Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 227
Filtrar
1.
Mol Biotechnol ; 2021 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-34843094

RESUMO

Myocardial infarction (MI) is one of the most common global diseases. Recently, microRNA 199a-5p (miR-199a-5p) has been recognized as a vital regulator in several human diseases. Nevertheless, the function of miR-199a-5p and the associated downstream molecular mechanisms in myocardial injury remain undescribed. Here, we assessed the relative expression of miR-199a-5p in an oxidative stress injury model of human myocardial cells. The effects of miR-199a-5p on myocardial cell viability were determined by cell counting kit-8 (CCK-8), terminal deoxynucleotidyl transferase UTP nick end labeling (TUNEL), flow cytometry, and western blot assays. Online bioinformatic analysis was used to predict the aim of miR-199a-5p in cardiomyocyte injury, which was confirmed by dual-luciferase reporter assays. miR-199a-5p increased the growth rate of cardiomyocytes after treatment with a hypoxic environment. miR-199a-5p acted as an inhibitor directly targeted hypoxia-inducible factor-1 (HIF1α) expression, which was higher in the cardiomyocyte injury model than that in healthy myocardial cells. Upregulated HIF1α expression abolished miR-199a-5p-induced cell proliferation in the cardiomyocyte hypoxia model. Our results suggest that miR-199a-5p is a potential prognostic biomarker in myocardial damage.

2.
Heart ; 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593533

RESUMO

OBJECTIVE: To assess whether patients with aortic valve stenosis (AS) with elevated lipoprotein(a) (Lp(a)) are characterised by increased valvular calcification activity compared with those with low Lp(a). METHODS: We performed 18F-sodium fluoride (18F-NaF) positron emission tomography/CT in patients with mild to moderate AS (peak aortic jet velocity between 2 and 4 m/s) and high versus low Lp(a) (>50 mg/dL vs <50 mg/dL, respectively). Subjects were matched according to age, gender, peak aortic jet velocity and valve morphology. We used a target to background ratio with the most diseased segment approach to compare 18F-NaF uptake. RESULTS: 52 individuals (26 matched pairs) were included in the analysis. The mean age was 66.4±5.5 years, 44 (84.6%) were men, and the mean aortic valve velocity was 2.80±0.49 m/s. The median Lp(a) was 79 (64-117) mg/dL and 7 (5-11) mg/dL in the high and low Lp(a) groups, respectively. Systolic blood pressure and low-density-lipoprotein cholesterol (corrected for Lp(a)) were significantly higher in the low Lp(a) group (141±12 mm Hg vs 128±12 mm Hg, 2.5±1.1 mmol/L vs 1.9±0.8 mmol/L). We found no difference in valvular 18F-NaF uptake between the high and low Lp(a) groups (3.02±1.26 vs 3.05±0.96, p=0.902). Linear regression analysis showed valvular calcium score to be the only significant determinant of valvular 18F-NaF uptake (ß=0.63; 95% CI 0.38 to 0.88 per 1000 Agatston unit increase, p<0.001). Lp(a) was not associated with 18F-NaF uptake (ß=0.17; 95% CI -0.44 to 0.88, p=0.305 for the high Lp(a) group). CONCLUSION: Among patients with mild to moderate AS, calcification activity is predominantly determined by established calcium burden. The results do not support our hypothesis that Lp(a) is associated with valvular 18F-NaF uptake.

3.
Front Cell Neurosci ; 15: 751439, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630045

RESUMO

Myelination of neuronal axons in the central nervous system (CNS) by oligodendrocytes (OLs) enables rapid saltatory conductance and axonal integrity, which are crucial for normal brain functioning. Previous studies suggested that different subtypes of oligodendrocytes in the CNS form different types of myelin determined by the diameter of axons in the unit. However, the molecular mechanisms underlying the developmental association of different types of oligodendrocytes with different fiber sizes remain elusive. In the present study, we present the evidence that the intracellular Ca2+ release channel associated receptor (Itpr2) contributes to this developmental process. During early development, Itpr2 is selectively up-regulated in oligodendrocytes coinciding with the initiation of myelination. Functional analyses in both conventional and conditional Itpr2 mutant mice revealed that Itpr2 deficiency causes a developmental delay of OL differentiation, resulting in an increased percentage of CAII+ type I/II OLs which prefer to myelinate small-diameter axons in the CNS. The increased percentage of small caliber myelinated axons leads to an abnormal compound action potentials (CAP) in the optic nerves. Together, these findings revealed a previously unrecognized role for Itpr2-mediated calcium signaling in regulating the development of different types of oligodendrocytes.

4.
Ann Palliat Med ; 10(9): 10114-10123, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628932

RESUMO

Multidisciplinary treatment, mainly chemotherapy combined with immunotherapy, is preferred in patients with advanced lung cancer who are negative for driver genes and have an Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0-1; in contrast, patients with an ECOG PS score of 3-4 should be managed with supportive treatment and palliative care rather than chemotherapy or other antitumor treatments. In the real-world settings, however, in the Chinese population, a large proportion of patients and their families are willing to take risks to receive benefit from oncological treatments. We encountered a patient who had definite advanced lung adenocarcinoma with multiple metastases and fusion in abdominal lymph nodes. Intestinal obstruction and obstructive jaundice were also observed. Despite the application of gastrointestinal decompression, continuous parenteral nutrition support, common bile duct stenting, and pancreatic duct stenting, no effective antitumor therapy (except in the case of immunotherapy) was attempted due to the high tumor burden and poor ECOG PS score in this patient. After effective communication with the family members, toripalimab was attempted in this patient with great success (the patient did not receive chemotherapy and only received immunotherapy). In the spring of 2019, imported programmed death receptor-1 (PD-1) antibodies (pabolizumab and navulizumab) listed in the Chinese market were expensive, and the people could not afford the cost. However, treprizumab was just on the market, with low price and high pharmacoeconomics. Therefore, the drug was selected for treatment.) The patient achieved almost complete remission, with a progression-free survival (PFS) of about 2.5 years. The expression of programmed death-ligand 1 (PD-L1) was high in this patient. Toripalimab monotherapy may be applied in patients with high PD-L1 expression although any potential adverse effects should be closely monitored. To our knowledge, no other data from clinical trials and real-world cases have thus far been reported concerning the application of immunotherapy in ECOG PS 4 patients with advanced lung cancer. The innovation of this article is that although the patient has advanced cancer and ECOG PS 4 is an end-stage patient, immunotherapy is still given and achieved great success.


Assuntos
Adenocarcinoma de Pulmão , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/tratamento farmacológico , Anticorpos Monoclonais Humanizados , Processos Grupais , Humanos , Imunoterapia , Neoplasias Pulmonares/tratamento farmacológico , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
5.
Resuscitation ; 2021 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-34624410

RESUMO

OBJECTIVE: This study aimed to investigate the predictive value of pulse oximetry plethysmography (POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients. METHODS: This was a multicenter, observational, prospective cohort study of patients hospitalized with cardiac arrest at 14 teaching hospitals cross China from December 2013 through November 2014. The study endpoint was ROSC, defined as the restoration of a palpable pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion or cessation of CPR. RESULTS: 150 out-of-hospital cardiac arrest (OHCA) patients and 291 in-hospital cardiac arrest (IHCA) patients were enrolled prospectively. ROSC was achieved in 20 (13.3%) and 64 (22.0%) patients in these cohorts, respectively. In patients with complete end-tidal carbon dioxide (ETCO2) and POP data, patients with ROSC had significantly higher levels of POP area under the curve (AUCp), wave amplitude (Amp) and ETCO2 level during CPR than those without ROSC (all p < 0.05). Pairwise comparison of receiver operating characteristic (ROC) curve analysis indicated no significant difference was observed between ETCO2 and Amp (p = 0.204) or AUCp (p = 0.588) during the first two minutes of resuscitation. CONCLUSION: POP may be a novel and effective method for predicting ROSC during resuscitation, with a prognostic value similar to ETCO2 at early stage.

6.
Surg Innov ; : 15533506211044389, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559004

RESUMO

BACKGROUND: Three-dimensional computed tomography bronchography and angiography (3D-CTBA) provides detailed imaging information for pulmonary segmentectomy. This study was performed to verify the feasibility of 3D-CTBA-guided thoracoscopic segmentectomy for the treatment of pulmonary nodules. METHODS: A retrospective analysis was performed on all patients who underwent 3D-CTBA-guided uniport thoracoscopic segmentectomies or subsegmentectomies for pulmonary nodules in the period from May 2019 to May 2020. All of the information related to perioperative management and surgical operations was retrieved from the medical records and operating notes for detailed analysis. RESULTS: A total of 104 eligible operations involving the resection of 110 nodules with diameters in the range of 5-20 mm were included. Under 3D-CTBA guidance, the pulmonary nodules were located with an accuracy of 100% (110/110) and the median resection margin was 24.3 mm (17-33 mm). Additionally, the segmental (subsegmental) bronchi, arteries, and veins were identified with accuracy rates of 100% (104/104), 96.2% (100/104), and 94.2% (98/104), respectively. The postoperative complications consisted of 3 cases of pulmonary infection (2.9%), 6 cases of arrhythmia (5.8%), 2 cases of hemoptysis (1.9%), 4 cases of air leak (3.8%), and 2 cases of subcutaneous emphysema (1.9%). No perioperative death occurred. CONCLUSION: 3D-CTBA-guided thoracoscopic segmentectomy is an effective surgical approach for the management of pulmonary nodules.

7.
Nat Commun ; 12(1): 5472, 2021 09 16.
Artigo em Inglês | MEDLINE | ID: mdl-34531406

RESUMO

Dual-energy X-ray absorptiometry (DXA) is underutilized to measure bone mineral density (BMD) and evaluate fracture risk. We present an automated tool to identify fractures, predict BMD, and evaluate fracture risk using plain radiographs. The tool performance is evaluated on 5164 and 18175 patients with pelvis/lumbar spine radiographs and Hologic DXA. The model is well calibrated with minimal bias in the hip (slope = 0.982, calibration-in-the-large = -0.003) and the lumbar spine BMD (slope = 0.978, calibration-in-the-large = 0.003). The area under the precision-recall curve and accuracy are 0.89 and 91.7% for hip osteoporosis, 0.89 and 86.2% for spine osteoporosis, 0.83 and 95.0% for high 10-year major fracture risk, and 0.96 and 90.0% for high hip fracture risk. The tool classifies 5206 (84.8%) patients with 95% positive or negative predictive value for osteoporosis, compared to 3008 DXA conducted at the same study period. This automated tool may help identify high-risk patients for osteoporosis.


Assuntos
Absorciometria de Fóton/métodos , Algoritmos , Densidade Óssea , Aprendizado Profundo , Fraturas Ósseas/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Fraturas Ósseas/fisiopatologia , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/fisiopatologia , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoporose/fisiopatologia , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Sensibilidade e Especificidade
8.
Front Immunol ; 12: 694573, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34484191

RESUMO

Inclusion membrane proteins (Incs) play an important role in the structure and stability of chlamydial inclusion and the interaction between Chlamydia spp. and their hosts. Following Chlamydia infection through the respiratory tract, human polymorphonuclear neutrophils (hPMN) not only act as the primary immune cells reaching the lungs, but also serve as reservoir for Chlamydia. We have previously identified a Chlamydia psittaci hypothetical protein, CPSIT_0556, as a medium expressed inclusion membrane protein. However, the role of inclusion membrane protein, CPSIT_0556 in regulating hPMN functions remains unknown. In the present study, we found that CPSIT_0556 could not only inhibit hPMN apoptosis through the PI3K/Akt and NF-κB signaling pathways by releasing IL-8, but also delays procaspase-3 processing and inhibits caspase-3 activity in hPMN. Up-regulating the expression of anti-apoptotic protein Mcl-1 and down-regulating the expression of pro-apoptotic protein Bax could also inhibit the translocalization of Bax in the cytoplasm into the mitochondria, as well as induce the transfer of p65 NF-κB from the cytoplasm to the nucleus. Overall, our findings demonstrate that CPSIT_0556 could inhibit hPMN apoptosis through PI3K/Akt and NF-κB pathways and provide new insights towards understanding a better understanding of the molecular pathogenesis and immune escape mechanisms of C. psittaci.

9.
J Oncol ; 2021: 7462012, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34462636

RESUMO

Objective: To explore the effect of prophylactic radiotherapy on patients with stage II-III esophageal cancer (EC) after esophageal cancer radical operation (ECRO) and influencing factors on EC recurrence. Methods: Totally, 65 patients with EC in our hospital were enrolled. Among them, 30 patients were treated by routine ECRO as a control group (Con group) and 35 patients by prophylactic radiotherapy as a research group (Res group). Then, the following measures were taken: record the efficacy on both groups, quantify their C-reactive protein (CRP) and white blood cell count (WBC) before and after therapy, evaluate their mental state through the revised piper fatigue scale (PFS-R) before and after therapy, determine their changes in Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) before and after therapy, compare them in terms of lymph-node metastatic rate (LNMR), hematogenous metastasis rate (HMR), anastomotic recurrence rate (ARR), and 3-year survival rate, compare them in terms of life quality after therapy via the Quality of Life-Core Questionnaire (QLQ-C30), and analyze influencing factors on their recurrence. Results: The Res group showed a notably higher total effective rate (TER) than the Con group (P=0.037). After therapy, CRP and WBC in both groups increased, but their levels were not considerably different in both (P > 0.05). Additionally, after therapy, in contrast to the Con group, the Res group got notably lower PFS-R, SDS, and SAS scores, showed notably lower LNMR and ARR and notably higher 3-year survival rate, and experienced notably higher life quality (all P < 0.05), and the HMR results were not considerably different in both groups (P > 0.05). Moreover, carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), esophageal inflammation history, family medical history, postoperative complications, and lymphatic and vascular infiltration were risk factors for the disease recurrence, and treatment method was the protective factor for it. Conclusion: For patients with stage II-III EC after ECRO, prophylactic radiotherapy is highly effective and safe and can lower the recurrence rate, so it is worth popularizing in clinical practice.

10.
IUCrJ ; 8(Pt 4): 595-607, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34258008

RESUMO

Despite ceaseless efforts in past decades, the memory effect of semi-crystalline polymers has not been elucidated completely yet. An important reason why is that residual lamellar crystals in the structured melt are difficult to characterize. Recently, we developed a new small-angle X-ray scattering (SAXS) theory [Li et al. (2019). IUCrJ, 6, 968-983] and Fourier transform method [Li et al. (2020). CrystEngComm, 22, 3042-3058] for lamellar crystals that could derive structural information from SAXS readily. In this study, we tried to employ the new theory and method to characterize residual lamellar crystals in the structured melt. It was found that although scattering peaks cannot be observed in raw scattering profiles, they actually exist. Subtracting free-melt scattering and multiplying by q 4 benefit the observation of these weak scattering peaks. With the new Fourier transform method, it was found that indeed as proposed previously, thicker lamellar crystals exist in the structured melt. To determine the lateral size of residual lamellar crystal especially, a new method was developed under the guidance of the new theory. With the new method, it was found that although the crystallinity is very low (∼1% at 174°C), the lateral sizes in the structured melts are still large, e.g. 45.3 nm at 174°C, much greater than the critical nucleation size. This implies that these residual lamellar crystals can act as athermal nuclei after quenching to a lower temperature, as proposed by Ziabicki & Alfonso [(1994). Colloid Polym. Sci. 272, 1027-1042; (2002). Macromol. Symp. 185, 211-231] more than 20 years ago. The methodologies proposed here could also be applied to other polymer lamellar systems.

11.
Hepatol Commun ; 5(6): 1051-1068, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34141989

RESUMO

Individuals exhibiting an intermediate alcohol drinking pattern in conjunction with signs of metabolic risk present clinical features of both alcohol-associated and metabolic-associated fatty liver diseases. However, such combination remains an unexplored area of great interest, given the increasing number of patients affected. In the present study, we aimed to develop a preclinical DUAL (alcohol-associated liver disease plus metabolic-associated fatty liver disease) model in mice. C57BL/6 mice received 10% vol/vol alcohol in sweetened drinking water in combination with a Western diet for 10, 23, and 52 weeks (DUAL model). Animals fed with DUAL diet elicited a significant increase in body mass index accompanied by a pronounced hypertrophy of adipocytes, hypercholesterolemia, and hyperglycemia. Significant liver damage was characterized by elevated plasma alanine aminotransferase and lactate dehydrogenase levels, extensive hepatomegaly, hepatocyte enlargement, ballooning, steatosis, hepatic cell death, and compensatory proliferation. Notably, DUAL animals developed lobular inflammation and advanced hepatic fibrosis. Sequentially, bridging cirrhotic changes were frequently observed after 12 months. Bulk RNA-sequencing analysis indicated that dysregulated molecular pathways in DUAL mice were similar to those of patients with steatohepatitis. Conclusion: Our DUAL model is characterized by obesity, glucose intolerance, liver damage, prominent steatohepatitis and fibrosis, as well as inflammation and fibrosis in white adipose tissue. Altogether, the DUAL model mimics all histological, metabolic, and transcriptomic gene signatures of human advanced steatohepatitis, and therefore serves as a preclinical tool for the development of therapeutic targets.

12.
Acta Crystallogr B Struct Sci Cryst Eng Mater ; 77(Pt 3): 311-320, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34096512

RESUMO

The engineering of supramolecular architectures needs accurate descriptions of the intermolecular interactions in crystal structures. Tetrathiafulvalene (TTF) is an effective building block used in the construction of promising functional materials. The parallel packing of the neutral TTF-TTF system was studied previously using the high-level quantum chemical method, advancing it as a valuable model system. The recently developed tight-binding quantum chemical method GFN2-xTB and local coupled-cluster method DLPNO-CCSD(T) were used to investigate the stacking interactions of TTF and selected derivatives deposited in the Cambridge Structural Database. Using the interaction energy of the TTF-TTF dimer calculated at the CCSD(T)/CBS level as the reference, the accuracies of the two methods are investigated. The energy decomposition analysis within the DLPNO-CCSD(T) framework reveals the importance of dispersion interaction in the TTF-related stacking systems. The dispersion interaction density plot vividly shows the magnitude and distribution of the dispersion interaction, providing a revealing insight into the stacking interactions in crystal structures. The results show that the GFN2-xTB and DLPNO-CCSD(T) methods could achieve accuracy at an affordable computational cost, which would be valuable in understanding the nature of parallel stacking in supramolecular systems.

13.
J Am Pharm Assoc (2003) ; 61(5): 605-613, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34023278

RESUMO

BACKGROUND: Global effort is key to prevent and control infections effectively. Whereas pharmacists' involvement in the immunization neighborhood, collaborative effort to meet immunization needs of the public, has reduced burden of vaccine-preventable diseases in Western countries, the impact of pharmacist-involved vaccination advocacy and delivery in Asia Pacific remains unclear. OBJECTIVE: To examine the evidence for impact of pharmacists on immunization advocacy and delivery in Asia Pacific and to assess Singaporean pharmacists' experience in becoming immunizing pharmacists through the American Pharmacists Association's Pharmacy-based Immunization certificate training program. METHODS: A mixed-method study consisted of systematic review and survey was conducted. The systematic review was conducted by searching PubMed and Cumulative Index to Nursing and Allied Health databases from inception to March 2021. Randomized controlled trials and observational studies related to pharmacist-involved immunization advocacy and training conducted in Asia Pacific were included. Eligible studies were appraised for quality using CONsolidated Standards of Reporting Trials (CONSORT) and STrengthening the Reporting of OBservational checklists. In addition, a 20-item Likert-scale survey evaluated the pharmacists' experience in becoming immunizing pharmacists in Singapore. Frequencies of each response to the survey items were analyzed. RESULTS: Six studies were eligible for inclusion; 2 assessing impact of pharmacist as immunizer, 3 reporting outcomes of pharmacist-involved vaccine advocacy, and 1 evaluating the structure of pharmacist immunization training. Although study quality was minimal, all studies echoed positive findings as a result of pharmacist-provided immunization advocacy and delivery. Of the 23 pharmacists completing the survey, 91.3% strongly agreed that quality training was important to become immunizing pharmacists. CONCLUSION: Although limited in number, studies conducted in Asia Pacific reported increased vaccination rates when involving pharmacists. Coupled with the enthusiasm to be trained in immunization advocacy and delivery as elucidated by the Singaporean pharmacists, pharmacists in Asia Pacific should also be advocated for their role in the immunization neighborhood as part of the global effort against vaccine-preventable infectious diseases.


Assuntos
Assistência Farmacêutica , Farmacêuticos , Humanos , Imunização , Programas de Imunização , Estados Unidos , Vacinação
14.
Heart ; 107(17): 1422-1428, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33963048

RESUMO

OBJECTIVES: To investigate the prevalence and quantity of aortic valve calcium (AVC) in two large cohorts, stratified according to age and lipoprotein(a) (Lp(a)), and to assess the association between Lp(a) and AVC. METHODS: We included 2412 participants from the population-based Rotterdam Study (52% women, mean age=69.6±6.3 years) and 859 apparently healthy individuals from the Amsterdam University Medical Centers (UMC) outpatient clinic (57% women, mean age=45.9±11.6 years). All individuals underwent blood sampling to determine Lp(a) concentration and non-enhanced cardiac CT to assess AVC. Logistic and linear regression analyses were performed to investigate the associations of Lp(a) with the presence and amount of AVC. RESULTS: The prevalence of AVC was 33.1% in the Rotterdam Study and 5.4% in the Amsterdam UMC cohort. Higher Lp(a) concentrations were independently associated with presence of AVC in both cohorts (OR per 50 mg/dL increase in Lp(a): 1.54 (95% CI 1.36 to 1.75) in the Rotterdam Study cohort and 2.02 (95% CI 1.19 to 3.44) in the Amsterdam UMC cohort). In the Rotterdam Study cohort, higher Lp(a) concentrations were also associated with increase in aortic valve Agatston score (ß 0.19, 95% CI 0.06 to 0.32 per 50 mg/dL increase). CONCLUSIONS: Lp(a) is robustly associated with presence of AVC in a wide age range of individuals. These results provide further rationale to assess the effect of Lp(a) lowering interventions in individuals with early AVC to prevent end-stage aortic valve stenosis.

15.
J Surg Res ; 264: 296-308, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33845413

RESUMO

BACKGROUND: Skin-sparing debridement (SSd) was introduced as an alternative to en bloc debridement (EBd) to decrease morbidity caused by scars in patients surviving Necrotizing soft-tissue infections (NSTI). An overview of potential advantages and disadvantages is needed. The aim of this review was to assess (1) whether SSd is noninferior to EBd regarding general outcomes, that is, mortality, length of stay (LOS), complications, and (2) if SSd does indeed result in decreased skin defects. METHODS: A systematic literature search was performed according to the PRISMA guidelines. All human studies describing patients treated with SSd were included, when at least of evidence level consecutive case series. Studies describing up to 20 patients were pooled to improve readability and prevent overemphasis of findings from single small studies. RESULTS: Ten studies, one cohort study and nine case series, all classified as poor based on Chambers criteria for case series, were included. Compared to patients treated with EBd, patients treated with SSd had no increased mortality rate, LOS or complication rate. SSd-treated patients had a high rate (75%) of total delayed primary closure (DPC) in the pooled case series. CONCLUSION: The current available evidence is of insufficient quality to conclude whether SSd is noninferior to EBd for all assessed outcomes. There are suggestions that SSd may result in a decreased need for skin transplants, which could potentially improve the (health related) quality of life in survivors. Experienced surgical teams could cautiously implement SSd under close monitoring, ideally with uniform outcome registry.


Assuntos
Desbridamento/métodos , Tratamentos com Preservação do Órgão/métodos , Complicações Pós-Operatórias/epidemiologia , Infecções dos Tecidos Moles/cirurgia , Tela Subcutânea/patologia , Desbridamento/efeitos adversos , Humanos , Tempo de Internação/estatística & dados numéricos , Necrose/cirurgia , Tratamentos com Preservação do Órgão/efeitos adversos , Complicações Pós-Operatórias/etiologia , Qualidade de Vida , Pele/patologia , Transplante de Pele/estatística & dados numéricos , Infecções dos Tecidos Moles/mortalidade , Infecções dos Tecidos Moles/patologia , Tela Subcutânea/cirurgia , Resultado do Tratamento
16.
World J Emerg Med ; 12(2): 105-110, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33728002

RESUMO

BACKGROUND: It is challenging to establish peripheral intravenous access in adult critically patients. This study aims to compare the success rate of the first attempt, procedure time, operator satisfaction with the used devices, pain score, and complications between intraosseous (IO) access and central venous catheterization (CVC) in critically ill Chinese patients. METHODS: In this prospective clustered randomized controlled trial, eight hospitals were randomly divided into either the IO group or the CVC group. Patients who needed emergency vascular access were included. From April 1, 2017 to December 31, 2018, each center included 12 patients. We recorded the data mentioned above. RESULTS: A total of 96 patients were enrolled in the study. There were no statistically significant differences between the two groups regarding sex, age, body mass index, or operator satisfaction with the used devices. The success rates of the first attempt and the procedure time were statistically significant between the IO group and the CVC group (91.7% vs. 50.0%, P<0.001; 52.0 seconds vs. 900.0 seconds, P<0.001). During the study, 32 patients were conscious. There was no statistically significant difference between the two groups regarding the pain score associated with insertion. There were statistically significant differences between the two groups regarding the pain score associated with IO or CVC infusion (1.5 vs. 0.0, P=0.044). Complications were not observed in the two groups. CONCLUSIONS: IO access is a safe, rapid, and effective technique for gaining vascular access in critically ill adults with inaccessible peripheral veins in the emergency departments.

17.
ACS Appl Mater Interfaces ; 13(5): 6699-6709, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33523647

RESUMO

Driven by the evolution of electronic packaging technology for high-dense integration of high-power, high-frequency, and multi-function devices in modern electronics, thermal management materials have become a crucial component for guaranteeing the stable and reliable operation of devices. Because of its admirable in-plane thermal conductivity, graphene is considered as a desired thermal conductor. However, the promise of graphene films has been greatly weakened as the existence of grain boundaries lead to a high extent of phonon scattering. Here, a stitching strategy is adopted to fabricate an rGO/g-C3N4 film, where 2D g-C3N4 works as a linker to covalently connect adjacent rGO sheets for expanding the size of graphene and forming an in-plane rGO/g-C3N4 heterostructure. The in-plane thermal conductivity of the rGO/g-C3N4 film reaches 41.2 W m-1 K-1 at a g-C3N4 content of only 1 wt %, which increased by 17.3% compared to pristine rGO. The interfaced thermal resistance between rGO and g-C3N4 is further examined by non-equilibrium molecular dynamics simulations. Furthermore, owing to the unique light absorption and welding ability of g-C3N4, the rGO/g-C3N4 film presents superior solar-thermal and electric-thermal responses to controllably regulate the chip temperature against overcooling. This work provides a facile approach to construct a large-sized rGO sheet and combines heat dissipation and heating capability in the same thermal management material for future electronics.

18.
Neuroreport ; 32(3): 214-222, 2021 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33470760

RESUMO

OBJECTIVE: This study aimed to observe the effect of glutamine (Gln) on brain damage in septic rats and explore its possible mechanism. METHODS: Ninety-three Sprague-Dawley rats were randomly divided into five groups: sham operation group, sepsis group, Gln-treated group, quercetin/Gln-treated group, and alloxan/Gln-treated group. The rats in each group were continuously monitored for mean arterial pressure (MAP) and heart rate changes for 16 h. Neuroreflex scores were measured 24 h after surgery. The water content of the brain tissue was measured. Plasma neuron enolase and cysteine protease-3 were measured using the ELISA. The expression levels of heat shock protein 70 (HSP70) and oxygen-N-acetylglucosamine (O-GlcNAc) were determined by western blot analysis. Finally, the brain tissue was observed via hematoxylin and eosin staining. RESULTS: The brain tissue water content, plasma neuron enolase content, brain tissue cysteine protease-3 content, and nerve reflex score were significantly lower in the Gln-treated group than in the sepsis group (P < 0.05). At the same time, the pathological brain tissue damage in the Gln-treated group was also significantly reduced. It is worth noting that the expression of HSP70 and the protein O-GlcNAc modification levels in the Gln-treated group were significantly elevated than the levels in the sepsis group (P < 0.05), and reversed by pretreatment with the HSP and O-GlcNAc inhibitors quercetion and alloxan. CONCLUSIONS: Gln can attenuate brain damage in rats with sepsis, which may be associated with increased protein O-GlcNAc modification.

19.
Int J Clin Pract ; 75(4): e13759, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33098255

RESUMO

AIMS: To investigate current awareness and practices of neurological prognostication in comatose cardiac arrest (CA) patients. METHODS: An anonymous questionnaire was distributed to 1600 emergency physicians in 75 hospitals which were selected randomly from China between January and July 2018. RESULTS: 92.1% respondents fulfilled the survey. The predictive value of brain stem reflex, motor response and myoclonus was confirmed by 63.5%, 44.6% and 31.7% respondents, respectively. Only 30.7% knew that GWR value < 1.1 indicated poor prognosis and only 8.1% know the most commonly used SSEP N20. Status epilepticus, burst suppression and suppression were considered to predict poor outcome by only 35.0%, 27.4% and 20.9% respondents, respectively. Only 46.7% knew NSE and only 24.7% knew S-100. Only a few respondents knew that neurological prognostication should be performed later than 72 hours from CA either in TTM or non-TTM patients. In practice, the most commonly used method was clinical examination (85.4%). Only 67.9% had used brain CT for prognosis and 18.4% for MRI. NSE (39.6%) was a little more widely used than S-100ß (18.0%). However, SSEP (4.4%) and EEG (11.4%) were occasionally performed. CONCLUSIONS: Neurological prognostication in CA survivors had not been well understood and performed by emergency physicians in China. They were more likely to use clinical examination rather than objective tools, especially SSEP and EEG, which also illustrated that multimodal approach was not well performed in practice.


Assuntos
Parada Cardíaca , China/epidemiologia , Coma , Parada Cardíaca/diagnóstico , Humanos , Prognóstico , Sobreviventes
20.
Lasers Med Sci ; 36(4): 783-790, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32651700

RESUMO

The optical properties of hemoglobin could indicate the degree of hemolysis. We aimed to utilize this to develop a real-time blood damage monitoring device for cardiopulmonary bypass (CPB) systems. The real-time blood damage monitoring device comprised a near-infrared spectroscopy optical module with a fiber spectrometer and monitoring platform and computer software developed using LabVIEW 2017. The fiber spectrometer operated at wavelengths of 545, 660, and 940 nm and contained a detector fiber bundle (source-detector distance = 1.0-2.5 cm). CPB operation was simulated using an artificial heart-lung machine with a flow rate of 3, 4, or 5 L/min. Four hundred milliliter of anticoagulated porcine blood was continuously rotated for 4 h. The transmittance, reflectivity, and absorbance of the blood were measured using the optical device at a frequency of 25 Hz and then digitally averaged into 1-s interval. Samples of damaged blood were collected at regular intervals for in vitro hemolysis tests to calculate the normalized index of hemolysis (NIH). All experiments were repeated three times. We prepared 28 blood bags containing 400 ml of anticoagulant. Paired t test was used to examine the test-retest reliability of the differences between the three methods and control samples. Statistical tests revealed significant differences in the mean values between the test and control groups over time (P < 0.01). Relationship was established between the real-time monitoring results and the NIH values. An effective blood damage detection method that combined in vitro hemolysis tests and near-infrared spectroscopy was achieved. The results demonstrate the clinical potential of a real-time, low-cost, and reliable blood damage monitoring device to improve the safety of CPB operation.


Assuntos
Ponte Cardiopulmonar/instrumentação , Espectroscopia de Luz Próxima ao Infravermelho , Máquina Coração-Pulmão , Hemoglobinas/metabolismo , Hemólise , Humanos , Reprodutibilidade dos Testes
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...