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1.
Eur J Cancer Prev ; 29(1): 42-52, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30950925

RESUMO

Preclinical studies have suggested the antitumorigenic properties of metformin on prostate cancer; results from epidemiological studies remain contradictory. We aim to investigate the evidence of metformin and the risk of prostate cancer. PubMed, Embase, Cochrane Library, and Web of Science databases were searched for eligible studies. Meta-analyses were carried out using the most fully adjusted hazard ratios and the corresponding 95% confidence intervals. Eighteen cohort studies and six case-control studies representing 2 009 504 male patients with type 2 diabetes mellitus were identified. The pooled HR of prostate cancer for metformin therapy was 0.97 (0.84-1.12) in case-control studies and 0.94 (0.79-1.12) in cohort studies, respectively. In cohort studies, we found that there was a modest association in studies with samples from Europe, but not in studies with samples from North America, Asia, and Oceania. In addition, metformin showed a slightly protective effect compared with sulfonylurea, but not insulin and other comparators. Meta-regression analyses found that obesity and prostate-specific antigen adjustment in statistical models may be the sources of heterogeneity. However, there were no significant differences in subgroups stratified by time-related biases, analytical approaches, types of risk estimates, study quality, publication year, and whether adjusted for smoking, alcohol abuse, hemoglobin A1c, diabetes duration, and other confounding factors. Our study showed that metformin therapy was not associated with the risk of prostate cancer in patients with type 2 diabetes mellitus. However, exploratory analyses suggest that metformin use may be protective in a certain subgroup of patients.

2.
Anal Chim Acta ; 1094: 160-167, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31761043

RESUMO

Metal-organic cages (MOCs) are a novel kind of porous materials which have three dimensional structures with perpetual and well-defined holes. They have attracted wide consideration for relatively simple synthesis and potential applications such as separation, sensing, microreactor and catalysis etc. In this study, a homochiral MOC [Zn3L2] was prepared as a novel stereoselective stationary phase and added into poly (ionic liquid-co-ethylene dimethacrylate) (Zn3L2@poly(IL-co-EDMA)) monolith for capillary electrochromatography (CEC). The chiral analytes comprising mandelic acid, benzoin and furoin enantiomer were separated perfectly using the monolithic column Zn3L2@poly(IL-co-EDMA), and the effects of buffer pH, acetonitrile percentage and buffer concentration on enantiomers separation were confirmed. Moreover, incorporation of MOC [Zn3L2] into IL polymer monolith strengthened obviously the stereoselective isolation of some positional isomers (such as nitrophenols, nitrotoluenes, xylenes, and ionones). The relative standard deviations (RSDs) of the retention time for intra-day (n = 5) and inter-day (n = 3) and column-to-column (n = 3) enantioseparations were all below 5.0%. This novel monolithic column combined distinct features of the stereoselective materials with the eminent traits of ionic liquid matrix, it has great application potential in CEC.

3.
Ecotoxicol Environ Saf ; 187: 109829, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31654869

RESUMO

Screening appropriate washing agents to remediate soils contaminated with heavy metals is crucial for decreasing metal hazards posing to environment and human health. In this study, two plant washing agents-water-extracted from Fagopyrum esculentum and Fordiophyton faberi, were applied to remove soil Pb, Zn, and Cd by washing. Results indicated that metal removals augmented with increase of washing solution concentrations, decreased with increasing pH values of the solution and followed the pseudo-second-order model depending on contact duration. At concentration of 50 g/L, pH 3 and contact duration of 120 min, F. esculentum had higher removals of Pb (5.98-6.83%), Zn (21.82-27.94%), and Cd (39.90-40.74%) than those of F. faberi. And metal ions could be removed by binding with carboxyl, hydroxyl, amide, amine and aromatic groups in washing solutions. The potential risks of residual metals declined by 51.35-52.12% for mine soil and 48.51-49.96% for farmland soil with exchangeable and carbonate-bound fractions obviously extracted after a single washing (P < 0.05). And soil organic carbon and nutrients increased to some extent except for total phosphorus and available potassium. Moreover, soil phytotoxicity lowered except that some adverse effects on seed germination existed. Therefore, the water extract from F. esculentum is a promising washing agent for heavy metal removal.

4.
Bioresour Technol ; 295: 122255, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31639626

RESUMO

To investigate the feasibility of vegetal gallic acid (GA) improving silage quality, fermentation parameter, nitrogen distribution and bacterial community of mulberry leaves and stylo ensiled with 1% and 2% GA were analyzed after 60-d fermentation. The results showed that GA addition decreased dry matter loss (6.08% vs 5.35%, 17.79% vs 11.56% in mulberry leaves and style silage, respectively), pH (6.51 vs 5.98, 5.55 vs 4.57), butyric acid (0.41% and 0.83% DM, undetected in GA groups) and ammonia-N (0.71% vs 0.19%, 1.46% vs 0.29% TN) contents and increased lactic acid (2.27% vs 6.68%, 0.91% vs 1.91% DM) and acetic acid (1.68% vs 3.20%, 0.97% vs 2.02% DM) contents. Meanwhile, the relative abundance of Clostridium or Enterobacter was decreased, and that of lactate-producing bacteria was increased in mulberry leaves and stylo silage. In conclusion, GA could be used as a green additive to improve fermentation quality and protein preservation during ensiling.


Assuntos
Morus , Silagem , Bactérias , Fermentação , Ácido Gálico , Nitrogênio , Folhas de Planta
5.
Bioresour Technol ; 295: 122268, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31675519

RESUMO

To find a comprehensive way to enhance the utilizability of steam-exploded hippophae, calcium oxide (CaO) preimpregnation, cellulase-added storage and saccharification with addition of Tween 20 were investigated in this study. Both CaO preimpregnation and cellulase addition promoted the ensiling fermentation of anaerobically stored steam-exploded hippophae indicated by lower cellulose proportion and higher organic acids content, but led to the decrease of saccharification yield by 11.83% and 46.77-51.22%, respectively. When taking into account of organic acids being utilizable energy source, storing with addition of cellulase enhanced the utilizability of the materials in whole. Moreover, the addition of Tween 20 enhanced saccharification yield of the steam-exploded hippophae by 26.69-45.25%. Additionally, FTIR and XRD spectra clearly illustrated the structural alteration during storage. It is concluded that storing with addition of cellulase and hydrolyzing with addition of Tween 20 can enhance the utilizability of steam-exploded hippophae.


Assuntos
Celulase , Hippophae , Compostos de Cálcio , Hidrólise , Óxidos , Polissorbatos , Vapor
6.
Food Chem ; 303: 125401, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31466031

RESUMO

Salt addition and thermal pretreatment were used to improve the freeze-thaw stability of Pickering emulsion gels (PEGs) stabilized by compound proteins. Thermal pretreatment with the presence of salt could promote the formation of gel-like structure and alter the interactions between the emulsion droplets of PEGs, sequentially increase the resistance of the PEGs to water separation, creaming, and oiling-off during freeze-thaw cycles (freeze at -20 °C for 22 h and thawing at 37 °C for 2 h), especially at higher salt levels (200 and 500 mM). Microstructures indicated that the presence of high salt concentration and heat pretreatment could help to maintain the gel-like structures of PEGs during freeze-thaw cycles. Overall, our results showed that novel viscoelastic food materials with good freeze-thaw stability can be produced by controlling the electrostatic interactions between the emulsion droplets and the gelation of emulsion gels. These materials may be useful for application in frozen food products.


Assuntos
Fixadores/química , Géis/química , Emulsões/química , Congelamento , Temperatura Alta , Óleos/química , Concentração Osmolar , Cloreto de Sódio/análise , Água/química
7.
J Ethnopharmacol ; 246: 112210, 2020 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-31479707

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Compound Danshen tablet, an herbal preparation consisting of salviae miltiorrhizae, notoginseng and borneolum, is extensively employed clinically to treat angina pectoris, coronary arteriosclerosis and significantly improve microcirculation. AIM OF THE STUDY: To reveal the potential underlying cardioprotective mechanism(s) in isoproterenol-induced myocardial injury in high-fat-diet fed mice. MATERIALS AND METHODS: Cardiac transcriptomics was analyzed by Illumina mRNA-Seq sequencing. The restored cardiovascular diseases (CVD)-related genes by Compound Danshen tablet were validated by quantitative real time polymerase chain reaction (qRT-PCR). Furthermore, Cardiac metabolomics were also performed using gas chromatography-mass spectrometry. RESULTS: From the transcriptomics study, we found the levels of 24 up-regulated and 44 down-regulated genes in the control compared to model groups. Among them, seven gene levels were restored by treatment of Compound Danshen tablet. Four CVD-related genes at the mRNA level (Sprr1a, Ppp1r3c, Bmp10 and Hspa1b) were validated successfully by qRT-PCR. From the metabolomics study, 37 differentially expressed metabolites were identified between the control and model groups. Among them, 21 metabolites were restored by treatment of Compound Danshen tablet. These altered metabolites are involved in glucose metabolism, fatty acid metabolism and amino acid metabolism. CONCLUSION: These genes and metabolites might provide clues for further molecular mechanistic study of Compound Danshen tablet.

8.
J Nanosci Nanotechnol ; 20(3): 1859-1865, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31492353

RESUMO

As oxidation is inevitable during application of microwave absorbing materials (MAM) exposed to oxygen-containing atmosphere at elevated temperatures. The investigations concerning influences of oxidation on microstructure and microwave absorption (MA) properties are of great significance. Aiming to better regulating MA for Si3N4-based ceramics serviced in high temperature environment, the evolution of MA properties of SiCw/Si3N4 composites (SwSN) after oxidation at 1200 °C in ambient air for short time was studied. It was found that after oxidation for 7.5 h, both the real and imaginary permittivity of SwSN showed only slight decrease due to good oxidation protection provided by dense SiO2 layer formed on the surface. Moreover, SwSN after short-time of oxidation also showed an almost negligible decline in MA properties. SwSN which has good oxidation resistance and stable microwave attenuation abilities was subjected to oxidation at 1200 °C for short time. The results showed its favorable and potential applications in high-temperature microwave absorption fields.

9.
J Nanosci Nanotechnol ; 20(3): 1962-1967, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31492368

RESUMO

Oroxylum as a traditional Chinese medicine, was used as a green and novel bio-template to synthesize tremella-like Li3V2(PO4)3/C composite (LVPC) cathode materials by adopting a facile immersion method. The microstructures were analyzed by X-ray diffraction analysis, scanning electron microscopy, and transmission electron microscopy. The electrochemical properties were investigated by galvanostatic charge-discharge experiments. The LVPC revealed specific capacity of 95 mAh·g-1 at 1 C rate within potential range of 3.0-4.3 V. After 100 cycles at 0.2 C, the retention of discharge capacity was 96%. The modified electrochemical performance is mainly resulted from the distinct tremella-like structure.

10.
Nat Prod Res ; : 1-5, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31795750

RESUMO

Sanguisorba officinalis L. is a traditional herbal plant that belongs to the genus Sanguisorba and the family Rosaceae. A new ursane-type triterpenoid, 3-oxo-urs-11, 13(18)-dien-19, 28-olide (1), two known ursane-type triterpenoids (3 - 4) and three known oleanane-type triterpenoids (2, 5 - 6) were isolated from the roots of S. officinalis by silica gel column and MPLC. Their structures were identified by interpretation of spectroscopic data (1 D NMR, 2 D NMR, HR-ESI-MS) and comparison with those reported in the literature. Compound 2 was isolated from the Rosaceae family, compounds 3-5 were obtained from the genus Sanguisorba, and compound 6 was obtained from the S. officinalis for the first time. Additionally, all of the isolated compounds were evaluated for their cytotoxic activity against three human cancer cells. Compound 3 showed better cytotoxic activity against A549, HeLa, SK-Hep1 cells than the other compounds with IC50 values of 48.58 ± 1.88, 47.84 ± 2.01, 42.31 ± 2.43 µM, respectively.

11.
Sci Total Environ ; : 134623, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31796292

RESUMO

The purpose of this study was to effectively dispose of bean dregs (BD) using composting technology, which could provide a theoretical basis for the disposal of BD. Therefore, the influence of different quantities of bean dregs (BD) (0%, 5%, 10% and 15%, w/w with a dry base of pig manure (PM)) on the decomposition and humification of organic matter during PM-composting was investigated, and a 0% BD amendment was used as the control (CK). Wheat straw was used as a bulking agent. Compared to the CK, the BD amendment promoted the degradation of organic matter. The degree of organic matter degradation increased by 16.46-25.04% upon BD amendment. Furthermore, the BD amendment improved humification and increased indices of the humification ratio (HR), percentage of humic acids (PHA), degree of polymerization (DP) and the humification index (HI). Furthermore, Fourier transform infrared (FTIR) spectroscopy indicated that the aromatic structure was enhanced with the BD amendment, and excitation-emission matrix (EEM) fluorescence spectra showed increased humic-like substance production. Additionally, the dissolved organic carbon (DOC), germination index (GI), electrical conductivity (Ec) and carbon/nitrogen (C/N) influenced the maturity and stability of composting. Comparatively, a 10% BD addition showed the optimal performance among all PM-composting treatments.

12.
Artigo em Inglês | MEDLINE | ID: mdl-31791578

RESUMO

Loss of E-cadherin elicits epithelial-mesenchymal transition (EMT). While both the Src family of membrane-associated non-receptor tyrosine kinases (SFKs) and Slit2 binding to Roundabout 1 (Robo1) have been shown to induce E-cadherin repression and EMT, whether these two signaling pathways are mechanistically coupled remains unknown in epithelial cells. Here we found that Slit2 and Robo1 overexpression activated Src kinases for tyrosine phosphorylation, degradation of E-cadherin and induction of EMT. Specific blockade of Slit2 binding to Robo1 inactivated Src, prevented E-cadherin phosphorylation and EMT induction. Biochemically, the cytoplasmic CC3 motif of Robo1 (CC3) bound directly to the SH2 and 3 domains of c-Src and the cytoplasmic domains of E-cadherin. Slit2 induced Robo1 association with endogenous c-Src and E-cadherin, whereas ectopic expression of CC3 dissociated this protein complex in colorectal epithelial cells. These results indicate that Slit2 not only induces Robo1 binding to Src, but also recruits Src to E-cadherin for tyrosine phosphorylation of E-cadherin, leading to E-cadherin degradation and EMT induction in colorectal epithelial cells.

13.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(10): 1186-1190, 2019 Oct 30.
Artigo em Chinês | MEDLINE | ID: mdl-31801711

RESUMO

OBJECTIVE: To investigate the differential expression of miR-126-5p in patients with lung adenocarcinoma and explore the possible mechanism. METHODS: We searched STARBASE database to analyze the differential expression of miR-126-5p between lung adenocarcinoma tissues and normal lung tissues. The prognosis of patients with lung adenocarcinoma was analyzed on Kaplan-Meier Plotter online website, and the survival curves of the patients with different expression levels of miR-126-5p were generated. The target gene of mir-126-5p was predicted by STARBASE database, and the expression level of the target gene and its influence on the patients' prognosis were analyzed using online website tool. We also examined the expression levels of miR-126-5p in peripheral serum of 30 healthy control subjects and 30 patients with lung adenocarcinoma using qPCR. RESULTS: Analysis of the data from STARBASE database showed a high expression of miR-126-5p in normal lung tissues but a low expression in lung adenocarcinoma tissues. Kaplan-Meier Plotter online analysis based on big data analysis showed that patients with a high expression of miR-126-5p had a better survival prognosis than those with a low expression (HR=0.68, P=0.015). MiR-126-5p was predicted to bind to the 3'UTR region of BRCC3 mRNA, and their expression levels were negatively correlated (r=0.197, P < 0.05). Compared with normal tissues, lung adenocarcinoma tissues expressed high levels of BRCC3, which was associated with a poor prognosis of the patients (HR=1.39, P < 0.05). The serum level of miR-126-5p was significantly higher in healthy control subjects than in patients with lung adenocarcinoma (1.23 ± 0.21 vs 0.63 ± 0.12, P < 0.05). CONCLUSIONS: The expression level of miR-126-5p is lowered in lung adenocarcinoma tissue, and patients with lung adenocarcinoma have lower serum level of miR-126-5p than healthy subjects. A high expression of miR-126-5p is associated with a more favorable prognosis of the patients than a low expression. miR-126-5p may play a role against cancer by regulating BRCC3.

14.
Arch Osteoporos ; 15(1): 1, 2019 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-31802295

RESUMO

PURPOSE: This study aimed to evaluate the prevalence and risk factors of secondary osteoporosis (OP) in patients with systemic lupus erythematosus (SLE) and provide a theoretical basis for clinical prevention and treatment of SLE. METHODS: Take systematic review and meta-analysis of relevant studies. Data sources are CINAHL databases, PubMed, Embase, Wan Fang, Weipu, and CNKI databases. Eligibility criteria are cross-sectional or case-control studies which analyzed the prevalence and risk factors of OP in SLE. Two authors independently screened all studies; a third author verified and identify controversial studies. The quality of the included articles was evaluated. Stata 11 and Rev-Man 5.2 software were used for data processing. RESULTS: Thirty-one articles were included, with a total sample size of 3089 SLE, including 529 OP cases and 2560 non-OP cases. Meta-analysis showed that the prevalence of OP among SLE was 16% (95% CI (0.12, 0.19)). The risk of OP in SLE cases compared with controls was significantly greater with OR of 2.03 (95% CI 1.33-3.10, P = 0.001). Age, disease duration, cumulative glucocorticoid dose, duration of glucocorticoid therapy, SLICC, and menopause had significant differences between two groups. No statistical differences of daily glucocorticoid dose, SLEDAI, and BMI were found between OP and non-OP cases. CONCLUSIONS: Our study found a statistically significant increased risk of OP in SLE patients compared with controls. SLE patients should be actively screened for OP and its consequences. Larger longitudinal studies are needed to confirm this possible association. The prevalence of OP in SLE was 16%. Compared with controls, the risk of OP in SLE was 2.03. There were significant differences of age, disease duration, cumulative glucocorticoid dose, time of glucocorticoid, SLICC, and menopause, while daily glucocorticoid dose, SLEDAI, and BMI had no statistical differences between OP and non-OP cases.

15.
Opt Express ; 27(21): 30763-30772, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31684319

RESUMO

All-InSb film-based and spiral antenna-assisted Au-InSb-Au metal-semiconductor-metal detector is reported with dual-band photoresponse in the infrared (IR) and millimeter wave range. At IR, the detector exhibits a long wavelength 100% cut-off at 7.3 µm. Under an applied bias of 5 mA, the uncooled blackbody responsivity and specific detectivity are 3.5 A/W and 1×108 Jones, respectively. The f-3dB value measured at 2.94 µm is 75 KHz, corresponding to a detector rise speed of 4.7 µs. At millimeter wave range, the detector shows a narrowband response determined by the coupling of the antenna. A voltage responsivity of 25 V/W is achieved at 167 GHz (1.796 mm) under an applied bias of 25 mA, and the corresponding noise equivalent power (NEP) is 1.0×10-10 WHz-1/2, which can be improved to 1.8×10-12 WHz-1/2 if normalized to the real active semiconductor area. A f-3dB value of 17.5 KHz, corresponding to a detector rise speed of 20 µs is achieved in this range. A proof of principle for IR-modulated photoresponse for millimeter wave is achieved with a maximum modulation depth of 47.5%. This All-InSb film-based detector and the modulation are promising for future novel optoelectronic devices in IR and millimeter waves.

16.
J Chromatogr Sci ; 2019 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-31711232

RESUMO

Glaucocalyxin A, a novel potent negative Akt regulator, is a major active constituent of Rabdosia japonica. A simple, specific and sensitive ultra-high pressure liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated for the quantification of glaucocalyxin A in rat plasma, lung and brain tissues after intravenous administration. Sample preparation was carried out through a simple liqiud-liquid extraction with ethyl acetate using bullatine A as internal standard. The chromatographic separation was achieved by using an Agilent ZORBAX Eclipse Plus C18 column (3.0 mm × 100 mm, 1.8 µm) with a mobile phase of acetonitrile and water containing 0.1% formic acid in a gradient elution. Mass spectrometry analysis was conducted in positive ionization mode with multiple reaction monitoring transitions at m/z 333.2 â†’ 157.1 for glaucocalyxin A and m/z 344.2 â†’ 128.1 for IS. Calibration curves were linear over the ranges of 20.0-4000 ng/mL for both plasma and tissue samples (r2 > 0.99). The Lower limit of quantification (LLOQ) was 0.284 ng/mL. The intra-day and inter-day precision relative standard deviation (RSD%) were <14.9%, while the accuracy ranged from -12.5 to 17.0% for LLOQ and quality control samples. This UHPLC-MS/MS method was successfully applied in the pharmacokinetics, lung and brain tissue distributions of glaucocalyxin A after intravenous administration.

17.
Acta Pharmacol Sin ; 2019 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-31685977

RESUMO

At present, few available drugs can be used to either improve pathological features or prevent the progression of Alzheimer's disease (AD). DL0410 ((1,1'-([1,1'-biphenyl]-4,4'-diyl) bis (3-(piperidin-1-yl) propan-1-one) dihydrochloride) is a multiple-target small molecule that has been found to reverse cognitive impairment in different animal models of AD. In this study we evaluated the cognition-improving effects of DL0410 in APP/PS1 transgenic mice and explored the underlying mechanisms. APP/PS1 transgenic mice were administered DL0410 (3, 10, 30 mg· kg-1· d-1, ig) for 2 months. We found that DL0410 administration significantly ameliorated cognitive deficits in both the nest-building and Morris water maze tests. In electrophysiological analysis of hippocampal slices, we showed that DL0410 administration significantly enhanced the field EPSP slope and HFS-induced LTP in CA1 area. Furthermore, we revealed that DL0410 administration significantly increased the phosphorylation of AKT and the activity of GSK-3ß in the hippocampus and cortex. Moreover, DL0410 administration dose-dependently increased the expression level of phosphorylated ERK1/2 in the hippocampus and cortex. In addition, DL0410 dose-dependently decreased the neuronal loss by decreasing the production of Aß deposition, inhibited glial overactivation, and the production of inflammatory cytokines such as TNF-α, IL-1ß, and IL-6. We conclude that DL0410 ameliorates cognitive deficits in APP/PS1 transgenic mice by promoting synaptic transmission via activating the AKT/GSK-3ß and MAPK/ERK signaling pathway and reducing neuronal loss. DL0410 may be an effective agent for AD treatment in the future.

18.
Org Lett ; 2019 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-31763857

RESUMO

An efficient rhodium-catalyzed redox-neutral annulations of N-phenoxyacetamides and ynones via successive double C-H bond activations has been developed. A series of novel and complex indenols bearing a benzofuran unit were generated with moderate to excellent regioselecetivities under mild conditions. Adding N-ethylcyclohexanamine (CyNHEt) could restrict the formation of the mono C-H bond activation byproduct, which is not the intermediate of the reaction demonstrated via the mechanistic investigations.

19.
Artigo em Inglês | MEDLINE | ID: mdl-31764404

RESUMO

BACKGROUND: Metformin is associated with improved survival among hepatocellular carcinoma (HCC) patients with diabetes mellitus. However, the role of metformin in the survival of hepatitis B virus (HBV)-related HCC patients with diabetes mellitus after radical resection is unclear, so this study aimed to assess the effects of metformin on the clinical outcomes of patients who received radical resection for HCC. PATIENTS AND METHODS: A total of 250 HCC patients (30-78 years old) diagnosed with diabetes mellitus were selected between 2000 and 2013 from the First Affiliated Hospital of Nanchang University and the Eastern Hepatobiliary Surgery Hospital in China. Patients were divided into the metformin group (n = 66) and the nonmetformin group (n = 184). A propensity score matching analysis was performed to evaluate the effect of metformin in patients receiving radical resection for HCC. RESULTS: In the propensity score-matched cohort (n = 176), the overall survival (OS) in the metformin group at 1, 3, and 5 years was significantly higher than in the nonmetformin group (P = 0.002), and a similar treatment effect was observed for disease-free survival (DFS) (P = 0.030). The adjusted Cox proportional hazards model showed that metformin usage significantly improved OS [hazard ratio: 0.558, 95% confidence interval (CI): 0.385-0.810]. CONCLUSIONS: Metformin is associated with satisfactory clinical outcomes among HBV-related HCC patients with diabetes mellitus after radical resection. The use of metformin could significantly improve the OS and reduce the risk of HCC recurrence in patients after radical resection. A prospective controlled study is recommended to verify the metformin effect and explore its possible mechanisms.

20.
J Vasc Surg ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31668557

RESUMO

BACKGROUND: Frailty syndrome confers a greater risk of morbidity and mortality after operative interventions. The aim of the present study was to assess the effect of frailty on the outcomes after carotid interventions, including both carotid endarterectomy (CEA) and carotid artery stenting (CAS). METHODS: We performed an 8-year (2005-2012) retrospective analysis of the National Surgery Quality and Improvement Program database, including patients who had undergone CEA or CAS for carotid artery stenosis. A modified frailty index score was calculated. Frail status was defined as a modified frailty index score of ≥0.27. The outcome measures were inpatient complications, mortality, failure to rescue (FTR), hospital length of stay, and 30-day readmissions. Multivariable regression analysis was performed to study the association between frailty and the perioperative outcomes. RESULTS: The data from 37,875 patients were included. Of the 37,875 patients, 95.7% had undergone CEA, and 27.3% of the patients were frail (27% of the CEA and 26% of the CAS groups had qualified as frail). Overall, 11.7% of the patients had experienced complications, 2.2% had died, and 6.7% had been readmitted after discharge. On regression analysis, after controlling for age, gender, albumin level, type of surgery, and American Society of Anesthesiologists class, frail status was an independent predictor of complications (23.5% vs 7.2%; P < .001), mortality (5.2% vs 1.1%; P = .02), FTR (12.1% vs 4.7%; P = .02), and 30-day readmissions (14.9% vs 3.7%; P = .03). On subanalysis of the patients who had undergone CAS, no association was found between frail status and the occurrence of complications (odds ratio [OR], 1.5; 95% confidence interval [CI], 0.8-3.2), mortality (OR, 1.2; 95% CI, 0.6-2.7), FTR (OR, 0.9; 95% CI, 0.4-2.3), and 30-day readmission rate (OR, 1.1; 95% CI, 0.5-3.1). CONCLUSIONS: Frailty syndrome was associated with morbidity and mortality among patients undergoing surgical interventions for carotid stenosis. In the present study, frailty was associated with significant mortality and morbidity for those who had undergone CEA but not for those who had undergone CAS. However, the present study was not designed to determine the optimal treatment of frail patients. Incorporating frailty status into the treatment algorithm (CEA vs CAS) might provide a more accurate risk assessment and improve patient outcomes.

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