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1.
BMC Geriatr ; 21(1): 260, 2021 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-33874889

RESUMO

BACKGROUND: The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure. METHODS: We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure. RESULTS: The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m2 in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080-1.087) and 1.026(1.024-1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m2 and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced. CONCLUSION: These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.


Assuntos
Hipertensão , Idoso , Pressão Sanguínea , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Masculino , Obesidade , Fatores de Risco , Circunferência da Cintura
2.
J Clin Neurol ; 17(2): 220-228, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33835742

RESUMO

BACKGROUND AND PURPOSE: Brainstem gliomas (BSGs) in adults are rare brain tumors with dismal outcomes. The aim of this study was to determine the clinical and genetic features in a series of BSGs and their association with the prognosis. METHODS: Fifty patients who underwent a stereotactic biopsy between January 2016 and April 2018 at a single institution were collected. Data on clinicopathological characteristics were analyzed and factors associated with patient survival were identified using a Cox regression model. RESULTS: The median age at diagnosis was 55.5 years, and 62% of the patients were male. Glioblastoma (44%) accounted for the largest proportion of BSGs, and oligodendroglioma (2 of 50) was rarely encountered. The IDH mutation (6 of 44) occurred infrequently in astrocytomas, and IDH-mutant tumors harbored both ATRX loss and MGMT promoter methylation at a relatively low level. Wild-type IDH astrocytomas were identified as having high rates of 1p/19q codeletion (5 of 38) and loss of heterozygosity 1p (8 of 38) or 19q (8 of 38) only. In diffuse midline glioma H3K27M mutant, MGMT promoter methylation occurred in three of four cases. Patients were offered radiotherapy and/or concurrent/adjuvant temozolomide chemotherapy, and their median survival time was 13 months. Multivariate analysis revealed that a low tumor grade, absence of tumor enhancement, duration of symptoms ≥3 months, Karnofsky performance status ≥70, and ATRX loss conferred a survival advantage. CONCLUSIONS: Adult BSGs showed different molecular genetic characteristics, but also resembled supratentorial gliomas in their clinical features associated with oncological outcomes.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33896165

RESUMO

A kind of N, P, C, O-containing polymer was easily prepared via microwave heating of phytic acid and thiourea just for 90 s. After impregnation and reduction of H2PdCl4, highly dispersed Pd single atoms/sub-nano clusters loaded on the phytic acid/thiourea polymer (Pd-CNSP) were successfully obtained. Owing to the synergetic effect of the polymer support and Pd, the catalyst Pd-CNSP achieves a great atomic efficiency of Pd species and exhibits an outstanding catalytic ability in the reduction of 4-nitrophenol. The k value of the catalyst Pd-CNSP (2.17 min-1 mg-1) is about 19 times higher than that of the commercial Pd/C (5 wt %) catalyst. The turnover frequency value is as high as 848 min-1, which is the highest value reported so far. Pd-CNSP also has good selectivity for the reduction of halogen-substituted (Cl and Br) nitroaromatics. It is expected to be mass-produced and used in other industrial hydrogenation reactions.

4.
Biomed Res Int ; 2021: 8864436, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33860055

RESUMO

The development of immunotherapy has greatly changed the advanced-stage non-small-cell lung cancer (NSCLC) treatment landscape. The complexity and heterogeneity of tumor microenvironment (TME) lead to discrepant immunotherapy effects among patients at the same pathologic stages. This study is aimed at exploring potential biomarkers of immunotherapy and accurately predicting the prognosis for advanced NSCLC patients. RNA-seq data and clinical information on stage III/IV NSCLC were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). In TCGA-NSCLC with stage III/IV (n = 192), immune scores and stromal scores were calculated by using the ESTIMATE algorithms. Univariate, LASSO, and multivariate Cox regression analyses were performed to screen prognostic TME-related genes (TMERGs) and constructed a gene signature risk score model. It was validated in external dataset including GSE41271 (n = 91) and GSE81089 (n = 36). Additionally, a nomogram incorporating TMERG signature risk score and clinical characteristics was established. Further, we accessed the proportion of 22 types of tumor-infiltrating immune cells (TIIC) from the CIBERSORT website and analyzed the difference between two risk groups. OS of patients with high immune/stromal scores were higher (log-rank P = 0.044/log-rank P = 0.048). Multivariate Cox regression identified six prognostic TMERGs, including CD200, CHI3L2, CNTN1, CTSL, FYB1, and SLC52A1. We developed a six-gene risk score model, which was validated as an independent prognostic factor for OS (HR: 3.32, 95% CI: 2.16-5.09). Time-ROC curves showed useful discrimination for TCGA-NSCLC cohort (1-, 2-, and 3-year AUCs were 0.718, 0.761, and 0.750). The predictive robustness was validated in the external dataset. The C-index and 1-, 2-, and 3-year AUCs of nomogram were the largest, which demonstrated the nomogram had the greatest predictive accuracy and effectiveness and could be used for clinical guidance. Besides, the increased infiltration of T cells regulatory (Tregs) and macrophages M2 in the high-risk group suggested that chronic inflammation may reduce survival probability in patients with advanced NSCLC. We conducted a comprehensive analysis of the tumor microenvironment and identified the TMERG signature, which could predict prognosis accurately and provide a reference for the personalized immunotherapy for advanced NSCLC patients.

5.
Ann Hematol ; 100(6): 1547-1552, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33839882

RESUMO

POEMS syndrome is a rare plasma cell disorder. Lenalidomide has recently emerged as a therapeutic option for POEMS syndrome. Cereblon has been identified as the direct target of lenalidomide, and high cereblon expression is associated with better response and outcome to lenalidomide therapy in multiple myeloma patients. Here, we analyzed the predictive value of cereblon, IKZF1, and IKZF3 in CD138+ selected plasma cells from forty-one newly diagnosed POEMS syndrome patients treated with lenalidomide in combination with dexamethasone at both gene and protein levels. We found that patients with high cereblon expression tended to achieve better hematologic response compared to those with low expression (p = 0.024 for gene expression; p = 0.01 for protein expression). Multivariate Cox regression analysis revealed high cereblon mRNA expression as an independent prognostic marker for longer progression-free survival (hazard ratio 0.542; 95% CI 0.337-0.871; p = 0.011). In conclusion, our results emphasized the role of cereblon mRNA expression as a unique biomarker for predicting the clinical response and outcome of lenalidomide-based therapy in newly diagnosed POEMS syndrome patients.

6.
Front Endocrinol (Lausanne) ; 12: 609580, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33679616

RESUMO

Ectopic fat deposition (EFD) in the kidney plays a key role in the development of diabetic nephropathy (DN). Mitochondria-associated ER membranes (MAMs) are structures that connect to the endoplasmic reticulum (ER) and are involved in lipid metabolism. However, there are few studies on MAMs in the field of kidney disease, and the relationship between EFD and MAMs in DN is still unclear. In this study, increased EFD in the kidneys of DN patients was observed, and analysis showed that the degree of EFD was positively correlated with renal damage. Then, the MAMs were quantified by an in situ proximity ligation assay (PLA). The MAMs in the kidneys were found to gradually decrease through the different stages of DN, while the expression of ADRP (a marker of lipid droplets) and tubulointerstitial damage increased. Moreover, correlation analysis showed that the MAMs were negatively correlated with serum lipid levels, the EFD in the kidney and renal damage. Finally, we observed decreased expression of MAM-control proteins (DsbA-L, PACS-2, and MFN-2) in different stages of DN and they were associated with lipid deposition and renal damage. These data showed that the destruction of MAMs in DN might be the cause of EFD and interstitial damage in the kidney.

7.
Nanotechnology ; 32(29)2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33789255

RESUMO

The ability to control, manipulate, and read out nanomechanical resonators is of great significance for many applications. In this work, we start by constructing a nonlinear dynamic model that is deduced from the fundamental beam-photon-electron interaction and energy band theories, with the aim of describing a complicated cavity-free optomechanical coupling process. Based on the model established, we first reveal the manipulation of a resonator's response, including softening and hardening effects due to laser injection. By driving the laser parametrically, we comprehensively investigate the control of the resonator's dynamics, in particular, in the nonlinear regime. It is found that both the laser power and frequency can be used to directly manipulate the NEMS resonator's dynamics, e.g., by amplitude amplification, periodicity changes, and periodic-chaotic state conversion. We then provide bifurcation diagrams, which evidence a deterministic evolution of dynamics. Finally, we perform a special study of the control of chaotic states of the nanomechanical resonator using laser parametric driving. The maximal Lyapunov exponents together with time series calculation show that the chaotic states can be controlled at a few specific frequency points of the injecting laser. This work not only provides guidance for using lasers to control nanoscale resonators, but also sheds light on the exploration of novel applications based on nonlinear NEMS resonators.

8.
J Cell Mol Med ; 25(9): 4307-4315, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33779058

RESUMO

POEMS syndrome is a rare plasma cell dyscrasia with distinct lipid metabolism abnormalities at disease onset. However, the serum lipidomic characteristics in patients with POEMS syndrome were not investigated. The study performed an untargeted lipidome screening by liquid chromatography-tandem mass spectrometry (LS-MS/MS) in the pre- and post-treatment serum of 24 patients with POEMS syndrome, together with the serum of 24 paired healthy controls. Patients with POEMS syndrome had a distinct serum lipid composition compared with healthy controls, and a 3-lipid model had a predictive accuracy of 93.5% in distinguishing patients and healthy controls consisting of fatty acyl 17-oxo-20Z-hexacosenoic acid, phosphatidylcholine(16:0/18:1(9Z)) and sterol lipid 5b-pregnanediol. Four lipids including 17-oxo-20Z-hexacosenoic acid (r = 0.423, P = .040) were correlated with risk stratification, and 2 lipids including Cer(d18:0/13:0) were inversely related to serum vascular endothelial growth factor level (r=-0.465, P = .022). Eleven lipids were related to disease activity, including arachidonic acid which was inversely related and lysoPC(20:4) which was positively related. The study indicated a distinct lipid characteristic profile of patients with POEMS syndrome different from healthy controls and identified several lipids that may serve as potential diagnostic markers and monitors of therapeutic efficacy, as well as indicating potential metabolism pathways involved in the pathological process.

10.
J Phys Chem A ; 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33525870

RESUMO

Diethyl carbonate (DEC) oxidation with different levels of O3 addition was performed in an atmospheric laminar flow reactor from 400 to 850 K. Experimental results showed that, without O3 addition, the oxidation of DEC began from 650 K with no low-temperature reactivity, while with O3 addition the low-temperature chemistry of DEC was observed from 450 K. A DEC/O3 kinetic model was developed, and the model predictions agreed with the experimental data reasonably well with a slight overprediction of DEC oxidation between 550 and 750 K. The low-temperature chemistry of DEC with O3 addition was described in the reaction pathway of DEC. It was found that O3 assisted the low-temperature oxidation of DEC mainly through the production of the active O: atom instead of the direct reaction with the fuel molecule. The present work indicated that the Li-ion battery degradation at 400-500 K might result from the low-temperature chemistry of DEC with active oxygen supplies from the cathode metal oxide materials or from singlet O2 during the battery discharge process. This article used O3 to mimic the oxidizing environment in the Li-ion battery by providing active atomic oxygen. It provided insights into the chemically sensitized gas-phase low-temperature chemistry of DEC and explained the mechanism of battery degradation involving the low-temperature oxidation at the electrolyte solvent and the cathode interface from 400 to 500 K.

11.
Ann Vasc Surg ; 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33556529

RESUMO

OBJECT: The study sought to compare the safety and effectiveness of drug-coated balloon (DCB) with bare nitinol stent in patients with complex femoropopliteal(FP) lesions in real-world practice. METHODS: Patients with symptomatic (Rutherford stage 2 to 5) femoropopliteal lesions who underwent DCB or bare nitinol stent implantation at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital from June 2016 to September 2017 were included. Demographics, angiographic and procedural variables were included. Freedom from target lesion revascularization (TLR), primary patency and major adverse events were obtained from follow-up results at 3,6 and12 months. Descriptive analysis was performed on all variables. RESULTS: A total of 90 eligible patients were enrolled, which included 51 DCB subjects (mean age, 63.1 ± 13.2 years; 76.5% male) with 55 lesions and 39 nitinol stent subjects (mean age, 66.5 ± 10.5 years; 61.5% male) with 42 lesions. Significant higher primary patency was observed in the DCB group compared with the stent group (74.5% vs. 52.4%; log-rank test P = 0.018; HR 0.335, 95%CI 0.124-0.903, P = 0.031). The rates of freedom from TLR (f-TLR) were 78.2% and 59.5% (log-rank test P = 0.032) for the DCB group and the stent group, respectively, at 12 months. CD-TLR rates were 18.2% vs. 38.1% with a P-value of 0.023. Female sex (HR 6.122, 95%CI 1.880-19.934, P = 0.003), lesion length over 20 cm (HR 5.514, 95%CI 2.312-13.148, P < 0.001) and renal insufficiency (HR 2.609, 95%CI 1.087-6.260, P = 0.032) were suggested as independent risk factors of reducing primary patency. There were no significant differences in major adverse events between the 2 groups. CONCLUSION: The result above demonstrates that DCB treatment has higher primary patency and lower TLR at 12 months than nitinol stent. These data confirm the safety and effectiveness of the DCB for patients with complex femoropopliteal lesions.

13.
BMJ Open ; 11(1): e041072, 2021 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431489

RESUMO

OBJECTIVE: To investigate the association between a parental and/or sibling history of diabetes and clinical characteristics. DESIGN: A cross-sectional study. SETTING: The data were collected from the endocrinology department of The Second Xiangya Hospital of Central South University from June 2017 to October 2019. PARTICIPANTS: A total of 894 newly diagnosed patients with type 2 diabetes were recruited. Data on clinical characteristics were collected from patient medical records. Pancreatic ß-cell function and insulin resistance were calculated with the homeostatic model assessment. SPSS V.25.0 was used to perform the analysis. RESULTS: The percentages of patients with parental and sibling histories of diabetes were 14.8% and 9.8%, respectively. The prevalence of diabetic ketoacidosis (DKA) was 3.9%. Compared with those with no parental history of diabetes, patients with a parental history of diabetes were characterised by early-onset disease (41.70±10.88 vs 51.17±14.09 years), poor glycaemic control of fasting blood glucose (10.84±5.21 vs 8.91±4.38 mmol/L) and a high prevalence of DKA (7.6% vs 3.3%). The patients with a sibling history of diabetes had later disease onset (56.05±9.86 vs 49.09±14.29 years) and lower BMI (24.49±3.48 vs 25.69±3.86 kg/m2) than those with no sibling history of diabetes. Univariate regression suggested that both parental history (p=0.037) and sibling history (p=0.011) of diabetes were associated with ß-cell function; however, multiple regression analysis showed that only a sibling history of diabetes was associated with ß-cell function (p=0.038). Univariate regression revealed a positive correlation between parental history of diabetes (p=0.023, OR=2.416, 95% CI 1.132 to 5.156) and DKA. Unfortunately, this correlation was not statistically significant for either patients with a parental history (p=0.234, OR=1.646, 95% CI 0.724 to 3.743) or those with a sibling history (p=0.104, OR=2.319, 95% CI 0.841 to 6.389) after adjustments for confounders. CONCLUSION: A sibling history of diabetes was associated with poor ß-cell function, and a parental history of diabetes was associated with poor glycaemic control and a high prevalence of DKA.

14.
Int J Comput Assist Radiol Surg ; 16(2): 231-240, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33459977

RESUMO

PURPOSE: The automated clipping of surgical nasal endoscopic video is a challenging task because there are many hard frames that have indiscriminative visual features which lead to misclassification. Prior works mainly aim to classify these hard frames along with other frames, and it would seriously affect the performance of classification. METHODS: We propose a hard frame detection method using a convolutional LSTM network (called HFD-ConvLSTM) to remove invalid video frames automatically. Firstly, a new separator based on the coarse-grained classifier is defined to remove the invalid frames. Meanwhile, the hard frames are detected via measuring the blurring score of a video frame. Then, the squeeze-and-excitation is used to select the informative spatial-temporal features of endoscopic videos and further classify the video frames with a fine-grained ConvLSTM learning from the reconstructed training set with hard frames. RESULTS: We justify the proposed solution through extensive experiments using 12 surgical videos (duration:8501 s). The experiments are performed on both hard frame detection and video frame classification. Nearly 88.3% fuzzy frames can be detected and the classification accuracy is boosted to 95.2%. HFD-ConvLSTM achieves superior performance compared to other methods. CONCLUSION: HFD-ConvLSTM provides a new paradigm for video clipping by breaking the complex clipping problem into smaller, more easily managed 2-classification problems. Our investigation reveals that the hard framed detection based on blurring score calculation is effective for nasal endoscopic video clipping.

16.
Chemosphere ; 267: 129184, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33348267

RESUMO

In the process of municipal solid waste (MSW) pyrolysis, kaolinite possesses an outstanding trapping effect on semi-volatile metal vapors (Pb, Cd) through physical and chemical adsorption. In this paper, the microscopic mechanism of PbCl2 and CdCl2 adsorption on the surface of Al rings and Si rings of kaolinite was investigated by combining Monte Carlo method with density functional theory (DFT). The calculations indicate that the continuously enriched pore structure in the process of dehydroxylation indirectly influences the adsorption of PbCl2/CdCl2 by kaolinite. Under the non-bond interaction and electron transfer induction, PbCl2 molecules are more conveniently adsorbed on the Al-(001) surface than CdCl2, while the adsorption sites of CdCl2 molecules are more widely distributed on the Si-(001) surface. Moreover, the transform in the Al-coordination and the exposed active oxygen atoms significantly affect the adsorption activity of kaolinite (the capability to gain and lose electrons). Considering the energy barrier and electrophilic nucleophilic sensitivity, it is more feasible for PbCl2/CdCl2 to be adsorbed near IV/V-coordinated Al and active O under Van der Waals action. Subsequently, IV/V-coordinated Al will act as an electron acceptor, and the active oxygen atoms after dehydrogenation will serve as an electron donor. Under the induction of the energy difference of frontier orbitals, the electrons transfer will encourage the formation of more stable adsorption states. The results shed new light on strengthening the adsorption activity of kaolinite to PbCl2/CdCl2 in the process of MSW pyrolysis.


Assuntos
Caulim , Resíduos Sólidos , Adsorção , Modelos Teóricos , Pirólise
17.
Sci Total Environ ; 750: 141215, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32862000

RESUMO

This paper reports the results obtained for microwave-assisted catalytic fast pyrolysis (MACFP) of rice husk. The MACFP process employed a hierarchical catalyst prepared via a combination of organic alkali treatment (TPAOH) and the generation of an external layer of MCM-41-type mesoporous channels. We propose this catalyst which is used for the first time for pyrolysis of lignocellulosic biomass, as a tool to reduce coke agglomeration and increase hydrocarbon yields. Our results indicate that during catalyst preparation the mass fraction of cetyltrimethylammonium bromide (CTAB) has a direct effect on the content of MCM-41 formed on top of the HZSM-5 core. For MACFP, we hypothesize that the small molecules generated from thermal decomposition of rice husk react further to form aromatic and aliphatic hydrocarbons by decarbonylation, decarboxylation, oligomerization and aromatization. The highest hydrocarbon yield (60.5%) was obtained for a catalyst modified by a 2.0 mol/L TPAOH solution, with 10 wt% of CTAB (template for producing MCM-41), as well as with digestion and crystallization at 110 °C for 24 h. In addition, the highest liquid yield (47.6 wt%) was obtained at 550 °C. The relative content of hydrocarbons goes through a maximum of 60.5% with CTAB mass fraction which was higher than values obtained with MCM-41 (3.2%) and HZSM-5 (36.0%). Characterization and catalytic testing results suggest that the digestion temperature plays a more important role in the catalyst synthesis than the crystallization temperature. High digestion temperature (120 °C) decreases the overall hydrocarbon selectivity from 60.5% (110 °C) to 39.2%. The relative content of oxygenates reached the lowest value of 35.9% at the digestion and crystallization temperature of 110 °C. The synergistic effect of the MCM-41 shell and the HZSM-5 core promotes the catalytic activity, leading to outstanding deoxygenation capabilities and excellent selectivity to BTEX (52.7%).


Assuntos
Oryza , Pirólise , Biocombustíveis , Biomassa , Catálise , Temperatura Alta , Micro-Ondas , Dióxido de Silício
18.
Leukemia ; 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33262528

RESUMO

POEMS syndrome is a rare plasma cell dyscrasia. Little is known about its pathogenesis and genetic features. We analyzed the mutational features of purified bone marrow plasma cells from 42 patients newly diagnosed with POEMS syndrome using a two-step strategy. Whole exome sequencing of ten patients showed a total of 170 somatic mutations in exonic regions and splicing sites, with paired peripheral blood mononuclear cells as a control. Three significantly mutated genes-LILRB1 (10%), HEATR9 (20%), and FMNL2 (10%)-and eight mutated known driver genes (MYD88, NFKB2, CHD4, SH2B3, POLE, STAT3, CHD3, and CUX1) were identified. Target region sequencing of 77 genes were then analyzed to validate the mutations in an additional 32 patients. A total of 32 mutated genes were identified, and genes recurrently mutated in more than three patients included CUX1 (19%), DNAH5 (16%), USH2A (16%), KMT2D (16%), and RYR1 (12%). Driver genes of multiple myeloma (BIRC3, LRP1B, KDM6A, and ATM) and eleven genes reported in light-chain amyloidosis were also identified in target region sequencing. Notably, VEGFA mutations were detected in one patient. Our study revealed heterogeneous genomic profiles of bone marrow plasma cells in POEMS syndrome, which might share some similarity to that of other plasma cell diseases.

19.
Medicine (Baltimore) ; 99(50): e23488, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327282

RESUMO

BACKGROUND: Family nursing with the assistance of network (FNAN) improves nurses' practice and provides family/community-oriented nursing care. This study aimed to explore the effects of FNAN on the clinical outcome and life quality of coronary atherosclerotic heart disease (CHD) patients underwent coronary artery bypass grafting (CABG). TRIAL DESIGN: This study is a randomized, placebo-controlled and double-blind trial. METHODS: One-hundred and twelve patients underwent CABG were randomly divided into control group (CG, routine family nursing care) and experimental group (EG, FNAN) and the allocation ratio was 1:1. The situation of anxiety and depression were analyzed using the Hamilton Anxiety Scale (HAMA) scale and Hamilton Depression Scale (HAMD). Sleep quality was measured by using Pittsburgh Sleep Quality Index (PSQI). Lung function parameters were measured, including minute ventilation (MVV), partial pressure of oxygen (PaO2), partial pressure of arterial carbon dioxide (PaCO2), oxygen saturation measurement by pulse oximetry (SpO2), forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). Life quality was measured by using Chronic Obstructive Pulmonary Disease Assessment Test (CAT). RESULTS: After a 3-month intervention, 10 and 6 patients were lost in the CG and EG groups, respectively. The scores of HAMA, HAMD, PSQI and CAT were reduced in the EG group when compared with the CG group (P < .05). The values of MVV, PaO2, SpO2, FEV1 and FVC in the EG group was higher than those in the CG group whereas the levels of PaCO2 in the EG group was lower than those in the CG group (P < .05). PSQI score had a strong relationship with the values of MVV, PaO2, PaCO2, SpO2, FEV1, and FVC. CONCLUSION: FNAN improves the clinical outcome and life quality in the patients underwent CABG.


Assuntos
Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Enfermagem Familiar , Padrões de Prática em Enfermagem , Idoso , Doença da Artéria Coronariana/enfermagem , Doença da Artéria Coronariana/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
20.
Front Endocrinol (Lausanne) ; 11: 536241, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193075

RESUMO

Endocrinopathy is an important characteristic of POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes) syndrome. However, endocrine responses to different regimens were unknown so far. Here we investigated endocrine characteristics in 383 patients with newly diagnosed POEMS syndrome and thyroid responses 1 year after treatment with autologous peripheral stem cell transplantation, melphalan plus dexamethasone, or lenalidomide plus dexamethasone. Overt hypothyroidism and subclinical hypothyroidism were noted in 20.6% (79/383) and 36.0% (138/383) of patients. Adrenal insufficiency was noted in 13.6% (43/316) of patients. Hyperprolactinemia was noted in 62.7% (207/330) of patients. Hypogonadism was noted in 48.0% (60/125) of female and 22.6% (51/226) of male patients. Thyroid function was significantly related with baseline risk stratification (p < 0.001) and significantly improved regardless of initial regimens. Patients with baseline hypothyroidism had a significant inferior progression-free survival (PFS) (p = 0.028) and overall survival (OS) (p = 0.006). Three-year PFS in patients with and without baseline hypothyroidism were 68.9 vs. 82.5%, respectively. Three-year OS rates in patients with and without baseline hypothyroidism were 82.8 vs. 92.8%, respectively. In summary, hypothyroidism, hyperprolactinemia, and hypogonadism are common endocrinopathies in POEMS syndrome. Thyroid function significantly improved regardless of the initial regimens. Thyroid function parallels with baseline risk stratification, and patients with baseline hypothyroidism have significantly inferior OS and PFS.

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