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1.
Am J Obstet Gynecol ; 2019 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-31586602

RESUMO

BACKGROUND: Standard treatment of early cervical cancer involves a radical hysterectomy and retroperitoneal lymph node dissection. The existing evidence on the incidence of adverse events following minimally invasive versus open radical hysterectomy for early cervical cancer is either non-randomized or retrospective. OBJECTIVE: To compare the incidence of adverse events following minimally invasive versus open radical hysterectomy for early cervical cancer. STUDY DESIGN: The Laparoscopic Approach to Carcinoma of the Cervix (LACC) trial was a multinational, randomized non-inferiority trial conducted between 2008 and 2017, in which surgeons from 33 tertiary gynecological cancer centers in 24 countries randomized 631 women International Federation of Gynecology and Obstetrics 2009 stage IA1 with lymph-vascular invasion to IB1 cervical cancer to either minimally invasive versus open radical hysterectomy. Patients were randomly assigned to undergo minimally invasive (n = 319) or open radical hysterectomy (n = 312). The LACC trial was suspended for enrolment in September 2017 due to an increased risk of recurrence and death in the minimally invasive surgery group. Here we report on a secondary outcome measure, the incidence of intra and postoperative adverse events within 6 months after surgery. RESULTS: Of 631 patients randomized, 536 (85%) (mean age, 46.0 years) met inclusion criteria for this analysis; 279 (52%) underwent minimally invasive radical hysterectomy, and 257 (48%) underwent open radical hysterectomy. Of those, 300 (56%), 91 (16.9%), 69 (12.8%) experienced at least one grade 2+, grade 3+, or a serious adverse event. The incidence of intraoperative grade 2+ adverse events was 12% (34/279 patients) in the minimally invasive versus 10% (26/257) in the open group (p=0.45). The overall incidence of postoperative grade 2+ adverse events was 54% (152/279 patients) in the minimally invasive versus 48% (124/257) in the open group (p=0.14). CONCLUSIONS: For early cervical cancer, the use of minimally invasive compared with open radical hysterectomy resulted in a similar overall incidence of intraoperative or postoperative adverse events.

2.
World J Gastroenterol ; 25(36): 5515-5529, 2019 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-31576097

RESUMO

BACKGROUND: Researchers have investigated the diagnostic value of protein induced by vitamin K absence or antagonist II (PIVKA-II) and alpha-fetoprotein (AFP) in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), and obtained abundant clinical diagnostic data. However, PIVKA-II and AFP have unsatisfactory specificity and sensitivity in the diagnosis of early-stage HBV-related HCC. Gamma-glutamyltransferase (γ-GT) and aspartate aminotransferase (AST) are common biomarkers for evaluating liver function, and we hypothesized that the γ-GT/AST ratio in combination with PIVKA-II and AFP would improve the diagnosis of early-stage HBV-related HCC. AIM: To evaluate the diagnostic value of γ-GT/AST ratio alone or in combination with PIVKA-II and AFP in HBV-related HCC. METHODS: Serum levels of γ-GT, AST, PIVKA-II, and AFP were detected and analysed in 176 patients with HBV-related HCC and in 359 patients with chronic hepatitis B. According to tumour size and serum level of HBV DNA, HBV-related HCC patients were divided into the following categories: Early-stage HCC patients, HCC patients, HBV DNA positive (HBV DNA+) HCC patients, and HBV DNA negative (HBV DNA-) HCC patients. Receiver-operating characteristic (ROC) curves were used to analyse and compare the diagnostic value of the single and combined detection of various biomarkers in different types of HBV-related HCC. RESULTS: Tumour size was positively correlated with serum levels of PIVKA-II and AFP in HCC patients (r = 0.529, a P < 0.001 and r = 0.270, b P < 0.001, respectively), but there was no correlation between tumour size and the γ-GT/AST ratio (r = 0.073, P = 0.336). The areas under the receiver-operating characteristic curves (AUROCs) of the γ-GT/AST ratio in early-stage HCC patients, HBV DNA+ HCC patients and HBV DNA- HCC patients were not significantly different from that in the total HCC patients (0.754, 0.802, and 0.705 vs 0.779, respectively; P > 0.05). When PIVKA-II was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, and HBV DNA+ HCC, the AUROCs of PIVKA-II increased, with values of 0.857 vs 0.835, 0.925 vs 0.913, and 0.958 vs 0.954, respectively. When AFP was combined with the γ-GT/AST ratio in the diagnosis of early-stage HCC, HCC, HBV DNA+ HCC, and HBV DNA- HCC, the AUROCs of AFP increased, with values of 0.757 vs 0.621, 0.837 vs 0.744, 0.868 vs 0.757, and 0.840 vs 0.828, respectively. CONCLUSION: The γ-GT/AST ratio may be better than PIVKA-II and AFP in the diagnosis of early-stage HBV-related HCC, and its combination with PIVKA-II and AFP can improve the diagnostic value for HBV-related HCC.

3.
Anal Bioanal Chem ; 2019 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-31591675

RESUMO

Hydrophilic and hydrophobic deep eutectic solvents (DESs) as "green" solvents were applied in this study for the microextraction of environmental samples. A series of DESs (five hydrophilic and three hydrophobic) were synthesized and characterized by Fourier transform infrared spectroscopy. Physicochemical property parameters of eight DESs including water solubility, density, conductivity, and freezing point were assessed. Compared with the performance of five hydrophilic DESs in water phase, the three hydrophobic DESs were more suitable for application in dispersive liquid-liquid microextraction for the determination of sulfonamides in water sample. In dispersive liquid-liquid microextraction process, analytical parameters including type and volume of extraction solvent, extraction time, and pH of water sample were investigated. Under optimum conditions, 60 µL of hydrophobic DESs was used for extraction for 2 min in pH = 7.0 sample. The linear ranges were 0.05-5.0 µg/mL for the four sulfonamides with the correlation coefficients in the range of 0.9991-0.9999. The limits of detection were in the range of 0.0005-0.0009 µg/mL and the limits of quantification were in the range of 0.0019-0.0033 µg/mL. The recoveries of the analytes of the proposed method for the spiked samples were 80.17-93.5%, with the relative standard deviation less than 6.31%. The results indicated that three hydrophobic DESs showed commendable performance for extraction of sulfonamides, and hydrophobic DES-based microextraction method was successfully applied for monitoring sulfonamides in water samples. Graphical abstract.

4.
Eur J Obstet Gynecol Reprod Biol ; 242: 92-98, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31574390

RESUMO

BACKGROUND: The impact of chemotherapy on disease-specific survival in patients with borderline ovarian tumors (BOTs) has not been studied previously. METHODS: Patients with BOTs were identified from The Surveillance, Epidemiology, and End Results (SEER) database. Associations of chemotherapy and other risk factors with disease-specific survival were analyzed using Cox proportion hazards regression models. RESULTS: A total of 6065 patients diagnosed during 1988-2000 were selected. The mean age at diagnosis was 48.0 ±â€¯16.5 with a median follow-up time of 190.0 ±â€¯72.5 months. The majority of BOTs were at stage I (86.7%) and treated with surgery (99.3%). Chemotherapy and radiotherapy were given to 343 patients (5.7%) and 33 (0.5%) patients, respectively. A total of 296 patients (4.9%) died from this disease. Both univariate and multivariate survival analysis showed that chemotherapy, older age, bilateral tumor, advanced stage, non-surgery and radiotherapy were associated with worse disease-specific survival. The comprised effect of chemotherapy remained after patients were stratified by age, histology and stage. CONCLUSIONS: Chemotherapy is associated with worse disease-specific survival in patients with BOTs. Tumor laterality, age, stage and other treatments are also prognostic factors for this disease.

6.
Artigo em Inglês | MEDLINE | ID: mdl-31545541

RESUMO

Monodispersed hairy nanocomposites system with typical 2-nm (isophthalic acid) 24 Cu 24 metal-organic polyhedron (MOP) as core protected by 24 polymer chains with controlled narrow molecular weight distribution has been experimentally probed by imaging and scattering studies for the heterogeneity of polymers in the nanocomposites and the confinement effect the MOPs imposing to anchored polymers. Typical confined-extending surrounded by one entanglement area is proposed to picture the physical states of polymer chains. This model dictates the counterintuitive thermal and rheological properties and prohibited solvent exchange properties of the nanocomposites whilst those polymer chain states are tunable and deterministic on the basis of their component inputs. Enlightened by the uncovered relationship between the basic structure and behavior of the MOP nanocomposites, a MOP-composited thermoplastic elastomer has been successfully obtained for the first time, providing practical solutions to improve the mechanical/rheological performances and processabilities of inorganic MOPs for suit practical applications, e.g. separation membranes.

7.
Eur Spine J ; 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31522274

RESUMO

OBJECTIVES: To systematically evaluate the impact of topical vancomycin powder for microbial profile in spinal surgical site infections. METHODS: All available literature regarding the topical use of vancomycin powder to prevent postoperative spinal infections was retrieved from the MEDLINE, EMBASE, and Cochrane databases starting from the creation date and up until September 30, 2018. RESULTS: A total of 21 studies involving 15,548 patients were reviewed. The combined odds ratio showed that topical use of vancomycin powder was effective for reducing the incidence of gram-positive bacterial infections in spinal surgical sites (OR 0.41, P < 0.00001) without affecting its efficacy in the prevention of polymicrobial infections (OR 0.30, P = 0.03). Additionally, it could significantly reduce the infection rate of methicillin-resistant staphylococcus (OR 0.34, P < 0.0001). However, topical vancomycin powder showed no advantage for preventing gram-negative bacterial infections (OR 0.94, P = 0.75). CONCLUSIONS: Topical administration of vancomycin powder may not increase the rates of gram-negative bacterial or polymicrobial infections in spinal surgical sites. On the contrary, it can significantly reduce the infection rates of gram-positive bacteria, methicillin-resistant staphylococcus (MRS) and microorganism. Of course, the topical vancomycin powder cannot change the rates of gram-negative bacterial infections, which may be related to the antimicrobial spectrum of vancomycin. Due to the limited number of articles included in this study, additional large-scale and high-quality studies are needed to provide more reliable clinical evidence.

8.
Opt Express ; 27(17): 23830-23838, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31510282

RESUMO

Optical rogue waves emerge in nonlinear optical systems with extremely large amplitudes, and leave without a trace. In this work, we reveal the emergence of optical polarization rogue waves in supercontinuum generation from a zero-dispersion fiber, pumped by a dissipative soliton laser. Flat spectral broadening is achieved by modulation instability, followed by cascaded four-wave-mixing. In this process, we identify the emergence of optical polarization rogue waves, based on the probability density function of the relative distance among polarization states. Experimental results show that optical polarization rogue waves originate from vector multi-wave-mixing. Besides, we observe double peaks, and even triple peaks in the histogram of the state of polarization. This is a new and intriguing property, never observed so far in optical rogue waves, for example those emerging in the statistics of pulse intensities. Our polarization domain statistical analysis provides a new insight into the still debated topic of the mechanism for rogue wave generation in optical supercontinuum.

9.
Sensors (Basel) ; 19(17)2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31484311

RESUMO

MEMS-based skin friction sensors are used to measure and validate skin friction and its distribution, and their advantages of small volume, high reliability, and low cost make them very important for vehicle design. Aiming at addressing the accuracy problem of skin friction measurements induced by existing errors of sensor fabrication and assembly, a novel fabrication technology based on visual alignment is presented. Sensor optimization, precise fabrication of key parts, micro-assembly based on visual alignment, prototype fabrication, static calibration and validation in a hypersonic wind tunnel are implemented. The fabrication and assembly precision of the sensor prototypes achieve the desired effect. The results indicate that the sensor prototypes have the characteristics of fast response, good stability and zero-return; the measurement ranges are 0-100 Pa, the resolution is 0.1 Pa, the repeatability accuracy and linearity are better than 1%, the repeatability accuracy in laminar flow conditions is better than 2% and it is almost 3% in turbulent flow conditions. The deviations between the measured skin friction coefficients and numerical solutions are almost 10% under turbulent flow conditions; whereas the deviations between the measured skin friction coefficients and the analytical values are large (even more than 100%) under laminar flow conditions. The error resources of direct skin friction measurement and their influence rules are systematically analyzed.

10.
Mediators Inflamm ; 2019: 8613523, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31530996

RESUMO

Background: Epidemiological studies have shown that exposure to PM induces oxidative stress, leading to a variety of health problems. In particular, PM2.5 contains a lot of substances harmful to the human body and penetrates into the lungs to induce lung injury. At the same time, there is increasing evidence that oxidative stress also affects the severity of lung injury. However, there is still no good way to reduce or eliminate these hazards. In the future, more experimental research is needed to further confirm the mechanisms of these hazards and formulate effective preventive measures and treatment plans for their hazard mechanisms. Curcumin has been reported to reduce oxidative stress and inflammatory damage and protect organs. Objective: To investigate whether curcumin can play a protective role against PM2.5-induced oxidative stress and inflammatory damage by inducing expression of the HO-1/CO/P38 MAPK pathway. Methods: In this experiment, PM2.5 was dropped into the trachea to establish a lung injury model in mice. 28 SPF-grade male Kunming mice were randomly divided into 4 groups: normal control group, saline control group, PM2.5 treatment group, and curcumin intervention group. Albumin (ALB), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP) were measured in alveolar lavage fluid (BALF) to assess lung tissue damage. Colorimetric detection of oxidative stress indicators such as MDA, GSH-PX, T-AOC, and CAT in the lung tissue was performed. The levels of IL-6 and TNF-α in the lung tissue were determined by ELISA. Histopathological examination was used for the assessment of alveolar epithelial damage. The protein expression of the HO-1/P38 MAPK pathway in the lung tissue was determined by Western blot and immunohistochemistry. Endogenous CO was detected by spectrophotometry. The results showed that the expression of the HO-1/CO/P38 MAPK protein in the lung tissue was significantly increased in the curcumin intervention group compared with the PM2.5 treatment group, and it was statistically significant (P < 0.05). Compared with the PM2.5 treatment group, the curcumin intervention group can reduce the amount of ALB, LDH, and ALP in BALF; reduce the levels of MDA, IL-1, and TNF-α in the lung tissue; and improve GSH-PX, T-AOC, and CAT levels, but there is no statistical difference (P > 0.05). Conclusion: We found that PM2.5 can cause lung damage through oxidative stress and inflammatory responses. Oxidative stress and inflammatory responses increase the expression of HO-1/CO/P38 MAPK. The intervention of curcumin can further increase the expression of HO-1/CO/P38 MAPK.

11.
Electrophoresis ; 2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31373704

RESUMO

A new material called as porous aromatic frameworks modified graphene oxide (PAFs-GO) was synthesized, and it was used as an adsorbent in pipette-tip SPE for the effective purification and enrichment of theophylline in tea sample by HPLC. The properties of PAFs-GO were characterized by field emission SEM, FTIR, thermogravimetry analysis and Brunauer Emmett Teller N2 adsorption-desorption analysis. The results of static adsorption and dynamic adsorption test showed PAFs-GO had higher adsorption ability (93.25 mg/g) than graphene oxide. The LOD and LOQ of the method were 0.0141 and 0.0471 µg/mL, respectively. The acceptable method reproducibility was found as intra- and inter-day precisions, yielding the RSDs <4.62%. By introducing PAFs as support skeleton, the specific surface area of GO was effectively increased, and the penetrability was improved. Studies showed that the proposed method had been successfully applied for purification and enrichment of theophylline in complex tea matrix.

12.
Surg Oncol ; 31: 8-13, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31446304

RESUMO

BACKGROUND: The standard prognostic system for malignant ovarian germ cell tumors (MOGCT) has not yet been established and the scope of surgery was also controversial. Mixed ovarian malignant germ cell tumor (mGCT) is a rare histological type of MOGCT with higher malignant degree than other types. The aim of the present study was to investigate the clinical features and prognosis of mGCT, and prognostic factors for MOGCT to provide guidance for future treatment. METHODS: Retrospective analysis was carried out on 137 patients, who were admitted from 1991 to 2014. Survival curves were constructed using Kaplan-Meier method and were compared with the log-rank test across various pathological types and different stages. Multivariate survival analysis was performed using Cox's proportional hazards model. RESULTS: There were 29 dysgerminomas (DG), 3 embryonal carcinomas (EC), 43 immature teratomas (IT), 48 yolk sac tumors (YST) and 14 mixed germ cell tumors (mGCT). The most common type of mGCT is YST (85.7%), followed by IT (64.3%), EC (28.6%), and DG (21.4%). The respective 5-year OS rates were 100% in DG, 100% in EC, 92.5% in IT, 54.5% in YST and 66.7% in mGCT, while the corresponding 5-year PFS rate were 89.7% in DG, 100% in EC, 85.1% in IT, 55.9% in YST and 60% in mGCT. FIGO stage Ⅲ-Ⅳ, certain pathological types (Yolk sac tumors and mGCT) and the number of postoperative chemotherapy courses were independently unfavorable prognostic in a multivariate model that included age, Admission decade, fertility-sparing surgery, and comprehensive staging surgery. CONCLUSIONS: Fertility-sparing surgery and incomplete surgical staging did not affect the prognosis. It might be safe to preserve fertility and shrink the scope of the surgical procedures in MOGCT patients regardless of stage or pathology. However, prospective randomized controlled trials were needed for further evaluation.

13.
Cell Commun Signal ; 17(1): 109, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31462314

RESUMO

BACKGROUND: Breast cancer is the leading cause of cancer-related death in women worldwide. Metastatic disease remains the primary cause of death in patients with breast cancer. Basal-like breast cancer (BLBC) is associated with aggressive behavior, stem-like phenotype, high histological grade, poor clinical features, and high rates of recurrences and/or metastasis. However, the mechanism of BLBC phenotype shaping remains obscure. METHODS: Seventeen normal breast/breast cancer cell lines were used for evaluating the breast cancer subtype-markers, WNT targets and constitutive components, and epithelial mesenchymal transition (EMT) markers analysis by western blot. One hundred and twenty formalin-fixed breast cancer tissues were used for immunohistochemistry (IHC) staining. Nine online platforms (cBioPortal, CCLE, GEPIA, etc.) were used for related analyses. RESULTS: We identified Wnt5b as a key regulatory factor that governs the phenotype of BLBC by activating canonical and non-canonical WNT signaling. Wnt5b exhibited basal-like specificity in cells and clinical samples both at the mRNA and protein levels and also showed good correlation with basal-like phenotype at the mRNA level. Besides, Wnt5b was also a promising therapeutic target for LGK-974 treatment. In addition, we identified that CK1α was expressed at low levels in BLBC and that the activation of CK1α by pyrvinium was an alternative strategy for BLBC treatment. CONCLUSIONS: Wnt5b is not only a diagnostic biomarker but also a potential therapeutic target of BLBC.

14.
ACS Appl Mater Interfaces ; 11(37): 34020-34029, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31432659

RESUMO

Perovskite solar cells were developed very fast in the past decade, but hybrid perovskite materials with unbalanced charge carrier diffusion lengths were not fully addressed by either conventional or planar heterojunction device structures. In this study, high-performance perovskite solar cells with bulk heterojunction device structures where CH3NH3PbI2.55Br0.45 is blended with an n-type high-electron-mobility Zn2SnO4 nanoparticle as the photoactive layer are reported. Systematic studies indicate that the CH3NH3PbI2.55Br0.45:Zn2SnO4 bulk heterojunction thin film possesses enhanced and balanced charge carrier mobilities, superior film morphology with enlarged crystal sizes, and suppressed trap density. Photoluminescence and time-resolved photoluminescence studies further demonstrate that there is an efficient photoinduced charge carrier transfer between CH3NH3PbI2.55Br0.45 and Zn2SnO4 nanoparticles. Thus, bulk heterojunction perovskite solar cells by the CH3NH3PbI2.55Br0.45:Zn2SnO4 thin film exhibit over 21.07% power conversion efficiency, which is more than 12% enhancement as compared to that (18.74%) observed from planar heterojunction perovskite solar cells by the pristine CH3NH3PbI2.55Br0.45 thin film. Moreover, bulk heterojunction perovskite solar cells possess significantly suppressed photocurrent hysteresis, dramatically enhanced device stability, and reproducibility. All these results demonstrate that high-performance perovskite solar cells can be realized through bulk heterojunction device structures.

15.
Int Immunopharmacol ; 75: 105836, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31450153

RESUMO

Sepsis is one of the most significant challenges in intensive care units, which is associated with increased morbidity and mortality. Sepsis-associated encephalopathy (SAE) is a severe complication which can cause death and serious disabilities. Calcium signaling in astrocyte is essential for cellular activation and the potential resolution of infection or inflammation in SAE patients. The transient receptor potential melastatin 2 (TRPM2) channel has been identified as a unique fusion of a Ca2+-permeable nonselective cation channel, which plays an important role in inflammation and immune response. Because of its role as an oxidative stress sensor in astrocytes, we investigated the function of TRPM2 in inflammation mediators (interleukin (IL)-1ß, IL-6 and tumor necrosis factor (TNF)-α) release, Bcl-2/E1B-19 K-interacting protein 3 (BNIP3), apoptosis inducing factor (AIF) and Endonuclease G (Endo G) expression. We showed that TRPM2-KO mice, when intraperitoneally (i.p) injected with LPS, exhibited better neurologic assessment scores and decreased inflammatory injury in hippocampal neurons compared with wild-type (WT) mice. The absence of TRPM2 triggered less production of inflammatory mediators (IL-1ß, IL-6, TNF-α) and decreased apoptosis related proteins (BNIP3, AIF, Endo G) expressions in response to LPS induced sepsis. Furthermore, TRPM2-deficient astrocytes (transfected with TRPM2 siRNA) upon LPS stimulation also induced decreased IL-1ß, IL-6 and TNF-α level. Our data suggested that decreased production of inflammatory cytokines and apoptosis related proteins with TRPM2 deletion could regulate inflammatory stress and decrease inflammatory injury in hippocampal neurons, and consequently, ameliorate brain disorder.

16.
J Craniofac Surg ; 30(7): 2174-2177, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31425405

RESUMO

BACKGROUND: Underdevelopment of nose and chin in East Asians is quite common. Rhinoplasty and mentoplasty are effective procedures to solve the above-depicted defects and can achieve remarkable cosmetic effects. An autologous costal cartilage graft has become an ideal material for rhinoplasty, especially for revision surgery. However, many problems in the clinical application of costal cartilage remain unresolved. This study is to investigate application strategies of autologous costal cartilage grafts in rhino- and mentoplasty. METHODS: The methods involved are as follows: application of an integrated cartilage scaffold; comprehensive application of diced cartilage; and chin augmentation of an autologous costal cartilage graft. RESULTS: In this study, satisfactory facial contour appearance was immediately achieved in 28 patients after surgery; 21 patients had satisfactory appearance of the nose and chin during the 6- to 18-month follow-up. Cartilage resorption was not observed. Two patients had nasal tip skin redness and were cured after treatment. CONCLUSION: This procedure can be used to effectively solve: curvature of the costal cartilage segment itself; warping of the carved costal cartilage; and effective use of the costal cartilage segment. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

17.
Medicine (Baltimore) ; 98(27): e16040, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277097

RESUMO

BACKGROUND: Intraoperative blood salvage as a blood-saving strategy has been widely used in surgery. Considering its theoretic risk of malignant tumor cells being reinfused and the corresponding blood metastases, the safety of intraoperative blood salvage in cancer surgery remains controversial. METHODS: Following the Preferred Reporting Items for Systemic Review and Meta-Analysis (PRISMA), we searched the Cochrane Library, MEDLINE and EMBASE to November 2017. We included only studies comparing intraoperative blood salvage with allogeneic blood transfusion. RESULTS: This meta-analysis included 9 studies with 4354 patients with 1346 patients in the intraoperative blood salvage group and 3008 patients in the allogeneic blood transfusion group. There were no significant differences in the 5-year overall survival outcome (odds ratio [OR] 1.12; 95% confidence interval [CI], 0.80-1.58), 5-year disease-free survival outcome (OR 1.08; 95% CI 0.86-1.35), or 5-year recurrence rate (OR 0.86; 95% CI 0.71-1.05) between the 2 study groups. Subgroup analysis also showed no significant differences in the 5-year overall survival outcome (OR 0.97; 95% CI 0.57-1.67) of hepatocellular carcinoma patients in liver transplantation. CONCLUSIONS: For patients with malignant disease, intraoperative blood salvage did not increase the tumor recurrence rate and had comparable survival outcomes with allogeneic blood transfusion.


Assuntos
Transfusão de Sangue Autóloga/efeitos adversos , Recuperação de Sangue Operatório/efeitos adversos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Recidiva Local de Neoplasia/etiologia , Neoplasias/cirurgia , Estudos Retrospectivos , Análise de Sobrevida
18.
Clin Rehabil ; 33(11): 1713-1721, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31328545

RESUMO

OBJECTIVE: We aimed to perform a systematic review and meta-analysis to compare the treatment effects of unstable shoes and flat shoes on lower back pain patients. DATA SOURCES: Literature databases, including PubMed, Web of Science, and EMBASE (up to June 2019), were searched systematically. REVIEW METHODS: Two authors independently screened the retrieved records and identified the randomized controlled trials where patients with lower back pain who wore unstable shoes as intervention and wore flat shoes as a control. Relevant data were extracted for meta-analysis using Review Manager 5.3 software. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the pooled outcome evidence levels. RESULTS: Five randomized controlled trials and 251 patients were included in the analysis. The meta-analysis results showed that there was a tendency toward a reduction in the Roland-Morris disability questionnaire score (mean difference (MD) -2.16, 95% confidence interval (CI) -4.28 to -0.03, I2 = 53%) and pain score (MD -0.84, 95% CI -1.66 to -0.02, I2 = 84%) in patients wearing unstable shoes compared to those wearing flat shoes. There was no significant difference in the life quality scores between the unstable shoe and flat shoe groups (MD -0.59, 95% CI -6.18 to 5.01, I2 = 0%). Functional disability and pain scores were determined to have very low-quality evidence, and life quality scores were determined to have low-quality evidence according to the Grading of Recommendations Assessment, Development and Evaluation analysis. CONCLUSION: Unstable shoes may be effective in treating lower back pain in the clinic, but the conclusion was limited by the current low-quality studies.

19.
Medicine (Baltimore) ; 98(29): e16460, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31335704

RESUMO

BACKGROUND: Lumbar fusion is considered to the gold standard for treatment of spinal degenerative diseases but results in adjacent segment degeneration and acquired spinal instability. Total disc replacement is a relatively new alternative avoiding the occurrence of the above complications. The systematic review and meta-analysis was designed to evaluate whether total disc replacement exhibited better outcomes and safety. METHODS: PubMed, Web of Science, Embase, the Cochrane Library, Chinese National Knowledge Infrastructure Database(CNKI), Wangfang database, and VIP database were searched for RCTs comparing total disc replacement with lumbar fusion. All statistical analyses were carried out using the RevMan5.3 and STATA12.0 software. RESULTS: Of 1116 citations identified by our search strategy, 14 RCTs met the inclusion criteria. Compared to lumbar fusion, total disc replacement significantly improved ODI, VAS, SF-36, patient satisfaction, overall success, reoperation rate, ODI successful, reduced operation time, shortened duration of hospitalization, decreased postsurgical complications. However, total disc replacement did not show a significant difference regarding blood loss, consumption of analgesics, neurologic success and device success with lumbar fusion. And charges were significantly lower for total disc replacement compared with lumbar fusion in the 1-level patient group, while charges were similar in the 2-level group. CONCLUSION: Total disc replacement is recommended to alleviate the pain of degenerative lumbar diseases, improve the state of lumbar function and the quality of life of patients, provide a high level of security, have better health economics benefits for 1-level patients.


Assuntos
Degeneração do Disco Intervertebral/cirurgia , Vértebras Lombares/patologia , Fusão Vertebral , Substituição Total de Disco , Humanos , Degeneração do Disco Intervertebral/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Fusão Vertebral/efeitos adversos , Fusão Vertebral/métodos , Substituição Total de Disco/efeitos adversos , Substituição Total de Disco/métodos , Resultado do Tratamento
20.
Nat Nanotechnol ; 14(7): 719-727, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31235893

RESUMO

Anthropogenic carbon nanotubes, with a fibrous structure and physical properties similar to asbestos, have recently been found within human lung tissues. However, the reported carbon-nanotube-elicited pulmonary pathologies have been mostly confined to inflammatory or neoplastic lesions in the lungs or adjacent tissues. In the present study, we demonstrate that a single pulmonary exposure to multi-walled carbon nanotubes dramatically enhances angiogenesis and the invasiveness of orthotopically implanted mammary carcinoma, leading to metastasis and rapid colonization of the lungs and other organs. Exposure to multi-walled carbon nanotubes stimulates local and systemic inflammation, contributing to the formation of pre-metastatic and metastatic niches. Our study suggests that nanoscale-material-elicited pulmonary lesions may exert complex and extended influences on tumour progression. Given the increasing presence of carbon nanotubes in the environment, this report emphasizes the urgent need to escalate efforts assessing the long-term risks of airborne nanomaterial exposure in non-lung cancer progression.

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