RESUMO
BACKGROUND: Early rehabilitation is the foundation for recovery for those admitted to an intensive care unit. Appropriate assessment of consciousness is needed before any rehabilitative intervention begins. METHODS: This prospective study compared the validity, reliability and applicability of the sedation-agitation scale, the Richmond Agitation-Sedation Scale, the motor activity assessment scale and the Glasgow Coma Scale in a working neurological intensive care unit. Eighty-three stroke patients were assessed with the four scales by the same 3 raters acting independently: a senior physician, a senior therapist and a trainee. That generated 996 assessment records for comparison. RESULTS: Good agreement (r=0.98-0.99) was found among the sedation-agitation scale, the Richmond Agitation-Sedation Scale, the motor activity assessment scale scores, but the Glasgow Coma Scale ratings correlated less well (r=0.72-0.76) with the others. Consistent results were also found among the three raters. After stratification of the ratings by age, gender, level of consciousness and Acute Physiology and Chronic Health Evaluation score, the scales reported significant differences among the levels of consciousness and among those with different Acute Physiology and Chronic Health Evaluation results, but not with different age or gender strata. CONCLUSIONS: The four instruments tested are all reliable enough and feasible for use as a tool for consciousness screening in a neurological intensive care unit.
Assuntos
Estado de Consciência , Acidente Vascular Cerebral , Sedação Consciente/métodos , Estudos de Viabilidade , Humanos , Unidades de Terapia Intensiva , Estudos Prospectivos , Agitação Psicomotora/diagnóstico , Reprodutibilidade dos Testes , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/terapiaRESUMO
Phagocytosis, a vital defense mechanism, involves the recognition and elimination of foreign substances by cells. Phagocytes, such as neutrophils and macrophages, rapidly respond to invaders; macrophages are especially important in later stages of the immune response. They detect "find me" signals to locate apoptotic cells and migrate toward them. Apoptotic cells then send "eat me" signals that are recognized by phagocytes via specific receptors. "Find me" and "eat me" signals can be strategically harnessed to modulate antitumor immunity in support of cancer therapy. These signals, such as calreticulin and phosphatidylserine, mediate potent pro-phagocytic effects, thereby promoting the engulfment of dying cells or their remnants by macrophages, neutrophils, and dendritic cells and inducing tumor cell death. This review summarizes the phagocytic "find me" and "eat me" signals, including their concepts, signaling mechanisms, involved ligands, and functions. Furthermore, we delineate the relationships between "find me" and "eat me" signaling molecules and tumors, especially the roles of these molecules in tumor initiation, progression, diagnosis, and patient prognosis. The interplay of these signals with tumor biology is elucidated, and specific approaches to modulate "find me" and "eat me" signals and enhance antitumor immunity are explored. Additionally, novel therapeutic strategies that combine "find me" and "eat me" signals to better bridge innate and adaptive immunity in the treatment of cancer patients are discussed.
Assuntos
Neoplasias , Fagocitose , Transdução de Sinais , Humanos , Neoplasias/imunologia , Neoplasias/terapia , Transdução de Sinais/imunologia , Animais , Fagócitos/imunologia , ApoptoseRESUMO
Colorectal cancer (CRC) is one of the most lethal cancers. Single-cell RNA sequencing (scRNA-seq) and protein-protein interactions (PPIs) have enabled the systematic study of CRC. In our research, the activation of the AKT pathway in CRC was analyzed by KEGG using single-cell sequencing data from the GSE144735 dataset. The correlation and PPIs of MDFI and ITGB4/LAMB3 were examined. The results were verified in the TCGA and CCLE and further tested by coimmunoprecipitation experiments. The effect of MDFI on the AKT pathway via ITGB4/LAMB3 was validated by knockdown and lentiviral overexpression experiments. The effect of MDFI on oxaliplatin/fluorouracil sensitivity was probed by colony formation assay and CCK8 assay. We discovered that MDFI was positively associated with ITGB4/LAMB3. In addition, MDFI was negatively associated with oxaliplatin/fluorouracil sensitivity. MDFI upregulated the AKT pathway by directly interacting with LAMB3 and ITGB4 in CRC cells, and enhanced the proliferation of CRC cells via the AKT pathway. Finally, MDFI reduced the sensitivity of CRC cells to oxaliplatin and fluorouracil. In conclusion, MDFI promotes the proliferation and tolerance to chemotherapy of colorectal cancer cells, partially through the activation of the AKT signaling pathway by the binding to ITGB4/LAMB3. Our findings provide a possible molecular target for CRC therapy.
Assuntos
Neoplasias Colorretais , Integrina beta4 , Calinina , Fatores de Regulação Miogênica , Proteínas Proto-Oncogênicas c-akt , Humanos , Linhagem Celular Tumoral , Proliferação de Células , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Fluoruracila/farmacologia , Regulação Neoplásica da Expressão Gênica , Integrina beta4/genética , Integrina beta4/metabolismo , Fatores de Regulação Miogênica/genética , Fatores de Regulação Miogênica/metabolismo , Oxaliplatina/farmacologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais , Calinina/genética , Calinina/metabolismoRESUMO
OBJECTIVE: To explore the swallowing functions of stroke patients with dysphagia. METHODS: A total of 41 subjects were recruited.There were 15 stroke patients with dysphagia, 12 stroke patients without swallowing disorders and 14 age-and gender-matched healthy controls.Surface electromyography (sEMG) was employed over the suprahyoid muscle group.Single swallow was applied twice with 5 and 10 ml of thin liquid barium as well as 5 and 10 ml of paste barium.The duration, average amplitude of sEMG and peak amplitude of submental muscle contraction were compared among three groups.Three-way analysis of variance (ANOVA) was performed. RESULTS: No significant differences existed in the general data among three groups (P > 0.05).However, all volumes, consistencies and durations [ (1.38 ± 0.21), (1.66 ± 0.30), (1.46 ± 0.24), (1.78 ± 0.28) s] were significantly longer for the group of dysphagia patients than for those without dysphagia and healthy subjects (P < 0.05).And the average amplitudes ( (16 ± 6), (15 ± 5), (20 ± 13), (19 ± 7) µV) were significantly smaller for the group of dysphagia patients than for those without dysphagia and healthy subjects (P < 0.05) while the peak amplitudes ((48 ± 23), (51 ± 23), (51 ± 31), (63 ± 32) µV) were significantly smaller for the group of dysphagia patients than for those without dysphagia and healthy subjects (P < 0.05). There were no significant differences between patients without dysphagia and those of healthy subjects (P > 0.05). CONCLUSION: As a simple and useful tool, sEMG is feasible for evaluating swallowing function and quantifying the strength of swallowing muscles in post-stroke patients with dysphagia.
Assuntos
Transtornos de Deglutição/fisiopatologia , Músculos Faciais/fisiopatologia , Acidente Vascular Cerebral/fisiopatologia , Idoso , Estudos de Casos e Controles , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A fundamental goal in cancer-associated genome sequencing is to identify the key genes. Protein-protein interactions (PPIs) play a crucially important role in this goal. Here, human reference interactome (HuRI) map was generated and 64,006 PPIs involving 9094 proteins were identified. Here, we developed a physical link and co-expression combinatory network construction (PLACE) method for genes of interest, which provides a rapid way to analyze genome sequencing datasets. Next, KaplanâMeier survival analysis, CCK8 assays, scratch wound assays and Transwell assays were applied to confirm the results. In this study, we selected single-cell sequencing data from patients with hepatocellular carcinoma (HCC) in GSE149614. The PLACE method constructs a protein connection network for genes of interest, and a large fraction (80%) of the genes (screened by the PLACE method) were associated with survival. Then, PLACE discovered that transmembrane protein 14B (TMEM14B) was the most significant prognostic key gene, and target genes of TMEM14B were predicted. The TMEM14B-target gene regulatory network was constructed by PLACE. We also detected that TMEM14B-knockdown inhibited proliferation and migration. The results demonstrate that we proposed a new effective method for identifying key genes. The PLACE method can be used widely and make outstanding contributions to the tumor research field.
Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/genética , Prognóstico , Neoplasias Hepáticas/genética , Mapeamento Cromossômico , Análise de Sequência de RNARESUMO
Immunotherapy is one of the fastest developing areas in the field of oncology. Many immunological treatment strategies for refractory tumors have been approved and marketed. Nevertheless, much clinical and preclinical experimental evidence has shown that the efficacy of immunotherapy in tumor treatment varies markedly among individuals. The commensal microbiome mainly colonizes the intestinal lumen in humans, is affected by a variety of factors and exhibits individual variation. Moreover, the gut is considered the largest immune organ of the body due to its influence on the immune system. In the last few decades, with the development of next-generation sequencing (NGS) techniques and in-depth research, the view that the gut microbiota intervenes in antitumor immunotherapy through the immune system has been gradually confirmed. Here, we review important studies published in recent years focusing on the influences of microbiota on immune system and the progression of malignancy. Furthermore, we discuss the mechanism by which microbiota affect tumor immunotherapy, including immune checkpoint blockade (ICB) and adoptive T-cell therapy (ACT), and strategies for modulating the microbial composition to facilitate the antitumor immune response. Finally, opportunity and some challenges are mentioned to enable a more systematic understanding of tumor treatment in the future and promote basic research and clinical application in related fields.
RESUMO
A 65-day growth trial was conducted to investigate the dietary protein requirements for Culter mongolicus fingerlings. Isolipidic and isoenergetic diets were formulated with five dietary protein levels (32%, 37%, 42%, 47%, and 52%). Each diet was assigned to triplicate groups of 70 C. mongolicus fingerlings (0.99±0.08 g). The results indicated that weight gain and specific growth rate (SGR) increased with increasing dietary protein levels up to 47%. The activities of intestinal trypsin and lipase were the lowest in the 32% protein and 52% protein groups, while amylase activity reduced markedly in the 47% protein group. These results suggest that different dietary protein levels may cause different transformations of nutrients. The activities of superoxide dismutase (SOD) and lysozyme were not affected by varying dietary protein levels, except for those in the 32% protein group. In contrast, the content of malondialdehyde (MDA) increased with increasing dietary protein levels and reaching a maximum in the 52% protein group, suggesting that MDA accumulation depends on the protein concentration and the potential oxidative stress. Taken together, based on the broken-line analysis of SGR, we recommended the optimum dietary protein for C. mongolicus fingerlings to be 48.97%~49.31%.
Assuntos
Proteínas Alimentares/metabolismo , Muramidase/metabolismo , Estresse Oxidativo , Superóxido Dismutase/metabolismo , Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Animais , Antioxidantes/metabolismo , Dieta , Suplementos Nutricionais/análise , Peixes , Sistema Imunitário , Lipase/química , Necessidades Nutricionais , Tripsina/químicaRESUMO
The Oswestry Disability Index (ODI) is one of the most widely used questionnaires that assess disability in patients with low back pain (LBP). Responsiveness is both an important psychometric property of an instrument and a key issue for clinicians when choosing suitable outcome measures. The objective of this study was to examine the responsiveness of the Chinese version of the ODI (ODI-Chinese) for subjects with chronic LBP following a physical therapy program. In total, 76 patients with chronic LBP completed the ODI-Chinese, a visual analog scale (VAS) of pain, and the Chinese version of Short Form-36 (SF-36) before and after treatment. All patients also completed a global perception of change Likert scale in condition after the program. The scale was collapsed to produce a dichotomous variable outcome, improved or non-improved. The responsiveness of the instruments was determined using the standardized response means (SRM) and receiver operating characteristics (ROC). After treatment, 56 patients considered themselves to be improved. The SRM of the ODI-Chinese was -1.2 in the improved group and -0.4 in the non-improved group. The area of the ROC curve for the ODI-Chinese was 0.77 (95% CI 0.66-0.89). Therefore, the Chinese version of the ODI is both responsive and appropriate for use in chronic LBP patients after conservative therapy.
Assuntos
Avaliação da Deficiência , Dor Lombar/diagnóstico , Dor Lombar/reabilitação , Inquéritos e Questionários/normas , Tradução , Adulto , Idoso , China , Feminino , Humanos , Dor Lombar/psicologia , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
BACKGROUND: Patients with Alzheimer's disease (AD) have gut microbiome alterations compared with healthy controls. However, previous studies often assess AD patients who have been on medications or other interventions for the disease. Also, simultaneous determination of gut microbiome in patients with mild cognitive impairment (MCI) or AD in a study is rare. OBJECTIVE: To determine whether there was a gut microbiome alteration in patients newly diagnosed with AD or MCI and whether the degree of gut microbiome alteration was more severe in patients with AD than patients with MCI. METHODS: Fecal samples of 18 patients with AD, 20 patients with MCI, and 18 age-matched healthy controls were collected in the morning for 16S ribosomal RNA sequencing. No patient had medications or interventions for AD or MCI before the samples were collected. RESULTS: Although there was no difference in the microbial α-diversity among the three groups, patients with AD or MCI had increased ß-diversity compared with healthy controls. Patients with AD had decreased Bacteroides, Lachnospira, and Ruminiclostridium_9 and increased Prevotella at the genus level compared with healthy controls. The changing direction of these genera in patients with MCI was the same as patients with AD. However, Lachnospira was the only genus whose abundance in patients with MCI was statistically significantly lower than healthy controls. Bacteroides, Lachnospira, and Ruminiclostridium_9 were positively associated with better cognitive functions whereas Prevotella was on the contrary when subjects of all three groups were considered. The negative correlation of Prevotella with cognitive functions remained among patients with MCI. CONCLUSION: Patients newly diagnosed with AD or MCI have gut dysbiosis that includes the decrease of potentially protective microbiome, such as Bacteroides, and the increase of microbiome that can promote inflammation, such as Prevotella. Our results support a novel idea that the degree of gut dysbiosis is worsened with the disease stage from MCI to AD.
Assuntos
Doença de Alzheimer/microbiologia , Disfunção Cognitiva/microbiologia , Microbioma Gastrointestinal , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Povo Asiático , Biodiversidade , China , Cognição , Disfunção Cognitiva/psicologia , Progressão da Doença , Fezes/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RNA Ribossômico 16S/análiseRESUMO
Ticks are known as vectors of several pathogens causing various human and animal diseases including Lyme borreliosis, tick-borne encephalitis, and Crimean-Congo hemorrhagic fever. While China is known to have more than 100 tick species well distributed over the country, our knowledge on the likely distribution of ticks in the future remains very limited, which hinders the prevention and control of the risk of tick-borne diseases. In this study, we selected four representative tick species which have different regional distribution foci in mainland China. i.e., Dermacentor marginatus, Dermacentor silvarum, Haemaphysalis longicornis and Ixodes granulatus. We used the MaxEnt model to identify the key environmental factors of tick occurrence and map their potential distributions in 2050 under four combined climate and socioeconomic scenarios (i.e., SSP1-RCP2.6, SSP2-RCP4.5, SSP3-RCP7.0 and SSP5-RCP8.5). We found that the extent of the urban fabric, cropland and forest, temperature annual range and precipitation of the driest month were the main determinants of the potential distributions of the four tick species. Under the combined scenarios, with climate warming, the potential distributions of ticks shifted to further north in China. Due to a decrease in the extent of forest, the distribution probability of ticks declined in central and southern China. In contrast with previous findings on an estimated amplification of tick distribution probability under the extreme emission scenario (RCP8.5), our studies projected an overall reduction in the distribution probability under RCP8.5, owing to an expected effect of land use. Our results could provide new data to help identify the emerging risk areas, with amplifying suitability for tick occurrence, for the prevention and control of tick-borne zoonoses in mainland China. Future directions are suggested towards improved quantity and quality of the tick occurrence database, comprehensiveness of factors and integration of different modelling approaches, and capability to model pathogen spillover at the human-tick interface.
Assuntos
Encefalite Transmitida por Carrapatos , Ixodes , Doença de Lyme , Doenças Transmitidas por Carrapatos , Animais , China/epidemiologia , Mudança Climática , Humanos , Doenças Transmitidas por Carrapatos/epidemiologiaRESUMO
BACKGROUND: Cricopharyngeal muscle dysfunction (CPD) management has been challenging in clinical practice. OBJECTIVE: To compare the efficacy and safety of ultrasound-guided botulinum toxin injection and balloon catheter dilatation in treating CPD. METHODS: Forty patients with CPD were randomly divided into two groups, namely the botulinum toxin injection group (BTX group) and balloon dilatation group (BD group). Patients in the BTX group received a single ultrasound-guided injection of 50 units of botulinum toxin type A, while the BD group received dilatation therapy five times per week, consecutively for two weeks. Relative opening percentage of the upper esophageal sphincter (UES), the penetration-aspiration scale (PAS), and the Dysphagia Outcome Severity Scale (DOSS) were evaluated by a videofluoroscopic swallowing study (VFSS) at baseline, 1-month, and 3-months posttreatment. The Functional Oral Intake Scale (FOIS) and Standardized Swallowing Assessment (SSA) were also used to evaluate participants' swallowing function at baseline and the 1-week, 2-week, 1-month, and 3-month follow-ups. RESULTS: A generalized estimating equation (GEE) model revealed the significant main effect for time in UES, PAS, DOSS, FOIS, and SSA compared to baseline (P <0.05), while no group-by-time interactions (except for the PAS assessment) or main effect for treatment was detected among the above multiple variances. No systematic complications or severe adverse effects were noted. CONCLUSION: Both ultrasound-guided botulinum toxin type A injections and balloon dilatation therapy have been proven as safe and effective treatments for CPD patients. Future clinical trials with longer follow-up periods and more participants are warranted.
Assuntos
Toxinas Botulínicas Tipo A , Transtornos de Deglutição , Toxinas Botulínicas Tipo A/uso terapêutico , Catéteres , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Dilatação , Esfíncter Esofágico Superior , Humanos , Resultado do Tratamento , Ultrassonografia de IntervençãoRESUMO
INTRODUCTION: Patients with amnesic mild cognitive impairment (aMCI) are more likely to develop Alzheimer disease than corresponding age normal population. Because Alzheimer disease is irreversible, early intervention for aMCI patients seems important and urgent. We have designed a pilot multicenter, randomized, parallel controlled trial to assess the efficacy and safety of acupuncture on aMCI, explore the feasibility of acupuncture in the treatment of aMCI, so as to provide a reference for large-sample clinical trials in the next stage. METHOD: We designed a pilot multicenter, randomized, parallel controlled trial. This trial aims to test the feasibility of carrying out a large-sample clinical trial. In this trial, 50 eligible patients with aMCI will be included and allocated to acupuncture group (nâ=â25) or sham acupuncture group (nâ=â25) at random. Subjects will accept treatment 2 times a week for 12âweeks continuously, with a total of 24 treatment sessions. We will select 6 acupoints (GV20, GV14, bilateral BL18, bilateral BL23). For the clinical outcomes, the primary outcome is Montreal cognitive assessment, which will be assessed from baseline to the end of this trial. And the secondary outcomes are Mini-mental State Examination, Delayed Story Recall, Clinical Dementia Rating scale, Global Deterioration Scale, Activity of Daily Life, Alzheimer Disease Assessment Scale-Cognitive Section, brain magnetic resonance imaging, brain functional magnetic resonance imaging, and event-related potential P300, which will be assessed before and after treatment. In addition, we will assess the safety outcomes from baseline to the end of this trial and feasibility outcome after treatment. We will evaluate neuropsychological assessment scale (Montreal cognitive assessment, Mini-mental State Examination, Alzheimer Disease Assessment Scale-Cognitive Section) at 3âmonths and 6âmonths after treatment. DISCUSSION: This pilot trial aims to explore the feasibility of the trial, verify essential information of its efficacy and safety. This pilot study will provide a preliminary basis for carrying out a larger clinical trial of acupuncture on aMCI in near future.
Assuntos
Terapia por Acupuntura/métodos , Doença de Alzheimer/terapia , Disfunção Cognitiva/terapia , Doença de Alzheimer/diagnóstico , Amnésia/terapia , Disfunção Cognitiva/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Estudos de Viabilidade , Humanos , Testes de Estado Mental e Demência , Projetos Piloto , Resultado do TratamentoRESUMO
Ticks are known as the vectors of various zoonotic diseases such as Lyme borreliosis and tick-borne encephalitis. Though their occurrences are increasingly reported in some parts of China, our understanding of the pattern and determinants of ticks' potential distribution over the country remain limited. In this study, we took advantage of the recently compiled spatial dataset of distribution and diversity of ticks in China, analyzed the environmental determinants of ten frequently reported tick species and mapped the spatial distribution of these species over the country using the MaxEnt model. We found that presence of urban fabric, cropland, and forest in a place are key determents of tick occurrence, suggesting ticks were likely inhabited close to where people live. Besides, precipitation in the driest month was found to have a relatively high contribution in mapping tick distribution. The model projected that theses ticks could be widely distributed in the Northwest, Central North, Northeast, and South China. Our results added new evidence on the potential distribution of a variety of major tick species in China and pinpointed areas with a high potential risk of tick bites and tick-borne diseases for raising public health awareness and prevention responses.