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PURPOSE: To maintain safe intrarenal pelvic pressure (IPP), the combination of flexible ureteroscope (fURS) and traditional ureteral access sheath (T-UAS) should maintain a basic rule that is the ratio of endoscope-sheath diameter (RESD) ≤ 0.75. However, the negative-pressure ureteral access sheath (NP-UAS) may break the rule of negative pressure suction. This study aimed to examine the effect of NP-UAS on IPP and flow rate (FR) with varying RESD. METHODS: In a 3D-printed renal model, flexible ureteroscopy lithotripsy (fURL) was replicated. Six sizes of fURS paired with 12Fr T-UAS and NP-UAS resulted in six distinct RESDs of 0.63, 0.78, 0.87, 0.89, 0.90, and 0.91. While the irrigation pressure (IRP) was set between 100 and 800 cmH2O and the sucking pressure (SP) was set between 0 and 800 cmH2O, the IPP and FR were measured in each RESD. RESULTS: NP-UASs can reduce the IPP and increase the FR at the same RESD compared to T-UASs. The IPP decreased with increasing SP with NP-UAS. When RESD ≤ 0.78, T-UAS and NP-UAS can maintain IPP < 40 cmH2O in most circumstances. When RESD = 0.87, it is challenging for T-UAS to sustain IPP < 40 cmH2O; however, NP-UAS can do so. When RESD ≥ 0.89, it is difficult to maintain an IPP < 40 cmH2O even with NP-UAS. CONCLUSION: NP-UAS can decrease IPP and increase FR compared with T-UAS. To maintain a safe IPP, it is recommended that RESD < 0.85 when utilizing NP-UAS.
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Cálculos Renais , Ureter , Humanos , Ureteroscopia/métodos , Rim , UreteroscópiosRESUMO
OBJECTIVE: To explore the parameters influencing intraoperative calculi excretion (ICE) during flexible ureteroscopy lithotripsy (fURL) using in vitro simulation experiments. METHODS: 3D-printed human kidney models were used to simulate the elimination of gravel during fURL. The factors influencing the ICE during fURL were analyzed by comparing the effects of different degrees of hydronephrosis (mild, moderate, and severe), surgical positions (supine and lateral position), ratios of endoscope-sheath diameter (RESD) (0.625, 0.725, and 0.825), gravel sizes (0.50-1.00 mm, 0.25-0.50 mm, and 0.10-0.25 mm), and ureteral access sheaths (UASs) (traditional UAS and negative-pressure UAS) on ICE. RESULTS: The impacts of various UAS, RESD, degree of hydronephrosis, surgical positions, and gravel sizes on ICE were all significant (p < 0.05). We found no evidence of multicollinearity for all the independent variables, and the linear regression equation fitted as ICE ( g / min ) = 0.102 + 0.083 ∗ UAS grade - 0.050 ∗ RESD grade - 0.048 ∗ hydronephrosis grade + 0.065 ∗ position grade - 0.027 ∗ gravel size grade (R2 = 0.569). CONCLUSION: Employing negative-pressure UAS, smaller RESD, milder hydronephrosis, lateral position, and smaller gravel size contribute to improved ICE during fURL. Among them, the adoption of negative-pressure UAS had the most substantial effects.
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Hidronefrose , Cálculos Renais , Litotripsia , Cálculos Ureterais , Humanos , Ureteroscopia , Cálculos Renais/cirurgia , Ureteroscópios , Cálculos Ureterais/cirurgiaRESUMO
Osteoporosis is a highly prevalent metabolic disease characterized by low systemic bone mass and deterioration of bone microarchitecture, resulting in reduced bone strength and increased fracture risk. Current treatment options for osteoporosis are limited by factors such as efficacy, cost, availability, side effects, and acceptability to patients. Gold nanoparticles show promise as an emerging osteoporosis therapy due to their osteogenic effects and ability to allow therapeutic delivery but have inherent constraints, such as low specificity and the potential for heavy metal accumulation in the body. This study reports the synthesis of ultrasmall gold particles almost reaching the Ångstrom (Ång) dimension. The antioxidant alpha-lipoic acid (LA) is used as a dispersant and stabilizer to coat Ångstrom-scale gold particles (AuÅPs). Alendronate (AL), an amino-bisphosphonate commonly used in drug therapy for osteoporosis, is conjugated through LA to the surface of AuÅPs, allowing targeted delivery to bone and enhancing antiresorptive therapeutic effects. In this study, alendronate-loaded Ångstrom-scale gold particles (AuÅPs-AL) were used for the first time to promote osteogenesis and alleviate bone loss through regulation of the WNT signaling pathway, as shown through in vitro tests. The in vivo therapeutic effects of AuÅPs-AL were demonstrated in an established osteoporosis mouse model. The results of Micro-computed Tomography, histology, and tartrate-resistant acid phosphatase staining indicated that AuÅPs-AL significantly improved bone density and prevented bone loss, with no evidence of nanoparticle-associated toxicity. These findings suggest the possible future application of AuÅPs-AL in osteoporosis therapy and point to the potential of developing new approaches for treating metabolic bone diseases using Ångstrom-scale gold particles.
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Alendronato , Ouro , Nanopartículas Metálicas , Osteoporose , Ácido Tióctico , Animais , Alendronato/química , Alendronato/farmacologia , Ácido Tióctico/química , Ácido Tióctico/farmacologia , Ouro/química , Osteoporose/tratamento farmacológico , Camundongos , Nanopartículas Metálicas/química , Feminino , Osteogênese/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Conservadores da Densidade Óssea/química , Conservadores da Densidade Óssea/farmacologia , Conservadores da Densidade Óssea/uso terapêutico , Tamanho da PartículaRESUMO
PURPOSE: Major Depressive Disorder (MDD) and Insomnia Disorder (ID) are prevalent psychiatric conditions often occurring concurrently, leading to substantial impairment in daily functioning. Understanding the neurobiological underpinnings of these disorders and their comorbidity is crucial for developing effective interventions. This study aims to analyze changes in functional connectivity within attention networks and default mode networks in patients with depression and insomnia. METHODS: The functional connectivity alterations in individuals with MDD, ID, comorbid MDD and insomnia (iMDD), and healthy controls (HC) were assessed from a cohort of 174 participants. They underwent rs-fMRI scans, demographic assessments, and scale evaluations for depression and sleep quality. Functional connectivity analysis was conducted using region-of-interest (ROI) and whole-brain methods. RESULTS: The MDD and iMDD groups exhibited higher Hamilton Depression Scale (HAMD) scores compared to HC and ID groups (P < 0.001). Both ID and MDD groups displayed enhanced connectivity between the left and right orbital frontal cortex compared to HC (P < 0.05), while the iMDD group showed reduced connectivity compared to HC and ID groups (P < 0.05). In the left insula, reduced connectivity with the right medial superior frontal gyrus was observed across patient groups compared to HC (P < 0.05), with the iMDD group showing increased connectivity compared to MDD (P < 0.05). Moreover, alterations in functional connectivity between the left thalamus and left temporal pole were found in iMDD compared to HC and MDD (P < 0.05). Correlation analyses revealed associations between abnormal connectivity and symptom severity in MDD and ID groups. CONCLUSIONS: Our findings demonstrate distinct patterns of altered functional connectivity in individuals with MDD, ID, and iMDD compared to healthy controls. These findings contribute to a better understanding of the pathophysiology of depression and insomnia, which could be used as a reference for the diagnosis and treatments of these patients.
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Rede de Modo Padrão , Transtorno Depressivo Maior , Imageamento por Ressonância Magnética , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/fisiopatologia , Distúrbios do Início e da Manutenção do Sono/diagnóstico por imagem , Masculino , Feminino , Adulto , Transtorno Depressivo Maior/fisiopatologia , Pessoa de Meia-Idade , Rede de Modo Padrão/fisiopatologia , Rede Nervosa/fisiopatologia , Rede Nervosa/diagnóstico por imagem , Atenção/fisiologia , Comorbidade , Encéfalo/fisiopatologia , Encéfalo/diagnóstico por imagem , ConectomaRESUMO
End-groups halogenation strategies, generally refers to fluorination and chlorination, have been confirmed as simple and efficient methods to regulate the photoelectric performance of non-fullerene acceptors (NFAs), but a controversy over which one is better has existed for a long time. Here, two novel NFAs, C9N3-4F and C9N3-4Cl, featured with different end-groups were successfully synthesized and blended with two renowned donors, D18 and PM6, featured with different electron-withdrawing units. Detailed theoretical calculations and morphology characterizations of the interface structures indicate NFAs based on different end-groups possess different binding energy and miscibility with donors, which shows an obvious influence on phase-separation morphology, charge transport behavior and device performance. After verified by other three pairs of reported NFAs, a universal conclusion obtained as the devices based on D18 with fluorination-end-groups-based NFAs and PM6 with chlorination-end-groups-based NFAs generally show excellent efficiencies, high fill factors and stability. Finally, the devices based on D18: C9N3-4F and PM6: C9N3-4Cl yield outstanding efficiency of 18.53 % and 18.00 %, respectively. Suitably selecting donor and regulating donor/acceptor interface can accurately present the photoelectric conversion ability of a novel NFAs, which points out the way for further molecular design and selection for high-performance and stable organic solar cells.
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Spin state is often regarded as the crucial valve to release the reactivity of energy-related catalysts, yet it is also challenging to precisely manipulate, especially for the active center ions occupied at the specific geometric sites. Herein, a π-π type orbital coupling of 3d (Co)-2p (O)-4f (Ce) was employed to regulate the spin state of octahedral cobalt sites (CoOh) in the composite of Co3O4/CeO2. More specifically, the equivalent high-spin ratio of CoOh can reach to 54.7 % via tuning the CeO2 content, thereby triggering the average eg filling (1.094) close to the theoretical optimum value. The corresponding catalyst exhibits a superior water oxidation performance with an overpotential of 251â mV at 10â mA cm-2, rivaling most cobalt-based oxides state-of-the-art. The π-π type coupling corroborated by the matched energy levels between Ce t1u/t2u-O and CoOh t2g-O π type bond in the calculated crystal orbital Hamilton population and partial density of states profiles, stimulates a π-donation between O 2p and π-symmetric Ce 4fyz 2 orbital, consequently facilitating the electrons hopping from t2g to eg orbital of CoOh. This work offers an in-depth insight into understanding the 4f and 3d orbital coupling for spin state optimization in composite oxides.
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Airway stent insertion is important for patients with airway stenosis. Currently, the most widely used airway stents in clinical procedures are silicone and metallic stents, which offer patients effective treatment. However, these stents composed of permanent materials need to be removed, subjecting patients to invasive manipulation once more. As a result, there is a growing demand for biodegradable airway stents. Biodegradable materials for airway stents are now available in two types: biodegradable polymers and biodegradable alloys. Polymers that include poly (
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Polidioxanona , Traqueia , Animais , Humanos , Polímeros , Stents , Ligas , Implantes AbsorvíveisRESUMO
OBJECTIVES: To establish a rapid method for the analysis of bucinnazine in blood by UPLC-MS/MS and to apply the method to the practical case. METHODS: After the internal standard was added to blood, the protein was precipitated with 900 µL mixed solution (Vacetonitrileâ¶Vwater=8â¶2). After vortex and centrifugation, the protein was measured through 0.22 µm filter membrane. The separation was performed on C18 chromatography column, with acetonitrile and 5 mmol/L ammonium acetate containing 0.1% formic acid aqueous as mobile phase gradient elution at the flow rate of 0.4 mL/min. Multiple reaction monitoring scan was performed in electrospray positive ion mode, quantitative measurement was performed by internal standard method, and methodological verification was carried out. RESULTS: The linear relationship of bucinnazine in blood was good in the range of 0.5-200 µg/L, the correlation coefficient (r) was 0.999 7, the limit of detection was 0.1 µg/L, the limit of quantitation was 0.5 µg/L, and the recovery was 78.3%-83.8% at 1, 10 and 100 µg/L mass concentration levels. The matrix effect was 69.4%-73.8%, the intra-day precision was 1.9%-2.8%, and the inter-day precision was 2.8%-3.2%, the accuracy was 3.1%-3.5%. The stability test results of 1 and 100 µg/L mass concentrations at -25 â showed that the accuracy (bias) of 10 d was less than 4.5%. CONCLUSIONS: This method has the advantages of simple pre-treatment process, fast sample processing speed, high sensitivity of instrument analysis, good stability of content determination and reliable identification results, and can meet the needs of case identification.
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Espectrometria de Massas em Tandem , Espectrometria de Massas em Tandem/métodos , Cromatografia Líquida , Cromatografia Líquida de Alta Pressão/métodos , AcetonitrilasRESUMO
The wearable application of flexible organic solar cells (f-OSCs) necessitates high power conversion efficiency (PCE) and mechanical robustness. However, photoactive films based on efficient non-fullerene small molecule acceptors (NF-SMAs) are typically brittle, leading to poor mechanical stability in devices. In this study, we achieved a remarkable PCE of 18.06 % in f-OSCs while maintaining ultrahigh mechanical robustness (with a crack-onset strain (COS) of higher than 11 %) by incorporating a linker dimerized acceptor (DOY-TVT). Compared to binary blends, ternary systems exhibit reduced non-radiative recombination, suppressed crystallization and diffusion of NF-SMAs, and improved load distribution across the chain networks, enabling the dissipation of the load energy. Thus, the ternary f-OSCs developed in this study achieved, high PCE and stability, surpassing binary OSCs. Moreover, the developed f-OSCs retained 97 % of the initial PCE even after 3000 bending cycles, indicating excellent mechanical stability (9.1 % higher than binary systems). Furthermore, the rigid device with inverted structure based on the optimal active layer exhibited a substantial increase in efficiency retention, with 89.6 % after 865â h at 85 °C and 93 % after more than 1300â h of shelf storage at 25 °C. These findings highlight the potential of the linker oligomer acceptor for realizing high-performing f-OSCs with ultrahigh mechanical robustness.
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BACKGROUND: Conventional chemotherapy has poor efficacy in triple-negative breast cancer (TNBC) which is highly heterogeneous and aggressive. Imaging-guided therapy is usually combined with diverse treatment modalities, could realize the integration of diagnosis and treatments. Therefore, the primary challenge for combinational therapy is designing proper delivery systems to accomplish multiple synergistic effects. RESULTS: Herein, a facile nanoplatform was manufactured to fulfill the all-in-one approaches for TNBC combinational therapy. Fe3+-based metal-phenolic networks (MPNs) with bovine serum albumin (BSA) modification served as drug delivery carriers to encapsulate bleomycin (BLM), forming BFE@BSA NPs. The self-assembly mechanism, pH-responsive drug release behavior, and other physicochemical properties of this system were characterized. The potential of BFE@BSA NPs as photothermal transduction agents and magnetic resonance imaging (MRI) contrast agents was explored. The synergistic anti-tumor effects consisting of BLM-induced chemotherapy, Fenton reactions-mediated chemodynamic therapy, and photothermal therapy-induced apoptosis were studied both in vitro and in vivo. Once internalized into tumor cells, released BLM could cause DNA damage, while Fenton reactions were initiated to produce highly toxic â¢OH. Upon laser irradiation, BFE@BSA NPs could convert light into heat to achieve synergistic effects. After intravenous administration, BFE@BSA NPs exhibited great therapeutic effects in 4T1 tumor xenograft model. Moreover, as T1-weighted MRI contrast agents, BFE@BSA NPs could provide diagnosis and treatment monitoring for individualized precise therapy. CONCLUSIONS: A nano-system that integrated imaging and combinational therapy (chemotherapy, chemodynamic therapy and photothermal therapy) were developed to kill the tumor and monitor therapeutic efficacy. This strategy provided an all-in-one theranostic nanoplatform for MRI-guided combinational therapy against TNBC.
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Nanopartículas , Neoplasias , Neoplasias de Mama Triplo Negativas , Linhagem Celular Tumoral , Meios de Contraste , Portadores de Fármacos/uso terapêutico , Humanos , Imageamento por Ressonância Magnética , Nanopartículas/química , Neoplasias/tratamento farmacológico , Fototerapia/métodos , Terapia Fototérmica , Soroalbumina Bovina/uso terapêutico , Neoplasias de Mama Triplo Negativas/diagnóstico por imagem , Neoplasias de Mama Triplo Negativas/tratamento farmacológicoRESUMO
BACKGROUND: To investigate a 3-stage screening procedure and explore the clinical features of subjects at Clinical High Risk (CHR) for psychosis in a representative sample of Chinese college students. METHODS: An epidemiological survey of the prevalence of the CHR syndrome in Chinese college students that was selected by stratified random sampling from Shanghai, Nanjing and Nanchang cities was done following a 3-stage procedure. Participants were initially screened with the Prodromal Questionnaire-brief version (PQ-B), and whose distress score of PQ-B exceeded 24 would be invited to a telephone assessment using the subscale for positive symptoms of the Scale of Prodromal Symptoms (SOPS)/Structured Interview for Prodromal Syndromes (SIPS). Lastly, participants who scored 3 or higher in any item of the subscale would be administered with the SIPS interview conducted by trained researchers to confirm the diagnosis of CHR syndrome. RESULTS: Twenty-three thousand sixty-three college students completed the survey during September 2017 to October 2018. Seventy-two students were diagnosed as CHR subjects, and the detection rate in the total sample was 0.3%. The peak age range for the first diagnosis of CHR was 17 to 20 years. Thirteen and forty-six were set as the cutoff points of PQ-B total score and distress score to balance the greatest sensitivity and specificity. Binary logistic regression revealed that 8 items in PQ-B showed significant distinction for detecting CHR subjects. CONCLUSIONS: The 3-stage screening method can be utilized in the detection of CHR subjects for psychosis in the general population, during which delusional ideas, perceptual abnormalities and suspiciousness deserve great attention.
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Transtornos Psicóticos , Adolescente , Adulto , China/epidemiologia , Estudos Epidemiológicos , Humanos , Sintomas Prodrômicos , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Estudantes , Adulto JovemRESUMO
BACKGROUND: To promote the integration of medical resources, Beijing has built medical alliances since 2012, but this reform has not changed the state of disordered medical treatment. Patients are still willing to go to high-level hospitals for medical treatment. What causes patients to prefer high-level hospitals? To explore the reasons behind this preference for high-level medical treatment among patients and to guide patients to make visits in an orderly manner, we conducted this study and compared patients' satisfaction with hospitals of different levels in the context of medical resource integration. METHODS: This study conducted a questionnaire survey among 1250 patients who were selected in 18 medical alliances in Beijing from October to December 2016. The study type is a comparative study based on cross-sectional data. Patient satisfaction was the main outcome, and descriptive analysis, chi-square tests, nonparametric tests and binary logistic regression analysis were used. The level of statistical significance was set at p < 0.05. RESULTS: The overall satisfaction score of the medical alliances was 3.375, and the satisfaction scores of core hospitals and cooperative hospitals were 2.77 and 3.07, respectively. The overall patient satisfaction rate was 44.62%, and the satisfaction rates of core hospitals and cooperative hospitals were 34.34 and 50.43%, respectively. The type of hospital and understanding of medical alliance policy were the factors associated with patient satisfaction with the medical alliance. CONCLUSIONS: The patients' satisfaction with cooperative hospitals was higher than their satisfaction with core hospitals. Although the patients were more satisfied with the service attitude of the cooperative hospitals, they still preferred core hospitals due to their higher expectations for their medical treatment and greater trust in their medical technology. It is necessary to explore the establishment of closed medical alliances under the unified management of human and financial resources to enable medical alliances to become a community of common interests and provide integrated medical services for patients.
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Hospitais/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
The long noncoding RNA Malat1 has been reported to be an oncogene that promotes tumor progress and correlates with prognosis in glioma. Growing evidence shows that autophagy plays a very important role in tumorigenesis and tumor cell survival, but whether Malat1 regulates autophagy in glioma is still unclear. In this study, we found that Malat1 expression and autophagy activity were significantly increased in glioma tissues compared with adjacent normal tissues. Additionally, Malat1 level was positively correlated with the expression of LC3-II (autophagy marker) mRNA in vivo. In vitro assays revealed that Malat1 significantly promoted autophagy activation and cell proliferation in glioma cells. More importantly, inhibition of autophagy by 3-MA relieved Malat1-induced cell proliferation. These data demonstrated that Malat1 activates autophagy and increases cell proliferation in glioma. We further investigated the molecular mechanisms whereby Malat1 functioned on glioma cell autophagy and proliferation. We found that Malat1 served as an endogenous sponge to reduce miR-101 expression by directly binding to miR-101. Moreover, Malat1 abolished the suppression effects of miR-101 on glioma cell autophagy and proliferation, which involved in upregulating the expression of miR-101 targets STMN1, RAB5A and ATG4D. Overall, our study elucidated a novel Malat1-miR-101-STMN1/RAB5A/ATG4D regulatory network that Malat1 activates autophagy and promotes cell proliferation by sponging miR-101 and upregulating STMN1, RAB5A and ATG4D expression in glioma cells.
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Proteínas Relacionadas à Autofagia/genética , Autofagia , Cisteína Endopeptidases/genética , Regulação Neoplásica da Expressão Gênica , Glioma/genética , MicroRNAs/metabolismo , RNA Longo não Codificante/metabolismo , Estatmina/genética , Proteínas rab5 de Ligação ao GTP/genética , Proteínas Relacionadas à Autofagia/metabolismo , Linhagem Celular Tumoral , Proliferação de Células , Cisteína Endopeptidases/metabolismo , Glioma/metabolismo , Glioma/patologia , Humanos , MicroRNAs/genética , RNA Longo não Codificante/genética , Reação em Cadeia da Polimerase em Tempo Real , Estatmina/metabolismo , Regulação para Cima , Proteínas rab5 de Ligação ao GTP/metabolismoRESUMO
OBJECTIVES: To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosing lung or mediastinal lymph node cancer and tuberculosis. METHODS: Clinical and pathological data of 553 patients who underwent EBUS-TBNA from January 2013 to September 2016 in West China Hospital of Sichuan University were reviewed. The sensitivity, specificity and accuracy of EBUS-TBNA for diagnosing lymph node tumor and tuberculosis of hilar and mediastinal lymph nodes were calculated. RESULTS: The sensitivity, specificity and accuracy of EBUS-TBNA in diagnosing hilar and mediastinal lymph node cancer were 89.2% (263/295), 100% (247/247) and 94.1% (510/542), respectively, compared with 70% (76/117), 97.2% (385/396) and 89.9% (461/513), respectively, for diagnosing tuberculosis identified though granulomatous biopsy. In the 102 cases with acid fast staining and TB-PCR, 63.7% accuracy (58/91), 90.9% (10/11) sensitivity and 66.7% (68/102) specificity were found for any positive findings from acid fast bacilli or TB-DNA. CONCLUSIONS: EBUS-TBNA has high sensitivity and specificity for diagnosing hilar and mediastinal tumor, which can be used in combination with acid fast staining and TB-PCR for diagnosing tuberculosis.
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Neoplasias Pulmonares/diagnóstico , Metástase Linfática/diagnóstico , Neoplasias do Mediastino/diagnóstico , Tuberculose/diagnóstico , Broncoscopia , China , Humanos , Pulmão , Linfonodos , Mediastino , Estudos Retrospectivos , Sensibilidade e Especificidade , UltrassonografiaRESUMO
OBJECTIVE: This study investigated whether liquid-based cytology (LBC) can improve diagnostic values of cytological assessment of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). STUDY DESIGN: A cohort of 600 cases in West China Hospital was prospectively studied from June 2012 to September 2013. EBUS-TBNA was carried out in outpatients under local anesthesia and moderate sedation. The procedure was performed with an echobronchoscope (BF-UC160F-OL8, Olympus, Tokyo, Japan). Histological cores were stained with hematoxylin and eosin for further study. Additional immunohistological analysis was performed for establishing a reliable diagnosis when necessary. Aspirates were smeared on glass slides and separate aspirates were processed by the monolayer SurePath method. RESULTS: In total, 480 malignant tumors and 120 benign lesions were confirmed by histological examination. The sensitivity of SurePath liquid-based preparations and conventional smears was 82.1 and 56%, and the specificity was 87.5 and 82.5%, respectively. The combined specificity was 100%. Positive predictive values of the two groups were 96.3 and 92.8%, whereas negative predictive values were 54.9 and 31.9%, respectively. The difference between the two groups was significant (p < 0.001). CONCLUSIONS: LBC preparation can improve cytological assessment of EBUS-TBNA. Histological study is necessary in cases in which the cytological diagnosis is obscure.
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Broncoscopia , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Neoplasias Pulmonares/patologia , Pulmão/patologia , China , Humanos , Imuno-Histoquímica , Neoplasias Pulmonares/classificação , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Terminologia como AssuntoRESUMO
(1) Background: Although abnormal emotion regulation is a key characteristic of youth with prodromal psychotic symptoms and is closely related to the degree of distress caused by these symptoms, research on the internal heterogeneity of emotion regulation within this clinically high-risk population has been insufficient. (2) Methods: The current study analyzed data from 394 college students with prodromal psychotic symptoms, using latent profile analysis (LPA) to identify emotion regulation profiles based on differences in expressive suppression and cognitive reappraisal. One-way ANOVA was employed to examine the relationship between the identified latent profiles and distress of symptoms. (3) Results: Three latent profiles were identified: "high cognitive reappraisal group" (n = 117, 29.70%), "moderate cognitive reappraisal group" (n = 233, 59.14%), and "low cognitive reappraisal group" (n = 44, 11.16%). Significant differences in distress of negative symptoms (F = 9.122, p < 0.05) and perceptual abnormalities (F = 3.103, p < 0.05) were observed across the latent profiles but not in unusual thought content and specific perceptual abnormalities (both p > 0.05). The "low cognitive reappraisal group" exhibited the most severe distress of symptoms, followed by the "moderate cognitive reappraisal group", while the "high cognitive reappraisal group" experienced the least distress. (4) Conclusions: The current study provides evidence for the heterogeneity of emotion regulation among youth with prodromal psychotic symptoms and reveals differences in distress of perceptual abnormalities and negative symptoms between the latent profiles of emotion regulation. These findings support the development of targeted psychological interventions to alleviate the distress of symptoms and improve quality of life.
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BACKGROUND: Psychotic-like experiences (PLEs) are a part of the continuum of psychosis and are common in the general population. While most of these experiences are transient, they are strongly correlated with an increased risk of various adverse psychological outcomes. Anxiety and depressive symptoms also occur frequently in the adolescent population. Much research has previously demonstrated a correlation between these two symptoms and PLEs. However, few investigations have examined what influences this association, and sex and resilience may be important moderators. METHODS: This study selected a sample of first-year students from a university in Shanghai. A total of 2970 adolescents completed questionnaires measuring sociodemographic characteristics, anxiety/depressive symptoms by SCL-90, resilience by CD-RISC, and self-reported PLEs by PQ-16. RESULTS: The findings indicated that PLEs were prevalent in the sample, with at least one PQ-16 item present in 42.5% of individuals. Anxiety/depressive symptoms were significantly associated with PLEs, and there was a sex difference in this association (p < 0.001). What is more, this relationship was stronger in males than in females. Additionally, we found a significant interaction (p < 0.001) between resilience and anxiety/depressive symptoms when looking at the correlates of PLEs. Those with stronger resilience showed a considerably weaker connection between PLEs and symptoms of anxiety and depression. CONCLUSIONS: These findings can potentially inform the development of targeted new clinical interventions.
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In recent decades, the demand for clean and renewable energy has grown increasingly urgent due to the irreversible alteration of the global climate change. As a result, organic solar cells (OSCs) have emerged as a promising alternative to address this issue. In this review, we summarize the recent progress in the molecular design strategies of benzodithiophene (BDT)-based polymer and small molecule donor materials since their birth, focusing on the development of main-chain engineering, side-chain engineering and other unique molecular design paths. Up to now, the state-of-the-art power conversion efficiency (PCE) of binary OSCs prepared by BDT-based donor materials has approached 20%. This work discusses the potential relationship between the molecular changes of donor materials and photoelectric performance in corresponding OSC devices in detail, thereby presenting a rational molecular design guidance for stable and efficient donor materials in future.
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Introduction: China has issued and implemented a series of policies aimed at preventing and controlling workplace violence (WPV) against licensed doctors. However, the prevalence of WPV has not been fundamentally curbed. The aim of this study was to present the prevalence of WPV, identify its influencing factors and propose responsive measures. Method: The online Chinese Physician Practice Survey was conducted with purposive sampling method among licensed doctors in China from January 2022 to June 2022. Data covered licensed doctors' sociodemographic characteristics, occupational characteristics, prevalence of WPV, and perception of effective countermeasures. Results: A total of 74,305 licensed doctors participated in this study. A total of 44.88% of respondents had experienced WPV, among them, either physical violence only (1.06%) or non-physical violence only (89.91%) or encountered both of them (9.03%). Age, gender, marital status, education level, professional title and registration type were all associated with WPV, being younger, non-married, more educated, and higher professional title are all risk factors for WPV. Male (OR = 1.396, 95CI%: 1.355 to 1.439), clinicians (OR = 1.342,95%CI: 1.177 to 1.529), who were single (OR = 1.174, 95%CI: 1.111 to 1.241), with master's degree (OR = 2.021, 95%CI: 1.739 to 2.349) and professional title were subsenior (OR = 1.194, 95%CI: 1.125 to 1.267) were most likely to occur WPV. WPV occurred mostly in provincial capitals, public hospitals, primary and community hospitals, and departments of internal medicine, surgery, pediatrics, emergency medicine and mental health. Overall, 44.24% of doctors perceived that strengthening crackdowns on criminal behaviors was the most effective measure to prevent WPV against healthcare staff. Conclusion: The frequency of WPV decreased after the implementation of relevant laws and policies. Future efforts should be made to strengthen crackdowns on illegal and criminal activities and to issue specific legal provisions on the prevention and control of WPV against doctors.
Assuntos
Médicos , Violência no Trabalho , Humanos , Masculino , Criança , Estudos Transversais , Abuso Físico , China/epidemiologiaRESUMO
OBJECTIVE: Spasticity is one of the most prevalent ischemic stroke sequelae and the leading cause of disability after stroke. Although electroacupuncture pretreatment has been shown to be effective in the treatment of ischemic stroke, its therapeutic effect and mechanism on post-stroke spasm remain unknown. The purpose of this study was to look into the potential mechanism of electroacupuncture pretreatment in inducing the NF-κB/NLRP3 signaling pathway and the gut-brain axis in the therapy of spasm after stroke. METHODS: After electroacupuncture treatment at Baihui (DU20) and Qubin (G87), the rat model of middle cerebral artery occlusion (MCAO) was first established. HE, Nissl, and TUNEL staining were used to detect pathological alterations in the rat brain. The relative levels of IL-4, IL-6, TNF-α, and TMAO were determined by ELISA. qRT-PCR and Western blot were used to evaluate the mRNA and protein levels of NF-κB p65, NLRP3, caspase3 and caspase9. Gas chromatography-mass spectrometry (GC-MS) was used to determine the levels of short-chain fatty acids (SCFAs) in rat gut. RESULTS: Hippocampal cells from rats with spasticity following stroke in the MCAO group were chaotic and loosely distributed with an unclear border, a blurred nucleolus, and vanished cytoplasm when compared to those from the sham operation group. Furthermore, the number of surviving neurons decreased while the number of apoptotic cells increased. In the I/R group, relative levels of IL-6, TNF-α, and TMAO increased considerably, while NF-κB p65, NLRP3, caspase3, and caspase9 were dramatically downregulated. The intestinal contents of n-propyl acetate and propyl butyrate were lowered in rats with spasticity following stroke. Electroacupuncture treatments miraculously remedied all of the foregoing pathogenic alterations. CONCLUSION: Pretreatment with electroacupuncture relieves spasticity after stroke by decreasing the inflammatory response, suppressing the NF-κB/NLRP3 signaling pathway, and modulating the gut-brain axis by increasing n-propyl acetate and propyl butyrate levels in the bowel. Our findings establish a new molecular mechanism and theoretical foundation for electroacupuncture therapy of ischemic stroke.