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1.
Zhongguo Gu Shang ; 33(1): 43-6, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32115923

RESUMO

OBJECTIVE: To compare the relationship between direct lateral approach and posterolateral approach in the treatment of femoral neck fracture, and to provide reference for the choice of the best approach. METHODS: From January 2015 to December 2018, 266 patients with femoral neck fracture underwent hip replacement were selected, including 154 males and 112 females, aged 58 to 74 (69.8±8.1) years. Direct lateral approach and posterolateral approach were used in 133 cases in each group. The difference of reoperation rate and dislocation rate between the two groups was compared. Cox proportional risk regression model was used to evaluate the potential factors of reoperation and dislocation after total hip replacement. RESULTS: The rate of reoperation and dislocation in direct lateral approach group was lower than that in posterolateral approach group (P<0.05) . Cox proportional risk regression model showed that posterolateral approach had higher postoperative reoperation rate and dislocation rate than direct lateral approach, and its relative risk ratio (95%CI) was, reoperationï¼»2.65 (1.23- 5.36) , P=0.02ï¼½; dislocationï¼»5.15 (1.68-9.15) , P=0.01ï¼½. CONCLUSION: Posterolateral approach is the influencing factor of reoperation and dislocation after hip replacement. Age, gender, cognitive dysfunction, replacement position, ASA score and other factors have no effect on reoperation and dislocation.


Assuntos
Artroplastia de Quadril , Fraturas do Colo Femoral , Luxações Articulares , Idoso , Feminino , Fraturas do Colo Femoral/complicações , Fraturas do Colo Femoral/diagnóstico , Fraturas do Colo Femoral/cirurgia , Humanos , Luxações Articulares/complicações , Luxações Articulares/diagnóstico , Luxações Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Reoperação , Resultado do Tratamento
2.
Artigo em Inglês | MEDLINE | ID: mdl-32193931

RESUMO

To address the challenge from microbial resistance and biofilm, this work develops three gemini peptide amphiphiles with basic tetrapeptides spacer 12-(Arg)4-12, 12-(Lys)4-12 and 12-(His)4-12, and finds they exhibit varied antimicrobial/anti-biofilm activities. 12-(Arg)4-12 shows the best performance, possessing the broad-spectrum antimicrobial activity and excellent anti-biofilm capacity. The antimicrobial and anti-biofilm activities strongly depend on the membrane permeation and self-assembling structure of these peptide amphiphiles. Gemini peptide amphiphile with highly polar arginine as spacer, 12-(Arg)4-12, self-assembles into short rods which are prone to dissociate into monomers to permeate and lysis membrane, leading to its broad-spectrum antimicrobial activity and high efficiency in eradicating biofilm. Long rods formed by relatively weaker polar 12-(Lys)4-12 are less prone to disassemble into monomers for further membrane permeation, which make it selectively kill more negatively charged bacteria and endow it medium anti-biofilm activity. Low polar 12-(His)4-12 aggregates into long fibers which are very difficult to dissociate and they mainly electrostatically bind on the negative microbial surface, resulting in its weakest antimicrobial and anti-biofilm activity. This study reveals the effect of antimicrobial peptide structure and aggregation on the antimicrobial activities, and would be helpful for developing high-efficient antimicrobial peptides with anti-biofilm activity.

3.
Artigo em Inglês | MEDLINE | ID: mdl-32065712

RESUMO

An organic semiconductor-bacteria biohybrid photosynthetic system is used to efficiently realize CO2 reduction to produce acetic acid with the non-photosynthetic bacteria Moorella thermoacetica. Perylene diimide derivative (PDI) and poly(fluorene-co-phenylene) (PFP) were coated on the bacteria surface as photosensitizers to form a p-n heterojunction (PFP/PDI) layer, affording higher hole/electron separation efficiency. The π-conjugated semiconductors possess excellent light-harvesting ability and biocompatibility, and the cationic side chains of organic semiconductors could intercalate into cell membranes, ensuring efficient electron transfer to bacteria. Moorella thermoacetica can thus harvest photoexcited electrons from the PFP/PDI heterojunction, driving the Wood-Ljungdahl pathway to synthesize acetic acid from CO2 under illumination. The efficiency of this organic biohybrid is about 1.6 %, which is comparable to those of reported inorganic biohybrid systems.

4.
Chemistry ; 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32073730

RESUMO

It is challenging to design metal catalysts for in situ transformation of endogenous biomolecules with good performance inside living cells. Herein, we report a multifunctional metal catalyst, ruthenium-coordinated oligo(p-phenylenevinylene) (OPV-Ru), for intracellular catalysis of transfer hydrogenation of nicotinamide adenine dinucleotide (NAD+ ) to its reduced format (NADH). Owing to its amphiphilic characteristic, OPV-Ru possesses good self-assembly capability in water to form nanoparticles through hydrophobic interaction and π-π stacking, and numerous positive charges on the surface of nanoparticles displayed a strong electrostatic interaction with negatively charged substrate molecules, creating a local microenvironment for enhancing the catalysis efficiency in comparison to dispersed catalytic center molecule (TOF value was enhanced by about 15 fold). OPV-Ru could selectively accumulate in the mitochondria of living cells. Benefiting from its inherent fluorescence, the dynamic distribution in cells and uptake behavior of OPV-Ru could be visualized under fluorescence microscopy. This work represents the first demonstration of a multifunctional organometallic complex catalyzing natural hydrogenation transformation in specific subcellular compartments of living cells with excellent performance, fluorescent imaging ability, specific mitochondria targeting and good chemoselectivity with high catalysis efficiency.

5.
Biomater Sci ; 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32073034

RESUMO

The construction of intelligent self-assembly systems with cancer targeting photodynamic therapy abilities is highly required for increasing the precise therapeutic efficiency in clinical treatment. Herein, a cationic water soluble conjugated polymer (PFT-SH) functionalized with thiol groups was designed and synthesized via a palladium-catalyzed Suzuki coupling reaction. Firstly, PFT-SH can enter cells and form loose aggregations by hydrophobic and π-π stacking interactions. Secondly, a high level of H2O2 in cancer cells oxidizes sulfhydryl groups to disulfide bonds and then forms more and larger aggregations. Finally, PFT-SH showed remarkable ROS producing ability under white light irradiation with 78% quantum yields (ΦΔ). Due to this unique self-aggregation property, PFT-SH was successfully used to achieve in situ self-assembly specifically inside cancer cells for targeted imaging. Both the specific aggregation of PFT-SH in cancer cells and its ROS producing ability led to its use in the targeted killing of cancer cells through efficient photodynamic therapy.

6.
ACS Appl Mater Interfaces ; 12(7): 7995-8005, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32013384

RESUMO

The combination of photothermal therapy (PTT) with chemotherapy has great potential to maximize the synergistic effect of thermo-induced chemosensitization and improve treatment performance. To achieve high drug-loading capacity as well as precise synchronization between the controllable release of chemotherapeutics and the duration of near-infrared PTT, in this work, a facile one-step method was first developed to fabricate a novel injectable in situ forming photothermal modulated hydrogel drug delivery platform (D-PPy@PNAs), in which a PNIPAM-based temperature-sensitive acidic triblock polymer [poly(acrylic acid-b-N-isopropylamide-b-acrylic acid (PNA)] was utilized as the stabilizing agent in the polymerization of polypyrrole (PPy). The in situ forming hydrogels showed a sensitive temperature-responsive sol-gel phase-transition behavior, as well as an excellent photothermal property. The strong interaction of ionic bonds together with π-π stacking interactions resulted in high doxorubicin (DOX) loading capacity and controlled/sustained drug release behavior. In addition, D-PPy@PNAs also displayed enhanced cellular uptake and promoted intratumoral penetration of DOX upon NIR laser irradiation. The synergistic photothermal therapy-chemotherapy of D-PPy@PNA hydrogels greatly improved the antitumor efficacy in vivo. Therefore, thermosensitive polypyrrole-based D-PPy@PNA hydrogels may be powerful drug delivery nanoplatforms for precisely synergistic photothermo-chemotherapy of tumors.

7.
J Hazard Mater ; 392: 122279, 2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32087399

RESUMO

Bifunctional catalyst Fe/Fe3C@C with magnetism was successfully prepared by sol-gel method and proved to degrade methyl orange with high efficiency under microwave irradiation. The Fe/Fe3C@C catalysts calcined at 500 °C, 600 °C, 700 °C were intensively characterized and compared in their crystalline structure, porosity, morphology and dielectric property. The results imply a phase and structure transformation in the materials as the calcination temperature increased. Fe/Fe3C@C-700 exhibited a core-shell structure and an apparent Fe3C phase. In addition, Fe/Fe3C@C-700 demonstrated excellent dielectric property as a microwave absorber than Fe/Fe3C@C-500 and Fe/Fe3C@C-600. At the same time, it gave a 100 % removal rate in 30 s for the degradation of methyl orange under microwave irradiation, outperformed the Fe/Fe3C@C-500 and Fe/Fe3C@C-600 and most other reported catalysts in similar studies. The possible mechanism of the methyl orange degradation should be ascribed to the in situ generation of •OH and O2•- active species over the Fe/Fe3C@C catalyst. The excellent microwave absorbing property of Fe/Fe3C@C-700 could also boost its catalytic activity and play a critical role during the super-fast microwave-assisted degradation process. The findings in this study could be informative for the development of a continuous process of dye wastewater treatment for industrial implementation.

8.
J Biomed Mater Res A ; 2020 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-32090462

RESUMO

Facial nerves are frequently crushed or cut during facial surgery. In this study, the feasibility of repairing facial nerves in rabbits after crush or cut off injury was evaluated using collagen conduits with A collagen-binding domain (CBD)-human basic fibroblast growth factor (bFGF). A total of 39 six-month-old New Zealand White rabbits were randomly divided into four groups of nine rabbits, and bilateral crush or cut off injuries were made on each animal's face. Three rabbits were classified as the healthy control. The facial nerves were cut or crushed and then were either untreated or wrapped with a collagen conduit plus bFGF. At the 15, 30, and 90 days after the injury, three rabbits in each group were sacrificed. Regeneration of the injured facial nerve was evaluated using electrophysiological examination (compound muscle action potentials, CAMPs), scanning electron microscopy, and histological observation. The results suggested that using collagen conduits with recombinant proteins CBD-bFGF to repair facial nerves with crush or cut off injuries promoted functional facial nerve recovery. This treatment, as a possible therapeutic for patients with facial nerve injury, requires further investigation.

9.
Nature ; 577(7791): 549-555, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31942075

RESUMO

Treatment with immune checkpoint blockade (ICB) has revolutionized cancer therapy. Until now, predictive biomarkers1-10 and strategies to augment clinical response have largely focused on the T cell compartment. However, other immune subsets may also contribute to anti-tumour immunity11-15, although these have been less well-studied in ICB treatment16. A previously conducted neoadjuvant ICB trial in patients with melanoma showed via targeted expression profiling17 that B cell signatures were enriched in the tumours of patients who respond to treatment versus non-responding patients. To build on this, here we performed bulk RNA sequencing and found that B cell markers were the most differentially expressed genes in the tumours of responders versus non-responders. Our findings were corroborated using a computational method (MCP-counter18) to estimate the immune and stromal composition in this and two other ICB-treated cohorts (patients with melanoma and renal cell carcinoma). Histological evaluation highlighted the localization of B cells within tertiary lymphoid structures. We assessed the potential functional contributions of B cells via bulk and single-cell RNA sequencing, which demonstrate clonal expansion and unique functional states of B cells in responders. Mass cytometry showed that switched memory B cells were enriched in the tumours of responders. Together, these data provide insights into the potential role of B cells and tertiary lymphoid structures in the response to ICB treatment, with implications for the development of biomarkers and therapeutic targets.

10.
Environ Int ; 136: 105451, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31924581

RESUMO

BACKGROUND: Few epidemiological studies have investigated associations of exposure to multiple metals with testosterone homeostasis and erythropoiesis, especially for the pregnant women. METHODS: Among all the 1644 participants enrolled in Hangzhou Birth Cohort Study (HBCS) at baseline, a total of 918 pregnant women with complete data of interest were analyzed. The whole blood metals levels were examined by inductively coupled plasma mass spectrometry (ICP-MS), and serum testosterone level was evaluated by chemiluminescent microparticle immunoassay (CMIA), and erythropoietic parameters values were extracted from medical record. Multivariable linear regression models were applied to estimate the relationships between metals levels and testosterone level, and between metals levels and erythropoietic parameters, and potential confounders were adjusted. RESULTS: Single metal model analysis revealed a significant association of blood As, Mn and Pb level with serum testosterone level. After controlling for multiple testing, the dose-response trend with statistical significance (FDR-adjusted p trend <0.05) was observed across tertiles of Pb with testosterone. This association, when by stratified by gender, remained in pregnant women with a male fetus but did not reach significant in those with a female fetus. Furthermore, blood Pb level was positively associated with red blood cell counts, hemoglobin level and hematocrit. Serum testosterone level was positively associated with red blood cell counts, hemoglobin level and hematocrit. Mediation analyses indicated that testosterone might act as a mediator in the association between Pb exposure and erythropoietic parameters. CONCLUSIONS: Serum testosterone level and hemoglobin level was positively related to blood Pb level among Chinese pregnant women, and testosterone might mediate the effect of Pb exposure on hemoglobin. Additional prospective studies are warranted to confirm the causality.

11.
Macromol Biosci ; 20(2): e1900301, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31762196

RESUMO

In this work, dual-mode antibacterial conjugated polymer nanoparticles (DMCPNs) combined with photothermal therapy (PTT) and photodynamic therapy (PDT) are designed and explored for efficient killing of ampicillin-resistant Escherichia coli (Ampr E. coli). The DMCPNs are self-assembled into nanoparticles with a size of 50.4 ± 0.6 nm by co-precipitation method using the photothermal agent poly(diketopyrrolopyrrole-thienothiophene) (PDPPTT) and the photosensitizer poly[2-methoxy-5-((2-ethylhexyl)oxy)-p-phenylenevinylene] (MEH-PPV) in the presence of poly(styrene-co-maleic anhydride) which makes nanoparticles disperse well in water via hydrophobic interactions. Thus, DMCPNs simultaneously possess photothermal effect and the ability of sensitizing oxygen in the surrounding to generate reactive oxygen species upon the illumination of light, which could easily damage resistant bacteria. Under combined irradiation of near-infrared light (550 mW cm-2 , 5 min) and white light (65 mW cm-2 , 5 min), DMCPNs with a concentration of 9.6 × 10-4 µm could reach a 93% inhibition rate against Ampr E. coli, which is higher than the efficiency treated by PTT or PDT alone. The dual-mode nanoparticles provide potential for treating pathogenic infections induced by resistant microorganisms in clinic.

12.
Genome ; 63(3): 145-153, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31825677

RESUMO

The V(D)J recombination is essential for generating a highly diverse repertoire of antigen receptors expressed on T and B lymphocytes. Here, we developed a linear-amplification VDJ-seq technique for quantifying V(D)J recombination of antigen receptor genes. This technique takes advantage of linear amplification using in vitro transcription and reverse transcription to avoid bias generated by the PCR amplification of low copy number of target DNA. The unrearranged alleles are removed by in vitro cleavage with the CRISPR-Cas9 system. The linear-amplification VDJ-seq assay was applied in quantification of the Vκ-Jκ recombination of the mouse Igκ gene with Jκ capture primers. The Jκ genes were detected in 95.86% of clean reads with more than half containing the Vκ gene, indicating high specificity of capturing and amplification. We also applied this approach to quantify the usage of Jα within the Trav12 gene family of the Tcra gene.

13.
Stem Cells Dev ; 29(2): 90-99, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31752619

RESUMO

Human embryonic stem cells (hESCs) have unlimited proliferation capacity and can differentiate into most types of somatic cells. We previously described that the overexpression of FLI1 as well as the activation of protein kinase C (FLI1-PKC) could rapidly and efficiently differentiate hESCs into endothelial cells (ECs). However, the relationship between vascular endothelial growth factor (VEGF) and PKC in hESC-EC differentiation is debated, and the roles of different PKC isoforms in hESC-EC differentiation remain unknown. In this study, after 2 days of induction, we found that the overexpression of FLI1 and the addition of VEGF-A to hESCs (FLI1-VEGF) could generate 19.6% ± 5.4% ECs. The induction efficiency of ECs was reduced from 72.3% ± 7.6% to 37.9% ± 4.9% following the addition VEGF-A siRNA to the FLI1-PKC system. However, the induction of ECs was nearly completely abrogated following the addition of the pan-PKC inhibitor to the FLI1-VEGF, FLI1-PKC, or other systems. The above results suggested that VEGF can partially replace PKC, but PKC plays a more critical role downstream of VEGF during hESC-EC induction. To further investigate which PKC isoform was mainly involved in converting hESCs to ECs, siRNAs were used to knock down nine PKC isoforms in the FLI1-PKC system. Only the knockdown of PKC-ɛ or PKC-η significantly decreased the induction efficiency of ECs to 51.1% ± 5.8% or 50.3% ± 5.1%, respectively. PKC-ɛ/η siRNA could suppress EC induction in other differentiation systems. Moreover, RNA-seq and quantitative polymerase chain reaction analysis also showed that only the expression of PKC-ɛ and PKC-η was robustly upregulated during hESC-EC induction. In summary, our results suggested that VEGF promoted the differentiation of ECs derived from hESCs, which mainly depended on PKC, specifically the PKC-ɛ and PKC-η pathways.

14.
Adv Healthc Mater ; 9(1): e1901295, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31746152

RESUMO

Design and fabrication of fibrous materials by natural biological macromolecules in light of biomimetics to achieve spatially cellular arrangements are highly desirable in tissue engineering. Herein, chromatin-inspired supramolecular fibers formed through the interfacial polyelectrolyte complexation (IPC) process by DNA and histone proteins for encapsulation and in situ differentiation of murine brain-derived neural stem cells (NSCs) are reported. High cell viability of encapsulated NSCs demonstrates the excellent biocompatibility of fibers as 3D scaffolds. Moreover, a cell-adhesive peptide (K6 -PEG-RGD) is introduced into fibers by electrostatic interaction to improve NSCs encapsulation efficiency and prevent them from migrating out of fibers for enhanced spatially cellular arrangement. In situ differentiation of NSCs into oligodendrocytes within fibers is revealed by immunocytochemical staining assay. Due to the robust abilities to encapsulate and in situ differentiate NSCs, these chromatin-inspired supramolecular fibers show great potential in neural system-related tissue.

15.
Nat Med ; 26(1): 39-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31873309

RESUMO

Immune checkpoint therapy with anti-CTLA-4 and anti-PD-1/PD-L1 has revolutionized the treatment of many solid tumors. However, the clinical efficacy of immune checkpoint therapy is limited to a subset of patients with specific tumor types1,2. Multiple clinical trials with combinatorial immune checkpoint strategies are ongoing; however, the mechanistic rationale for tumor-specific targeting of immune checkpoints is elusive. To garner an insight into tumor-specific immunomodulatory targets, we analyzed 94 patients representing five different cancer types, including those that respond relatively well to immune checkpoint therapy and those that do not, such as glioblastoma multiforme, prostate cancer and colorectal cancer. Through mass cytometry and single-cell RNA sequencing, we identified a unique population of CD73hi macrophages in glioblastoma multiforme that persists after anti-PD-1 treatment. To test if targeting CD73 would be important for a successful combination strategy in glioblastoma multiforme, we performed reverse translational studies using CD73-/- mice. We found that the absence of CD73 improved survival in a murine model of glioblastoma multiforme treated with anti-CTLA-4 and anti-PD-1. Our data identified CD73 as a specific immunotherapeutic target to improve antitumor immune responses to immune checkpoint therapy in glioblastoma multiforme and demonstrate that comprehensive human and reverse translational studies can be used for rational design of combinatorial immune checkpoint strategies.

16.
Artigo em Inglês | MEDLINE | ID: mdl-31825194

RESUMO

In this work, a new platform for pathogen discrimination and killing based on a conjugated polymer-quantum dot hybrid material was designed and constructed through the fluorescence resonance energy transfer (FRET) process. The hybrid material comprises water-soluble anionic CdSe/ZnS quantum dots (QDs) and a cationic poly(fluorene-alt-phenylene) derivative (PFP) through electrostatic interactions, thus promoting efficient FRET between PFP and QDs. Upon addition of different pathogen strains, the FRET from PFP to QDs was interrupted because of the competitive binding between PFP and the pathogens. Complexation of PFP and QDs also reduced the dark toxicity to a more desirable level, therefore potentially realizing the controllable killing of pathogens. The technique provides a promising theranostic platform in pathogen discrimination and disinfection based on FRET and phototoxicity of the PFP and QDs.

17.
R Soc Open Sci ; 6(11): 191307, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31827862

RESUMO

In order to improve the quality of catalysis products of algae, composite molecular sieve catalyst was prepared by digestion and crystallization of HZSM-5 to reduce the oxygen content of the catalytic products. According to the analysis of the pyrolysis products, the best preparation conditions were chosen of tetra propylammonium hydroxide (TPAOH) solution 2.0 mol l-1, cetyltrimethylammonium bromide (CTAB) solution 10 wt%, crystallization temperature 110°C, digestion-crystallization time: 24-24 h. The results indicate that the main function of catalysts is to promote the conversion of alcohols into hydrocarbons by reducing energy barriers. Catalysed by the composite molecular sieve, the content of alcohols in the pyrolysis products decreased from more than 30% to less than 10%, the content of hydrocarbons increased from 20% to nearly 60%, while all the adverse components remained at a low level, which indicates that the catalytic pyrolysis products are of high quality. The great deoxidation effect of composite molecular sieves is not only due to the expansion of the range of organic matter during re-pyrolysis, but also the increasing of the residence time of pyrolysis products inside the structure for the external mesoporous structure.

18.
J Asian Nat Prod Res ; : 1-7, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847583

RESUMO

Two new alkaloids (1,2) and one new enoic acid (3), together with three known piericidins (4-6), were isolated from the liquid fermentation of the salt lake derived Streptomyces sp. QHA10. The structures of 1-3 were elucidated based on extensive spectroscopic data (NMR, HRESIMS) as well as single-crystal X-ray diffraction. Compound 3 showed potential anti-inflammatory activity by inhibiting the production of nitric oxide (NO) in lipopolysaccharide (LPS)-induced RAW 264.7 mouse macrophages with the IC50 value of 24.5 µM.

19.
Life Sci ; 239: 117021, 2019 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-31678552

RESUMO

OBJECTIVES: Clematichinenoside AR (AR) is a saponin extracted for traditional Chinese medicine with the effects of improving the expression of tight junction (TJ) proteins and mediating anti-inflammatory activities. However, its effect on Crohn's disease (CD) is still unknown. We aimed to investigate the impact of AR on CD-like colitis and determine the mechanism underlying its effects. METHODS: Interleukin-10 gene knockout (Il-10-/-) mice (male, fifteen weeks old) with spontaneous colitis were allocated to the positive control and AR-treated (32 mg/kg AR administered every other day by gavage for 4 weeks) groups. Wild-type (WT) mice (male, fifteen weeks old) composed the negative control group. The effects of AR on intestinal barrier function and structure and T cell responses as well as the potential mechanisms underlying these effects were investigated. RESULTS: AR treatment significantly improved spontaneous colitis in Il-10-/- mice as demonstrated by reductions in the inflammatory score, disease activity index (DAI) and levels of inflammatory factors. The effects of AR on colitis in Il-10-/- mice were related to protecting intestinal barrier function and maintaining immune system homeostasis (regulatory T cell (Treg)/T helper 17 (Th17) cell balance). The anticolitis effect of AR may partly act by downregulating PI3K/Akt signaling. CONCLUSIONS: AR may have therapeutic potential for treating CD in humans.


Assuntos
Colite/tratamento farmacológico , Colite/genética , Interleucina-10/genética , Intestinos/patologia , Saponinas/uso terapêutico , Triterpenos/uso terapêutico , Animais , Translocação Bacteriana/efeitos dos fármacos , Colite/patologia , Citocinas/metabolismo , Intestinos/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologia , Linfócitos T Auxiliares-Indutores/efeitos dos fármacos , Linfócitos T Reguladores/efeitos dos fármacos
20.
Medicine (Baltimore) ; 98(47): e18144, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31764856

RESUMO

BACKGROUND: There is currently no consensus on the appropriate selection of inotropic therapy in ventricular dysfunction. The objective of the study was to detect the effects of different inotropes on the hemodynamics of patients who developed low cardiac output. METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched (all updated December 31, 2017). The inclusion criteria were as follows: low cardiac index (CI < 2.5 L/min/m) or New York Heart Association class II-IV, and at least 1 group receiving an inotropic drug compared to another group receiving a different inotropic/placebo treatment. The exclusion criteria were studies published as an abstract only, crossover studies, and studies with a lack of data on the cardiac index. RESULTS: A total of 1402 patients from 37 trials were included in the study. Inotropic drugs were shown to increase the cardiac index (0.32, 95%CI:0.25, 0.38), heart rate (7.68, 95%CI:6.36, 9.01), and mean arterial pressure (3.17, 95%CI:1.96, 4.38) than the placebo. Overall, the pooled estimates showed no difference in terms of cardiac index, heart rate, mean arterial pressure, systemic vascular resistance, and mean pulmonary arterial pressure among the groups receiving different inotropes. CONCLUSIONS: Our systematic review found that inotrope therapy is not associated with the amelioration of hemodynamics. An accurate evaluation of the benefits and risks, and selection of the correct inotropic agent is required in all clinical settings.


Assuntos
Cardiotônicos/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/fisiopatologia , Hemodinâmica , Cardiotônicos/farmacologia , Ensaios Clínicos como Assunto , Hemodinâmica/efeitos dos fármacos , Humanos , Meta-Análise em Rede
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