Résumé
O objetivo deste estudo foi relatar a experiência do desenvolvimento de uma proposta de educação continuada executada pela equipe de enfermagem com agentes comunitários de saúde (ACS), considerando como foco a vacinação infantil. Trata-se de um relato de experiência elaborado e vivenciado por enfermeiro e acadêmico de enfermagem em novembro de 2019, com a participação de duas equipes pertencentes a uma Unidade Básica de Saúde do município de Arapiraca (AL). Através da metodologia de ensino da problematização por meio do Arco de Maguerez, foram realizadas oficinas e ações educativas para os ACS, a partir das necessidades relatadas por esses profissionais em relação à vacinação infantil. Tais atividades proporcionaram maior aproximação com a realidade vivenciada por quem ocupa a posição de educador e incentivador do cuidado da saúde durante a visita domiciliar. Além disso, enfatizaram a importância do enfermeiro enquanto responsável pela educação continuada da equipe. Verificou-se ainda que o diálogo aberto e horizontal, de modo empático, proporcionou a construção de uma ferramenta eficaz, de fácil manuseio e de baixo custo, que gerou uma melhor memorização e segurança não somente para os ACS nas visitas domiciliares, mas também nas atividades de outros profissionais atuantes no campo da promoção da saúde infantil.
This study reports the experience of developing an educational product based on continued education carried out by a nursing team with community health agents (CHA) considering childhood vaccination as the focus. This is an experience report that was prepared and experienced by a nurse and nursing student in November 2019, with the participation of two teams belonging to a basic health unit in the municipality of Arapiraca, Alagoas, Brazil. Using the problematization teaching methodology by Arco de Marguerez, workshops and educational actions were carried out for the CHA based on the needs they reported regarding childhood vaccination, which provided a greater approximation with the reality experienced by those in the position of educators and encouragers of health care during home visits. Furthermore, it emphasized the importance of nurses as responsible for the team's continuing education. It was also verified that open and horizontal dialogue empathetically provided the construction of an effective, easy to use, low cost tool, bringing better memorization and safety not only for community agents during home visits but also in activities from other professionals working in the field of child health promotion.
El objetivo de este estudio fue reportar la experiencia de desarrollo de una propuesta de educación continua realizada por el equipo de enfermería con agentes comunitarios de salud (ACS), considerando como enfoque la vacunación infantil. Este es un reporte de experiencia elaborado y vivido por un enfermero y un estudiante de enfermería en noviembre de 2019, con la participación de dos equipos de una unidad básica de salud de la ciudad de Arapiraca, Brasil. Utilizando la metodología de enseñanza de problematización del Arco de Maguerez, se realizaron talleres y acciones educativas para ACS a partir de las necesidades reportadas por estos profesionales con relación a la vacunación infantil. Estas actividades proporcionaron una mayor aproximación a la realidad vivida por quienes ocupan la posición de educador y motivador del cuidado de la salud durante la visita domiciliaria. Además, destacaron la importancia del enfermero como responsable de la formación continua del equipo. También se constató que el diálogo abierto y horizontal, de manera empática, propició la construcción de una herramienta efectiva, fácil de usar y de bajo costo, que generó una mejor memorización y seguridad no solo para los ACS durante las visitas domiciliarias, sino también en las actividades de otros profesionales que trabajan en el campo de la promoción de la salud infantil.
Sujets)
Humains , Enfant , Programmes de vaccinationRésumé
In the past few decades, microbubbles were widely used as ultrasound contrast agents in the field of tumor imaging. With the development of research, ultrasound targeted microbubble destruction technology combined with drug-loaded microbubbles can achieve precise drug release and play a therapeutic role. As a micron-scale carrier, microbubbles are difficult to penetrate the endothelial cell space of tumors, and nano-scale drug delivery system—nanobubbles came into being. The structure of the two is similar, but the difference in size highlights the unique advantages of nanobubbles in drug delivery. Based on the classification principle of shell materials, this review summarized micro/nanobubbles used for ultrasound diagnosis or treatment and discussed the possible development directions, providing references for the subsequent development.
Résumé
@#Wound healing is a complex process that includes haemostasis and inflammation, followed by a proliferation period and repair and finally remodelling. Ocular surgeries, particularly in glaucoma cases, aim at minimal fibrosis to preserve the function of trabeculectomy as an alternative pathway for aqueous drainage. Hence, it is important to find an agent to modulate the wound healing process. This review presents compilation of wound modulation agents that have been tested in vitro, in vivo, or clinically on patients undergoing ocular surgeries, particularly for glaucoma. We identified agents into four groups, mostly for glaucoma filtration operations: anti-metabolites, anti-growth factors, mechanical barriers and rho kinases. The effect of these agents is highlighted in this review. In conclusion, despite recognized drawbacks of antimetabolites, they are still regarded as the gold standard and the most efficient treatment as anti-scarring agents use in ocular surgeries. More studies are needed to inquire agents that efficient yet has minimal adverse effects both in short and long term.
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Ischemia-reperfusion injury (IRI) is an extremely complicated pathophysiological process, which may occur during the process of myocardial infarction, stroke, organ transplantation and temporary interruption of blood flow during surgery, etc. As key molecules of immune system, macrophages play a vital role in the pathogenesis of IRI. M1 macrophages are pro-inflammatory cells and participate in the elimination of pathogens. M2 macrophages exert anti-inflammatory effect and participate in tissue repair and remodeling and extracellular matrix remodeling. The balance between macrophage phenotypes is of significance for the outcome and treatment of IRI. This article reviewed the role of macrophages in IRI, including the balance between M1/M2 macrophage phenotype, the mechanism of infiltration and recruitment into different ischemic tissues. In addition, the potential therapeutic strategies of targeting macrophages during IRI were also discussed, aiming to provide reference for alleviating IRI and promoting tissue repair.
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L'hypertension artérielle est une maladie à forte progression reste un problème de santé publique. Mais, les pratiques de sa prise en charge se heurtent à différents obstacles. Cette recherche questionne les problèmes qui caractérisent les pratiques de prise en charge de l'hypertension artérielle au Centre Hospitalier et Universitaire d'Abomey-Calavi au Bénin. Pour y parvenir, nous avons opté pour une analyse basée sur les méthodes quantitatives et qualitatives. L'échantillon est constitué de 130 personnes enquêtées. De l'analyse des résultats collectés, des difficultés éprouvées entre patients et agents de santé dans la prise en charge de l'hypertension artérielle, se caractérise par le manque de relation soignant-soigné. De même, 90% des enquêtés estiment avoir peu de ressources humaines qualifiées et du faible pouvoir d'achat des patients pour faire face aux coûts élevés du traitement de l'hypertension (86,75%). Ainsi, le manque de plateau technique et les frais de consultations spécialisées posent problèmes y compris les suivis de l'éducation hygiéno-diététique. Cet état de fait compromet les pratiques de prise en charge et les formations globales que le système soin est supposé assurer aux usagers qui le fréquentent. Ces résultats suggèrent l'urgence de formations pour le renforcement des capacités pour repérer la précarité et la réorganisation des mesures de prise en charge de l' hypertension artérielle dans le périmètre sanitaire béninois.
Arterial hypertension remains a rapidly growing public health problem. However, management practices face a number of obstacles. This research questions the problems that characterize arterial hypertension management practices at the Centre Hospitalier et Universitaire d'Abomey-Calavi in Benin. To achieve this, we opted for an analysis based on quantitative and qualitative methods. The sample consisted of 130 respondents. From the analysis of the results collected, of the difficulties experienced between patients and health workers in the management of arterial hypertension, most of those surveyed claimed to have a complexity that characterizes the training of health workers. Similarly, 90% of respondents felt that they had few non-cardiologist practitioners, and that patients had little purchasing power to meet the high costs of treating hypertension (86.75%). As a result, the cost of specialized consultations and complementary examinations poses a problem, including follow-up health and diet education. This state of affairs compromises management practices and the comprehensive training that the healthcare system is supposed to provide for its users. These results suggest the urgent need for training to identify precariousness, and the reorganization of hypertension management measures within the Beninese health perimeter.
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Enquêtes et questionnaires , Frais et honorairesRésumé
Background: The prevalent utilization of medicinal plants in communities underscores their promise as antimicrobial agents amid rising antibiotic resistance. This study assesses five medicinal plants; Bambusa vulgaris, Hibiscus sabdariffa, Heteropogon contortus, Moringa oleifera, and Carica papaya against clinical isolates of Salmonella Typhi and Shigella dysenteriae. Methodology: Five medicinal plants were chosen based on traditional knowledge and ethnobotanical practices. Phytochemical analysis followed standard methods. Plant extracts were prepared using ethanol, ethyl acetate, dichloromethane, and hexane. Various concentrations (R conc., D1 conc., D2 conc, D3 conc, and D4 conc) of the extracts were evaluated using Kirby-Bauer disk diffusion and broth dilution methods to ascertain antimicrobial properties, including minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC). Results: Phytochemical analysis revealed abundant saponins, cardiac glycosides, terpenoids, steroids, flavonoids, phenolics, and tannins, notably higher with ethanol extraction. Hibiscus sabdariffa demonstrated potent activity against S. Typhi with inhibition zone diameters of 29.00 mm (R conc), 27.00 mm (D1 conc), 14.00 mm (D2 conc), and 4.00 mm (D3 conc). Heteropogon contortus exhibited activity against S. dysenteriae with inhibition zone diameter of 25.05 mm (R conc), 15.00 mm (D1 conc), 10.00 mm (D2 conc), and 5.00 mm (D3 onc). The inhibition zone diameters of B. vulgaris were 18.50 mm (R conc), 17.00 mm (D1 conc), and 10.00 mm (D2 conc) against S. dysenteriae. The MIC and MBC were similar for both organisms, with H. sabdariffa (MIC: D3-4.27 mg/mL, MBC: D1-68.25 mg/mL) and H. contortus (MIC: D3-4.69 mg/mL, MBC: R-75.00 mg/mL), while M. oleifera, C. papaya, and B. vulgaris had negligible antimicrobial activity. Conclusion: Hibiscus sabdariffa and H. contortus exhibited potent antimicrobial effects against Salmonella, with MICs of 4.27 mg/mL and 4.69 mg/mL, and MBCs of 68.25 mg/mL and 75.00 mg/mL respectively. Their consistent low MICs against Shigella suggest their potentials for antibiotic production.
Contexte: L'utilisation répandue des plantes médicinales dans les communautés souligne leur promesse en tant qu'agents antimicrobiens dans un contexte de résistance croissante aux antibiotiques. Cette étude évalue cinq plantes médicinales; Bambusa vulgaris, Hibiscus sabdariffa, Heteropogon contortus, Moringa oleifera et Carica papaya contre les isolats cliniques de Salmonella Typhi et Shigella dysenteriae. Méthodologie: Cinq plantes médicinales ont été choisies sur la base des connaissances traditionnelles et des pratiques ethnobotaniques. L'analyse phytochimique a suivi les méthodes standard. Des extraits de plantes ont été préparés en utilisant de l'éthanol, de l'acétate d'éthyle, du dichlorométhane et de l'hexane. Diverses concentrations (R conc., D1 conc., D2 conc., D3 conc et D4 conc) des extraits ont été évaluées à l'aide des méthodes de diffusion sur disque Kirby-Bauer et de dilution en bouillon pour vérifier les propriétés antimicrobiennes, y compris les concentrations minimales inhibitrices (CMI) et les concentrations minimales concentrations bactéricides (MBC). Résultats: L'analyse phytochimique a révélé une abondance de saponines, de glycosides cardiaques, de terpénoïdes, de stéroïdes, de flavonoïdes, de composés phénoliques et de tanins, notamment plus élevés avec l'extraction à l'éthanol. Hibiscus sabdariffa a démontré une activité puissante contre S. Typhi avec des diamètres de zone d'inhibition de 29,00 mm (conc R), 27,00 mm (conc D1), 14,00 mm (conc D2) et 4,00 mm (conc D3). Heteropogon contortus a présenté une activité contre S. dysenteriae avec un diamètre de zone d'inhibition de 25,05 mm (R conc), 15,00 mm (D1 conc), 10,00 mm (D2 conc) et 5,00 mm (D3 onc). Les diamètres de zones d'inhibition de B. vulgaris étaient de 18,50 mm (conc R), 17,00 mm (conc D1) et 10,00 mm (conc D2) contre S. dysenteriae. La CMI et la MBC étaient similaires pour les deux organismes, avec H. sabdariffa (CMI: D3-4,27 mg/mL, MBC: D1-68,25 mg/mL) et H. contortus (CMI: D3-4,69 mg/mL, MBC: R -75,00 mg/mL), tandis que M. oleifera, C. papaya et B. vulgaris avaient une activité antimicrobienne négligeable. Conclusion: Hibiscus sabdariffa et H. contortus ont présenté de puissants effets antimicrobiens contre Salmonella, avec des CMI de 4,27 mg/mL et 4,69 mg/mL et des MBC de 68,25 mg/mL et 75,00 mg/mL respectivement. Leurs CMI constamment faibles contre Shigella suggèrent leur potentiel de production d'antibiotiques.
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Abstract Background: The antiemetic effectiveness of olanzapine, as a prophylactic off-label antiemetic drug, for Postoperative Nausea and Vomiting (PONV) is unknown. In this systematic review and meta-analysis, the authors evaluate the efficacy and side effects of olanzapine as a prophylactic antiemetic in adult patients who undergo general anesthesia and assess adverse effects. Methods: A systematic search was done on electronic bibliographic databases in July 2023. Randomized controlled trials of olanzapine as a prophylactic antiemetic for PONV in adults who underwent general anesthesia were included. The authors excluded non-RCTs and retracted studies. The authors set no date of publication or language limits. The outcomes were the incidence of PONV within 24 h postoperatively and the safety of olanzapine. The risk of bias was assessed according to the tool suggested by the National Heart, Lung, and Blood Institute. Results: Meta-analysis included 446 adult patients. Olanzapine reduced on average 38 % the incidence of PONV. The estimated risk ratio (95 % CI) of olanzapine versus control was 0.62 (0.42-0.90), p = 0.010, I2 = 67 %. In the subgroup meta-analysis, doses of olanzapine (10 mg) reduced on average 49 % of the incidence of PONV (RR = 0.51 [0.34-0.77], p = 0.001, I2 = 31 %). Conclusion: This systematic review with meta-analysis indicated that olanzapine as a prophylactic antiemetic alone or combined with other antiemetic agents reduced the incidence of postoperative nausea and vomiting. However, this conclusion must be presented with some degree of uncertainty due to the small number of studies included. There was a lack of any evidence to draw conclusions on side effects.
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Relato de caso de paciente com rinossinusite crônica com polipose nasal em tratamento com dupilumabe. São descritos os aspectos clínicos e o impacto na qualidade da vida do paciente. Imagens tomográficas evidenciam a melhora do processo inflamatório e a regressão dos pólipos nasais.
We report the case of a patient with chronic rhinosinusitis with nasal polyps treated with dupilumab. The clinical features and impact on the patient's quality of life are described. Computed tomography shows improvement of the inflammatory process and regression of the nasal polyps.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Anticorps monoclonaux , Anti-inflammatoires non stéroïdiensRésumé
Background & objectives: Statin use has been shown to be associated with a decreased risk of several types of cancer, however, the data on diffuse large B-cell lymphoma (DLBCL) are still inconclusive. This study aimed to systematically summarize all available data on this association and conduct a meta-analysis on the same. Methods: A systematic review was performed using EMBASE and MEDLINE databases from inception upto October 2019 with a search strategy that included terms such as ‘statin’ and ‘DLBCL’. Eligible studies included either case–control or cohort studies that reported the association between statin use and the risk of DLBCL. Relative risk, odds ratio (OR), hazard: risk ratio or standardized incidence ratio of this association and standard error were extracted and combined for calculating the pooled effect estimate using random-effects, generic inverse variance method. Results: A total of 1139 articles were screened. Of these six studies satisfied the inclusion criteria and were included for the meta-analysis. Statin use was associated with a significantly reduced risk of DLBCL with the pooled OR of 0.70 (95% confidence interval, 0.56-0.88; I2=70%). The funnel plot (fairly symmetric) was not suggestive of the presence of a publication bias. Interpretation & conclusions: The present systematic review and meta-analysis found that statin use is associated with a 30 per cent reduced odds of DLBCL. However, the pooled analysis utilized data from observational studies so causation cannot be concluded upon. Hence, it suggested that randomized-controlled studies are still needed to confirm this potential benefit.
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Introduction: Hypersensitivity to chemotherapeutic and biological agents has increased in recent years due to their frequent use. Avoidance has been the first line of defense, leading to decreased treatment efficacy and increased adverse events. Objective: To characterize the sociodemographic and clinical aspects of patients with hypersensitivity reactions to chemotherapeutic agents who underwent desensitization and biological procedures in a Colombian city. Methods: This observational, descriptive, retrospective, multicenter study was conducted in patients with hypersensitivity reactions to chemotherapeutic and biological agents who underwent desensitization. Results: In the 14 included patients with a history of hypersensitivity reactions to chemotherapeutic and biological agents (57.1% women; median age 42.5 years), 45 desensitization procedures were performed. The most commonly prescribed drug was rituximab (57%). The skin was the most frequent reaction site (78.6%), and systemic corticosteroids were the most common treatment (78.6%). Breakthrough reactions occurred in 31.1% of the patients and only premedication with corticosteroids was associated with less severe reactions. All cases of desensitization were successful. Conclusions: Desensitization to chemotherapeutic and biological agents proved to be a useful and safe tool in a Colombian population.
Introdução: A hipersensibilidade aos agentes quimioterápicos e biológicos aumentou nos últimos anos devido ao seu uso frequente. Evitar tem sido a primeira linha de ação, levando à diminuição da eficácia do tratamento e ao aumento de eventos adversos. Objetivos: Caracterizar os aspectos sociodemográficos e clínicos de pacientes com reações de hipersensibilidade a agentes quimioterápicos submetidos a dessensibilização e procedimentos biológicos em uma cidade colombiana. Métodos: Foi realizado um estudo observacional, descritivo, retrospectivo e multicêntrico em pacientes com reações de hipersensibilidade a agentes quimioterápicos e biológicos submetidos à dessensibilização. Resultados: Foram incluídos 45 procedimentos de dessensibilização em 14 pacientes com histórico de reações de hipersensibilidade a agentes quimioterápicos e biológicos (57,1% mulheres, com mediana de idade de 42,5 anos). O medicamento mais relatado foi o rituximabe (57%). O envolvimento cutâneo foi o mais frequente (78,6%) e os corticosteroides sistêmicos foram o tratamento mais utilizado (78,6%). As reações ocorreram em 31,1% e apenas a pré-medicação com corticosteroides foi associada a uma menor gravidade destas. Todos os casos de dessensibilização foram bem-sucedidos. Conclusões: A dessensibilização a agentes quimioterápicos e biológicos provou ser uma ferramenta útil e segura em uma população colombiana.
Sujets)
HumainsRésumé
Abstract Individuals with autism spectrum disorder may present social-communicative and behavioral deficits. Recently, research on treatment and diagnosis has shifted its focus to the application of new tech nologies. Among them is virtual reality, which guarantees a high sense of realism to the experience and allows the implementation of a virtual agent that facilitates the use of the application. In social skills interventions, it has been mostly chosen to implement a virtual agent with a human appearance. Virtual humans guide the user-system interaction through the use of verbal and nonverbal language. They can be equipped with responsiveness: the ability to provide responses to the user based on data recorded during the use of the technology. Responsiveness is functional when the goal is to create an interaction similar to that of everyday life, as it allows for behavioral responses and, at a more sophisticated level, vocal responses. Considering virtual agents capable of holding a conversation with the user, to date three different methods have been implemented that make communication more or less realistic. This brief review proposes a synopsis of relevant virtual humans' features and highlights some key ASD research areas wherein virtual humans are implemented for diagnosis and treatment. A total of 11 studies were selected and their analysis was summarized into 7 main categories. Finally, the clinical and technological implications of the results found were discussed.
Resumen Los individuos con trastorno del espectro autista pueden presentar déficits socio-comunicativos y conductuales. Recientemente, la investigación sobre el tratamiento y el diagnóstico se ha centrado en la aplicación de nuevas tecnologías. Entre ellas se encuentra la realidad virtual, que garantiza un alto sentido de realismo a la experiencia y permite la implementación de un agente virtual que facilite el uso de la aplicación. En las intervenciones de habilidades sociales, se ha optado mayoritariamente por implementar un agente virtual con apariencia humana. Los humanos virtuales guían la interacción usuario-sistema mediante el uso de lenguaje verbal y no verbal. Estos pueden estar dotados de responsividad: la capacidad de proporcionar respuestas al usuario basadas en los datos registrados durante el uso de la tecnología. La responsividad es funcional cuando el objetivo es crear una interacción similar a la de la vida cotidiana, ya que permite dar respuestas conductuales y, a un nivel más sofisticado, respuestas vocales. Considerando los agentes virtuales capaces de mantener una conversación con el usuario, hasta la fecha se han implementado tres métodos diferentes que hacen que la comunicación sea más o menos realista. Esta breve revisión propone una sinopsis de las características de los humanos virtuales relevantes y destaca algunas áreas de investigación clave del TEA en las que se implemen tan humanos virtuales para el diagnóstico y el tratamiento. Se seleccionó un total de 11 estudios y su análisis se resumió en 7 categorías principales. Por último, se discuten las implicaciones clínicas y tecnológicas de los resultados encontrados.
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Background: The laryngeal mask airway (LMA) has reached ample popularity for the management of airway during surgery. Propofol, used as induction agent, causes change in blood pressure and heart rate (HR) while insertion of LMA. Sevoflurane, whereas, has the potential to be a good induction agent as propofol. We have compared propofol and sevoflurane for easy insertion of LMA among adults in minor surgeries. Aim and Objectives: The primary objective of the study was to compare the ease of insertion of LMA and its characteristics related to insertion among adults in minor elective surgeries using intravenous propofol or inhalational sevoflurane. While time taken to set induction and actual event of LMA insertion along with number of attempts, jaw relaxation time, LMA insertion time, apnea time, monitoring hemodynamic changes, and occurrence of complications were taken as secondary objectives. Materials and Methods: It was a prospective and observational study done in Department of Anesthesiology and Operation Theaters of Fortis Hospital, Kolkata, after getting ethical approval. Total 100 patients were recruited by consecutive sampling and divided into two groups - P (propofol) and S (sevoflurane) group. Anesthesia induction time, jaw relaxation time, LMA insertion time, etc. were noted. LMA insertion conditions were assessed by a 3-point scale using six variables, total score was calculated for each group. Hemodynamic parameters and induction complications were also recorded. Results: There was no significant difference in demographic parameters, American Society of Anesthesiologists class, Modified Mallampati Grading, and LMA size, between the groups. LMA insertion time was comparable between the two groups. Regarding complications, there was no incidence of coughing while minor gagging (4%) and laryngospasm (6%) were noted only with sevoflurane. Final summation of scores showed excellent insertion characteristics with propofol (94%) and sevoflurane (84%), respectively, with no significant difference. Conclusion: Inhalational sevoflurane may be regarded as a viable alternative to inj. propofol for insertion of laryngeal mask among adults in minor elective surgeries.
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Acute myeloid leukemia (AML) is a genetic heterogeneous disease in which primordial and juvenile myeloid cells proliferate or accumulate abnormally in bone marrow, peripheral blood and other tissues, resulting in damage to normal hematopoietic function. Studies have shown that about 30% of AML patients have FMS-like tyrosine kinase 3 (FLT3), FLT3 abnormal regulation is closely related to the occurrence and development of AML. At present, FLT3 has become an important target for developing small molecular targeted drugs. Currently, a variety of FLT3 inhibitors and FLT3 degraders have been developed targeting FLT3, and some compounds have exhibited good anti-AML activity. This article summarizes and sorts out the current mainstream drugs for AML therapeutic targeting FLT3, in order to provide a reference for the development and design of AML drugs.
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Antiviral therapy for chronic hepatitis C virus (HCV) infection has entered the era of direct antiviral agent (DAA), and up to 95% of patients could be clinically cured. Under this circumstance, HCV infection has gradually changed from relative contraindication to surgical indication for kidney transplantation. However, at present, the number of kidney transplantation from HCV-infected donors or recipients has been rarely reported in China. The short-term follow-up data of HCV-negative recipients undergoing kidney transplantation from HCV-positive renal allografts in other countries have confirmed that DAA yields high cure rate and safety in the treatment of HCV infection, and recipients could obtain favorable short-term survival and allograft outcome. However, the long-term safety of HCV-infected kidney transplantation remains to be validated by clinical trials with large sample size and long-term follow-up. In this article, the virological clearance, allograft outcome and safety of DAA use in HCV-negative recipients undergoing kidney transplantation from HCV-positive renal allografts under the intervention of DAA were investigated, aiming to evaluate clinical safety and efficacy of this pattern of kidney transplantation and deepen the understanding of safe use of HCV-positive organs.
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Antibacterial therapy is a global health issue. The antibiotic resistance is becoming an increasingly serious threat, which caused by misuse and overuse of antibacterial agents combined with the emergence of new resistance mechanism. The resulting infection treatment risk and incidence of the spread of disease, severe cases and deaths are increased in different degrees. With the extensive application of biomaterials and nanotechnology to biomedicine, extensive research has been conducted on antibacterial infection. With the specific physicochemical properties like optical, electric and magnetic and high penetration, inorganic nanomaterials can produce natural antibacterial effect. Nanomedicine can be designed to allow controlled drug release and targeting effect, thus demonstrated better antibacterial efficiency. In this review, the mechanism of antibacterial resistance is described, and the antibacterial infection research on inorganic nanomaterials, as well as nano-drug delivery system including liposomes, nanoparticles, dendrimers and biomimetic nanocarriers are summarized. Nanomaterials and nanotechnology offer promising strategies for the development of new agents that can improve efficacy on antibacterial infections and overcome antibiotic resistance potentially.
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Objective @# To investigate the outcomes of a novel direct pulp capping agent containing platelet-rich fibrin (PRF) and mineral trioxide aggregate (MTA). @*Methods @# A total of 32 New Zealand rabbits were randomly divided into 4 groups, namely, the PRF+MTA group (P+M group), PRF group (P group), MTA group (M group) and blank control group (BC group), with 8 rabbits per group. Dental pulp exposure and direct pulp capping were performed, and complete crown square sealing was performed on 2 mandibular central incisor teeth of each rabbit. Four rabbits from each group were euthanized after each observation period (7 and 28 days). The experimental teeth were subjected to HE staining. Inflammatory cell infiltration, calcified bridge formation and pulp tissue disorganization were observed and graded. @*Results@#Inflammatory cell infiltration: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05); group P+M and group M did not significantly differ (P>0.05). Calcified bridge formation: on the 7th and 28th days, group P+M was lighter than group P, group M and group BC (P<0.05); on the 28th day, group M was higher than group BC (P<0.05). Under microscope, the calcified bridge contained cellular components and was surrounded by odontoblast-like cells, sharing a structure resembled osteodentin; dentin tubule-like structure could not be observed in calcified bridge, and the calcified bridge resembled certain points of osteodentin. Pulp tissue disorganization: on the 7th day, group P+M and group M were lighter than group BC (P<0.05); on the 28th day, group P+M was lighter than group P and group BC (P<0.05). group P+M and group M did not significantly differ (P>0.05). @*Conclusion @# The combination of PRF and MTA for direct pulp capping provided light inflammatory cell infiltration, stable pulp status and a strong ability of pulp tissue to form calcified bridge, and the calcified bridge resembled certain points of osteodentin.
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Objective To evaluate the effect of extracorporeal membrane oxygenation (ECMO) on early allograft dysfunction (EAD) after heart transplantation. Methods Clinical data of 614 heart transplant recipients were retrospectively analyzed. All recipients were divided into the ECMO group (n=43) and non-ECMO group (n=571) according to postoperative application of ECMO. In the ECMO group, the conditions of recipients undergoing ECMO after heart transplantation were summarized. Perioperative status and long-term prognosis of recipients were compared between two groups. Results Among 43 recipients undergoing ECMO, 17 cases underwent thoracotomy due to bleeding, 10 cases of infection, 4 cases of venous thrombosis of the lower limbs, and 1 case of stroke, respectively. Twenty-six recipients were recovered and discharged after successful weaning from ECMO, six died during ECMO support, six died after weaning from ECMO, five received retransplantation due to unsuccessful weaning from ECMO, and only one survived after retransplantation. Compared with the non-ECMO group, intraoperative cardiopulmonary bypass duration was significantly longer, the proportion of recipients requiring postoperative intra-aortic balloon pump (IABP), dialysis due to renal insufficiency, reoperation for hemostasis, infection, mechanical ventilation time≥96 h and tracheotomy was significantly higher, and the length of postoperative intensive care unit (ICU) stay was significantly longer in the ECMO group (all P < 0.05). The survival rate after discharge and 90-d survival rate in the ECMO group were 63% and 96%, significantly lower than 97% and 100% in the non-ECMO group (both P < 0.05). Survival analysis showed that the long-term survival rate in the ECMO group was significantly lower than that in the non-ECMO group (P < 0.05). After excluding the recipients who died within 90 d after heart transplantation, no significant difference was observed in the long-term survival rate (P > 0.05). Conclusions ECMO is an effective treatment of EAD after heart transplantation. The short-term survival rate of recipients using ECMO after heart transplantation is lower than that of those who do not use ECMO, and there is no significant difference in long-term survival of recipients surviving 90 d after heart transplantation.
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OBJECTIVE@#To improve the rat model of cervical spondylosis of vertebral artery type (CSA) induced by injecting sclerosing agent. To evaluate the efficacy of injecting sclerosing agent to induce CSA.@*METHODS@#Forty Health SPF SD rats(20 males and 20 females), were randomly divided into two groups:the model group (20) and the blank group (20). All the animals were followed up for 4 weeks for the observation of general situation, transcranial Doppler(TCD) detection of blood flow velocity, pulsatility index and resistive index of the vertebral artery, measurement of mental distress by open-field test.@*RESULTS@#One to two days after establish the animal model, rats in the model group appeared apathetic with decreased autonomic activities, trembling, squinting, increased eye excrement, etc., and no rats died during the experiment. The mean blood flow velocity of the model group was lower than that of the blank group (P<0.05), and the pulsatilit index and resistive index of the model group were higher than that of the blank group (P<0.05). The mental distress of the model group was significantly higher than that of the blank group.@*CONCLUSION@#The modified injection of sclerosing agent is a practical method to establish the rat model of CSA, with high success rate, high stability, low mortality and simple operation.
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Mâle , Animaux , Femelle , Rats , Sclérothérapie , Solutions sclérosantes/usage thérapeutique , Rat Sprague-Dawley , Spondylose/thérapie , Rachis , Artère vertébraleRésumé
OBJECTIVE@#To investigate the clinical characteristics, prognostic factors and efficacy of hypomethylating agent (HMA) in patients with chronic myelomonocytic leukemia (CMML).@*METHODS@#The clinical data of 37 newly diagnosed patients with CMML was analyzed retrospectively, and their clinical characteristics and the efficacy of HMA were summarized. Kaplan-Meier and Log-rank test were used for univariate survival analysis, and Cox proportional hazards regression model was used for multivariate analysis.@*RESULTS@#The median age at diagnosis was 67 years old. Their common manifestations included fatigue, bleeding, abnormal blood routine and fever. Most patients had splenomegaly. According to FAB classification, there were 6 cases of myelodysplastic CMML and 31 cases of myeloproliferative CMML, while according to WHO classification, 8 patients belonged to CMML-0, 9 patients to CMML-1 and 20 patients to CMML-2. At the time of diagnosis, the median white blood cell count was 32.84×109/L, median hemoglobin (Hb) was 101 g/L, median platelet count was 65×109/L, median absolute monocyte count was 9.53×109//L, median absolute neutrophil count (ANC) was 11.29×109//L and median lactate dehydrogenase (LDH) was 374 U/L. Cytogenetic abnormalities were found in 4 cases among the 31 patients who underwent karyotype analysis or fluorescence in situ hybridization detection. There were 12 patients who had analyzable results and gene mutations were identified in 11 cases, including ASXL1, NRAS, TET2, SRSF2 and RUNX1. Among the 6 patients who were treated with HMA and could be evaluated for efficacy, 2 patients achieved complete remission, 1 patient achieved partial remission and 2 patients achieved clinical benefit. Compared with the non-HMA treatment group, overall survival (OS) time was not significantly prolonged in the HMA treatment group. Univariate analysis showed that Hb<100 g/L, ANC≥12×109/L, LDH≥250 U/L and peripheral blood (PB) blasts ≥5% were significantly associated with poor OS, while WHO classification CMML-2, Hb<100 g/L, ANC≥12×109/L, LDH≥250 U/L and PB blasts≥5% were significantly associated with poor leukemia-free survival (LFS) (P<0.05). Multivariate analysis showed that ANC≥12×109/L and PB blasts≥5% were significantly associated with poor OS and LFS (P<0.05).@*CONCLUSION@#CMML has high heterogeneity in clinical characteristics, genetic changes, prognosis and treatment response. HMA can not significantly improve the survival of CMML patients. ANC≥12×109/L and PB blasts≥5% are independent prognostic factors of OS and LFS in patients with CMML.
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Humains , Sujet âgé , Leucémie myélomonocytaire chronique/génétique , Études rétrospectives , Hybridation fluorescente in situ , Analyse de survie , PronosticRésumé
Activated platelets may interact with various types of leukocytes such as monocytes, neutrophils, dendritic cells, and lymphocytes, trigger intercellular signal transduction, and thus lead to thrombosis and synthesis of massive inflammatory mediators. Elevated levels of circulating platelet-leukocyte aggregates have been found in patients with thrombotic or inflammatory diseases. This article reviews the latest research on the formation, function, and detection methods of platelet-leukocyte aggregates and their role in the onset of Kawasaki disease, so as to provide new ideas for studying the pathogenesis of Kawasaki disease.