RESUMO
Repeated implantation failure (RIF) is one of the most prominent problems in the field of assisted reproduction. Neu5Gc on the surface of decidual macrophages (dMΦ) leads to different activation patterns of dMΦ, which affects embryo implantation and development. Cmah-/- (Neu5Gc-deficient) mice induced to produce anti-Neu5Gc antibodies in vivo were given a special diet rich in Neu5Gc and their fertility was monitored. The long-term diet rich in Neu5Gc induced the decrease of endometrial receptivity of female mice. The pregnancy rate of female mice fed the normal diet was 63.6% (n = 11) and the average number of embryos was 9.571 ± 1.272, while the pregnancy rate of female mice fed the diet rich in Neu5Gc was 36.4% (n = 11) and the average number of embryos in pregnant mice was 5.750 ± 3.304. The intake of Neu5Gc and the production of anti-Neu5Gc antibody led to M1 polarization of endometrial dMΦ and abnormal embryo implantation.
Assuntos
Implantação do Embrião , Macrófagos , Gravidez , Animais , Feminino , CamundongosRESUMO
PURPOSE: This study aimed to examine the differences between different sleep assessment methods for preschool children. METHODS: Preschool children (n = 54, mean age: 4.6 years) were recruited from kindergarten. Data were collected using an accelerometer, a sleep log, and sleep questionnaire. Furthermore, correlation analysis, Bland-Altman analysis, and repeated measures ANOVA were performed. RESULTS: (1) The sleep duration evaluated by different sleep assessment methods were all significantly correlated, among which the sleep log and Sadeh algorithm showed the highest correlation (r = 0.972, p < .001), while the Tudor-Locke algorithm and the sleep questionnaire demonstrated the lowest correlation (r = 0.383, p < .01); (2) The points between different sleep assessment methods were all within 95% LoA, except for the sleep log and Tudor-Locke algorithm; (3) In various methods of sleep assessment, significant differences were observed in sleep onset (F2 (1.6,85.0) = 32.8, p < .001, η2 : 0.38), while no significant differences were observed in sleep offset (F2 (1.5,80.1) = 32.8, p = .05, η2 : 0.05); (4) In addition, no significant difference in sleep onset was observed between the sleep questionnaire and sleep log (p > .05), and there was also no significant difference in sleep onset between the Sadeh algorithm and the Tudor-Locke algorithm (p > .05). CONCLUSIONS: Both the Sadeh algorithm and the Tudor-Locke algorithm can be used as effective algorithms for sleep duration assessment of Chinese preschool children, with the latter having obvious advantages in large sample surveys. Future research should pay attention to the differences between different sleep assessment methods when using these algorithms.
Assuntos
Actigrafia , Sono , Pré-Escolar , Humanos , Actigrafia/métodos , Duração do Sono , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Thoracic trauma is common, and traffic accident-related traumatic injury can cause acute stress leading to esophageal motility disorders. Interstitial cells of Cajal (ICCs) are regarded as gastrointestinal pacemaker cells. AIM: This study explored the mechanism underlying changes in lower esophagus ICCs under acute stress conditions. METHODS: Fifty adult rabbits, randomly divided into one healthy control and four study groups, were subjected to right chest puncture using a Hopkinson bar. Thereafter, one group was immediately subjected to lower esophagectomy, whereas the other three groups were maintained for 24, 48 and 72 h after puncture and subjected to lower esophagectomy. Immunohistochemistry was used to detect ICC distribution, morphology and density, and TUNEL assays were used to determine ICC apoptosis. Enzyme-linked immunosorbent assays (ELISAs) were used to measure cortisol, epinephrine, dopamine, IL-9, cholecystokinin (CCK) and vasoactive intestinal peptide (VIP). Western blotting and RT-PCR were performed to detect changes in SCF/c-kit and nNOS pathways. RESULTS: After puncture, lung tissue was hemorrhaged, alveoli in puncture areas were destroyed, esophageal pH was decreased, and serum cortisol, epinephrine and dopamine levels increased. ICC numbers increased and apoptotic ICCs decreased in all stress groups after puncture (all p < .01). IL-9, CCK and VIP levels in lower esophagus tissue were increased after puncture (all p < .01). Moreover, SCF/c-kit and nNOS pathways were upregulated in response to stress (all p < .01). CONCLUSIONS: Acute stress promotes increases in lower esophageal ICCs that might affect esophagus ICC functions and esophageal motility.
Assuntos
Células Intersticiais de Cajal , Animais , Coelhos , Dopamina/metabolismo , Epinefrina/metabolismo , Esôfago , Hidrocortisona/metabolismo , Interleucina-9/metabolismo , Proteínas Proto-Oncogênicas c-kitRESUMO
OBJECTIVE: To investigate the clinical effect of concentrated growth factors (CGF) combined with deproteinized bovine bone mineral (DBBM) on Alveolar ridge preservation during implantology. METHODS: A total of 38 patients were selected and randomly divided into 2 groups, with 19 cases in each group. The extraction sockets were filled with DBBM with or without CGF. Visual analogue scale (VAS) pain score was recorded within1 week and Landry wound healing index (LWHI) was recorded at 1, 2 and 3 weeks after operation. CBCT was taken preoperatively and 3 and 6 months postoperatively to measure and compare the changes of vertical height, width and gray value of alveolar bone at extraction site. The changes of alveolar bone contour were observed clinically and compared between the two groups. RESULTS: The VAS score of CGF group was lower than control group on the 1st and 3rd day after operation (P < 0.05). The LWHI of CGF group was higher than control group 1 week after operation (P < 0.05). The absorption of the labial and palatal plates height and the width in the CGF group was significantly less than the control group at 3 months (P < 0.05). The gray value of alveolar bone in CGF group was significantly higher than control group at 3 months (P < 0.05). There was no significant difference in new bone contour between the two groups (P > 0.05). 94.7% cases in CGF group did not undergo bone grafting, which was significantly higher than control group (78.9%). CONCLUSIONS: The use of CGF combined with DBBM can help to reduce postoperative pain at the early stage of healing, form sufficient keratinized gingival tissue, effectively maintain the height and width of alveolar bone in the three-dimensional direction and provide good conditions for implant repair in the future.
Assuntos
Perda do Osso Alveolar , Aumento do Rebordo Alveolar , Substitutos Ósseos , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/prevenção & controle , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Animais , Substitutos Ósseos/uso terapêutico , Bovinos , Humanos , Extração Dentária/métodos , Alvéolo Dental/cirurgiaRESUMO
OBJECTIVE: The purpose of this study was to apply concentrated growth factor (CGF) to the transplanted area with inflammation, to observe the clinical effects of CGF on the inflammation area assisted by 3D printing technology. METHODS: A total of 52 compromised mandibular first or second molar with chronic periapical lesions were transplanted with mature third molars. The patients were divided into CGF group (n = 26) and control group (n = 26) and transplanted into fresh extraction sockets with or without CGF. All the patients underwent clinical and radiographic examinations during the follow-up. RESULTS: Average surgery and extra-oral time were 39 min (± 7.8) and 42 s (± 10.2). The success rates of CGF group and control group were 100% and 92.3% respectively. Most of the periapical lesions in CGF group healed completely within 3 months, which was significantly faster than control group. The initial stability of CGF group was better than control group immediately after operation, and the degree of pain in CGF group was lower than control group on the 1st and 3rd day after operation. CONCLUSIONS: The application of CGF in recipient site with chronic periapical lesions can accelerate the regeneration of alveolar bone and the healing of inflammation, greatly shorten the healing period. Meanwhile, CGF help to reduce postoperative pain and reaction at the early stage of healing and increase the success rate of autogenous tooth transplantation (ATT). Additionally, the use of 3D printing model can greatly reduce the extra-oral time of donor teeth.
Assuntos
Dente Serotino , Dente Impactado , Humanos , Inflamação , Peptídeos e Proteínas de Sinalização Intercelular , Dente Serotino/cirurgia , Transplante AutólogoRESUMO
BACKGROUND: Clinical situations in intensive care units (ICUs) change rapidly, and many factors may prolong the length of stay (LOS) of patients. OBJECTIVES: The objectives of the study were to examine the effects of implementing an electronic-ICU (e-ICU) and an informatics system in an ICU on the LOS of patients and quality of care. METHODS: We evaluated the implementation of a technology electronic dashboard-ICU (TED-ICU) system to upload automatically physiological information and clinical data within the critical care unit for providing real-time information to the care team. Furthermore, TED-ICU software automatically performed Sequential Organ Failure Assessment (SOFA) every 48 h. If a patient's SOFA score decreased by more than 2 points, there was an automatic reminder for transferring patients to the general ward. We prospectively collected data for this study from the ICU before and after implementing the e-ICU. RESULTS: In total, 2248 patients were admitted to our ICU during the study period (1147 and 1101 patients before and after TED-ICU implementation, respectively). Demographic characteristics and in-hospital mortality rates did not differ significantly between the two groups, and the LOS decreased from 7.26 to 5.53 days (p < 0.01). CONCLUSION: Implementing an informatics system (TED-ICU) and care bundle in ICUs can reduce the LOS.
Assuntos
Sistemas de Informação Hospitalar , Unidades de Terapia Intensiva/estatística & dados numéricos , Pacotes de Assistência ao Paciente , Qualidade da Assistência à Saúde , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva/normas , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Estudos ProspectivosRESUMO
The purpose of this study was to study the absorption characteristics of eight main components from dragon's blood phenolic extracts in Caco-2 cells based on the humancolon cancer cell Caco-2 model, and to clarify the oral absorption mechanism of such phenolic extracts. UPLC-MS/MS was used in this study to determine the content of 8 active ingredients including thevetiaflavone, 7,4'-dihydroxyflavone, 7,4'-dihydroxy-5-methoxyhomoisoflavanone, 7,4'-dihydroxyhomoisoflavanone, loureirin C, loureirin A, loureirin B and pterostilbene from dragon's blood phenolic extracts, and Caco-2 cells were used to investigate the effects of incubation time, concentration, temperature, P-gp inhibitor, MRP inhibitor, OCTN1 inhibitor and OCTN2 inhibitor on the absorption of each component. In addition, the transport experiment was conducted to measure the apparent permeability coefficient P_(app) and transport rate of the eight main components to predict the oral absorption mechanism of dragon's blood phenolic extracts. The experimental results showed that the cell uptake of the eight main components in dragon's blood phenolic extracts was time-dependent and concentration dependent, and the uptake of each component did not need to consume energy, which was consistent with the passive diffusion process. P-gp inhibitor, MRP inhibitor and OCTN1 inhibitor had no effect on the cell uptake of each component, only the addition of OCTN2 inhibitor significantly reduced the uptake of pterostilbene(P<0.05). In the transport results, the ER values of the outflow rates of the eight components were all less than 1.5. The above results show that the absorption mechanism of the eight components in Draconis resina phenolic extract may be passive diffusion, and pterostilbene may be the substrate of OCTN2.
Assuntos
Extratos Vegetais , Espectrometria de Massas em Tandem , Células CACO-2 , Cromatografia Líquida , Humanos , Extratos Vegetais/farmacologiaRESUMO
In this study, we investigated the function of Mitsugumin 53 (MG53) in regulation of mitochondrial autophagy in skeletal muscle cells and explored its potential application in the prevention and treatment of skeletal muscle atrophy in rats with chronic kidney disease (CKD). The expression of autophagy beclin 1 regulator 1 (Ambra1) and MG53 in skeletal muscles of 5/6 nephrectomized rats was measured, and the effect of MG53 on mitochondrial autophagy of C2C12 myoblasts was investigated by in vitro experiments. Our results show the expression of Ambra1 and MG53 in the skeletal muscle of CKD rats was significantly decreased. In vitro experiments showed that MG53 overexpression could promote the expression of Ambra1 and mitochondrial autophagy in C2C12 cells, suggesting that recovery of autophagy by MG53 intervention may help remove abnormal mitochondria and alleviate muscle atrophy. In conclusion, the damaged or functionally incomplete mitochondria in CKD rats could not be effectively removed, which may be related to the low activity of Ambra1. In vitro experiments showed that MG53 overexpression could promote the expression of Ambra1 in C2C12 cells and restore mitochondrial autophagy. Whether MG53 can help remove abnormal mitochondria and relieve CKD-induced muscle atrophy requires further study.
Assuntos
Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Autofagia , Proteínas de Transporte/metabolismo , Mitocôndrias/metabolismo , Mioblastos/citologia , Mioblastos/metabolismo , Animais , Linhagem Celular , Masculino , Proteínas de Membrana , Proteínas Associadas aos Microtúbulos/metabolismo , Músculos/metabolismo , Ratos Sprague-Dawley , Insuficiência Renal Crônica/metabolismoRESUMO
GOALS: The main goal of this study was to explore the dose-effect relationship of ilaprazole. BACKGROUND: Ilaprazole is a kind of benzimidazole proton-pump inhibitor, which was confirmed efficacious and safe in treatment of duodenal ulcer (DU). However, the dose-effect relationship of ilaprazole was not clear. STUDY: This was a double-blind, parallel, randomized study. Patients aged above 18 years with at least one endoscopically confirmed active nonmalignant DU were treated with rabeprazole 10 mg or ilaprazole 10 mg/5 mg for 4 weeks. Healing of ulcer was determined by its resolution from active to scarring stage. Symptoms relief was evaluated using a graded score. Safety and tolerability were evaluated on basis of clinical assessments. RESULTS: A total of 390 patients completed the study finally. Ulcers were successfully healed in 75.38%, 77.86%, and 83.72% of patients after 4-week treatment with rabeprazole 10 mg, ilaprazole 5 mg, and ilaprazole 10 mg, respectively. The 4-week healing rate difference between rabeprazole 10 mg and ilaprazole 5 mg was 2.48% (95% confidence interval: -7.79% to 12.74%) leading to accept the noninferiority hypothesis. Logistic regression model suggested that ilaprazole 10 mg was superior to ilaprazole 5 mg at week 2 (odds ratio, 1.92; 95% confidence interval: 1.02, 3.59; P=0.04). Most patients (80%) became asymptomatic after treatment. At the dosages administered, the 3 drug groups exhibited similar efficacy and a similar safety profile. CONCLUSIONS: Ilaprazole 5 mg is not inferior to rabeprazole 10 mg in treating DU, and a dose-effect relationship have been revealed between 5 mg and 10 mg of ilaprazole.
Assuntos
2-Piridinilmetilsulfinilbenzimidazóis , Úlcera Duodenal , Inibidores da Bomba de Prótons , Rabeprazol , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , 2-Piridinilmetilsulfinilbenzimidazóis/administração & dosagem , 2-Piridinilmetilsulfinilbenzimidazóis/efeitos adversos , Antiulcerosos/administração & dosagem , Antiulcerosos/efeitos adversos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal/patologia , Inibidores da Bomba de Prótons/administração & dosagem , Inibidores da Bomba de Prótons/efeitos adversos , Rabeprazol/administração & dosagem , Rabeprazol/efeitos adversosRESUMO
KEY MESSAGE: Six Sec14-like PITP genes from sugarcane were identified, two of them were cloned, and their biological functions were characterized indicating their involvement in plant defense against biotic and abiotic stresses. Sec14, a phosphatidylinositol transfer protein (PITP) is widely present in eukaryotes. In this study, the structure and expression patterns of six Sec14-like PITP genes (ScSEC14-1, ScSEC14p, ScSFH1, ScSFH2, ScPATL1, and ScPATL2) from sugarcane were analyzed, and two of them (ScSEC14-1 and ScSEC14p) were cloned and functionally verified. Phylogenetic analysis divided these genes into four groups, including group I (ScSFH1 and ScSFH2), group II (ScPATL1 and ScPATL2), Group III (ScSEC14p), and group V (ScSEC14-1). qRT-PCR analysis showed tissue-specific expression of these genes, primarily in the root, leaf, and bud tissues. They responded differently to SA, MeJA, and ABA stresses. ScSEC14-1, ScSEC14p, and ScSFH2 were upregulated by CuCl2 and CdCl2, while ScSEC14-1, ScSFH1, ScSFH2, and ScPATL1 were upregulated by PEG and NaCl. When infected by Sporisorium scitamineum, the transcripts of ScSFH1, ScSFH2, ScPATL1, and ScPATL2 were upregulated in the resistant genotype Yacheng 05-179, while those of ScSEC14-1 and ScSEC14p were upregulated in the susceptible genotype ROC22. Subcellular localization showed that ScSEC14-1 and ScSEC14p were mainly localized in the plasma membrane and cytoplasm. Enhanced growth of Escherichia coli BL21 cells expressing ScSEC14-1 and ScSEC14p showed high tolerance to NaCl and mannitol stresses. The transient overexpression of ScSEC14-1 and ScSEC14p in Nicotiana benthamiana leaves enhanced its resistance to the infection of tobacco pathogens Ralstonia solanacearum and Fusarium solani var. coeruleum. We can conclude the involvement of ScSEC14-1 and ScSEC14p in the defense against biotic and abiotic stresses, which should facilitate further research on Sec14-like PITP gene family, especially its regulatory mechanisms in sugarcane.
Assuntos
Saccharum/metabolismo , Secas , Regulação da Expressão Gênica de Plantas , Filogenia , Proteínas de Plantas/classificação , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Estresse Fisiológico/genética , Estresse Fisiológico/fisiologiaRESUMO
PURPOSE: The study proposed to determine the superiority between locking plate and nonlocking miniplate for mandibular fractures (MFs) treatment. METHODS: A comprehensive electronic search examining Medline-Ovid, Embase, and PubMed databases language without date was performed in February 2018. Inclusion criteria were studies in humans, including randomized controlled trials, controlled clinical trials, with the aim of comparing the 2 techniques. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size. RESULTS: Thirteen publications were enrolled into the analysis. The results showed that there were significant differences in overall complications (RR, 0.62; 95% CI, 0.351-1.094; Pâ=â0.06), postoperative infection (RR, 0.503, 95% CI, 0.223-1.136) when comparing locking miniplates with nonlocking miniplates in treating mandible fractures. The incidence of malocclusion showed a statistically significant difference in the outcome favoring locking miniplates (fixed: RR, 0.503; 95% CI, 0.125-2.030; Pâ=â0.06). In addition, the use of locking miniplates had a lower postoperative maxillomandibular fixation rate than the use of nonlocking miniplates (RR, 0.414; 95% CI, 0.196-0.872; Pâ=â0.002). CONCLUSION: The result of meta-analysis revealed that use of locking plate is superior to the nonlocking plate in the reducing of postoperative complication rates in the management of MFs.
Assuntos
Placas Ósseas , Fixação Interna de Fraturas , Fraturas Mandibulares/cirurgia , Complicações Pós-Operatórias , Fixação Interna de Fraturas/efeitos adversos , Fixação Interna de Fraturas/instrumentação , Fixação Interna de Fraturas/métodos , Humanos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Resultado do TratamentoRESUMO
Colorectal cancer (CRC) is one of the most frequent malignant tumors. Signaling by the PI3K/AKT pathway is crucial for CRC development and progression, including proliferation and migration. Celastrol has an anticancer effect, but its mechanism needs to be determined. Here, we showed that celastrol suppressed CRC cell proliferation and migration. Celastrol treatment also decreased the PI3K/AKT pathway components, and MMP3 and MMP7 expression levels. In addition, knockdown of AKT, not mTOR, inhibited MMP3 and MMP7 expression levels and AKT silencing promoted the celastrol-induced effects on CRC cell proliferation and migration. Taken together, these findings indicated that the celastrol-induced antitumor effects were mediated through MMP3 and MMP7 by the PI3K/AKT signaling pathway.
Assuntos
Neoplasias Colorretais/tratamento farmacológico , Metaloproteinase 3 da Matriz/metabolismo , Metaloproteinase 7 da Matriz/metabolismo , Inibidores de Fosfoinositídeo-3 Quinase , Proteínas Proto-Oncogênicas c-akt/antagonistas & inibidores , Triterpenos/farmacologia , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Neoplasias Colorretais/enzimologia , Neoplasias Colorretais/patologia , Células HCT116 , Humanos , Metaloproteinase 3 da Matriz/biossíntese , Metaloproteinase 3 da Matriz/genética , Metaloproteinase 7 da Matriz/biossíntese , Metaloproteinase 7 da Matriz/genética , Inibidores de Metaloproteinases de Matriz/farmacologia , Triterpenos Pentacíclicos , Fosfatidilinositol 3-Quinases/biossíntese , Fosfatidilinositol 3-Quinases/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Proteínas Proto-Oncogênicas c-akt/biossíntese , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Serina-Treonina Quinases TOR/antagonistas & inibidores , Serina-Treonina Quinases TOR/biossíntese , Regulação para Cima/efeitos dos fármacosRESUMO
OBJECTIVE: This report detailed four cases of tumor recurrence in the subfrontal region after cerebellar medulloblastoma resection without local relapse and explored the causes of recurrence. In addition, a case-based update and insight into the entity is attempted. METHODS: All four patients received cerebellar medulloblastoma resection and postoperative radiotherapy. They were admitted to our hospital when they were found to have a recurrent tumor in the subfrontal region of the anterior skull base. All four patients received re-resection of the tumor, which was confirmed to be recurrent medulloblastoma by postoperative pathological results. RESULTS: All patients received local radiotherapy and temozolomide chemotherapy after recurrent tumor resection. They all died due to multiple organ failure resulting from tumor metastasis to other sites or tumor regrowth within 2 years after the second operation. CONCLUSION: Medulloblastoma metastasize to the subfrontal region and develop a homogenous recurrence is rare. Underdosage of radiation, a gravity-related sanctuary effect, surgical position, and perioperative hydrocephalus management might be factors contributing to this supratentorial meningeal recurrence. A better prevention of tumor recurrence might be achieved by extensive microsurgical tumor resection in the initial operation and by minimizing the need for a permanent V-P shunt in the treatment of perioperative hydrocephalus as well as by administering full-dose radiotherapy to the region of the cribriform plate in the subfrontal area.
Assuntos
Neoplasias Cerebelares/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Meduloblastoma/diagnóstico por imagem , Adolescente , Neoplasias Cerebelares/cirurgia , Criança , Pré-Escolar , Evolução Fatal , Feminino , Lobo Frontal/cirurgia , Humanos , Masculino , Meduloblastoma/cirurgia , Recidiva Local de Neoplasia/diagnóstico por imagem , Recidiva Local de Neoplasia/cirurgiaRESUMO
PURPOSE: To study risk factors associated with renal injuries in elderly patients with multiple myeloma. METHODS: From January 2012 to January 2015 135 elderly patients with multiple myeloma who were treated in Xuzhou No.1 People's Hospital were enrolled in this study. Risk factors associated with their renal function, such as gender, serum levels of hemoglobin, uric acid, serum calcium and phosphorus, serum and urinary levels of ß2 microglobulin, diastolic blood pressure and light chain protein distribution were assessed before and after relative treatments. RESULTS: Compared with patients with normal renal function, the proportion of severe anemia, serum uric acid, calcium, and phosphorus levels were significantly higher in patients with abnormal renal function. Also, serum and urinary ß2 microglobulin levels and diastolic blood pressure were significantly higher in patients with abnormal renal function. Light chain protein of patients with abnormal renal function (mostly λ protein), severe anemia, abnormally increased calcium and high diastolic blood pressure were independent risk factors in renal injuries. Blood urea nitrogen (BUN) and creatinine levels in both groups returned to normal after the anemia was corrected. Compared with the abnormal renal function group, one-year survival rate in the normal renal function group with myeloma was significantly higher. CONCLUSION: Increased diastolic blood pressure, moderate and severe anemia as well as elevated level of serum calcium were independent risk factors for renal injuries in multiple myeloma. Blood pressure control (especially diastolic blood pressure) and correcting the anemia were proved to be effective means for reversing the disturbed renal function and ameliorating patients' quality of life .
Assuntos
Nefropatias/etiologia , Mieloma Múltiplo/complicações , Idoso , Idoso de 80 Anos ou mais , Nitrogênio da Ureia Sanguínea , Cálcio/sangue , Creatinina/sangue , Diástole , Feminino , Humanos , Rim/fisiopatologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Mieloma Múltiplo/fisiopatologia , Qualidade de Vida , Fatores de RiscoRESUMO
BACKGROUND: The coronary no-reflow (NR) phenomenon, which is associated with poor clinical outcomes, is usually referred to as a post-percutaneous coronary intervention (PCI) state. NR can occur in different stages of the PCI procedure, not only including the post-stenting stage, but from balloon pre-dilation to pre-stenting. The clinical significance of NR in the different stages of the PCI procedure is unclear. The purpose of the current study was to analyze the clinical and angiographic characteristics, the prognosis for NR patients in the aforementioned two stages and to determine the predictors of NR in the early stage. METHODS: Between January 2009 and December 2013, a total of 420 consecutive patients with ST-segment elevation myocardial infarction (STEMI) underwent primary PCI. Sixty-three patients (15%) with NR constituted the study population. The patients were divided into an early NR group and a subsequent NR group. The clinical and angiographic findings were compared between the two groups. Multivariate logistic regression was used to determine the predictors for early NR. The long-term clinical outcomes after PCI were analyzed. RESULTS: Regarding the baseline characteristics, we identified that the early NR group had statistically significant effects on the higher percentage of diabetes mellitus (42.9% vs. 20%), lower admission systolic blood pressure (SBP) (102.2 ± 8.3 mmHg vs. 110.5 ± 7.6 mmHg), higher percentage of Killip classification III (71.4% vs. 45.7%,) and longer reperfusion time (7.1 ± 2.3 h vs. 5.88 ± 2.2 h) compared to the subsequent NR group.There were significant differences between the two groups with respect to the percentage of initial thrombolysis in myocardial infarction (TIMI) flow 0/1 (64.3% vs. 37.1%), target lesion length (31.4 ± 13.6 mm vs. 20.5 ± 17.3 mm) and thrombus score ⩾ 4 (67.9% vs. 42.9%; p < 0.05 for all). Multiple stepwise logistic regression analysis indicated that an admission SBP < 100 mmHg (OR = 4.580; 95% CI = 1.385-15.150; p = 0.0130), reperfusion time ⩾ 6 h (OR = 4.978; 95% CI = 1.468-16.882; p = 0.010) and a thrombus score ⩾ 4 (OR = 2.708; 95% CI = 0.833-8.799; p = 0.008) were the independent determinants of the early NR. During a 1-year follow-up, the all-cause mortality and overall major adverse cardiac events (MACEs) in the early NR group occurred significantly more often than in the subsequent NR group (28.6% vs. 5.7% and 35.7% vs. 14.3%, respectively, p ITALIC! <0.05). The early NR group had a lower left ventricular ejection fraction (LVEF) (42.5 ± 4.7 vs. 47.8 ± 3.5, p ITALIC! < 0.001) and a larger left ventricular end diastolic diameter (LVEDD) (56.0 ± 4.0 vs. 51.5 ± 4.7, p = 0.001) at the end of the follow-up. CONCLUSION: Early NR patients during primary PCI have more severe baseline clinical and angiographic characteristics, as well as a poorer long-term prognosis.
Assuntos
Fenômeno de não Refluxo/mortalidade , Fenômeno de não Refluxo/fisiopatologia , Fenômeno de não Refluxo/cirurgia , Intervenção Coronária Percutânea , Idoso , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
BACKGROUND: Although the occurrence of acute myeloid leukemia (AML) after chemotherapy for multiple myeloma (MM) is common in clinical settings, the simultaneous occurrence of these malignancies in patients without previous exposure to chemotherapy is a rare event. Etiology, disease management, and clinical treatment remain unclear for this particular occurrence. To the best of our knowledge, this study is the first to report a case of simultaneous presentation of AML and MM after exposure to ultraviolet irradiation. CASE PRESENTATION: We reported the case of a 73-year-old man (Han Chinese ethnicity) without previous medical history of AML and MM. The morphology and immunology of bone marrow cells confirmed the co-existence of AML and MM. Fluorescent in situ hybridization analysis of immunomagnetically separated abnormal plasma cells showed abnormal expression of the amplified RB-1, TP53, and CDKN2C (1p32). Cytogenetic analysis demonstrated Y chromosome deletion. After the patient was administered with bortezomib combined with cytarabine + aclarubicin + granulocyte colony-stimulating factor (CAG regimen), and evident curative effects were observed. The patient achieved and maintained complete remission for more than 6 months. Prior to the disease occurrence, the patient had received ultraviolet irradiation for 1 year and was detected with aberrant gene expression of RB-1, TP53, and CDKN2C (1p32). Nevertheless, the correlation of this phenomenon with the etiology of concurrent AML with MM remains unclear. CONCLUSION: This study discussed the case of a patient diagnosed with AML concurrent with MM, who has no previous exposure to chemotherapy. This patient was successfully treated by bortezomib combined with CAG regimen. This study provides a basis for clinical treatment guidance for this specific group of patients and for confirmation of the disease etiology.
Assuntos
Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/patologia , Mieloma Múltiplo/tratamento farmacológico , Mieloma Múltiplo/patologia , Aclarubicina/administração & dosagem , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Citarabina/administração & dosagem , Fator Estimulador de Colônias de Granulócitos/administração & dosagem , Humanos , Leucemia Mieloide Aguda/complicações , Masculino , Mieloma Múltiplo/complicações , Indução de RemissãoRESUMO
OBJECTIVE: Differences in the condylar between both sides in class III cases with mandibular deviated are important for the diagnosis, treatment, and retention in this kind of patient. To detect the subtle differences, we analyzed the size, shape, and bone density with three-dimensional reconstructed technology. METHODS: The symmetry group and the asymmetry group each with 20 cases were chosen according to some standards. The computed tomographic data obtained and three-dimensional model were built with SimPlant software. The distance and angle were measured in the three-dimensional model, and the bone density was measured with the SimPlant software. The differences between the separated side in each group and the difference between the 2 groups were analyzed. RESULTS: In the asymmetry group, some measurement projects of the bilateral condyles showed significant differences, such as the ramal height, condylar perpendicular height, the area of maximum cross section of condylar, condylar medialateral diameter, length of posterior slope, and angle of posterior slope. When the asymmetry group was compared with the symmetry group, the condyles of the asymmetry group showed more asymmetrical variations in morphology, such as the ramal height, the condylar perpendicular height, the area of maximum cross section of condylar, the medialateral diameter, the length of anterior slope, and angle of posterior slope. The bone mineral density of the condylar anterior and condylar medial point was higher in the nondeviated side, and the bone mineral density of the condylar posterior was higher in the deviated side, and no statistically significant difference was found in the symmetry group. CONCLUSIONS: In class III malocclusion with mandibular deviation patients, the three-dimensional morphology and bone density of condylar on the deviated side differ from the nondeviated side, which indicates the association between asymmetrical jaw function and joint remodeling.
Assuntos
Cefalometria/métodos , Assimetria Facial/diagnóstico por imagem , Má Oclusão Classe III de Angle/diagnóstico por imagem , Côndilo Mandibular/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Density functional calculations have been performed for the structural, electronic, and magnetic properties of Au5M (M = Sc-Zn) clusters. Geometry optimizations indicate that the M atoms in low-energy Au5M isomers prefer to occupy the most highly coordinated position. The ground-state clusters except Au5Sc possess a planar structure. The vibrational spectra of the doped clusters are completely different from that of a pure gold cluster. The relative stability and chemical activity are investigated through the averaged binding energy and energy gap for the most stable Au5M clusters. It is found that the impurity atoms (not including the Zn atom) can enhance the thermal stability of the host cluster. The chemical activity of Au5M clusters is higher than that of the Au6 cluster. The calculated energy gaps are in accord with available approximate experimental data. The vertical ionization potential, the electron affinity, and photoelectron spectrum are computed and simulated theoretically for all of the ground-state clusters. The magnetism analyses show that the magnetic moment of these Au5M clusters varies from 0 to 5 µB by substituting a Au atom in a Au6 cluster with various M atoms and is mainly localized on the M atom for M = Ti-Ni.
RESUMO
OBJECTIVE: We conducted a perspective study to investigate the association between mRNA expression quantities of ERCC1, BRCA1, RRM1 and RRM2 and response to chemotherapy and clinical outcome of advance Non-Small Cell Lung Cancer.(NSCLC). METHODS: Two hundred eight patients who were diagnosed as advanced stage NSCLC were included in our study. A fluorescence-based and real-time detection method was used to determine the relative cDNA quantification for ERCC1, BRCA1, RRM1 and RRM2, and ß-actin was used as the reference gene. RESULTS: The median expression levels of ERCC1, BRCA1, RRM1 and RRM2 mRNA were 0.67±0.17, 0.095±0.012, 0.24±0.17 and 2.45±0.32, respectively. Our study found that the low ERCC1 (OR=1.82, 95% CI=1.01-3.20) and Low BRCA1 (OR=2.53, 95%CI=1.38-4.64) mRNA expression was more likely to response to chemotherapy when compared with high expression, respectively. Multivariate Cox regression analysis indicated that patients with low mRNA expression of ERCC1 and BRCA1 attained 0.43 (OR=0.43, 95%CI=0.27-0.89) and 0.37 (OR=0.37, 95%CI=0.22-0.66) fold risk of death from NSCLC. However, we found RMM1 and RRM2 mRNA expression could not influence the response to chemotherapy and clinical outcome of NSCLC. CONCLUSION: ERCC1 and BRCA1 mRNA expression could be important predictive markers for individualized platinum-based chemotherapy for NSCLC patients.