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1.
BMC Cardiovasc Disord ; 23(1): 56, 2023 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-36710320

RESUMO

BACKGROUND: Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported. CASE PRESENTATION: A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE. CONCLUSION: It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment.


Assuntos
Fibrilação Atrial , Ablação por Cateter , Embolia , Ablação por Radiofrequência , Feminino , Humanos , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Fibrilação Atrial/tratamento farmacológico , Resultado do Tratamento , Artéria Mesentérica Superior/diagnóstico por imagem , Artéria Mesentérica Superior/cirurgia , Ablação por Cateter/efeitos adversos , Ablação por Cateter/métodos , Dor Abdominal/etiologia , Dor Abdominal/cirurgia
2.
BMC Anesthesiol ; 23(1): 315, 2023 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-37715177

RESUMO

OBJECTIVE: To investigate the impact of patent foramen ovale (PFO) on the short-term outcomes of living donor liver transplantation (LDLT) in children with biliary atresia. METHODS: With the approval of the hospital ethics committee, 304 children with biliary atresia who underwent LDLT in our center from January 2020 to December 2021 were enrolled. According to the results of echocardiography before the operation, the subjects were divided into the PFO group (n = 73) and the NoPFO group (n = 231). The baseline characteristics; intraoperative recipient-related data and donor-related data; incidence of postreperfusion syndrome (PRS); postoperative mechanical ventilation time; ICU stay duration; postoperative hospital stay duration; liver function index; incidences of postoperative complications including acute renal injury (AKI), graft dysfunction, hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT); and one-year survival rate were compared between the two groups. RESULTS: The median age in the PFO group was 6 months and that in the NoPFO group was 9 months (P < 0.001), and the median height (65 cm) and weight (6.5 kg) in the PFO group were significantly lower than those in the NoPFO group (68 cm, 8.0 kg) (P < 0.001). The preoperative total bilirubin level (247 vs. 202 umol/L, P = 0.007) and pediatric end-stage liver disease (PELD) score (21 vs. 16, P = 0.001) in the PFO group were higher than those in the NoPFO group. There were no significant differences in the intraoperative PRS incidence (46.6% vs. 42.4%, P = 0.533 ), postoperative mechanical ventilation time (184 vs. 220 min, P = 0.533), ICU stay duration (3.0 vs. 2.5 d, P = 0.267), postoperative hospital stay duration (22 vs. 21 d, P = 0.138), AKI incidence (19.2% vs. 24.7%, P = 0.333), graft dysfunction incidence (11.0% vs. 12.6%, P = 0.716), HAT incidence (5.5% vs. 4.8%, P = 0.762), PVT incidence (2.7% vs. 2.2%, P = 0.675) or one-year survival rate (94.5% vs. 95.7%, P = 0.929) between the two groups. CONCLUSION: The presence of PFO has no negative impact on short-term outcomes in children with biliary atresia after LDLT.


Assuntos
Injúria Renal Aguda , Atresia Biliar , Doença Hepática Terminal , Forame Oval Patente , Transplante de Fígado , Criança , Humanos , Lactente , Forame Oval Patente/complicações , Forame Oval Patente/cirurgia , Doadores Vivos , Atresia Biliar/cirurgia , Estudos Retrospectivos , Índice de Gravidade de Doença
3.
Proc Natl Acad Sci U S A ; 117(27): 16065-16071, 2020 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-32571945

RESUMO

Human navigation relies on inputs to our paired eyes and ears. Although we also have two nasal passages, there has been little empirical indication that internostril differences yield directionality in human olfaction without involving the trigeminal system. By using optic flow that captures the pattern of apparent motion of surface elements in a visual scene, we demonstrate through formal psychophysical testing that a moderate binaral concentration disparity of a nontrigeminal odorant consistently biases recipients' perceived direction of self-motion toward the higher-concentration side, despite that they cannot verbalize which nostril smells a stronger odor. We further show that the effect depends on the internostril ratio of odor concentrations and not the numeric difference in concentration between the two nostrils. Taken together, our findings provide behavioral evidence that humans smell in stereo and subconsciously utilize stereo olfactory cues in spatial navigation.


Assuntos
Testes de Navegação Mental , Percepção Olfatória/fisiologia , Olfato/fisiologia , Adulto , Sinais (Psicologia) , Feminino , Humanos , Masculino , Cavidade Nasal , Odorantes , Fluxo Óptico , Estimulação Luminosa , Adulto Jovem
4.
Biochem Biophys Res Commun ; 514(2): 482-489, 2019 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-31056254

RESUMO

Traditionally, the development of osteoarthritis (OA) is associated with factors such as aging and injure, but more and more epidemiological and biological evidence suggests that the disease is closely related to metabolic syndrome and metabolic components. Ubiquitin-specific protease 3(USP3), a member of the USPs family, is a specific protease capable of cleavage of ubiquitin chains linked by proline residues. In our presented study, we firstly found that USP3 expression level was decreased in OA. USP3 overexpression inhibited IL-1ß induced chondrocytes apoptosis and nuclear factor κB (NF-κB) activation. USP3 knockdown induced chondrocytes apoptosis and activated NF-κB pathway. USP3 interacts with TRAF6 (tumor necrosis factor-receptor-associated factor 6), which is an essential adaptor protein for the NF-κB (nuclear factor κB) signaling pathway and plays important roles in inflammation and immune response. IL-1ß treatment up-regulated the polyubiquitination of TRAF6 in chondrocytes, which was attenuated when USP3 was forced expression. Our study mechanistically links USP3 to TRAF6 in osteoarthritis development. Moreover, these data support the pursuit of USP3 and TRAF6 as potential targets for osteoarthritis therapies.


Assuntos
Apoptose , Condrócitos/citologia , Enzimas Desubiquitinantes/metabolismo , Interleucina-1beta/metabolismo , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Osteoartrite/metabolismo , Proteases Específicas de Ubiquitina/metabolismo , Ubiquitina/metabolismo , Células Cultivadas , Condrócitos/patologia , Humanos , NF-kappa B/metabolismo , Osteoartrite/tratamento farmacológico , Osteoartrite/enzimologia , Osteoartrite/patologia , Ubiquitinação
6.
Eur J Orthop Surg Traumatol ; 24(3): 395-401, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23483320

RESUMO

To assess the efficacy of postoperative pain management and the concentration change of PGE-2 and IL-6 of joint fluid with parecoxib after postoperative total knee arthroplasty. In the study, 100 patients experiencing primary TKA were randomly divided into study group, receiving parecoxib sodium (40 mg) intravenously (IV) at the completion of surgery and once every 12 h for totally 6 times postoperatively, and placebo group, receiving normal saline 2 mL IV at the same time points. Efficacy was assessed by total amount of morphine consumed, pain intensity, range of motion (ROM), the concentration change of PGE-2 and IL-6 of joint fluid, and postoperative nausea and vomiting (PONV) postoperatively. Patients in study group consumed significantly less morphine, experienced significant less pain scores, and obtained significantly more ROM (P < 0.01) compared with that in placebo group during 3 days postoperatively. The concentration of PGE-2 and IL-6 of joint fluid in study group are significantly lower than that in placebo group (P < 0.01) during 24 h postoperatively. The overall incidence of PONV was low and was not significantly different between the two groups. The present study demonstrated that the perioperative administration of parecoxib after primary TKA resulted in significantly improved postoperative analgesic management as defined by reduction in opioid requirement, lower pain scores and ROM, and significantly lowered local inflammation factors PGE2 and IL-6.


Assuntos
Artroplastia do Joelho/métodos , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Inflamação/prevenção & controle , Isoxazóis/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Líquido Sinovial/metabolismo , Idoso , Analgésicos Opioides/administração & dosagem , Artroplastia do Joelho/efeitos adversos , Inibidores de Ciclo-Oxigenase 2/administração & dosagem , Dinoprostona/metabolismo , Método Duplo-Cego , Feminino , Humanos , Inflamação/etiologia , Inflamação/metabolismo , Interleucina-6/metabolismo , Isoxazóis/administração & dosagem , Articulação do Joelho/fisiopatologia , Masculino , Pessoa de Meia-Idade , Morfina/administração & dosagem , Medição da Dor , Dor Pós-Operatória/etiologia , Náusea e Vômito Pós-Operatórios/etiologia , Náusea e Vômito Pós-Operatórios/prevenção & controle , Amplitude de Movimento Articular/efeitos dos fármacos
7.
Int J Surg Case Rep ; 116: 109432, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38432165

RESUMO

INTRODUCTION: Mitochondrial DNA depletion syndrome (MDS) is a kind of autosomal recessive genetic disorder associated with a reduction in mitochondrial DNA (mtDNA) copy number caused by mutations in nuclear genes during nucleotide synthesis, which affects the energy production of tissues and organs. Changes in hemodynamics during liver transplantation may lead to high energy-demanding organs and tissues being vulnerable. This report described the intraoperative management during liver transplantation in a child with MDS. Ultimately, the child was discharged smoothly without any complications. PRESENTATION OF THE CASE: A five-year-old boy was diagnosed with mitochondrial depletion syndrome preoperatively and scheduled for living donor liver transplantation. The incidence of postreperfusion syndrome (PRS) could not be avoided for 30 min after opening, despite our best efforts to aggressively prevent it before opening. While ensuring hemodynamic stability, we actively prevented and adopted high-energy-demand organ protection strategies to reduce the incidence of postoperative complications. Finally, the child was discharged 28 days after the operation, and no other complications were found. DISCUSSION: Liver transplantation can be performed for liver failure in this disease to improve the quality of life and prolong the life of patients. As this child has mitochondrial DNA depletion syndrome, the disruption of cellular energy generation caused by mitochondrial malfunction puts high-energy-demanding organs and tissues at risk during surgery. It motivates us to pay closer attention to the prevention and treatment of PRS in anesthetic management to minimize damage to the child's organs and tissues with high energy demands. CONCLUSIONS: This report describes the intraoperative management during liver transplantation in a child with mitochondrial depletion syndrome. To increase the safety of perioperative anesthesia and reduce mortality in patients with mitochondrial disease, for such patients, maintaining an acid-base balance and a stable internal environment is essential. We should also pay attention to protecting body temperature, using vasoactive drugs beforehand to lessen the incidence of PRS, and protecting high-energy-demanding organs afterward.

8.
J Orthop Surg Res ; 19(1): 12, 2024 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-38167052

RESUMO

OBJECTIVE: The choice of osteotomy in joint replacement surgery for Crowe type IV developmental dysplasia of the hip (DDH) is a challenging and controversial procedure. In this study, we compared the clinical efficacy of a combination of greater trochanter osteotomy and tension wire fixation with that of subtrochanteric osteotomy. METHODS: We performed 15 primary total hip arthroplasty (THA) procedures between January 2016 and July 2020 on 13 patients with a combination of greater trochanter osteotomy and tension wire fixation (the GTT group) and 12 THA procedures in 11 patients using subtrochanteric osteotomy (the STO group). The mean follow-up was 2.8 years (range 2.2-4.5 years) in the GTT group and 2.6 years (range 2.5-4.3 years) in the STO group. Clinical scores and radiographic results were evaluated during the final follow-up for the 15 hips in the GTT group and 12 hips in the STO group. RESULTS: Postoperative Harris hip scores, implant position, and the surgery time did not differ between the treatment groups. There were no differences in preoperative leg length discrepancy LLD (P = 0.46) and postoperative LLD (P = 0.56) between the two groups. Bone union occurred within 6 months after surgery in 12 hips in the GTT group (92.3%) and in 9 hips (81.8%) in the STO group. One case in the GTT group and two cases in the STO group had nonunion, and additionally, there was one case of postoperative nerve injury in the STO group, while no symptoms of nerve damage were observed in the GTT group. CONCLUSION: The GTT method demonstrated many advantages and reliable clinical results for Crowe type IV DDH patients undergoing THA. This is a surgical method that warrants further development and promotion clinically.


Assuntos
Artroplastia de Quadril , Displasia do Desenvolvimento do Quadril , Luxação Congênita de Quadril , Humanos , Artroplastia de Quadril/métodos , Displasia do Desenvolvimento do Quadril/diagnóstico por imagem , Displasia do Desenvolvimento do Quadril/cirurgia , Luxação Congênita de Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/cirurgia , Estudos Retrospectivos , Fêmur/diagnóstico por imagem , Fêmur/cirurgia , Resultado do Tratamento , Osteotomia/métodos , Seguimentos
9.
Mitochondrial DNA B Resour ; 9(1): 200-203, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38288248

RESUMO

Discogobio brachyphysallidos Huang 1989 is a Cyprinidae fish species that is endemic to the upper Pearl River. In the present study, the complete mitochondrial genome of D. brachyphysallidos collected from the Nanpanjiang River was sequenced and annotated. The mitochondrial genome encompassed 13 protein-coding genes, two ribosomal RNA (rRNA) genes, 22 transfer RNA (tRNA) genes, and the control region (D-loop). The total length of the mitochondrial genome was determined to be 16,594 base pairs (bp), with a GC content of 41.7%. Phylogenetic analyses revealed that D. brachyphysallidos may be a sister to D. longibarbatus and D. macrophysallidos. These findings provide insight into the genetic information and phylogenetic relationships of D. brachyphysallidos.

10.
Sci Data ; 11(1): 572, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38834584

RESUMO

Hemibagrus guttatus, also named as spotted longbarbel catfish, is an economical fish in China. However, their gender cannot be easily distinguished from their appearance, which largely impedes their artificial breeding. Therefore, we provided two gap-free chromosome-level genomes of male and female spotted longbarbel catfish by combining wtdbg2, LR_Gapcloser and TGS-GapCloser assembly approaches with Hi-C data and accurate Pacbio HiFi long-reads. We assembled 30 chromosomes without any gap. Their genome sizes are approximately 749.1 Mb and 747.8 Mb of male and female individuals. The completeness results of BUSCO evaluation show about 94.2% and 95.0%, representing a high-level of completeness of both genomes. We also obtained 35,277 and 34,571 protein-coding gene sets from male and female individuals. Both available gap-free chromosome-level genomes of H. guttatus will provide excellent references for resequencing of male and female individuals to identify accurate markers for distinguishing gender of this fish.


Assuntos
Peixes-Gato , Cromossomos , Genoma , Animais , Feminino , Masculino , Peixes-Gato/genética
11.
Int J Colorectal Dis ; 28(5): 611-21, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23386215

RESUMO

PURPOSE: The published data on the evaluation of feasibility and safety of single-incision laparoscopic colorectal surgery (SILC) compared with traditional multiport laparoscopic colorectal surgery (MLC) remained controversial. The present cumulative meta-analysis and systematic review were performed to provide a more objective and precise estimate. MATERIALS AND METHODS: PubMed, the Cochrane Library, and also, manual searches were employed to identify potentially eligible studies which were published before June 7, 2012. The association was assessed by odds ratio (OR) and means with 95 % confidence intervals (CI). RESULTS: A total of 20 comparative studies were included, with 670 patients underwent SILC and 838 patients underwent MLC. For overall pooled estimates, no evidence of between trial differences was found in overall conversion rate (OR, 1.7; 95 % CI, 0.97 to 3.01), overall complication rate (OR, 0.82; 95 % CI, 0.63 to 1.08), and operative time (mean, -3.59; 95 % CI, -10.95 to 3.77); significantly between trial differences were found in estimated blood loss (mean, -18.61; 95 % CI, -31.33 to -5.90) and post-operative hospital stay (mean, -0.54; 95 % CI, -0.95 to -0.12). The cumulative meta-analysis identified a potentially increased conversion rate of SILC compared with MLC with the increased percentage of malignancies, but no significant differences could be identified in overall complication rate. CONCLUSION: This meta-analysis suggested the feasibility and safety of SILC performed by experienced hands, though potentially higher overall conversion rate occurred in malignancies. SILC will benefit the patients much more with its superiority over MLC.


Assuntos
Cirurgia Colorretal , Laparoscopia , Cirurgia Colorretal/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Tempo de Internação , Complicações Pós-Operatórias/etiologia , Viés de Publicação , Resultado do Tratamento
12.
Zhonghua Wai Ke Za Zhi ; 51(2): 152-6, 2013 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-23711010

RESUMO

OBJECTIVE: To observe the change of clearance and range of joint improved situation during total knee arthroplasty (TKA) by operating extended release manipulation of the posterior knee clearance. METHODS: A total of 120 patients with knee osteoarthritis undergoing unilateral TKA from March 2010 to March 2012 were equally randomized prospectively assigned to the experimental group and control group, each 60 cases. There were 46 male and 74 female patients, the mean age was 63.6 years (range from 49 to 75 years). After the osteotomy of the tibia and the femoral condyle and before the release of soft tissue intraoperation, patients in experimental group were taken the extended release manipulation of the posterior knee clearence while the control group were cleaned the osteophyte of the posterior condyle only, 2-sided paired t test was used to compare the clearence intraoperation and the time to flexion angle of 90° and 120° and the maximum angle after 3 months' follow-up. RESULTS: There was no significant difference of the index between the experimental group and control group (P > 0.05). Between experimental group and control group, the difference was significant in extention clearance ((18.9 ± 1.5) mm vs. (17.9 ± 1.6) mm, t = 3.53, P < 0.01) intraoperation, and no significant difference in flexion clearance ((20.7 ± 1.8) mm vs. (20.2 ± 1.9) mm, t = 1.48, P > 0.05). It took longer time for the knee flexion range of motion to 90°(t = 10.2399, P < 0.01) or 120°(t = 11.142, P < 0.01) of the control group than that of the experimental group, and the difference of the maximum range of motion between experimental group and control group was significant statistically at the 3-months follow-up (t = 4.4255, P < 0.01). All the patients were followed up for 3 - 24 months, average of 14.6 months, no femoral component loosening happened. CONCLUSIONS: Extended release of the posterior knee clearance benefits the knee extension clearence intraoperation and functional exercise of range of motion postoperation, while it is no meaning to the flexion clearence.


Assuntos
Artroplastia do Joelho , Liberação da Cápsula Articular/métodos , Articulação do Joelho/fisiopatologia , Articulação do Joelho/cirurgia , Osteoartrite do Joelho/cirurgia , Amplitude de Movimento Articular , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/fisiopatologia , Osteotomia , Resultado do Tratamento
13.
World J Gastroenterol ; 29(46): 6092-6094, 2023 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-38130737

RESUMO

Only limited information is available about the connection between massive blood transfusion and postoperative survival rates in pediatric liver transplantation. The aim of Gordon's study was to examine the potential impact of perioperative transfusion on postoperative complications and death in young children receiving pediatric living-donor liver transplantation (PLDLT). The authors concluded that transfusion of a red blood cell volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short- and long-term postoperative morbidity and mortality after PLDLT. However, viscoelastic coagulation monitoring was not utilized in the study; instead, only conventional coagulation monitoring was conducted. Overall, the choice of blood coagulation monitoring method during blood transfusion can have a significant impact on patient prognosis. Several studies have shown that the viscoelastic coagulation testing such as thrombelastography (TEG) is highly sensitive and accurate for diagnosing coagulation dysfunction. Indeed, a TEG-guided blood transfusion strategy can improve prognosis. Moreover, postreperfusion syndrome is one of the most common complications of liver transplantation and an important factor affecting the prognosis of patients and should also be included in regression analysis.


Assuntos
Transplante de Fígado , Tromboelastografia , Humanos , Criança , Pré-Escolar , Transplante de Fígado/efeitos adversos , Transplante de Fígado/métodos , Doadores Vivos , Testes de Coagulação Sanguínea , Transfusão de Sangue
14.
Cancer Biother Radiopharm ; 38(2): 102-110, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32865426

RESUMO

Background: The role of circular RNAs in the pathogenesis of gastric cancer (GC) has been well documented by numerous studies. However, whether circ_0003789 plays a role during GC progression remains to be determined. Thus, this study investigated the biological functions of circ_0003789 during GC progression. Materials and Methods: Circ_0003789 expression was determined using quantitative real-time polymerase chain reaction in GC and matched para-carcinoma normal tissues. Functional experiments were performed to estimate changes in the proliferation, apoptosis, migration, and invasion of GC cells treated to silence circ_0003789. E-cadherin, vimentin, Wnt3a, and ß-catenin expression was determined using immunofluorescence staining and Western blot assays. Xenograft tumor growth and Ki67 expression were also evaluated in vivo. Results: Circ_0003789 was upregulated in GC tissues and cells, and its upregulation positively correlated with poor tumor differentiation, distal metastasis, and advanced clinical stage. Silencing circ_0003789 inhibited GC cell proliferation, migration, invasion, and the epithelial-mesenchymal transition (EMT), both in vitro and in vivo. Mechanistically, the Wnt/ß-catenin signaling pathway was repressed by circ_0003789 silencing. Conclusions: Circ_0003789 facilitates GC progression by inducing the EMT through the Wnt/ß-catenin signaling pathway.


Assuntos
Transição Epitelial-Mesenquimal , Neoplasias Gástricas , Humanos , beta Catenina/genética , beta Catenina/metabolismo , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Transição Epitelial-Mesenquimal/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Gástricas/patologia , Regulação para Cima , Via de Sinalização Wnt/genética
15.
Artigo em Inglês | MEDLINE | ID: mdl-38082738

RESUMO

We propose a neural network-based framework to optimize the perceptions simulated by the in silico retinal implant model pulse2percept. The overall pipeline consists of a trainable encoder, a pre-trained retinal implant model and a pre-trained evaluator. The encoder is a U-Net, which takes the original image and outputs the stimulus. The pre-trained retinal implant model is also a U-Net, which is trained to mimic the biomimetic perceptual model implemented in pulse2percept. The evaluator is a shallow VGG classifier, which is trained with original images. Based on 10,000 test images from the MNIST dataset, we show that the convolutional neural network-based encoder performs significantly better than the trivial downsampling approach, yielding a boost in the weighted F1-Score by 36.17% in the pre-trained classifier with 6×10 electrodes. With this fully neural network-based encoder, the quality of the downstream perceptions can be fine-tuned using gradient descent in an end-to-end fashion.


Assuntos
Aprendizado Profundo , Processamento de Imagem Assistida por Computador/métodos , Redes Neurais de Computação , Retina , Simulação por Computador
16.
BMJ Paediatr Open ; 7(1)2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37407250

RESUMO

BACKGROUND: Living donor liver transplantation (LT) is the main treatment for paediatric biliary atresia (BA) in Asia. During LT, a series of haemodynamic changes often occur during LT reperfusion, which is called postreperfusion syndrome (PRS), and PRS is related to a prolonged postoperative hospital stay, delayed recovery of graft function and increased mortality. To reduce adverse reactions after paediatric living donor LT (LDLT), our study's objectives were to ascertain the incidence of PRS and analyse possible risk factors for PRS. METHODS: With the approval of the Ethics Committee of our hospital, the clinical data of 304 paediatric patients who underwent LDLT from January 2020 to December 2021 were analysed retrospectively. According to the presence or absence of PRS, the paediatric patients were divided into the non-PRS group and the PRS group. Independent risk factors of PRS were analysed using logistic regression analysis. RESULTS: PRS occurred in 132 recipients (43.4%). The peak values of AST (816 (507-1625) vs 678 (449-1107), p=0.016) and ALT (675 (415-1402) vs 545 (389-885), p=0.015) during the first 5 days after LDLT in paediatric patients with PRS were significantly higher than those in the non-PRS group. Meanwhile, the paediatric patients in the PRS group had longer intensive care unit stays and hospital stays, as well as lower 1-year survival rates. Graft cold ischaemic time (CIT) ≥90 min (OR (95% CI)=5.205 (3.094 to 8.754)) and a temperature <36°C immediately before reperfusion (OR (95% CI)=2.973 (1.669 to 5.295)) are independent risk factors for PRS. CONCLUSIONS: The occurrence of hypothermia (<36.0℃) in children immediately before reperfusion and graft CIT≥90 min are independent risk factors for PRS. PRS was closely related to the postoperative adverse outcomes of paediatric patients.


Assuntos
Atresia Biliar , Transplante de Fígado , Traumatismo por Reperfusão , Humanos , Criança , Transplante de Fígado/efeitos adversos , Doadores Vivos , Estudos Retrospectivos , Traumatismo por Reperfusão/epidemiologia , Traumatismo por Reperfusão/etiologia , Atresia Biliar/cirurgia , Atresia Biliar/complicações , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Fatores de Risco
17.
World J Gastrointest Surg ; 15(9): 2021-2031, 2023 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-37901739

RESUMO

BACKGROUND: Cold ischemia-reperfusion of the liver is an inevitable occurrence in liver transplantation that may also cause damage to the heart. Perioperative myocardial injury during liver transplantation can increase the incidence of postoperative mortality, but there is little research on the incidence of myocardial injury in children who undergo living donor liver transplantation (LDLT). Therefore, this study mainly explores the independent risk factors for myocardial injury in children who undergo LDLT. AIM: To analyze the data of children who underwent LDLT to determine the risk factors for intraoperative myocardial injury. METHODS: We retrospectively analyzed the inpatient records of pediatric patients who underwent LDLT in Tianjin First Central Hospital from January 1, 2020, to January 31, 2022. Recipient-related data and donor-related data were collected. The patients were divided into a myocardial injury group and a nonmyocardial injury group according to the value of the serum cardiac troponin I at the end of surgery for analysis. Univariate analysis and multivariate logistic regression were used to evaluate the risk factors for myocardial injury during LDLT in pediatric patients. RESULTS: A total of 302 patients met the inclusion criteria. The myocardial injury group had 142 individuals (47%), and the nonmyocardial injury group included 160 patients (53%). Age, height, and weight were significantly lower in the myocardial injury group (P < 0.001). The pediatric end-stage liver disease (PELD) score, total bilirubin, and international standardized ratio were significantly higher in the myocardial injury group (P < 0.001). The mean arterial pressure, lactate, hemoglobin before reperfusion, duration of the anhepatic phase, cold ischemic time, incidence of postreperfusion syndrome (PRS), and fresh frozen plasma transfusion were significantly different between the two groups (P < 0.05). The postoperative intensive care unit stay and peak total bilirubin values in the first 5 d after LDLT were significantly higher in the myocardial injury group (P < 0.05). The pediatric patients with biliary atresia in the nonmyocardial injury group who underwent LDLT had a considerably higher one-year survival rate than those in the myocardial injury group (P = 0.015). Multivariate logistic regression revealed the following independent risk factors for myocardial injury: a high PELD score [odds ratio (OR) = 1.065, 95% confidence interval (CI): 1.013-1.121; P = 0.014], a long duration of the anhepatic phase (OR = 1.021, 95%CI: 1.003-1.040; P = 0.025), and the occurrence of intraoperative PRS (OR = 1.966, 95%CI: 1.111-3.480; P = 0.020). CONCLUSION: A high PELD score, a long anhepatic phase duration, and the occurrence of intraoperative PRS were independent risk factors for myocardial injury during LDLT in pediatric patients with biliary atresia.

18.
Pain Med ; 12(3): 387-93, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21266004

RESUMO

OBJECTIVE: Postoperative pain after total hip arthroplasty (THA) is not well tolerated. We assessed postoperative pain relief and the need for opioid use after using a cocktail of local and intraarticular analgesic injection (LIA) after THA. METHODS: Eighty patients undergoing THA under spinal anesthesia were randomly assigned to receive either LIA or placebo. The LIA was composed of 5 mg morphine, 30 mg bupivacaine (15 mg/1.5 mL), 1 mL betamethasone, and 0.5 mL epinephrine (1:1,000) intraoperatively. We compared three outcomes total morphine consumption, visual analog scale (VAS) at rest and during activity, and hip flexion angle while standing. RESULTS: When compared with placebo, opioid consumption was significantly reduced in the trial group, as well as VAS at rest and during mobilization. Earlier rehabilitation and better range of motion (ROM) were achieved in the trial group. There were no significant differences in side effects or postoperative wound healing between groups. CONCLUSION: In patients undergoing THA, LIA may reduce postoperative systemic opioid use and offer better pain control and earlier rehabilitation, without observable risks.


Assuntos
Analgésicos Opioides/uso terapêutico , Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Artroplastia de Quadril/efeitos adversos , Injeções Intra-Articulares , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/uso terapêutico , Betametasona/administração & dosagem , Betametasona/uso terapêutico , Bupivacaína/administração & dosagem , Bupivacaína/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Placebos/uso terapêutico , Amplitude de Movimento Articular , Resultado do Tratamento
19.
Ann Palliat Med ; 10(6): 6753-6759, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34237975

RESUMO

BACKGROUND: Placenta previa is one dangerous disease which threatens the health of pregnant women and their fetuses. The purpose of this study was to evaluate the clinical value of ultrasound combined with magnetic resonance imaging (MRI) in screening for placenta previa complicated by placenta accreta. METHODS: Seventy patients with abnormal fetal position admitted to our hospital from January 2019 to January 2020 were selected for the study. Patients were diagnosed by ultrasound alone, MRI alone, and ultrasound combined with MRI. Diagnostic accuracy, sensitivity, specificity and false positive and negative diagnosis rates were evaluated against the postoperative pathological examinations of the patients. RESULTS: The diagnostic accuracy, sensitivity and false negative rate for ultrasound combined with MRI were 86.27%, 97.78% and 72.00%, respectively. These results were significantly superior to those of MRI or ultrasound alone (P<0.05). The specificity and false positive rate for ultrasound combined with MRI were 13.73% and 5.26%, respectively, which were not significantly different from those for MRI or ultrasound alone (P>0.05). CONCLUSIONS: Compared with ultrasound or MRI alone, ultrasound combined with MRI has higher accuracy and sensitivity in the diagnosis of placenta previa with placenta accreta, along with lower false positive diagnosis rates. These findings are clinically important for improving the diagnostic efficiency.


Assuntos
Placenta Acreta , Placenta Prévia , Feminino , Humanos , Imageamento por Ressonância Magnética , Placenta Acreta/diagnóstico por imagem , Placenta Prévia/diagnóstico por imagem , Gravidez , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia
20.
Food Funct ; 11(7): 5788-5798, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32572416

RESUMO

Colloidal delivery systems could be designed to retard lipid oxidation in foods, thereby extending their shelf-lives and improving their nutritional quality. In this study, a class of novel fluid core-hard shell biopolymer particles with lipid droplets being encapsulated in the biopolymer has been designed and fabricated to increase their lipid oxidative stability. This was achieved by injecting a mixture of Tween 80-coated lipid droplets, xanthan gum, and calcium ions into a sodium alginate solution at either pH 3 or 7. The viscosity, hardness, microstructure, physical stability, and chemical stability of the droplet-loaded fluid core-hard shell (FCHS) biopolymer particles were then measured. The results indicated that the FCHS biopolymer particles had thinner, denser, and harder shells at pH 3 than at pH 7. The thickness of the alginate biopolymer particle walls could be modulated by varying the xanthan gum to alginate ratio used during fabrication. The lipid oxidation measurements indicated that the primary (PV) and secondary (TBARS) reaction products decreased by approximately 60% and 75%, respectively, compared to the control after 13 days of storage at pH 3. These results indicate that the encapsulation of lipid droplets within the FCHS biopolymer particles substantially increased their oxidative stability. The biopolymer particles developed in this study may have promising applications in various food, pharmaceutical, and cosmetic products for retarding lipid oxidation.


Assuntos
Biopolímeros/química , Emulsões/química , Ácidos Graxos Insaturados/administração & dosagem , Peroxidação de Lipídeos , Alginatos , Cálcio , Ácidos Graxos Insaturados/química , Tecnologia de Alimentos , Dureza , Humanos , Concentração de Íons de Hidrogênio , Gotículas Lipídicas , Metabolismo dos Lipídeos , Lipídeos , Oxirredução , Tamanho da Partícula , Polissacarídeos Bacterianos , Polissorbatos , Reologia , Tecnologia Farmacêutica , Substâncias Reativas com Ácido Tiobarbitúrico , Viscosidade , Água
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