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Forkhead box M1 (FOXM1) is a key regulator of mitosis and is identified as an oncogene involved in several kinds of human malignancies. However, how it induces carcinogenesis and related therapeutic approaches remains not fully understood. In this study, we aimed to identify a regulatory axis involving FOXM1 and its target gene DEP domain containing 1 (DEPDC1) and investigate their biological functions. FOXM1 bound to the promoter and transcriptionally induced DEPDC1 expression, in turn, DEPDC1 physically interacted with FOXM1, promoted its nuclear translocation, and reinforced its transcriptional activities. The FOXM1/DEPDC1 axis was indispensable for cancer cells, as evidenced by the fact that DEPDC1 rescued cell growth inhibition caused by FOXM1 knockdown, and silencing DEPDC1 efficiently attenuated tumor growth in a murine hepatocellular carcinoma model. Furthermore, strong positive associations between FOXM1/DEPDC1 axis and poor clinical outcome were observed in human hepatocellular carcinoma samples, further indicating their significance for hepatocarcinogenesis. Finally, we attempted to exploit immunotherapy approaches to target the FOXM1/DEPDC1 axis. Several HLA-A24:02-restricted T-cell epitopes targeting FOXM1 or DEPDC1 were identified through bioinformatic analysis. Then, T cell receptor (TCR)-engineered T cells targeting FOXM1262-270 or DEPDC1294-302 were successfully established and proved to efficiently eradicate tumor cells. Our findings highlight the significance of the FOXM1/DEPDC1 axis in the process of oncogenesis and indicate their potential as immunotherapy targets.
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BACKGROUND & AIMS: The role of solute carrier family 25 member 15 (SLC25A15), a critical component of the urea cycle, in hepatocellular carcinoma (HCC) progression remains poorly understood. This study investigated the impact of SLC25A15 on HCC progression and its mechanisms. METHODS: We systematically investigated the function of SLC25A15 in HCC progression using large-scale data mining and cell, animal, and organoid models. Furthermore, we analyzed its involvement in reprogramming glutamine metabolism. RESULTS: SLC25A15 expression was significantly decreased in HCC tissues, and patients with low SLC25A15 levels had a poorer prognosis. Hypoxia-exposed HCC cells or tissues had lower SLC25A15 expression. A positive correlation between HNF4A, a transcription factor suppressed by hypoxia, and SLC25A15 was observed in both HCC tissues and cells. Modulating HNF4A levels altered SLC25A15 mRNA levels. SLC25A15 upregulated SLC1A5, increasing glutamine uptake. The reactive metabolic pathway of glutamine was increased in SLC25A15-deficient HCC cells, providing energy for HCC progression through additional lipid synthesis. Ammonia accumulation due to low SLC25A15 levels suppressed the expression of OGDHL (oxoglutarate dehydrogenase L), a switch gene that mediates SLC25A15 deficiency-induced reprogramming of glutamine metabolism. SLC25A15-deficient HCC cells were more susceptible to glutamine deprivation and glutaminase inhibitors. Intervening in glutamine metabolism increased SLC25A15-deficient HCC cells' response to anti-PD-L1 treatment. CONCLUSION: SLC25A15 is hypoxia-responsive in HCC, and low SLC25A15 levels result in glutamine reprogramming through SLC1A5 and OGDHL regulation, promoting HCC progression and regulating cell sensitivity to anti-PD-L1. Interrupting the glutamine-derived energy supply is a potential therapeutic strategy for treating SLC25A15-deficient HCC. IMPACT AND IMPLICATIONS: We first demonstrated the tumor suppressor role of solute carrier family 25 member 15 (SLC25A15) in hepatocellular carcinoma (HCC) and showed that its deficiency leads to reprogramming of glutamine metabolism to promote HCC development. SLC25A15 can serve as a potential biomarker to guide the development of precision therapeutic strategies aimed at targeting glutamine deprivation. Furthermore, we highlight that the use of an inhibitor of glutamine utilization can enhance the sensitivity of low SLC25A15 HCC to anti-PD-L1 therapy.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Animales , Humanos , Carcinoma Hepatocelular/genética , Glutamina , Neoplasias Hepáticas/genética , Hipoxia/genética , Transporte Biológico , Antígenos de Histocompatibilidad Menor , Sistema de Transporte de Aminoácidos ASC/genéticaRESUMEN
BACKGROUND: Breath-hold volumetric interpolated breath-hold examination (BH-VIBE) of multiphase contrast-enhanced liver magnetic resonance imaging (MPCE-LMRI) requires good cooperative individuals to comply with multiple breath-holds. PURPOSE: To develop a free-breathing modified VIBE (FB-mVIBE) as a substitute of BH-VIBE in MPCE-LMRI. MATERIAL AND METHODS: We modified VIBE with a high acceleration factor (2 × 2) and four averages to produce the mVIBE scan. A total of 90 individuals (40 men; mean age = 54.6 ± 10.0 years) who had received MPCE-LMRI as part of a voluntary health check-up for oncology survey were enrolled. Each participant was scanned in four phases (pre-contrast, arterial phase, venous phase, and delay phase), and each phase had two sequential scans. To encounter the timing effect of contrast enhancement, three scan orders were designed: BH-VIBE and FB-mVIBE (group A, n = 30); BH-VIBE and FB-VIBE (group B, n = 30); and FB-mVIBE and BH-VIBE (group C, n = 30). The comparisons included the objective measurements and 25 visual-score by two abdominal radiologists independently. RESULTS: Consistency between raters was observed for all three sequences (intraclass correlation coefficient [ICC] = 0.741-0.829). For rater 1, the mean scores of FB-mVIBE (23.67 ± 1.32) were equal to those of BH-VIBE (23.83 ± 1.98) in groups C and B (P = 0.852). The mean scores of FB-mVIBE (22.07 ± 3.02), but significantly higher than those of FB-VIBE (14.7 ± 3.41) in groups A and B (P <0.001). Similar scores were found for rater 2. The objective measurement of FB-mVIBE were equal to or higher than BH-VIBE and markedly superior to FB-VIBE. CONCLUSION: FB-mVIBE is a practical alternative to BH-VIBE for individuals who cannot cooperate with multiple breath-holds for MPCE-LMRI.
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Contencion de la Respiración , Medios de Contraste , Hígado , Imagen por Resonancia Magnética , Humanos , Masculino , Persona de Mediana Edad , Femenino , Imagen por Resonancia Magnética/métodos , Hígado/diagnóstico por imagen , Aumento de la Imagen/métodos , Anciano , Reproducibilidad de los Resultados , Adulto , Interpretación de Imagen Asistida por Computador/métodos , Neoplasias Hepáticas/diagnóstico por imagen , Hepatopatías/diagnóstico por imagenRESUMEN
Anthracnose disease is one of the most important diseases of Dioscorea alata and many other food yams, which is caused by Colletotrichum gloeosporioides fungus from the Glomerellaceae family of the Sordariomycetes class. In the present study, a C. gloeosporioides starin named CgDa01 was isolated from D. alata, and its genome was sequenced based on Oxford Nanopore technology (ONT) and the Illumina sequencing platform. The high-quality genome of CgDa01 was assembled with a 62.78 Mb genome size and 15,845 predicted protein-coding genes. The proteins of predicted genes were annotated using multiple public databases, including the nonredundant protein database, the InterProScan databases, and Kyoto Encyclopedia of Genes and Genomes. Among the annotated protein-coding genes, 55 were predicted as potential virulence genes by the fungal virulence factor database. The C. gloeosporioides CgDa01 genome assembly described in this study can serve as a resource for better understanding the pathogenic mechanism of C. gloeosporioides on yam hosts.
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Colletotrichum , Dioscorea , Dioscorea/genética , Dioscorea/microbiología , Enfermedades de las Plantas/microbiología , Colletotrichum/genética , VirulenciaRESUMEN
BACKGROUND: This study aimed to uncover the potential effects of zingerone (ZIN), one of the bioactive compounds in ginger, on the development of obesity as well as the mechanisms responsible for these effects in C57BL/6J mice fed with a high-fat diet (HFD). RESULTS: Supplementation with 0.2% (wt/wt) zingerone for 16 weeks significantly reduced the final body weight, liver weight, and epididymal white adipose tissue (eWAT) weight without changing the food intake of the mice when compared with the HFD group. The hyperlipidemia of HFD-fed mice was ameliorated after zingerone administration, including decreased plasma triacylglycerol (TG) and total cholesterol (TC) level. The lipid content in liver was lower and the adipocyte size in eWAT and inguinal white adipose tissue (iWAT) was smaller in HFD + ZIN-fed mice compared with HFD group. Zingerone also binds with nuclear hormone receptor peroxisome proliferator-activated receptor alpha (PPARα) with an optimal docking energy of -7.31 kJ/mol. Uncoupling protein 1 (UCP1), PPAR-γ coactivator-1α (PGC-1α), and PR domain containing 16 (PRDM16), the downstream genes of PPAR which are related to thermogenic function of adipocytes, were significantly increased in both brown adipose tissue (BAT) and inguinal white adipose tissue (iWAT) after zingerone administration, in comparison with HFD fed mice. Zingerone intake also restructured the community composition of gut microbiota. The ratio of Firmicutes to Bacteroidetes was decreased, and the relative abundance of Akkermansia_mucinphila was increased. CONCLUSION: Zingerone can attenuate obesity and related symptoms in HFD-fed mice, probably through the modulation of PPARα-thermogenesis-gut microbiota interactions. © 2022 Society of Chemical Industry.
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Microbioma Gastrointestinal , PPAR alfa , Ratones , Animales , PPAR alfa/metabolismo , Ratones Obesos , Ratones Endogámicos C57BL , Obesidad/metabolismo , Tejido Adiposo Blanco/metabolismo , Dieta Alta en Grasa , TermogénesisRESUMEN
BACKGROUND: In recent years, there has been an increasing demand for plant-based cheese analogues, however, the protein content of plant-based cheeses currently on the market is generally low and cannot meet the nutritional needs of consumers. RESULTS: Based on the ideal value similarity method (TOPSIS) analysis the best recipe for plant-based cheese was 15% tapioca starch, 20% soy protein isolate, 7% gelatine as a quality enhancer and 15% coconut oil. The protein content of this plant-based cheese was170.1 g kg-1 , which was close to commercial dairy-based cheese and significantly higher than commercial plant-based cheese, The fat content was 114.7 g kg-1 , lower than that of commercial dairy-based cheese. The rheology properties show that the viscoelasticity of the plant-based cheese is higher than that of dairy-based cheese and commercial plant-based. The microstructure results show that the type and content of protein has a significant impact on its microstructure. The Fourier-transform infrared (FTIR) spectrum of the microstructure shows a characteristic value at 1700 cm-1 , because the starch was heated and leached to form a complex with lauric acid under the action of hydrogen bond. It can be inferred that in the interaction between plant-based cheese raw materials, fatty acids serve as a bridge between starch and protein. COUCLUSION: This study described the formula of plant-based cheese and the interaction mechanism between the ingredients, providing a basis for the development of subsequent plant-based cheese related products. © 2023 Society of Chemical Industry.
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Queso , Queso/análisis , Proteínas , Reología , Viscosidad , AlmidónRESUMEN
Considering the importance of defining the minimum number of axons between recipient and donor branches, that is, the definition of histological compatibility in distal neurotizations for the success of the procedure and the surgeon's freedom to choose individualized strategies for each patient, this systematic review was conducted to find out the most recent studies on the subject. The objective of this systematic review was to determine the importance of the number of axons and the relationship between axon counts in the donor and recipient nerves in the success of nerve transfer. A literature review was performed on five international databases: Web of Science, Scopus, Wiley (Cochrane Database), Embase, and PubMed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed (2020 version), a guide designed to guide the elaboration of systematic literature reviews. One hundred and fifty-seven studies were found, and 23 were selected based on the eligibility criteria. The articles presented were conclusive in determining the importance of the number of axons in the success of nerve transfer. Still, the relationship between the number of axons in the donor and recipient nerves seems more relevant in the success of transfers and is not always explored by the authors. The review of the articles has provided compelling evidence that the number of axons is a critical determinant of the success of nerve transfer procedures. However, the relationship between the number of axons in the donor nerve and that in the recipient nerve appears to be even more crucial for successful transfers, a factor that is not always adequately explored by authors in the existing literature. Level of evidence : Level IV, therapeutic study.
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Adoptive transfer of T cell receptor (TCR)-engineered T cells targeting viral epitopes represents a promising approach for treating virus-related cancers. However, the efficient identification of epitopes for T cells and the corresponding TCR remains challenging. Here, we report a workflow permitting the rapid generation of human papillomavirus (HPV)-specific TCR-T cells. Six epitopes of viral proteins belonged to HPV16 or HPV18 were predicted to have high affinity to A11:01 according to bioinformatic analysis. Subsequently, CTL induction were performed with these six antigen peptides separately, and antigen-specific T cells were sorted by FACS. TCR clonotypes of these virus-specific T cells were determined using next-generation sequencing. To improve the efficiency of TCRαß pair validation, a lentiviral vector library containing 116 TCR constructs was generated that consisted of predominant TCRs according to TCR repertoire analysis. Later, TCR library transduced T cells were simulated with peptide pool-pulsed antigen-presenting cells, then CD137-positive cells were sorted and subjected to TCR repertoire analysis. The top-hit TCRs and corresponding antigen peptides were deduced and validated. Through this workflow, a TCR targeting the E692-101 of HPV16 was identified. These HPV16-specific TCR-T cells showed high activity towards HPV16-positive human cervical cancer cells in vitro and efficiently repressed tumor growth in a murine model. This study provides a HPV16-specific TCR fitted to the HLA-A11:01 population, and exemplifies an efficient approach that can be applied in large-scale screening of virus-specific TCRs, further encouraging researchers to exploit the therapeutic potential of the TCR-T cell technique in treating virus-related cancers.
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Linfocitos T , Neoplasias del Cuello Uterino , Femenino , Humanos , Ratones , Animales , Receptores de Antígenos de Linfocitos T , Papillomavirus Humano 16 , Neoplasias del Cuello Uterino/terapia , Péptidos , EpítoposRESUMEN
BACKGROUND & AIM: The development of hepatocellular carcinoma (HCC) is associated with the formation of communication networks leading to the recruitment of disease-modifying macrophages. However, how oncogenes in tumour cells control paracrine communication is not fully understood. METHODS: Transgenic mice with liver-specific expression of the constitutively active yes-associated protein (YAPS127A ) or an orthotopic implantation model served as tumour models. FACS-sorted F4/80+ /CD11bdim /CD146- /retinoid- macrophages from healthy and tumour-bearing livers were used for transcriptomic profiling. Expression data of 242 human HCCs and a tissue microarray consisting of 91 HCCs and seven liver tissues were analyzed. RESULTS: Screening of primary tumour cells expressing YAPS127A identified CC chemokine ligand 2 (Ccl2) as a macrophage chemoattractant, whose expression was regulated in a YAP/TEA domain family member 4 (TEAD4)-dependent manner. Ccl2 expression was associated with a loss of Kupffer cells (KCs) and an increase in immature macrophages (Mɸimm ) in hepatocarcinogenesis. Recruited Mɸimm were characterized by a lack of functional polarization (M0 signature) and high expression of the Ccl2 receptors C-C motif chemokine receptor 2 (Ccr2), C-X3-C motif chemokine receptor 1 (Cx3cr1) and pro-angiogenic platelet-derived growth factors (Pdgfa/Pdgfb). Mɸimm formed cellular clusters in the perivascular space, which correlated with vascular morphometric changes indicative for angiogenesis. In human HCCs, the M0 signature served as an identifier for poor clinical outcome and CCL2 correlated with YAP expression and vascular network formation. CONCLUSIONS: In conclusion, YAP/TEAD4-regulated Ccl2 associates with perivascular recruitment of unpolarized Mɸimm and may contribute to a proangiogenic microenvironment in liver cancer.
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Carcinoma Hepatocelular , Quimiocina CCL2 , Neoplasias Hepáticas , Animales , Carcinoma Hepatocelular/patología , Proteínas de Ciclo Celular , Quimiocina CCL2/metabolismo , Humanos , Macrófagos del Hígado/metabolismo , Ligandos , Neoplasias Hepáticas/patología , Macrófagos/metabolismo , Ratones , Receptores CCR2/genética , Receptores CCR2/metabolismo , Factores de Transcripción , Microambiente Tumoral , Remodelación Vascular , Proteínas Señalizadoras YAPRESUMEN
In comparison with traditional inorganic electrochromic materials, organic polymers offer advantages such as fast switching speed, flexibility, lightweightness, low cost and nontoxicity, solution-processability, and color tunability. Herein, a series of hyper-branched copolymers are synthesized from triphenylamine and 3,4-ethylenedioxythiophene with different feed ratios via iron(III) chloride (FeCl3 )-mediated oxidative polymerization. The resultant organic-soluble polymers are easily processable and their corresponding electrochromic devices are found to be stable with limited degradation upon 2500 cycles. In addition to their facile synthesis to achieve solution-processable polymers, studies also show that the polymers exhibit multielectrochromic properties and give rise to five colored states upon oxidative-doping by applying an external voltage between 0 and 2.0 V, providing an interesting example of polymers with unique electrochromic switching among up to five colors, from yellow at the neutral state, to pale green, pale purple, orange, and finally gray.
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Compuestos Férricos , Polímeros , Aminas , TiofenosRESUMEN
The flavor profile of five brands of instant vermicelli seasonings were identified by headspace solid-phase micro-extraction coupled with gas chromatography-mass spectrometry (HS-SPME/GC-MS) and electronic nose (e-nose). GC-MS showed that the volatile compounds of instant vermicelli seasonings were significantly different. Alkenes, alcohols, aldehydes and ketones were the major volatile compounds in instant vermicelli seasonings. The seasonings could be classified based on differences in volatile compounds. The overall volatiles profiles were also analyzed by e-nose. E-nose determination and GC-MS statistical analysis had similar results. The volatile compounds showed good correlation with e-nose sensors according to partial least square regression models. Both methods had good potential application in evaluating flavor quality and differentiating among instant vermicelli seasonings.
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BACKGROUND: Infective endocarditis caused by Actinomyces spp. is extremely rare. However, cases by new species of Actinomyces have been increasingly reported due to advances in laboratory techniques, and many of these species do not cause classic presentations of actinomycosis. Actinomyces neuii is reported to have a tendency to cause endovascular infection. The course of infective endocarditis caused by Actinomyces spp. is usually indolent. CASE PRESENTATION: A 61-year-old man with history of infective endocarditis, end stage renal disease, and monoclonal gammopathy was admitted for an abrupt fever, confusion, dysarthria, and facial droop after hemodialysis. Echocardiogram showed vegetations on both the aortic and mitral valves. Two sets of blood culture grew A. neuii. Brain MRI showed multiple bilateral cerebral infarcts consistent with septic emboli. The patient recovered after valvular surgery and prolonged intravenous and oral antibiotic therapy. CONCLUSIONS: This case illustrates an unusually acute presentation of A. neuii infective endocarditis. As with other Gram-positive bacilli, Actinomyces spp. isolates are often regarded as a result of contamination. One should keep it in mind as a cause of infective endocarditis in vulnerable patient populations.
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Actinomyces/aislamiento & purificación , Actinomicosis/diagnóstico , Endocarditis/diagnóstico , Actinomicosis/tratamiento farmacológico , Actinomicosis/microbiología , Enfermedad Aguda , Antibacterianos/uso terapéutico , Ecocardiografía , Endocarditis/tratamiento farmacológico , Endocarditis/microbiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Elbow flexion deficit is a frequent problem in traumatic brachial plexus injuries and reestablishment of this function is the primary treatment goal. When management is delayed, or the initial acute approach fails, free functional transfer of the gracilis muscle for elbow flexion is the treatment of choice. In this report, the authors present the results of a comparison study on different donor nerves (spinal accessory and ulnar) in elbow flexion reconstruction with gracilis flap for traumatic adult brachial plexus injuries. METHODS: Retrospective analysis of patients with both total or partial traumatic brachial plexus injuries was carried out. Of the 38 patients enrolled, 37 were male (97.4%) with a mean age of 28.3 years. The mean follow-up period was 25 months. Postoperative function of the gracilis muscle flap was recorded and patients were divided into two groups according to donor nerve: spinal accessory nerve (SAN) (18 cases), and motor fascicles of the ulnar (ULNAR) (20 cases). RESULTS: Twenty-six cases obtained elbow flexion strength M3 or M4 (68.4%): 0 M0 (0.0%), 4 M1 (10.5%), 8 M2 (21.1%), 9 M3 (23.7%) and 17 M4 (44.7%). The mean interval to first recorded M3 muscular strength was 12.4 months. Functional elbow flexion strength (≥ M3) had the following distribution: SAN 83.3% (15/18) and ULNAR 55.0% (11/20) (p = .086). CONCLUSION: No statistical difference for final muscle strength was found between donor nerve groups.
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Neuropatías del Plexo Braquial/cirugía , Plexo Braquial/lesiones , Lesiones de Codo , Músculo Grácil/trasplante , Rango del Movimiento Articular/fisiología , Adolescente , Adulto , Plexo Braquial/cirugía , Neuropatías del Plexo Braquial/etiología , Estudios de Cohortes , Articulación del Codo/cirugía , Femenino , Estudios de Seguimiento , Colgajos Tisulares Libres/inervación , Colgajos Tisulares Libres/trasplante , Músculo Grácil/inervación , Humanos , Masculino , Persona de Mediana Edad , Transferencia de Nervios/métodos , Traumatismos de los Nervios Periféricos/diagnóstico , Traumatismos de los Nervios Periféricos/cirugía , Modelos de Riesgos Proporcionales , Recuperación de la Función/fisiología , Estudios Retrospectivos , Medición de Riesgo , Estadísticas no Paramétricas , Donantes de Tejidos , Resultado del Tratamiento , Adulto JovenRESUMEN
Bi2S3/BiOCl (denoted as BS-BC) heterojunction photocatalyst has been reported to be able to increase light absorption, promote charge separation and consequently enhance photocatalytic efficiency in comparison with single BiOCl. However, the heterojunction was usually prepared by a two-step method, i.e., BiOCl was firstly prepared and then to BS-BC heterojunction through an ion exchange strategy. In this work, BS-BC was prepared by a one-pot room temperature route, where Bi(NO3)3 dissolved in aqueous urea solution could homogeneously react with a mixture solution of NaCl and thiacetamide (TAA) to form BS-BC heterojunction. The urea could prohibit the hydrolysis of Bi(NO3)3 and accelerate the decomposition of TAA to release S2-, and as a consequence, the heterojunction photocatalyst with small size and large interfacial area could be prepared in several hours. The resulted heterojunction exhibited better visible-light photocatalytic activity for RhB degradation than individual BiOCl or that prepared by a two-step route due to close contact between Bi2S3 and BiOCl, modified band structures and effective interfacial charge transfer.
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INTRODUCTION: Indication of free tissue transfer for limb reconstruction continues to grow, and despite the good results with this treatment option, complications can impair the functional results and cause a raise in health costs, with prolonged hospitalization. Therefore, peri-operative surgical information and comorbidities were described and analyzed, for identification of independent risk factors for complications of free flaps results for traumatic wounds. For our knowledge, intraoperative ischemia time of free flap was not previously studied for post-traumatic limb reconstruction, which could influence results, in these traumatic cases, with the highest rates of complications among microsurgical flap reconstructions. METHODS: From July 2014 to January 2017, all patients with free flaps for limb reconstruction were consecutively included. Data on personal medical history, intra-operative microsurgical procedure, and laboratory tests were collected and complications analyzed. Descriptive and inferential statistics were performed. RESULTS: Sixty-two free flaps for traumatic limb reconstruction in 60 patients were studied. We observed a higher rate of complications in patients who underwent surgery > seven days after the trauma, patients with obesity, when used recipient veins from the superficial system for drainage of the flap, and in those in whom the ischemia time of the free flap was higher in univariate analyzes. After logistic regression, the remaining independent risk factors for complications were ischemia time of free flap > two hours and obesity. The presence of thrombocytosis was associated with partial flap loss. CONCLUSIONS: The independent risk factors for complications were ischemia time of free flap > two hours and obesity.
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Extremidades/cirugía , Colgajos Tisulares Libres/efectos adversos , Microcirugia/efectos adversos , Procedimientos de Cirugía Plástica/efectos adversos , Complicaciones Posoperatorias/etiología , Adulto , Anciano , Estudios Transversales , Extremidades/lesiones , Femenino , Colgajos Tisulares Libres/irrigación sanguínea , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Heridas y Lesiones/cirugía , Adulto JovenRESUMEN
BACKGROUND AND OBJECTIVES: The study aimed to investigate the relationship between obesity and postsurgical gastroparesis syndrome (PGS), and to construct a scoring system and a risk model to identify patients at high risk. METHODS: A total of 634 patients were retrospectively analyzed. Clinical characteristics were evaluated via receiver operating characteristic (ROC) curve analysis. Logistic analysis was performed to determine the independent predictive indicators of PGS. A scoring system consisting of these indicators and a risk-rating model were constructed and evaluated via ROC curve analysis. RESULTS: Based on the ROC curves, the visceral fat area (VFA) cutoff value for PGS was 94.00. Logistic analysis showed that visceral obesity (VFA ≥ 94.00 cm2 ), the reconstruction technique, and tumor size were independent prognostic factors for PGS. The scoring system could predict PGS reliably with a high area under the ROC curve ([AUC] = 0.769). A high-risk rating had a high AUC (AUC I = 0.56, AUC II = 0.65, and AUC III = 0.77), indicating that the risk-rating model could effectively screen patients at high risk of PGS. CONCLUSIONS: Visceral obesity defined by VFA effectively predicted PGS. Our scoring system may be a reliable instrument for identifying patients most at risk of PGS.
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Gastrectomía/efectos adversos , Gastroparesia/etiología , Neoplasias Gástricas/cirugía , Anciano , Femenino , Gastroparesia/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Obesidad Abdominal/complicaciones , Complicaciones Posoperatorias , Estudios Retrospectivos , Medición de Riesgo , Neoplasias Gástricas/patologíaRESUMEN
PURPOSE: Although a reasonable number of studies report satisfactory results with fibrin glue application in microvascular anastomosis since 1977, its utilization in the clinical setting has being scant in the literature. The aim of this study was to report the cumulated experience with the fibrin glue in free flaps over a period of 10 years, comparing the survival rate with the standard sutured anastomosis. PATIENTS AND METHODS: From August 2001 through November 2014, 83 consecutive free flaps were performed by a team of surgeons from two hospitals. About 56 flaps were performed in 56 patients using the fibrin glue augmented microvascular anastomosis and 27 flaps were performed in 27 patients using the conventional anastomosis technique. The decision on whether or not the fibrin glue should be used at the anastomoses was based on its availability and whose surgeon was performing the anastomoses. About approximately 60% of sutures stitches were used that would be used in a conventional anastomosis, when fibrin glue application was anticipated (ranging from 5 to 7 sutures in the arteries and 5 to 8 in the veins). RESULTS: The overall survival rate of the flaps performed with fibrin glue application was 92.85%. In one case, a revision of the venous anastomosis was required due to early flap congestion. Four cases (7.14%) had failure of the first free flap and two of them were submitted to another free flap without fibrin glue application. In the flaps performed with the conventional anastomosis technique the survival rate was 92.59%. This difference was not statistically significant (P = 0.97). CONCLUSION: The application of fibrin glue in microvascular anastomoses did not increase the rate of flap loss and had a potential to reduce the number of sutures required to complete an anastomosis by its sealing effect. © 2016 Wiley Periodicals, Inc. Microsurgery 37:218-221, 2017.
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Adhesivo de Tejido de Fibrina/uso terapéutico , Microcirugia/métodos , Técnicas de Sutura , Cicatrización de Heridas/fisiología , Adulto , Anciano , Anastomosis Quirúrgica/métodos , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Seguridad del Paciente , Estudios Retrospectivos , Medición de Riesgo , Traumatismos de los Tejidos Blandos/diagnóstico , Traumatismos de los Tejidos Blandos/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante , Grado de Desobstrucción Vascular/fisiología , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/cirugía , Adulto JovenRESUMEN
Major depressive disorder (MDD) has become a leading contributor to the global burden of disease; however, there are currently no reliable biological markers or physiological measurements for efficiently and effectively dissecting the heterogeneity of MDD. Here we propose a novel method based on scalp electroencephalography (EEG) signals and a robust spectral-spatial EEG feature extractor called kernel eigen-filter-bank common spatial pattern (KEFB-CSP). The KEFB-CSP first filters the multi-channel raw EEG signals into a set of frequency sub-bands covering the range from theta to gamma bands, then spatially transforms the EEG signals of each sub-band from the original sensor space to a new space where the new signals (i.e., CSPs) are optimal for the classification between MDD and healthy controls, and finally applies the kernel principal component analysis (kernel PCA) to transform the vector containing the CSPs from all frequency sub-bands to a lower-dimensional feature vector called KEFB-CSP. Twelve patients with MDD and twelve healthy controls participated in this study, and from each participant we collected 54 resting-state EEGs of 6 s length (5 min and 24 s in total). Our results show that the proposed KEFB-CSP outperforms other EEG features including the powers of EEG frequency bands, and fractal dimension, which had been widely applied in previous EEG-based depression detection studies. The results also reveal that the 8 electrodes from the temporal areas gave higher accuracies than other scalp areas. The KEFB-CSP was able to achieve an average EEG classification accuracy of 81.23% in single-trial analysis when only the 8-electrode EEGs of the temporal area and a support vector machine (SVM) classifier were used. We also designed a voting-based leave-one-participant-out procedure to test the participant-independent individual classification accuracy. The voting-based results show that the mean classification accuracy of about 80% can be achieved by the KEFP-CSP feature and the SVM classifier with only several trials, and this level of accuracy seems to become stable as more trials (i.e., <7 trials) are used. These findings therefore suggest that the proposed method has a great potential for developing an efficient (required only a few 6-s EEG signals from the 8 electrodes over the temporal) and effective (~80% classification accuracy) EEG-based brain-computer interface (BCI) system which may, in the future, help psychiatrists provide individualized and effective treatments for MDD patients.
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Trastorno Depresivo Mayor , Algoritmos , Interfaces Cerebro-Computador , Electroencefalografía , Humanos , Procesamiento de Señales Asistido por Computador , Máquina de Vectores de SoporteRESUMEN
A case-cohort analysis of human immunodeficiency virus (HIV)-infected individuals receiving antiretroviral therapy (ART) was performed within a multicountry randomized trial (PEARLS) to assess the prevalence of persistently elevated C-reactive protein (CRP) levels, based on serial measurements of CRP levels, and their association with HIV clinical failure. A persistently elevated CRP level in plasma (defined as ≥ 5 mg/L at both baseline and 24 weeks after ART initiation) was observed in 50 of 205 individuals (24%). A persistently elevated CRP level but not an elevated CRP level only at a single time point was independently associated with increased clinical failure, compared with a persistently low CRP level, despite achievement of virologic suppression. Serial monitoring of CRP levels could identify individuals who are at highest risk of HIV progression and may benefit from future adjunct antiinflammatory therapies.
Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Proteína C-Reactiva/metabolismo , Infecciones por VIH/tratamiento farmacológico , Adulto , Estudios de Casos y Controles , Femenino , Salud Global , Infecciones por VIH/sangre , Infecciones por VIH/patología , Humanos , Inflamación , Masculino , Insuficiencia del TratamientoRESUMEN
Versatile and readily available battery materials compatible with a range of electrode configurations and cell designs are desirable for renewable energy storage. Here we report a promising class of materials based on redox active colloids (RACs) that are inherently modular in their design and overcome challenges faced by small-molecule organic materials for battery applications, such as crossover and chemical/morphological stability. RACs are cross-linked polymer spheres, synthesized with uniform diameters between 80 and 800 nm, and exhibit reversible redox activity as single particles, as monolayer films, and in the form of flowable dispersions. Viologen-based RACs display reversible cycling, accessing up to 99% of their capacity and 99 ± 1% Coulombic efficiency over 50 cycles by bulk electrolysis owing to efficient, long-distance intraparticle charge transfer. Ferrocene-based RACs paired with viologen-based RACs cycled efficiently in a nonaqueous redox flow battery employing a simple size-selective separator, thus demonstrating a possible application that benefits from their colloidal dimensions. The unprecedented versatility in RAC synthetic and electrochemical design opens new avenues for energy storage.