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1.
Eur Rev Med Pharmacol Sci ; 24(1): 43-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31957817

RESUMO

OBJECTIVE: Tumor-derived exosomes have been repeatedly studied as tumor antigens, suppressing T-cell signaling molecules and promoting apoptosis in ovarian cancer (OC). Long non-coding RNAs (lncRNAs) have been recognized as major regulators in tumorigenesis, including OC. For this study, we try to find out the mechanism of exosomes and lncRNA FAL1 in OC. MATERIALS AND METHODS: After the extraction and identification of exosomes, the internalization of exosomes was observed. Invasion and migration experiments were conducted to investigate the effect of SKOV3 cells-secreted exosomes on OC tumorigenesis and metastasis. Furthermore, the in vivo findings were verified via xenograft tumors in nude mice. FAL1 was knocked out on exosomes. OC cells treated with exosomes were co-cultured with lncRNA FAL1 or/and PTEN to measure cell invasion and migration. RESULTS: SKOV3-secreted exosomes were absorbed and internalized by OC cells. After exosome treatment, the migration and invasion of OC cells were enhanced, tumors in nude mice were larger and heavier, metastasis was increased, and lncRNA FAL1 expression was increased. When lncRNA FAL1 was knocked out, the promoting effects of SKOV3 cells-secreted exosomes on OC cell metastasis were weakened, along with increased PTEN level and decreased AKT phosphorylation level. In HO-8910PM cells treated with siRNA-FAL1 exosomes and siRNA-PTEN, cell invasion and migration, and AKT phosphorylation were restored. CONCLUSIONS: SKOV3-secreted exosomes inhibited the PTEN/AKT signaling pathway by transferring lncRNA FAL1, thus inhibiting OC cell metastasis in vitro and in vivo.

2.
Neoplasma ; 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31829023

RESUMO

Melatonin receptor type 1 (MTNR1A or MT1) is known to play an important role in cancer progression; however, its prognostic value for resected gastric adenocarcinoma (RGA) is unknown. In this study, we examined the potential of MT1 as a prognostic biomarker for RGA. The expression of the MT1 was evaluated in 67 patients with RGA by immunohistochemistry, and the relationship between MT1 levels and RGA prognosis was analyzed by Chi-square test, multivariate Cox regression, Kaplan-Meier method, and log-rank test. High MT1 expression was associated with a poor survival rate (29.0%, p = 0.002) and the occurrence of metastasis (62.9%, p = 0.004). Kaplan-Meier survival analysis and log rank tests revealed that patients with high expression of the MT1 had significantly shorter median overall survival compared to those with low expression (33.0 vs. 65.0 months, respectively; p=0.02). Multivariate Cox analysis indicated that the calculated death risk (hazard ratio [HR]) in patients with high expression levels of the MT1 increased to 2.68 (95% confidence interval [CI] 1.21-5.94, p = 0.015), which was higher compared to those with low levels. HR of death was also high in patients with advanced T stage (2.51; 95 % CI 1.00-6.26, p = 0.049) and metastasis (5.02; 95% CI 1.94-13.03, p = 0.001). Our results showed that high MT1 expression in primary gastric adenocarcinoma tissues was associated with the occurrence of metastasis and poor prognosis. It may have prognostic significance as a potential biomarker in patients with RGA.

3.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 479-485, 2019 Oct 12.
Artigo em Chinês | MEDLINE | ID: mdl-31713375

RESUMO

OBJECTIVE: To understand the prevalence and risk factors of Blastocystis hominis infection in inpatients in Jiangjin District, Chongqing City. METHODS: A cross-sectional study was conducted in a community hospital in Jiangjin District, Chongqing City, and the inpatients were surveyed by questionnaires. After obtaining the informed consent from the inpatients or legal guardians, the stool and blood samples were collected and examined by microscopy and PCR from April 17 to May 1, 2018. The univariate analysis and logistic regression analysis were used to analyze the risk factors of the B. hominis infection. RESULTS: A total of 198 hospitalized patients were investigated, and the infection rate of B. hominis was 10.61% (21/198), and the infection rate of the females (12.10%) was higher than that of the males (8.11%), but the difference was not statistically significant. The highest rate of infection was 19.23% in the age group of 10 to 20 years, followed by 17.74% in the age group of 60 years and above, and the lowest rate was 2.38% in the age group of 20 to 40 years. The difference in infection rates of B. hominis among the different age groups was statistically significant (P < 0.05). The infection rate of B. hominis in the people who used dry pail latrines was 33.30%, which was higher than that of the people who used water flush toilets (9.10%) (P < 0.05). The genotypes of B. hominis were ST1, ST3, ST6 and ST7, and ST6 and ST3 being the most predominant genotypes which accounted for 47.62% (10/21) and 38.10% (8/21) respectively, and among the infected males, the genotypes were only ST3 and ST6. The multiple logistic regression analysis showed that among the factors affecting B. hominis infection, only keeping pets was a risk factor [OR = 3.798, 95% CI (1.245, 11.581), P < 0.05]. CONCLUSIONS: A high prevalence of B. hominis infection is found in the inpatients in Jiangjin District, Chongqing City, the predominant genotypes are ST6 and ST3, and keeping pets may be one of the main risk factors.


Assuntos
Infecções por Blastocystis , Blastocystis hominis , Adolescente , Adulto , Infecções por Blastocystis/sangue , Infecções por Blastocystis/epidemiologia , Blastocystis hominis/genética , Criança , China/epidemiologia , Estudos Transversais , Fezes/parasitologia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Inquéritos e Questionários , Adulto Jovem
4.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 31(5): 498-503, 2019 Jul 25.
Artigo em Chinês | MEDLINE | ID: mdl-31713378

RESUMO

OBJECTIVE: To investigate the prevalence and risk factors of Blastocystis hominis infections among patients with HIV/AIDS in Fuyang City, Anhui Province. METHODS: A cross-sectional study was conducted in Fuyang City, Anhui Province in 2016. The demographic and socioeconomic status, and the lifestyle and production style were collected using a questionnaire survey. B. hominis DNA was detected in subjects'stool samples using a PCR assay, and the CD4+ T lymphocyte count and HIV viral load were measured in the subjects' blood samples. The risk factors of B. hominis infections among patients with HIV/AIDS were identified using univariate and multivariate logistic regression analyses. RESULTS: A total of 398 HIV/AIDS patients were enrolled in this study, with a mean age of 49.3 years, a mean body weight of 55.9 kg and a mean height of 164.4 cm. The prevalence of B. hominis infection was 6.78% in the study subjects, and no gender- (χ2 = 1.589, P = 0.207), education level- (χ2 =0.508, P = 0.776), marital status- (χ2 = 0.419, P = 0.811) or occupation-specific prevalence (χ2 = 2.744, P = 0.615) was detected. Among the patients with HIV/AIDS, there were no significant differences in the age (t = 0.370, P = 0.712), height (t = 1.587, P =0.113), body weight (t = 0.516, P = 0.606), CD4+ T lymphocyte count (t = 1.187, P = 0.230) or HIV viral load (t = 0.193, P =0.496) between B. hominis-infected and uninfected individuals. Dinking non-tap water [OR = 6.554, 95% CI: (1.876 to 22.903)] and keeping dogs [OR = 5.895, 95% CI: (2.017 to 17.225)] were identified as risk factors for B. hominis infection in patients with HIV/AIDS. CONCLUSIONS: The prevalence of B. hominis infection is high in HIV/AIDS patients, and drinking non-tap water and keeping dogs are risk factors for B. hominis infection among HIV/AIDS patients.


Assuntos
Infecções por Blastocystis , Blastocystis hominis , Infecções por HIV , Animais , Infecções por Blastocystis/complicações , Infecções por Blastocystis/epidemiologia , Estudos Transversais , Cães , Fezes/parasitologia , Feminino , HIV , Infecções por HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco
5.
Zhonghua Wai Ke Za Zhi ; 57(3): 236-240, 2019 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-30861654

RESUMO

Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise.Plate fixation and intramedullary nail fixation are the common options for closed fractures.This article focuses on the two treatment methods and some important auxiliary technologies in both domestic and foreign, hoping to provide some references for clinical treatment.


Assuntos
Fraturas da Tíbia , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Amplitude de Movimento Articular , Resultado do Tratamento
6.
BMC Cancer ; 19(1): 100, 2019 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-30674295

RESUMO

BACKGROUND: Post-operative pneumonia (Pop) following meningioma surgery is the dominant systemic complication which could cause serious threats to patients. It is unclear whether hematological biochemical markers are independently associated with the Pop. This study attempted to perform a more comprehensive study of taking both clinical factors and hematological biomarkers into account to promote the management of patients after meningioma surgery. METHODS: We collected clinical and hematological parameters of 1156 patients undergoing meningioma resection from January 2009 to January 2013. According to whether the symptoms of pneumonia had manifested,patients were divided into the Pop group and the Non-Pop group. We analyzed the distinctions of clinical factors between the two groups. We successively performed univariate and multivariate regression analysis to identify risk factors independently associated with the Pop. RESULTS: 4.4% patients infected with the Pop (51 of 1156). The median age at diagnosis of the Pop patients was significantly older than the Non-Pop group (p = 0.002). There were strike distinctions of post-operative hospital stays between two groups, with 21 days and 7 days each (p < 0.001). On multivariate analysis, tumor relapse (p < 0.001), skull base lesions (p = 0.001), intra-operative blood transfusion (p = 0.018) and cardiovascular diseases (p = 0.001) were linked with increased risk of the Pop following meningioma resection. For hematological biochemical markers, it was the factor of Red blood cell distribution width-standard deviation (RDW-SD) (OR 5.267, 95%CI 1.316, 21.078; p = 0.019) and Neutrophils lymphocytes ratio (NLR) (OR 2.081, 95%CI 1.063, 4.067; p = 0.033) that could appreciably predict the Pop. CONCLUSIONS: Apart from tumor recurrence, localizations, intra-operative blood transfusion and cardiovascular diseases are independent risk factors for the Pop. We initially found hematological RDW-SD and NLR are also important predictors.


Assuntos
Neoplasias Meníngeas/sangue , Meningioma/sangue , Pneumonia/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , China/epidemiologia , Índices de Eritrócitos , Feminino , Humanos , Contagem de Leucócitos , Linfócitos/citologia , Masculino , Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Pessoa de Meia-Idade , Neutrófilos/citologia , Período Pré-Operatório , Análise de Regressão , Estudos Retrospectivos , Fatores de Risco
7.
Eur Rev Med Pharmacol Sci ; 22(22): 7768-7777, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30536323

RESUMO

OBJECTIVE: The purpose of this study was to examine centromere protein U (CENPU) expression in non-small cell lung cancer (NSCLC) and identify the clinical values of CENPU, as well as investigate the potential molecular mechanisms in NSCLC. PATIENTS AND METHODS: The expression levels and clinical significance of CENPU were systematically evaluated in human protein atlas datasets and TCGA datasets. CENPU protein expression was studied by Western blotting. CENPU mRNA expression was studied by Real Time-Polymerase Chain Reaction (RT-PCR). Proliferation, migration, and invasion capacities of CENPU cells were assessed after silencing CENPU. Apoptosis was determined using flow cytometry. Western blotting was performed to assess the protein expression levels. RESULTS: We found that the expression of CENPU at mRNA and protein levels was significantly up-regulated in both NSCLC tissues and cell lines. Overexpression of CENPU was significantly associated with poor prognosis of NSCLC patients. Knockdown of CENPU significantly suppressed proliferation, migration, and invasion, and caused apoptosis of NSCLC cells in vitro. In addition, knockdown of CENPU suppressed epithelial-mesenchymal transition (EMT). Furthermore, our results revealed that the abnormal expression of CENPU could influence the Wnt/ß-catenin signaling pathway. CONCLUSIONS: CENPU was highly expressed in NSCLC tissues and its knockdown of CENPU strongly suppressed NSCLC cell proliferation and metastasis through modulating Wnt/ß-catenin signaling. Targeting CENPU could be a promising therapeutic strategy for patients with CENPU.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Neoplasias Pulmonares/genética , Proteínas Nucleares/genética , Apoptose/genética , Proteínas de Ciclo Celular , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Transição Epitelial-Mesenquimal/genética , Histonas , Humanos , Via de Sinalização Wnt/genética
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 52(8): 837-841, 2018 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-30107719

RESUMO

Objective: To edentify the increased cost, the decreased benefits and effectiveness of hepatitis B vaccine event reported by media in 2013 in China both in Chinese nationwide and in Shenzhen. Methods: The decision analytic-Markov models were constructed. The cohort born in 2013 in nationwide and in Shenzhen were respectively introduced to the models. The vaccination coverage and the rates of antibody to hepatitis B surface antigen were determined as major parameters. The average costs and benefits per case, the effectiveness which included the numbers of hepatitis B virus (HBV) infection and the patients with HBV-related diseases, the average quality-adjusted life years (QALYs) per case were calculated from the medical-care and societal perspectives. The benefit cost ratio (BCR), ratio of the total costs and the net QALYs were as indicators of cost-benefit and cost-effectiveness analysis, respictively. Results: In nationwide, the BCRs decreased from 9.10 and 8.58 to 2.48 and 2.43, respectively, because the average costs increased to 6 796.60 yuan (RMB) and 8 451.45 yuan, and average benefits decreased to 6 799.57 yuan and 8 484.41 yuan, respectively, from the medical-care and societal perspectives. In Shenzhen, the BCRs decreased from 16.21 and 14.51 to 3.11 and 3.04 with the average costs of 5 244.88 yuan and 8 937.64 yuan, and average benefits of 5 248.11 yuan and 8 977.27 yuan. Totally, the increase of 2.1314 million and 181 hundreds of the HBV infectors occurred for the event in nationwide and in Shenzhen, respectively. Of all the infectors increased the most, the numbers of acute and chronic hepatitis B were 1 904 hundreds and 807 hundreds in nationwide, 794 and 395 in Shenzhen, espectively. The decreases of average QALY per case were 0.119 8 in nationwide and 0.090 6 in Shenzhen. The costs per averted a QALY increased from 6 231.90 yuan to 22 883.51 yuan in nationwide, from 3 567.25 yuan to 1 8571.49 yuan in Shenzhen (for medical-care perspective), from 8 252.79 yuan and 6 807.45 yuan to 29 091.92 yuan and 32 553.60 yuan (for societal perspective). Conclusion: The hepatitis B vaccine event reported by media in 2013 in China caused the costs increased, both benefits and the economic values obviously decreased.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Hepatite B/economia , Meios de Comunicação de Massa , Vacinação/economia , China/epidemiologia , Análise Custo-Benefício , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Humanos , Anos de Vida Ajustados por Qualidade de Vida
9.
Eur Rev Med Pharmacol Sci ; 22(15): 5004-5013, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30070337

RESUMO

OBJECTIVE: This study aims to explore the role and the mechanism of Parkin protein in cardiac function and ventricular remodeling in myocardial infarction (MI) rats, and to provide a new sight for the treatment of myocardial infarction. MATERIALS AND METHODS: Fifty Sprague- Dawley (SD) male rats were randomly divided into 5 groups: sham operation group (Sham group), model group (MI group), low-dose Parkin group (L-Parkin group), middle-dose Parkin group (M-Parkin group) and high-dose Parkin group (H-Parkin group). The rat model of myocardial infarction was established by ligation of the anterior descending branch. Small animal ultrasound was used to measure cardiac function. The myocardial infarct size was observed by triphenyltetrazolium chloride (TTC) staining. The pathological changes of myocardial tissues were observed by hematoxylin-eosin (HE) staining. The myocardial cell apoptosis was detected by TUNEL assay. The mRNA expression of matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9), tissue inhibitor of matrix metalloproteinase 1 (TIMP1), tissue inhibitor of matrix metalloproteinase 2 (TIMP2) were detected by qRT-PCR. The expression of Parkin protein in myocardial tissue of rats was detected by Western-blot. RESULTS: Compared with MI group, left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV) in Parkin overexpressing group were significantly decreased (p<0.05), while the value of left ventricular short axis shortening (FS) and left ventricular ejection fraction (EF %) in Parkin overexpression group were significantly increased (p<0.05). Overexpression of Parkin improved abnormal structure of myocardial tissue, reduced the size of myocardial infarct, made the arrangement of myocardium fibers more neatly and made the stain of myocardial cells more uniformly. Apoptosis index (AI) values were significantly decreased (p<0.05), and MMP2, MMP9, TIMP1 and TIMP2 mRNA levels were significantly decreased (p<0.05), while Parkin protein expression was significantly elevated in a dose-dependent manner (p<0.05). CONCLUSIONS: After treatment with Parkin in myocardial infarction rats, the relevant mRNA levels decreased, the number of apoptotic cells decreased, the myocardial fiber morphology returned to normal, the myocardial infarct size decreased, and the cardiac function of rats improved. Therefore, Parkin therapy plays an active role in cardiac function and ventricular remodeling in myocardial infarction rats.


Assuntos
Infarto do Miocárdio/patologia , Ubiquitina-Proteína Ligases/metabolismo , Remodelação Ventricular , Animais , Apoptose , Modelos Animais de Doenças , Masculino , Metaloproteinase 2 da Matriz/genética , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/genética , Metaloproteinase 9 da Matriz/metabolismo , Infarto do Miocárdio/metabolismo , Miocárdio/metabolismo , Miocárdio/patologia , Ratos , Ratos Sprague-Dawley , Inibidor Tecidual de Metaloproteinase-1/genética , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Ubiquitina-Proteína Ligases/genética , Função Ventricular Esquerda
10.
Zhonghua Yu Fang Yi Xue Za Zhi ; 52(7): 743-747, 2018 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-29996303

RESUMO

Objective: To verify the costs, benefit and effectiveness of hepatitis B immunoprophylaxis strategies in Shenzhen during 2006-2030. Methods: The markov model was constructed to reflect the reality of the newborn vaccination and prevention of mother to child transmission (PMTCT) strategy, the cost, benefit and effectiveness during 2006-2015 and 2016-2030 was evaluated and predicted by the model. The model was constructed with the basic parameters such as the positive rate of hepatitis B surface antibody, perinatal HBV infection rate, the screening rate and positive rate of HBsAg of pregnant women, the utility value of hepatitis B and the parameters of markov model. and the coverage rates, vaccination fee of hepatitis B and the expenditures of patients with HB-related diseases.The costs were calculated from the payer, medical-care and all society perspective. The effectiveness and benefits of the strategy were evaluated and predicted by the numbers of HBV infection and the patients with HBV-related diseases prevented, life years (LYs), quality adjusted life years (QALYs), the net benefits (NBs) and benefit cost ratio (BCRs). Results: From the payer, medical-care and all society perspectives, the costs for the strategy were 153 million Yuan, 5.51 billion Yuan and 10.92 billion Yuan, respectively from 2006 to 2030 of which the forecast costs for 2016-2030 were 120 million Yuan, 3.87 billion yuan and 7.81 billion yuan. During the year 2006-2030, the numbers of HBV infection and the HBV-related diseases was 2.48 million, more than 1.335 million LYs and 1.619 million QALYs should be obtained from the strategy implemented. From medical-care and all society perspectives, NBs should be 88.68 billion yuan and 150.13 billion yuan with the BCRs of 17.08 and 14.75, respectively. Particularly, the NBs value of 22.37 billion yuan and 37.98 billion yuan and the BCR value of 14.62 and 13.20 was calculated for the past period, but the future NBs of 66.31 billion yuan and 112.15 billion yuan and BCR of 18.12 and 15.36 in the year 2016-2030. The further benefits were increased evidently in the future. Conclusion: The hepatitis B immunization in Shenzhen has a high economic effectivenee and benefits, and it is worth to invest sustainably.


Assuntos
Vacinas contra Hepatite B/administração & dosagem , Vacinas contra Hepatite B/economia , Hepatite B/economia , Hepatite B/prevenção & controle , China , Análise Custo-Benefício , Feminino , Hepatite B/transmissão , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Cadeias de Markov , Gravidez
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(1): 36-41, 2018 Jan 09.
Artigo em Chinês | MEDLINE | ID: mdl-29972962

RESUMO

Objective: To analysis teratogenic effect of GDC-0449 to fetus and set up the animal model of GDC-0449 induced oromandibular limb hypogenesis in mouse for further research of its pathogenesis. Methods: Twenty-seven pregnant Institute of Cancer Research (ICR) mice were randomly divided into: control group, embryonic day 8.5 (E8.5) exposed groups, E9.5 exposed groups, E10.5 exposed groups, E11.5 exposed groups, E12.5 exposed groups, E13.5 exposed groups, E14.5 exposed groups and E15.5 exposed groups. Each group had 3 mice. Exposed groups were treated with the Hedgehog pathway antagonist GDC-0449 at a single dose 150 mg/kg by oral gavage from E8.5 to E15.5. At E16.5, embryonic phenotypes were analyzed in detail by stereo microscope and histology. After establish an optimal dysmorphogenic concentration, 6 pregnant ICR mice were randomly divided into control group and the optimal group, embryonic phenotypes were analyzed by whole-mount skeletal staining and micro-computed tomography at E18.5. Results: The mice were exposed to GDC-0449 on E11.5 and E12.5 had a high incidence of cleft palate. GDC-0449 exposed between E9.5 and E10.5 caused craniofacial and limb dysmorphology, including micrognathia, microglossia, ectrodactylia, partial anodontia and cleft palate. Most interestingly, these are extremely similar to oromandibular limb hypogenesis syndrome. Conclusions: The results of this study indicate that GDC-0449 can be used to induce micrognathia, microglossia, ectrodactylia, partial anodontia and cleft palate. This work established a novel mouse model for oromandibular limb hypogenesis.


Assuntos
Anilidas/toxicidade , Fissura Palatina/induzido quimicamente , Anormalidades Craniofaciais/induzido quimicamente , Modelos Animais de Doenças , Proteínas Hedgehog/antagonistas & inibidores , Deformidades Congênitas dos Membros/induzido quimicamente , Piridinas/toxicidade , Animais , Feminino , Idade Gestacional , Camundongos , Camundongos Endogâmicos ICR , Micrognatismo/induzido quimicamente , Fenótipo , Gravidez , Distribuição Aleatória , Doenças da Língua/induzido quimicamente , Microtomografia por Raio-X
12.
Public Health ; 154: 151-160, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29245022

RESUMO

OBJECTIVES: A randomized controlled study was conducted with 422 homeless, stimulant-using gay/bisexual (G/B) men and 29 transgender women (n = 451) to assess two community-based interventions to reduce substance abuse and improve health: (a) a nurse case-managed program combined with contingency management (NCM + CM) versus (b) standard education plus contingency management (SE + CM). STUDY DESIGN: Hypotheses tested included: a) completion of hepatitis A/B vaccination series; b) reduction in stimulant use; and c) reduction in number of sexual partners. METHODS: A deconstructive cost analysis approach was utilized to capture direct costs associated with the delivery of both interventions. Based on an analysis of activity logs and staff interviews, specific activities and the time required to complete each were analyzed as follows: a) NCM + CM only; b) SE + CM only; c) time to administer/record vaccines; and d) time to receive and record CM visits. Cost comparison of the interventions included only staffing costs and direct cash expenditures. RESULTS: The study outcomes showed significant over time reductions in all measures of drug use and multiple sex partners, compared to baseline, although no significant between-group differences were detected. Cost analysis favored the simpler SE + CM intervention over the more labor-intensive NCM + CM approach. Because of the high levels of staffing required for the NCM relative to SE, costs associated with it were significantly higher. CONCLUSIONS: Findings suggest that while both intervention strategies were equally effective in achieving desired health outcomes, the brief SE + CM appeared less expensive to deliver.


Assuntos
Estimulantes do Sistema Nervoso Central/administração & dosagem , Análise Custo-Benefício , Promoção da Saúde/economia , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adulto , Bissexualidade/psicologia , Bissexualidade/estatística & dados numéricos , Feminino , Promoção da Saúde/métodos , Pessoas em Situação de Rua/psicologia , Pessoas em Situação de Rua/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Minorias Sexuais e de Gênero/estatística & dados numéricos , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos
13.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 52(10): 744-748, 2017 Oct 07.
Artigo em Chinês | MEDLINE | ID: mdl-29050091

RESUMO

Objective: To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy. Methods: The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ(2) tests. Results: Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ(2)=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ(2)=0.31, χ(2)=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ(2)=6.68, P<0.05). Conclusions: MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.


Assuntos
Fístula/congênito , Fístula/diagnóstico , Doenças Faríngeas/congênito , Doenças Faríngeas/diagnóstico , Seio Piriforme , Adolescente , Bário , Estudos de Viabilidade , Humanos , Hipofaringe , Laringoscopia/métodos , Pescoço , Postura , Estudos Prospectivos , Rotação , Tomografia Computadorizada por Raios X , Manobra de Valsalva
15.
Sci Rep ; 7(1): 7740, 2017 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-28798487

RESUMO

While pyrochlore iridate thin films are theoretically predicted to possess a variety of emergent topological properties, experimental verification of these predictions can be obstructed by the challenge in thin film growth. Here we report on the pulsed laser deposition and characterization of thin films of a representative pyrochlore compound Bi2Ir2O7. The films were epitaxially grown on yttria-stabilized zirconia substrates and have lattice constants that are a few percent larger than that of the bulk single crystals. The film composition shows a strong dependence on the oxygen partial pressure. Density-functional-theory calculations indicate the existence of BiIr antisite defects, qualitatively consistent with the high Bi: Ir ratio found in the films. Both Ir and Bi have oxidation states that are lower than their nominal values, suggesting the existence of oxygen deficiency. The iridate thin films show a variety of intriguing transport characteristics, including multiple charge carriers, logarithmic dependence of resistance on temperature, antilocalization corrections to conductance due to spin-orbit interactions, and linear positive magnetoresistance.

17.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(7): 841-844, 2017 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-28738453

RESUMO

WHO has developed and issued global hepatitis B elimination program. Continuing hepatitis B immunization and conducting community based antiviral treatment for chronic hepatitis B are the most important strategies for hepatitis B elimination. According to the estimation of related cost by WHO, the cost of antiviral therapy would be very high. Great achievement has been made in hepatitis B immunization in China, but the prevalence of chronic hepatitis B is high. Elimination of hepatitis B needs a large amount of public resource, posing serious challenge to public health policy making. Economics research on hepatitis B prevention and treatment can provide evidence and technical support for hepatitis B elimination. In this column "Economic evaluations of hepatitis B" , the related articles in this issue summarize the progress in this research field, which is inspiring and encouraging.


Assuntos
Análise Custo-Benefício , Vacinas contra Hepatite B/administração & dosagem , Hepatite B/epidemiologia , Hepatite B/prevenção & controle , Vacinação/métodos , Antivirais/uso terapêutico , China , Hepatite B/complicações , Hepatite B Crônica , Humanos , Programas de Imunização
18.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(7): 845-851, 2017 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-28738454

RESUMO

Objective: To construct the Markov models to reflect the reality of prevention and treatment interventions against hepatitis B virus (HBV) infection, simulate the natural history of HBV infection in different age groups and provide evidence for the economics evaluations of hepatitis B vaccination and population-based antiviral treatment in China. Methods: According to the theory and techniques of Markov chain, the Markov models of Chinese HBV epidemic were developed based on the national data and related literature both at home and abroad, including the settings of Markov model states, allowable transitions and initial and transition probabilities. The model construction, operation and verification were conducted by using software TreeAge Pro 2015. Results: Several types of Markov models were constructed to describe the disease progression of HBV infection in neonatal period, perinatal period or adulthood, the progression of chronic hepatitis B after antiviral therapy, hepatitis B prevention and control in adults, chronic hepatitis B antiviral treatment and the natural progression of chronic hepatitis B in general population. The model for the newborn was fundamental which included ten states, i.e. susceptiblity to HBV, HBsAg clearance, immune tolerance, immune clearance, low replication, HBeAg negative CHB, compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC) and death. The susceptible state to HBV was excluded in the perinatal period model, and the immune tolerance state was excluded in the adulthood model. The model for general population only included two states, survive and death. Among the 5 types of models, there were 9 initial states assigned with initial probabilities, and 27 states for transition probabilities. The results of model verifications showed that the probability curves were basically consistent with the situation of HBV epidemic in China. Conclusion: The Markov models developed can be used in economics evaluation of hepatitis B vaccination and treatment for the elimination of HBV infection in China though the structures and parameters in the model have uncertainty with dynamic natures.


Assuntos
Antivirais/administração & dosagem , Vacinas contra Hepatite B/economia , Hepatite B Crônica/prevenção & controle , Hepatite B/prevenção & controle , Programas de Imunização/economia , Vacinação em Massa/economia , Adulto , China , Hepatite B/imunologia , Antígenos de Superfície da Hepatite B , Vacinas contra Hepatite B/uso terapêutico , Antígenos E da Hepatite B , Vírus da Hepatite B/imunologia , Humanos , Recém-Nascido , Neoplasias Hepáticas , Cadeias de Markov
19.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(7): 852-859, 2017 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-28738455

RESUMO

Objective: To evaluate the cost effectiveness of nationwide prevention of mother to child transmission (PMTCT) strategy for hepatitis B, and estimate the willing to pay and budget impacts on the PMTCT. Methods: The decision analytic Markov model for the PMTCT was constructed and a birth cohort of Chinese infants born in 2013 was used to calculate the cost-effectiveness of the PMTCT among them compared with those receiving no intervention. The parameters in the model were obtained from literatures of national surveys or Meta-analysis. The costs, cases of HBV-related diseases and quality-adjusted life-years (QALYs) were obtained from the societal and payer perspectives, respectively. The incremental cost-effectiveness ratio (ICER) was used as measures of strategy optimization. One-way and probability sensitivity analysis were performed to explore the uncertainty of the primary results. In addition, cost-effectiveness acceptability curve and cost-effectiveness affordability curves were drawn to illustrate the cost effectiveness threshold and financial budget of the PMTCT strategy. Results: The lifetime cost for PMTCT strategy was 4 063.5 yuan (RMB) per carrier, which was 37 829.7 yuan (RMB) lower compared with those receiving no intervention. Due to the strategy, a total of 24.516 1 QALYs per person would be gained, which was higher than that in those receiving no intervention. From societal perspective, the ICER was -59 136.6 yuan (RMB) per additional QALYs gained, indicating that the PMTCT is cost effective. The results were reliable indicated by one-way, multi-way and probability sensitivity analyses. By the CEAC, the willing to pay was much lower than the cost-effectiveness threshold. From the affordability curve of the PMTCT strategy, the annual budget ranged from 590.4 million yuan (RMB) to 688.8 million yuan (RMB), which was lower than the financial ability. Based on the results of cost-effectiveness affordability curves, the higher annual budget was determined, the higher probability of affordability for the PMTCT would be obtained under the same willing to pay state. Only when the annual budget reaches 688.8 million yuan (RMB), the goal of PMTCT would be fully realized. Conclusions: The PMTCT strategy in China was cost effective, and the cost is not beyond the financial budget needed and the willing to pay. The strategy, which is consistent with the global hepatitis B elimination efforts, should be conducted widely in China.


Assuntos
Análise Custo-Benefício , Transmissão Vertical de Doença Infecciosa/economia , Criança , China , Hepatite B , Humanos , Lactente , Anos de Vida Ajustados por Qualidade de Vida
20.
Zhonghua Liu Xing Bing Xue Za Zhi ; 38(7): 860-867, 2017 Jul 10.
Artigo em Chinês | MEDLINE | ID: mdl-28738456

RESUMO

Objective: Since eliminating hepatitis B in China would need considerable public health resources, the economics problem of the strategy of community-based antiviral treatment for chronic hepatitis B (CHB) has become an important issue. The cost-effectiveness and affordability of the strategy were evaluated in this study. Methods: According to the advocacy on eliminating hepatitis B by WHO and the comprehensive protocol of community based prevention of major infectious diseases and the guideline for CHB prevention and treatment in China, the decision analytic Markov model was constructed with the parameters from national surveys or Meta-analysis. A cohort population aged 20-59 years was used as study subjects. The strategy of CHB antiviral treatment was compared with the strategies of hepatitis B vaccination and non-intervention, respectively. The costs and disability-adjusted life years (QALYs) of the strategies were calculated from the societal and payer perspectives. The incremental cost-effectiveness ratio (ICER) and the cost-effectiveness ratio (CER) were calculated for the comparison of the strategies. One-way and probability sensitivity analysis were performed for uncertainty of the results. And the cost-effectiveness and affordability curves were introduced to estimate the budget impact on the strategies. Results: In the Chinese aged 20-59 years, the ICER of CHB antiviral treatment was 37 598.6 yuan (RMB) per QALYs and the ICERs were smaller in the low age groups, indicating that the antiviral treatment strategy is cost-effective and low age groups should be the priority population. The ICER of hepatitis B vaccination was -64 000.0 yuan (RMB) per QALYs, indicating that hepatitis B vaccination is cost saving. The CER of CHB antiviral treatment ranged from 731.8 to 1 813.3 yuan (RMB) per QALYs compared with hepatitis B vaccination, and the CER of CHB antiviral treatment was higher than that of hepatitis B vaccination in all age groups, indicating that hepatitis B vaccination would be more cost-effective than CHB antiviral treatment. The price of antiviral drug, entercavir, can influence the cost effectiveness of CHB antiviral treatment. If the price of entercavir declined half, CHB antiviral treatment would be cost-saving. The probability sensitivity analysis showed that people's willing to pay for CHB antiviral treatment should not be ignored, although the results of economics evaluation of CHB antiviral treatment were reliable. The results of affordability analysis indicated that the antiviral treatment strategy could not be implemented with the budget lower than 30 million yuan (RMB), the probability of implementing the strategy was 42.6% if the budget reaches 127 million yuan (RMB), and only when the budget reaches 269 million yuan (RMB), the goal of CHB antiviral treatment strategy can be fully realized. Conclusions: Although the strategy of CHB antiviral treatment as prevention in Chinese aged 20-59 years is cost-effective, it is not an appropriate public health measure due to the high cost. The cost effectiveness would be higher by conducting hepatitis B vaccination and then antiviral treatment in susceptible population.


Assuntos
Antivirais/economia , Antivirais/uso terapêutico , Análise Custo-Benefício , Antígenos E da Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/virologia , Adulto , China , Antígenos E da Hepatite B/metabolismo , Hepatite B Crônica/imunologia , Humanos , Pessoa de Meia-Idade , Vigilância da População , Anos de Vida Ajustados por Qualidade de Vida , Adulto Jovem
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