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1.
BMC Med ; 21(1): 192, 2023 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-37226271

RESUMO

BACKGROUND: Both low-carbohydrate (LC) and calorie-restricted (CR) diets have been shown to have metabolic benefits. However, the two regimens have yet to be thoroughly compared. We conducted a 12-week randomized trial to compare the effects of these diets separately and in combination on both weight loss and metabolic risk factors in overweight/obese individuals. METHODS: A total of 302 participants were randomized to LC diet (n = 76), CR diet (n = 75), LC + CR diet (n = 76), or normal control (NC) diet (n = 75) using a computer-based random number generator. The primary outcome was the change in body mass index (BMI). The secondary outcomes included body weight, waist circumference, waist-to-hip ratio, body fat, and metabolic risk factors. All participants attended health education sessions during the trial. RESULTS: A total of 298 participants were analyzed. BMI change over 12 weeks was - 0.6 (95% CI, - 0.8 to - 0.3) kg/m2 in NC, - 1.3 (95% CI, - 1.5 to - 1.1) kg/m2 in CR, - 2.3 (95% CI, - 2.6 to - 2.1) kg/m2 in LC, and - 2.9 (95% CI, - 3.2 to - 2.6) kg/m2 in LC + CR. LC + CR diet was more effective than LC or CR diet alone at reducing BMI (P = 0.001 and P < 0.001, respectively). Furthermore, compared with the CR diet, the LC + CR diet and LC diet further reduced body weight, waist circumference, and body fat. Serum triglycerides were significantly reduced in the LC + CR diet group compared with the LC or CR diet alone. Plasma glucose, homeostasis model assessment of insulin resistance, and cholesterol concentrations (total, LDL, and HDL) did not change significantly between the groups during the 12-week intervention. CONCLUSIONS: The reduction of carbohydrate intake without restricting caloric intake is more potent to achieve weight loss over 12 weeks when compared to a calorie-restricted diet in overweight/obese adults. The combination of restricting carbohydrate and total calorie intake may augment the beneficial effects of reducing BMI, body weight, and metabolic risk factors among overweight/obese individuals. TRIAL REGISTRATION: The study was approved by the institutional review board of Zhujiang Hospital of Southern Medical University and registered at the China Clinical Trial Registration Center (registration number: ChiCTR1800015156).


Assuntos
Carboidratos da Dieta , Sobrepeso , Adulto , Humanos , Restrição Calórica , Obesidade , Dieta com Restrição de Carboidratos
2.
CMAJ ; 195(21): E729-E738, 2023 05 29.
Artigo em Inglês | MEDLINE | ID: mdl-37247880

RESUMO

BACKGROUND: The role of statin therapy in the development of kidney disease in patients with type 2 diabetes mellitus (DM) remains uncertain. We aimed to determine the relationships between statin initiation and kidney outcomes in patients with type 2 DM. METHODS: Through a new-user design, we conducted a multicentre retrospective cohort study using the China Renal Data System database (which includes inpatient and outpatient data from 19 urban academic centres across China). We included patients with type 2 DM who were aged 40 years or older and admitted to hospital between Jan. 1, 2000, and May 26, 2021, and excluded those with pre-existing chronic kidney disease and those who were already on statins or without follow-up at an affiliated outpatient clinic within 90 days after discharge. The primary exposure was initiation of a statin. The primary outcome was the development of diabetic kidney disease (DKD), defined as a composite of the occurrence of kidney dysfunction (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2 and > 25% decline from baseline) and proteinuria (a urinary albumin-to-creatinine ratio ≥ 30 mg/g and > 50% increase from baseline), sustained for at least 90 days; secondary outcomes included development of kidney function decline (a sustained > 40% decline in eGFR). We used Cox proportional hazards regression to evaluate the relationships between statin initiation and kidney outcomes, as well as to conduct subgroup analyses according to patient characteristics, presence or absence of dyslipidemia, and pattern of dyslipidemia. For statin initiators, we explored the association between different levels of lipid control and outcomes. We conducted analyses using propensity overlap weighting to balance the participant characteristics. RESULTS: Among 7272 statin initiators and 12 586 noninitiators in the weighted cohort, statin initiation was associated with lower risks of incident DKD (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.62-0.83) and kidney function decline (HR 0.60, 95% CI 0.44-0.81). We obtained similar results to the primary analyses for participants with differing patterns of dyslipidemia, those prescribed different statins, and after stratification according to participant characteristics. Among statin initiators, those with intensive control of high-density lipoprotein cholesterol (LDL-C) (< 1.8 mmol/L) had a lower risk of incident DKD (HR 0.51, 95% CI 0.32-0.81) than those with inadequate lipid control (LDL-C ≥ 3.4 mmol/L). INTERPRETATION: For patients with type 2 DM admitted to and followed up in academic centres, statin initiation was associated with a lower risk of kidney disease development, particularly in those with intensive control of LDL-C. These findings suggest that statin initiation may be an effective and reasonable approach for preventing kidney disease in patients with type 2 DM.


Assuntos
Diabetes Mellitus Tipo 2 , Dislipidemias , Inibidores de Hidroximetilglutaril-CoA Redutases , Insuficiência Renal Crônica , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/epidemiologia , LDL-Colesterol , Estudos Retrospectivos , Insuficiência Renal Crônica/epidemiologia , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia
3.
BMC Public Health ; 23(1): 2506, 2023 12 14.
Artigo em Inglês | MEDLINE | ID: mdl-38097979

RESUMO

BACKGROUND: Many researchers have examined the impact of social insurance on health in elderly. However, in most cases, they have only demonstrated correlational results and have not been able to determine causal effects, possibly because confounding biases have not been fully addressed. In this study, we investigated the health effects of the New Rural Pension Scheme (NRPS) on the elderly (age≥60 years old) with chronic diseases in rural areas, and to explore the causal relationship and effects of NRPS and health status. METHODS: This paper used data from the 2018 China Health and Retirement Longitudinal Study (CHARLS) and applied Bayesian networks and fuzzy regression discontinuity design to conduct causal analysis. Bayesian networks were used to explore the causal directed acyclic graphs of factors related to NRPS and health status. Based on the results of Bayesian network, a fuzzy regression discontinuity design was employed to estimate the causal effect of NRPS on health status. RESULTS: Among rural elderly with chronic diseases, Bayesian network mapping of causal relationships among NRPS, health status and covariates showed that age was a common cause of NRPS receipt and satisfaction with health. The results of the fuzzy regression discontinuity analysis showed that the effect of receiving NRPS on the health status was positive, but there was no statistically significant difference concerning the interval estimates. The results of the subgroup analysis with chronic obstructive pulmonary disease (COPD) and asthma indicated that the effect of NRPS receipt on the health status of elderly people with COPD was positive. There was a statistically significant effect of receiving NRPS on self-rated health description ([Formula: see text]) and health satisfaction ([Formula: see text]) in COPD population and a statistically significant effect of receiving NRPS on health satisfaction in asthma population ([Formula: see text]). CONCLUSION: This paper has confirmed the contribution and positive causal effect of NRPS on health status in a subgroup of older adults with COPD and asthma, using the CHARLS database as evidence. Thus, Chinese government should increase the take-up rate of the NRPS to enhance their positive impact on health status of elderly people with chronic diseases in rural areas.


Assuntos
Asma , Doença Pulmonar Obstrutiva Crônica , Humanos , Idoso , Pessoa de Meia-Idade , Aposentadoria , Estudos Longitudinais , Teorema de Bayes , Pensões , Nível de Saúde , População Rural , Doença Crônica , China/epidemiologia , Asma/epidemiologia
4.
Br J Clin Pharmacol ; 88(6): 2747-2756, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34964162

RESUMO

AIMS: The mortality of critically ill patients undergoing mechanical ventilation (MV) is high and few strategies are available. We explored the relationship between ondansetron pre-treatment, the neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR), and mortality of ventilated patients in the intensive care unit. METHODS: We developed a retrospective cohort study that involved patients undergoing MV in the Multiparameter Intelligent Monitoring in Intensive Care IV (MIMIC-IV) database. Causal mediation analysis was conducted to assess the relationship of ondansetron use and mortality and to explore the potential causal pathway mediated by the NLR or PLR. The primary outcome was 28-day mortality. RESULTS: A total of 17 927 eligible patients took part in the study (5665 had taken ondansetron before MV initiation and 12 262 patients had not). The odds ratio (OR) for 28-day mortality for ondansetron use uncorrelated with the mediator (NLR, PLR) was 0.72 (95% confidence interval [CI] = 0.64-0.81, P < .001). Ondansetron was also associated with a reduction in 28-day mortality after controlling for the mediator of NLR (OR = 0.98, 95% CI = 0.97-0.99, P < .01). For the indirect effect, the NLR could explain 13.47% (95% CI = 8.59-20.54%, P < .01) of the impact of ondansetron use on 28-day mortality. The proportion mediated increased to 21.50% (95% CI = 12.36-47.44%, P < .01) for 90-day mortality. Adjusted mediation analysis revealed no suggestion of a causal mediation pathway for this effect by the PLR (P = .12). CONCLUSIONS: NLR may play substantial roles in the relationship between ondansetron pre-treatment before initiation of mechanical ventilation and the reduction of death risk in ventilated patients.


Assuntos
Neutrófilos , Respiração Artificial , Cuidados Críticos , Humanos , Unidades de Terapia Intensiva , Linfócitos , Análise de Mediação , Neutrófilos/metabolismo , Ondansetron/uso terapêutico , Contagem de Plaquetas , Prognóstico , Estudos Retrospectivos
5.
BMC Nephrol ; 23(1): 62, 2022 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-35144580

RESUMO

BACKGROUND: To develop a reliable model to predict rapid kidney function decline (RKFD) among population at risk of cardiovascular disease. METHODS: In this retrospective study, key monitoring residents including the elderly, and patients with hypertension or diabetes of China National Basic Public Health Service who underwent community annual physical examinations from January 2015 to December 2020 were included. Healthy records were extracted from regional chronic disease management platform. RKFD was defined as the reduction of estimated glomerular filtration rate (eGFR) ≥ 40% during follow-up period. The entire cohort were randomly assigned to a development cohort and a validation cohort in a 2:1 ratio. Cox regression analysis was used to identify the independent predictors. A nomogram was established based on the development cohort. The concordance index (C-index) and calibration plots were calculated. Decision curve analysis was applied to evaluate the clinical utility. RESULTS: A total of 8455 subjects were included. During the median follow-up period of 3.72 years, the incidence of RKFD was 11.96% (n = 1011), 11.98% (n = 676) and 11.92% (n = 335) in the entire cohort, development cohort and validation cohort, respectively. Age, eGFR, hemoglobin, systolic blood pressure, and diabetes were identified as predictors for RKFD. Good discriminating performance was observed in both the development (C-index, 0.73) and the validation (C-index, 0.71) cohorts, and the AUCs for predicting 5-years RKFD was 0.763 and 0.740 in the development and the validation cohort, respectively. Decision curve analysis further confirmed the clinical utility of the nomogram. CONCLUSIONS: Our nomogram based on five readily accessible variables (age, eGFR, hemoglobin, systolic blood pressure, and diabetes) is a useful tool to identify high risk patients for RKFD among population at risk of cardiovascular disease in primary care. Whereas, further external validations are needed before clinical generalization.


Assuntos
Doenças Cardiovasculares/complicações , Nomogramas , Insuficiência Renal/complicações , Insuficiência Renal/diagnóstico , Fatores Etários , Idoso , Pressão Sanguínea , Técnicas de Apoio para a Decisão , Complicações do Diabetes , Feminino , Taxa de Filtração Glomerular , Hemoglobinas/metabolismo , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco
6.
BMC Med Res Methodol ; 21(1): 193, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34563138

RESUMO

BACKGROUND: As a hot method in machine learning field, the forests approach is an attractive alternative approach to Cox model. Random survival forests (RSF) methodology is the most popular survival forests method, whereas its drawbacks exist such as a selection bias towards covariates with many possible split points. Conditional inference forests (CIF) methodology is known to reduce the selection bias via a two-step split procedure implementing hypothesis tests as it separates the variable selection and splitting, but its computation costs too much time. Random forests with maximally selected rank statistics (MSR-RF) methodology proposed recently seems to be a great improvement on RSF and CIF. METHODS: In this paper we used simulation study and real data application to compare prediction performances and variable selection performances among three survival forests methods, including RSF, CIF and MSR-RF. To evaluate the performance of variable selection, we combined all simulations to calculate the frequency of ranking top of the variable importance measures of the correct variables, where higher frequency means better selection ability. We used Integrated Brier Score (IBS) and c-index to measure the prediction accuracy of all three methods. The smaller IBS value, the greater the prediction. RESULTS: Simulations show that three forests methods differ slightly in prediction performance. MSR-RF and RSF might perform better than CIF when there are only continuous or binary variables in the datasets. For variable selection performance, When there are multiple categorical variables in the datasets, the selection frequency of RSF seems to be lowest in most cases. MSR-RF and CIF have higher selection rates, and CIF perform well especially with the interaction term. The fact that correlation degree of the variables has little effect on the selection frequency indicates that three forest methods can handle data with correlation. When there are only continuous variables in the datasets, MSR-RF perform better. When there are only binary variables in the datasets, RSF and MSR-RF have more advantages than CIF. When the variable dimension increases, MSR-RF and RSF seem to be more robustthan CIF CONCLUSIONS: All three methods show advantages in prediction performances and variable selection performances under different situations. The recent proposed methodology MSR-RF possess practical value and is well worth popularizing. It is important to identify the appropriate method in real use according to the research aim and the nature of covariates.


Assuntos
Aprendizado de Máquina , Simulação por Computador , Humanos , Modelos de Riscos Proporcionais
7.
Phys Chem Chem Phys ; 24(1): 551-559, 2021 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-34904986

RESUMO

High-energy density and low-cost sodium-ion batteries are being sought to meet increasing energy demand. Here, R-MnO2 is chosen as a cathode material of sodium-ion batteries owing to its low cost and high energy density. The structural transformation from the tunnel R-MnO2 to the layered NaMnO2 and electrochemical properties during the charge/discharge are investigated at the atomic level by combining XRD and related electrochemical experiments. Na≤0.04MnO2 has a tunnel R-MnO2 phase structure, Na≥0.42MnO2 has a layered NaMnO2 phase structure, and Na0.04-0.42MnO2 is their mixed phase. Mn3+ 3d4[t2gß3dz2(1)3dx2-y2(0)] in NaMnO2 loses one 3dz2 electron and the redox couple Mn3+/Mn4+ delivers 206 mA h g-1 during the initial charge. The case that the Fermi energy level difference between R-MnO2 and NaMnO2 is lower than that between the layered Na(12-x)/12MnO2 and NaMnO2 makes the potential plateau of R-MnO2 turning into NaMnO2 lower than that of the layered Na(12-x)/12MnO2 to NaMnO2. This can be confirmed by our experiment from the 1st-2nd voltage capacity profile of R-MnO2 in EC/PC (ethylene carbonate/propylene carbonate) electrolyte. The study would give a new view of the production of sustainable sodium battery cathode materials.

8.
Nutr Metab Cardiovasc Dis ; 31(8): 2302-2310, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34154891

RESUMO

BACKGROUND AND AIMS: The association between isoflavone (ISF) consumption and cardiovascular disease (CVD) remains controversial because of limited evidence. Carotid atherosclerosis is an established indicator of subclinical CVD. The study aimed to investigate the relationship between dietary ISF intake and subclinical CVD in middle-aged and elderly adults. METHODS AND RESULTS: A total of 873 subjects aged 40-70 years without CVD were enrolled in this cross-sectional study. A restricted cubic spline was used to investigate the association between ISF intake and subclinical CVD risk. The odds ratio (OR) and 95% confidence interval of the risk of subclinical CVD for ISF were estimated by two-segmented logistic regression analysis. In Model 2, there was a non-linear association between ISF intake and the risk of subclinical CVD among women (Pnon-linear = 0.002), with an inverse association below the change point. The nadir for the risk of subclinical CVD among women was 7.26 mg/day (energy-adjusted). Below the change point, an increase of 1 mg ISF/day reduced the risk of subclinical CVD by 15%. There was no significant association between ISF intake and subclinical CVD risk above the change point (OR = 1.01 [0.99, 1.04]). ISF intake was not associated with subclinical CVD risk in men (Model 2: Pnon-linear = 0.224). CONCLUSIONS: Below the change point (7.26 mg/day), women with a higher intake of ISF had a significantly lower risk of subclinical CVD. Encouraging the consumption of ISF-rich foods may help to lower CVD risk in middle-aged and elderly women. TRIAL REGISTRATION: This study is registered at http://www.chictr.org.cn (ChiCTR 1900022445).


Assuntos
Doenças Cardiovasculares/prevenção & controle , Dieta Saudável , Isoflavonas/administração & dosagem , Comportamento de Redução do Risco , Adulto , Fatores Etários , Idoso , Doenças Assintomáticas , Doenças Cardiovasculares/diagnóstico por imagem , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Nutritivo , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Fatores Sexuais
9.
Environ Res ; 181: 108946, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31780051

RESUMO

BACKGROUND: Longer ambulance response time (ART) delaying treatment would worsen conditions of seriously ill or injured patients, but limited evidence is available on the effects of weather factors on ART. This study aims to assess precipitation- and temperature-ART associations and their potential lagged effects using a novel modeling strategy. METHODS: Based on 779,156 emergency records during 2010-2016 from the whole population in Shenzhen, China, we creatively combined quantile regression with distributed-lag nonlinear models to examine the non-linear and lagged effects of hourly precipitation and temperature on ART at the 50th and 90th percentiles. RESULTS: A linear precipitation-ART association with a delay of 9.01 (95%CI, 7.82-10.20) seconds at median ART for a 1 mm increase in hourly precipitation, and the effects lasted for 5 h with the greatest effect at the current hour. A two linear thresholds temperature-ART association revealed 1 °C decrease below 19 °C caused 1.68 (95%CI, 0.92-2.44) seconds delay in total ART over lag 0-7 h, and 1 °C increase above 24 °C caused 2.44 (95%CI, 1.55-3.33) seconds delay. The hourly call volumes exceeding 54 calls caused 8.79 (95%CI, 8.71-8.86) seconds delay in total ART for 1 more call, but not affected the effects of weather factors. The internal ART suffered more from the hourly call volumes, while the external ART suffered more from precipitation and temperature. The effects were apparently greater on ART at the 90th percentile than median. CONCLUSIONS: Precipitation and temperature are independent risk factors for ambulance services performance, and their lagged effects are notable. The external ART and patients with long ART are vulnerable. More attention should be paid to weather and ART, and these findings may have implications for effective policies to reduce ART to protect public health.


Assuntos
Ambulâncias , Chuva , China , Humanos , Tempo de Reação , Estações do Ano , Temperatura
10.
BMC Public Health ; 19(1): 1262, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31510992

RESUMO

BACKGROUND: Nonspecific Low Back Pain (NLBP) is a common disease with a low cure rate and significant impact on the population. This study aimed to develop and validate a pre-scoring system for identifying the risk of suffering from NLBP among the general population in Guangzhou. METHODS: A total of 1439 eligible subjects were surveyed in Guangzhou by stratified random sampling and was divided randomly into the development dataset (69.6%) and validation dataset (30.4%) subsequently. Based on the development dataset, potential associated factors (average exercise times weekly, the intensity of daily work, etc.) with NLBP were tested by the sequential logistic regression, and a pre-scoring system was formulated with Sullivan's method and graded afterward. The internal validity of the system was assessed by AUC and calibration plot, and the external validation was performed in the validation dataset. RESULTS: The prevalence rates of NLBP in the development dataset and the validation dataset were 12.97 and 13.27%, respectively. Age, BMI, average exercise times weekly, gender, educational level, the intensity of daily work, place of residence, monthly income, overall evaluation of health condition and physiology health were identified as significant factors. The total risk score ranged from 0 to 38, which was split into three risk grades: low risk (0 to 18), intermediate risk (19 to 22) and high risk (23 to 38). The pre-scoring system had an adequate calibration and a good discriminating ability with bootstrap-corrected AUC equaling 0.861 in the development dataset and 0.821 in the validation dataset. CONCLUSIONS: A pre-scoring system that could help clinicians to assess the risk of NLBP in the general population was validated. Further validation of the system in a new population or prospective cohort study is suggested.


Assuntos
Dor Lombar/epidemiologia , Medição de Risco/métodos , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Reprodutibilidade dos Testes , Adulto Jovem
11.
Scand J Gastroenterol ; 53(12): 1519-1525, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30621477

RESUMO

OBJECTIVES: Flat colorectal adenomas have a high risk of malignancy; however, their detection is often difficult due to their flat morphology. In this retrospective, large-scale study, we investigated the prevalence and characteristics of flat adenomas in a population in China. METHODS: We analyzed the data collected for 16951 consecutive patients who underwent colonoscopy at four participating hospitals between September 2013 and September 2015. All colonoscopies were performed without magnification. RESULTS: Among the 1,6951 patients, 2938 (17.3%) had adenoma and 796 (4.7%) had flat adenomas. The detection of flat adenoma showed a weak correlation with the detection of adenoma (r = 0.666). Multivariable logistic regression analysis revealed the following independent factors influencing the detection of flat adenomas: patient-related factors of age, presence of warning symptoms, history of adenomas and bowel preparation as well as endoscopist-related factors of endoscopist's level of proficiency, number of colonoscopy operators and withdrawal time. CONCLUSIONS: The prevalence of flat adenomas in our study on Chinese patients was consistent with that reported from other countries. Factors conducive to the detection of flat adenomas were patient age of > 60 years, warning symptoms, history of adenoma, good bowel preparation, experienced endoscopist, single-operator colonoscopy and colonoscopy withdrawal time of >6 min.


Assuntos
Adenoma/diagnóstico por imagem , Colonoscopia , Neoplasias Colorretais/diagnóstico por imagem , Erros de Diagnóstico , Adenoma/epidemiologia , Adulto , Idoso , China/epidemiologia , Neoplasias Colorretais/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo
12.
J Gastroenterol Hepatol ; 31(1): 172-9, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26138256

RESUMO

BACKGROUND AND AIM: It is essential to develop a novel evaluation system for the quality of individual colonoscopy and provide guidelines on whether and when to follow up the patient after the initial colonoscopy. This study aimed to establish and validate a scoring system for the quality of individual colonoscopy in terms of the adenoma miss rate (AMR). METHODS: Patients undergoing two consecutive colonoscopies within 90 days between 2009 and 2011 from different levels of hospitals in China were enrolled into this study. Potential risk factors for adenoma miss at the individual colonoscopy in a cohort of patients were evaluated in univariate and multivariate analyses. Corresponding scores for the procedure-related factors were generated based on their weights, and a scoring system was established and then validated by correlating the system with AMR. RESULTS: A total of 2093 patients were enrolled. Procedure-related factors at the individual colonoscopy (including bowel preparation and imaging methods), doctor experience, retroflexion, and withdrawal time were identified to be independent risk factors, and each of these factors was scored from 0 to 3. Then, a novel scoring system for the quality of individual colonoscopy (ranging from 0 to 9) was established, which was closely correlated with the AMRs in the establishment (adjusted R(2) = 0.845) and validation databases (adjusted R(2) = 0.733). CONCLUSIONS: The developed and validated evaluation system, consisting of procedure-related independent factors, successfully assesses the quality of individual colonoscopy in terms of AMRs.


Assuntos
Colonoscopia , Garantia da Qualidade dos Cuidados de Saúde/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Colonoscopia/métodos , Erros de Diagnóstico/prevenção & controle , Erros de Diagnóstico/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Análise Multivariada , Guias de Prática Clínica como Assunto , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
13.
Exp Mol Pathol ; 99(1): 173-9, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26103003

RESUMO

Colorectal cancer (CRC) is one of the most common malignancies. Increasing evidences indicate that dysregulation of miRNAs is a frequent event in CRC and contributes to the pathogenesis of CRC. In this study, we found that over-expression of miR-34a inhibited cell proliferation and invasion, induced a cell cycle arrest and triggered apoptosis, while knockdown of miR-34a showed the opposite effects. Moreover, ectopic miR-34a suppressed tumor growth and metastasis of CRC cells in vivo. FMNL2 and E2F5 were identified as direct targets of miR-34a. Reintroduction of FMNL2 or E2F5 without 3'UTR region reversed the inhibitory effects of miR-34a on cell proliferation and invasion. MiR-34a was down-regulated in CRC cells and inversely correlated with FMNL2 and E2F5 expressions. Our study suggests that miR-34a is an important tumor suppressor of CRC progression by targeting FMNL2 and E2F5, thus providing new insight into the molecular mechanisms underlying CRC progression and establishing a strong potential for the application of miR-34a as a novel therapeutic marker against CRC.


Assuntos
Neoplasias Colorretais/genética , Fator de Transcrição E2F5/metabolismo , Regulação Neoplásica da Expressão Gênica , MicroRNAs/metabolismo , Proteínas/metabolismo , Regiões 3' não Traduzidas , Apoptose/genética , Pontos de Checagem do Ciclo Celular , Linhagem Celular Tumoral , Proliferação de Células/genética , Neoplasias Colorretais/patologia , Progressão da Doença , Regulação para Baixo , Fator de Transcrição E2F5/genética , Forminas , Genes Supressores de Tumor , Células HCT116 , Células HT29 , Humanos , MicroRNAs/genética , Proteínas/genética
14.
Zhonghua Xin Xue Guan Bing Za Zhi ; 42(11): 922-6, 2014 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-25620254

RESUMO

OBJECTIVE: To investigate the impact of pre-operative uric acid on acute kidney injury (AKI) after cardiac surgery in elderly patients. METHODS: Clinical data were collected from 936 elderly patients (age ≥ 60 years) undergoing cardiac surgery with cardiopulmonary bypass in Guangdong General Hospital between January 2005 and May 2011. The baseline serum creatinine was defined as the latest serum creatinine before surgery, and AKI was diagnosed according to RIFLE criteria. Patients were divided into three groups according to the sex-specific cutoff values of serum uric acid tertiles (group A: ≤ 384.65 µmol/L in men, and ≤ 354.00 µmol/L in women; group B:384.66-476.99 µmol/L in men and 354.01-437.96 µmol/L in women; group C: ≥ 477.00 µmol/L in men and ≥ 437.97 µmol/L in women). Multivariate logistic regression analysis was used to analyze the independent risk factors for AKI. RESULTS: Among 936 elderly patients, 576 cases (61.5%) developed AKI. Mean uric acid concentration was higher in AKI patients than in Non-AKI patients ( (436.6 ± 119.1) µmol/L vs. (398.0 ± 107.2) µmol/L, P < 0.001). The incidence of AKI was 56.1% (175/312) in group A, 56.3% (175/311) in group B, 72.2% (226/313) in group C (P < 0.001). Multiple logistic regression analysis showed that, after adjusted for age, gender, co-morbidities(hypertension, diabetes mellitus, cerebrovascular disease, chronic obstructive pulmonary disease), previous cardiac surgery, eGFR<60 ml×min(-1) ×1.73 m(-2), heart function ≥ 3 (NYHA), positive urine protein, combination of coronary artery bypass grafting and valvular surgery, cardiopulmonary bypass operation time, aortic cross-clamping time, pre-operative angiotensin converting enzyme inhibitor or angiotensin II receptor blockers and lipid-lowering drugs use, early postoperative angiotensin converting enzyme inhibitor or angiotensin II receptor blockers, diuretics and digoxin use, post-operation central venous pressure, risk of post operative AKI was significantly higher in group C than in group A (OR:1.897, 95%CI: 1.270-2.833, P = 0.002). CONCLUSION: Pre-operative elevated uric acid is an independent risk factor of AKI after cardiac surgery in elderly patients.


Assuntos
Injúria Renal Aguda/etiologia , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Ácido Úrico/sangue , Idoso , Antagonistas de Receptores de Angiotensina , Inibidores da Enzima Conversora de Angiotensina , Ponte Cardiopulmonar , Ponte de Artéria Coronária , Feminino , Humanos , Incidência , Testes de Função Renal , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Fatores de Risco
15.
Sci Rep ; 14(1): 9760, 2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38684847

RESUMO

Metallurgical dust and sludge are solid waste resources with recycling value. In recent years, rotary hearth furnace has become the most important means to treat metallurgical dust and sludge because of its wide range of raw materials and strong treatment capacity. In this study blast furnace ash and converter sludge were selected as the research objects, and high-quality metallized pellets were prepared based on the rotary hearth furnace process. The strength changed of pellets, the reduction process of iron oxides and the removal process of zinc during the roasting of pellets in rotary hearth furnace were studied. To explore the reasonable roasting condition for preparing metallized pellets in rotary hearth furnace. The optimum roasting temperature of the pellets was 1250℃ and the roasting time was 25 min. The compressive strength, metallization rate and dezincification rate of metallized pellets reached 1361N, 97.44% and 95.67%, respectively. The efficient resource utilization of various metallurgical dust and sludge is realized.

16.
ACS Omega ; 9(23): 24633-24642, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38882097

RESUMO

SrFe1-x Si x O3-δF y cathode materials (x = 0.05, 0.1, 0.15; y = 0, 0.1, 0.5) were prepared via a solid-state method. X-ray diffraction results show that the synthesized F doping samples were perovskite structure. X-ray photoelectron spectroscopy findings show that F- anions were doped into SrFe1-x Si x O3-δ. Transmission electron microscopy and energy-dispersive spectroscopy were performed to analyze the microstructure and element distribution in the materials, respectively. Double-layer composite cathode symmetric cells were prepared through a screen printing method. Scanning electron microscopy images revealed that the double-layer composite cathode adhered well to the electrolyte. The doping with F- can increase the coefficient of thermal expansion of SrFe1-x Si x O3-δ. The electrochemical impedance spectroscopy results indicate that the oxygen transport capacity of the SrFe0.95Si0.05O3-δ material can be improved by doping with F-, but such a method can decrease the oxygen transport capacity of SrFe0.9Si0.1O3-δ. At 800 °C, the peak power density of the single cell supported by an anode and SrFe0.9Si0.1O3-δF0.1 as the cathode reached 388.91 mW/cm2. Thus, the incorporation of F- into SrFe1-x Si x O3-δ cathode materials can improve their electrochemical performance and enable their application as cathode materials for solid-oxide fuel cells.

17.
RSC Adv ; 14(25): 17498-17506, 2024 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-38818363

RESUMO

Nowadays, the widespread concern over controlling CO2 emissions and mitigating the adverse effects of greenhouse gases on global climate has attracted significant attention. In this study, g-C3N4 was synthesized by thermopolymerizing urea. Subsequently, ZIF-8 was combined with g-C3N4 using an in situ deposition method, resulting in the fabrication of ZIF-8/g-C3N4 composite photocatalysts at various molar ratios. Effective incorporation of ZIF-8 into g-C3N4 suppressed the recombination of photogenerated electrons and holes, thereby enhancing CO2 capture capacity and preserving light absorption capabilities. The ZIF-8/g-C3N4 composite demonstrates excellent photocatalytic performance for CO2 reduction, where the optimized material exhibited a CO2 adsorption capacity 1.52 times that of pure g-C3N4 and increased the conversion of CO2 to CH4 by more than sevenfold. This study harnesses the superior CO2 adsorption properties of metal-organic frameworks to develop more efficient photocatalysts, enhancing CO2 conversion efficacy and offering insights for developing efficient photocatalysts that utilize CO2.

18.
RSC Adv ; 14(28): 19707-19717, 2024 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-38903670

RESUMO

In recent decades, environmental protection and energy issues have gained significant attention, and the development of efficient, environmentally friendly catalysts has become especially crucial for the advancement of photocatalytic technology. This study employs the sintering method to produce biochar. A hybrid photocatalyst for the degradation of RHB under visible light was prepared by loading varying proportions of biochar onto g-C3N4 using ultrasonic technology. Among them, 2% CGCD (2% biochar/g-C3N4) achieved a degradation rate of 91.3% for RHB after 30 minutes of visible light exposure, which was more than 25% higher than GCD (g-C3N4), and exhibited a higher photocurrent intensity and lower impedance value. The enhancement in photocatalytic activity is primarily attributed to the increased utilization efficiency of visible light and the electron transfer channel effect from a minor amount of biochar, effectively reducing the recombination of photo-generated charge carriers on the g-C3N4 surface, thereby significantly improving photocatalytic activity. The degradation of RHB is synergistically mediated by O2 -, h+ (photo-generated holes), and ˙OH. The free radical capture experiment indicates that O2 - and ˙OH are the primary active components, followed by h+.

19.
J Antimicrob Chemother ; 68(3): 573-6, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23221626

RESUMO

OBJECTIVES: We recently demonstrated that both 3-hydroxyphthalic anhydride (HP)- and maleic anhydride-modified chicken ovalbumin (OVA) could effectively inhibit HIV-1 infection. But because OVA may cause allergy in some human subjects, here we replaced OVA with human serum albumin (HSA) in designing a new anti-HIV-1 agent, HP-HSA, and then tested its anti-HIV-1 activity and cytotoxicity. METHODS: The in vitro anti-HIV-1 activities of HP-HSA were detected by measuring p24 production and luciferase activity. The cytotoxicities of HP-HSA on target cells and human vaginal and cervical epithelial cells and the effect of HP-HSA on human peripheral blood mononuclear cell (PBMC) proliferation were evaluated by XTT assay. The effect of HP-HSA on interferon-γ secretion by PBMCs was detected by enzyme-linked immunospot (ELISPOT) assay. RESULTS: We found that HP-HSA exhibited broad and potent antiviral activity against infection by the HIV-1 strains tested, including drug-resistant strains. HP-HSA displayed no or low cytotoxicity on human vaginal and cervical epithelial cells and the cells used for testing HIV-1 infectivity. In addition, HP-HSA had no significant effect on proliferation or interferon-γ secretion by normal or phytohaemagglutinin-stimulated human PBMCs. A time-of-addition assay indicated that HP-HSA was an HIV-1 entry inhibitor. CONCLUSIONS: Because of its broad and potent anti-HIV-1 activity, low cytotoxicity and low immunogenicity to humans, HP-HSA has great potential for further development as a microbicide to prevent the sexual transmission of HIV.


Assuntos
Anti-Infecciosos/farmacologia , Inibidores da Fusão de HIV/farmacologia , HIV-1/efeitos dos fármacos , Anidridos Ftálicos/farmacologia , Albumina Sérica/farmacologia , Internalização do Vírus/efeitos dos fármacos , Proliferação de Células , Células Cultivadas , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/virologia , Feminino , HIV-1/fisiologia , Humanos , Interferon gama/metabolismo , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/virologia , Albumina Sérica Humana
20.
J Gastroenterol Hepatol ; 28(6): 937-45, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23489041

RESUMO

BACKGROUND AND AIM: Endoscopic sphincterotomy (EST) alone and EST combined with balloon dilation (ESBD) are important endoscopic techniques for stone extraction. We were to conduct a meta-analysis to compare the efficacy and safety of ESBD and EST. METHODS: Meta-analysis was performed respectively on randomized controlled trials (RCTs) and nonrandomized studies comparing the efficacy and safety of ESBD and EST. RESULTS: The results of three RCTs showed that stone removal in first session (relative risk [RR] 1.01, 0.92-1.11, P=0.85) and the utility of endoscopic mechanical lithotripsy (EML) (RR 0.78, 0.49-1.23, P=0.29) were equivalent between ESBD and EST. ESBD has equivalent complications (RR 0.61, 0.17-2.25, P=0.46) and post-ERCP pancreatitis (Peto odds ratio [OR] 1.11, 0.37-3.35, P=0.86), but less bleeding (Peto OR 0.10, 0.03-0.30, P<0.0001). The analysis of six retrospective studies suggested higher initial success in stone removal (RR 1.11, 1.02-1.20, P=0.01) and less EML (RR 0.32, 0.22-0.46, P<0.00001) in ESBD group. Less complications (RR 0.60, 0.44-0.83, P=0.02) happened in ESBD group, but equivalent post-ERCP pancreatitis (Peto OR 0.65, 0.37-1.15, P=0.14) and bleeding (Peto OR 0.60, 0.29-1.26, P=0.18). For patients with stones ≥ 15 mm, ESBD required less EML (RR 0.35, 0.24-0.51, P<0.00001) and caused fewer complications (RR 0.67, 0.38-0.92, P=0.02). CONCLUSIONS: ESBD is feasible for the treatment of choledocholithiasis without increased risk of complications, causing less bleeding. However, it warrants more clinical trials to compare the efficacy and safety of ESBD and EST.


Assuntos
Coledocolitíase/terapia , Esfinterotomia Endoscópica , Ensaios Clínicos como Assunto , Terapia Combinada , Dilatação , Humanos , Estudos Retrospectivos
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