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1.
Zhonghua Jie He He Hu Xi Za Zhi ; 47(7): 638-646, 2024 Jul 12.
Article in Chinese | MEDLINE | ID: mdl-38955749

ABSTRACT

Objective: To explore the characteristics of adverse drug reactions during the 24-week therapy with delamanid-containing regimen for patients with multidrug-resistant and rifampicin-resistant pulmonary tuberculosis (MDR/RR-PTB). Methods: The prospective multicenter study was conducted from June 2020 to June 2023. A total of 608 eligible patients with MDR/RR-PTB were enrolled in 26 tuberculosis medical institutions in China including 364 males and 79 females, aged 39.6(19.0-68.0) years. Patients were treated with chemotherapy regimens containing delamanid. Patients were closely supervised during treatment of medication, and all adverse reactions occurring during treatment were monitored and recorded. The clinical characteristics of adverse reactions were evaluated by descriptive analysis. Chi-square test and multivariate logistic regression were used to analyze the related factors of QTcF interval prolongation (QT corrected with Fridericia's formula). Results: Of the 608 patients enrolled in this study, 325 patients (53.5%) reported 710 adverse events within 24 weeks of treatment. The top 6 most common complications were hematological abnormalities (143 patients, 23.5%), QT prolongation (114 patients, 18.8%), liver toxicity (85 patients, 14.0%), gastrointestinal reaction (41 patients, 6.7%), peripheral neuropathy (25 patients, 4.1%) and mental disorders (21 patients, 3.5%). The prolongation of QT interval mostly occurred in the 12th week after the first dose of medication. Serious adverse reactions occurred in 21 patients (3.5%). There were 7 patients (1.2%) with mental disorders, including 2 patients (0.3%) with severe mental disorders. Conclusions: The safety of dalamanid-based regimen in the staged treatment of MDR/RR-PTB patients was generally good, and the incidence of adverse reactions was similar to that reported in foreign studies. This study found that the incidence of QT interval prolongation in Chinese patients was higher than that reported overseas, suggesting that the monitoring of electrocardiogram should be strengthened when using drugs containing delamanid that may cause QT interval prolongation.


Subject(s)
Antitubercular Agents , Nitroimidazoles , Oxazoles , Rifampin , Tuberculosis, Multidrug-Resistant , Tuberculosis, Pulmonary , Humans , Male , Female , Tuberculosis, Multidrug-Resistant/drug therapy , Adult , Prospective Studies , Rifampin/adverse effects , Middle Aged , Oxazoles/adverse effects , Oxazoles/therapeutic use , Oxazoles/administration & dosage , Antitubercular Agents/adverse effects , Tuberculosis, Pulmonary/drug therapy , Nitroimidazoles/adverse effects , Nitroimidazoles/therapeutic use , Nitroimidazoles/administration & dosage , Aged , China , Young Adult , Drug-Related Side Effects and Adverse Reactions/etiology
2.
Zhonghua Jie He He Hu Xi Za Zhi ; 45(5): 445-452, 2022 May 12.
Article in Chinese | MEDLINE | ID: mdl-35527459

ABSTRACT

Objective: To compare the screening value of QuantiFERON-TB Gold Plus (QFT-Plus) and QuantiFERON®-TB Gold in tube (QFT-GIT) in the auxiliary diagnosis of pulmonary tuberculosis (TB). Methods: A screening test was performed. Patients who were hospitalized in Guangzhou Chest Hospital and underwent QFT-GIT testing from October to December 2020 were prospectively included as research subjects, QFT-Plus testing was added. And the basic information, clinical manifestations, laboratory test results, imaging examinations and other data of these patients were collected. A total of 207 patients were included and divided into tuberculosis group and non-tuberculosis group according to these data. There were 124 cases in the tuberculosis group (94 confirmed patients and 30 clinically diagnosed patients), including 90 males and 34 females, aged 18-93 years, with a median age of 57 (38, 67) years. The non-tuberculosis group included 83 patients (16 patients with non-tuberculous Mycobacteria and 67 patients with other lung diseases), including 49 males and 34 females, with a median age of 60 (51, 68) years. The confirmed patients were subdivided into three grades of low, medium and high Mycobacteriam tuberculosis (MTB) bacterial load, and three grades of mild, moderate and severe pulmonary tuberculosis. The results of QFT-Plus and QFT-GIT were compared, and the levels of IFN-γ in different antigen tubes were compared. Differences between different groups were compared using Mann-Whitney U test and Kruskal-Wallis H test. Results: The QFT-Plus showed a high degree of agreement with the QFT-GIT (κ=0.786, 95%CI: 0.740-0.832), while the main discordant result was QFT-GIT negative/QFT-Plus positive, accounting for 15/17. The sensitivity of QFT-GIT was 80.7%(95%CI: 0.706-0.880), the specificity was 76.3%(95%CI: 0.649-0.850), the positive predictive value was 79.8%(95%CI: 0.697-0.873), and the negative predictive value was 77.3%(95%CI: 0.659-0.859), repectively. QFT-Plus showed a sensitivity of 84.3%(95%CI: 0.743-0.910), a specificity of 78.8% (95%CI: 0.679-0.868), and a positive predictive value of 80.5%(95%CI: 0.703-0.879), the negative predictive value being 82.9%(95%CI: 0.721-0.902), slightly improved to that of the QFT-GIT. Also, this study found that there were significant differences in IFN-γ values between different MTB load or disease severity (P<0.05). Conclusions: There is a good consistency between the QFT-Plus test and the QFT-GIT test, both of which show good application value in the auxiliary diagnosis of pulmonary tuberculosis. Moreover, because of the addition of tuberculosis-specific CD8 cell antigen, the QFT-Plus test has higher sensitivity, lower uncertainty and more application value. This study also found that the bacterial load and disease severity of patients with pulmonary tuberculosis may have a certain correlation with the measured value of IFN-γ.


Subject(s)
Latent Tuberculosis , Tuberculosis, Pulmonary , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Interferon-gamma , Interferon-gamma Release Tests/methods , Latent Tuberculosis/diagnosis , Male , Middle Aged , Tuberculin Test , Tuberculosis, Pulmonary/diagnosis , Young Adult
3.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(2): 209-216, 2022 Apr 18.
Article in Chinese | MEDLINE | ID: mdl-35435181

ABSTRACT

OBJECTIVE: To investigate the effects of CACNA1H gene knockout (KO) on autistic-like behaviors and the morphology of hippocampal neurons in mice. METHODS: In the study, 25 CACNA1H KO mice of 3-4 weeks old and C57BL/6 background were recruited as the experimental group, and 26 wild type (WT) mice of the same age and background were recruited as the control group. Three-chamber test and open field test were used to observe the social interaction, anxiety, and repetitive behaviors in mice. After that, their brain weight and size were measured, and the number of hippocampal neurons were observed by Nissl staining. Furthermore, the CACNA1H heterozygote mice were interbred with Thy1-GFP-O mice to generate CACNA1H-/--Thy1+(KO-GFP) and CACNA1H+/+-Thy1+ (WT-GFP) mice. The density and maturity of dendritic spines of hippocampal neurons were observed. RESULTS: In the sociability test session of the three-chamber test, the KO mice spent more time in the chamber of the stranger mice than in the object one (F1, 14=95.086, P < 0.05; Post-Hoc: P < 0.05), without any significant difference for the explored preference index between the two groups (t=1.044, P>0.05). However, in the social novelty recognition test session, no difference was observed between the time of the KO mice spend in the chamber of new stranger mice and the stranger one (F1, 14=18.062, P < 0.05; Post-Hoc: P>0.05), and the explored preference index of the KO mice was less than that of the control group (t=2.390, P < 0.05). In the open field test, the KO mice spent less time in the center of the open field apparatus than the control group (t=2.503, P < 0.05), but the self-grooming time was significantly increased compared with the control group (t=-2.299, P < 0.05). Morphological results showed that the brain weight/body weight ratio (t=0.356, P>0.05) and brain size (t=-0.660, P>0.05) of the KO mice were not significantly different from those of the control group, but the number of neurons were significantly reduced in hippocampal dentate gyrus compared with the control group (t=2.323, P < 0.05). Moreover, the density of dendritic spine of dentate gyrus neurons in the KO-GFP mice was significantly increased compared with the control group (t=-2.374, P < 0.05), without any significant difference in spine maturity (t=-1.935, P>0.05). CONCLUSION: CACNA1H KO mice represent autistic-like behavior, which may be related to the decrease in the number of neurons and the increase in the density of dendritic spine in the dentate gyrus.


Subject(s)
Autistic Disorder , Calcium Channels, T-Type , Animals , Autistic Disorder/genetics , Calcium Channels, T-Type/genetics , Gene Knockout Techniques , Hippocampus , Mice , Mice, Inbred C57BL , Mice, Knockout , Neurons
4.
Eur Rev Med Pharmacol Sci ; 25(2): 1080-1086, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33577064

ABSTRACT

OBJECTIVE: This study aimed to explore the atypical imaging findings of the novel coronavirus pneumonia (COVID-19) and its evolution. MATERIALS AND METHODS: The atypical imaging data of ten patients in our hospital who tested positive for COVID-19 were analyzed retrospectively, and the distribution, morphology, and image evolution of the lesions were analyzed. High-resolution computed tomography (HRCT) was performed in all cases, and the imaging features were analyzed and summarized by two senior radiologists. RESULTS: Of these ten patients, three were male, and seven were female. The age of these patients ranged from 21-53 years, with an average age of 36.3 ± 3.6. The first symptom was fever in nine cases and dry cough in one case. A total of 17 lesions were detected in these ten patients. Five patients had a single lesion, and five patients had multiple lesions, for a total of 12 lesions. Ten lesions (58.82%) were located in the inferior lobe of the right lung, four lesions (23.53%) in the left inferior lobe, two lesions (11.76%) in the left upper lobe, and one lesion (5.88%) in the right middle lobe. Among the five single lesions, two were solid lesions, two were mixed ground-glass lesions, and one was a pure ground-glass lesion. Among the 12 multiple lesions, eight were solid lesions, two were mixed ground-glass lesions, and two were pure ground-glass lesions. Atypical manifestations in image signs: five lesions (29.41%) had single solid and sub-solid nodules, and four lesions (23.53%) had cavitary nodules. Typical manifestation (the presence of "white lung"): three lesions (17.65%) had an air bronchogram, two lesions (11.76%) had crazy-paving signs, two lesions (11.76%) had vascular thickening, and one lesion (5.88%) had halo signs. At reexamination 2-6 days later, 15 lesions (88.24%) had enlarged or increased, and two lesions (11.76%) had decreased or absorbed. CONCLUSIONS: Patients with COVID-19 may have atypical imaging findings. Radiologists should improve their understanding of the novel coronavirus pneumonia to avoid any missed diagnoses.


Subject(s)
COVID-19/diagnostic imaging , Lung/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , COVID-19/physiopathology , Female , Humans , Lung/physiopathology , Male , Middle Aged , Tomography, X-Ray Computed/trends , Young Adult
5.
Tob Induc Dis ; 18: 96, 2020.
Article in English | MEDLINE | ID: mdl-33262682

ABSTRACT

INTRODUCTION: Many studies have revealed that exposure to secondhand smoke (SHS) substantially increases the risk of smoking related diseases especially among the vulnerable groups, yet data on the location of SHS exposure among youth in Malaysia are still lacking. The study aims to describe the prevalence and factors associated with SHS exposure at home, outside the home, and inside the school among school-going adolescents in Malaysia. METHODS: We derived the data from the TECMA study, which used a cross-sectional study design and multi-stage sampling method to obtain a representative sample of school-going adolescents aged 11-19 years in Malaysia in 2016. Data were collected through a self-administered approach using a pre-validated standard questionnaire. Descriptive and multivariate analyses were used to analyze the data, and results are presented as adjusted odds ratio (AOR) with 95% confidence interval (95% CI). RESULTS: SHS exposure for the past seven days was higher outside the home (51.2%; 95% CI: 49.2-53.2) compared to at home (37.8%; 95% CI: 35.8-39.9) while 27.3% (95% CI: 25.1-29.5) of school-going adolescents reported exposure to SHS inside the school in the past one month. In the regression analyses, older adolescents, those of Malay and Bumiputra Sarawak ethnicities, adolescents from rural areas and current smokers had higher likelihood of exposure to SHS at home, outside home and inside the school. Our study also found that adolescents who were current smokers had higher odds of being exposed to SHS at home (AOR=2.87; 95% CI: 2.57-3.21), outside the home (AOR=3.46; 95% CI: 3.05-3.92) and in the school (AOR=2.25; 95% CI: 2.01-2.51). CONCLUSIONS: Health promotion measures should target parents/guardians and household members to reduce SHS exposure among adolescents. In addition, smoke-free regulation should be fully enforced in school. Furthermore, more public places should be designated non-smoking areas to reduce SHS exposure and denormalize smoking behavior.

6.
Tob Induc Dis ; 18: 80, 2020.
Article in English | MEDLINE | ID: mdl-33013276

ABSTRACT

INTRODUCTION: Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap. METHODS: We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS. RESULTS: Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period. CONCLUSIONS: Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.

7.
Zhonghua Wai Ke Za Zhi ; 58(7): 525-529, 2020 Jul 01.
Article in Chinese | MEDLINE | ID: mdl-32610423

ABSTRACT

Objective: To investigate the clinical characteristics of pancreatic cystic neoplasms in pediatric patients. Methods: The clinical data of 13 patients with pancreatic cystic neoplasm at Wuhan Children's Hospital from July 2007 to November 2019 were collected.There were 5 males and 8 females, with a mean age of 133 months(range: 9 to 170 months). Eleven patients presented with abdominal pain, vomiting, and a palpable mass. Tumors were located in the pancreatic head(n=7), body(n=2) and tail(n=4), respectively. Results: The preoperative diagnosis was confirmed by imaging examination in 11 patients, CT and MRI was significantly superior to ultrasound in the exact diagnosis of the tumor types. In this group, surgical methods mainly included pancreaticoduodenectomy(n=3), pylorus-preserving pancreatoduodenectomy(n=1), duodenum-preserving pancreas head resection(n=3), spleen-preserving distal pancreatectomy (n=3), distal pancreatectomy plus splenectomy(n=2), and tumor enucleation(n=1). Postoperative complications including biochemical leakage(n=1), delayed gastric emptying(grade A) (n=1), adhesive intestinal obstruction(n=1), transient elevation of platelet count(n=2), all were cured by conservative treatment. In one patient biliary leakage occurred and later developed into biliary stricture, this patient underwent the second operation 6 weeks later and recovered smoothly. All patients were diagnosed by postoperative pathology, including solid pseudopapillary neoplasm(n=10), serous cystadenoma(n=1), mucinous cystadenoma(n=1) and cystic lymphangiom(n=1). Three cases were lost in this group, the rest of patients were all accepted outpatient or telephones follow-up. There was no evidence of recurrence or metastasis during 3 to 92 months follow-up. Conclusions: The incidence of pancreatic cystic neoplasm is low in the pediatric patients. Symptomatic patients should receive surgical treatment timely. It's safe and effective to choose the organs and functions-preserving surgical method.


Subject(s)
Pancreatectomy , Pancreatic Neoplasms/surgery , Pancreaticoduodenectomy , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Pancreatectomy/adverse effects , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/pathology , Pancreaticoduodenectomy/adverse effects
8.
Tob Induc Dis ; 18: 53, 2020.
Article in English | MEDLINE | ID: mdl-32565765

ABSTRACT

INTRODUCTION: We investigated the prevalence of children's exposure to secondhand smoke (SHS) in the car of their parents/guardians and the associated factors. METHODS: A self-administered validated questionnaire was used to obtain data from the nationally representative samples of school-going adolescents aged 11-19 years in Malaysia. Prevalence rates were computed and chi-squared tests and multiple logistic regression were conducted. RESULTS: Of the participants, 23.3% reported exposure to SHS at least once in the car of their parents/guardians during the last 7 days before the survey. The prevalence and likelihood of SHS exposure were significantly higher in Malays, descendants of natives of Sabah and Sarawak, schools in rural areas, females, and current smokers. However, age group and knowledge on the harmful effects of SHS were not significant after adjusting for confounding effects. CONCLUSIONS: A substantial proportion of school-going adolescents were exposed to secondhand smoke in the car of their parents/guardians. This highlights the need for effective tobacco control measures to include health promotion and smoke-free car regulations to be introduced to prevent severe health hazards and to reduce smoking initiation among non-smoking adolescents.

9.
AJNR Am J Neuroradiol ; 40(1): 33-38, 2019 01.
Article in English | MEDLINE | ID: mdl-30498017

ABSTRACT

BACKGROUND AND PURPOSE: Alberta Stroke Program Early CT Score (ASPECTS) was devised as a systematic method to assess the extent of early ischemic change on noncontrast CT (NCCT) in patients with acute ischemic stroke (AIS). Our aim was to automate ASPECTS to objectively score NCCT of AIS patients. MATERIALS AND METHODS: We collected NCCT images with a 5-mm thickness of 257 patients with acute ischemic stroke (<8 hours from onset to scans) followed by a diffusion-weighted imaging acquisition within 1 hour. Expert ASPECTS readings on DWI were used as ground truth. Texture features were extracted from each ASPECTS region of the 157 training patient images to train a random forest classifier. The unseen 100 testing patient images were used to evaluate the performance of the trained classifier. Statistical analyses on the total ASPECTS and region-level ASPECTS were conducted. RESULTS: For the total ASPECTS of the unseen 100 patients, the intraclass correlation coefficient between the automated ASPECTS method and DWI ASPECTS scores of expert readings was 0.76 (95% confidence interval, 0.67-0.83) and the mean ASPECTS difference in the Bland-Altman plot was 0.3 (limits of agreement, -3.3, 2.6). Individual ASPECTS region-level analysis showed that our method yielded κ = 0.60, sensitivity of 66.2%, specificity of 91.8%, and area under curve of 0.79 for 100 × 10 ASPECTS regions. Additionally, when ASPECTS was dichotomized (>4 and ≤4), κ = 0.78, sensitivity of 97.8%, specificity of 80%, and area under the curve of 0.89 were generated between the proposed method and expert readings on DWI. CONCLUSIONS: The proposed automated ASPECTS scoring approach shows reasonable ability to determine ASPECTS on NCCT images in patients presenting with acute ischemic stroke.


Subject(s)
Image Interpretation, Computer-Assisted/methods , Machine Learning , Neuroimaging/methods , Stroke/diagnostic imaging , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Alberta , Brain Ischemia/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Female , Humans , Male , Middle Aged , Sensitivity and Specificity
10.
AJNR Am J Neuroradiol ; 40(1): 39-44, 2019 01.
Article in English | MEDLINE | ID: mdl-30573458

ABSTRACT

BACKGROUND AND PURPOSE: Thrombus characteristics identified on non-contrast CT (NCCT) are potentially associated with recanalization with intravenous (IV) alteplase in patients with acute ischemic stroke (AIS). Our aim was to determine the best radiomics-based features of thrombus on NCCT and CT angiography associated with recanalization with IV alteplase in AIS patients and proximal intracranial thrombi. MATERIALS AND METHODS: With a nested case-control design, 67 patients with ICA/M1 MCA segment thrombus treated with IV alteplase were included in this analysis. Three hundred twenty-six radiomics features were extracted from each thrombus on both NCCT and CTA images. Linear discriminative analysis was applied to select features most strongly associated with early recanalization with IV alteplase. These features were then used to train a linear support vector machine classifier. Ten times 5-fold cross-validation was used to evaluate the accuracy of the trained classifier and the stability of the selected features. RESULTS: Receiver operating characteristic curves showed that thrombus radiomics features are predictive of early recanalization with IV alteplase. The combination of radiomics features from NCCT, CTA, and radiomics changes is best associated with early recanalization with IV alteplase (area under the curve = 0.85) and was significantly better than any single feature such as thrombus length (P < .001), volume (P < .001), and permeability as measured by mean attenuation increase (P < .001), maximum attenuation in CTA (P < .001), maximum attenuation increase (P < .001), and assessment of residual flow grade (P < .001). CONCLUSIONS: Thrombus radiomics features derived from NCCT and CTA are more predictive of recanalization with IV alteplase in patients with acute ischemic stroke with proximal occlusion than previously known thrombus imaging features such as length, volume, and permeability.


Subject(s)
Image Interpretation, Computer-Assisted/methods , Intracranial Thrombosis/diagnostic imaging , Neuroimaging/methods , Stroke/diagnostic imaging , Support Vector Machine , Aged , Case-Control Studies , Computed Tomography Angiography/methods , Female , Humans , Intracranial Thrombosis/drug therapy , Intracranial Thrombosis/pathology , Male , Middle Aged , ROC Curve , Stroke/drug therapy , Tissue Plasminogen Activator/therapeutic use , Tomography, X-Ray Computed/methods , Treatment Outcome
11.
Zhonghua Jie He He Hu Xi Za Zhi ; 41(12): 954-958, 2018 Dec 12.
Article in Chinese | MEDLINE | ID: mdl-30522193

ABSTRACT

Objective: To explore the signal pathway of M2-type polarization induced by Mycobacterium tuberculosis (MTB)-specific peptide E7. Methods: Monocyte-macrophages were divided into blank control group, M1 positive stimulus group [co-stimulated with lipopolysaccharide and gamma interferon (IFN-γ)], M2 positive group(co-stimulated with IL-4 and IL-13), and E7 experimental group (with MTB-specificity polypeptide E7 stimulated). The expression of M1 type markers CD(16), IL-6, TNF-α and M2 type markers CD(163), CD(206), IL-10 were detected at 12, 18, 24 and 36 h. Furthermore, peroxisome proliferators-activated receptors-γ (PPAR-γ) blocker was used in the blank control group, M2-positive stimulus group and E7 experimental stimulus group. T test was used to compare the expression of PPAR-γ and CD(163) before and after the addition of blockers. Results: Compared with the positive control group and the blank control group, the expression of TNF-α in the E7 experimental group gradually reached the peak when macrophages were stimulated for 18 h(the relative expression was 20.02), and then the expression of TNF-α gradually decreased and the expression of CD(163) increased. The expression of CD(163) peaked at 24 h (the relative expression was 2.44). After adding the inhibitor, the expression of PPAR-γ in E7 stimulation group was lower than before blocking (before blocking 0.94±0.06, after blocking 0.69±0.09, P=0.028). CD(163) expression level was significantly lower than that before blocking (before blocking 3.95±0.61, after blocking 2.87±0.20, P=0.047). Conclusion: The MTB-specific peptide E7 induced differentiation of macrophages into M2 type, a process that may be involving PPAR-γ in just another kinase-signal transducer and activator of transcription pathway.


Subject(s)
Macrophages , Monocytes , Mycobacterium tuberculosis , Humans , Interferon-gamma , Signal Transduction
12.
Andrologia ; 50(7): e13039, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29740874

ABSTRACT

Men with type 2 diabetes (T2D) and obesity are often characterised by low testosterone (T). We aimed to determine whether exenatide (EXE) combined metformin (MET) treatment has a better effect on serum total testosterone (TT) levels than glimepiride (GLI) combined MET treatment in men with T2D and obesity. In a multicentre, 12-week observational study, 176 obese T2D men with failed glycaemic control were included in the study: ninety men (mean age, 43.00 ± 8.50 years) in EXE + MET group and 86 men (mean age, 44.00 ± 7.00 years) in GLI + MET group. Serum TT levels were more significantly increased in EXE + MET group than GLI + MET group (121.72 ± 56.73 ng/dl versus 34.67 ± 16.30 ng/dl). The increasement of TT levels in those patients who lost body weight ≥5% was significantly greater than those who lost weight <5% in the two groups. The changes in TT levels are closely related to the changes in waist circumference (r = -.443, p < .001). Sexual function assessment of EXE + MET group was more significantly improved than GLI + MET group (p < .001). No serious adverse events were observed. In conclusion, short-term combined treatment with EXE and MET is superior to GLI combined MET treatment in the improvement of serum TT levels, which could lead to an improvement of sexual hypofunction in patients with obesity and T2D.


Subject(s)
Anti-Obesity Agents/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Hypoglycemic Agents/therapeutic use , Obesity/drug therapy , Sexual Dysfunction, Physiological/drug therapy , Testosterone/blood , Adult , Anti-Obesity Agents/pharmacology , Blood Glucose/drug effects , Body Weight/drug effects , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/complications , Drug Therapy, Combination/methods , Exenatide/pharmacology , Exenatide/therapeutic use , Humans , Hypoglycemic Agents/pharmacology , Male , Metformin/pharmacology , Metformin/therapeutic use , Middle Aged , Obesity/blood , Obesity/complications , Sexual Dysfunction, Physiological/blood , Sexual Dysfunction, Physiological/etiology , Sulfonylurea Compounds/pharmacology , Sulfonylurea Compounds/therapeutic use , Treatment Outcome
13.
Tob Induc Dis ; 16: 01, 2018.
Article in English | MEDLINE | ID: mdl-31516402

ABSTRACT

INTRODUCTION: The continuous monitoring of smoking prevalence and its associated factors is an integral part of anti-smoking programmes and valuable for the evaluation of the effectiveness of anti-smoking measures and policies. This study aimed at determining prevalence of smoking and identifying socio-demographic factors associated with smoking among adults in Malaysia aged 15 years and over. METHODS: This is a cross-sectional study with a representative sample of 21 445 adults in Malaysia, aged 15 years and over, selected via a stratified, two-stage proportionate-to-size sampling method. Data were obtained from face-to-face interviews by trained research assistants, using a standard validated questionnaire. Multivariable logistic regression was performed to determine socio-demographic factors associated with smoking among Malaysians. RESULTS: The overall prevalence of smoking was 22.8% (95% CI: 21.9-23.8%), with males having a significantly higher prevalence compared to females (43.0%, 95% CI: 41.1-44.6 vs 1.4%, 95% CI: 1.1-1.7). The highest smoking prevalence was observed among other ethnicities (35.7%), those aged 25-44 years (59.3%), and low educational attainment (25.2%). Males, those with lower educational attainment and Malays were significantly associated with smoking. CONCLUSIONS: The prevalence of smoking among Malaysians, aged 15 years and over, remains high despite the implementation of several anti-smoking measures over the past decades. Specially tailored anti-smoking policies or measures, particularly targeting males, the Malays, younger adults and those with lower educational attainment, are greatly warranted to reduce the prevalence of smoking in Malaysia.

14.
Tob Induc Dis ; 16: 55, 2018.
Article in English | MEDLINE | ID: mdl-31516452

ABSTRACT

INTRODUCTION: Electronic cigarettes (e-cigarettes) are new smoking devices that have gained popularity recently. However, there is limited evidence on e-cigarette consumption in Malaysia. This study aims to determine the prevalence, risk factors and perception associated with e-cigarette use among those attending government hospitals and health clinics in Malaysia. METHODS: A cross-sectional hospital-based study was conducted in seven public hospitals and health clinics in Malaysia, which were selected through a two-stage cluster sampling. A validated questionnaire was used to obtain data from the selected participants. Multivariable logistic regression was employed to determine the association between sociodemographics and perceptions of e-cigarette use. RESULTS: Almost three-quarters (73.6%; n=923/1254) of participants were aware of e-cigarettes and 13.2% (n=122/923) reported having ever used e-cigarettes. The prevalence was significantly higher among males (18.1%), smokers (21.4%), and younger age group 18-34 years (30.2%). Ever users showed favourable perceptions towards e-cigarettes compared to non-users (23.3% vs 30.14%, p<0.001). Multivariable logistic regression revealed that current smokers, younger age group and those possessing a positive perception towards e-cigarettes were likely to be ever users of e-cigarettes. CONCLUSIONS: The study showed that the awareness level of e-cigarettes was high amongst the population but the prevalence of ever e-cigarette user was moderate. Most of the ever e-cigarette users were male, current smokers, young adults and those with favourable perceptions towards e-cigarettes. Therefore, effective health educational activities regarding safe usage of e-cigarettes targeting those group identified in this study are warranted to reduce the negative outcomes from the use of this product.

15.
Nanoscale ; 9(35): 13214-13221, 2017 Sep 14.
Article in English | MEDLINE | ID: mdl-28853487

ABSTRACT

Introducing and modulating the oxygen deficiency concentration have been received as an effective way to obtain high catalytic activity in perovskite oxides. However, it is difficult to control the oxygen vacancy in conventional oxygen defect engineering due to harsh reaction conditions at elevated temperatures and the reducing atmosphere, which make it impractical for many technological applications. Herein, we report a new approach to oxygen defect engineering based on the combination of the current effect and temperature cycling at low temperature. Our investigations revealed that the electrical conductivity of the (011)-La0.7Sr0.3CoO3/PMN-PT film changes continuously from metallicity to insulativity under repeated transport measurements below room temperature, which indicates the transformation of the Co4+ state to Co3+ in the film. Further experiments and analysis revealed that oxygen vacancies can be well regulated by the combined current effect and temperature cycling in repeated measurements, which results in a decrease of Co4+/Co3+ and thus the remarkable variation of conductive properties of the film. Our work provides a simple and highly efficient method to engineer oxygen vacancies in perovskite-type oxides and brings new opportunities in designing high-efficiency oxidation catalysts.

16.
Clin Exp Immunol ; 190(1): 40-53, 2017 10.
Article in English | MEDLINE | ID: mdl-28617942

ABSTRACT

Datura metel L. is a medicinal herb that contains withasteroids and has a wide range of biological activities. We isolated seven withasteroids from the flowers of D. metel L and examined their ability to inhibit immune responses in vitro and in vivo. Among the withasteroids, withasteroid B2 exhibited the strongest inhibitory effect on immune responses comparing B2 with other isolated compounds from D. metel L., including suppressing the differentiation of CD4+ T cells by inhibiting the expression and production of T cell lineage-specific master regulators and cytokines and directly suppressing the cytokine-induced Janus kinase/signal transducer and activator of transcription (JAK/STAT) signalling pathways. In the interleukin (IL)-23-induced mouse ear model of skin disease, B2 repressed disease development by inhibiting the expression of proinflammatory mediators in murine ear skin. Moreover, B2 affected the maturation of dendritic cells (DCs) in vitro which, in turn, induced T cell differentiation with an increased regulatory T cell (Treg ) phenotype and decreased T helper type 17 (Th17) phenotype. This study provides new evidence that B2 might ameliorate chronic inflammatory skin diseases by suppressing pathogenic CD4+ T cell differentiation and the IL-17+ retinoic-acid-receptor-related orphan receptor gamma t (RORγt)+ /IL-10+ forkhead box protein 3 (FoxP3)+ ratio. These findings suggest that B2 might mediate the therapeutic effects observed in psoriasis patients following treatment with D. metel L.


Subject(s)
Immunosuppressive Agents/therapeutic use , Psoriasis/drug therapy , Skin/drug effects , T-Lymphocytes, Regulatory/drug effects , Th17 Cells/drug effects , Withanolides/therapeutic use , Animals , Cell Differentiation , Cells, Cultured , Datura metel/immunology , Disease Models, Animal , Forkhead Transcription Factors/metabolism , Humans , Immunomodulation , Interleukin-10/metabolism , Interleukin-17/metabolism , Interleukin-23/immunology , Janus Kinases/metabolism , Mice , Mice, Inbred BALB C , Mice, Inbred C57BL , Nuclear Receptor Subfamily 1, Group F, Member 3/metabolism , Psoriasis/immunology , STAT Transcription Factors/metabolism , Signal Transduction/drug effects , Skin/pathology , T-Lymphocytes, Regulatory/immunology , Th17 Cells/immunology , Withanolides/chemistry
17.
Zhonghua Nei Ke Za Zhi ; 55(10): 804-806, 2016 Oct 01.
Article in Chinese | MEDLINE | ID: mdl-27686446
18.
Genet Mol Res ; 15(2)2016 Jun 10.
Article in English | MEDLINE | ID: mdl-27323144

ABSTRACT

Lung cancer is the most common cancer occurring worldwide. The human X-ray repair complementing group 1 (XRCC1) gene is one of the most important candidate genes that influence the susceptibility to lung cancer. The objective of this study was to analyze the potential association between the c.1804C>A genetic variant of XRCC1 and lung cancer susceptibility. A total of 703 subjects were recruited for this study. Genotyping of c.1804C>A genetic variant was performed using the created restriction site-polymerase chain reaction. Statistically significant differences in allele frequencies and genotype were found between lung cancer patients and cancer-free controls. The genotype AA was statistically associated with the increased risk of lung cancer when compared to the wild genotype, CC, and the carrier genotype, CA/CC (AA vs CC: OR = 2.71, 95%CI = 1.57-4.67, P < 0.001; AA vs CA/CC: OR = 2.54, 95%CI = 1.50-4.29, P < 0.001). The allele A likely contributes to the susceptibility to lung cancer (A vs C: OR = 1.47, 95%CI = 1.17-1.84, P = 0.001). Our data indicates that the c.1804C>A genetic variant of XRCC1 is statistically associated with the susceptibility to lung cancer in the Chinese population.


Subject(s)
DNA-Binding Proteins/genetics , Genetic Association Studies , Genetic Predisposition to Disease , Lung Neoplasms/genetics , Aged , Asian People/genetics , Female , Gene Frequency , Genotype , Humans , Lung Neoplasms/pathology , Male , Middle Aged , Risk Factors , X-ray Repair Cross Complementing Protein 1
19.
Andrologia ; 47(2): 236-42, 2015 Mar.
Article in English | MEDLINE | ID: mdl-24605934

ABSTRACT

Benign prostatic hyperplasia (BPH) is a prevalent disease globally, and accumulating evidence has indicated an association between BPH, insulin resistance (IR) and diabetes. Exendin-4 is widely used in clinics, which could enhance the proliferation of pancreatic ß cells. The ability of exendin-4 to promote tumorigenesis has been of concern, and whether exendin-4 would enhance the propagation of BPH is not fully understood. We aimed to determine whether glucagon-like peptide-1 receptors (GLP-1Rs) were expressed in rat prostate and to determine the effect of exendin-4 on prostate of BPH. Male Wistar rats were used and assigned to six groups: normal diet (ND), high-fat diet (HFD), HFD + exendin-4, HFD + BPH, HFD + BPH + exendin-4 and HFD + BPH + rosiglitazone group. After castration, steroids were injected subcutaneously for 4 weeks to induce BPH. Rats were kept on high-fat diet to induce IR. Treatment groups were treated with exendin-4 and rosiglitazone. Prostatic index and HOMA-IR index were used to evaluate the prostatic hyperplasia status and the degree of IR respectively. The expression of GLP-1R was indicated not only by immunohistochemistry, but also by Western blot analysis. The expression of GLP-1R was significantly higher, and HOMA-IR index and body weight significantly decreased after administration of exendin-4. However, no significant differences in the prostatic index were observed between exendin-4 treatment groups and non-exendin-4 treatment groups. Prostatic index was not influenced by exendin-4 maybe by improving IR and weight loss.


Subject(s)
Diet, High-Fat , Insulin Resistance , Peptides/pharmacology , Prostate/drug effects , Prostate/pathology , Prostatic Hyperplasia/pathology , Venoms/pharmacology , Animals , Body Weight/drug effects , Disease Models, Animal , Dose-Response Relationship, Drug , Exenatide , Glucagon-Like Peptide-1 Receptor , Male , Peptides/therapeutic use , Prostate/metabolism , Prostatic Hyperplasia/drug therapy , Prostatic Hyperplasia/metabolism , Rats , Rats, Wistar , Receptors, Glucagon/metabolism , Rosiglitazone , Severity of Illness Index , Thiazolidinediones/pharmacology , Venoms/therapeutic use
20.
Genet Mol Res ; 13(1): 1735-43, 2014 Mar 17.
Article in English | MEDLINE | ID: mdl-24535912

ABSTRACT

Parenchyma vascular malformation (VM) is a common disease in modern society. Here, we investigated the clinical effects and safety of interventional therapy (IT) on the treatment of parenchyma VM. From January 1998 to December 2010, 31 patients with VM who elected IT were investigated, including 11 cases of venous VM and 20 cases of arteriovenous malformation. There were 19 males and 12 females, ranging from 12 to 51 years in age. VM often occurred in the four limbs and other areas, such as the trunk and reproductive organs. Under the guidance of digital subtraction angiography, vascular hardener was injected into the VM spot via percutaneous puncture. Then, embolotherapy was conducted via the transcatheter feeding artery. We found that, in all cases, the malformed vessels were completely or partially blocked. After treatment, the local swelling of vessels was alleviated and the diabrosis and bleeding ceased. The soft tissue lump shrank, then stiffened and became fixed. There was no occurrence of severe intraoperative or postoperative complications in any patient. In summary, IT is an effective method for treating parenchyma VM, causes only a minor operative wound, and should be viewed as the first choice intervention.


Subject(s)
Mesophyll Cells/pathology , Vascular Malformations/therapy , Adult , Angiography, Digital Subtraction , Embolization, Therapeutic , Female , Humans , Male , Mesophyll Cells/diagnostic imaging , Middle Aged , Vascular Malformations/diagnostic imaging , Young Adult
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