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1.
Sci Rep ; 11(1): 3634, 2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33574406

RESUMO

This study was conducted to investigate (1) the association between solid fuel use for cooking and cognitive function; (2) the moderating effects of gender and residential area on cognitive scores among solid fuel users; and (3) the effects of solid fuel use on cognitive decline among different gender and age subgroups in 2011-2018. A total of 5140 Chinese middle-aged and elderly participants were successfully followed for 7 years (2011-2018). Solid fuel use was self-reported as using solid fuel for cooking at home, and cognitive function was assessed by 4 parts: episodic memory, time orientation, numerical ability and picture drawing. After adjusting for covariates, solid fuel users had lower cognitive scores, and the moderation effects of gender and residence on cognitive function were significant among the solid fuel users. In addition, compared with the group of clean fuel users, solid fuel users had a faster decline rate of cognitive function among the subgroups of female and elderly people.

2.
J Reconstr Microsurg ; 2021 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-33592636

RESUMO

BACKGROUND: This study is to describe the distribution of natural true anastomoses associated with the distally based perforator-plus sural neurocutaneous flap (sural flap), summarize our experience in the flap with high pivot point, and compare the outcomes between the flaps with high and low pivot points. METHODS: Five amputated lower limbs were perfused, and the integuments were radiographed. We retrospectively analyzed 378 flaps, which were divided into two groups: pivot points located ≤8.0 cm (low pivot point group) and >8.0 cm (high pivot point group) proximal to the tip of the lateral malleolus. Partial necrosis rates were compared between two groups. RESULTS: The arterial chain surrounding the sural nerve was linked by true anastomoses from the intermalleolar line to popliteal crease. True anastomoses existed among peroneal perforators and between these perforators and the arterial chain. There were 93 flaps with high pivot point and 285 flaps with low pivot point. Partial necrosis rates were 16 and 9.1% in the high and low pivot point group (p = 0.059), respectively. CONCLUSION: True anastomosis connections among peroneal perforators and the whole arterial chain around sural nerve enable the sural flap to survive with a greater length. The sural flap with high pivot point is a good option for reconstructing soft-tissue defects in the middle and distal leg, ankle, and foot, particularly when the lowest peroneal perforator presents damage, greater distance to the defects, discontinuity with the donor site, or anatomical variation.

3.
Artigo em Inglês | MEDLINE | ID: mdl-33569851

RESUMO

BACKGROUND: There is debate amongst the hepatology community regarding the simple non-invasive scoring systems and histological scores (even it was developed for histologic classification) in predicting clinical outcomes in patients with non-alcoholic fatty liver disease (NAFLD). AIM: To determine whether the presence of simple non-invasive scoring systems and histological scores could predict all-cause mortality, liver-related mortality and liver disease decompensation (liver failure, cirrhosis, HCC or decompensated liver disease). METHODS: The pooled hazard ratio (pHR) of prognostic factors and incidence rate per 1000 person-year in NAFLD patients was calculated, and further adjusted by 2 different models of handling the duplicated data. RESULTS: A total of 19 longitudinal studies were included. Most simple non-invasive scoring systems (FIB-4, BARD and APRI) and histological score (NAS, Brunt and SAF) failed in predicting mortality, and only the NFS>0.676 showed prognostic ability to all-cause mortality (4 studies, 7564 patients, 118352 person-year followed up, pHR 1.44, 95% CI 1.05-1.96). The incidence rate per 1000 person-year of all-cause mortality, liver-related mortality, cardiovascular-related mortality and liver disease decompensation resulted in a pooled incidence rate/1000 person-year of 22.65 (14 studies, 95% CI 9.62-53.31), 3.19 (7 studies, 95% CI 1.14-8.93), 6.02 (6 studies, 95% CI 4.69-7.74) and 11.46 (4 studies, 95% CI 5.33-24.63), respectively. CONCLUSION: NFS showed promising prognostic value to all-cause mortality. Most present simple non-invasive scoring systems and histological scores were failed to predict clinical outcomes.

4.
Int Immunopharmacol ; 93: 107393, 2021 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-33529914

RESUMO

BACKGROUND: B cells play a key role in the pathogenesis of immune thrombocytopenia (ITP) by producing platelet autoantibodies. Accumulating evidence suggest that microRNA (miRNA) is a critical regulator in B cells. The contribution of miRNA to B cell dysfunction in ITP has not been described. The aim of this study was to examine the expression of miRNA let-7b-5p in B cells of ITP patients and investigate its possible association with B cell function in ITP. METHODS: The CD19+ cells were isolated from peripheral mononuclear cells of ITP patients and healthy controls using immunomagnetic microbeads. B cell survival in vitro was evaluated by cell counting. The level of let-7b-5p was quantified by quantitative PCR. The surface expression of B cell activating factor receptor (BAFF-R) was detected by flow cytometry. The role of let-7b-5p was examined in isolated B cells by transfecting miRNA mimics or inhibitors. RESULTS: The results showed that let-7b-5p in B cells was elevated, and B cell survival was enhanced in ITP patients compared with healthy controls. BAFF and B cell receptor stimulation can induce the expression of let-7b-5p in vitro. Overexpression of let-7b-5p in B cells enhanced the expression of surface BAFF-R and promoted B cell survival. Moreover, let-7b-5p enhanced the phosphorylation of NF-κB2 p100 and upregulated the expression of survival factor Bcl-xL after BAFF induction. CONCLUSION: Let-7b-5p is a pro-survival miRNA in B cells and increased let-7b-5p is associated with enhanced surface BAFF-R in ITP.

5.
BMC Anesthesiol ; 21(1): 48, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33579195

RESUMO

BACKGROUND: Delirium was characterized with a series of symptoms of a sudden onset of disturbances in attention, a loss in memory loss and defects in other cognitive abilities that were also appeared in the syndrome of anxiety. Even though there are overlapped clinical symptoms existed in anxiety and delirium, the relationship between anxiety and delirium was still unclear. The propose of this study was to investigated the effect of preoperative anxiety on postoperative delirium. METHODS: Three hundred and seventy-two adults undergoing total hip arthroplasty were enrolled from October 2019 to May 2020 in the study. The preoperative anxiety was measured with the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). The participants were allocated into anxiety group (HADS-A≧7) and non-anxiety group (HADS-A < 7). The primary outcome was the incidence of the postoperative delirium assessed with the Confusion Assessment Method (CAM). The secondary outcomes were the duration and the severity of delirium evaluated with the Memorial Delirium assessment Scale (MDAS). The risks of delirium were also evaluated with logistic regression analysis. RESULTS: There were 325 patients enrolled in the end, 95 of whom met the criteria for anxiety. The incidence of delirium was 17.8% in all participants. The patients with anxiety had a higher incidence of delirium than the non-anxiety patients (25.3% vs. 14.8%, odds ratio (OR) = 0.51, 95% confidence interval (CI) = 0.92-0.29, p = 0.025). However, no significant differences were found in the duration and the severity of the delirium between the above two groups. The age, alcohol abuse, history of stroke, scores of the HADS-A, and education level were considered to be predictors of delirium. CONCLUSIONS: The preoperative anxiety predicted the incidence of the postoperative delirium in total hip arthroplasty patients. The related intervention may be a good point for delirium prophylaxis. TRIAL REGISTRATION: It was registered at Chinese Clinical Trial Registry ( www.chictr.org.cn ) with the name of "the effect of preoperative anxiety on the postoperative cognitive function" ( ChiCTR1900026054 ) at September 19, 2019.

6.
BMC Public Health ; 21(1): 6, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33397334

RESUMO

BACKGROUND: The stigma of tuberculosis (TB) poses a significant challenge to TB control because it leads to delayed diagnosis and non-adherence. However, few studies on TB-related stigma have been completed in China. The aim of the current study was to explore the status of TB-related stigma and its associated predictive factors among TB patients in Dalian, Northeast China. METHODS: An institution-based, cross-sectional survey was conducted among outpatients at Dalian Tuberculosis Hospital in Liaoning Province, Northeast China. Data were collected by using a questionnaire that measured TB-related stigma, treatment status, anxiety, social support, doctor-patient communication and so on. A multiple linear regression model was used to determine the predictors of TB-related stigma. RESULTS: A total of 601 eligible participants were recruited. The mean score for TB-related stigma was 9.07, and the median score was 10. The average scores for anxiety, social support and doctor-patient communication were 4.03, 25.41 and 17.17, respectively. Multiple linear regression analysis revealed that patients who were female (ß = 1.19, 95% CI: 0.38-2.01, P < 0.05), had self-assessed moderate or severe disease (ß = 1.08, 95% CI: 0.12-2.03 and ß = 1.36, 95% CI: 0.03-2.70, respectively, P < 0.05), and had anxiety (ß = 0.38, 95% CI: 0.30-0.46, P < 0.001) were more likely to have a greater level of TB-related stigma than their counterparts. However, a significantly lower level of TB-related stigma was observed in patients with good social support (ß = - 0.25, 95% CI: - 0.33--0.17, P < 0.001) and doctor-patient communication (ß = - 0.14, 95% CI: - 0.29--0.00, P < 0.05). CONCLUSIONS: This study showed that stigma among TB patients was high. Targeted attention should be paid to female patients and patients with moderate or severe disease in TB stigma-related interventions. Moreover, the important role of social support and doctor-patient communication in reducing TB-related stigma should also be emphasized.

7.
J Control Release ; 331: 416-433, 2021 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-33503486

RESUMO

Albumin, a multifunctional protein, is widely used to prepare nanocarriers. Hyaluronic acid (HA) is a natural glycosaminoglycan that can specifically bind receptors, such as cluster of differentiation-44. Therefore, HA is commonly used as ligands for the surface modification of versatile nanocarriers. The combined utilization of albumin and HA as nanocarriers shows outstanding superiorities including efficient targeting, reducible particle size, pH and/or hyaluronidase sensitive drug release, combining capacity for various drugs, biocompatibility, non-immunogenicity, biodegradability and high stability. However, to the best of our knowledge, HA and albumin based nanoparticles have not been reviewed for drug delivery so far. This review involves the introduction of the essential information of HA and albumin as well as a brief presentation of the preparation methods of HA and albumin based nanocarriers. Moreover, the application of HA and albumin based nanoparticles as drug delivery carriers in tumors, joints, vitreum and skin tissue is systematically discussed with the potential and prospect in combined therapy and theranostics. In addition, the unique advantages of the HA and albumin based nanoparticles and their contributions to the improvement of drug delivery systems are further expounded in detail.

8.
Int J Mol Med ; 47(2): 547-560, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33416091

RESUMO

Autophagy is reported to be involved in the formation of skin hypertrophic scar (HTS). However, the role of autophagy in the process of fibrosis remains unclear, therefore an improved understanding of the molecular mechanisms associated with autophagy may accelerate the development of effective therapeutic strategies against HTS. The present study evaluated the roles of autophagy mediated by transcription factor EB (TFEB), a pivotal regulator of lysosome biogenesis and autophagy, in transforming growth factor­ß1 (TGF­ß1)­induced fibroblast differentiation and collagen production. Fibroblasts were treated with TGF­ß1, TGF­ß1 + tauroursodeoxycholic acid (TUDCA) or TGF­ß1 + TFEB­small interfering RNA (siRNA). TGF­ß1 induced phenotypic transformation of fibroblasts, as well as collagen synthesis and secretion in fibroblasts in a dose­dependent manner. Western blotting and immunofluorescence analyses demonstrated that TGF­ß1 upregulated the expression of autophagy­related proteins through the endoplasmic reticulum (ER) stress pathway, whereas TUDCA reversed TGF­ß1­induced changes. Reverse transcription­quantitative PCR (RT­qPCR), western blotting and RFP­GFP­LC3 double fluorescence analyses demonstrated that knockdown of TFEB by TFEB­siRNA decreased autophagic flux, upregulated the expression of proteins involved in the apoptotic pathway, such as phosphorylated­α subunit of eukaryotic initiation factor 2, C/EBP homologous protein and cysteinyl aspartate specific proteinase 3, and also downregulated the expression of α­smooth muscle actin and collagen I (COL I) in fibroblasts. Immunofluorescence confocal analyses and enzyme­linked immunosorbent assay indicated that TGF­ß1 increased the colocalization of COL I with lysosomal­associated membrane protein 1 and Ras­related protein Rab­8A, a marker of secretory vesicles, in fibroblasts, as well as the secretion of pro­COL Iα1 in culture supernatants. Meanwhile, these effects were abolished by TFEB knockdown. The present results suggested that autophagy reduced ER stress, decreased cell apoptosis and maintained fibroblast activation not only through degradation of misfolded or unfolded proteins, but also through promotion of COL I release from the autolysosome to the extracellular environment.

9.
Exp Mol Med ; 53(1): 8-18, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33462379

RESUMO

Hepatocyte nuclear factor 4α (HNF4α), a member of the nuclear receptor superfamily, is described as a protein that binds to the promoters of specific genes. It controls the expression of functional genes and is also involved in the regulation of numerous cellular processes. A large number of studies have demonstrated that HNF4α is involved in many human malignancies. Abnormal expression of HNF4α is emerging as a critical factor in cancer cell proliferation, apoptosis, invasion, dedifferentiation, and metastasis. In this review, we present emerging insights into the roles of HNF4α in the occurrence, progression, and treatment of cancer; reveal various mechanisms of HNF4α in cancer (e.g., the Wnt/ß-catenin, nuclear factor-κB, signal transducer and activator of transcription 3, and transforming growth factor ß signaling pathways); and highlight potential clinical uses of HNF4α as a biomarker and therapeutic target for cancer.

11.
Patient Prefer Adherence ; 14: 2327-2336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33262582

RESUMO

Purpose: China is the second highest tuberculosis (TB) burden in the world, and TB patients in the rural areas are about twice as many as urban patients. The purpose of present study was to explore the roles of medication adherence, doctor-patient trust and communication on treatment effects, and its inequality between urban and rural areas. Methods: There were 564 eligible TB patients, from four tuberculosis hospitals in China, participating in this cross-sectional study. They filled out questionnaires regarding socio-demographic characteristics, medication adherence, treatment effect, doctor-patient trust, and communication. The structural equation model (SEM) was applied to explore the hypotheses in this study. All statistical analysis was done by SPSS 25.0 and Mplus 7.0 statistical software. Results: This study included 267 (47.34%) urban and 297 (52.66%) rural eligible TB patients. The data fitted the research model well, and the urban TB patients reported better treatment effect than the rural ones (P=0.027). Overall, treatment adherence positively predicted treatment effect (Est.=0.353, P<0.001); doctor-patient communication positively influenced treatment adherence (Est.=0.214, P=0.002); and treatment adherence positively mediated the role of communication on treatment effect (Est.=0.076), 95% CI (0.026, 0.152). While in the grouping model, the urban patients' treatment effect was only influenced by adherence (Est.=0.286, P=0.003); for the rural patients, treatment adherence (Est.=0.464, P<0.001) and doctor-patient trust (Est.=0.382, P=0.019) directly predicted treatment effects, and treatment adherence positively mediated the role of doctor-patient communication on treatment effect (Est.=0.175, P=0.006). Conclusion: The treatment effect of TB patients, from urban and rural China, was influenced by a different mechanism, among which rural TB patients need not only improve the treatment adherence but also establish good doctor-patient trust and communication to improve treatment effects. These findings provided a theoretical guide on treatment and control for rural TB patients.

12.
PLoS Biol ; 18(12): e3000967, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33270628

RESUMO

Tumor necrosis factor-alpha (TNF-α) plays an important pathogenic role in cardiac hypertrophy and heart failure (HF); however, anti-TNF is paradoxically negative in clinical trials and even worsens HF, indicating a possible protective role of TNF-α in HF. TNF-α exists in transmembrane (tmTNF-α) and soluble (sTNF-α) forms. Herein, we found that TNF receptor 1 (TNFR1) knockout (KO) or knockdown (KD) by short hairpin RNA or small interfering RNA (siRNA) significantly alleviated cardiac hypertrophy, heart dysfunction, fibrosis, and inflammation with increased tmTNF-α expression, whereas TNFR2 KO or KD exacerbated the pathological phenomena with increased sTNF-α secretion in transverse aortic constriction (TAC)- and isoproterenol (ISO)-induced cardiac hypertrophy in vivo and in vitro, respectively, indicating the beneficial effects of TNFR2 associated with tmTNF-α. Suppressing TNF-α converting enzyme by TNF-α Protease Inhibitor-1 (TAPI-1) to increase endogenous tmTNF-α expression significantly alleviated TAC-induced cardiac hypertrophy. Importantly, direct addition of exogenous tmTNF-α into cardiomyocytes in vitro significantly reduced ISO-induced cardiac hypertrophy and transcription of the pro-inflammatory cytokines and induced proliferation. The beneficial effects of tmTNF-α were completely blocked by TNFR2 KD in H9C2 cells and TNFR2 KO in primary myocardial cells. Furthermore, we demonstrated that tmTNF-α displayed antihypertrophic and anti-inflammatory effects by activating the AKT pathway and inhibiting the nuclear factor (NF)-κB pathway via TNFR2. Our data suggest that tmTNF-α exerts cardioprotective effects via TNFR2. Specific targeting of tmTNF-α processing, rather than anti-TNF therapy, may be more useful for the treatment of hypertrophy and HF.

13.
Sci Rep ; 10(1): 21956, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33319841

RESUMO

Doctor-patient trust is not strong in China, but studies examining this factor remain insufficient. The present study aimed to explore the effect of doctor-patient communication, medical service quality, and service satisfaction on patient trust in doctors. Five hundred sixty-four patients with tuberculosis participated in this cross-sectional study in Dalian, China. They completed questionnaires assessing socio-demographic characteristics, doctor-patient communication, medical service quality, service satisfaction and patient trust in medical staff. A structural equation model was applied to examine the hypotheses, and all the study hypotheses were supported: (1) doctor-patient communication, medical service quality and service satisfaction were positively associated with building doctor-patient trust; (2) service quality positively mediated the relationship between doctor-patient communication and trust; (3) medical service satisfaction positively mediated the relationship between doctor-patient communication and trust; (4) medical service satisfaction positively mediated the relationship between medical service quality and doctor-patient trust; and (5) medical service quality and service satisfaction were the positively sequential mediators between communication and doctor-patient trust. Based on these findings, improvements in doctor-patient communication, medical service quality, and service satisfaction are the important issues contributing to the rebuilding of doctor-patient trust in medical service delivery.

14.
Ying Yong Sheng Tai Xue Bao ; 31(10): 3509-3517, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-33314841

RESUMO

We explored the application of different feature mining methods combined with genera-lized boosted regression models in digital soil mapping. Environmental covariates were selected by two feature selection methods i.e., recursive feature elimination and selection by filtering. Using the original environmental covariates and the selected optimal variable combination as independent varia-bles, soil pH prediction model of Anhui Province was established and mapped based on the genera-lized boosted regression model and random forest model. The results showed that both kinds of feature mining methods could effectively improve the accuracy of soil pH prediction by generalized boosted regression models and random forest model, and could reduce dimensionality. Compared with the random forest model, the prediction accuracy of the validation set of the generalized boosted regression model was slightly lower. In the training set, the accuracy of the generalized boosted regression models was much higher than that of the random forest model, with higher interpretation and better overall effect. The main parameters of the random forest model, ntree and mtry, had limi-ted effect on the model. Different parameters and their combination could affect the prediction accuracy of the generalized boosted regression models, and thus should be tuned before modeling. The results of spatial mapping showed that soil pH in Anhui Province showed a pattern of "south acid and north alkali".


Assuntos
Mineração , Solo , Concentração de Íons de Hidrogênio
15.
Mol Omics ; 16(6): 533-542, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33315023

RESUMO

Acute kidney injury (AKI) is a frequently seen critical disorder in the clinic. The current research aimed to examine the role of hydroxyacid oxidase 2 (FABP7) in AKI-induced cell apoptosis. A total of 289 overlapping genes were used to perform gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses and to construct a protein-protein interaction (PPI) network using the DAVID database and Cytoscape software. The 10 hub genes of the PPI network were screened out using the cytohubba plug-in of Cytoscape software. FABP7 represented both the differentially expressed gene (DEG) from the GSE44925 and GSE62732 datasets and the top hub gene of the PPI network. The results of the PAS assay showed that FABP7 knockout in vivo aggravated lipopolysaccharide (LPS)-induced AKI. Meanwhile, LPS inhibited cell viability and the expression of FABP7, PPARγ, PPARα, PTEN and p27kip1, and increased the TNF-α level, and cleaved caspase-3/-9 expression and the phosphorylation of PTEN in vitro. FABP7 overexpression reversed the effects of LPS on inhibiting cell viability and proliferation, promoting cell apoptosis, increasing the expression of FABP7, PPARγ, PTEN and p27kip1, and reducing cleaved caspase-3/-9 expression and the phosphorylation of PTEN, but had no influence on PPARα expression. The PPARγ signal pathway inhibitors blocked the protective effect of FABP7 overexpression in LPS-treated TCMK-1 cells, while the PPARγ signal pathway activator inhibited the harmful effect of FABP7 inhibition in LPS-treated TCMK-1 cells. In conclusion, FABP7 overexpression inhibited the AKI-induced cell apoptosis and promoted the proliferation through activating the PPARγ signal pathway in vivo and in vitro.

16.
Nature ; 588(7838): 419-423, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33328665

RESUMO

A quantum anomalous Hall (QAH) state is a two-dimensional topological insulating state that has a quantized Hall resistance of h/(Ce2) and vanishing longitudinal resistance under zero magnetic field (where h is the Planck constant, e is the elementary charge, and the Chern number C is an integer)1,2. The QAH effect has been realized in magnetic topological insulators3-9 and magic-angle twisted bilayer graphene10,11. However, the QAH effect at zero magnetic field has so far been realized only for C = 1. Here we realize a well quantized QAH effect with tunable Chern number (up to C = 5) in multilayer structures consisting of alternating magnetic and undoped topological insulator layers, fabricated using molecular beam epitaxy. The Chern number of these QAH insulators is determined by the number of undoped topological insulator layers in the multilayer structure. Moreover, we demonstrate that the Chern number of a given multilayer structure can be tuned by varying either the magnetic doping concentration in the magnetic topological insulator layers or the thickness of the interior magnetic topological insulator layer. We develop a theoretical model to explain our experimental observations and establish phase diagrams for QAH insulators with high, tunable Chern number. The realization of such insulators facilitates the application of dissipationless chiral edge currents in energy-efficient electronic devices, and opens up opportunities for developing multi-channel quantum computing and higher-capacity chiral circuit interconnects.

17.
Gland Surg ; 9(5): 1244-1257, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33224799

RESUMO

Background: The incidence of thyroid cancer among young adults is increasing; however, the clinical challenges specific to this population, such as diagnosis, reduced healthcare access, and inconsistent care, have received limited attention. Here, we conducted a subgroup analysis on a series of relatively young patients with differentiated thyroid carcinomas (DTCs), focusing on those with distant metastases at stage II, to obtain a deeper understanding of the factors influencing survival. Methods: Information on <45- or <55-year-old patients at any T/N stage with distant metastasis (M1) was extracted from the SEER database according to the staging system in the 6th and 8th American Joint Committee on Cancer (AJCC) editions, respectively. Patient mortality was evaluated using Cox proportional hazards regression analyses and Kaplan-Meier analyses with log-rank tests. Results: Both cancer-specific and all-cause mortality rates per 1,000 person-years for patients ≥35 years old significantly differed from those of patients <35 years old. DTC-specific survival curves also significantly differed between these age groups, according to both the AJCC 6.0 and 8.0-based analyses (P=0.0017 and P<0.001, respectively), as did patient survival curves (P=0.0003, P<0.001, respectively). The multivariate Cox regression model also revealed that poor OS was strongly predicted by race (P<0.001) in the analysis based on the criteria of 8th AJCC staging system. Conclusions: Age is a risk factor for disease-specific and overall survival (OS) in young patients with stage II DTC, and young male patients exhibited poorer survival than females. Race also emerged as a potential risk factor for young patients in stage II. These findings offer guidance for improving the older and newer versions of the AJCC staging system.

18.
ACS Appl Mater Interfaces ; 12(47): 53365-53375, 2020 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-33170615

RESUMO

The incorporation of porous supporting materials to prepare shape-stable phase change materials (PCMs) is of great interest in recent years. However, extensive reported composite PCMs are shape-stable in the air atmosphere but neglected in the water environment. To develop shape-stable and waterproof PCMs is important for their outdoor applications but challenging. Herein, we report a novel cellulose nanocrystal/poly(N-isopropylacrylamide) (CNC/PNIPAM) gel-supported hexadecanol (H-anol) PCM with good thermal storage properties and excellent shape stability in both air and water environments. The CNC/PNIPAM hydrogel is prepared through an ultraviolet-induced C═C cross-linking reaction, and its physical structure and mechanical properties are well characterized. H-anol is then directly immerged into the CNC/PNIPAM alcogel by a facile and low-cost solvent-exchange strategy. The mechanism of the solvent-exchange strategy has been established. Because of the temperature-sensitive hydrophilic/hydrophobic transform behavior of the CNC/PNIPAM network, the CNC/PNIPAM/H-anol PCM displays excellent shape stability in a water environment by forming a dense hydrophobic surface, providing it with great potential in all-weather thermal energy storage applications.

19.
Front Med (Lausanne) ; 7: 585859, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33195345

RESUMO

Background: The efficacy and safety of corticosteroids and immunosuppressive therapy remain controversial for the treatment of immunoglobulin A nephropathy (IgAN). This study aimed to evaluate the effects of corticosteroid and immunosuppressant therapy in Chinese patients with early-stage IgAN whose estimated glomerular filtration rate (eGFR) was ≥45 ml/min/1.73 m2 and proteinuria was ≥1 g/24 h at biopsy. Methods: Patients with biopsy-proven IgAN were retrospectively enrolled from four study centers between 2007 and 2016. Patients were regularly followed up for at least 1 year or until the study end point. Patients were categorized into three treatment groups: supportive care (SC), steroids alone (CS), and steroids plus immunosuppressants (IT). The observed responses to therapy included complete remission (CR), partial remission (PR), no response (NR), and end-stage renal disease (ESRD). The primary end point of the current study was defined as a 50% decline in eGFR and/or ESRD. Results: A total of 715 patients (male 47% and female 53%) were recruited and followed up for 44.69 ± 24.13 months. The observed CR rate was 81.8% with corticosteroids alone (CS), 62.7% with corticosteroids + immunosuppresants (IT), and 37% with supportive care alone (SC). Renal outcomes were remarkably better in the CS group compared with the SC and IT groups (the percentage of patients reaching the end point in each group was 4.6 vs. 14.4 vs. 11.5%, respectively; p = 0.001). Moreover, 36 and 80-month renal survival were significantly better for the CS group (98.3 and 86.4%) than for the IT (94.2 and 82.4%) and SC (94.0 and 51.6%) groups. Early CKD stage also presented with better kidney survival (p < 0.001). Renal survival of CKD stage 1 patients was relatively good regardless of the specific treatment regimen. CS and IT treatment significantly improved renal survival for CKD stage 2 patients when compared with the SC group (p < 0.001 and 0.007, respectively). However, renal survival of CKD stage 3a patients was not impacted by any of the three treatment regimens. Subgroup analysis also showed that renal survival of patients with proteinuria >3.5 g, M1, E0, S1, T0, and C0 was significantly better in the CS group than in the SC and IT groups. A multivariate model showed that hypertension, serum creatinine, E1 lesion, and T1/T2 lesion remained independent predictors of poor renal survival. Conclusions: Immunosuppressive therapy does not have further benefit beyond that provided by steroids. Corticosteroids plus optimal supportive care may further be beneficial in treating early-stage IgAN patients in that it could significantly improve the short-term renal outcome.

20.
Medicine (Baltimore) ; 99(46): e23236, 2020 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-33181711

RESUMO

BACKGROUND: Butylphthalide is widely used for the adjunctive treatment of vascular dementia; however, the clinical evidences are not well synthesized yet. METHODS: We proposed a systematic review and meta-analysis to evaluate the efficacy and safety of butylphthalide as adjunctive therapy for vascular dementia. Seven electronic databases (China National Knowledge Infrastructure, Wanfang database, Chongqing VIP database, China Biomedical Literature Database, Pubmed, EMBASE and Cochrane library) will be searched for eligible randomized controlled trials (RCTs). Required data of included studies will be collected. Quality of studies will be evaluated using Cochrane risk of bias assessment tool. Data synthesis will be performed using Review Manager software. Subgroup analysis and sensitivity analysis will also be carried. RESULTS: Synthesis results of current available RCTs regarding the efficacy and safety of butylphthalide for the treatment vascular dementia will be provided by this systematic review and meta-analysis. CONCLUSION: This systematic review and meta-analysis will provide high level evidence of butylphthalide clinical application. REGISTRATION: PROSPERO CRD42020168947.


Assuntos
Benzofuranos/uso terapêutico , Protocolos Clínicos , Demência Vascular/tratamento farmacológico , Benzofuranos/farmacologia , Benzofuranos/normas , Demência Vascular/fisiopatologia , Humanos , Metanálise como Assunto , Inibidores da Agregação de Plaquetas/farmacologia , Inibidores da Agregação de Plaquetas/normas , Inibidores da Agregação de Plaquetas/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Resultado do Tratamento
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