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BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) is a devastating form of stroke with high morbidity, disability and mortality. Helicobacter pylori is a major pathogen responsible for chronic gastritis, leading to gastric ulcers and ultimately gastric cancer. Although it remains controversial whether H. pylori infection causes peptic ulcers under various traumatic stimuli, some related studies suggest that H. pylori infection may be an important factor in delaying peptic ulcer healing. However, the linking mechanism between ICH and H. pylori infection remain unclear. The purpose of this study was to examine the genetic features and pathways shared in ICH and H. pylori infection, and compare immune infiltration. METHODS: We used microarray data for ICH and H. pylori infection from the Gene Expression Omnibus (GEO) database. Differential gene expression analysis was performed on both datasets using the R software and the limma package to find the common differentially expressed genes (DEGs). In addition, we performed functional enrichment analysis on DEGs, determined protein-protein interactions (PPIs), identified Hub genes using the STRING database and Cytoscape software, and constructed microRNA-messenger RNA (miRNA-mRNA) interaction networks. Additionally, immune infiltration analysis was performed with the R software and related R packages. RESULTS: A total of 72 DEGs were identified between ICH and H. pylori infection, including 68 upregulated genes and 4 downregulated genes. Functional enrichment analysis revealed that multiple signaling pathways are closely linked to both diseases. In addition, the cytoHubba plugin identified 15 important hub genes, namely PLEK, NCF2, CXCR4, CXCL1, FGR, CXCL12, CXCL2, CD69, NOD2, RGS1, SLA, LCP1, HMOX1, EDN1, and ITGB3.Also, the correlation analysis of immune cell fractions revealed a limited link between their immune-related common genes and immune cells. CONCLUSION: Through bioinformatics methods, this study revealed that there are common pathways and hub genes between ICH and H. pylori infection. Thus, H. pylori infection may have common pathogenic mechanisms with the development of peptic ulcer after ICH. This study provided new ideas for early diagnosis and prevention of ICH and H. pylori infection.
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Infecções por Helicobacter , Helicobacter pylori , Úlcera Gástrica , Humanos , Redes Reguladoras de Genes , Helicobacter pylori/genética , Perfilação da Expressão Gênica/métodos , Infecções por Helicobacter/complicações , Infecções por Helicobacter/genética , Hemorragia Cerebral , Biologia Computacional/métodosRESUMO
OBJECTIVE: To explore which intraventricular fibrinolytic agent - urokinase (UK) or recombinant tissue plasminogen activator (rt-PA) - combined with extraventricular drainage (EVD) is most suitable for patients with spontaneous intraventricular hemorrhage (IVH). PATIENTS AND METHODS: We searched PubMed, MEDLINE, OVID, Embase, and Cochrane Library databases for relevant articles and assessed their quality and extracted statistical analyses using Stata 13.0 and Revman 5.3 software. RESULTS: Compared with EVD alone, EVD combined with an agent causing intraventricular fibrinolysis (IVF) improved the survival and prognosis of patients with IVH. Regarding the patients' survival rates and prognoses, the treatments, from best to worst results were EVD + UK, EVD + rt-PA, EVD alone. The proportion of patients with serious disability also increased with these treatments, however, with the highest to lowest proportions being EVD + rt-PA, EVD + UK, EVD alone. In addition, EVD + IVF was associated with a higher risk of intracranial rebleeding (from lowest to highest incidence: EVD alone, EVD + rt-PA, EVD + UK). Finally, EVD + UK is associated with an increased risk of potential intracranial infection (from lowest to highest incidence: EVD + rt-PA, EVD alone, EVD + UK). CONCLUSIONS: EVD + UK may be the best approach to improving patients' survival rate and prognosis. However, it also presents the highest risk of intracranial infection and rebleeding. EVD + IVF increased the proportion of patients with serious disability.
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Terapia Trombolítica , Ativador de Plasminogênio Tecidual , Hemorragia Cerebral/tratamento farmacológico , Drenagem , Fibrinolíticos/uso terapêutico , Humanos , Metanálise em Rede , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do TratamentoRESUMO
OBJECTIVE: This study aimed to establish and verify a model for predicting death within 2 days after spontaneous cerebral hemorrhage based on the patient's characteristics at the time of admission. METHODS: During 2015-2017, the records of a cohort of 397 patients with clinically diagnosed cerebral hemorrhage were collected for model development. Minimum absolute contraction and the selection operator (lasso) regression model were used to determine factors that most consistently and correctly predicted death after cerebral hemorrhage. Discrimination and calibration were used to evaluate the performance of the resulting nomogram. After internal validation, the nomogram was further assessed during 2017-2018 using a different cohort of 200 consecutive subjects. RESULTS: The nomogram included four predictors from the lasso regression analysis: Glasgow Coma Scale, hematoma location, hematoma volume, and primary intraventricular hemorrhage. The nomogram showed good discrimination and good calibration for both training and verification cohorts. Decision curve analysis showed that the prediction nomogram was clinically useful. CONCLUSION: This prediction model can be used for early, simple, and accurate prediction of early death following cerebral hemorrhage.
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Hemorragia Cerebral/mortalidade , Hemorragia Cerebral Intraventricular/mortalidade , Mortalidade Hospitalar , Nomogramas , Idoso , Hemorragia Cerebral/diagnóstico por imagem , Hemorragia Cerebral Intraventricular/diagnóstico por imagem , Feminino , Escala de Coma de Glasgow , Hematoma/diagnóstico por imagem , Hematoma/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Reprodutibilidade dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
Municipal solid waste incineration fly ash (MSWIFA) can be reused as a positive additive to strengthen soft soil. In this study, MSWIFA was initially used as a supplementary solidification material in combination with ordinary Portland cement to prepare fly ash cement-stabilized soil (FACS) with silty sand and silty clay, respectively. The ratio of MWSIFA to total mass was 5%, 10%, and 15%, and the cement content was set as 10% and 15%. The mechanical properties of FACS were evaluated by unconfined compressive strength test. The heavy metal-leaching test was conducted to estimate the environmental risk of FACS. The scanning electron microscope was used to test the micro-structure of FACS. The X-ray diffraction was performed to analyze material composition of FACS. The result indicates that the collaborative solidification of soft soil with MSWIFA and cement is feasible. Regarding the silty clay, the FA had positive effects on the silty clay in the service age (between 50 and 100% with 15% MSWIFA), as the MSWIFA reformulated the initial silty clay structure, resulting in interconnection and pore fill between particles. It can be founded that C-S-H and ettringite are the main products of MSWIFA and cement hydration, which are formed by the hydration of C3S and C2S. Regarding the silty sand, the MSWIFA decreased the peak strength (between 35 and 48% with 15% MSWIFA) but increased the ductility of the stabilized cement. Under the same mix proportions, the leaching toxicities of Zn and Pb in FACS of silty clay were obviously lower than were those of silty sand. Generally, the leaching concentrations of tested metals under all the mix proportions were well below the limit value set by GB 18598-2019 for hazardous waste landfill. Thus, the reuse of MSWIFA in cement-stabilized soil would be one of the effective methods in soft soil treatment and solid waste reduction.
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Metais Pesados , Eliminação de Resíduos , Cinza de Carvão , Resíduos Sólidos/análise , Argila , Solo , Areia , Incineração , Metais Pesados/análise , Eliminação de Resíduos/métodos , Carbono/química , Material ParticuladoRESUMO
Background: Gliomas are the most prevalent primary brain tumors, and patients typically exhibit poor prognoses. Increasing evidence suggests that telomere maintenance mechanisms play a crucial role in glioma development. However, the prognostic value of telomere-related genes in glioma remains uncertain. This study aimed to construct a prognostic model of telomere-related genes and further elucidate the potential association between the two. Methods: We acquired RNA-seq data for low-grade glioma (LGG) and glioblastoma (GBM), along with corresponding clinical information from The Cancer Genome Atlas (TCGA) database, and normal brain tissue data from the Genotype-Tissue Expression (GTEX) database for differential analysis. Telomere-related genes were obtained from TelNet. Initially, we conducted a differential analysis on TCGA and GTEX data to identify differentially expressed telomere-related genes, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses on these genes. Subsequently, univariate Cox analysis and log-rank tests were employed to obtain prognosis-related genes. Least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate Cox regression analysis were sequentially utilized to construct prognostic models. The model's robustness was demonstrated using receiver operating characteristic (ROC) curve analysis, and multivariate Cox regression of risk scores for clinical characteristics and prognostic models were calculated to assess independent prognostic factors. The aforementioned results were validated using the Chinese Glioma Genome Atlas (CGGA) dataset. Finally, the CIBERSORT algorithm analyzed differences in immune cell infiltration levels between high- and low-risk groups, and candidate genes were validated in the Human Protein Atlas (HPA) database. Results: Differential analysis yielded 496 differentially expressed telomere-related genes. GO and KEGG pathway analyses indicated that these genes were primarily involved in telomere-related biological processes and pathways. Subsequently, a prognostic model comprising ten telomere-related genes was constructed through univariate Cox regression analysis, log-rank test, LASSO regression analysis, and multivariate Cox regression analysis. Patients were stratified into high-risk and low-risk groups based on risk scores. Kaplan-Meier (K-M) survival analysis revealed worse outcomes in the high-risk group compared to the low-risk group, and establishing that this prognostic model was a significant independent prognostic factor for glioma patients. Lastly, immune infiltration analysis was conducted, uncovering notable differences in the proportion of multiple immune cell infiltrations between high- and low-risk groups, and eight candidate genes were verified in the HPA database. Conclusions: This study successfully constructed a prognostic model of telomere-related genes, which can more accurately predict glioma patient prognosis, offer potential targets and a theoretical basis for glioma treatment, and serve as a reference for immunotherapy through immune infiltration analysis.
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Background: Intracerebral hemorrhage (ICH) is a serious brain condition with high mortality and disability rates. In recent decades, several risk factors related to death risk have been identified, with several models predicting mortality, but rarely used and accepted in daily clinical practice. Aims: To establish and validate a predictive nomogram of spontaneous ICH death that can be used to predict patient death within 7 days. Study Design: Cohort study. Methods: A cohort of 449 patients with ICH, diagnosed clinically from January 2015 to December 2017, were identified as the model training cohort. Univariate analysis and least absolute contraction and selection operator (Lasso) regression were used to determine the most powerful predictors of patients with ICH. Discrimination, calibration, and clinical applicability were used to assess the function of the new nomogram. In external validation, we also evaluated the nomogram in another 148 subjects (validation cohort) examined between January and December 2018. Results: We observed no significant differences in patient baseline characteristics in the training and validation cohorts, including sex, age, Glasgow coma scale (GCS) score, and one-week mortality rates. The model included three predictive variables from univariate and multivariate analysis, including GCS scores, hematoma volume, and brainstem hemorrhage (BSH). Internal validation revealed that the nomogram had a good discrimination, the area under the receiver operating characteristic curve (AUC) was 0.935, and calibration was good (U = -0.004, P = 0.801). Similarly, this nomogram also showed good differentiation ability (AUC = 0.925) and good accuracy (U = -0.007, P = 0.241) in the validation cohort data. Decision curve analysis indicated that the new prediction model was helpful. Conclusion: At the early stages of the condition, our prediction model accurately predicts the death of patients with ICH.
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Hemorragia Cerebral , Nomogramas , Estudos de Coortes , Hematoma , Humanos , Estudos RetrospectivosRESUMO
The purpose of this study was to establish and validate a nomogram to estimate the 30-day probability of death in patients with spontaneous cerebral hemorrhage. From January 2015 to December 2017, a cohort of 450 patients with clinically diagnosed cerebral hemorrhage was collected for model development. The minimum absolute contraction and the selection operator (lasso) regression model were used to select the strongest prediction of patients with cerebral hemorrhage. Discrimination and calibration were used to evaluate the performance of the resulting nomogram. After internal validation, the nomogram was further assessed in a different cohort containing 148 consecutive subjects examined between January 2018 and December 2018. The nomogram included five predictors from the lasso regression analysis, including: Glasgow coma scale (GCS), hematoma location, hematoma volume, white blood cells, and D-dimer. Internal verification showed that the model had good discrimination, (the area under the curve is 0.955), and good calibration [unreliability (U) statistic, p = 0.739]. The nomogram still showed good discrimination (area under the curve = 0.888) and good calibration [U statistic, p = 0.926] in the verification cohort data. Decision curve analysis showed that the prediction nomogram was clinically useful. The current study delineates a predictive nomogram combining clinical and imaging features, which can help identify patients who may die of cerebral hemorrhage.
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Hemorragia Cerebral/mortalidade , Nomogramas , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Escala de Coma de Glasgow , Hematoma/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
Objective: This network meta-analysis aimed to explore the effect of different drugs on mortality and neurological improvement in patients with traumatic brain injury (TBI), and to clarify which drug might be used as a more promising intervention for treating such patients by ranking. Methods: We conducted a comprehensive search from PubMed, Medline, Embase, and Cochrane Library databases from the establishment of the database to 31 January 2022. Data were extracted from the included studies, and the quality was assessed using the Cochrane risk-of-bias tool. The primary outcome measure was mortality in patients with TBI. The secondary outcome measures were the proportion of favorable outcomes and the occurrence of drug treatment-related side effects in patients with TBI in each drug treatment group. Statistical analyses were performed using Stata v16.0 and RevMan v5.3.0. Results: We included 30 randomized controlled trials that included 13 interventions (TXA, EPO, progesterone, progesterone + vitamin D, atorvastatin, beta-blocker therapy, Bradycor, Enoxaparin, Tracoprodi, dexanabinol, selenium, simvastatin, and placebo). The analysis revealed that these drugs significantly reduced mortality in patients with TBI and increased the proportion of patients with favorable outcomes after TBI compared with placebo. In terms of mortality after drug treatment, the order from the lowest to the highest was progesterone + vitamin D, beta-blocker therapy, EPO, simvastatin, Enoxaparin, Bradycor, Tracoprodi, selenium, atorvastatin, TXA, progesterone, dexanabinol, and placebo. In terms of the proportion of patients with favorable outcomes after drug treatment, the order from the highest to the lowest was as follows: Enoxaparin, progesterone + vitamin D, atorvastatin, simvastatin, Bradycor, EPO, beta-blocker therapy, progesterone, Tracoprodi, TXA, selenium, dexanabinol, and placebo. In addition, based on the classification of Glasgow Outcome Scale (GOS) scores after each drug treatment, this study also analyzed the three aspects of good recovery, moderate disability, and severe disability. It involved 10 interventions and revealed that compared with placebo treatment, a higher proportion of patients had a good recovery and moderate disability after treatment with progesterone + vitamin D, Bradycor, EPO, and progesterone. Meanwhile, the proportion of patients with a severe disability after treatment with progesterone + vitamin D and Bradycor was also low. Conclusion: The analysis of this study revealed that in patients with TBI, TXA, EPO, progesterone, progesterone + vitamin D, atorvastatin, beta-blocker therapy, Bradycor, Enoxaparin, Tracoprodi, dexanabinol, selenium, and simvastatin all reduced mortality and increased the proportion of patients with favorable outcomes in such patients compared with placebo. Among these, the progesterone + vitamin D had not only a higher proportion of patients with good recovery and moderate disability but also a lower proportion of patients with severe disability and mortality. However, whether this intervention can be used for clinical promotion still needs further exploration.
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The title compound, {[Zn(C(12)H(8)O(4))(C(5)H(5)N)(H(2)O)]·C(5)H(5)N}(n), has been prepared by hydro-thermal reaction. The Zn(II) atom is six-coordinated by four carboxyl-ate O atoms of two p-phenylenediacrylate (ppda(2-)) ligands, one N atom of a pyridine mol-ecule and one O atom of a water mol-ecule in a distorted octa-hedral environment. The carboxyl-ate groups of the ppda(2-) anions are in a bridging-chelating mode, in which two O atoms chelate one Zn(2+) ion. These connections result in an extended chain structure. Parallel packing of the chains forms a two-dimensional network with inter-molecular edge-to-face inter-actions. Further linkages between the layers through O-Hâ¯O hydrogen-bonding inter-actions result in a three-dimensional supra-molecular architecture with one-dimensional recta-nglar channels.
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OBJECTIVE: This study was performed to explore the efficacy and safety of different surgical interventions in patients with spontaneous supratentorial intracranial hemorrhage (SSICH) and determine which intervention is most suitable for such patients. PATIENTS AND METHODS: We searched the PubMed, Medline, OVID, Embase, and Cochrane Library databases. The quality of the included studies was assessed. Statistical analyses were performed using the software Stata 13.0 and RevMan 5.3. RESULTS: Endoscopic surgery (ES), minimally invasive surgery combined with urokinase (MIS + UK), minimally invasive surgery combined with recombinant tissue plasminogen activator (MIS + rt-PA), and craniotomy were associated with higher survival rates and a lower risk of intracranial rebleeding than standard medical care (SMC) in patients with SSICH, especially in younger patients with few comorbidities. The order from highest to lowest survival rate was ES, MIS + UK, MIS + rt-PA, craniotomy, and SMC. The order from lowest to highest intracranial rebleeding risk was ES, MIS + UK, craniotomy, MIS + rt-PA, and SMC. Additionally, compared with SMC, all four surgical interventions (ES, MIS + rt-PA, MIS + UK, and craniotomy) improved the prognosis and reduced the proportion of patients with serious disability. The order from most to least favorable prognosis was MIS + rt-PA, ES, MIS + UK, craniotomy, and SMC. The order from highest to lowest proportion of patients with serious disability was ES, MIS + rt-PA, MIS + UK, craniotomy, and SMC. CONCLUSIONS: This study revealed that the efficacy and safety of different surgical interventions (ES, MIS + UK, MIS + rt-PA, craniotomy) were superior to those of SMC in the patients with SSICH, especially in younger patients with few comorbidities. Among them, ES was the most reasonable and effective intervention. ES was found not only to improve the survival rate and prognosis but also to have the lowest risk of intracranial rebleeding and the lowest proportion of patients with serious disability.
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Craniotomia/métodos , Acidente Vascular Cerebral Hemorrágico/cirurgia , Hemorragias Intracranianas/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Hemorragia dos Gânglios da Base/cirurgia , Terapia Combinada , Drenagem/métodos , Fibrinolíticos/uso terapêutico , Humanos , Metanálise em Rede , Hemorragia Putaminal/cirurgia , Recidiva , Taxa de Sobrevida , Doenças Talâmicas/cirurgia , Ativador de Plasminogênio Tecidual/uso terapêutico , Resultado do Tratamento , Ativador de Plasminogênio Tipo Uroquinase/uso terapêuticoRESUMO
The title Pb(II) coordination polymer, [PbCl(2)(C(13)H(14)N(2))], was prepared by the hydro-thermal reaction of PbCl(2) with 4,4,-trimethyl-enedipyridine in a 1:1 ratio. It exhibits a two-dimensional layered structural motif consisting of PbCl(2) chains and the flexible bridged 4,4'-trimethyl-enedipyridine ligand. The connections result in a cavity of about 4 × 15â Å.