RESUMO
BACKGROUND: A more extensive surgical resection of glioma contributes to improved overall survival (OS) and progression-free survival (PFS). However, some patients miss the chance of surgical resection when the tumor involves critical structures. PURPOSE: The present study aimed to assess the feasibility of neoadjuvant 125I brachytherapy followed by total gross resection for initially inoperable glioma. METHODS: Six patients diagnosed with inoperable glioma due to invasion of eloquent areas, bihemispheric diffusion, or large tumor volume received 125I brachytherapy. Surgical resection was performed when the tumor shrank, allowing a safe resection, assessed by the neurosurgeons. Patients were followed up after surgery. RESULTS: Shrinkage of the tumor after adjuvant 125I brachytherapy enabled a total gross resection of all six patients. Four patients were still alive at the last follow-up, with the longest survival time of more than 50 months, two of which returned to everyday life with a KPS of 100. Another two patients had neurological injuries with KPSs of 80 and 50, respectively. One patient with grade II glioma died 34 months, and another with grade IV glioma died 40 months after the combined therapy. CONCLUSIONS: In the present study, the results demonstrated that 125I brachytherapy enabled a complete resection of patients with initially unresectable gliomas. 125I brachytherapy may offer a proper neoadjuvant therapy method for glioma.
Assuntos
Braquiterapia , Neoplasias Encefálicas , Glioma , Braquiterapia/métodos , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/cirurgia , Glioma/radioterapia , Glioma/cirurgia , Humanos , Radioisótopos do Iodo , Terapia NeoadjuvanteRESUMO
BACKGROUND: LINC00152 (long intergenic non-protein coding RNA 152) was identified as an oncogenic lncRNA in multiple cancers. In the current study, we aimed to explore the transcriptional profile of LINC00152 in oral squamous cell carcinoma (OSCC) and its regulations at the transcriptional level. METHODS: Bioinformatic analysis was performed by extracting the OSCC subset from The Cancer Genome Atlas (TCGA)-Head and Neck Squamous Cell Carcinoma (HNSC). LINC00152 subcellular localization and its interacting transcriptional factors (TFs) were explored. Dual-luciferase assay and ChIP-qPCR were applied to study transcriptional regulation. In vitro and in vivo tumor cell growth models were used for functional assays. RESULTS: NR_024206.2 was the dominant isoform that accounts for 80% of all transcripts of LINC00152. LINC00152 upregulation was associated with unfavorable survival of patients with OSCC. LINC00152 knockdown significantly impaired OSCC cell growth in vitro and in vivo. RNA FISH assay confirmed nuclear and cytoplasmic distribution of LINC00152. It physically interacted with Upstream Transcription Factor 1 (USF1), a common transcription factor in mammalian cells. USF1 could bind to the promoter region of MRPL52 (Mitochondrial Ribosomal Protein L52) and activate its transcription. LINC00152 could enhance the binding, thereby indirectly elevating MRPL52 expression. USF1 or MRPL52 knockdown slowed the proliferation of OSCC cells and partly canceled LINC00152-mediated growth-promoting effects. CONCLUSION: This study revealed a novel LINC00152-USF1/MRPL52 axis promoting OSCC tumor growth.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Fator 1-alfa Nuclear de Hepatócito/metabolismo , MicroRNAs , Neoplasias Bucais , RNA Longo não Codificante/genética , Animais , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Linhagem Celular Tumoral , Proliferação de Células/genética , Regulação Neoplásica da Expressão Gênica/genética , Neoplasias de Cabeça e Pescoço/genética , Humanos , Mamíferos/genética , Mamíferos/metabolismo , MicroRNAs/genética , Neoplasias Bucais/genética , RNA Longo não Codificante/metabolismo , Proteínas Ribossômicas/genética , Proteínas Ribossômicas/metabolismo , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Transcrição GênicaRESUMO
OBJECTIVE: The purpose of this study was to develop a combined radiomics model to predict coronary plaque texture using perivascular fat CT radiomics features combined with clinical risk factors. METHODS: The data of 200 patients with coronary plaques were retrospectively analyzed and randomly divided into a training group and a validation group at a ratio of 7:3. In the training group, The best feature set was selected by using the maximum correlation minimum redundancy method and the least absolute shrinkage and selection operator. Radiomics models were built based on different machine learning algorithms. The clinical risk factors were then screened using univariate logistic regression analysis. and finally a combined radiomics model was developed using multivariate logistic regression analysis to combine the best performing radiomics model with clinical risk factors and validated in the validation group. The efficacy of the model was assessed by a receiver operating characteristic curve, the consistency of the nomogram was assessed using calibration curves, and the clinical usefulness of the nomogram was assessed using decision curve analysis. RESULTS: Twelve radiomics features were used by different machine learning algorithms to construct the radiomics model. Finally, the random forest algorithm built the best radiomics model in terms of efficacy, and this was combined with age to construct a combined radiomics model. The area under curve for the training and validation group were 0.98 (95% confidence interval, 0.95-1.00) and 0.97 (95% confidence interval, 0.92-1.00) with sensitivities of 0.92 and 0.86 and specificities of 0.99 and 1, respectively. The calibration curve demonstrated that the nomogram had good consistency, and the decision curve analysis demonstrated that the nomogram had high clinical utility. CONCLUSIONS: The combined radiomics model established based on CT radiomics features and clinical risk factors has high value in predicting coronary artery calcified plaque and can provide a reference for clinical decision-making.
Assuntos
Vasos Coronários , Tomografia Computadorizada por Raios X , Tecido Adiposo , Vasos Coronários/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X/métodosRESUMO
Isoliquiritigenin (ISL) is a flavonoid with a chalcone structure extracted from the natural herb Glycyrrhiza glabra. Its anti-inflammatory, antibacterial, antioxidant, and anticancer activities have been extensively studied. Moreover, ISL also possess hypolipidemic and atherosclerosis-reducing effects. However, its cholesterol-lowering mechanisms have not been reported yet. Niemann Pick C1 Like 1 (NPC1L1) is a specific transporter of cholesterol uptake. In this study, we found for the first time that ISL downregulates NPC1L1 expression and competitively inhibits cellular cholesterol uptake by binding to NPC1L1 in a concentration-dependent manner in vitro. This study provides a theoretical basis for further investigation of the molecular mechanisms of its cholesterol-lowering effect in vivo and inspired emerging drug research for cholesterol-lowering purposes through NPC1L1 inhibition.
Assuntos
Anticolesterolemiantes , Chalconas , Chalconas/farmacologia , Transporte Biológico , Proteínas de Membrana Transportadoras/metabolismo , Colesterol/metabolismo , Anticolesterolemiantes/farmacologiaRESUMO
Elevated cholesterol significantly increases the risk of developing atherosclerosis and coronary heart disease. The key to treating hypercholesterolemia is lowering plasma cholesterol levels. There have been no studies on the cholesterol-lowering potential of parthenolide (PTL), a naturally occurring small molecule from Tanacetum parthenium. Here, we first put forth PTL's cholesterol-lowering ability to inhibit cellular uptake of cholesterol in a dose-dependent manner. Its performance was on par with the positive control drug, ezetimibe. Niemann-Pick C1 Like-1 (NPC1L1) has been identified as a potential therapeutic target for hypercholesterolemia. The interaction of PTL with NPC1L1 could be explained by the results of molecular docking and filipin staining further reinforces this hypothesis. Furthermore, PTL reduced the expression of NPC1L1 in HepG2 cells in a concentration-dependent manner, which suggests that PTL functions as a potential NPC1L1 inhibitor with therapeutic potential for hypercholesterolemia.
Assuntos
Anticolesterolemiantes , Hipercolesterolemia , Hiperlipidemias , Anticolesterolemiantes/farmacologia , Anticolesterolemiantes/uso terapêutico , Colesterol/metabolismo , Ezetimiba/farmacologia , Filipina , Humanos , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/metabolismo , Hiperlipidemias/metabolismo , Proteínas de Membrana Transportadoras/metabolismo , Simulação de Acoplamento Molecular , SesquiterpenosRESUMO
BACKGROUND: To compare the clinical outcomes of patients with benign or aggressive tumors of the femoral neck who underwent surgical curettage with the use of the direct anterior approach (DAA) and a standard lateral approach. METHODS: Those patients from 2010 to 2017 were retrospectively enrolled. The patients were divided into two groups: group A, consisting of patients who had undergone surgery via the lateral approach; and group B, consisting of patients who had undergone the same procedure via the DAA. RESULTS: Fifty-eight patients were divided into group A (n = 46) and group B (n = 12). The median follow-up was 43 months (15-97 months). There was no significant difference in the 1-year and 3-year recurrence rates (p = 0.74). Group B had comparable operation time and a significantly shorter incision length, less intraoperative blood loss, less postoperative drainage, a shorter hospital stay and less pain on the first postoperative day. Group B also had better hip function as assessed by the Harris Hip Score one month and one year postoperatively. One patient in group B experienced intraoperative incomplete fracture of the femoral neck, which was treated conservatively. CONCLUSIONS: Surgical curettage for patients with benign or aggressive tumors of the femoral neck via the DAA had a comparable local control rate and a better perioperative and functional outcome than via the lateral approach. Certain quality of the femoral neck should be required to avoid pathological fracture, which is difficult to treat by internal fixation in the DAA.
Assuntos
Artroplastia de Quadril , Fraturas do Colo Femoral , Neoplasias Femorais , Fraturas do Colo Femoral/diagnóstico por imagem , Fraturas do Colo Femoral/cirurgia , Colo do Fêmur , Humanos , Recidiva Local de Neoplasia , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: The prognosis of patients with progressive or recurrent high-grade gliomas (HGGs) after surgery remains poor. Iodine-125 brachytherapy is emerging as a salvage method for the treatment of gliomas. This study aimed to investigate whether permanent iodine-125 brachytherapy could be used as an effective therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection. METHODS: Between March 2004 and August 2016, 58 patients with progressive or recurrent HGG after gross total resection were included in this study. Twenty-nine patients underwent radiotherapy and/or chemotherapy and then permanent iodine-125 brachytherapy (SRCI group). Twenty-nine patients underwent permanent iodine-125 brachytherapy alone (SI group). Follow-up was carried out at 1, 3, and 6 months and then at 1, 2, 3, and 5 years after iodine-125 implantation. The median overall survival (OS) and progression-free survival (PFS), procedure-related complications and clinical outcomes were evaluated. RESULTS: No procedure-related fatal events happened. The temporary morbidity rate was 11.9%. The median OS and PFS for patients in the SI group were 22 and 8 months compared with 21 and 7 months in the SRCI group. No significant differences were found. Age and Karnofsky Performance Status (KPS) were independent prognostic factors for OS. Age, KPS and histology were independent prognostic factors for PFS. CONCLUSIONS: Permanent iodine-125 brachytherapy could be used as an effective therapeutic method even without radiotherapy and/or chemotherapy for progressive or recurrent HGG after gross total resection.
Assuntos
Braquiterapia/métodos , Neoplasias Encefálicas/terapia , Glioma/terapia , Recidiva Local de Neoplasia/radioterapia , Terapia de Salvação/métodos , Adolescente , Adulto , Fatores Etários , Idoso , Braquiterapia/efeitos adversos , Encéfalo/patologia , Encéfalo/efeitos da radiação , Encéfalo/cirurgia , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/patologia , Feminino , Seguimentos , Glioma/diagnóstico , Glioma/mortalidade , Glioma/patologia , Humanos , Radioisótopos do Iodo/administração & dosagem , Radioisótopos do Iodo/efeitos adversos , Avaliação de Estado de Karnofsky , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Recidiva Local de Neoplasia/patologia , Prognóstico , Intervalo Livre de Progressão , Radioterapia Adjuvante/métodos , Estudos Retrospectivos , Fatores de Risco , Terapia de Salvação/efeitos adversos , Adulto JovemRESUMO
An amendment to this paper has been published and can be accessed via the original article.
RESUMO
BACKGROUND: Tuberculosis is a disease that may affect any organ of the body. Multifocal tuberculosis involving multiple systems with associated symptoms are rare, which makes the diagnosis challenging. Distinguishing multifocal tuberculosis from lesions metastatic from system malignancy is difficult. Single detection method is difficult to make a diagnosis. A combination of multiple methods is essential. CASE PRESENTATION: A 17-year-old male presented with a 20 days weakness of lower limbs, which aggravated for 6 days. The PET/CT showed increased metabolism of ileocecal intestinal and terminal ileum wall, multiple enlarged lymph node (LNs), multiple osteolytic bone lesions, and soft tissue intensity belong T7 and T8 vertebrae. To confirm the diagnosis of the disease, a biopsy of the mediastinum lymph nodes was carried out. Polymerase chain reaction (PCR) test of the specimen was positive for the Mycobacterium tuberculosis, the T-SPOT and Xpert MTB/RIF test were also positive, which suggested the presence of Mycobacterium tuberculosis. The final diagnosis was multifocal tuberculosis, the patients received the resection of the mass in the spine. Anti-tuberculosis drugs were given. The myodynamia and muscle tension of the patients recovered following the therapy. CONCLUSIONS: Our results indicated that Multifocal tuberculosis should also be taken into consideration when lesions metastatic from system malignancy were suspected from images results even without the clinical symptoms of tuberculosis, and combination of multiple diagnosis methods were essential for the diagnosis of multifocal disease.
Assuntos
Linfonodos/patologia , Tuberculose/diagnóstico , Adolescente , Antituberculosos/uso terapêutico , Humanos , Linfonodos/microbiologia , Linfadenopatia/microbiologia , Linfadenopatia/patologia , Masculino , Mycobacterium tuberculosis/genética , Reação em Cadeia da Polimerase , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Neoplasias da Coluna Vertebral/patologia , Tuberculose/tratamento farmacológicoRESUMO
To validate the feasibility of two types of bioactive glass that contains spherical and radical spherical nano-sized particles in promoting bone repair, we hypothesize that radical spherical nano-sized particles have higher bone repair effectiveness than spherical one due to the physicochemical properties. We rigorously compared the physicochemical properties and bioactivities of these two types of bioactive glass. Specifically, we measured the size, surface morphology, concentration of ionic-dissolution products, bioactivity, and biological effects of two groups of bioactive glass on rat bone marrow mesenchymal stem cells (rBMSCs) and evaluate their effect on proliferation and osteogenic differentiation of rBMSCs in vitro. We observed that spherical nano-bioactive glass (SNBG) was spherical with smooth boundary, while the radial spherical nano-bioactive glass (RSNBG) had radial pore on the surface of particle boundary. When the two materials were immersed in simulated body fluid for 24 h, RSNBG produced more and denser hydroxyapatite carbonate than SNBG. The concentration of Ca and Si ions in RSNBG 24 h extract is higher than that of SNBG, while the concentration of P ions is lower. Proliferation, alkaline phosphatase (ALP) activity, intracellular Ca ion concentrations defined as the number of mineralized nodules produced, and the expression of osteogenic genes were significantly higher in rBMSCs co-cultured with 50 µg/mL RSNBG than SNBG. Overall, these results validated our hypothesis that RSNBG can provide better benefit than SNBG for inducing proliferation and osteogenic differentiation in rBMSCs, in turn suggested the feasibility of this RSNBG in further studies and utilization toward the ends of improved bone repair effectiveness.
Assuntos
Células da Medula Óssea/efeitos dos fármacos , Vidro/química , Células-Tronco Mesenquimais/efeitos dos fármacos , Nanopartículas/química , Osteogênese/efeitos dos fármacos , Alicerces Teciduais/química , Animais , Materiais Biocompatíveis/química , Cálcio/química , Diferenciação Celular , Proliferação de Células , Células Cultivadas , Íons , Nanotecnologia , Tamanho da Partícula , Ratos , Ratos Sprague-Dawley , Propriedades de SuperfícieRESUMO
BACKGROUND: Our purpose was to examine the outcomes of patients who underwent extensive resection of periacetabular tumors involving the sacroiliac joint and joint reconstruction with a hemipelvic endoprosthesis. METHODS: The records of 25 consecutive patients diagnosed with Enneking type I/II/IV pelvic tumors from 2010 to 2016 who received resection and hemipelvic endoprosthesis reconstruction were retrospectively reviewed. RESULTS: The median follow-up period was 48 months. At the most recent follow-up, 11 patients were alive, with estimated 3- and 5-year survival rates of 45.6 and 38.0%, respectively. Fourteen patients died, with a mean survival of 20.8 months, and 8 patients had local recurrence at an average of 9.3 months after surgery. Distal metastases were detected in 11 patients at an average of 11.0 months after surgery. The total complication rate was 56.0%, and the most common complications were wound healing disturbances (28.0%) and deep infections (16.0%). The prosthesis-related complication rate was 24.0%; periprosthetic infections and aseptic loosening were most common. The estimated 1- and 3-year prosthesis survival rates were 81.2 and 63.2%, respectively. The mean Musculoskeletal Tumor Society score was 48.0%. Function and prosthesis-related complications did not differ significantly after adding an extra screw fixation to the first sacral vertebra. CONCLUSIONS: Reconstruction with the hemipelvic endoprosthesis described herein provides satisfactory function with a relatively low complication rate. Adding an extra screw fixation to the first sacral vertebra was not associated with any improvement in the clinical results after short-term follow-up. Improvement and further studies of this endoprosthesis are needed.
Assuntos
Acetábulo/cirurgia , Neoplasias Ósseas/cirurgia , Implantação de Prótese/métodos , Articulação Sacroilíaca/cirurgia , Acetábulo/patologia , Adolescente , Adulto , Neoplasias Ósseas/mortalidade , Neoplasias Ósseas/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Próteses e Implantes , Infecções Relacionadas à Prótese/epidemiologia , Procedimentos de Cirurgia Plástica/instrumentação , Estudos Retrospectivos , Articulação Sacroilíaca/patologia , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: Fatigue is the most common symptom in Systemic Lupus Erythematosus (SLE) patients. Many fatigue instruments have been used in SLE, with Fatigue Severity Scale (FSS) mostly adopted. However, fatigue instruments haven't been tested in the Chinese SLE population. The aim of our study was to test the psychometric properties of FSS in Chinese SLE patients. METHODS: A cross-sectional study was conducted. 201 patients diagnosed with SLE were enrolled in the study with convenience sampling. Fatigue score, depression score and vitality subscale score of SF-36 were collected. Floor and ceiling effects were tested. Factor analysis was conducted. Reliability and validity of FSS were also tested. RESULTS: Floor (4.50%) and ceiling (4.00%) effects were minimal. One factor was extracted, explaining 61.80% of total variance. When item1 and item 2 were deleted, one factor explained 69.54% of variance, and Cronbach's Alpha increased from 0.92 to 0.93. Intraclass correlation coefficient (ICC) was 0.94. Fatigue correlated with both depression (r = 0.52, P < 0.01) and vitality (r = - 0.55, P < 0.01), indicating acceptable construct validity for original FSS. When item 1 and 2 were removed, the correlation coefficient between 7-item FSS and vitality increased (r = - 0.58, P < 0.01), while correlation coefficient between 7-item FSS and depression remained the same (r = 0.52, P < 0.01). Known-groups validity was verified by that patients with depression showed higher fatigue score both for 9-item (Z = -5.56, P < 0.001) and 7-item FSS (Z = -5.70, P < 0.001). CONCLUSIONS: 9-item FSS is a reliable instrument and can be used to assess fatigue problem in Chinese SLE patients, and 7-item FSS also demonstrated good psychometric properties in the same participants.
Assuntos
Fadiga/diagnóstico , Fadiga/etiologia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Povo Asiático , Estudos Transversais , Depressão/diagnóstico , Depressão/etiologia , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Índice de Gravidade de DoençaRESUMO
The purpose of this study is to analyze various surface grafting modifications of fiberglass-reinforced resin based composite piles. In addition, the effects of surface modifications of fiberglass-reinforced resin piles in terms of biosafety and mechanical strength were studied. According to different surface treatment methods, the fiberglass was divided into five groups (A-E): a blank control group, a KH570 processing group, a KH570 processing+Bis-GMA grafting 1 h group, a KH570 processing+Bis-GMA grafting 3 h group and a KH570 processing+Bis-GMA grafting 7 h group. All surface-treated materials were characterized using scanning electron microscope, thermogravimetric analyses and Fourier transform infrared spectrum and mechanical testing using a universal mechanical tester. The biosafety was evaluated by cell viability experiments and repeated oral toxicity tests and Ames tests. The Bis-GMA grafting modification further enhanced the mechanical properties of resin piles. By increasing the grafting time, the grafting effect and mechanical properties were further enhanced. The surfaces grafted for 7 h (Group E) remarkably improved the mechanical properties (flexural strength ~696.24 MPa; flexural load ~185.67N). The graft modifications improved the mechanical properties of fiber pile resin-based materials. The prolonged grafting time further improved the mechanical properties corresponding to enhanced grafting and the formation of a stable interface between fibers and the resin matrix. The surface-modified dental resin-based fiber did not show any signs of toxicity, cytotoxicity or mutagenicity, suggesting the potential biological safety of these materials in the clinical practice.
Assuntos
Resinas Compostas/química , Contenção de Riscos Biológicos , Materiais Dentários , Endodontia/métodos , Vidro/química , Ácidos Polimetacrílicos/química , Animais , Bis-Fenol A-Glicidil Metacrilato/química , Módulo de Elasticidade , Fibroblastos/metabolismo , Humanos , Teste de Materiais , Camundongos , Testes de Mutagenicidade , Resinas Sintéticas , Salmonella typhimurium , Silanos , Espectroscopia de Infravermelho com Transformada de Fourier , Estresse Mecânico , Propriedades de Superfície , Temperatura , Resistência à Tração , TermogravimetriaRESUMO
BACKGROUND: Ovarian hyperstimulation syndrome is an iatrogenic complication of controlled ovarian stimulation. Early ovarian hyperstimulation syndrome occurs during luteal phase of controlled ovarian stimulation within 9 days after human chorionic gonadotropin trigger and reflects an acute consequence of this hormone on the ovaries. Late ovarian hyperstimulation syndrome occurs 10 or more days after human chorionic gonadotropin trigger and reflects increased endogenous human chorionic gonadotropin levels following pregnancy. Human chorionic gonadotropin stimulates granulosa-lutein cells to produce vascular endothelial growth factor messenger RNAs, which in turn raises serum vascular endothelial growth factor concentration and increases vascular permeability in women with ovarian hyperstimulation syndrome. Efforts to reduce the incidence and severity of ovarian hyperstimulation syndrome after oocyte retrieval, and in particular primary prevention efforts, are vital to prevent thrombogenesis and other serious complications. OBJECTIVE: The objective of the study was to compare the efficacy of letrozole, an aromatase inhibitor, with aspirin in primary prevention of early ovarian hyperstimulation syndrome and to compare vascular endothelial growth factor levels between groups. STUDY DESIGN: Participants in this prospective randomized trial included 238 participants undergoing cryopreservation of the whole embryos after oocyte retrieval with at least 1 of the following high-risk factors for ovarian hyperstimulation syndrome: oocyte retrieval ≥25; estradiol level ≥5000 pg/mL on the day of human chorionic gonadotropin administration; and clinical or ultrasonographic evidence of ovarian hyperstimulation syndrome on the day of oocyte retrieval, such as ultrasonographic evidence of ascites. After human chorionic gonadotropin triggering, experimental (119 cases) and control (119 cases) groups received letrozole and aspirin, respectively, for 5 days. The 5 categories of ovarian hyperstimulation syndrome include no, yes-mild, yes-moderate, yes-severe, and yes-critical. The primary outcome was the incidence and severity of early ovarian hyperstimulation syndrome. The secondary outcome included vascular endothelial growth factor level both on the second and seventh day after the human chorionic gonadotropin trigger, and clinical and laboratory features of ovarian hyperstimulation syndrome symptoms. RESULTS: The incidence of ovarian hyperstimulation syndrome was significantly higher in women receiving aspirin, compared with letrozole (90.2% vs 80.4%, P = .044). Moderate and severe ovarian hyperstimulation syndrome was also higher in the aspirin group, 45.1%, compared with the letrozole group, 25.0% (P = .002). Moreover, the duration of luteal phase was shortened in letrozole group compared with aspirin group (8.1 ± 1.1 days vs 10.5 ± 1.9 days, P < .001). The vascular endothelial growth factor level was significantly higher in the letrozole-treated group than aspirin-treated group (0.49 ± 0.26 vs 0.42 ± 0.22, P = .029). CONCLUSION: Letrozole was more effective than aspirin in decreasing the incidence of moderate and severe early-onset ovarian hyperstimulation syndrome. Our results indicate that ovarian hyperstimulation syndrome might be caused through a luteolytic effect rather than through modulation of vascular endothelial growth factor, racing by a decline in estradiol and termination of early-onset ovarian hyperstimulation syndrome in advance in high-risk women with cryopreservation of the whole embryos.
Assuntos
Inibidores da Aromatase/uso terapêutico , Nitrilas/uso terapêutico , Síndrome de Hiperestimulação Ovariana/prevenção & controle , Triazóis/uso terapêutico , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Ascite/diagnóstico por imagem , Ascite/etiologia , Aspirina/uso terapêutico , Gonadotropina Coriônica/uso terapêutico , Estradiol/metabolismo , Feminino , Humanos , Letrozol , Fase Luteal , Recuperação de Oócitos/métodos , Síndrome de Hiperestimulação Ovariana/complicações , Síndrome de Hiperestimulação Ovariana/diagnóstico por imagem , Síndrome de Hiperestimulação Ovariana/metabolismo , Indução da Ovulação/métodos , Prevenção Primária , Substâncias para o Controle da Reprodução/uso terapêutico , Medição de Risco , Índice de Gravidade de Doença , Fator A de Crescimento do Endotélio Vascular/metabolismoRESUMO
This retrospective study evaluated the embryo pooling strategy for managing insufficient number of embryos in preimplantation genetic diagnosis (PGD) through serial vitrification of cleavage-stage embryos from consecutive cycles, and simultaneous blastocysts biopsy in combination with blastocysts obtained in ultimate fresh cycle. A retrospective analysis of the cumulative pregnancy rate of 68 patients underwent cleavage-stage embryos accumulation (Embryo Pooling Group) and 94 patients underwent one stimulation cycle (Control Group) over a 2-year period were conducted. The blastocyst formation rate was comparable between the consecutive cycles and the ultimate cycle in embryo pooling group (56.0 versus 62.0%, p = .078). No significant difference existed between twice-vitrified and once-vitrified warmed blastocysts with respect to implantation rate (50.8 versus 46.3%, p = .658). The implantation rate and cumulative pregnancy rate of embryo pooling group were 49.0 and 67.6%, respectively, which were statistically comparable to the corresponding values of 48.9 and 73.4% obtained in control group. Our study suggests that in patients undergoing ICSI-PGD who do not reach enough embryos in a single stimulation cycle, pooling embryos from consecutive ovarian stimulation cycles is a promising strategy, which can render a cumulative pregnancy rate comparable to those patients who only require one stimulation cycle.
Assuntos
Criopreservação , Embrião de Mamíferos , Diagnóstico Pré-Implantação , Técnicas de Reprodução Assistida , Vitrificação , Adulto , Feminino , Humanos , Gravidez , Estudos RetrospectivosRESUMO
OBJECTIVE: To investigate the value of X-ray digital tomosynthesis (DTS) in the diagnosis of urinary stones compared with kidney ureter bladder radiography. METHODS: Between February 2011 and February 2012, 80 consecutively enrolled patients with urinary stones proved by UMDCT, the total number of which was 138, underwent additional DTS and KUB (kidney, ureter and bladder) then the number of stones and the proportions (the sensitivity of detecting stones) were recorded under all kinds of circumstances. Any two cases were selected in comparison with each other among the following four cases (DTS and KUB before and after bowel preparation).The data from all cases were statistically processed by chi-square test of four-fold table. RESULTS: The diagnostic sensitivity of DTS before and after bowel preparation, KUB before and after preparation were 94.2%, 96.4%, 47.8% and 66.7%, respectively. No significant differences between DTS before bowel preparation and DTS after bowel preparation were found. Significant differences were observed in other five ways. CONCLUSION: DTS is hardly affected by intestinal gas, feces and bones compared with KUB. Use of DTS results in improved detection rate and definition of stones with the same positioning function as KUB.
Assuntos
Ureter , Bexiga Urinária , Cálculos Urinários , Humanos , Rim , Posicionamento do Paciente , Intensificação de Imagem Radiográfica , Raios XRESUMO
OBJECTIVE: To discuss the method, safety and effect of embedding ¹²5I to Brachytherapy vertebral column metastasis tumor by CT guided. METHODS: 31 cases of vertebral column metastasis tumor were treated with percutaneous embedding ¹²5I by CT guided. They were observed the preoperative size and contour of lesions and were planed the activity and dosage of ¹²5I , the PD (prescribed dose) was 110-140 Gy, and the particle activity was 26.0-29.6 Mbq. CT scanning and therapeutic effect analysis were immediately carried out after operations. We also made CT scanning regularly to analyze the effect. RESULTS: 31 cases of vertebral column metastasis tumor were respectively re-examed of CT in 2, 4, 6 and 12 months after operation. We surveyed the local rate, evaluate the easement of pain and observed the tumor. The local response rate of 19 cases with paravertebral mass was 19/19, 19/19, 18/19, 17/19 cases in turn. The probability of odynolysis 31 cases after 2, 4, 6 months therapy was 96.8% (30/31) , 96.8% (30/31) , 90.3% (28/31) , 71.0% (22/31) in turn. 9.68% of 31 cases that was happened significant ossification in the devastated vertebral body. 12 cases appeared skin pigmentation without myelodiastasis or cutaneous ulcer. CONCLUSION: The method to treat the vertebral column metastasis tumor of embedding ¹²5I by CT guided was simple, reliable and safety.
Assuntos
Braquiterapia , Neoplasias da Medula Espinal/radioterapia , Tomografia Computadorizada por Raios X , Humanos , Neoplasias da Medula Espinal/secundárioRESUMO
Typical physiological characteristics of tumors, such as weak acidity, low oxygen content, and upregulation of certain enzymes in the tumor microenvironment (TME), provide survival advantages when exposed to targeted attacks by drugs and responsive nanomedicines. Consequently, cancer treatment has significantly progressed in recent years. However, the evolution and adaptation of tumor characteristics still pose many challenges for current treatment methods. Therefore, efficient and precise cancer treatments require an understanding of the heterogeneity degree of various factors in cancer cells during tumor evolution to exploit the typical TME characteristics and manage the mutation process. The highly heterogeneous tumor and infiltrating stromal cells, immune cells, and extracellular components collectively form a unique TME, which plays a crucial role in tumor malignancy, including proliferation, invasion, metastasis, and immune escape. Therefore, the development of new treatment methods that can adapt to the evolutionary characteristics of tumors has become an intense focus in current cancer treatment research. This paper explores the latest understanding of cancer evolution, focusing on how tumors use new antigens to shape their "new faces"; how immune system cells, such as cytotoxic T cells, regulatory T cells, macrophages, and natural killer cells, help tumors become "invisible", that is, immune escape; whether the diverse cancer-associated fibroblasts provide support and coordination for tumors; and whether it is possible to attack tumors in reverse. This paper discusses the limitations of targeted therapy driven by tumor evolution factors and explores future strategies and the potential of intelligent nanomedicines, including the systematic coordination of tumor evolution factors and adaptive methods, to meet this therapeutic challenge.
Assuntos
Imunoterapia , Neoplasias , Microambiente Tumoral , Humanos , Microambiente Tumoral/efeitos dos fármacos , Imunoterapia/métodos , Neoplasias/tratamento farmacológico , Neoplasias/terapia , Neoplasias/imunologia , Nanomedicina/métodos , Animais , Nanopartículas/química , Antineoplásicos/química , Antineoplásicos/farmacologiaRESUMO
Early detection of liver diseases holds paramount importance in optimizing treatment outcomes and prognosis, thereby significantly enhancing the likelihood of recovery while mitigating the risk of progression to liver cancer. Liver diseases encompass a spectrum of conditions, each potentially manifesting distinct enzymatic profiles. Monitoring these enzymes in situ facilitates timely intervention and therapeutic management. In recent years, the field of biosensor technology has witnessed remarkable advancement, owing to strides in biomedicine and computational sciences. Biosensors have garnered widespread utility across medical and biological domains, spanning the detection of disease biomarkers, drug release tracking, ion imaging, and fluorescence imaging within living organisms. These applications have markedly enhanced imaging resolution and have the potential to refine disease diagnosis accuracy for clinicians. A pivotal aspect in the successful application of this technology lies in the construction of fluorescence probes adept at swiftly and selectively identifying target enzymes by amalgamating liver disease enzymes with fluorescence probe technology. However, research in this niche area remains relatively scarce. Building upon this foundational understanding, the present review delineates the utilization of biosensors in the early diagnosis of liver disease. Serving as a theoretical framework, this review envisages the development of high-performance biosensors tailored for the early detection of liver cancer. Furthermore, it offers insights into the potential of biosensor technology to progress and broaden its practical applications, thus contributing to the advancement of diagnostic methodologies in liver disease management.