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1.
J Vasc Surg ; 2024 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-38621637

RESUMO

OBJECTIVE: As it remains unclear whether there are sex-based differences in clinical outcomes after thoracic endovascular aortic repair (TEVAR), this meta-analysis aimed to evaluate differences in early outcomes and overall survival between female and male patients who underwent TEVAR. METHODS: The PubMed, Embase, Web of Science, and Cochrane Central databases were searched for eligible studies published through June 10, 2023, that reported sex-based differences in clinical outcomes after TEVAR. The primary outcome was operative mortality; second outcomes included stroke, spinal cord ischemia, acute kidney injury, hospital length of stay, and overall survival. Patient characteristics, operative data, and early outcomes were aggregated using the random-effects model, presenting pooled risk ratio (RR) or standardized mean difference along with their corresponding 95% confidence intervals (CIs). Overall survival was assessed by reconstructing individual patient data to generate sex-specific pooled Kaplan-Meier curves. This study was registered in PROSPERO (CRD42023426069). RESULTS: Of the 1785 studies retrieved, 14 studies met all eligibility criteria, encompassing a total of 17,374 patients, comprising 5026 female and 12,348 male patients. Female patients were older, had a smaller maximum aortic diameter, had lower rates of smoking and coronary artery disease, and had higher rates of anemia. Intraoperatively, female patients were more likely to use iliac conduits and require blood transfusions. There were no sex-based differences in operative mortality (RR: 1.12, 95% CI: 0.90-1.40; P = .309), stroke (RR: 1.14, 95% CI: 0.95-1.38; P = .165), spinal cord ischemia (RR: 1.33, 95% CI: 0.83-2.14; P = .234), acute kidney injury (RR: 0.78, 95% CI: 0.52-1.17; P = .228), and hospital length of stay (standardized mean difference: 0.09, 95% CI: -0.03 to 0.20; P = .141). Pooled Kaplan-Meier estimates showed a worse overall survival in female patients compared with male patients (87.2% vs 89.8% at 2 years, log-rank P = .001). CONCLUSIONS: Among patients treated by TEVAR, female sex was not associated with increased risk of operative mortality or major morbidity. However, female patients exhibited a lower overall survival after TEVAR compared with male patients.

2.
Cancer Control ; 31: 10732748241261553, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38850515

RESUMO

BACKGROUND: Our objective is to develop a predictive model utilizing the ferritin and transferrin ratio (FTR) and clinical factors to forecast overall survival (OS) in breast cancer (BC) patients. METHODS: We conducted a retrospective analysis of clinical data from 2858 BC patients diagnosed between 2013 and 2021. Subsequently, the cohort of 2858 BC patients underwent random assignment into distinct subsets: a training cohort comprising 2002 patients and a validation cohort comprising 856 patients, maintaining a proportional ratio of 7:3. Employing multivariable Cox regression analysis within the training cohort, we derived a prognostic nomogram. The predictive performance was assessed using calibration curves, C-index, and decision curve analysis. RESULTS: The final prognostic model included the TNM stage, subtype, hemoglobin levels, and the ferritin-transferrin ratio. The nomogram achieved a C-index of .794 (95% CI: .777-.810). The nomogram demonstrated superior predictive accuracy for OS at 3, 5, and 7 years for BC, with area under the time-dependent curves of .812, .782, and .773, respectively. These values notably outperformed those of the conventional TNM stage. Decision curve analysis reaffirmed the greater net benefit of our nomogram compared to the TNM stage. These findings were subsequently validated in the independent validation cohort. CONCLUSION: The FTR-based prognostic model may predict a patient's OS better than the TNM stage in a clinical setting. The nomogram can provide an early, affordable, and reliable tool for survival prediction, as well as aid clinicians in treatment option-making and prognosis evaluation. However, further multi-center prospective trials are required to confirm the reliability of the existing nomogram.


BackgroundOur objective is to develop a predictive model utilizing the ferritin and transferrin ratio (FTR) and clinical factors to forecast overall survival (OS) in breast cancer (BC) patients.MethodsWe conducted a retrospective analysis of clinical data from 2858 BC patients diagnosed between 2013 and 2021. Subsequently, the cohort of 2858 BC patients underwent random assignment into distinct subsets: a training cohort comprising 2002 patients and a validation cohort comprising 856 patients, maintaining a proportional ratio of 7:3. Employing multivariable Cox regression analysis within the training cohort, we derived a prognostic nomogram. The predictive performance was assessed using calibration curves, C-index, and decision curve analysis.ResultsThe final prognostic model included the TNM stage, subtype, hemoglobin levels, and the ferritin-transferrin ratio. The nomogram achieved a C-index of .794 (95% CI: .777-.810). The nomogram demonstrated superior predictive accuracy for OS at 3, 5, and 7 years for BC, with area under the time-dependent curves of .812, .782, and .773, respectively. These values notably outperformed those of the conventional TNM stage. Decision curve analysis reaffirmed the greater net benefit of our nomogram compared to the TNM stage. These findings were subsequently validated in the independent validation cohort.ConclusionThe FTR-based prognostic model may predict a patient's OS better than the TNM stage in a clinical setting. The nomogram can provide an early, affordable, and reliable tool for survival prediction, as well as aid clinicians in treatment option-making and prognosis evaluation. However, further multi-center prospective trials are required to confirm the reliability of the existing nomogram.


Assuntos
Neoplasias da Mama , Ferritinas , Nomogramas , Transferrina , Humanos , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Neoplasias da Mama/sangue , Feminino , Ferritinas/sangue , Transferrina/análise , Transferrina/metabolismo , Pessoa de Meia-Idade , Estudos Retrospectivos , Prognóstico , Adulto , Idoso , Estadiamento de Neoplasias
3.
J Antimicrob Chemother ; 78(8): 1934-1943, 2023 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-37311203

RESUMO

INTRODUCTION: A lower adherence rate (percentage of individuals taking drugs as prescribed) to ART may increase the risk of emergence and transmission of HIV drug resistance, decrease treatment efficacy, and increase mortality rate. Exploring the impact of ART adherence on the transmission of drug resistance could provide insights in controlling the HIV epidemic. METHODS: We proposed a dynamic transmission model incorporating the CD4 cell count-dependent rates of diagnosis, treatment and adherence with transmitted drug resistance (TDR) and acquired drug resistance. This model was calibrated and validated by 2008-2018 HIV/AIDS surveillance data and prevalence of TDR among newly diagnosed treatment-naive individuals from Guangxi, China, respectively. We aimed to identify the impact of adherence on drug resistance and deaths during expanding ART. RESULTS: In the base case (ART at 90% adherence and 79% coverage), we projected the cumulative total new infections, new drug-resistant infections, and HIV-related deaths between 2022 and 2050 would be 420 539, 34 751 and 321 671. Increasing coverage to 95% would reduce the above total new infections (deaths) by 18.85% (15.75%). Reducing adherence to below 57.08% (40.84%) would offset these benefits of increasing coverage to 95% in reducing infections (deaths). Every 10% decrease in adherence would need 5.07% (3.62%) increase in coverage to avoid an increase in infections (deaths). Increasing coverage to 95% with 90% (80%) adherence would increase the above drug-resistant infections by 11.66% (32.98%). CONCLUSIONS: A decrease in adherence might offset the benefits of ART expansion and exacerbate the transmission of drug resistance. Ensuring treated patients' adherence might be as important as expanding ART to untreated individuals.


Assuntos
Síndrome da Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Humanos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , China/epidemiologia , Resistência a Medicamentos , Cooperação e Adesão ao Tratamento , Farmacorresistência Viral , Prevalência , Fármacos Anti-HIV/uso terapêutico , Fármacos Anti-HIV/farmacologia
4.
J Cardiovasc Pharmacol ; 81(4): 280-291, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36652727

RESUMO

ABSTRACT: The occurrence and development of aortic aneurysms are accompanied by senescence of human aortic smooth muscle cells (HASMCs). Because the mechanism of HASMC senescence has not been fully elucidated, the efficacy of various antisenescence treatments varies. Decreased nicotinamide adenine dinucleotide (NAD + ) levels are one of the mechanisms of cell senescence, and there is a lack of evidence on whether increasing NAD + levels could alleviate HASMC senescence and further retard the progression of aortic aneurysms.We constructed an HASMC-based organ-on-a-chip microphysiological model. RNA sequencing was performed on cell samples from the vehicle control and angiotensin II groups to explore biological differences. We detected cellular senescence markers and NAD + levels in HASMC-based organ-on-a-chip. Subsequently, we pretreated HASMC using the synthetic precursor of NAD + , nicotinamide mononucleotide, and angiotensin II treatment, and used rhythmic stretching to investigate whether nicotinamide mononucleotide could delay HASMC senescence.The HASMC-based organ-on-a-chip model can simulate the biomechanical microenvironment of HASMCs in vivo, and the use of angiotensin II in the model replicated senescence in HASMCs. The senescence of HASMCs was accompanied by downregulation of the expression level of nicotinamide phosphoribosyltransferase and NAD + . Pretreatment with nicotinamide mononucleotide significantly increased the NAD + level and alleviated the senescence of HASMCs, but did not change the expression level of nicotinamide phosphoribosyltransferase.Our study provides a complementary research platform between traditional cell culture and animal experiments to explore HASMC senescence in aortic aneurysms. Furthermore, it provides evidence for NAD + boosting therapy in the clinical treatment of aortic aneurysms.


Assuntos
Aneurisma Aórtico , Mononucleotídeo de Nicotinamida , Animais , Humanos , Mononucleotídeo de Nicotinamida/farmacologia , Mononucleotídeo de Nicotinamida/metabolismo , Angiotensina II/metabolismo , Nicotinamida Fosforribosiltransferase/metabolismo , NAD/metabolismo , Aneurisma Aórtico/metabolismo , Miócitos de Músculo Liso/metabolismo
5.
J Appl Toxicol ; 43(8): 1108-1118, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36451289

RESUMO

Cardiovascular diseases are the leading cause of death worldwide. Meanwhile, environment air pollution has become a serious health risk factor, contributing to the mortality of respiratory and cardiovascular diseases. A substantial body of evidence has shown that many types of vascular diseases are related to air pollution. The physiology and pathophysiology of the three layers of vascular vessels, especially the inner and medial layer, contribute to the process of vascular diseases. Vascular smooth muscle cells (VSMCs) are the predominant cells in the medial layer, and several studies have indicated that air pollution has an adverse effect on VSMCs. There are numerous sources of air pollution across the world, and the components of air pollutants are a complex mixture of gaseous pollutants and particulate matter. Among these air pollutants, particulate matter (PM)2.5 presents the highest risk factor leading to global mortality from cardiovascular disease and disability. In this review, we primarily focus on the impacts of PM2.5 exposure on VSMCs. We further discuss the correlation between exposure to PM2.5 and other vascular diseases and present potential protective and treatment strategies to decrease vascular mortality related to air pollution.


Assuntos
Poluentes Atmosféricos , Doenças Cardiovasculares , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Doenças Vasculares , Humanos , Material Particulado/análise , Músculo Liso Vascular , Doenças Cardiovasculares/induzido quimicamente , Poluentes Atmosféricos/toxicidade , Poluentes Atmosféricos/análise , Exposição Ambiental/efeitos adversos
6.
Eur Heart J ; 43(3): 228-235, 2022 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-34849712

RESUMO

AIMS: The incidence of acute aortic dissection (AAD) has been shown to have seasonal variation, but whether this variation can be explained by non-optimum ambient temperature and temperature change between neighbouring days (TCN) is not clear. METHODS AND RESULTS: We performed a time-stratified case-crossover study in the Registry of Aortic Dissection in China covering 14 tertiary hospitals in 11 cities from 2009 to 2019. A total of 8182 cases of AAD were included. Weather data at residential address were matched from nearby monitoring stations. Conditional logistic regression model and distributed lag nonlinear model were used to estimate the associations of daily temperature and TCN with AAD, adjusting for possible confounders. We observed an increase of AAD risk with lower temperature cumulated over lag 0-1 day and this association became statistically significant when daily mean temperature was below 24°C. Relative to the referent temperature (28°C), the odds ratios (ORs) of AAD onset at extremely low (-10°C) and low (1°C) temperature cumulated over lag 0-1 day were 2.84 [95% confidence interval (CI): 1.69, 4.75] and 2.36 (95% CI: 1.61, 3.47), respectively. A negative TCN was associated with increased risk of AAD. The OR of AAD cumulated over lag 0-6 days was 2.66 (95% CI: 1.76, 4.02) comparing the extremely negative TCN (-7°C) to no temperature change. In contrast, a positive TCN was associated with reduced AAD risk. CONCLUSION: This study provides novel and robust evidence that low ambient temperature and temperature drop between neighbouring days were associated with increased risk of AAD onset. KEY QUESTION: Incidence of acute aortic dissection (AAD) was reported to have seasonal trends, but it remains unclear whether non-optimum ambient temperature and temperature change between neighbouring days (TCN) is associated with AAD onset. KEY FINDING: Daily mean temperature lower than 24°C was significantly associated with increased risk of AAD at lag 0-1 day. A negative TCN (temperature drop) was associated with increased risk of AAD, whereas a positive TCN was associated with decreased risk. TAKE HOME MESSAGE: This multi-centre, case-crossover study provides novel and robust evidence that low ambient temperature and temperature drop between neighbouring days were associated with increased AAD risk.


Assuntos
Dissecção Aórtica , Dissecção Aórtica/epidemiologia , Dissecção Aórtica/etiologia , China/epidemiologia , Temperatura Baixa , Estudos Cross-Over , Humanos , Estações do Ano , Temperatura
7.
Perfusion ; : 2676591231205124, 2023 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-37776228

RESUMO

BACKGROUND: Postoperative patients with Type A aortic dissection (TAAD) often experience severe inflammatory responses caused by multiple factors perioperatively. However, the effect of postoperative glucocorticoid (GC) use, which is a potent anti-inflammatory agent, on complications or all-cause mortality is unclear. METHODS: Patients with TAAD who underwent surgical repair requiring deep hypothermic circulatory arrest between January 2020 and December 2021 were included in the study. Characteristics of patients treated with and without GCs were compared. The primary outcome was in-hospital mortality, and a composite secondary outcome was defined as in-hospital death or any major complications. Propensity score matching was used to balance baseline differences between groups. Kaplan-Meier curves were used to compare survival probability. RESULTS: A total of 393 postoperative patients with TAAD were included in the study. Forty of them (10.2%) received GC treatment at a median daily methylprednisolone-equivalent dose of 0.6 mg/kg (0.4-0.7) for a median period of 2 (1-3) days. Patients on GCs had more intraoperative blood transfusions, higher postoperative APACHE II (12 vs 9, p = .004) and SOFA (9 vs 6, p < .001) scores, worse perioperative hepatic, renal and cardiac function. The in-hospital mortality in the matched cohort did not differ between groups [GC n = 11/40 (27.5%) versus Non-GC n = 19/80 (23.8%); p = .661]. CONCLUSIONS: The propensity to use GCs correlated with the critical status of the patient. However, low dose and short-term postoperative GC treatment did not reduce in-hospital mortality rates among patients with TAAD. A more appropriate regimen should be further investigated.

8.
Mediators Inflamm ; 2022: 1878766, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36248192

RESUMO

The purpose of this study was to uncover potential diagnostic indicators of pulmonary arterial hypertension (PAH), evaluate the function of immune cells in the pathogenesis of the disease, and find innovative treatment targets and medicines with the potential to enhance prognosis. Gene Expression Omnibus was utilized to acquire the PAH datasets. We recognized differentially expressed genes (DEGs) and investigated their functions utilizing R software. Weighted gene coexpression network analysis, least absolute shrinkage and selection operators, and support vector machines were used to identify biomarkers. The extent of immune cell infiltration in the normal and PAH tissues was determined using CIBERSORT. Additionally, the association between diagnostic markers and immune cells was analyzed. In this study, 258DEGs were used to analyze the disease ontology. Most DEGs were linked with atherosclerosis, arteriosclerotic cardiovascular disease, and lung disease, including obstructive lung disease. Gene set enrichment analysis revealed that compared to normal samples, results from PAH patients were mostly associated with ECM-receptor interaction, arrhythmogenic right ventricular cardiomyopathy, the Wnt signaling pathway, and focal adhesion. FAM171B was identified as a biomarker for PAH (area under the curve = 0.873). The mechanism underlying PAH may be mediated by nave CD4 T cells, resting memory CD4 T cells, resting NK cells, monocytes, activated dendritic cells, resting mast cells, and neutrophils, according to an investigation of immune cell infiltration. FAM171B expression was also associated with resting mast cells, monocytes, and CD8 T cells. The results suggest that PAH may be closely related to FAM171B with high diagnostic performance and associated with immune cell infiltration, suggesting that FAM171B may promote the progression of PAH by stimulating immune infiltration and immune response. This study provides valuable insights into the pathogenesis and treatment of PAH.


Assuntos
Hipertensão Arterial Pulmonar , Biomarcadores , Redes Reguladoras de Genes , Humanos , Hipertensão Arterial Pulmonar/genética , Transdução de Sinais
9.
Surg Today ; 52(8): 1170-1177, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35079897

RESUMO

PURPOSES: To characterize the clinical features and surgical outcomes of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) in patients with only mild septal hypertrophy. METHODS: The clinical characteristics and surgical outcomes of 53 HOCM patients with a basal septal thickness ≤ 16 mm (mild group) were compared with those of 128 HOCM patients with a basal septal thickness > 16 mm (control group). RESULTS: The mild group had a greater prevalence of mitral subvalvular anomalies than the control group (79.2% vs. 6.3%, p < 0.001). Neither iatrogenic septal perforation nor inadequate septal myectomy was observed after myectomy in the mild group. There were no deaths during a median follow-up of 10 months. Transthoracic echocardiography 6 months after myectomy revealed a significant decrease in maximum gradients in both groups, from baseline 90.5 ± 21.5 mmHg to 10.3 ± 4.4 mmHg in the mild group (p < 0.001) and from 95.0 ± 22.0 mmHg to 12.0 ± 5.9 mmHg (p < 0.001) in the control group. Neither residual obstruction nor residual mitral regurgitation was recorded in the mild group. CONCLUSIONS: Symptomatic patients with hypertrophic obstructive cardiomyopathy and mild septal hypertrophy may have a higher prevalence of mitral subvalvular abnormalities. Mitral subvalvular management during myectomy can achieve outstanding results for these patients.


Assuntos
Cardiomiopatia Hipertrófica , Septos Cardíacos , Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/cirurgia , Septos Cardíacos/diagnóstico por imagem , Septos Cardíacos/cirurgia , Humanos , Hipertrofia , Valva Mitral/cirurgia , Resultado do Tratamento
10.
Ecol Lett ; 24(9): 1776-1787, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34170613

RESUMO

Identifying generalisable processes that underpin population dynamics is crucial for understanding successional patterns. While longitudinal or chronosequence data are powerful tools for doing so, the traditional focus on community-level shifts in taxonomic and functional composition rather than species-level trait-demography relationships has made generalisation difficult. Using joint species distribution models, we demonstrate how three traits-photosynthetic rate, adult stature, and seed mass-moderate recruitment and sapling mortality rates of 46 woody species during secondary succession. We show that the pioneer syndrome emerges from higher photosynthetic rates, shorter adult statures and lighter seeds that facilitate exploitation of light in younger secondary forests, while 'long-lived pioneer' and 'late successional' syndromes are associated with trait values that enable species to persist in the understory or reach the upper canopy in older secondary forests. Our study highlights the context dependency of trait-demography relationships, which drive successional shifts in sapling's species composition in secondary forests.


Assuntos
Árvores , Clima Tropical , Florestas , Dinâmica Populacional , Síndrome
11.
J Transl Med ; 19(1): 27, 2021 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413474

RESUMO

BACKGROUND: KRAS gene is the most common type of mutation reported in colorectal cancer (CRC). KRAS mutation-mediated regulation of immunophenotype and immune pathways in CRC remains to be elucidated. METHODS: 535 CRC patients were used to compare the expression of immune-related genes (IRGs) and the abundance of tumor-infiltrating immune cells (TIICs) in the tumor microenvironment between KRAS-mutant and KRAS wild-type CRC patients. An independent dataset included 566 cases of CRC and an in-house RNA sequencing dataset were served as validation sets. An in-house dataset consisting of 335 CRC patients were used to analyze systemic immune and inflammatory state in the presence of KRAS mutation. An immue risk (Imm-R) model consist of IRG and TIICs for prognostic prediction in KRAS-mutant CRC patients was established and validated. RESULTS: NF-κB and T-cell receptor signaling pathways were significantly inhibited in KRAS-mutant CRC patients. Regulatory T cells (Tregs) was increased while macrophage M1 and activated CD4 memory T cell was decreased in KRAS-mutant CRC. Prognosis correlated with enhanced Tregs, macrophage M1 and activated CD4 memory T cell and was validated. Serum levels of hypersensitive C-reactive protein (hs-CRP), CRP, and IgM were significantly decreased in KRAS-mutant compared to KRAS wild-type CRC patients. An immune risk model composed of VGF, RLN3, CT45A1 and TIICs signature classified CRC patients with distinct clinical outcomes. CONCLUSIONS: KRAS mutation in CRC was associated with suppressed immune pathways and immune infiltration. The aberrant immune pathways and immune cells help to understand the tumor immune microenvironments in KRAS-mutant CRC patients.


Assuntos
Neoplasias do Colo , Neoplasias Colorretais , Relaxina , Antígenos de Neoplasias , Neoplasias do Colo/genética , Neoplasias Colorretais/genética , Genes ras , Humanos , Mutação/genética , Prognóstico , Proteínas Proto-Oncogênicas p21(ras)/genética , Microambiente Tumoral
12.
Nitric Oxide ; 109-110: 26-32, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33667622

RESUMO

BACKGROUND: To assess the relationship between the intrapulmonary shunt and PaO2/FiO2 in severe hypoxemic patients after acute type A aortic dissection (ATAAD) surgery and to evaluate the effect of inhaled nitric oxide (iNO) on intrapulmonary shunt. METHODS: Postoperative ATAAD patients with PaO2/FiO2 ≤ 150 mmHg were enrolled. Intrapulmonary shunt was calculated from oxygen content of different sites (artery [CaO2], mixed venous [CvO2], and alveolar capillary [CcO2]) using the Fick equation, where intrapulmonary shunt = (CcO2-CaO2)/(CcO2-CvO2). Related variables were measured at baseline (positive end expiratory pressure [PEEP] 5 cm H2O), 30 min after increasing PEEP (PEEP 10 cm H2O), 30 min after 5 ppm iNO therapy (PEEP 10 cm H2O + iNO), and 30 min after decreasing PEEP (PEEP 5 cm H2O + iNO). RESULTS: A total of 20 patients were enrolled between April 2019 and December 2019. Intrapulmonary shunt and PaO2/FiO2 were correlated in severe hypoxemic, postoperative ATAAD patients (adjusted R2 = 0.467, p < 0.001). A mixed model for repeated measures revealed that iNO, rather than increasing PEEP, significantly decreased the intrapulmonary shunt (by 15% at a PEEP of 5 cm H2O and 16% at a PEEP of 10 cm H2O, p < 0.001 each) and increased PaO2/FiO2 (by 63% at a PEEP of 5 cm H2O and 65% at a PEEP of 10 cm H2O, p < 0.001 each). After iNO therapy, the decrement of intrapulmonary shunt and the increment of PaO2/FiO2 were also correlated (adjusted R2 = 0.375, p < 0.001). CONCLUSIONS: This study showed that intrapulmonary shunt and PaO2/FiO2 were correlated in severe hypoxemic, postoperative ATAAD patients. Furthermore, iNO, rather than increasing PEEP, significantly decreased the intrapulmonary shunt to improve severe hypoxemic conditions.


Assuntos
Dissecção Aórtica/complicações , Hipóxia/tratamento farmacológico , Óxido Nítrico/uso terapêutico , Troca Gasosa Pulmonar/efeitos dos fármacos , Administração por Inalação , Adulto , Aorta/cirurgia , Gasometria , Humanos , Hipóxia/etiologia , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/administração & dosagem , Oxigênio/metabolismo , Respiração com Pressão Positiva
13.
Langmuir ; 37(3): 1235-1246, 2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33434429

RESUMO

In this study, the effect of sodium dodecyl sulfonate (SDS) on the foam stability of dodecylamine (DDA) and on its adsorption configuration at the gas-liquid interface was investigated. Froth stability experiments, surface tension measurements, time-of-flight secondary-ion mass spectrometry measurements, and molecular dynamics simulation calculations were performed in this investigation. The results revealed that the foam stability of DDA solution was extremely strong, and the addition of SDS could decrease the foam stability when the concentration of DDA was less than a certain value. The decrease in foam stability could be ascribed to several reasons, namely, the big cross-sectional area of SDS at the gas-liquid interface and low adsorption capacity of surfactants at the gas-liquid interface, the high surface tension, the change in the double-layer structure, the small thickness of the gas-liquid interfacial layer, the weak interaction intensity between the head groups of the surfactants and the water molecules, the strong movement ability of the water molecules around the head groups, and the sparse and less upright arrangement configuration of molecules at the gas-liquid interface. These findings can greatly help in solving the strong foam stability problem in DDA flotation and provide a method for reducing foam stability.

14.
J Cardiovasc Pharmacol ; 78(2): 211-220, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33990514

RESUMO

ABSTRACT: Aortic aneurysm (AA) remains one of the primary causes of death worldwide. Of the major treatments, prophylactic operative repair is used for AA to avoid potential aortic dissection or rupture. To halt the development of AA and alleviate its progression into aortic dissection, pharmacological treatment has been investigated for years. Currently, ß-adrenergic blocking agents, losartan, irbesartan, angiotensin-converting-enzyme inhibitors, statins, antiplatelet agents, doxycycline, and metformin have been investigated as potential candidates for preventing AA progression. However, the paradox between preclinical successes and clinical failures still exists, with no medical therapy currently available for ideally negating the disease progression. This review describes the current drugs used for pharmacological management of AA and their individual potential mechanisms. Preclinical models for drug screening and evaluation are also discussed to gain a better understanding of the underlying pathophysiology and ultimately find new therapeutic targets for AA.


Assuntos
Aorta/efeitos dos fármacos , Aneurisma Aórtico/tratamento farmacológico , Fármacos Cardiovasculares/uso terapêutico , Remodelação Vascular/efeitos dos fármacos , Animais , Aorta/metabolismo , Aorta/patologia , Aneurisma Aórtico/metabolismo , Aneurisma Aórtico/patologia , Fármacos Cardiovasculares/efeitos adversos , Dilatação Patológica , Modelos Animais de Doenças , Progressão da Doença , Humanos , Transdução de Sinais , Resultado do Tratamento
15.
World J Surg Oncol ; 19(1): 23, 2021 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478479

RESUMO

BACKGROUND: The use of 3-dimensional (3D) endoscopic thyroidectomy (ET) has been increasing, but its feasibility and safety have not been well documented for thyroidectomy. Hence, to systematically investigate the comparative outcomes during 3D-ET and 2-dimensional (2D) ET for benign and malignant lesions, we conducted this meta-analysis. METHODS: Based on the PRISMA guidelines, a systematic database search of the PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), and Chinese Wanfang databases was performed. The eligible studies were published in English and Chinese up to October 2020. The major endpoints evaluated were procedure time, blood loss, postoperative drainage, postoperative hospitalization, postoperative complications, total number of lymph node dissections (LNDs), and total cost. RESULTS: A total of 15 relevant studies including 1190 patients (583 for 3D-ET and 607 for 2D-ET) compared the application of 3D and 2D laparoscopic systems in thyroid surgery, of which 8 were endoscopic benign thyroidectomy (EBT) and 7 were endoscopic malignant thyroidectomy (EMT). Our meta-analysis indicated that 3D-ET generally had advantages over 2D-ET in terms of procedure time (P = 0.000), blood loss (P = 0.000), postoperative drainage (P = 0.000), postoperative complications (P = 0.000), and LNDs (P = 0.006). However, there were no significant differences between the two systems in terms of total cost (P = 0.245) or postoperative hospitalization (P = 0.068). Subgroup analysis showed consistency of the overall outcomes in each subset, but a shorter postoperative hospitalization in 3D-EBT was revealed. CONCLUSIONS: Compared to 2D-ET, 3D endoscopic thyroidectomy is an efficient, safe, and reliable method with better depth perception and stereoscopic vision, and an equally satisfactory outcome. More clinical RCTs with long-term follow-up are required to reproduce these promising results.


Assuntos
Laparoscopia , Neoplasias da Glândula Tireoide , China , Endoscopia , Humanos , Excisão de Linfonodo , Prognóstico , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Resultado do Tratamento
16.
Tech Coloproctol ; 25(12): 1291-1300, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34581900

RESUMO

BACKGROUND: The greater omentum has played a unique biological role in regenerative surgery. The aim of our study was to alter the anterior sacral structure by filling the anterior sacral space with the greater omentum and evaluate its effect on the low anterior resection syndrome (LARS) after total mesorectal excision (TME) surgery for low rectal cancer. METHODS: We retrospectively collected clinical data of patients with primary low rectal cancer who underwent TME and ileostomy closure in our hospital from March 2018 to March 2020. Spearman correlation analysis was conducted to analyze the correlation between postoperative mesorectal fascia (MRF) thickness and LARS score. Subsequently, we prospectively used a tipped greater omental flap graft to reconstruct the anterior rectal sacral structures (MRF reconstruction) in 17 patients and compared LARS scores and rectal compliance (RC) at week 12 after closure of the ileostomy in both groups. RESULTS: There were 47 patients with No-MRF reconstruction (31 males, mean age 60.68 ± 9.21 years) and 17 with MRF reconstruction (10 males, mean age 49.82 ± 14.74 years). Correlation analysis indicated that MRF thickness and RC were negatively correlated with LARS severity (p < 0.05). The LARS score of patients with MRF reconstruction at 12 weeks was significantly better than that of those with No-MRF reconstruction (32.97 ± 2.65 vs. 26.94 ± 1.52, p = 0.001), and the RC of MRF reconstruction were lower (2.80 ± 0.55 vs. 3.67 ± 0.38, p = 0.001). In addition, MRF reconstruction and No-MRF reconstruction have the similar incidence of postoperative complications (p = 0.156). No hemorrhage or necrosis of the greater omentum flap was observed in any of the patients. CONCLUSIONS: Greater omentum flap transplantation can significantly improve the symptoms of LARS at 12 weeks after ileostomy closure and we expect it to become a new surgical procedure for the treatment of low rectal cancer.


Assuntos
Complicações Pós-Operatórias , Neoplasias Retais , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Omento/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Síndrome
17.
Int Heart J ; 62(2): 329-336, 2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33731518

RESUMO

The reasons of residual left ventricular outflow tract (LVOT) obstruction following alcohol septal ablation (ASA) remain unclear, and outcomes of myectomy following failed ASA remain underreported.Thirteen symptomatic patients (10 women, a median age of 60.0 years) who underwent septal myectomy following failed ASA were reviewed. The patients were followed up for a median of 6 months. The clinical characteristics and outcomes of these patients were analyzed and were compared with those of 178 patients who underwent isolated myectomy without previous ASA at our institution during the same period.In the first ASA procedure, the median number of septal perforator arteries injected was 1.0 with the median value of peak creatine kinase following ablation of 978.5 U/L.Uncontrollable extent and location of infarcted myocardium caused by ablation and mitral subvalvular anomalies were found in four (30.8%) and seven (53.8%) patients, respectively. No operative or follow-up deaths occurred. The median maximum LVOT gradients fell from preoperative 112.0 to 8.5 mmHg at follow-up (P < 0.001). Compared with controls, patients with failed ASA had a higher proportion of mitral subvalvular anomalies (53.8% versus 13.5%, P = 0.001) and developed a higher incidence of complete atrioventricular block following myectomy (15.4% versus 1.7%, P = 0.038).Low institutional or operator experience with ablation, uncontrollable extent and location of infarcted myocardium caused by ablation, and mitral subvalvular anomalies may be reasons for failed ASA. Surgical myectomy for the treatment of residual LVOT obstruction after unsuccessful ASA may be associated with favorable results.


Assuntos
Técnicas de Ablação/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/métodos , Etanol/farmacologia , Septos Cardíacos/cirurgia , Obstrução do Fluxo Ventricular Externo/terapia , Adulto , Idoso , Feminino , Seguimentos , Frequência Cardíaca/fisiologia , Septos Cardíacos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Falha de Tratamento , Obstrução do Fluxo Ventricular Externo/diagnóstico , Obstrução do Fluxo Ventricular Externo/fisiopatologia
18.
Int Heart J ; 62(5): 1069-1075, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34588406

RESUMO

The surgical strategies for acute type-A aortic dissection (aTAAD) with coronary artery involvement have been controversial, and its prognosis remains unclear. Thus, in this study, we aim to determine the characteristics, surgical strategies, and prognosis of patients with coronary artery involvement due to aTAAD.Retrospective analysis of 65 consecutive aTAAD patients with coronary artery involvement between September 2005 and January 2012 was performed. The patients were divided into two groups: those treated with aTAAD repair and coronary ostia reimplantation (Neri type-A, group A, n = 37) and those with aTAAD repair and coronary artery bypass grafting (Neri type B and C, group B, n = 28).Overall in-hospital mortality was determined to be 8.1% for group A and 21.4% for group B (P = 0.124). No significant difference was determined between groups A and B in cardiopulmonary bypass time, cross-clamp time, cerebral perfusion time, and hospitalization time. Intensive care unit (ICU) stay was 5.8 ± 7.4 days for group A, whereas it was 12.4 ± 10.6 days for group B (P = 0.009). The morbidity of postoperative temporary and permanent neurological dysfunction was similar between the two groups, while renal and respiratory dysfunction were 8.1% versus 25.0% and 16.2% versus 39.3%, respectively (P = 0.062, P = 0.036). Average follow-up time was 112.0 ± 44.8 months, and survival curves have not shown statistical significance between two groups (P = 0.386).Coronary artery dissection with Neri type B and C in acute TAAD has been associated with higher early death, but comparable long-term survival after discharge. However, combined immediate coronary artery bypass grafting and aortic repair remains a safe, effective, and acceptable approach to these challenging group of patients.


Assuntos
Dissecção Aórtica/cirurgia , Doença da Artéria Coronariana/cirurgia , Doença Aguda , Adulto , Idoso , Dissecção Aórtica/classificação , Dissecção Aórtica/complicações , Doença da Artéria Coronariana/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
19.
Hum Mol Genet ; 27(2): 307-321, 2018 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-29149261

RESUMO

Glucose transporter 10 (GLUT10) is a member of the GLUT family of membrane transporters, and mutations in this gene cause arterial tortuosity syndrome (ATS). However, the physiological role and regulation of GLUT10 in arteries remains unclear. To further understand its physiological roles in major arteries, we examined the regulatory mechanisms of GLUT10 in ASMCs and aortic tissues. Interestingly, we find that targeting of GLUT10 to mitochondria is increased in ASMCs under both stress and aging conditions, which enhances dehydroascorbic acid (DHA) uptake and maintains intracellular ascorbic acid (AA) levels. We further demonstrate that the targeting of GLUT10 to mitochondria is important to maintain redox homeostasis, mitochondrial structure and mitochondrial function in ASMCs. A missense mutation of GLUT10 (Glut10G128E) impairs mitochondrial targeting in ASMCs. Consequently, ASMCs isolated from Glut10G128E mice exhibit increased reactive oxygen species (ROS) levels, fragmented mitochondria and impaired mitochondrial function, as well as enhanced cell proliferation and migration. In vivo, mitochondrial structure is altered, and ROS levels are heightened in aortic tissues of Glut10G128E mice. Furthermore, increased number and disorganization of ASMCs, along with progressive arterial wall remodeling were observed in aortic tissues of Glut10G128E mice. These defects were coincident with elevated systolic blood pressure in aged Glut10G128E animals. Our results describe a novel mechanism that GLUT10 targeting to mitochondria under stress and aging condition has a critical role in maintaining AA levels, redox homeostasis and mitochondrial structure and function in ASMCs, which is likely to contribute to the maintenance of healthy vascular tissue.


Assuntos
Artérias/metabolismo , Proteínas Facilitadoras de Transporte de Glucose/metabolismo , Animais , Aorta/metabolismo , Transporte Biológico/genética , Linhagem Celular , Proteínas Facilitadoras de Transporte de Glucose/genética , Homeostase , Humanos , Camundongos , Camundongos Endogâmicos C3H , Mitocôndrias/metabolismo , Mutação , Oxirredução , Ratos , Espécies Reativas de Oxigênio/metabolismo
20.
J Sci Food Agric ; 100(13): 4671-4677, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32253757

RESUMO

BACKGROUND: Gel properties are important in determining the quality of surimi. In addition to myofibrillar proteins, lipids play an important role in the formation of surimi gel. Phospholipids (PL) are amphoteric lipids that cannot be removed through rinsing. Paradoxically, the addition of PL increases or decreases gel strength. This research aimed to investigate the effects of specific lipids on the gelation properties of surimi from three different carp. RESULTS: The hardness, chewiness, and gel strength of bighead carp (Aristichthys nobilis: BC) surimi were higher, and the total lipid content was lower when compared with grass carp (Ctenopharyngodon idellus: GC) and silver carp (Hypophthalmichthys molitrix: SC) surimi. Bighead carp surimi had lower levels of phosphatidylethanolamine (PE), phosphatidylinositols (PI), and phosphatidylcholine (PC), and higher phosphatidylserine (PS) and sphingomyelin (SM) content. The gelation properties of surimi increased with increasing concentrations of SM and PS. Furthermore, increased levels of saturated fatty acids (SFAs) and decreased levels of polyunsaturated fatty acids (PUFAs) increased gelation properties. Finally, higher hydrophobic interactions and more disulfide bonds were shown to increase gel network structure stability, resulting in improving gel strength in BC surimi. CONCLUSION: The textural characteristics and gel strength of surimi were dependent on the PL content, including total lipid levels and the types of fatty acids. This may account for previous conflicting reports on PL effects on gel strength. This study provides insight into how the texture of surimi can be improved and provides a starting point for further research. © 2020 Society of Chemical Industry.


Assuntos
Produtos Pesqueiros/análise , Aditivos Alimentares/análise , Géis/química , Fosfolipídeos/análise , Animais , Carpas , China , Manipulação de Alimentos , Interações Hidrofóbicas e Hidrofílicas
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