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1.
Front Cell Infect Microbiol ; 11: 721439, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604110

RESUMO

Background: The incidence of invasive candidiasis is increasing worldwide. However, the epidemiology, antifungal susceptibility, and virulence of Candida spp. in most hospitals remain unclear. This study aimed to evaluate invasive candidiasis in a tertiary care hospital in Nanchang City, China. Methods: MALDI-TOF MS and 18S rDNA ITS sequencing were used to identify Candida strains. Randomly amplified polymorphic DNA analysis was used for molecular typing; biofilm production, caseinase, and hemolysin activities were used to evaluate virulence. The Sensititre™ YeastOne YO10 panel was used to examine antifungal susceptibility. Mutations in ERG11 and the hotspot regions of FKS1 of drug-resistant strains were sequenced to evaluate the possible mechanisms of antifungal resistance. Results: We obtained 110 Candida strains, which included 40 Candida albicans (36.36%), 37 C. parapsilosis (33.64%), 21 C. tropicalis (19.09%), 9 C. glabrata (8.18%), 2 C. rugose (1.82%), and 1 C. haemulonii (0.91%) isolates. At a limiting point of 0.80, C. albicans isolates could be grouped into five clusters, C. parapsilosis and C. tropicalis isolates into seven clusters, and C. glabrata isolates into only one cluster comprising six strains by RAPD typing. Antifungal susceptibility testing revealed that the isolates showed the greatest overall resistance against fluconazole (6.36%), followed by voriconazole (4.55%). All C. albicans and C. parapsilosis isolates exhibited 100% susceptibility to echinocandins (i.e., anidulafungin, caspofungin, and micafungin), whereas one C. glabrata strain was resistant to echinocandins. The most common amino acid substitutions noted in our study was 132aa (Y132H, Y132F) in the azole-resistant strains. No missense mutation was identified in the hotpot regions of FKS1. Comparison of the selected virulence factors detectable in a laboratory environment, such as biofilm, caseinase, and hemolysin production, revealed that most Candida isolates were caseinase and hemolysin producers with a strong activity (Pz < 0.69). Furthermore, C. parapsilosis had greater total biofilm biomass (average Abs620 = 0.712) than C. albicans (average Abs620 = 0.214, p < 0.01) or C. tropicalis (average Abs620 = 0.450, p < 0.05), although all C. glabrata strains were either low- or no-biofilm producers. The virulence level of the isolates from different specimen sources or clusters showed no obvious correlation. Interesting, 75% of the C. albicans from cluster F demonstrated azole resistance, whereas two azole-resistant C. tropicalis strains belonged to the cluster Y. Conclusion: This study provides vital information regarding the epidemiology, pathogenicity, and antifungal susceptibility of Candida spp. in patients admitted to Nanchang City Hospital.

3.
Sci Rep ; 11(1): 17846, 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34497313

RESUMO

We studied the effects of leaf surface characteristics on canopy droplet behaviour using two rice cultivars with similar leaf shapes but significantly different leaf surface characteristics: Jia58 (glabrous rice; smooth leaf surface and no burrs) and Yongyou12 (hairy-leaved rice; rough leaf surface covered with burrs). The plants were subjected to spray tests with different spray pressures and nozzle apertures. The results showed that the deposition amount per unit leaf area was significantly higher in the Yongyou12 canopy than in the Jia58 canopy. The diameter, volume median diameter, number median diameter, and coverage of droplets were significantly higher in Yongyou12 than in Jia58, while the coverage density of droplets was significantly lower. The proportion of small droplets of Jia58 is higher than that of Yongyou12. Thus, a larger amount of large-sized droplets could retain on the leaf surface of hairy-leaved rice, and a larger number of small-sized droplets were retained on the leaf surface of glabrous rice. Smaller pressure and larger flow nozzle were conducive to the retention of the Jia58, while Yongyou12 required larger pressure and larger flow nozzles. Ultrastructural analyses revealed that the leaf surface of glabrous rice had no trichomes and more wax than hairy-leaved rice, and the critical surface tension was lower, resulting in the retention of mainly small droplets on its leaf surface and a lower deposition amount. Therefore, in order to increase the deposition of pesticide droplets on the leaf surface in production, glabrous rice should choose nozzles with smaller spray pressure and large flow rate.

4.
Mol Med Rep ; 24(5)2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34558644

RESUMO

Inflammation and oxidative stress are key steps in the progression of non­alcoholic steatohepatitis (NASH). Intervention in these two processes will therefore benefit NASH treatment. Peroxisome proliferator­activated receptor Î³ (PPARγ), as a multiple functional transcription factor, has been reported to be involved in the prevention of NASH progression. However, the mechanism by which PPARγ prevents NASH remains to be elucidated. The present study demonstrated that the level of PPARγ was inversely correlated with that of microRNA (miRNA/miRs)­21­5p in both mice and humans with NASH. Activation of PPARγ inhibited lipid droplet accumulation, hepatic inflammation and oxidative stress by downregulating miR­21­5p in an in vitro model. Luciferase reporter and chromatin immunoprecipitation assays demonstrated that PPARγ suppressed transcriptional activity of miR­21­5p and bound to miR­21­5p promoter region. Furthermore, PPARγ downregulated miR­21­5p while miR­21­5p upregulated secreted frizzled­related protein 5 (SFRP5) by targeting the 3'­UTR of its mRNA. In vivo experiments revealed that PPARγ repressed inflammation and oxidative stress and miR­21­5p expression while increased SFRP5 level in a NASH mouse model. In summary, PPARγ attenuates inflammation and oxidative stress in NASH by modulating the miR­21­5p/SFRP5 pathway, thus holding promise of a new target for NASH treatment.

5.
Insects ; 12(7)2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34357274

RESUMO

We studied the parasitism capacity of Spalangia endius as a pupal parasite of Bactocera dorsalis after switching hosts. We used pupae of B. dorsalis and M. domestica as the hosts and studied parasitism by S. endius in the laboratory. The parasitism capacities were compared at different host densities and different parasitoid ages. The two functional responses of S. endius fitted a Holling Type II equation. More M. domestica were parasitized than B. dorsalis at all the densities. The ability of S. endius to control M. domestica was α/Th (parasitism capacity) = 32.1950, which was much stronger than that of control B. dorsalis, which was α/Th = 4.7380. The parasitism rate of wasps that had parasitized B. dorsalis had decreased by the emergence time of parasitoids. These results suggest that the parasitoid-pest ratio should be 1:25 to maintain a relatively stable parasitism rate for control of B. dorsalis. The S. endius colony reared on M. domestica successfully controlled a low-density population of B. dorsalis in the lab. We provide evidence suggesting that the parasitism capacity of S. endius needs to be improved.

6.
Pharmaceuticals (Basel) ; 14(7)2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34358108

RESUMO

Angiogenesis plays a crucial role in tumor development and metastasis. Both bevacizumab and cediranib have demonstrated activity as single anti-angiogenic agents in endometrial cancer, though subsequent studies of bevacizumab combined with chemotherapy failed to improve outcomes compared to chemotherapy alone. Our objective was to compare the efficacy of cediranib and bevacizumab in endometrial cancer models. The cellular effects of bevacizumab and cediranib were examined in endometrial cancer cell lines using extracellular signal-related kinase (ERK) phosphorylation, ligand shedding, cell viability, and cell cycle progression as readouts. Cellular viability was also tested in eight patient-derived organoid models of endometrial cancer. Finally, we performed a phosphoproteomic array of 875 phosphoproteins to define the signaling changes related to bevacizumab versus cediranib. Cediranib but not bevacizumab blocked ligand-mediated ERK activation in endometrial cancer cells. In both cell lines and patient-derived organoids, neither bevacizumab nor cediranib alone had a notable effect on cell viability. Cediranib but not bevacizumab promoted marked cell death when combined with chemotherapy. Cell cycle analysis demonstrated an accumulation in mitosis after treatment with cediranib + chemotherapy, consistent with the abrogation of the G2/M checkpoint and subsequent mitotic catastrophe. Molecular analysis of key controllers of the G2/M cell cycle checkpoint confirmed its abrogation. Phosphoproteomic analysis revealed that bevacizumab and cediranib had both similar and unique effects on cell signaling that underlie their shared versus individual actions as anti-angiogenic agents. An anti-angiogenic tyrosine kinase inhibitor such as cediranib has the potential to be superior to bevacizumab in combination with chemotherapy.

7.
FASEB J ; 35(9): e21801, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34365657

RESUMO

The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) plays a crucial role in mediating viral entry into host cells. However, whether it contributes to pulmonary hyperinflammation in patients with coronavirus disease 2019 is not well known. In this study, we developed a spike protein-pseudotyped (Spp) lentivirus with the proper tropism of the SARS-CoV-2 spike protein on the surface and determined the distribution of the Spp lentivirus in wild-type C57BL/6J male mice that received an intravenous injection of the virus. Lentiviruses with vesicular stomatitis virus glycoprotein (VSV-G) or with a deletion of the receptor-binding domain (RBD) in the spike protein [Spp (∆RBD)] were used as controls. Two hours postinfection (hpi), there were 27-75 times more viral burden from Spp lentivirus in the lungs than in other organs; there were also about 3-5 times more viral burden from Spp lentivirus than from VSV-G lentivirus in the lungs, liver, kidney, and spleen. Deletion of RBD diminished viral loads in the lungs but not in the heart. Acute pneumonia was observed in animals 24 hpi. Spp lentivirus was mainly found in SPC+ and LDLR+ pneumocytes and macrophages in the lungs. IL6, IL10, CD80, and PPAR-γ were quickly upregulated in response to infection in the lungs as well as in macrophage-like RAW264.7 cells. Furthermore, forced expression of the spike protein in RAW264.7 cells significantly increased the mRNA levels of the same panel of inflammatory factors. Our results demonstrated that the spike protein of SARS-CoV-2 confers the main point of viral entry into the lungs and can induce cellular pathology. Our data also indicate that an alternative ACE2-independent viral entry pathway may be recruited in the heart and aorta.


Assuntos
Macrófagos/imunologia , Pneumonia Viral/imunologia , Pneumonia Viral/patologia , Glicoproteína da Espícula de Coronavírus/imunologia , Doença Aguda , Células Epiteliais Alveolares/virologia , Animais , Antígeno B7-1 , Linhagem Celular , Mediadores da Inflamação , Interleucina-10 , Interleucina-6 , Lentivirus/genética , Lentivirus/isolamento & purificação , Lentivirus/metabolismo , Pulmão/imunologia , Pulmão/patologia , Pulmão/virologia , Macrófagos/virologia , Masculino , Glicoproteínas de Membrana , Camundongos , Camundongos Endogâmicos C57BL , PPAR gama , Células RAW 264.7 , Glicoproteína da Espícula de Coronavírus/química , Glicoproteína da Espícula de Coronavírus/genética , Glicoproteína da Espícula de Coronavírus/metabolismo , Proteínas do Envelope Viral
8.
BMC Infect Dis ; 21(1): 723, 2021 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-34332526

RESUMO

BACKGROUND: Fatal hemorrhagic pneumonia is one of the most severe manifestations of Stenotrophomonas maltophilia (SM) infections. Here, we aimed to investigate the clinical characteristics of SM bacteremia and to identify the risk factors of hemorrhagic pneumonia caused by SM in patients with hematologic diseases. METHODS: The clinical records of 55 patients diagnosed with hematologic diseases and SM bacteremia were retrospectively reviewed. We compared patients' clinical characteristics and outcomes between the hemorrhagic pneumonia group and non-hemorrhagic pneumonia group. RESULTS: Twenty-seven (49.1%) patients developed hemorrhagic pneumonia. The overall mortality rate of SM bacteremia was 67.3%. Hemorrhagic pneumonia (adjusted HR 2.316, 95% CI 1.140-4.705; P = 0.020) was an independent risk factor of 30-day mortality in hematological patients with SM bacteremia. Compared with the non-hemorrhagic pneumonia group, patients in the hemorrhagic pneumonia group were older and showed clinical manifestations as higher proportions of isolated SM in sputum culture, neutropenia and elevated procalcitonin (PCT). Multivariate analysis showed that neutropenia, high levels of PCT, prior tigecycline therapy within 1 month were independent risk factors associated with hemorrhagic pneumonia. CONCLUSIONS: Neutropenia, high level of PCT and prior tigecycline therapy within 1 month were significant independent predictors of hemorrhagic pneumonia in hematologic patients with SM bacteremia. Due to no effective antibiotics to prevent hemorrhagic pneumonia, prophylaxis of SM infection and its progression to hemorrhagic pneumonia is particularly important.


Assuntos
Doenças Hematológicas , Neoplasias Hematológicas , Pneumonia , Stenotrophomonas maltophilia , Infecções por Bactérias Gram-Negativas , Humanos , Hospedeiro Imunocomprometido , Estudos Retrospectivos , Stenotrophomonas maltophilia/imunologia
9.
Cell ; 184(16): 4348-4371.e40, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34358469

RESUMO

Lung squamous cell carcinoma (LSCC) remains a leading cause of cancer death with few therapeutic options. We characterized the proteogenomic landscape of LSCC, providing a deeper exposition of LSCC biology with potential therapeutic implications. We identify NSD3 as an alternative driver in FGFR1-amplified tumors and low-p63 tumors overexpressing the therapeutic target survivin. SOX2 is considered undruggable, but our analyses provide rationale for exploring chromatin modifiers such as LSD1 and EZH2 to target SOX2-overexpressing tumors. Our data support complex regulation of metabolic pathways by crosstalk between post-translational modifications including ubiquitylation. Numerous immune-related proteogenomic observations suggest directions for further investigation. Proteogenomic dissection of CDKN2A mutations argue for more nuanced assessment of RB1 protein expression and phosphorylation before declaring CDK4/6 inhibition unsuccessful. Finally, triangulation between LSCC, LUAD, and HNSCC identified both unique and common therapeutic vulnerabilities. These observations and proteogenomics data resources may guide research into the biology and treatment of LSCC.

10.
Proc Natl Acad Sci U S A ; 118(36)2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34413211

RESUMO

The global spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the associated disease COVID-19, requires therapeutic interventions that can be rapidly identified and translated to clinical care. Traditional drug discovery methods have a >90% failure rate and can take 10 to 15 y from target identification to clinical use. In contrast, drug repurposing can significantly accelerate translation. We developed a quantitative high-throughput screen to identify efficacious agents against SARS-CoV-2. From a library of 1,425 US Food and Drug Administration (FDA)-approved compounds and clinical candidates, we identified 17 hits that inhibited SARS-CoV-2 infection and analyzed their antiviral activity across multiple cell lines, including lymph node carcinoma of the prostate (LNCaP) cells and a physiologically relevant model of alveolar epithelial type 2 cells (iAEC2s). Additionally, we found that inhibitors of the Ras/Raf/MEK/ERK signaling pathway exacerbate SARS-CoV-2 infection in vitro. Notably, we discovered that lactoferrin, a glycoprotein found in secretory fluids including mammalian milk, inhibits SARS-CoV-2 infection in the nanomolar range in all cell models with multiple modes of action, including blockage of virus attachment to cellular heparan sulfate and enhancement of interferon responses. Given its safety profile, lactoferrin is a readily translatable therapeutic option for the management of COVID-19.


Assuntos
Antivirais/farmacologia , Fatores Imunológicos/farmacologia , Lactoferrina/farmacologia , SARS-CoV-2/efeitos dos fármacos , Internalização do Vírus/efeitos dos fármacos , Replicação Viral/efeitos dos fármacos , Animais , COVID-19/tratamento farmacológico , COVID-19/imunologia , COVID-19/prevenção & controle , COVID-19/virologia , Células CACO-2 , Linhagem Celular Tumoral , Chlorocebus aethiops , Relação Dose-Resposta a Droga , Descoberta de Drogas , Reposicionamento de Medicamentos/métodos , Células Epiteliais , Heparitina Sulfato/antagonistas & inibidores , Heparitina Sulfato/imunologia , Heparitina Sulfato/metabolismo , Hepatócitos , Ensaios de Triagem em Larga Escala , Humanos , SARS-CoV-2/crescimento & desenvolvimento , SARS-CoV-2/patogenicidade , Células Vero
11.
Int J Clin Pract ; 75(10): e14619, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34235827

RESUMO

PURPOSE: In ambulant patients with lower limb DVT managed with Warfarin, there is a need for initial treatment and short time "bridging" with a rapidly acting anticoagulant until there is a stable therapeutic INR. In this study, results from bridging with subcutaneous low molecular weight heparin (LMWH) or oral Rivaroxaban were compared. METHODS: One hundred and twenty-four patients received LMWH and 98 patients received Rivaroxaban, both in addition to Warfarin. Patients were assessed at 1 and 4 weeks after treatment initiation for thrombus progression, bleeding, clinic attendance and INR. FINDINGS: The treatment groups were well matched. There were no significant differences between the treatment groups for any of the end-points at either 1 week or 4 weeks. IMPLICATIONS: In ambulant patients with DVT treated with Warfarin both Rivaroxaban and LMWH are suitable for use in the early phase of Warfarin treatment until therapeutic INR is achieved. Rivaroxaban is a suitable alternative to LMWH for patients who prefer not to have injections.


Assuntos
Anticoagulantes , Trombose Venosa , Anticoagulantes/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Humanos , Rivaroxabana/uso terapêutico , Trombose Venosa/tratamento farmacológico , Varfarina/uso terapêutico
12.
Sci Total Environ ; 794: 148608, 2021 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-34323765

RESUMO

Biochar has recently been widely used in environmental geotechnical engineering. However, its impact on soil cracking is not fully understood. In this study, the influence of different wood biochar dosages on the desiccation cracking characteristics of silty clay was studied, and the mechanism was elucidated through a combination of image and microstructural analysis. The results indicate biochar affects the desiccation cracking characteristics of soil across the whole process of water evaporation and crack development. The evaporation rate decreased with low amounts of biochar, but increased as the biochar content increased. At the stage of crack development, the addition of biochar increased the soil cracking water content, induced the formation of annular cracks in soil, and changed the soil crack development process. Quantitative results of the stabilized cracks show the surface crack ratio was decreased by 11.59% and 34.32%, and the average crack width was decreased by 14.83%, and 34.51%, after 5% and 10% biochar addition, respectively. Meanwhile, most of the single cracks in biochar-amended soil are fine. In addition, the surface crack ratio of soil without biochar addition first increased and then stabilized with an increase in the number of wetting-drying (W-D) cycles, while that of the biochar-amended soil decreased slightly. Comparing the crack networks after one and five W-D cycles, the number of cracks formed with 5% and 10% biochar addition decreased by -1.51% and 19.24%, and 15.29%, and 36.92%, respectively, indicating that after the addition of biochar, the soil becomes more resistant to cracking under W-D cycles. In summary, the addition of biochar may have inhibited desiccation cracking by (1) reducing the tensile stress on the soil surface, (2) increasing the repulsive forces between soil particles, (3) occupying the shrinkage space between soil particles, and (4) reducing the tensile strength between soil particles.


Assuntos
Carvão Vegetal , Dessecação , Argila , Solo
13.
Hematology ; 26(1): 435-443, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34130602

RESUMO

A retrospective study on 287 patients with SAA who underwent allo-HSCT between October 2012 and January 2020 was conducted to explore the outcomes, risk factors and treatment options for MC. Among 287 AA patients who excluded Fanconi anemia (FA), Congenital dyskeratosis (DKC), Paroxysmal nocturnal hemoglobinuria (PNH), etc.112 underwent matched sibling donor (MSD)-HSCT, 91 matched unrelated donor-HSCT and 84 haploidentical-HSCT. Patients were divided into the following 4 groups: group 1: Donor chimerism (DC); group 2: MC without cytopenia; group 3: MC with cytopenia; group 4: secondary graft failure (SGF).Compared with the other three groups, SGF predicted a poor prognosis of SAA (P< 0.001). In addition, SGF was associated with the early (within 3 months after transplantation) presence of MC and the high levels of MC. Uni- and multivariate logistic regression analysis showed that donor/recipient sex-mismatching and CTX + ATG regimen were high-risk factors for MC. Of note, in MC patients with cytopenia (group 3), the effective response rate reached 55% (6/11) following enhanced immunosuppression combined with cellular therapy, while only one of the four was effective who received enhanced immunosuppression alone.SGF was associated with poor prognosis, early presence of MC and increased levels of recipient chimerism. The donor/recipient sex-mismatching and CTX + ATG regimen based MSD-HSCT were risk factors for MC. Cellular therapy could improve the effective response rate of patients with progressive MC.


Assuntos
Anemia Aplástica/terapia , Quimerismo , Transplante de Células-Tronco Hematopoéticas , Adulto , Anemia Aplástica/diagnóstico , Anemia Aplástica/genética , Feminino , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transplante Homólogo/efeitos adversos
14.
Colloids Surf B Biointerfaces ; 205: 111880, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34116399

RESUMO

Development of a multifunctional nanotherapeutic agent with high contrast-enhanced dual-modal imaging and photothermal therapy (PTT) efficacy is of great interest. Combination of ultrasound (US) and computed tomography (CT) imaging offers high spatial resolution images, showing great potential in medical imaging. Herein, the semiconducting perfluorohexane (PFH) nanodroplets, MoS2-PFH-PLLAs, are developed by stabilizing PFH droplets with the coating shell of poly (lactic-co-glycolic acid) (PLLA) and encapsulating the droplets with photoabsorbers of ultrasmall molybdenum disulfide (MoS2) nanodots. Upon near-infrared (NIR) irradiation, the MoS2-PFH-PLLAs can absorb the NIR light and convert it into heat, which not only promotes liquid-to-gas phase transition of PFH but also triggers photothermal heating, resulting in contrast-enhanced US/CT imaging and photothermal killing effect in vitro. Furthermore, the production of microbubbles can serve as the blasting agents to collaboratively enhance PTT efficacy after NIR irradiation. When intravenously injected into tumor-bearing mice, the MoS2-PFH-PLLAs exhibit a dual-modal US/CT imaging-guided synergistically therapeutic efficacy under NIR irradiation, resulting in tumor ablation. These nanotherapeutic agents demonstrate good biocompatibility, highly contrast-enhanced US/CT imaging, and combinational enhanced PTT efficacy.


Assuntos
Hipertermia Induzida , Nanopartículas , Neoplasias , Animais , Linhagem Celular Tumoral , Diagnóstico por Imagem , Fluorcarbonetos , Camundongos , Molibdênio , Neoplasias/terapia , Fototerapia , Terapia Fototérmica
15.
Clin Interv Aging ; 16: 1173-1184, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34188460

RESUMO

Purpose: To determine the effectiveness of rehabilitation nursing program interventions in patients with acute ischemic stroke. Patients and Methods: An assessment-blinded randomized controlled trial was conducted at a tertiary referral hospital in China. Eligible patients were stratified according to their weighted corticospinal tract lesion load and then randomly assigned to an experimental group (n = 121) or a control group (n = 103). The experimental group received rehabilitation nursing from well-trained, qualified nurses (30 minutes per session, two sessions per day for seven consecutive days). The control group received therapist-led rehabilitation with the same timing and frequency. Comparative analysis of the primary outcomes was performed to determine non-inferiority with a predetermined non-inferiority margin. The primary outcomes were the Motor Assessment Scale, Fugl-Meyer Assessment, and the Action Research Arm Test assessed at baseline and after seven days of treatment. The secondary outcomes were the modified Barthel Index, the National Institutes of Health Stroke Scale, and the modified Rankin Scale, evaluated before and after the intervention and at 4 and 12 weeks of follow-up. Results: Two hundred participants completed the trial. In both groups, all outcomes improved significantly after seven days and at follow-ups. The rehabilitation nursing program was non-inferior to therapist-led treatment with lower 95% confidence limits beyond the margins for primary outcomes (P < 0.001). Conclusion: Both treatments had comparable effects; however, no definite conclusion could be drawn. Adequately powered studies are required.


Assuntos
Isquemia Encefálica/enfermagem , AVC Isquêmico/enfermagem , Enfermagem em Reabilitação/métodos , Reabilitação do Acidente Vascular Cerebral/métodos , Idoso , China , Terapia por Exercício/enfermagem , Humanos , Masculino , Pessoa de Meia-Idade , Relações Profissional-Paciente , Acidente Vascular Cerebral/terapia , Resultado do Tratamento
16.
Ann Palliat Med ; 10(6): 6892-6899, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34154364

RESUMO

BACKGROUND: As the last resort in intensive care units, physical restraint reduction is affected by various interventions. Several non-pharmacological interventions may directly reduce physical restraints, such as staff education, or indirectly reduce physical restraint, such as delirium prevention; however, their effectiveness has remained inconclusive. Therefore, we devised a protocol for umbrella reviews to summarize the evidence integrating data of different non-pharmacological interventions that may reduce physical restraint use. METHODS: The umbrella review will be conducted following the methodology formulated by the Joanna Briggs Institute (JBI). Electronic databases, including Web of Science, PubMed, EMBASE, PsycInfo, Psyc Articles, Psychology and Behavioral Science Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL), JBISRIS (JBI Database of Systematic Reviews and Implementation Reports), Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI, for Chinese literature), SinoMed (for Chinese literature), and WANFANG DATA (for Chinese literature), will be searched to identify articles published from January 2016 to December 2020. A systematic review and meta-analysis quality will be critically assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews). According to the GRADE (Grades of Recommendation, Assessment, Development, and Evaluation) guidelines, the evidence quality of each intervention will be assessed. Overlapping studies and the excess significance test will be performed to assess whether previous evidences are bias. DISCUSSION: This protocol was devised according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Umbrella reviews will be an excellent supplement to the evidence of the guideline adaptation and provide a broader picture of non-pharmacological interventions that may reduce the use of physical restraint, which can provide critical care nurses in intensive care units with the evidence they need. TRIAL REGISTRATION: This umbrella review protocol was documented in the PROSPERO registry (CRD42021242586).


Assuntos
Unidades de Terapia Intensiva , Restrição Física , China , Humanos , Metanálise como Assunto , Literatura de Revisão como Assunto , Revisões Sistemáticas como Assunto
17.
Geriatr Nurs ; 42(4): 843-849, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090229

RESUMO

Many terminally ill older adults depend on family members to make medical decisions in China. Many family members find it difficult to make do-not-resuscitate (DNR) decisions in emergency departments (ED). Currently, factors that affect DNR decision making by family members for older adults needing emergency care have not been well studied. This qualitative inquiry explores factors influencing DNR decision-making among family members of terminally ill older adults in ED. Semi-structured in-depth interviews were conducted for a 12-family member of terminally ill older adults at ED in China. Results of the conventional content analysis showed that family members made DNR decisions based on a wide of reasons: (a) subjective perception of family members, (b) conditions of the terminally ill older adults, (c) external environmental factors, and (d) internal family factors. The findings of this study expand our knowledge and understanding of factors influencing DNR decision-making by family members of terminally ill older adults in ED.

18.
Nurs Crit Care ; 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34132439

RESUMO

BACKGROUND: The early prediction model for delirium in intensive care units (ICUs)-E-PRE-DELIRIC-has been created to predict delirium development during the length of stay in ICUs. However, there have been few early predictive models for delirium in the cardiac surgical ICU (CSICU), and the predictive ability of the E-PRE-DELIRIC among patients following cardiac surgeries is still unknown. AIMS AND OBJECTIVES: To validate the performance of E-PRE-DELIRIC in CSICU. DESIGN: A retrospective cohort study. METHODS: Data were retrospectively extracted from the electronic records for patients admitted in CSICU from January 2018 to December 2018 in a tertiary teaching hospital in China. Adult patients were included following the criteria of the E-PRE-DELIRIC model. Predictors, including age, history of cognitive impairment, history of alcohol abuse, urgent admission, use of corticosteroids, respiratory failure, blood urea nitrogen, and mean arterial pressure, at the time of ICU admission were retrieved, and delirium was assessed twice a day using the Confusion Assessment Method for the ICU. The performance of the E-PRE-DELIRIC model was evaluated by area under receiver operator characteristic curve, precision-recall curve (AUPRC), Hosmer-Lemeshow (HL) test, and calibration belt. RESULTS: Of the 725 patients included, 120 (16.6%) developed delirium. The AUROC was 0.54 (95% confidence interval [CI], 0.48-0.59), and the AUPRC was 0.18 (95% CI, 0.12-0.20). The HL test showed a significant difference between predicted probability and delirium occurrence (χ2 = 17.326, P = .027), and the overestimation chance of the E-PRE-DELIRIC score was 0.24 to 0.43. CONCLUSION: The E-PRE-DELIRIC model has poor-to-fair predictive value in this study; thus, its application among the CSICU patients is limited. Development of reliable and validated tools for early prediction of delirium in CSICU is required. RELEVANCE TO CLINICAL PRACTICE: Early prediction of delirium risk at CSICU admission is of vital importance and could provide timely information to caregivers. However, the E-PRE-DELIRIC model should be applied cautiously in the CSICU because of the significant probability of over-estimating the risk of developing delirium.

19.
Sci Total Environ ; 784: 147221, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34088078

RESUMO

Semiconductor nanomaterials not only bring great convenience to peoples lives but also become a potential hazard to human health. The purpose of this study was to evaluate the toxicity of CuS/CdS nanocomposites in hepatocytes and mice liver. The CuS/CdS semiconductor nanocomposites were synthesized by a biomimetic synthesis - ion exchange strategy. Nanosize was confirmed by high-resolution transmission electron microscopy and dynamic light scattering. The composition and physical properties were measured by powder X-ray diffraction, Fourier transform infrared spectra, atomic absorption spectroscopy, thermogravimetry-differential scanning calorimetry and zeta potential analysis. The results revealed that CuS/CdS nanocomposites had 8.7 nm diameter and negative potential. Ion exchange time could adjust the ratio of CuS and CdS in nanocomposites. The toxicological study revealed that CuS/CdS nanocomposites could be internalized into liver cells, inhibited endogenous defense system (e.g. GSH and SOD), induced the accumulation of oxidation products (e.g. ROS, GSSG and MDA), and caused hepatocyte apoptosis. The in vivo experiments in Balb/c mice showed that the experimental dose (4 mg/kg) didn't cause observable changes in mice behavior, physical activity and pathological characteristics, but the continuous accumulation of Cd2+ in the liver and kidney might be responsible for its long-term toxicity.


Assuntos
Nanocompostos , Animais , Cobre , Hepatócitos , Fígado , Camundongos , Nanocompostos/toxicidade , Semicondutores , Espectroscopia de Infravermelho com Transformada de Fourier , Difração de Raios X
20.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(3): 944-950, 2021 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-34105498

RESUMO

OBJECTIVE: To investigate the clinical characteristics and risk factors of cytomegalovirus (CMV) infection after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe aplastic anemia (SAA). METHODS: Clinical data from 270 SAA patients with allo-HSCT were retrospectively analyzed, including 108 sib congruence patients and 162 substitute donors (68 unrelated donor congruence patients and 94 related haploid patients). Different pretreatment schemes were selected for different transplantation modes. The HLA-identical sibling and haploid grafts were all bone marrow and peripheral blood stem cells, and the grafts from unrelated donors were peripheral blood stem cells. After granulocyte implantation, blood CMV-DNA was regularly monitored. Flow cytometry was also used to determine the absolute number of CD3+, CD4+T lymphocytes and CD19+B lymphocytes at 1, 2, 3, 6 and 12 months after transplantation. RESULTS: CMV infection occurred in 229 of 270 patients with an incidence of 84.8%. Among them, 18 patients developed giant cell disease. Univariate analysis showed that alternative donors (unrelated total and haploid donors), mycophenolate mofetil and acute graft-versus-host disease were statistically significantly associated with CMV infection (P<0.05). Multivariate analysis showed that alternative donors were associated with CMV infection. The recovery of CD3+ and CD4+ in 6 months in the substitute donors was delayed in comparison with that in the full sib group. CONCLUSION: After allo-HSCT, substitute donors are more easily to develop CMV infection than full-sibling donors, and the reconstruction of immune function is delayed after transplantation.


Assuntos
Anemia Aplástica , Infecções por Citomegalovirus , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Humanos , Estudos Retrospectivos
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