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Two-dimensional materials have been considered as novel anode materials for LIBs because of their large surface area, small volume change, and low Li diffusion barrier. Among them, the two-dimensional material SixGey has many excellent properties as an anode. However, Ge is expensive and not suitable for mass production. Therefore, proper Ge doping is of great significance to improve performance and reduce cost. Herein, we systematically study the effect of Ge doping and its concentration on the structure and electrochemical performance of two-dimensional SixGey by density functional theory (DFT) calculations. The incorporation of low concentration Ge can improve the horizontal and vertical diffusion ability of Li atoms compared to silicene. However, excessive Ge will increase the horizontal diffusion energy barrier of Li and reduce the theoretical capacity, where Si6Ge2 has a relatively high theoretical capacity and a low diffusion energy barrier. In addition, fully lithiated 2D SixGey shows poor electrical conductivity and increasing Ge concentration seems to be effective in improving the electrical conductivity of the material. This study will provide significant theoretical guidance for the design and preparation of two-dimensional silicon-based materials.
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BACKGROUND: Airway fistula is a rare but threatening complication associated with high rates of morbidity and mortality. We report the experience of Amplatzer device application in airway fistulae that failed to be cured with a covered self-expandable metallic stent (SEMS). MATERIALS AND METHODS: Patients who failed occlusion with a covered self-expandable metallic stent and received Amplatzer device placement from Jan 2015 to Jan 2020 were retrospectively enrolled. A total of 14 patients aged 42 to 66 years (55.14 ± 7.87) were enrolled in this study. The primary diseases, types of fistula, types of stents, duration, size of fistula, and follow-up were recorded. RESULTS: All 14 patients with airway fistula failed to be occluded with a covered metallic stent and received Amplatzer device placement. Among the 14 patients, 6 had BPF, 3 had TEF and 5 had GBF. The average stent time was 141.93 ± 65.83 days. The sizes of the fistulae ranged from 3 to 6 mm. After Amplatzer device placement, the KPS score improved from 62.14 ± 4.26 to 75.71 ± 5.13 (P < 0.05). No procedure-related complications occurred. During the 1-month, 3-month and 6-month follow-ups, all the Amplatzer devices were partially surrounded with granulation. Only 1 patient with BPF failed with Amplatzer device occlusion due to the recurrence of lung cancer. CONCLUSION: In conclusion, the application of the Amplatzer device is a safe and effective option in the treatment of airway fistula that failed to be occluded with SEMSs.
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Fístula , Stents Metálicos Autoexpansíveis , Humanos , Estudos Retrospectivos , Resultado do Tratamento , StentsRESUMO
Two-dimensional silicon-based material siligene (SiGe) has a low diffusion barrier and high theoretical specific capacity, but the conductivity drops sharply after being fully lithiated. To improve their electrical conductivity, the three heterostructures (SV-G/S, DV-G/S, and SW-G/S) formed with defective graphene and SiGe were proposed and the feasibility of them as anode materials was analyzed systematically. Based on density functional theory, the structural properties of defective graphene/SiGe heterostructures (Def-G/S), the adsorption and diffusion behaviours of Li, the voltage and theoretical capacity, and electrical conductivity during the lithiation process were investigated. The results show that defective graphene can form a stable heterostructure with SiGe and the heterostructure with defects can accommodate more Li atoms. The good adsorption and low diffusion energy barrier ensure the capacity, cycling, and safety performance of Def-G/S as anode materials. Moreover, Def-G/S significantly improves the conductivity of pristine 2D SiGe after full lithiation. These excellent properties indicate that Def-G/S has great potential as an anode material for Li-ion batteries.
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AIM: To evaluate the safety and efficacy of balloon occlusion at the Zone II aorta for the management of morbidly adherent placenta. METHODS: From September 2015 to October 2018, a total of 80 consecutive patients who were prenatally diagnosed with morbidly adherent placenta were assigned into two groups: the balloon occlusion group (n = 40) and the non-balloon occlusion group (n = 40).The intraoperative estimated blood loss, blood transfusion, urine output, serum creatinine, blood urea nitrogen and hysterectomy rate were recorded and compared between the two groups. RESULTS: The estimated blood loss in the balloon occlusion group was significantly lower than that in the non-balloon occlusion group (811.75 ± 299.93 ml vs 1529.75 ± 808.01 ml, P < 0.001). The median amount of packed RBCs transfused in the balloon occlusion group and non-balloon occlusion group was 0 U and 2 U, respectively (P = 0.001). The women in the former group had a lower blood transfusion rate than those in the latter group (30% vs 57.5%, P = 0.013). Hysterectomy occurred in none in the balloon occlusion group but in six patients in the non-balloon occlusion group (P = 0.011). CONCLUSION: The middle abdominal aorta (Zone II) is not a forbidden zone for occlusion as long as the single occlusion time is limited to 15 min. Balloon occlusion at the Zone II aorta can effectively reduce blood loss, transfusion requirements and hysterectomy rates in patients with morbidly adherent placenta.
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Placenta Acreta , Doenças Placentárias , Placenta Prévia , Hemorragia Pós-Parto , Aorta Abdominal , Perda Sanguínea Cirúrgica/prevenção & controle , Cesárea , Feminino , Humanos , Histerectomia , Placenta , Placenta Acreta/cirurgia , Doenças Placentárias/cirurgia , Placenta Prévia/cirurgia , Hemorragia Pós-Parto/cirurgia , Gravidez , Estudos RetrospectivosRESUMO
OBJECTIVE: To evaluate the feasibility and safety of using cone-beam CT (CBCT) to measure changes in parenchymal blood volume (PBV) of patients with hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) and to guide microwave ablation (MWA) for residual tumors. METHODS: A retrospective study was performed on 42 patients with HCC who completed TACE and received CBCT-guided perfusion imaging. The residual active lesions after TACE were supplemented with MWA to complete the treatment process according to the residual PBV. The outcomes were analyzed, including PBV changes, interventional-related complications, local tumor progression (LTP) and overall survival (OS). RESULTS: Technical success was achieved in all lesions. Correlation analysis revealed that greater volume of residual PBV after MWA is negatively correlated with LTP. (p = .000); and the decrease of PBV was positively correlated with LTP (p = .000). All adverse events and complications were CTCAE Grade 1/2. After combination treatment, the 1-, 3-, and 5-year LTP-free survival were 97.6%, 69.0% and 15.1%, respectively, with a median LTP of 49.0 months (95% CI:43.129,54.871). Multivariate Cox regression revealed that the residual PBV > 13 ml/1000 was an independent factor predicting a shorter OS and LTP (Both p< .05). For LTP, multivariate Cox regression showed that a tumor in a single lesion were independently predicted to have a longer LTP in patients with HCC (p = .033). CONCLUSION: CBCT is feasible and safe to use to measure changes in the PBV before and after TACE treatment, while it can also guide MWA for the treatment of residual tumors in one session.
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Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/terapia , Tomografia Computadorizada de Feixe Cônico , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Perfusão , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Low-level laser (LLL) irradiation has been reported to promote neuronal differentiation, but the mechanism remains unclear. Brain-derived neurotrophic factor (BDNF) has been confirmed to be one of the most important neurotrophic factors because it is critical for the differentiation and survival of neurons during development. Thus, this study aimed to investigate the effects of LLL irradiation on Bdnf messenger RNA (mRNA) transcription and the molecular pathway involved in LLL-induced Bdnf mRNA transcription in cultured dorsal root ganglion neurons (DRGNs) using Ca2+ imaging, pharmacological detections, RNA interference, immunocytochemistry assay, Western blot, and qPCR analysis. We show here that LLL induced increases in the [Ca2+] i level, Bdnf mRNA transcription, cAMP-response element-binding protein (CREB) phosphorylation, and extracellular signal-regulated kinase (ERK) phosphorylation, mediated by Ca2+ release via inositol triphosphate receptor (IP3R)-sensitive calcium (Ca2+) stores. Blockade of Ca2+ increase suppressed Bdnf mRNA transcription, CREB phosphorylation, and ERK phosphorylation. Downregulation of phosphorylated (p)-CREB reduced Bdnf mRNA transcription triggered by LLL. Furthermore, blockade of ERK using PD98059 inhibitor reduced p-CREB and Bdnf mRNA transcription induced by LLL. Taken together, these findings establish the Ca2+-ERK-CREB cascade as a potential signaling pathway involved in LLL-induced Bdnf mRNA transcription. To our knowledge, this is the first report of the mechanisms of Ca2+-dependent Bdnf mRNA transcription triggered by LLL. These findings may help further explore the complex molecular signaling networks in LLL-triggered nerve regeneration in vivo and may also provide experimental evidence for the development of LLL for clinical applications.
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Fator Neurotrófico Derivado do Encéfalo/metabolismo , Cálcio/metabolismo , Proteína de Ligação ao Elemento de Resposta ao AMP Cíclico/metabolismo , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Terapia com Luz de Baixa Intensidade , Transdução de Sinais/efeitos da radiação , Transcrição Gênica , Animais , Fator Neurotrófico Derivado do Encéfalo/genética , Sobrevivência Celular/efeitos da radiação , Células Cultivadas , Ativação Enzimática/efeitos da radiação , Inositol 1,4,5-Trifosfato/metabolismo , Modelos Biológicos , Neurogênese/efeitos da radiação , Neurônios/citologia , Neurônios/efeitos da radiação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Ratos Sprague-Dawley , Transcrição Gênica/efeitos da radiaçãoRESUMO
It has been reported that electrical stimulation (ES) can promote nerve regeneration. One of the key factors leading to the promotion is calcium, which plays a vital role in the regulation on electrical activity of neurons, but the detailed mechanism is still an open question. In this study, ES was used to stimulate cultured dorsal root ganglion neurons (DRGNs) and we've found that ES could greatly promote neurite outgrowth, and calcium signaling was involved in the ES-induced neurite extension in our research. Detailed pharmacological tests indicated that ES-induced elevation of intracellular free calcium concentration ([Ca(2+)] i ) in DRGNs was realized predominately via calcium influx and calcium mobilization, both of which contributed to enhancing neurite outgrowth promoted by ES. Additionally, a calcium-triggered c-fos and brain-derived neurotrophic factor (BDNF) transcription and/or translation were discovered during the ES-induced neurite outgrowth of cultured DRGNs. To our knowledge, this is the first case of detailed snapshots of studying calcium-dependent neurite outgrowth and BDNF and c-fos expressions in DRGNs induced by ES, which may provide experimental evidence for applying ES to promote regeneration of injured nerves and to enhance synthesis of c-fos and BDNF in neurons, and may also help explore the complex molecular cascades underlying the progressive pathophysiological changes in the ES-induced nerve regeneration in future.
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Cálcio/fisiologia , Gânglios Espinais/fisiologia , Regeneração Nervosa/fisiologia , Neuritos/fisiologia , Animais , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Sinalização do Cálcio/fisiologia , Células Cultivadas , Estimulação Elétrica , Genes Precoces , Neurônios/fisiologia , Proteínas Proto-Oncogênicas c-fos/metabolismo , RatosAssuntos
Oclusão com Balão , Placenta Acreta , Placenta Prévia , Aorta Abdominal , Feminino , Humanos , Artéria Ilíaca , Placenta , GravidezRESUMO
Neurofibrillary tangles are aggregates of hyperphosphorylated tau that are one of the pathological hallmarks of Alzheimer's disease (AD). Tau phosphorylation is regulated by a balance of kinase and phosphatase activities. Our previous study has demonstrated that ginsenoside Rd, one of the principal active ingredients of Pana notoginseng, inhibits okadaic acid-induced tau phosphorylation in vivo and in vitro, but the underlying mechanism(s) is unknown. In this study, we showed that ginsenoside Rd pretreatment inhibited tau phosphorylation at multiple sites in beta-amyloid (Aß)-treated cultured cortical neurons, and in vivo in both a rat and transgenic mouse model. Ginsenoside Rd not only reduced Aß-induced increased expression of glycogen synthase kinase 3beta (GSK-3ß), the most important kinase involved in tau phosphorylation, but also inhibited its activity by enhancing and attenuating its phosphorylation at Ser9 and Tyr216, respectively. Moreover, ginsenoside Rd enhanced the activity of protein phosphatase 2A (PP-2A), a key phosphatase involved in tau dephosphorylation. Finally, an in vitro biochemical assay revealed that ginsenoside Rd directly affected GSK-3ß and PP-2A activities. Thus, our findings provide the first evidence that ginsenoside Rd attenuates Aß-induced pathological tau phosphorylation by altering the functional balance of GSK-3ß and PP-2A.
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Doença de Alzheimer/metabolismo , Ginsenosídeos/farmacologia , Quinase 3 da Glicogênio Sintase/metabolismo , Neurônios/efeitos dos fármacos , Proteína Fosfatase 2/metabolismo , Proteínas tau/metabolismo , Doença de Alzheimer/patologia , Peptídeos beta-Amiloides/metabolismo , Animais , Western Blotting , Modelos Animais de Doenças , Glicogênio Sintase Quinase 3 beta , Masculino , Camundongos , Camundongos Transgênicos , Neurônios/metabolismo , Neurônios/patologia , Fosforilação , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
Objective: Cervical artery dissection (CAD) is one of the major causes of stroke and most commonly occurs at the site of the extracranial internal carotid artery (ICA). This study aimed to assess the value of routine brain MRI, clinical information, and high-resolution, multi-contrast vessel wall MR imaging (hrVWI) for the timely detection of ICA dissection. Methods: A total of 105 patients with CAD and 105 without CAD were recruited for this study. The lesion type in the patients was determined based on images from different modalities, including brain MRI, magnetic resonance angiography (MRA), computed tomography angiography (CTA), digital subtraction angiography (DSA), ultrasonography, and hrVWI and clinical information. Each lesion was reviewed to determine the type following a stepwise procedure by referring to (1) brain MRI only; (2) brain MRI and clinical information; (3) hrVWI only; and (4) hrVWI, CTA, DSA, and clinical information. Results: Typical clinical presentations of patients with potential CAD include headache, neck pain, and/or Horner's syndrome. Representative imaging signs in the brain MRI included a crescentic or circular iso- or hyperintensity around the lumen, a curvilinear and isointense line crossing the lumen, or aneurysmal vessel dilation. Based on brain MRI alone, 54.3% (57/105) of the patients with CAD were correctly classified, and the accuracy increased to 73.3% (77/105) when clinical information was combined (P < 0.001) with high specificity and low sensitivity. Further analysis showed that hrVWI had the superior capability in detecting CAD, with a sensitivity and a specificity of 95.1% and 97.0%, respectively. Conclusion: The combination of brain MRI and clinical information could be used for the diagnosis of CAD; however, hrVWI should be sought for uncertain cases.
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Alzheimer's disease is a neurodegenerative disease characterized by the production of ß-amyloid proteins and hyperphosphorylation of tau protein. Inflammation and apoptotic severity were highly correlated with earlier age at onset of Alzheimer's disease and were also associated with cognitive decline. This study aims to examine whether the traditional Chinese medicine ginsennoside Rd could prevent cognitive deficit and take neuroprotective effects in ß-amyloid peptide 1-40-induced rat model of Alzheimer's disease. To produce Alzheimer's disease animal model, aggregated ß-amyloid peptide 1-40 injected into hippocampus bilaterally. Ginsennoside Rd protected their cognitive impairment and improved their memory function by daily intraperitoneal injection for 30 days consecutively. In addition, ginsennoside Rd alleviated the inflammation induced by ß-amyloid peptide 1-40. Furthermore, ginsennoside Rd played a role in the down-regulation of caspase-3 proteins and reduced the apoptosis that normally followed ß-amyloid peptide 1-40 injection. The results of this study showed that the pretreatment of ginsennoside Rd had neuroprotective effects in ß-amyloid peptide 1-40-induced AD model rat.
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Doença de Alzheimer/tratamento farmacológico , Transtornos Cognitivos/tratamento farmacológico , Modelos Animais de Doenças , Ginsenosídeos/uso terapêutico , Animais , Primers do DNA , Imuno-Histoquímica , Masculino , Aprendizagem em Labirinto , Estresse Oxidativo , Ratos , Ratos Sprague-Dawley , Reação em Cadeia da Polimerase em Tempo RealRESUMO
PURPOSE: The purpose of this study was to evaluate the effects of increasing zone II resuscitative endovascular balloon occlusion of the aorta (REBOA) occlusion times on physiological, end-organ and inflammatory responses in rabbits to assess the safe aortic occlusion time in a normovolemic rabbit model. METHODS: The zone ll aorta was occluded with a balloon in 32 rabbits (8 animals each for 15, 30, 60, and 90 min). 8 rabbits served as a control. ELISAs were used to examine the serum levels of ALT, AST, Cr, BUN, MDA, SOD, IL-8, IL-6, and TNF-α; HE staining was used to identify the morphological changes in the kidney; RT-PCR was used to detect the mRNA levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus; and Western blotting was used to measure the protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus. RESULTS: Plasma concentrations of liver markers, kidney markers, inflammatory factors and oxidative stress indicators were significantly increased at the end of reperfusion in the 30 min, 60 min and 90 min groups. Damage to the kidney occurred in the 30 min, 60 min and 90 min groups. The mRNA and protein expression levels of IL-6, IL-8, TNF-α and NF-κB in the kidney and uterus were significantly increased at the end of reperfusion in the 30 min group, and as the time of occlusion extended, these levels continued to increase. CONCLUSION: Activation of systemic inflammation and ischaemia-reperfusion injury of end-organs occurred when the occlusion time reached 30 min. Therefore, 15 min should be regarded as a safe period of REBOA in zone II.
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Choque Hemorrágico , Animais , Modelos Animais de Doenças , Feminino , Humanos , Interleucina-6 , Interleucina-8 , NF-kappa B , RNA Mensageiro , Coelhos , Artéria Renal , Fator de Necrose Tumoral alfaRESUMO
PURPOSE: To assess the clinical value of drug-eluting bead trans-arterial chemoembolization (DEB-TACE) combined with microwave ablation (MWA) vs. MWA treatment alone for early stage hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Consecutive data from 102 HCC patients at early stage who were referred to our hospital from December 2014 to May 2016 were retrospectively collected. Forty-seven patients underwent DEB-TACE combined with MWA treatment, whereas 55 patients underwent MWA alone. After 1 month of treatment, the tumour responses of the patients were assessed using the mRECIST criteria. Treatment-related complications and hepatic function were also analysed for the two groups. In addition, overall survival (OS) and progression-free survival (PFS) were calculated and compared. RESULTS: Patients in the combined treatment group (DEB-TACE combined with MWA) presented a better objective response rate (ORR) and disease control rate (DCR) compared with those in the monotherapy group (MWA treatment). The median OS and PFS were longer in the combined treatment group compared with the monotherapy group. Multivariate Cox's regression further illustrated that DEB-TACE + MWA vs. MWA was an independent protective factor for PFS and OS. No serious treatment-related complications were observed in any of the patients. CONCLUSION: Combined treatment with DEB-TACE appeared to have advantages in prolonging OS and PFS compared to MWA. Therefore, combined treatment was efficient and should be strongly recommended to early stage HCC patients.
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Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Carcinoma Hepatocelular/patologia , Humanos , Neoplasias Hepáticas/patologia , Micro-Ondas/uso terapêutico , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Background: Angiographic computed tomography (CT) is useful in various medical contexts, but little research has been presented regarding the application of cone beam CT (CBCT) in airway stenting. This study set out to evaluate the clinical feasibility of using CBCT in airway stent placement in a single-center retrospective cohort. Methods: A total of 228 patients with stenosis or fistula diseases were treated with metallic airway stents in the First Affiliated Hospital of Zhengzhou University from January 1, 2015, to December 31, 2018. Of them, 128 patients underwent fluoroscopy-guided airway stenting. CBCT scanning was performed on the other 100 patients during and after treatment, and their images were compared with those from postoperative multidetector CT (MDCT). The outcomes and complications in the CBCT-guided and fluoroscopy-guided groups were also assessed via Pearson's χ2 test or Fisher's exact test. Results: Tracheal stenting was performed successfully on the first attempt for 90 patients in the CBCT-guided group and 123 patients in the fluoroscopy-guided group. The mean measured diameters of the central airway in the CBCT images and MDCT images were 18.2±2.81 and 19.0±2.33 mm, respectively, and the mean lengths were 58.7±16.82 and 58.5±17.06 mm, respectively. In the CBCT-guided group and the fluoroscopy-guided group, the mean scores for visibility of the distal bronchus were 3.7±0.49 and 3.9±0.34, respectively; the mean scores for the pulmonary parenchyma were 3.3±0.71 and 3.9±0.31, respectively; and the mean scores for the airway above the upper stent graft were 1.8±0.41 and 4.0±0.20, respectively. Two of the three anatomical areas were reproduced in a diagnostically relevant way. The major complications rate was 7% and 19% in the CBCT-guided and fluoroscopy-guided groups, respectively. Conclusions: CBCT produces images with sufficient quality to replace MDCT as a reasonable control measure after stent implantation, and its use during surgery reduces complications relating to airway stent placement.
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OBJECTIVE: To investigate the expression and prognostic significance of EphA2 and EphrinA-1 in ovarian serous carcinomas. METHODS: Ninety five tumors from the patients with ovarian serous carcinomas and 2 ovarian cancer cell lines were recruited. The expressions of EphA2 and EphrinA-1 were examined by means of immunohistochemistry. The relationships among protein expression and clinicopathological features, survival of patients were analyzed. The mRNA and protein expressions of EphA2 and EphrinA-1 in ovarian cancer cell lines were measured with semiquantitative polymerase chain reaction and western blotting. RESULTS: The protein expressions of EphA2 and EphrinA-1 in tumor were 92.6% (88/95)and 97.9% (93/95) respectively, while were 40%(8/20) and 30% (6/20) in adjacent ovarian tissue (P = 0.000). EphA2 immunohistochemical staining could be observed in both tumour and vascular endothelial cells, and EphrinA-1 mainly localized in the tumor cells. The expression of EphA2 was significantly associated with the expression of EphrinA-1 (r = 0.98, P = 0.02). There was no significant correlation between the expressions of EphA2/EphrinA-1 and age, FIGO stage, residual tumour size and histological grade. High levels of both EphA2 and EphrinA-1 protein expression were significantly associated with a shorter overall survival in multivariate analysis (P < 0.05). High levels of EphA2 and EphrinA-1 mRNA and protein were detected in OVCAR3 and SKOV3 cell lines. CONCLUSION: There are over-expression of EphA2 and EphrinA-1 in ovarian serous carcinomas and ovarian cancer cell lines. Tumours with higher expression levels of both EphA2 and EphrinA-1 significantly associated with poorer clinical outcome.
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Cistadenocarcinoma Seroso/metabolismo , Neoplasias Ovarianas/metabolismo , Receptor EphA1/metabolismo , Receptor EphA2/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptor EphA1/genética , Receptor EphA2/genéticaRESUMO
In view of the challenges of the group Lasso penalty methods for multicancer microarray data analysis, e.g., dividing genes into groups in advance and biological interpretability, we propose a robust adaptive multinomial regression with sparse group Lasso penalty (RAMRSGL) model. By adopting the overlapping clustering strategy, affinity propagation clustering is employed to obtain each cancer gene subtype, which explores the group structure of each cancer subtype and merges the groups of all subtypes. In addition, the data-driven weights based on noise are added to the sparse group Lasso penalty, combining with the multinomial log-likelihood function to perform multiclassification and adaptive group gene selection simultaneously. The experimental results on acute leukemia data verify the effectiveness of the proposed method.
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Algoritmos , Neoplasias/classificação , Neoplasias/genética , Análise por Conglomerados , Biologia Computacional , Bases de Dados Genéticas/estatística & dados numéricos , Humanos , Leucemia/classificação , Leucemia/genética , Funções Verossimilhança , Modelos Genéticos , Família Multigênica , Análise de Sequência com Séries de Oligonucleotídeos/estatística & dados numéricos , Oncogenes , Análise de RegressãoRESUMO
OBJECTIVE: To compare the safety and efficacy of prophylactic balloon occlusion of the abdominal aorta (PBOA) performed at the level of the renal artery (PBOA-ARA) or below this level (PBOA-BRA) for the management of placenta accreta. METHODS: We conducted a retrospective investigation of 57 women scheduled for cesarean delivery who underwent PBOA at our hospital between October 2015 and July 2017. The balloon occlusion was performed at (PBOA-ARA group; n = 30) or below (PBOA-BRA group; n = 27) the renal artery origin. The perioperative data of the two groups were compared. RESULTS: Estimated blood loss was lower in the PBOA-ARA group than in the PBOA-BRA group (p > .05). There were no intergroup differences in intraoperative blood transfusion volume, hemoglobin reduction, urine output, and serum levels of creatinine and blood urea nitrogen. Postballoon release hemorrhage occurred in eight patients of the PBOA-BRA group, but in none of the PBOA-ARA group, indicating a significant difference (p = .007). Subgroup analysis of placenta types revealed that the estimated blood loss among women with placenta increta in the PBOA-ARA group was less than that in the PBOA-BRA group (p = .015), which was reflected by a significant difference in the reduction of hemoglobin levels (p = .042). CONCLUSIONS: PBOA at the level of the renal artery entailed lesser blood loss than that performed below the renal artery origin, particularly in the case of placenta increta; this, in turn, reduces the risk of postpartum hemorrhage from ovarian arteries and subsequent blockade of the ovarian artery origin.
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Oclusão com Balão , Placenta Acreta , Hemorragia Pós-Parto , Aorta Abdominal/cirurgia , Perda Sanguínea Cirúrgica/prevenção & controle , Cesárea/efeitos adversos , Feminino , Humanos , Histerectomia , Placenta Acreta/cirurgia , Hemorragia Pós-Parto/etiologia , Hemorragia Pós-Parto/prevenção & controle , Hemorragia Pós-Parto/cirurgia , Gravidez , Artéria Renal , Estudos RetrospectivosRESUMO
PURPOSE: CalliSpheres® microspheres (CSM) are the first drug-eluting beads (DEB) developed in China. This study aimed to compare treatment response, survival, and safety profiles between DEB transarterial chemoembolization (DEB-TACE) with CSM and conventional TACE (cTACE) in huge hepatocellular carcinoma (HCC) patients. METHODS: A total of 71 patients with huge HCC who underwent DEB-TACE or cTACE were consecutively enrolled in this retrospective cohort study. Treatment response was assessed at first month (M1), third month (M3), and sixth month (M6) after TACE therapy; progression-free survival (PFS) and overall survival (OS) were evaluated; liver function indexes were recorded before TACE operation (M0), at first week (W1), M1 and M6 after TACE therapy; adverse events which occurred after TACE operation were recorded. RESULTS: DEB-TACE presented with higher objective response rate (60.0% vs. 29.7%, p < 0.05) and disease control rate (86.7% vs. 59.4%, p < 0.05) compared with cTACE at M3. Regarding survival profiles, PFS [median: 3.3 months (95% CI: 2.8-3.7) vs. 2.1 months (95% CI: 1.7-2.5)] as well as OS [median: 7.8 months (95% CI: 4.6-11.0) vs. 5.7 months (95% CI: 5.0-6.3)] were longer in DEB-TACE group compared with cTACE group (both p < 0.01). Multivariate Cox's regression further illustrated that DEB-TACE vs. cTACE was an independent protective factor for PFS and OS (both p < 0.01). As for safety profiles, patients' liver function injury was reduced in the DEB-TACE group compared with the cTACE group. The incidence of fever was lower, and CINV was less severe in the DEB-TACE group compared with the cTACE group (both p < 0.05), while no difference in occurrence of liver abscess, increase of ascites, or moderate pain between two groups was observed. CONCLUSION: DEB-TACE with CSM presents with better treatment response, survival profiles, as well as safety profiles compared with cTACE in treatment for huge HCC patients.
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Aim: The aim of this study is to determine the efficacy and safety of the combination therapy of drug-eluting bead bronchial arterial chemoembolization plus anlotinib oral administration in the treatment of non-small-cell lung cancer (NSCLC). Methods: Consecutive data from 51 patients with advanced NSCLC were retrospectively collected from February 2018 to August 2019. All patients underwent drug-eluting bead bronchial arterial chemoembolization (DEB-BACE) followed by anlotinib treatment. Overall survival (OS) and progression-free survival (PFS) were calculated and analyzed using the Kaplan-Meier method and log-rank test, and factors associated with OS and PFS were assessed by a Cox proportional hazards test. Treatment response at 30 days was assessed by enhanced computed tomography (CT), and then the objective response rate (ORR) and disease control rate (DCR) were calculated. Treatment-related adverse events (TRAEs) were also evaluated. Results: The median OS was 18.4 months (95% CI, 16.6-20.2 months), and the median PFS was 8.4 months (95% CI, 6.2-10.6 months). The ORR and DCR for the whole cohort were 21.6 and 100%, respectively, at 30 days after the first cycle of treatment. Most of the treatment-related adverse reactions were mild and moderate and included anorexia, hypertension, fatigue, and hand-foot syndrome. Only eight (15.7%) patients developed grade 3 TRAEs. No deaths or other serious adverse reactions occurred. Both TNM stage and brain metastasis were independent risk factors for OS and PFS. Conclusion: DEB-BACE concomitant with anlotinib has promising efficacy and tolerable toxicity in patients with advanced NSCLC.