RESUMO
Objective: To analyze the incidence and risk factors for postoperative venous thromboembolism(VTE) in patients with stage â a non-small-cell lung cancer(NSCLC), so as to find evidence for further research of prophylactic anticoagulation. Methods: A total of 132 patients with stage â a NSCLC, 42 males and 90 females aged from 26 to 79 years with an average of (57±10) years, were retrospectively included in this study. All of them underwent surgical treatment at the Department of Thoracic Surgery of Beijing Chaoyang Hospital Affiliated with Capital Medical University from January 2017 to October 2020. A lower extremity venous ultrasound was performed before and after the operation. Participants were divided into VTE group (n=11) or non-VTE group (n=121) according to whether or not VTE occurred after operation. The surgical conditions, test indicators, imaging information, pathology information were compared between the two groups. Logistic regression analysis was performed to test the associations of VET with putative risks factors in which significant differences were observed. The independent risk factors of VET were determined by this way. Results: Postoperative VTE occurred in 11 cases (8.3%), including 10 cases (90.9%) of deep vein thrombosis (DVT) of lower limbs and 1 case (9.1%) of DVT complicated with pulmonary embolism (PE). The mean age of Patients in the VTE group was older than that in non-VTE Group ((65±9) years vs (57±10) years, P=0.009). On the fifth day after operation, patients in both groups had significantly higher D-dimer level compared with that before operation (3.18(1.55, 5.15) vs 1.54(1.09, 2.57); 2.66(1.17, 4.65) vs 1.34(0.78, 2.04))(both P<0.05). The value of neuron-specific enolase (NSE) and the number of lymph nodes removed during the operation in the VTE group were significantly higher than those in the non-VTE group ((21.54±12.37) vs (14.72±5.75); (19.7±8.2) vs (13.0±7.9)) (both P<0.05). There was no statistically significant difference in the approach of surgery, imaging features (tumor location, vascular cluster signs, etc.), and pathological information (pathological types, etc.) (all P>0.05). The logistic regression analysis showed that the number of lymph nodes removed during the operation was an independent risk factor related to the occurrence of VTE (OR=1.306, 95%CI:1.000-1.600,P<0.05). Conclusions: The incidence of postoperative VTE in patients with stage â a NSCLC is approximately 8.3%. The number of lymph nodes removed during the operation may be an independent risk factor for postoperative VTE in patients with stage â a NSCLC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Embolia Pulmonar , Tromboembolia Venosa , Idoso , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologiaRESUMO
Objective: To analyze the effect of chlorpyrifos on the expression of autophagy related proteins in rat hippocampal neurons, and to explore the role of autophagy in central nerve injury caused by acute chlorpyrifos poisoning. Methods: In October 2018, 35 male clean grade SD rats were randomly divided into 7 groups according to the observation time point, namely 0.5 d, 1 d, 2 d, 3 d, 5 d and 7 d groups and the control group, with 5 rats in each group. Each observation group was given 81.5 mg/kg chlorpyrifos by gavage, and the control group was given olive oil by gavage. The general conditions and poisoning symptoms of rats were observed continuously after exposure. The expressions of autophagy related proteins Beclin1, P62/SQSTM1 and LC3 in hippocampus were detected by Western blot. The cell morphology and LC3 expression in brain were observed by immunohistochemical staining. Results: Western blot results showed that compared with the control group, the expression of Beclin1 protein in hippocampal neurons of rats in the 1 d, 2 d, and 3 d groups increased, while the expression of P62/SQSTM1 protein in the 0.5 d, 1 d, and 2 d groups decreased, and the expression of LC3 protein was decreased in the 2 d group, and the differences were statistically significant (P<0.05) . The results of immunohistochemistry showed that the hippocampal neurons of rats in the 5 d group were arranged disorderly, and some nuclei contours disappeared, especially in the 7 d group. The LC3 protein was expressed in the cytoplasm, and the expression level gradually increased, reaching a peak on the second day. Conclusion: The early activation of autophagy in rats with acute chlorpyrifos poisoning may be involved in chlorpyrifos induced hippocampal neuronal injury.
Assuntos
Clorpirifos , Animais , Proteínas Relacionadas à Autofagia , Clorpirifos/toxicidade , Hipocampo , Masculino , Neurônios , Ratos , Ratos Sprague-DawleyRESUMO
Objective: To evaluate the clinical outcomes of on-pump total arterial revascularization with bilateral radial artery (BRA) and left internal mammary artery (LIMA) as conduits in coronary artery bypass grafting (CABG) patients with left ventricular dysfunction (LVD). Methods: All the perioperative medical records and follow-up results of coronary artery disease patients with left ventricular ejection fraction (LVEF) ≤ 40% undergoing CABG from 24 heart centers of 15 provinces and autonomous regions in China between July 2015 and December 2019 were retrospectively analyzed. Results: A total of 87 consecutive patients (55 males and 32 females) underwent on-pump CABG with BRA and LIMA, with a mean age of (57.5±9.1) years old. There were 22 patients complicated with primary hypertension, 12 with diabetes mellitus, 8 with peripheral vascular disease, 7 with chronic obstructive lung disease, 12 with mild renal injury and 3 with partial aortic calcification. There were 43 cases with in-stent stenosis, and 21 had left main disease. The mean LVEF and left ventricular end-diastolic diameter (LVEDD) was (35.5±7.3)% and (65.5±2.6) mm, respectively. The mean graft number, aortic cross-clamp time and cardiopulmonary bypass duration was 3.2±0.9, (90.5±22.7) min and (113.4±19.2) min, respectively. There were 32 mitral and 9 aortic valve replacements, and 5 tricuspid annuloplasties. Prophylactic intra-aortic balloon pumps were implanted in 27 patients. There were 2 operative deaths from acute heart failure. After surgery, there were 15 cases of atrial fibrillation, 1 case of acute kidney injury, 1 case of acute myocardial infarction, and 1 cases of stroke. All the patients fulfilled the follow-up, with a mean time of (39.5±7.7) months. At 3 months after surgery, LVEDD was decreased and LVEF was improved significantly compared with pre-operative indicators [(53.0±1.5) mm vs (65.5±2.6) mm, t=9.51 P=0.02; (45.2±3.3)% vs (35.5±7.3)%, t=13.79, P=0.001]. No major cardiac events were reported during the follow-up. At (30.5±7.4) months after surgery, 62.4% of patients (53/85) underwent coronary CT angiography examination, and the results indicated that the graft patency was 98.8%, with only one case of RA occlusion occurred. Conclusion: In selected patients of LVD, on-pump total arterial revascularization with BRA and LIMA conduits was proved to be safe and effective.
Assuntos
Doença da Artéria Coronariana , Disfunção Ventricular Esquerda , Idoso , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Volume Sistólico , Resultado do Tratamento , Função Ventricular EsquerdaRESUMO
Objective: To investigate the expression of nuclear factor erythroid 2-related factor 2 (Nrf2) in the lung tissue of rats with acute diquat (DQ) poisoning and the distribution of diquat in lungs. Methods: Fifty-four fasted male Wistar rats were randomized into control group (n=6) and exposure group (n=48) . According to the time point, the exposure group was divided into 2 h, 4 h, 12 h, 1 d, 3 d, 7 d, 11 d and 14 d groups with 6 rats in each group. Exposure groups were administered 11.55 mg/kg DQ (1 ml/100 g BW) by single-dose of intragastric administration, while the control group rats were given normal saline. The histopathological changes of lung tissue of rats in each group were observed. The expression of nrf2 in lung tissue was detected by immunohistochemistry, and the diquat concentration in lungs was determined by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS) . Results: In the exposure group, DQ was detected in lungs on 2 hours after poisoning. The concentration of DQ in lung tissue decreased gradually over time, and there was no accumulation in lung tissue. The histopathological changes of lung tissue were not obvious in the early stage of poisoning. The injury was the most serious on the 3rd day, a large number of inflammatory cells could be seen in alveolar cavity and lung stroma, and the pathological injury of lung tissue began to be alleviated on the 7th day. The results of immunohistochemistry showed that Nrf2 was mainly expressed in the nucleus of pulmonery cells. The expression of Nrf2 in the exposure group was significantly higher than the control group. The expression of Nrf2 increased significantly at the 12th hour (P<0.05) , reached the peak on the 3rd day (P<0.05) . There was no difference between the control group and the 14th day (P>0.05) . Conclusion: There was no accumulation of DQ in the lung tissue for a long time, and there was a hysteresis in lung injury induced by redox reaction of DQ. Nrf2 was highly expressed in the lung tissue of rats with acute DQ poisoning, which was correlated with histopathology injury of lung tissue, suggesting that Nrf2 plays an important role in antagonizing acute lung injury induced by DQ.
Assuntos
Lesão Pulmonar Aguda , Diquat , Paraquat , Lesão Pulmonar Aguda/induzido quimicamente , Animais , Diquat/toxicidade , Pulmão , Masculino , Fator 2 Relacionado a NF-E2/metabolismo , Paraquat/toxicidade , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
Objective: To establish the Wistar rat model of acute diquat poisoning and observe the pathological damage of main target organs. Methods: Thirty-six Wistar rats were randomly divided into six groups (n=6) , including one normal saline control group and five treatment groups which were separately given single-dose of intragastric administration at the doses of 46.2 mg/kg, 77.0 mg/kg, 115.5 mg/kg, 231.0 mg/kg and 346.5 mg/kg. The pathological changes of lung, liver and kidney were observed by hematoxylin and eosin (HE) and Masson staining. The optimal dose was determined according to the general situation and pathological changes. Thirty-six Wistar rats were randomly divided into five treatment groups and one normal saline control group. Treatment groups were given single-dose of intragastric administration according to the optimal dose. The rats were sacrificed at 1st, 3rd, 7th, 11th and 14th day after exposed, respectively. The activity of serum glutamic-pyruvic transaminase (ALT) and glutamic-oxalacetic transaminase (AST) were measured by chemical colorimetry. The pathological changes of lung, liver and kidney were observed by HE and Masson staining. Results: According to 14 d survival rate, the toxic symptoms and pathological changes, 115.50 mg/kg was determined the best dose. Given single-dose of intragastric administration at the doses of 115.50 mg/kg, it was found that the serum AST and ALT activity of rats on the first and third day of exposure was significant higher than those in control group. The results of pathological examination exhibited that in 115.50 mg/kg group, the pathological changes of lung, liver and kidney began to appear on the first day of exposure, the pathological changes were the most serious on the third day, and then gradually alleviated. On the 14th day, the alveolar septum was slightly widened, with inflammatory cell infiltration, local alveolar cavity became narrow, atrophy, peripheral alveolar compensation, bronchi and alveolar septum collagen fiber proliferation; The local renal tubular epithelial cells were enlarged and necrotic; the central vein surrounding hepatic cells showed vacuolar degeneration with punctate necrosis. Conclusion: The rat model of acute diquat poisoning can be successfully induced by single-dose of intragastric administration. The condition of wistar rats and the pathological damage of the main target organs could be observed during the whole course of 115.50 mg/kg administration.
Assuntos
Diquat , Rim , Fígado , Pulmão , Animais , Diquat/toxicidade , Modelos Animais de Doenças , Rim/efeitos dos fármacos , Fígado/efeitos dos fármacos , Pulmão/efeitos dos fármacos , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
BACKGROUND: Growing evidences indicate that inhalational anaesthetics can enhance the growth and malignant potential of tumour cells and may affect tumour recurrence after surgery. Tumour stem cells play a vital role in tumour recurrence. This study investigates the effect of sevoflurane on glioma stem cells (GSCs) in vitro and the underlying molecular mechanisms in this process. METHODS: Cultured GSCs were exposed to clinically relevant concentrations and durations of sevoflurane exposure. Cell proliferation and self-renewal capacity were determined. Expression of the stem cell marker CD133, vascular endothelial growth factor (VEGF), hypoxia-inducible factors (HIFs), and phosphorylated Akt, which is a protein kinase invoved in multiple cellular processes, were measured using western blotting. Small interfering RNAs and an Akt inhibitor were used to investigate specific pathways. RESULTS: Compared with controls, cells exposed to 2% sevoflurane for 6 h induced a larger number of proliferated cells (31.2±7.6% vs 19.0±5.8%; P<0.01). Levels of CD133, VEGF, HIF-1α, HIF-2α, and p-Akt were up-regulated by sevoflurane in a time- and concentration-dependent manner. Small interfering RNA against HIFs decreased the percentage of proliferating GSCs after sevoflurane exposure and pre-treatment of cells with an Akt inhibitor abrogated the expression of HIFs induced by sevoflurane. CONCLUSIONS: Sevoflurane can promote the expansion of human GSCs through HIFs in vitro. Inhaled anaesthetics may enhance tumour growth through tumour stem cells.
Assuntos
Anestésicos Inalatórios/farmacologia , Glioma/patologia , Subunidade alfa do Fator 1 Induzível por Hipóxia/efeitos dos fármacos , Éteres Metílicos/farmacologia , Células-Tronco Neoplásicas/efeitos dos fármacos , Western Blotting/métodos , Proliferação de Células/efeitos dos fármacos , Humanos , Técnicas In Vitro , RNA Interferente Pequeno/efeitos dos fármacos , Sevoflurano , Células Tumorais Cultivadas , Fator A de Crescimento do Endotélio Vascular/efeitos dos fármacosRESUMO
MicroRNA-34a (miR-34a) has been found to be downregulated in esophageal squamous cell carcinoma (ESCC) tissues compared with that in normal tissues (P < 0.05), and miR-34a overexpression increased apoptosis and decreased clonogenic formation. However, the clinical significance and prognostic value of miR-34a in ESCC has not yet been investigated. In total, 111 patients with ESCC diagnosed and treated at the Department of Thoracic Surgery of Fujian Provincial Hospital between March 2008 and February 2014 were included in this retrospective study. Quantitative real-time PCR was performed to detect expression levels of miR-34a. The associations between miR-34a expression and clinicopathological features were analyzed using χ(2) tests. For analysis of survival data, Kaplan-Meier curves were constructed, and the log-rank test was performed. The expression levels of miR-34a in ESCC tissues were significantly decreased (P < 0.01), compared with those in adjacent normal esophageal tissues. Low miR-34a expression in ESCC tissues was significantly associated with tumor differentiation (P = 0.013), lymph node status (P = 0.038), and advanced clinical stage (P < 0.001). The Kaplan-Meier analysis and log-rank test revealed that low miR-34a levels had a significant impact on overall survival of patients with ESCC (P = 0.006). Multivariate analyses showed that the expression of miR-34a was an independent prognostic factor for ESCC (P = 0.018). Our findings indicate that there is reduced expression of miR-34a in human ESCC tissues and suggest a crucial role for miR-34a downregulation in ESCC progression and prognosis.
Assuntos
Biomarcadores Tumorais/biossíntese , Carcinoma de Células Escamosas/genética , Neoplasias Esofágicas/genética , MicroRNAs/biossíntese , Prognóstico , Adulto , Idoso , Biomarcadores Tumorais/genética , Carcinoma de Células Escamosas/patologia , Intervalo Livre de Doença , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , MicroRNAs/genética , Pessoa de Meia-IdadeRESUMO
Non-syndromic cleft of the lip and/or palate (NSCLP) is a very common birth defect; the poliovirus receptor-like 1 gene (PVRL1) has been identified as a genetic risk factor for NSCLP in patients from Norway, the Philippines, and South America. Given the considerable variation in allele frequencies across these geographical regions, this study explored the relationship between NSCLP and mutations of PVRL1 in patients from Guangdong, China. We recruited 171 NSCLP patients and 100 volunteers, and divided our samples into 2 groups: a sequencing group and a mass spectrometry group. In the sequencing group, we screened for mutations in exons 2 and 5 of PVRL1 by polymerase chain reaction and direct sequencing in 71 NSCLP patients and 100 volunteers. In the mass spectrometry group, we screened for amino acid mutations in α-spliced transcript codons 112, 131, and 395, and in the ß-spliced transcript codon 1082 using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry analysis in 100 NSCLP patients and 100 volunteers. No mutations were detected in either PVRL1 exons 2 or 5 in the 71 NSCLP patients and 100 volunteers, nor did we find mutations of α-spliced transcript codons 112, 131, 395 and the ß-spliced transcript codon 1082 in any of the 100 NSCLP patients and 100 volunteers. Thus, mutations in exons 2 and 5 of PVRL1, and T334A, A391T, G1183A in the α-spliced transcript, and G1082T in the ß-spliced transcript do not participate in the development of NSCLP in patients from Guangdong.
Assuntos
Moléculas de Adesão Celular/genética , Fenda Labial/genética , Fissura Palatina/genética , Adolescente , Adulto , Processamento Alternativo , Sequência de Bases , Estudos de Casos e Controles , Moléculas de Adesão Celular/metabolismo , Criança , Pré-Escolar , China , Análise Mutacional de DNA , Feminino , Estudos de Associação Genética , Humanos , Lactente , Masculino , Nectinas , Adulto JovemRESUMO
Seed length and seed width are an important factor to the soybean yield. So the quantitative trait loci (QTL) location for seed length and seed width could assistant the breeding of soybean. In this study, the QTL underlying seed length and seed width were studied. A recombinant inbred line population of soybeans derived from a cross between the American semi-draft cultivars Charleston and Dongnong 594 were used in 7 environments. The quantitative trait loci underlying seed length, seed width, and seed length/seed width were analyzed by the method of composite interval mapping. Then, the epistatic effects and the QTL-environment (QE) interaction effects were also analyzed. Some valuable QTL sites found had great effect to the seed trait. Results showed that 7 QTLs underlying seed length were identified mainly on linkage groups D1a, C2, B1, A1, G, and A2. For the seed width, 7 QTLs were identified on linkage groups D1a and O. Two QTLs of seed length/seed width were identified on linkage groups D1b and C2. No QE interaction was found for QTLs of seed length and seed width in 7 environments. QTLs of seed length/seed width on linkage groups A1 and I had a QE interaction in 7 environments. Seven pairs of QTLs were identified that affected additive x additive epistatic effect of seed length, seed width, and seed length/seed width, which occurred among 8 linkage groups. These results supply a good foundation for molecular assistant breeding for soybean seed trait.
Assuntos
Glycine max/genética , Locos de Características Quantitativas/genética , Sementes/crescimento & desenvolvimento , Cruzamento , Mapeamento Cromossômico , Meio Ambiente , Epistasia Genética , Ligação Genética , Fenótipo , Sementes/anatomia & histologia , Sementes/genética , Glycine max/anatomia & histologia , Glycine max/crescimento & desenvolvimentoRESUMO
Objective: To determine the efficacy of eltrombopag for primary immune thrombocytopenia (ITP) in adults and the predictive factors for treatment-free response (TFR) . Methods: Clinical data of adults with ITP who received eltrombopag from June 14, 2013 to May 31, 2021 in the Hematology Department of Ruijin Hospital affiliated with Shanghai Jiao Tong University Medical College were retrospectively analyzed. The initial dose of eltrombopag was 25 mg/d, and the maximum dose was 75 mg/d; the dose was adjusted to maintain the platelet count to within 50-150×10(9)/L. Treatment was discontinued according either to the protocol, on the patient's wishes or doctor's judgment (prescription medication), or based on clinical trials. The efficacy of eltrombopag and factors for TFR among patients who achieved complete response and those who discontinued treatment were analyzed. Results: Overall, 106 patients with ITP (33 men and 73 women) were included in the study. The median age of patients was 50 (18-89) years. There were 2, 10, and 94 cases of newly diagnosed, persistent, and chronic ITP, respectively. The complete response rate was 44.3% (47/106), the response rate was 34.0% (36/106), and the overall response rate was 78.3% (83/106). Meanwhile, 83 patients who responded to treatment discontinued eltrombopag; of these, 81 patients were evaluated. Additionally, 17 patients (21.0%) achieved TFR. The median follow-up duration of patients who achieved TFR was 126 (30-170) weeks. The recurrence rate was 17.6% (3/17), and the relapse-free survival rate was 76.5%. The results of univariate analysis revealed that non-recurrence after discontinuation of other treatments for ITP (P=0.001), and platelet count and eltrombopag dose of ≥100×10(9)/L (P=0.007) and ≤25 mg/d (P=0.031), respectively, upon discontinuation of eltrombopag were predictors of TFR; these effects were attributed to prolonged effective duration of eltrombopag. Multivariate analysis showed that there was a correlation between non-recurrence and prolonged effective duration after discontinuation of other treatments for ITP (P=0.002) . Conclusion: Eltrombopag is effective for patients with ITP as it can result in TFR. Predictors for TFR include non-recurrence after discontinuation of concomitant ITP treatment, and platelet count and eltrombopag dose of ≥100 × 10(9)/L and ≤25 mg/d upon discontinuation of treatment, respectively.
Assuntos
Púrpura Trombocitopênica Idiopática , Masculino , Humanos , Adulto , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Púrpura Trombocitopênica Idiopática/diagnóstico , Estudos Retrospectivos , Resultado do Tratamento , China/epidemiologia , Benzoatos/uso terapêuticoRESUMO
OBJECTIVE: Radiation therapy is an important method for the treatment of chest tumors. This study discussed the placement error of three-dimensional (3D) conformal intensity-modulated radiotherapy in patients with different types of chest tumors and analyzed the relevant influencing factors. PATIENTS AND METHODS: 100 patients with chest tumors diagnosed and treated in our hospital from March 2016 to March 2018 were randomly selected as research subjects, including 42 cases of esophageal cancer, 44 cases of breast cancer, and 14 cases of lung cancer. All patients underwent 3D conformal radiotherapy. The setup errors of patients with esophageal cancer, breast cancer, and lung cancer were detected after 3D conformal radiotherapy. Besides, the influencing factors of 3D conformal for thoracic tumors were analyzed by multiple linear regression analysis. RESULTS: After 3D conformal radiotherapy, the systematic errors of patients with esophageal cancer in X-axis, Y-axis, and Z-axis were -0.10, 1.26 and 0.07, respectively, while the random errors in X-axis, Y-axis, and Z-axis were 1.18, -1.14, and 0.97 respectively. The times for the absolute values of the positioning error with a range of ≤5 mm in X-axis, Y-axis, and Z-axis were 40 (95.24%), 2 (4.76%) and 36 (85.71%), while these with a range of >5 mm in X-axis, Y-axis, and Z-axis were 6 (14.29%), 41 (97.62%) and 1 (2.38%), respectively. For patients with breast cancer, the systematic errors and random errors in X-axis, Y-axis, and Z-axis are -0.19, 1.19, and 0.15, as well as 0.97, 0.02 and 1.29, respectively. The times for the absolute values of the positioning error with a range of ≤5 mm and >5 mm were 41 (93.18%), 3 (6.82%), and 36 (81.82%), as well as 8 (18.18%), 42 (95.45%) and 2 (4.55%), severally. For patients with lung cancer, the systematic errors and random errors in X-axis, Y-axis, and Z-axis were 0.14, 1.42, and 0.15, as well as 1.35, -0.23 and 1.12, respectively. The times for the absolute values of the positioning error with the range of ≤5 mm and >5 mm were 14 (93.33%), 1 (6.67%), and 11 (73.33%), as well as 4 (26.67%), 14 (93.33%) and 1 (6.67%) after 3D conformal radiotherapy. After multiple linear regression analyses, gender and lung volume were the influencing factors of Z-axis setup error, and the lesion location was the influence factor of Y-axis setup error (p<0.05). CONCLUSIONS: There are certain positioning errors in the X-axis, Y-axis, and Z-axis directions of thoracic tumors receiving 3D conformal radiotherapy. Gender, lung volume, and lesion location are all important factors that affect the placement error. The results of this study provide a certain reference for the positioning error of radiation therapy for thoracic tumors, which is conducive to improving the accuracy of radiotherapy and better protecting the surrounding tissues.
Assuntos
Neoplasias da Mama , Neoplasias Esofágicas , Neoplasias Pulmonares , Radioterapia Conformacional , Radioterapia de Intensidade Modulada , Neoplasias Torácicas , Humanos , Feminino , Planejamento da Radioterapia Assistida por Computador/métodos , Incerteza , Radioterapia Conformacional/métodos , Neoplasias Torácicas/radioterapia , Neoplasias Pulmonares/radioterapia , Neoplasias da Mama/radioterapiaRESUMO
OBJECTIVE: The aim of this study was to analyze the setup error of the electronics portal image device (EPID) in intensity-modulated radiation therapy (IMRT) for thoracic tumors and the influence on the outward expansion distance of the target area. PATIENTS AND METHODS: A total of 202 patients with chest tumors admitted to our hospital from March 2016 to March 2018 were selected as the observation subjects. All patients were treated with IMRT. The original plan was developed based on the SM90 obtained by the planning target volume (PTV) expansion method, and the new plan was obtained by shifting the isocenter coordinates of the treatment plan according to the positioning error value obtained by EPID. Before the treatment, EPID scans were performed. The electronic radiation field images (ERIs) were registered with the digitally reconstructed radiographic images (DRRs) generated by the treatment planning system using the image registration software, and the setup errors in the X, Y, and Z directions were further measured. The PTV was developed according to ERIs, and the setup error was simulated to obtain the PTV with 95% internal target volume (ITV) reaching the prescribed dose under the condition of a setup error. The outward expansion distance of clinical target volume (CTV) â PTV was calculated. RESULTS: In this experiment, the setup errors in X, Y, and Z directions were (-2.00±1.16) mm, (0.16±1.14) mm, and (-0.55±1.16) mm, respectively. The systematic error in the Z direction was -3.00 mm, and the random error in the X direction was 3.30 mm. The CTV â PTV outward expansion distance was set as 7, 8 and 7 mm in the X direction, Y direction and Z direction, respectively. At this time, under the presence of setup error, the PTV D95 and the ITV V100 in the new plan were (62.23±3.85) Gy and (97.51±1.56) %, respectively, effectively ensuring that 95% ITV of 90% patients reached the prescribed dose. In contrast, the ITV D95 and ITV V100 in the presence of setup error were (56.11±5.26) Gy and (90.15±3.12) %, respectively, at a CTV â PTV outward expansion distance of 5 mm, which could not guarantee that 95% ITV of 90% patients reached the prescribed dose. In the presence of a setup error, the double-lung 5 Gy irradiation of the total heart volume (V5), the double-lung 20 Gy irradiation of the total heart volume (V20), mean lung dose (MLD), mean heart dose (MHD), and D1 cm3 of the new plan increased by 0.89%, 0.29%, 0.13%, 0.06%, and 5 Gy, respectively, compared with the original plan. CONCLUSIONS: In general, the first treatment of radiotherapy in thoracic tumors mostly has a certain degree of setup error, which is most evident in the X direction. When the CTV â PTV outward expansion distance is set at 7, 8, and 7 mm in the X direction, Y direction, and Z direction, respectively, it can effectively ensure that 95% ITV reach the prescribed dose in 90% of patients in the presence of a setup error. EPID helps to achieve the desired effect of radiotherapy, improves the efficacy of radiotherapy, and reduces the side effects caused by radiotherapy errors.
Assuntos
Radioterapia de Intensidade Modulada , Neoplasias Torácicas , Humanos , Radioterapia de Intensidade Modulada/métodos , Planejamento da Radioterapia Assistida por Computador/métodos , Dosagem Radioterapêutica , Neoplasias Torácicas/diagnóstico por imagem , Neoplasias Torácicas/radioterapia , EletrônicaRESUMO
Objective: To analyze the burden and changing trends of periodontal disease in adults of the mainland of China from 1990 to 2019, and to predict the incidence trends of periodontal disease in the next 25 years, with a goal to provide a basis for reducing the burden of periodontal disease and formulating relevant prevention and treatment measures. Methods: Data on the incidence, prevalence, and disability adjusted life years (DALY) rate of periodontal disease among adults in the mainland of China from 1990 to 2019 were extracted from the global burden of disease study 2019 (GBD 2019) database. The estimated annual percent change (EAPC) was used to estimate the temporal trend of periodontal disease, and the age-period-cohort model (APC) was used to predict the age-standardized incidence of periodontal disease in Chinese adults from 2020 to 2044. Results: From 1990 to 2019, the incidence, prevalence, and DALY rate of adult periodontal disease in the mainland of China showed an increasing trend, with EAPCs of 0.3 (95%CI: 0.1-0.6), 0.5 (95%CI: 0.1-0.8), and 0.5 (95%CI: 0.1-0.8), respectively. The incidence and prevalence of periodontitis among the population aged 35-39 years old and 40-44 years old increased the most significantly, with EAPCs of 0.8 and 0.7, respectively, whereas the change in periodontal disease prevalence tended to be stable and the increase trend in prevalence was lower in the elderly group (EAPC=0.4). The incidence (EAPC=2.1), prevalence (EAPC=2.6) and DALY rate (EAPC=2.6) of periodontal disease in females increased more than those in males (EAPC=1.9, 2.4, and 2.4, respectively), of which the prevalence had exceeded that of males in 2019. The APC model predicted that the prevalence of periodontal disease in the period of 2020-2044 in China would still be on an upward trend, and the increase rate would be higher in females than in males. Conclusions: The burden of periodontal disease among adults in China had been increasing over the past 30 years, especially among young and middle-aged adults as well as females, and the incidence of periodontal disease will continue to increase over the next 25 years.
Assuntos
Doenças Periodontais , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , China/epidemiologia , Bases de Dados Factuais , Incidência , Doenças Periodontais/epidemiologia , População do Leste Asiático , Prevalência , Anos de Vida Ajustados por DeficiênciaRESUMO
The interstitial cells of Cajal (ICC) are widely believed to be neuroeffector cells of smooth muscle activity in all tubular organs, including the oviduct. The avian oviduct involves the secretion, sheathing, and transportation of a large-sized egg, but there is no information available on ICC in this special organ. We have demonstrated the presence of ICC in different segments throughout the oviduct in the laying hen and provided details on their ultrastructure by transmission electron microscopy technique, for the first time. The observed ICC appeared bipolar and multipolar cells of different shapes, with varying nuclear morphologies, a thin rim of electron-dense cytoplasm, and an infrequent basal lamina. They showed moniliform primary processes with one or 2 secondary or terminal processes. We found ICC near smooth muscle cells, nerve fibers, and the epithelia, where they make specialized contacts in the form of close membrane associations or gap-like junctions and peg-and-socket-like junctions. Intricate labyrinthine-type networking contacts were also present in ICC processes. Moreover, we report for the first time, that ICC in avian oviduct make interdigitating contacts with the epithelium. Cytoplasmic organelles identified in ICC include numerous well-developed mitochondria, abundant rough endoplasmic reticulum, and dispersed intermediate filaments. Many caveolae and vesicles were also present. Golgi bodies and centrioles were rare. Fibroblasts, on the other hand, were distinct cells with larger cytoplasmic area, more rough endoplasmic reticulum, and less mitochondrial content. No basal lamina, intermediate filaments, or caveolae were present in fibroblasts. Their processes were shorter and showed no contacts with smooth muscle cells or nerves. We conclude that these ICC might also have a key role in the regulatory mechanisms of motility and transportation in the hen oviduct, as already proved in mammalian oviduct. Such role of ICC might also be responsible for the function of the muscular infundibulum, where the fertilization takes place, and that moves to surround the released ovum, failure of which results in the internal laying.
Assuntos
Galinhas/anatomia & histologia , Células Intersticiais de Cajal/ultraestrutura , Oviductos/ultraestrutura , Animais , Feminino , Microscopia Eletrônica de TransmissãoRESUMO
Objective: To evaluate the efficacy and safety of recombinant human thrombopoietin (rhTPO) treatment for primary immune thrombocytopenia (ITP) patients during the perioperative period. Methods: Adult ITP patients who were refractory to first-line glucocorticoid therapy and underwent selective surgery were enrolled to be treated with rhTPO at the dosage of 1.5×10(4)U/d subcutaneously during the perioperative period. rhTPO treatment would not be terminated until one of the following conditions occurred: â Platelet counts met the requirement of surgery; â¡Platelet counts were ≥100×10(9)/L; â¢Completed the 14 days of therapy. End points of the study were surgery rate, rhTPO therapy response rate, rescue therapy rate and adverse responses. Results: 42 patients were enrolled from Jan. 1, 2016 to Jun. 30, 2018. 14 were male and 28 were female. The median age was 60 (25-73) years old. There were no newly diagnosed patients. 5 patients were persistent and 37 were chronic. 27 patients completed selective surgery. The surgery rate was 64.3% (27/42) . Among them, 13 patients were under local anesthesia and 14 under general anesthesia. Of 42 cases receiving rhTPO therapy. 31 patients achieved responses, The overall response rate was of 73.8%. Among them, 24 patients achieved CR. The CR ratio was 77.4% (24/31) . 7 achieved response. The response ratio was 22.6% (7/31) . 11 patients did not respond to rhTPO therapy. The non-response rate was 26.2% (11/42) . The median time to reach CR was 7 (3-16) days. The median time to reach the peak of platelet counts were 10 (3-21) days. rhTPO was used for a median of 7 (3-14) days. The median platelet counts of patients undergoing surgery before rhTPO therapy, before surgery and at day 7 after surgery were 33 (20-89) ×10(9)/L, 125 (78-245) ×10(9)/L and 72 (30-250) ×10(9)/L, respectively. The median peak of platelet counts was 149 (101-466) ×10(9)/L. No infection, bleeding, thromboembolism and therapy-related adverse responses occurred in the patients. Conclusion: rhTPO for ITP patients during the perioperative period is safe and effective.
Assuntos
Púrpura Trombocitopênica Idiopática , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Perioperatório , Contagem de Plaquetas , Púrpura Trombocitopênica Idiopática/tratamento farmacológico , Proteínas Recombinantes , Trombopoetina/uso terapêuticoRESUMO
To elucidate the processes involved in the spatial and temporal maturation of spermatogenic cells in the testes of the soft-shelled turtle, Pelodiscus sinensis, we used a histological morphology method, TdT-mediated dUTP nick end-labeling (TUNEL) assay, the proliferating-cell nuclear antigen (PCNA), and electron microscopy. Seminiferous tubules from 100 turtles, normal for size of testes and semen quality, were collected during 10 months of a complete annual cycle (10 turtles/month). The seminiferous epithelium was spermatogenically active through the summer and fall, but quiescent throughout the rest of the year; germ cells progressed through spermatogenesis in a temporal rather than a spatial pattern, resulting in a single spermatogenic event that climaxed with one massive sperm release in November. The TUNEL method detected few apoptotic cells in spermatogenic testis, with much larger numbers during the spermatogenically quiescent phase. Spermatocytes were the most common germ cell types labeled by the TUNEL assay (a few spermatogonia were also labeled). Apoptotic spermatocytes had membrane blebbing and chromatin condensation during the resting phase, but not during active spermatogenesis. We inferred that accelerated apoptosis of spermatogonia and spermatocytes partly accounted for germ cell loss during the nonspermatogenic phase. The PCNA was expressed in nuclei of spermatogonia and primary spermatocytes during the spermatogenically active phase. During the regressive phase, PCNA-positive cells also included spermatogonia and spermatocytes, but the number of positive spermatocytes was less than that during the spermatogenically active phase. We concluded that seasonal variations in spermatogenesis in the soft-shelled turtle were both stage- and process-specific.
Assuntos
Apoptose/fisiologia , Proliferação de Células , Células Germinativas/citologia , Células Germinativas/fisiologia , Testículo/fisiologia , Tartarugas/fisiologia , Animais , Masculino , Estações do Ano , Testículo/citologiaRESUMO
The microanatomy of the intestinal epithelium in the Chinese soft-shelled turtle (CST) was studied by light and transmission electron microscopy (TEM). The small intestinal epithelium (SIE) was single layered or pseudostratified. The enterocytes contained mitochondria or mitochondria and lipid droplets. The enterocytes were arranged tightly in the apical parts of epithelium and connected by desmosomes and interdigitations. The large intestinal epithelium (LIE) was pseudostratified and the enterocytes did not contain lipid droplets. Enterocytes were arranged compactly in the apical part, forming spaces in the middle and basal parts of epithelium. Numerous mucous cells were scattered in the epithelium and there were intraepithelial lymphocytes (IELs) with their pseudopodia extended into the intestinal lumen. This study provides detailed features of intestinal epithelium in the Pelodiscus sinensis that could be related to function. In addition, these findings are discussed in relation to other vertebrates.
RESUMO
Objective: To investigate the effect of three types of material homogeneities(isotropy, transverse isotropy, and orthotropy) of mandible on the finite element analysis of implant. Methods: Three-dimensional model of complete mandible containing an implant was constructed and analyzed with isotropic, transversely isotropic, and orthotropic models, respectively. Results: The effective stress, tensile stress, and compressive stress of cortical bone of the orthogonal model were 1.2, 1.2, and 1.1 times larger than that of the isotropic model. The effective stress, tensile stress, and compressive stress of cancellous bone of the orthogonal model were 1.6, 2.6, and 3.3 times larger than that of the isotropic model. The effective strain, tensile strain, and compressive strain of cortical bone of the transversely isotropic model were 1.1, 1.0, and 1.1 times larger than that of the isotropic model. The effective strain, tensile strain, and compressive strain of cortical bone of the orthogonal model were 2.2, 1.8, and 1.7 times larger than that of the isotropic model. The stress and strain of cancellous bone increased when the material homogeneity changed from isotropy to transverse isotropy and to orthotropy. Moreover, in term of stress and strain distribution, the orthotropic modelling of mandible was most uniform followed by the transverse isotropy and the isotropy. Conclusions: In the finite element analysis of implant system, the orthotropic property of the mandible can not be neglected.
Assuntos
Mandíbula , Implantes Dentários , Análise de Elementos Finitos , Humanos , Modelos Biológicos , Pressão , Estresse MecânicoRESUMO
OBJECTIVE: To evaluate the effects of gestational subclinical hypothyroidism (SCH) on early neurodevelopment of offspring. STUDY DESIGN: A prospective study included 106 infants born to mothers with gestational SCH and 106 infants born to mothers who were euthyroid during pregnancy. The neurodevelopment of 12 to 24-month-old infants was assessed and compared using the Gesell developmental test (revised version). RESULTS: Infants born to mothers with gestational SCH and those born to euthyroid mothers had similar scores on the Gesell development test. No correlations were observed between maternal TSH concentration and Gesell developmental test scores of offspring. Infants born to mothers who had gestational SCH during the first trimester specifically and those born to euthyroid mothers had similar scores on the Gesell development test. No significant correlations were detected between maternal TSH concentration during the first trimester and offspring neurodevelopment. CONCLUSIONS: No detectable neurodevelopment deficit was observed in offspring up to 24 months old from mothers who had gestational SCH.