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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(7): 640-643, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31315761

RESUMO

OBJECTIVE: To explore the value and significance of the clinical application of whole exome sequencing (WES) in monogenic hereditary disorders in critically ill newborns. METHODS: The critically ill newborns in the neonatal intensive care unit with suspected hereditary diseases or unclear clinical diagnosis from June 2016 to December 2018 were enrolled. The whole blood samples from both newborns and parents were collected for WES. The detected genetic mutations were classified, the mutations associated with clinical phenotypes were searched for, and Sanger sequencing was performed to verify the mutations. RESULTS: A total of 45 newborns were enrolled, including 22 males and 23 females, and the median age of onset was 2.0 days. Of the 45 newborns, 12 (27%) were confirmed with monogenic hereditary disorders by molecular diagnostics, and the median age at diagnosis was 31.5 days. Of the 12 newborns with monogenic hereditary disorders, 5 (42%) were partially associated with clinical phenotypes but confirmed with monogenic hereditary disorders by additional information supplement and analysis. The improvement rate of newborns with monogenic hereditary disorders was 67% (8/12) after treatment. CONCLUSIONS: WES technology is a powerful tool for finding genetic mutations in monogenic hereditary disorders in critically ill newborns and can play a crucial role in clinical decision-making. However, a comprehensive interpretation of sequence data requires physicians to take the clinical phenotypes and the results of WES into consideration simultaneously.


Assuntos
Estado Terminal , Exoma , Feminino , Humanos , Recém-Nascido , Masculino , Mutação , Fenótipo , Sequenciamento Completo do Exoma
2.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(6): 562-566, 2019 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-31208510

RESUMO

OBJECTIVE: To examine blood concentrations of free carnitine (FC) in preterm infants with different gestational ages (GA) and birth weights (BW). METHODS: A total of 3 368 preterm infants were enrolled as subjects. According to GA, they were divided into extremely preterm birth (EPTB) group (GA <28 weeks; n=39), very preterm birth (VPTB) group (28 ≤GA <32 weeks; n=405), moderately preterm birth (MPTB) group (32 ≤GA <34 weeks; n=507), and late preterm birth (LPTB) group (34 ≤GA <37 weeks; n=2 417); according to BW, they were divided into extremely low birth weight (ELBW) group (BW <1 000 g; n=36), very low birth weight (VLBW) group (1 000 g ≤BW <1 500 g; n=387), low birth weight (LBW) group (1 500 g ≤BW <2 500 g; n=1 873), and normal birth weight (NBW) group (2 500 g ≤ BW <4 000 g; n=1 072). Blood concentrations of FC were measured between 72 hours and 7 days after birth. RESULTS: The EPTB and VPTB groups had significantly higher FC concentrations than the MPTB and LPTB groups (P<0.05), and the MPTB group had significantly higher FC concentrations than the LPTB group (P<0.05). The lower limit of the 95% medical reference range of FC increased with the reduction in GA. The ELBW and VLBW groups had significantly higher FC concentrations than the LBW and NBW groups (P<0.05). The LBW group had significantly higher FC concentrations than the NBW group (P<0.05). The lower limit of the 95% medical reference range of FC increased with the reduction in BW. CONCLUSIONS: There is a significant increase in blood FC concentrations in very/extremely preterm infants and very/extremely low birth weight infants, and tend to decrease with the increases in GA and BW.


Assuntos
Recém-Nascido Prematuro , Peso ao Nascer , Carnitina , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido de Peso Extremamente Baixo ao Nascer , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Gravidez
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 21(5): 458-462, 2019 May.
Artigo em Chinês | MEDLINE | ID: mdl-31104663

RESUMO

OBJECTIVE: To study the differences in growth and metabolism between small for gestational age (SGA) infants and appropriate for gestational age (AGA) infants. METHODS: A total of 1 370 preterm infants were enrolled in this study. According to the association between gestational age and birth weight, they were divided into SGA group with 675 infants and AGA group with 695 infants. The two groups were compared in terms of general conditions, physical growth and blood biochemical parameters. RESULTS: The SGA group had a significantly longer length of hospital stay than the AGA group (P<0.05). Compared with the AGA group, the SGA group had significantly lower body weight, body weight Z score, and body length at discharge and significantly higher incidence rate of extrauterine growth retardation and growth rate of head circumference (P<0.05). Compared with the AGA group, the SGA group had significantly longer time to full enteral nutrition and duration of parenteral nutrition (P<0.05). Compared with the AGA group, the SGA group had significantly higher levels of albumin, prealbumin, and serum phosphorus on admission and total bile acid before discharge, as well as a significantly lower albumin level before discharge (P<0.05). The incidence rates of asphyxia, neonatal respiratory distress syndrome, myocardial damage, feeding intolerance, pneumonia, sepsis, hypoglycemia and hypothyroxinemia in the SGA group were significantly higher than in the AGA group (P<0.05). CONCLUSIONS: Compared with AGA infants, SGA infants have significantly delayed physical development during hospitalization and significantly higher incidence rates of extrauterine growth retardation and related complications.


Assuntos
Recém-Nascido Prematuro , Recém-Nascido Pequeno para a Idade Gestacional , Síndrome do Desconforto Respiratório do Recém-Nascido , Peso ao Nascer , Idade Gestacional , Humanos , Lactente , Recém-Nascido
4.
World J Gastroenterol ; 25(13): 1618-1627, 2019 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-30983821

RESUMO

BACKGROUND: Chronic radiation proctitis (CRP) is a complication which occurs in 1%-5% of patients who undergo radiotherapy for pelvic malignancies. Although a wide range of therapeutic modalities are available, there is no literature to date showing any particularly appropriate therapeutic modality for each disease stage. Argon plasma coagulation (APC) is currently recommended as the first-choice treatment for hemorrhagic CRP, however, its indication based on long-term follow-up is still unclear. On the hypothesis that the long-term efficacy and safety of APC are not fully understood, we reviewed APC treatment for patients with hemorrhagic CRP from a single center. AIM: To assess the long-term efficacy and safety of APC for hemorrhagic CRP. METHODS: This is a retrospective study of consecutive patients treated with APC for hemorrhagic CRP from January 2013 to October 2017. Demographics, clinical variables, and typical endoscopic features were recorded independently. Success was defined as either cessation of bleeding or only occasional traces of bloody stools with no further treatments for at least 12 mo after the last APC treatment. We performed univariate and multivariate analyses to identify factors associated with success and risk factors for fistulas. RESULTS: Forty-five patients with a median follow-up period of 24 mo (range: 12-67 mo) were enrolled. Fifteen (33.3%) patients required blood transfusion before APC. Successful treatment with APC was achieved in 31 (68.9%) patients. The mean number of APC sessions was 1.3 (1-3). Multivariate analysis showed that APC failure was independently associated with telangiectasias present on more than 50% of the surface area [odds ratio (OR) = 6.53, 95% confidence interval (CI): 1.09-39.19, P = 0.04] and ulcerated area greater than 1 cm2 (OR = 8.15, 95%CI: 1.63-40.88, P = 0.01). Six (13.3%) patients had severe complications involving rectal fistulation. The only factor significantly associated with severe complications was ulcerated area greater than 1 cm2 (P = 0.035). CONCLUSION: The long-term efficacy of APC for hemorrhagic CRP is uncertain in patients with telangiectasias present on > 50% of the surface area and ulceration > 1 cm2.


Assuntos
Coagulação com Plasma de Argônio/efeitos adversos , Hemorragia Gastrointestinal/cirurgia , Complicações Pós-Operatórias/epidemiologia , Proctite/cirurgia , Lesões por Radiação/cirurgia , Telangiectasia/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Hemorragia Gastrointestinal/etiologia , Humanos , Mucosa Intestinal/irrigação sanguínea , Mucosa Intestinal/patologia , Mucosa Intestinal/efeitos da radiação , Mucosa Intestinal/cirurgia , Masculino , Pessoa de Meia-Idade , Neoplasias Pélvicas/radioterapia , Complicações Pós-Operatórias/etiologia , Proctite/etiologia , Proctite/patologia , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Reto/irrigação sanguínea , Reto/patologia , Reto/efeitos da radiação , Reto/cirurgia , Estudos Retrospectivos , Fatores de Risco , Telangiectasia/etiologia , Telangiectasia/patologia , Resultado do Tratamento
5.
Pregnancy Hypertens ; 14: 68-71, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30527121

RESUMO

OBJECTIVE: To identify the effect of pregnancy induced hypertension on neonatal outcomes in early and moderate preterm infants of gestational age less than 34 weeks. STUDY DESIGN: Prospectively collected data in 773 premature deliveries less than 34 weeks from 10 centers in China between July 2014 and July 2016 were analyzed in this cohort study. Univariate and Multivariate regression analyses were conducted to exam the effect of pregnancy induced hypertension on neonatal outcomes, including mortality to discharge, intrauterine growth restriction, severe brain injury, neonatal respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, early onset of sepsis and retinopathy of prematurity. RESULTS: The incidence of PIH in this cohort was 18.4%. Women with PIH tended to have a higher cesarean delivery rate (78.2% vs 40.9%, P < 0.001). More tocolytics and magnesium sulfate were used in PIH women (72.5% vs 48.7%, P < 0.001; 59.2% vs 34.7%, P < 0.001). Mean birth weight was lower in infants of PIH mothers than infants of non-PIH mothers (1522.1 ±â€¯348.8 g vs 1683.4 ±â€¯345.3, P < 0.001). In multivariate regression models, PIH was associated with increased risk of IUGR (OR 8.402; 95% CI 4.350-16.227) and lower odds of NRDS (OR 0.526; 95% CI 0.332-0.853). CONCLUSION: Preterm infants less than 34 weeks born to PIH women had a higher risk of intrauterine growth restriction and lower birth weight. PIH warrants more intensive interventions to prevent relevant infant morbidities.


Assuntos
Peso ao Nascer , Retardo do Crescimento Fetal/mortalidade , Hipertensão Induzida pela Gravidez , Recém-Nascido Prematuro , Adulto , China , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Doenças do Prematuro/mortalidade , Masculino , Gravidez , Resultado da Gravidez , Estudos Prospectivos
6.
Zhongguo Dang Dai Er Ke Za Zhi ; 20(8): 608-612, 2018 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-30111467

RESUMO

OBJECTIVE: To explore the effect of prone positioning on respiratory function in very preterm infants undergoing mechanical ventilation. METHODS: A total of 83 very preterm infants treated with mechanical ventilation were enrolled in the study and were randomly assigned to supine group and prone group. Four infants withdrew from the study and 79 infants completed treatment and observation (37 in the supine group and 42 in the prone group). Infants in both groups were mechanically ventilated in a volume assist-control mode. Infants in the prone group were ventilated in the supine position for 4 hours and in the prone position for 2 hours. Ventilator parameters, arterial blood gas analysis, and vital signs were recorded before grouping, every 6 hours in the supine group, and every hour after conversion into the prone position in the prone group, respectively. RESULTS: Fraction of inspired oxygen (FiO2), peak inspiratory pressure, mean inspiratory pressure, and duration of ventilation were significantly lower in the prone group than in the supine group (P<0.05); there were no significant differences in tidal volume or positive end-expiratory pressure between the two groups (P>0.05). The prone group had a significantly higher PO2/FiO2 ratio but significantly lower oxygenation index and respiratory rate than the supine group (P<0.05). There were no significant differences in arterial oxygen tension, pH, base excess, heart rate, or mean blood pressure between the two groups (P>0.05). CONCLUSIONS: Alternating ventilation between the prone position and supine position can improve oxygenation function, decrease the fraction of inspired oxygen, and shorten the duration of mechanical ventilation in very preterm infants undergoing mechanical ventilation.


Assuntos
Síndrome do Desconforto Respiratório do Recém-Nascido/fisiopatologia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Gasometria , Feminino , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Pulmão/fisiopatologia , Masculino , Oxigênio/metabolismo , Respiração com Pressão Positiva , Decúbito Ventral , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/metabolismo , Testes de Função Respiratória , Decúbito Dorsal
7.
J Phys Condens Matter ; 30(15): 155303, 2018 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-29488471

RESUMO

The optical properties and condensation degree (structure) of polymeric g-C3N4 depend strongly on the process temperature. For polymeric g-C3N4, its structure and condensation degree depend on the structure of molecular strand(s). Here, the formation and electronic structure properties of the g-C3N4 nanoribbon are investigated by studying the polymerization and crystallinity of molecular strand(s) employing first-principle density functional theory. The calculations show that the width of the molecular strand has a significant effect on the electronic structure of polymerized and crystallized g-C3N4 nanoribbons, a conclusion which would be indirect evidence that the electronic structure depends on the structure of g-C3N4. The edge shape also has a distinct effect on the electronic structure of the crystallized g-C3N4 nanoribbon. Furthermore, the conductive band minimum and valence band maximum of the polymeric g-C3N4 nanoribbon show a strong localization, which is in good agreement with the quasi-monomer characters. In addition, molecular strands prefer to grow along the planar direction on graphene. These results provide new insight on the properties of the g-C3N4 nanoribbon and the relationship between the structure and properties of g-C3N4.

8.
Future Oncol ; 13(17): 1473-1492, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28685592

RESUMO

AIM: To investigate the relationship between mutations of key genes in the EGFR signaling pathway and the prognosis of stage II colorectal cancer patients without chemotherapy. MATERIALS & METHODS: The incidence of KRAS, NRAS, BRAF, PIK3CA mutations and deficient DNA mismatch repair were assessed in 160 stage II colorectal cancer patients who had been treated by radical operation without adjuvant chemotherapy. RESULTS: Mutations in KRAS, BRAF or PIK3CA were associated with poor prognosis, while the deficient DNA mismatch repair status was not associated with the prognosis. Combining these three markers, the sensitivity of the predicted value for poor progression-free survival and overall survival reached 0.645 (p = 0.002) and 0.709 (p = 0.001), respectively. CONCLUSION: Knowing the mutation status of KRAS, BRAF or PIK3CA in stage II colorectal cancer can significantly improve the accuracy of prognoses.


Assuntos
Classe I de Fosfatidilinositol 3-Quinases/genética , Neoplasias Colorretais/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/patologia , Receptores ErbB/genética , Feminino , GTP Fosfo-Hidrolases/genética , Humanos , Masculino , Proteínas de Membrana/genética , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Prognóstico , Transdução de Sinais/genética
9.
World J Gastroenterol ; 22(24): 5598-608, 2016 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-27350738

RESUMO

AIM: To assess the efficacy and safety of diverting colostomy in treating severe hemorrhagic chronic radiation proctitis (CRP). METHODS: Patients with severe hemorrhagic CRP who were admitted from 2008 to 2014 were enrolled into this study. All CRP patients were diagnosed by a combination of pelvic radiation history, clinical rectal bleeding, and endoscopic findings. Inclusion criteria were CRP patients with refractory bleeding with moderate to severe anemia with a hemoglobin level < 90 g/L. The study group included patients who were treated by diverting colostomy, while the control group included patients who received conservative treatment. The remission of bleeding was defined as complete cessation or only occasional bleeding that needed no further treatment. The primary outcome was bleeding remission at 6 mo after treatment. Quality of life before treatment and at follow-up was evaluated according to EORTC QLQ C30. Severe CRP complications were recorded during follow-up. RESULTS: Forty-seven consecutive patients were enrolled, including 22 in the colostomy group and 27 in the conservative treatment group. When compared to conservative treatment, colostomy obtained a higher rate of bleeding remission (94% vs 12%), especially in control of transfusion-dependent bleeding (100% vs 0%), and offered a better control of refractory perianal pain (100% vs 0%), and a lower score of bleeding (P < 0.001) at 6 mo after treatment. At 1 year after treatment, colostomy achieved better remission of both moderate bleeding (100% vs 21.5%, P = 0.002) and severe bleeding (100% vs 0%, P < 0.001), obtained a lower score of bleeding (0.8 vs 2.0, P < 0.001), and achieved obvious elevated hemoglobin levels (P = 0.003), when compared to the conservative treatment group. The quality of life dramatically improved after colostomy, which included global health, function, and symptoms, but it was not improved in the control group. Pathological evaluation after colostomy found diffused chronic inflammation cells, and massive fibrosis collagen depositions under the rectal wall, which revealed potential fibrosis formation. CONCLUSION: Diverting colostomy is a simple, effective and safe procedure for severe hemorrhagic CRP. Colostomy can improve quality of life and reduce serious complications secondary to radiotherapy.


Assuntos
Colostomia , Hemorragia Gastrointestinal/cirurgia , Proctite/cirurgia , Lesões por Radiação/cirurgia , Estudos de Casos e Controles , Tratamento Conservador , Neoplasias do Endométrio/radioterapia , Feminino , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Proctite/complicações , Neoplasias da Próstata/radioterapia , Qualidade de Vida , Lesões por Radiação/complicações , Doenças Retais/cirurgia , Neoplasias Retais/radioterapia , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias do Colo do Útero/radioterapia
10.
Asian Pac J Cancer Prev ; 17(2): 631-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26925655

RESUMO

Radiation proctitis is a common complication after radiotherapy for pelvic malignant tumors. This study was conducted to assess the efficacy of novel almagate enemas in hemorrhagic chronic radiation proctitis (CRP) and evaluate risk factors related to rectal deep ulcer or fistula secondary to CRP. All patients underwent a colonoscopy to confirm the diagnosis of CRP and symptoms were graded. Typical endoscopic and pathological images, risk factors, and quality of life were also recorded. A total of 59 patients were enrolled. Gynecological cancers composed 93.1% of the primary malignancies. Complete or obvious reduction of bleeding was observed in 90% (53/59) patients after almagate enema. The mean score of bleeding improved from 2.17 to 0.83 (P<0.001) after the enemas. The mean response time was 12 days. No adverse effects were found. Moreover, long-term successful rate in controlling bleeding was 69% and the quality of life was dramatically improved (P=0.001). The efficacy was equivalent to rectal sucralfate, but the almagate with its antacid properties acted more rapidly than sucralfate. Furthermore, we firstly found that moderate to severe anemia was the risk factor of CRP patients who developed rectal deep ulcer or fistulas (P= 0.015). We also found abnormal hyaline-like thick wall vessels, which revealed endarteritis obliterans and the fibrosis underlying this disease. These findings indicate that almagate enema is a novel effective, rapid and well-tolerated method for hemorrhagic CRP. Moderate to severe anemia is a risk factor for deep ulceration or fistula.


Assuntos
Hidróxido de Alumínio/uso terapêutico , Carbonatos/uso terapêutico , Enema/métodos , Fístula/etiologia , Hemorragia Gastrointestinal/terapia , Hidróxido de Magnésio/uso terapêutico , Neoplasias/complicações , Proctite/terapia , Lesões por Radiação/terapia , Radioterapia/efeitos adversos , Adulto , Idoso , Antiácidos/uso terapêutico , Colonoscopia , Feminino , Fístula/diagnóstico , Seguimentos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias/patologia , Neoplasias/radioterapia , Proctite/diagnóstico , Proctite/etiologia , Prognóstico , Qualidade de Vida , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Estudos Retrospectivos , Fatores de Risco
11.
World J Gastroenterol ; 21(12): 3593-8, 2015 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-25834325

RESUMO

AIM: To assess the efficacy and safety of a modified topical formalin irrigation method in refractory hemorrhagic chronic radiation proctitis (CRP). METHODS: Patients with CRP who did not respond to previous medical treatments and presented with grade II-III rectal bleeding according to the Common Terminology Criteria for Adverse Events were enrolled. Patients with anorectal strictures, deep ulcerations, and fistulas were excluded. All patients underwent flexible endoscopic evaluation before treatment. Patient demographics and clinical data, including primary tumor, radiotherapy and previous treatment options, were collected. Patients received topical 4% formalin irrigation in a clasp-knife position under spinal epidural anesthesia in the operating room. Remission of rectal bleeding and related complications were recorded. Defecation, remission of bleeding, and other symptoms were investigated at follow-up. Endoscopic findings in patients with rectovaginal fistulas were analyzed. RESULTS: Twenty-four patients (19 female, 5 male) with a mean age of 61.5 ± 9.5 years were enrolled. The mean time from the end of radiotherapy to the onset of bleeding was 11.1 ± 9.0 mo (range: 2-24 mo). Six patients (25.0%) were blood transfusion dependent. The median preoperative Vienna Rectoscopy Score (VRS) was 3 points. Nineteen patients (79.2%) received only one course of topical formalin irrigation, and five (20.8%) required a second course. No side effects were observed. One month after treatment, bleeding cessation was complete in five patients and obvious in 14; the effectiveness rate was 79.1% (19/24). For long-term efficacy, 5/16, 1/9 and 0/6 patients complained of persistent bleeding at 1, 2 and 5 years after treatment, respectively. Three rectovaginal fistulas were found at 1 mo, 3 mo and 2 years after treatment. Univariate analysis showed associations of higher endoscopic VRS and ulceration score with risk of developing rectovaginal fistula. CONCLUSION: Modified formalin irrigation is an effective and safe method for hemorrhagic CRP, but should be performed cautiously in patients with a high endoscopic VRS.


Assuntos
Formaldeído/administração & dosagem , Hemorragia Gastrointestinal/terapia , Proctite/terapia , Lesões por Radiação/terapia , Irrigação Terapêutica/métodos , Idoso , Doença Crônica , Endoscopia Gastrointestinal , Feminino , Formaldeído/efeitos adversos , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Seleção de Pacientes , Valor Preditivo dos Testes , Proctite/diagnóstico , Proctite/etiologia , Lesões por Radiação/diagnóstico , Lesões por Radiação/etiologia , Estudos Retrospectivos , Fatores de Risco , Irrigação Terapêutica/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
12.
PLoS One ; 8(6): e65995, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23776587

RESUMO

BACKGROUND: BRAF mutation has been investigated as a prognostic factor in metastatic colorectal cancer (mCRC) undergoing anti-EGFR monoclonal antibodies (moAbs), but current results are still inconclusive. The aim of this meta-analysis was to evaluate the relationship between BRAF mutation status and the prognosis of mCRC patients treated with moAbs. METHODS: Eligible studies were identified by systematically searching Pubmed, the Cochrane Library, Web of Knowledge, and OVID. Risk ratio (RR) for overall response rate (ORR), Hazard ratios (HRs) for Progression free survival (PFS) and Overall survival (OS) were extracted or calculated. Prespecified subgroup analyses were conducted in KRAS wild-type and in different study types. The source of between-trial variation was explored by sensitivity analyses. Quality assessment was conducted by the Hayden's criteria. RESULTS: A total of twenty one trials including 5229 patients were identified for the meta-analysis. 343 patients displayed BRAF mutations of 4616 (7.4%) patients with known BRAF status. Patients with BRAF wild-type (WT) showed decreased risks of progression and death with an improved PFS(HR 0.38, 95% confidence intervals 0.29-0.51) and an improved OS (HR 0.35 [0.29-0.42]), compared to BRAF mutant. In KRAS WT population, there were even larger PFS benefit (HR 0.29[0.19,0.43]) and larger OS benefit (HR 0.26 [0.20,0.35]) in BRAF WT. A response benefit for BRAF WT was observed (RR 0.31[0.18,0.53]) in KRAS WT patients, but not observed in unselected patients (RR 0.76 [0.43-1.33]). The results were consistent in the subgroup analysis of different study types. Heterogeneity between trials decreased in the subgroup and explained by sensitivity analysis. No publication bias of ORR, PFS and OS were detected. CONCLUSIONS: The results indicate that BRAF mutant is a predictive biomarker for poor prognosis in mCRC patients undergoing anti-EGFR MoAbs therapy, especially in KRAS WT patients. Additional large prospective trials are required to confirm the predictive role of BRAF status.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Neoplasias Colorretais/tratamento farmacológico , Receptores ErbB/antagonistas & inibidores , Proteínas Proto-Oncogênicas B-raf/genética , Anticorpos Monoclonais/imunologia , Biomarcadores , Neoplasias Colorretais/genética , Receptores ErbB/imunologia , Humanos , Mutação
13.
J Cardiol ; 60(3): 242-7, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22704544

RESUMO

BACKGROUND: This study aimed to discover the pathogenesis of focal atrial fibrillation (AF) originating from pulmonary veins by observing the histological structure and special cells in the canine pulmonary vein model of persistent atrial fibrillation. METHODS: The pulmonary veins and the sinus node were obtained from 10 mongrel dogs (5 AF and 5 control group). Light microscopy, transmission electron microscopy, and immunohistochemistry were applied to transverse sections of each pulmonary vein and sinoatrial node. Morphological and distribution analyses were performed manually and automatically. RESULTS: Cardiomyocyte progenitor (CMPs) and interstitial cells of Cajal (ICCs) showing typical features of either very immature or developing cells were found in the pulmonary vein sections of all animals subjected to experimental AF but not in the control group. The cells were mainly identified in sections with a thick muscular sleeve. A positive immunostaining of CMPs was also demonstrated; the staining characteristic was similar to that of P cells in the sinoatrial node, suggesting that these cells may function in a pacemaker capacity. CONCLUSIONS: We demonstrated that pulmonary veins can host cardiac stem cell niches. Continuous rapid pacing can induce the differentiation of CMPs and ICCs, and CMPs may underlie the pacemaker activity of isolated pulmonary veins.


Assuntos
Fibrilação Atrial/patologia , Miócitos Cardíacos/patologia , Veias Pulmonares/patologia , Células-Tronco/patologia , Animais , Diferenciação Celular , Cães , Imuno-Histoquímica , Microscopia Eletrônica , Modelos Animais , Nó Sinoatrial/patologia
14.
Zhongguo Dang Dai Er Ke Za Zhi ; 14(1): 20-3, 2012 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-22289746

RESUMO

OBJECTIVE: To study the nutrition status of premature infants in the neonatal intensive care unit (NICU) and risk factors of extrauterine growth retardation (EUGR). METHODS: The clinical data of 110 premature infants who were admitted to the NICU from August 2007 to September 2008 were retrospectively reviewed. The possible factors influencing the nutrition status were analyzed. RESULTS: The incidence of EUGR was 53.6% (59/110), 31.8% (35/110) and 10.0% (11/110) by weight, length and head circumference respectively among the premature infants. The risk factors of EUGR included: small-for-gestational-age (SGA), low birth weight, low speed of weight gain during hospitalization, large extent of physiological weight loss, long time to reach oral calorie goal, and maternal complications. CONCLUSIONS: The nutrition status and physical development are not desirable in premature infants hospitalized in the NICU. Therefore, reasonable nutritional support and proactive control of risk factors are important strategies to improve the perinatal nutrition and long-term prognosis.


Assuntos
Transtornos do Crescimento/etiologia , Fenômenos Fisiológicos da Nutrição do Lactente , Doenças do Prematuro/fisiopatologia , Estado Nutricional , Peso ao Nascer , Feminino , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Modelos Logísticos , Masculino , Fatores de Risco
15.
Clin Cardiol ; 34(1): 59-63, 2011 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21259280

RESUMO

BACKGROUND: To evaluate the prognostic value of early and intensive lipid-lowering treatment on ventricular premature beat or nonsustained ventricular tachycardia (NSVT) after acute coronary syndrome (ACS) (ST-elevation myocardial infarction [STEMI], non-STEMI, and unstable angina pectoris). HYPOTHESIS: Provided that early and intensive lipid-lowering treatment can reduce ventricular premature beat or non-sustained ventricular tachycardia after ACS. METHODS: A total of 586 patients with ACS were randomly divided into 2 groups: group A (with conventional statin therapy, to receive 10 mg/day atorvastatin, n = 289) and group B (early and intensive statin therapy, 60 mg immediately and 40 mg/day atorvastatin, n = 297). The frequency of ventricular premature beat and NSVT was recorded with Holter monitoring after hospitalization (24 hours and 72 hours). RESULTS: Seventy-seven (11.8%) patients had NSVT. When compared to patients with no documented NSVT, patients with NSVT were older and more often had myocardial infarction, diabetes mellitus, atrial fibrillation, and an ejection fraction < 40% in their history. Ventricular premature beats decreased significantly in the early and aggressive treatment group (24 hours, P < 0.01; 72 hours, P < 0.001). A significant reduction in NSVT was seen in the early and aggressive (24 hours, P < 0.01; 72 hours, P < 0.001) group. No side effects were observed in either group. CONCLUSIONS: Early and intensive lipid-lowering treatment can obviously decrease ventricular premature beats and NSVT.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Antiarrítmicos/administração & dosagem , Ácidos Heptanoicos/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Pirróis/administração & dosagem , Taquicardia Ventricular/prevenção & controle , Complexos Ventriculares Prematuros/prevenção & controle , Síndrome Coronariana Aguda/complicações , Idoso , Atorvastatina , Distribuição de Qui-Quadrado , China , Método Duplo-Cego , Esquema de Medicação , Eletrocardiografia Ambulatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiologia , Fatores de Tempo , Resultado do Tratamento , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/etiologia
16.
Cardiol J ; 17(4): 381-5, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20690094

RESUMO

BACKGROUND: Our study's aim was to evaluate the prognostic value of early and intensive lipid-lowering treatment on ventricular premature beat or non-sustained ventricular tachycardia (NSVT) after acute coronary syndrome (STEMI, non-STEMI, and unstable angina pectoris). METHODS: Some 586 patients with acute coronary syndrome were randomly divided into two groups: Group A (with conventional statin therapy, to receive 10 mg/day atorvastatin, n = 289) and Group B (given early and intensive statin therapy, 60 mg immediately and 40 mg/day atorvastatin, n = 297). The frequency of ventricular premature beat and NSVT was recorded via Holter monitoring after hospitalization (24 h and 72 h). RESULTS: Seventy seven (11.8%) patients had NSVT. When compared to patients with no documented NSVT, patients with NSVT were older and more frequently had myocardial infarction in their history, diabetes mellitus, atrial fibrillation and an ejection fraction < 40%. Ventricular premature beats decreased significantly in the early and aggressive treatment group (24 h, p < 0.01; 72 h, p < 0.001). A significant reduction in NSVT was seen in the early and aggressive treatment group (24 h, p < 0.01; 72 h, p < 0.001). There were no side effects observed in either group. CONCLUSIONS: Early and intensive lipid-lowering treatment can clearly decrease ventricular premature beats and NSVT.


Assuntos
Síndrome Coronariana Aguda/tratamento farmacológico , Ácidos Heptanoicos/administração & dosagem , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Pirróis/administração & dosagem , Taquicardia Ventricular/prevenção & controle , Complexos Ventriculares Prematuros/prevenção & controle , Síndrome Coronariana Aguda/complicações , Idoso , Atorvastatina , Distribuição de Qui-Quadrado , China , Método Duplo-Cego , Esquema de Medicação , Eletrocardiografia Ambulatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Taquicardia Ventricular/diagnóstico , Taquicardia Ventricular/etiologia , Fatores de Tempo , Resultado do Tratamento , Complexos Ventriculares Prematuros/diagnóstico , Complexos Ventriculares Prematuros/etiologia
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