally interact with cytotoxic T lymphocytes (CTLs) and M2 macrophages in patients with triple-negative breast cancer (TNBC) who underwent adjuvant radiotherapy. METHODS: The transcriptional and phenotypic profiles of TNBC and other breast cancer subtypes were downloaded from gene expression omnibus (GEO). The abundance of infiltrated immune cells was evaluated through CIBERSORTx or MCP-counter. A weighted linear model, the score for MFS (SMFS), was developed using the least absolute shrinkage and selection operator (LASSO) in GSE58812 and validated in GSE2034 and GSE12276. The biological implication of the SMFS was explored by evaluating its associations with TNBC molecular subtypes and other radiosensitivity- or immune-related signatures. RESULTS: A model consisting of the PCDH12/ELP3, PCDH12/MSRA, and FAM160B2/MSRA gene expression ratios with non-zero coefficients finally selected by LASSO was developed using GSE58812. In GSE2034 (treatment with adjuvant radiotherapy), the SMFS was significantly associated with MFS in TNBC patients (hazard ratio (HR) = 8.767, 95% confidence interval (CI) 1.856-41.408, P = 0.006) and, to a lesser extent, in non-TNBC patients (HR = 2.888, 95% CI 1.076-7.750, P = 0.035). However, the interaction of subtype (TNBC vs non-TNBC) and the SMFS tended to be significant (Pinteraction = 0.081). In contrast, the SMFS was not significantly associated with MFS in either TNBC patients (P = 0.499) or non-TNBC patients (P = 0.536) in GSE12276 (treatment without radiotherapy). Among the four TNBC molecular subtypes, the c1 and c4 subtypes exhibited higher CTL infiltration and lower SMFS values than the c2 and c3 subtypes. In addition, the SMFS was positively correlated with the abundance of endothelial cells (r = 0.413, P < 0.001). CONCLUSION: The proposed model has the potential to predict MFS in TNBC patients after adjuvant radiotherapy, and the SMFS may represent a measurement of tumor immune suppression.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...