RESUMO
Patients with metabolic dysfunction-associated steatotic liver disease (MASLD), especially advanced metabolic dysfunction-associated steatohepatitis (MASH), have an increased risk of cardiovascular diseases (CVDs). Whether CVD events will, in turn, influence the pathogenesis of MASLD remains unknown. Here, we show that myocardial infarction (MI) accelerates hepatic pathological progression of MASLD. Patients with MASLD who experience CVD events after their diagnosis exhibit accelerated liver fibrosis progression. MI promotes hepatic fibrosis in mice with MASH, accompanied by elevated circulating Ly6Chi monocytes and their recruitment to damaged liver tissues. These adverse effects are significantly abrogated when deleting these cells. Meanwhile, MI substantially increases circulating and cardiac periostin levels, which act on hepatocytes and stellate cells to promote hepatic lipid accumulation and fibrosis, finally exacerbating hepatic pathological progression of MASH. These preclinical and clinical results demonstrate that MI alters systemic homeostasis and upregulates pro-fibrotic factor production, triggering cross-disease communication that accelerates hepatic pathological progression of MASLD.
Assuntos
Progressão da Doença , Camundongos Endogâmicos C57BL , Infarto do Miocárdio , Animais , Infarto do Miocárdio/patologia , Infarto do Miocárdio/metabolismo , Humanos , Camundongos , Masculino , Cirrose Hepática/patologia , Cirrose Hepática/metabolismo , Monócitos/metabolismo , Feminino , Pessoa de Meia-Idade , Inflamação/patologia , Inflamação/metabolismo , Hepatócitos/metabolismo , Hepatócitos/patologia , Fígado/patologia , Fígado/metabolismo , Moléculas de Adesão Celular/metabolismoRESUMO
BACKGROUND: Toxic epidermal necrolysis (TEN) is a life-threatening dermatological emergency mainly induced by drug hypersensitivity reactions. Standard management includes discontinuation of culprit drug and application of immunomodulatory therapy. However, mortality remains high due to complications like septic shock and multiorgan failures. Innovative approaches for skin care are crucial. This report introduces borneol-gypsum, a traditional Chinese drug but a novel dressing serving as an adjuvant of TEN therapy, might significantly improve skin conditions and patient outcomes in TEN. CASE SUMMARY: A 38-year-old woman diagnosed with eosinophilic granulomatosis with polyangiitis experienced gangrenous complications and motor nerve involvement. After initial treatment of high-dose corticosteroids and cyclophosphamide, symptom of foot drop improved, absolute eosinophil counts decreased, while limb pain sustained. Duloxetine was added to alleviate her symptom. Subsequently, TEN developed. Additional topical application of borneol-gypsum dressing not only protected the skin lesions from infection but also significantly eased localized pain. This approach demonstrated its merit in TEN management by promoting skin healing and potentially reducing infection risks. CONCLUSION: Borneol-gypsum dressing is a promising adjuvant that could significantly improve TEN management, skin regeneration, and patient comfort.
RESUMO
Objectives: Obesity, especially abdominal obesity, increases the prevalence of metabolic and cardiovascular disease (CVD). Fibroblast growth factor 21 (FGF21) has been identified as a critical regulator playing a therapeutic role in diabetes and its complications. This study aims to evaluate the relationship between serum FGF21 levels and body shape parameters in patients with hypertension (HP) and type 2 diabetes mellitus (T2DM). Methods: Serum FGF21 levels were determined in 1,003 subjects, including 745 patients with T2DM, and 258 individuals were selected as a healthy control in this cross-sectional study. Results: Serum FGF21 levels were significantly higher in T2DM patients with HP than those without [534.9 (322.6-722.2) vs. 220.65 (142.8-347.55) pg/ml, p < 0.001], and levels in both of these two groups were significantly increased compared with that of healthy control [123.92 (67.23-219.32) pg/ml, all p < 0.001]. These differences were also observed in body shape parameters, including weight, waistline, body mass index (BMI), body shape index (ABSI), and the percentage of abdominal obesity. Serum FGF21 levels in T2DM patients were positively correlated with body shape parameters, including weight, waistline, neck circumference, BMI, ABSI, percent of abdominal obesity, and triglyceride, while negatively with estimated glomerular filtration rate (all p < 0.01). The significance remained stable when adjusted for age and T2DM duration. In addition, both serum FGF21 concentrations and waistline were independently associated with HP in T2DM patients after the adjustment for risk factors (all p < 0.05). ROC analysis for FGF21 levels of 745 patients with T2DM identified 411.33â pg/ml as an optimal cut-off point to predict HP, with a sensitivity and specificity of 66.0% and 84.9%, respectively. Conclusions: FGF21 resistance occurs in patients of HP in T2DM, and positively correlates with body shape parameters (especially waistline and BMI). High levels of FGF21 may be a compensatory reaction to offset HP.
RESUMO
It's known to all that the refractory ascites treatment has so far been a very difficult clinical problem. We have extracted much experience from the practical techniques used in the refractory ascites treatments of more than 1,000 cases, and have developed the ascites ultrafiltration & concentration therapeutic instrument--FSCLZLY-A. The clinical applications show that it is very effective. Its effective rate is about 72.08%. Therefore, it is a very useful and important medical device for refractory ascites, for the improvement of renal function, and for the prevention of the infection of abdominal cavity.
Assuntos
Ascite/terapia , Ultrafiltração/instrumentação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Desenho de Equipamento , Feminino , Humanos , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ultrafiltração/métodosRESUMO
OBJECTIVE: To assess the two-year outcome of initial endodontic treatment and evaluate the relationship between the treatment outcome and relevant factors. METHODS: A total of 296 patients with 371 teeth received initial endodontic treatment between January 2005 and December 2007 were included in the study. The teeth were treated using crown down technique, and followed for two years. The outcome was examined clinically and radiographically. The relevant factors, including pulp vitality, apical periodontitis, the number of tooth root, and state of root canal obturation, were analyzed. RESULTS: 143 (176 teeth) from 296 patients (371 teeth) were followed for two years. 152 teeth (86.36%) with normal limits were assessed as "healed" (no apical periodontitis, no signs or symptoms). 24 teeth were assessed as "disease", 12 teeth were extracted and 12 teeth were retreated. The healing rate(HR) was statistically higher for vital teeth (95.38%) than that for devital teeth (81.08%). The HR of teeth without apical periodontitis (95.24%) was significantly higher than that with apical periodontitis (73.24%). Other factors were associated with different HR, but no statistical significance (P>0.05). CONCLUSION: Apical periodontitis and pulp vitality may be prognostic factors for outcome of initial endodontic treatment.
Assuntos
Periodontite Periapical , Tratamento do Canal Radicular , Polpa Dentária , Humanos , Obturação do Canal Radicular , Raiz Dentária , Resultado do TratamentoRESUMO
OBJECTIVE: To explore the use of dental operating microscope with ultrasonic instruments in root canal retreatment. METHODS: 164 root canals in 124 teeth of 111 patients who need root canal retreatment were treated under dental operating microscope (DOM) with ultrasonic instruments, then the success rates were calculated. RESULTS: Both 136 root canals with a success rate of 82.93% from 164 root canals and 103 teeth with a success rate of 83.06% from 124 teeth were managed successfully. The each category of the retreated teeth was 85.29% for calcified canals, 83.33% for canal subjected to resinifying therapy, 86.67% for misunderstood root canals, 100% for canals blocked by post, and 66.67% for both root canals blocked by instrument fragments and ledged. CONCLUSION: The use of microscope and ultrasonic instruments was proved to be an effective way in the root canal retreatment.
Assuntos
Cavidade Pulpar , Retratamento , Humanos , Microscopia , Tratamento do Canal Radicular , UltrassomRESUMO
Global ecological security becomes increasingly important with the intensive human activities. The function of ecological security is influenced by human activities, and in return, the efficiency of human activities will also be affected by the patterns of regional ecological security. Since the 1990s, China has initiated the construction of key projects "Yangtze Three Gorges Dam", "Qinghai-Tibet Railway", "West-to-East Gas Pipeline", "West-to-East Electricity Transmission" and "South-to-North Water Transfer" , etc. The interaction between these projects and regional ecological security has particularly attracted the attention of Chinese government. It is not only important for the regional environmental protection, but also of significance for the smoothly implementation of various projects aimed to develop an ecological rehabilitation system and to design a regional ecological security pattern. This paper made a systematic analysis on the types and characteristics of key project construction and their effects on the environment, and on the basis of this, brought forward the basic principles and methodology for ecological rehabilitation and security pattern design in this construction. It was considered that the following issues should be addressed in the implementation of a key project: 1) analysis and evaluation of current regional ecological environment, 2) evaluation of anthropogenic disturbances and their ecological risk, 3) regional ecological rehabilitation and security pattern design, 4) scenario analysis of environmental benefits of regional ecological security pattern, 5) re-optimization of regional ecological system framework, and 6) establishment of regional ecosystem management plan.