RESUMO
Exploring the clinical value of multiparametric magnetic resonance (Mp-MRI)-cognitive fusion method of targeted transperineal prostate puncture combined with rapid pathological diagnosis. Patients with suspected prostate cancer admitted to our hospital from 2022.01 to 2023.05 were selected as the study subjects, and Mp-MRI was performed and the suspected lesions were scored by the Prostate Imaging Reporting and Data System (PI-RADS). The enrolled patients were randomly divided into the transperineal prostate targeted puncture plus rapid pathology group (experimental group) and the transperineal prostate systematic combined targeted puncture plus conventional pathology group (control group), and the positive puncture rate, pathological findings, and complications were analyzed to compare the differences between the two groups. A total of 100 patients were enrolled, 53 in the experimental group [age 55-89 years, (73.17±7.79) years; tPSA 7.01-100 µg/L, mean 21.34 (12.38, 44.42) µg/L]and 47 in the control group [age 60-87 years, (71.96±7.07) years; tPSA 6.11-98.82 µg/L, mean 18.77 (9.04, 38.09) µg/L], and there was no significant difference between the two groups in the diagnostic positivity rate of overall PCa and clinically significant PCa (P>0.05); there was no significant difference in the highest Gleason score of pathological tissues between the two groups (P>0.05); the number of cases of medically induced sarcoid hematuria in the experimental group were significantly reduced compared with the control group (P<0.05). In terms of biopsy pain score (VAS), patients in the experimental group experienced less pain than those in the control group (P<0.05). The Mp-MRI-cognitive fusion method of transperineal targeted prostate puncture combined with rapid frozen section pathological examination can provide rapid and accurate pathological results, reduce the chance of post-puncture complications, and alleviate the pain caused by puncture sampling, which has high clinical value.
Assuntos
Próstata , Neoplasias da Próstata , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Imageamento por Ressonância Magnética , Punções , DorRESUMO
The surgical treatment of colorectal cancer will be more and more accurate and minimally invasive under the guidance of precision medicine. At the same time, it will derive and evolve non-surgical paths, such as immune checkpoint inhibitors and immune targeted therapy for microsatellite instability high/mismatch repair deficient colorectal cancer, and wait and watch path after neoadjuvant treatment for low advanced rectal cancer. Laparoscopic minimally invasive surgery for colorectal cancer will be gradually iterated by robots, which is the only way to intelligent surgery.
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Neoplasias Colorretais , Procedimentos Cirúrgicos Minimamente Invasivos , Humanos , Neoplasias Colorretais/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Laparoscopia/métodos , Medicina de Precisão , Instabilidade de Microssatélites , Procedimentos Cirúrgicos Robóticos/métodosRESUMO
Objective: To analyze the results of occupational health examinations of radiation workers in Shaanxi Province, and to provide basis and reference for effectively conduct occupational health monitoring. Methods: From April 2016 to January 2022, a questionnaire survey was conducted to collect the basic information on occupational health examinations of qualified radiation workers in Shaanxi Province from 2016 to 2021. Based on the abnormal rate of occupational health among radiation workers, 1018 people were randomly selected using a cluster stratified sampling method to analyze the occupational health examination results of different positions, types of work, gender, length of service, and exposure doses. Results: The chromosomal aberration rates of peripheral blood lymphocytes among radiation workers in Shaanxi Province from 2016 to 2021 were 0.26% (10/3876), 0.77% (27/3512), 0.16% (16/10153), 0.09% (13/14769), 0.10% (13/13399), and 0.12% (20/16671), respectively. The abnormal rates of thyroid ultrasound examination were 32.33% (150/464), 24.46% (649/2653), 55.24% (786/1423), 32.89% (888/2700), 35.69% (1475/4133), and 42.51% (1993/4688), respectively. There was a statistically significant difference in the abnormal rates among different years (P<0.05). The abnormal rate of renal function examination in male radiation workers was higher than that in females (P<0.05). Compared with non medical users, the abnormal rates of renal function, thyroid function, and blood routine examination in medical radiation workers were higher (P<0.05), and the abnormal rates of renal function, thyroid function, and blood routine examination in medical applications were higher than those in radiation diagnosis, nuclear medicine, and radiation therapy (P<0.05). The abnormal rates of electrocardiogram, chest X-ray, blood pressure, thyroid function, and blood routine increased with the length of service (P<0.05). The abnormal rates of blood pressure, liver function, kidney function, thyroid function, and blood routine examination increased with the exposure dose (P<0.05) . Conclusion: The occupational health status of radiation workers is not optimistic. Occupational health monitoring should be strengthened, especially interventional radiation diagnosis occupational health examination, as well as changes in the indicators of sensitive organs such as eye lens and thyroid, so as to ensure the health of radiation workers.
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Saúde Ocupacional , Feminino , Humanos , Masculino , Exame Físico , Pressão Sanguínea , Aberrações Cromossômicas , EletrocardiografiaRESUMO
PURPOSE: Obesity and a high body mass index (BMI) are considered as risk factors for abdominal wall hernia (AWH). However, anthropometric measures of body fat distribution (BFD) seem to be better indicators in the hernia field. This Mendelian randomization analysis aimed to generate more robust evidence for the impact of waist circumstance (WC), body, trunk, arm, and leg fat percentages (BFP, TFP, AFP, LFP) on AWH. METHODS: A univariable MR design was employed and the summary statistics allowing for assessment were obtained from the genome-wide association studies (GWASs). An inverse variance weighted (IVW) method was applied as the primary analysis, and the odds ratio value was used to evaluate the causal relationship between BFD and AWH. RESULTS: None of the MR-Egger regression intercepts deviated from null, indicating no evidence of horizontal pleiotropy (p > 0.05). The Cochran Q test showed heterogeneity between the genetic IVs for WC (p = 0.005; p = 0.005), TFP (p < 0.001; p < 0.001), AFP-L (p = 0.016; p = 0.015), LFP-R (p = 0.012; p = 0.009), and LFP-L (p < 0.001; p < 0.001). Taking the IVW random-effects model as gold standard, each standard deviation increment in genetically determined WC, BFP, TFP, AFP-R, AFP-L, LFP-R, and LFP-L raised the risk of AWH by 70.9%, 70.7%, 56.5%, 69.7%, 78.3%, 87.7%, and 72.5%, respectively. CONCLUSIONS: This study proves the causal relationship between AWH and BFD, attracting more attention from BMI to BFD. It provides evidence-based medical evidence that healthy figure management can prevent AWH.
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Estudo de Associação Genômica Ampla , Hérnia Ventral , Humanos , Análise da Randomização Mendeliana , alfa-Fetoproteínas , Herniorrafia , Distribuição da Gordura CorporalRESUMO
OBJECTIVE: This study explored the determinants of post-stroke depression (PSD) in ischemic stroke (AIS) patients and its association with the burden score of cerebral small vessel disease (CSVD). PATIENTS AND METHODS: We analyzed 374 AIS patients treated between January 2020 and January 2022. Patients were categorized into 90 with PSD and 284 without PSD, enabling an investigation into PSD risk factors and the CSVD-PSD relationship. RESULTS: There was no significant difference in health factors between PSD and non-PSD patients (p>0.05). However, significant disparities were noted in age, gender, initial Barthel Index (BI), Mini-Mental State Examination (MMSE) score, plasma fibrinogen, homocysteine, red cell distribution width, National Institutes of Health Stroke Scale (NIHSS) score, and CSVD burden score (p<0.05). Regression analysis indicated that these variables were pivotal PSD predictors (OR>1, p<0.05). Surprisingly, a positive correlation with PSD occurrence was found for age, NIHSS score, plasma fibrinogen, homocysteine levels, red cell distribution width, CSVD burden score (r=0.565, 0.615, 0.482, 0.514, 0.572, 0.608, respectively; p<0.05). Meanwhile, the MMSE score and BI index were inversely related to PSD onset (r=-0.604, -0.590; p<0.05). The ROC curve analysis of the combination model based on MMSE, NIHSS and CSVD score revealed an AUC of 0.926 and Youden's index of 0.744. CONCLUSIONS: Age, MMSE score, BI index, NIHSS score, plasma fibrinogen concentration, homocysteine level, red blood cell distribution width, and CSVD burden score are all major influencing factors in the occurrence of PSD. The combination model based on MMSE, NIHSS, and CSVD scores presented a valuable approach to predicting PSD.
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Doenças de Pequenos Vasos Cerebrais , AVC Isquêmico , Acidente Vascular Cerebral , Estados Unidos , Humanos , Depressão/diagnóstico , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/diagnóstico , Doenças de Pequenos Vasos Cerebrais/complicações , Fibrinogênio , HomocisteínaRESUMO
Curcumin, an extensively utilized natural pigment in the food industry, has attracted considerable attention due to its potential therapeutic effects, such as anti-tumorigenic and anti-inflammatory activities. The enzyme 17ß-Hydroxysteroid dehydrogenase 1 (17ß-HSD1) holds a crucial position in oestradiol production and exhibits significant involvement in oestrogen-responsive breast cancers and endometriosis. This study investigated the inhibitory effects of curcuminoids, metabolites, and analogues on 17ß-HSD1, a key enzyme in oestradiol synthesis. Screening 10 compounds, including demethoxycurcumin (IC50, 3.97 µM) and dihydrocurcumin (IC50, 5.84 µM), against human and rat 17ß-HSD1 revealed varying inhibitory potencies. These compounds suppressed oestradiol secretion in human BeWo cells at ≥ 5-10 µM. 3D-Quantitative structure-activity relationship (3D-QSAR) and molecular docking analyses elucidated the interaction mechanisms. Docking studies and Gromacs simulations suggested competitive or mixed binding to the steroid or NADPH/steroid binding sites of 17ß-HSD1. Predictive 3D-QSAR models highlighted the importance of hydrophobic regions and hydrogen bonding in inhibiting 17ß-HSD1 activity. In conclusion, this study provides valuable insights into the inhibitory effects and mode of action of curcuminoids, metabolites, and analogues on 17ß-HSD1, which may have implications in the field of hormone-related disorders.
Assuntos
17-Hidroxiesteroide Desidrogenases , Curcumina , Simulação de Acoplamento Molecular , Relação Quantitativa Estrutura-Atividade , Humanos , Ratos , Animais , Curcumina/análogos & derivados , Curcumina/farmacologia , Curcumina/química , 17-Hidroxiesteroide Desidrogenases/antagonistas & inibidores , 17-Hidroxiesteroide Desidrogenases/metabolismo , Estradiol/análogos & derivados , Estradiol/química , Estradiol/farmacologia , Estradiol/metabolismo , Inibidores Enzimáticos/farmacologia , Inibidores Enzimáticos/químicaRESUMO
La enfermedad COVID-19, causada por el coronavirus SARS-CoV-2, se ha extendido por todo el mundo. Se puede manifestar desde una forma asintomática hasta llegar a desarrollar un síndrome de distrés respiratorio agudo (SDRA). En este artículo se abordan aspectos relacionados con los factores de riesgo y las comorbilidades de los pacientes con COVID-19, así como el papel de las principales enfermedades respiratorias crónicas en su desarrollo y evolución, incluyendo la enfermedad pulmonar obstructiva crónica (EPOC), el asma y las enfermedades pulmonares intersticiales difusas (EPID). Las comorbilidades más prevalentes en los pacientes con COVID-19 son la hipertensión arterial (HTA), la diabetes mellitus (DM) y las enfermedades cardiovasculares. Además, se ha evidenciado que tanto el sobrepeso como la obesidad predisponen a la gravedad de la enfermedad COVID-19. Con respecto a las enfermedades respiratorias crónicas, parece que su prevalencia en pacientes con COVID-19 es inferior a la esperada
COVID-19 disease, caused by the SARS-CoV-2 coronavirus, has spread throughout the world. It can manifest from an asymptomatic form to the development of acute respiratory distress syndrome (ARDS). This article addresses aspects related to risk factors and comorbidities in patients with COVID-19, as well as the role of the main chronic respiratory diseases in their development and evolution, including chronic obstructive pulmonary disease (COPD), asthma and diffuse interstitial lung diseases (ILD). The most prevalent comorbidities in patients with COVID-19 are arterial hypertension (HTN), diabetes mellitus (DM) and cardiovascular diseases. In addition, it has been shown that both overweight and obesity predispose to the severity of the COVID-19 disease. With regard to chronic respiratory diseases, it seems that their prevalence in patients with COVID-19 is lower than expected
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Humanos , Infecções por Coronavirus/complicações , Pneumonia Viral/epidemiologia , Pandemias , Doenças Respiratórias/epidemiologia , Doença Crônica/classificação , Doença Crônica/epidemiologia , Asma/epidemiologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doenças Pulmonares Intersticiais/epidemiologia , Fatores de Risco , Comorbidade , Índice de Gravidade de DoençaRESUMO
Presentamos el caso de una mujer puérpera de 34 años, sin antecedentes de interés, que fue estudiada por un cuadro de fiebre y palpitaciones, con un posible síndrome constitucional asociado. En el estudio se detectó un derrame pericárdico masivo, que requirió la realización de ventana pleuropericárdica, y una masa pulmonar. El estudio anatomopatológico de la biopsia aguja gruesa de dicha masa proporcionó el diagnóstico de linfoma de Hodgkin (LH), por lo que se instauró tratamiento con quimioterápico tras completar el estudio de extensión. Hasta el momento actual se han descrito pocos casos similares en la literatura médica, ninguno en nuestro país. No obstante, a pesar de tratarse de una manifestación torácica poco frecuente, con este trabajo queremos resaltar la importancia de contemplar el LH en el diagnóstico diferencial de las masas pulmonares con derrame pericárdico asociado, pues se trata de una entidad curable que requiere de un diagnóstico precoz
We present the case of a 34-year-old puerperal woman, with no history of interest, who was studied for a fever and palpitations picture, with a possible associated constitutional syndrome. The study detected a massive pericardial effusion, which required a pleuropericardial window, and a pulmonary mass. The pathologic study of the thick needle biopsy of this mass provided the diagnosis of Hodgkin's lymphoma (HL), and therefore chemotherapy treatment was initiated after completing the extension study. To date, few similar cases have been described in the medical literature, none in our country. However, despite being a rare thoracic manifestation, with this work we want to highlight the importance of contemplating HL in the differential diagnosis of pulmonary masses with associated pericardial effusion, since it is a curable entity that requires an early diagnosis