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To explore the prevalence and related risk factors of osteoporosis (OP) in the elderly ≥60 years old in Jiuting Town, Songjiang District, Shanghai City. A total of 2 175 local residents aged ≥60 years old who participated in the questionnaire survey at the physical examination center of Jiuting Community Health Service Center, Songjiang District, Shanghai City from July 2021 to December 2022 were selected by a cross-sectional study with multi-stage sampling method. Questionnaire survey, blood test and bone mineral density (BMD) test were conducted.The differences in all the parameters among the elderly with different bone mass level were analyzed using t-test, chi-square test, binary logistic regression was used to screen the potential risk factors of OP.The results showed that the prevalence of OP in the elderly aged≥60 years old in Jiuting Town was 45.89%.The prevalence of OP increased gradually with the advanced age. The prevalence rate of male was significantly lower than that of female(χ2=211.94, P<0.01).Single factor analysis showed that Dairy products(χ2=9.01, P<0.05), taking calcium(χ2=42.88, P<0.05), physical exercise(χ2=24.73, P<0.05), exercise time(χ2=76.40, P<0.05) and sun exposure(χ2=55.71, P<0.05) were the protective factors for osteoporosis. Multifactor analysis showed that female(wald χ2=71.46, P<0.001) were the risk factors for osteoporosis. The age of the osteoporosis group was older than that of the non-osteoporosis group [osteoporosis group (72.47±6.89) years old, non-osteoporosis group (68.73±6.34) years old, and the difference was statistically significant, t=-11.67, P<0.05]. The waist circumference, alanine aminotransferase (ALT), creatinine (CR), blood urea nitrogen (BUN) and uric acid (UA) in the non-osteoporosis group were higher than those in the osteoporosis group, and the difference was statistically significant (all P<0.05). The levels of high-density lipoprotein (HDL)[osteoporosis group (1.34±0.35) mol/L, non-osteoporosis group (1.41±0.35) mol/L, t=-4.51, P<0.05] and alkaline phosphatase (ALP)[osteoporosis group (88.46±25.65) mol/L, osteoporosis group (94.56±32.32) mol/L, t=-4.79, P<0.05] in the osteoporosis group were lower than those in the non-osteoporosis group.Low awareness of the knowledge of osteoporosis risk factors(smoking, drinking coffee, high salt and drinking alcohol are 47.28%, 24.15%, 47.79% and 44.90%, respectively), diagnosis and treatment(The symptoms, prognosis, screening methods, medication time and follow-up screening time of osteoporosis were 26.87%, 17.88%, 21.77%, 6.65% and 15.99%, respectivel) and prevention(exercise mode, high calcium food, optimal age of calcium supplementation, the effect of vitamin D on OP, and the appropriate amount of milk to prevent osteoporosis were 33.16%, 42.01%, 13.27%, 12.07%, 9.01%, respectively) were in Jiuting Town. In conclusion, the prevalent rate of OP in the elderly ≥60 years old in Jiuting Town is 45.89%.The main risk factors are female and advanced age. Drinking tea, dairy products, combination of meat and vegetable, taking calcium, physical exercise and sun exposure were the protective factors for osteoporosis. The awareness rate of osteoporosis related knowledge is low, and health education should be strengthened in order to control and prevent the occurrence and development of osteoporosis.
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Densidad Ósea , Osteoporosis , Humanos , Osteoporosis/epidemiología , Femenino , Masculino , Factores de Riesgo , Prevalencia , Anciano , China/epidemiología , Estudios Transversales , Persona de Mediana Edad , Encuestas y Cuestionarios , Anciano de 80 o más AñosRESUMEN
Retrospective analysis was conducted on 9 patients with type â ¡ focal cortical dysplasia (FCD) who underwent stereo-electroencephalography (SEEG) implantation in the Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University from November 2020 to February 2023. The onset area, onset time, and frequency of high-frequency oscillations (HFO) were analyzed and the correlation of HFOs with interictal, preictal, and ictal periods. SEEG recordings of 80-500 Hz HFOs were observed in both interictal and ictal periods in 9 patients, with 6 patients exhibiting fast ripples (FR) in the range of 250-500 Hz. Surgical resection of the seizure onset area and FR-generating electrodes was performed, and postoperative follow-up for over 2 years indicated Engel I in 5 cases. 6 patients showed continuous discharge during the preictal period, and the distribution index of continuous discharge was positively correlated with seizure frequency. HFOs in the range of 80-500 Hz were present in all four seizure onset patterns during the ictal period. The onset area and FR-emitting electrode were surgically removed in 6 patients with continuous discharge and overlapping HFOs during the preictal period, with 5 cases of Engel I. Type â ¡ FCD discharges exhibited complexity, high discharge indices, and a close association with HFOs. Compared with the spike wave, the electrode range of HF is more limited, and the incidence of HF before attack is significantly increased, which is closely correlated with the onset area. The simultaneous occurrence of HFO and the spike waves has higher diagnostic value than the individual occurrence, effectively enhancing surgical efficacy.
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Epilepsia , Displasia Cortical Focal , Malformaciones del Desarrollo Cortical de Grupo I , Humanos , Estudios Retrospectivos , Epilepsia/diagnóstico , Convulsiones , ElectroencefalografíaRESUMEN
OBJECTIVE: The aim of this study was to clone the mRNA sequence of the Acyl-CoA dehydrogenase long chain (ACADL) gene of goats and explore the effect of ACADL on the differentiation of subcutaneous fat cells on this basis. METHODS: We obtained the ACADL gene of goats by cloning and used quantitative real-time polymerase chain reaction (qPCR) to detect the ACADL expression patterns of different goat tissues and subcutaneous fat cells at different lipid induction stages. In addition, we transfect intramuscular and subcutaneous adipocytes separately by constructing overexpressed ACADL vectors and synthesizing Si-ACADL; finally, we observed the changes in oil red stained cell levels under the microscope, and qPCR detected changes in mRNA levels. RESULTS: The results showed goat ACADL gene expressed in sebum fat. During adipocyte differentiation, ACADL gradually increased from 0 to 24 h of culture, and decreased. Overexpression of ACADL promoted differentiation of subcutaneous adipocytes in goat and inhibited their differentiation after interference. CONCLUSION: So, we infer ACADL may have an important role in positive regulating the differentiation process in goat subcutaneous adipocytes. This study will provide basic data for further study of the role of ACADL in goat subcutaneous adipocyte differentiation and lays the foundation for final elucidating of its molecular mechanisms in regulating subcutaneous fat deposition in goats.
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Use of high-performance fibers such as poly(p-phenylene-2,6-benzobisoxazole) (PBO) improves the mechanical properties of dental fiber-reinforced composites (FRCs). However, the surfaces of high-performance fibers are relatively inert, and the interface with the resin matrix is poor. This has become a limitation restricting the performance of PBO FRCs in dentistry. Nanomaterials were introduced onto PBO fibers to construct various hierarchical reinforcements to obtain a dental FRC with higher flexural performance and optimized interface bonding. Four hierarchical reinforcements were constructed: PBO-ZnO nanoparticles (NPs), PBO-ZnO nanowires (NWs), PBO-ZnO NPs-cage silsesquioxane (POSS), and PBO-ZnO NWs-POSS. Performance following this optimized method was evaluated at macroscale and microscale levels, including measurement of the interfacial properties and mechanical properties of FRCs. The physicochemical characteristics of PBO fibers before and after modification were measured to determine the interfacial bonding mechanisms and to verify the connection between the microinterface and macromechanical properties. The cytotoxicity of the preferred PBO FRC was evaluated using the CCK8 assay. In comparison to other designs, the interfacial shear strength (IFSS) of PBO-ZnO NWs-POSS was the highest (29.31 ± 2.40 MPa). The corresponding FRC had the highest flexural strength under a static load (925.0 ± 39.2 MPa), the flexural modulus (39.39 ± 1.41 GPa) was equivalent to that of human dentin, and in vitro cytotoxicity was acceptable. The interfacial bonding mechanisms of PBO-ZnO NWs-POSS resulted from mechanical interlocking, chemical bonds, hydrogen bonds, and van der Waals forces. In summary, the PBO-ZnO NWs-POSS hierarchical reinforcement was introduced in dental FRCs and showed remarkable enhancement of the IFSS and flexural properties. We verified that the PBO-ZnO NWs-POSS hierarchical reinforcement was successful. This PBO FRC may be applied in dentistry as a new option for endodontic posts. Our study provides an interface design strategy for developing high-performance FRCs reinforced with high-performance fibers for dental applications.
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Óxido de Zinc , Resinas Compuestas/química , Materiales Dentales/química , Resistencia Flexional , Humanos , Ensayo de Materiales , Propiedades de SuperficieRESUMEN
Objectives: To compare the efficiacy of retro-auricular single-site endoscopic thyroidectomy (RASSET) and that of transoral endoscopic thyroidectomy vestibular approach (TOETVA). Methods: In Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, 10 patients underwent RASSET from June 2021 to August 2021, and 21 patients underwent TOETVA from January 2016 to August 2021. All the 21 patients' clinical data was analyzed retrospectively. There were 2 males and 8 females in the RASSET group, aging (48.2±13.9) years (range: 28 to 67 years). There were 5 males and 16 females in the TOETVA group, aging (31.3±8.2) years (range: 21 to 49 years). All patients underwent thyroid lobectomy. A 3 cm in length incision was cut on single auricula posterior sulci to creat the approach in the RASSET group. Then a Trocar made with of a glove was inserted. Retaining the omohyoid, the sternocleidomastoid muscle and anterior cervical muscle were pulled apart, exposing a single lobe of the thyroid gland and lymphatic tissue of zone â ¥, for en-bloc resection. The clinical data of the two groups were collected and analyzed by t test, Mann-Whitney U test, Fisher exact test or χ2 test. Clinical data and postoperative efficacy indexes such as operation time, postoperative C reactive protein level, and postoperative complications were recorded. Results: Compared with the TOETVA group, the operation time was longer in the RASSET group ((256.8±77.0) minutes vs. (201.2±54.9) minutes, t=2.31, P=0.028), and increase of postoperative C reaction protein (24 hours postoperative vs. preoperative) was lower in the RASSET group (8.58(13.24) mg/L vs. 46.24(48.88) mg/L, Z=-4.311, P<0.01). But there was no significant difference between the RASSET group and TOETVA group in the number of lymph nodes dissection (2(5) vs. 2(3), Z=-0.326, P=0.759). Besides, there were no complications in the RASSET group. Conclusion: Retro-auricular single-site endoscopic thyroid loectomy is easy to achieve the en-bloc resection of tumors with a well-concealed scar and less traumatic dissection.
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Glándula Tiroides , Tiroidectomía , Endoscopía , Femenino , Humanos , Masculino , Tempo Operativo , Estudios RetrospectivosRESUMEN
Fat metabolism is an important and complex biochemical reaction in vivo and is regulated by many factors. Recently, the findings on high expression of fibroblast growth factor-16 (FGF16) in brown adipose tissue have led to an interest in exploring its role in lipogenesis and lipid metabolism. The study cloned the goat's FGF16 gene 624 bp long, including the complete open reading frame that encodes 207 amino acids. We found that FGF16 expression is highest in goat kidneys and hearts, followed by subcutaneous fat and triceps. Moreover, the expression of FGF16 reached its peak on the 2nd day of adipocyte differentiation (P < 0.01) and then decreased significantly. We used overexpression and interference to study the function of FGF16 gene in goat intramuscular preadipocytes. Silencing of FGF16 decreased adipocytes lipid droplet aggregation and triglyceride synthesis. This is in contrast to the situation where FGF16 is overexpressed. Furthermore, knockdown of FGF16 also caused down-regulated expression of genes associated with adipocyte differentiation including CCAAT enhancer-binding protein beta (P < 0.01), fatty acid-binding protein-2 (P < 0.01) and sterol regulatory element binding protein-1 (P < 0.05), but the preadipocyte factor-1 was up-regulated. At the same time, the genes adipose triglyceride lipase (P < 0.01) and hormone-sensitive lipase (P < 0.05) associated with triglyceride breakdown were highly expressed. Next, we locked the fibroblast growth factor receptor-4 (FGFR4) through the protein interaction network and interfering with FGF16 to significantly reduce FGFR4 expression. It was found that the expression profile of FGFR4 in adipocyte differentiation was highly similar to that of FGF16. Overexpression and interference methods confirmed that FGFR4 and FGF16 have the same promoting function in adipocyte differentiation. Finally, using co-transfection technology, pc-FGF16 and siRNA-FGFR4, siRNA2-FGF16 and siRNA-FGFR4 were combined to treat adipocytes separately. It was found that in the case of overexpression of FGF16, cell lipid secretion and triglyceride synthesis showed a trend of first increase and then decrease with increasing interference concentration. In the case of interference with FGF16, lipid secretion and triglyceride synthesis showed a downward trend with the increase of interference concentration. These findings illustrated that FGF16 mediates adipocyte differentiation via receptor FGFR4 expression and contributed to further study of the functional role of FGF16 in goat fat formation.
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Adipogénesis , Cabras , Adipocitos , Animales , Diferenciación Celular , Factores de Crecimiento de Fibroblastos/genética , Cabras/genéticaRESUMEN
Retrospective analysis of 18 cases of occupational acute 1, 2-dichloroethane (1, 2-DCE) poisoning. The results showed that all patients have the main manifestations such as dizziness, headache, unresponsiveness and other symptoms of nervous system damage; Brain CT showed varying degrees of diffuse white matter lesions. Brain MRI showed extensive involvement of white matter in both cerebral hemispheres. Affected white matter area presented low intensity on T1WI, hyperintensity on T2WI and T2-Flair; Lumbar puncture examination of cerebrospinal fluid (CSF) pressure (262.5±48.39) mm H(2)O; After treatment, the required time for CSF pressure to restore was (161.56±75.27) days (50-280) days. Summary, Occupational acute 1, 2-DCE poisoning caused by toxic encephalopathy can be manifested as persistent abnormalities in CSF pressure, and the CSF pressure drops slowly during treatment; Early head CT and lumbar puncture examination will be helpful for early detection of intracranial pressure in toxic encephalopathy caused by acute 1, 2-DCE poisoning. Dynamic monitoring of CSF provides guidance for acute 1, 2-DCE poisoning with a long time of treatment and various types of dehydrating agents.
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Dicloruros de Etileno/envenenamiento , Síndromes de Neurotoxicidad/diagnóstico , Exposición Profesional/efectos adversos , Encéfalo/diagnóstico por imagen , Líquido Cefalorraquídeo , Humanos , Imagen por Resonancia Magnética , Síndromes de Neurotoxicidad/patología , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
The purpose of this study was to compare the complications of patients treated for a benign parotid tumour (BPT) by extracapsular dissection (ECD) vs. partial superficial parotidectomy (PSP). A comprehensive literature investigation was conducted by searching electronic databases. A systematic review and meta-analysis of comparative studies were performed to assess ECD and PSP for the treatment of BPTs with fixed-effects models. The outcomes analysed were transient or permanent facial nerve injury, Frey syndrome, recurrence rate, infection, and salivary fistula/sialocele. A total of 1641 patients from seven studies (1120 ECD-treated and 521 PSP-treated patients) were included in this meta-analysis. Transient facial nerve injury (odds ratio (OR)=0.28, 95% confidence interval (CI): 0.11-0.71; p=0.008) and Frey syndrome (OR=0.12, 95% CI: 0.03-0.48; p=0.003) were less prevalent in the ECD group. The rates of permanent facial nerve injury (OR=0.77, 95% CI: 0.35-1.70; p=0.520), recurrence rate (OR=0.17, 95% CI: 0.02-1.75; p=0.14), infection (OR=0.70, 95% CI: 0.07-6.67; p=0.76), and salivary fistula/sialocele (OR=0.40, 95% CI: 0.06-2.66; p=0.350) were similar in both groups. Although there was a trend that ECD showed a reduced risk for complications, the present results are not sufficient to conclude that ECD is more beneficial than PSP.
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Neoplasias de la Parótida , Sudoración Gustativa , Humanos , Recurrencia Local de Neoplasia , Glándula Parótida , Complicaciones Posoperatorias , Estudios RetrospectivosRESUMEN
Objective: To investigate the prevalence and related risk factors of prostate diseases in traffic policemen. Methods: A total of 848 traffic policemen who took part in the physical examination among August and September in 2016 were selected as research subjects, and a questionnaire survey was conducted to collect their information including smoking, alcohol drinking, biological and physiological indicators, as well as prostate disease etc. The relationship between the prevalence of prostate diseases and related risk factors was analyzed by Non-conditional Logistic Regression. Results: The total prostate disease prevalence rate was 40.2% in the study subjects, and there is statistical significance (P<0.05) of differences between prostate disease group and non disease group in age, work age, smoking, drinking and field work. Single factor analysis showed that age, work age, smoking, and field work are independent risk factors of prostate disease (P<0.05) . Multivariate Logistic regression analysis showed that increasing age (OR 1.03) , smoking (OR 1.92) and field work time (OR 1.47) significantly increased the risk of prostate disease in male police after age, smoking, drinking, BMI, systolic blood pressure, diastolic blood pressure, fasting blood glucose, blood lipids and other indicators were adjusted. Conclusion: age, smoking and field work time are risk factors of prostate diseases in the traffic police. There is great significance in publicizing the harmful effects of smoking and reducing the duration of field work.
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Policia/estadística & datos numéricos , Enfermedades de la Próstata/epidemiología , Humanos , Modelos Logísticos , Masculino , Exposición Profesional , Prevalencia , Factores de RiesgoRESUMEN
Objective: This study aims at the review result of Guangzhou occupational health examination from 2012-2016 to analyze the distribution of crowd and to discover the occupational health hazard factors and key Protection object by finding the situation of the goal of occupational hazard factor diseases through review examination. Methods: By using retrospective study method, to choose those people who have accepted occupational health review examination handled by the review examination group of Guangzhou Occupational Prevention and Treatment Hospital from 2012 to 2016. And comprehensively analyze the review result of occupational health examination in 5 years. Results: There are 8618 cases of occupational health review examination handled by Guangzhou Occupational Prevent and Treatment Hospital and with complete data. From the Personnel structure, it refers that they are Predominantly male and their ages are mainly distributed under 40-year-old. Most of them work under the occupational disease inductive factors less than 5 years and most of the factor is contacting with noise. In the recent 5 years, we found out 1906 cases of occupational contraindications through total review, which takes 22.12% of total number of review People, including noise occupational contraindication in 61.59%. And we found 435 cases of suspected occupational disease which takes 5.05% of total number of review People, including suspected occupational noise deafness which takes the property of 60.23% and appears the most common disease. Suspected occupational diseases and occupational taboos are mainly male patients, and the age is mainly in the 30-49 age group, the working age is mainly less than 5 years. Conclusion: Occupational health examination is an important Part in occupational health, occupational health examination review is the most Prior Part in the occupational health examination, which Plays a key role to discover the target disease of the occupational hazard factors in time, Prevent the development of occupational diseases and protect laborer occupational health.
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Ruido en el Ambiente de Trabajo , Enfermedades Profesionales , Salud Laboral , Adulto , Humanos , Masculino , Estudios RetrospectivosRESUMEN
Objective: To investigate the clinical value of contrast-enhanced ultrasound in the diagnosis of renal masses. Methods: A total of 50 patients with renal masses who underwent partial nephrectomy were analyzed from January 2014 to October 2016 in the Department of Urology of China-Japan Union Hospital of Jilin University.In the intraoperative contrast-enhanced ultrasound, the characteristics of ultrasound imaging were recorded including location, size, boundary, echo, real-time internal and peripheral blood and renal pelvis distance, artery, guidance on the selection of surgical methods, intraoperative real-time estimation of the extent of tumor resection. Results: In the 50 patients, there were 49 cases enhancement in the imaging of the cystic masses, 1 case had no enhancement.Contrast-enhanced ultrasound assisted clinical accurate positioning 34 masses which were in the renal contour and not convex.And 15 patients were found main arteries of renal occupied lesions.There were 38 cases whose distance from occupying to pelvis was more than 0.5 cm, and maintained the original operation scheme for partial nephrectomy.There were 12 cases whose distance from occupying to pelvis was less than 0.5 cm, and proceeded radical resection. Conclusions: Intraoperative contrast-enhanced ultrasound can provide a more accurate imaging basis for the surgeon in partial nephrectomy.It's of great significance for the correct choice of surgical procedures, and can reduce or avoid the occurrence of postoperative complications.
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Neoplasias Renales/cirugía , Nefrectomía , Ultrasonografía Intervencional , Carcinoma de Células Renales , China , Humanos , RiñónRESUMEN
Objective: Diagnostic efficacy of serum markers is low for heart failure patients with preserved left ventricular ejection fraction (HF-pEF) as compared to heart failure patients with reduced left ventricular ejection fraction.We sought to explore the diagnostic value of serum levels of soluble ST2 (sST2) combined with interleukin-33 (IL-33) for the diagnosis of HF-pEF in this study. Methods: A total of 376 patients with HF-pEF (HF group), 376 matched-control patients without heart failure who shared similar clinical characteristics (non-HF group) were included in the study.Another 500 healthy individuals were recruited for assessing the normal ranges of IL-33 and sST2.Serum levels of NT-proBNP were measured by chemi-luminescence assay, while IL-33 and sST2 were measured by enzyme linked immunosorbent assay. Results: Serum levels of IL-33 and sST2 were not normally distributed in healthy population.Serum concentrations of IL-33 and sST2 were significantly higher in HF-pEF patients than in patients in non-HF group (median, IL-33: 0.437 µg/L vs. 0.127 µg/L, P<0.01; sST: 0.118 µg/L vs. 0.067 µg/L, P<0.01). The area under receiver operating characteristic curve (AUC) of sST2 for detecting HF-pEF was 0.763 (95%CI 0.729-0.795, P<0.01), with 71.01% sensitivity and 66.75% specificity, the AUC was 0.884 (95%CI 0.859-0.908, P<0.01), with 80.05% sensitivity and 81.91% specificity in patients with serum IL-33 higher than 0.117 µg/L (median level of serum IL-33 in healthy individuals, n=306). The AUC of NT-proBNP for detecting HF-pEF was 0.83, with 74.73% sensitivity and 84.57% specificity.The AUC of sST2 for detecting HF-pEF was significantly higher than NT-proBNP in population with high serum IL-33 (AUC: 0.88 vs. 0.83, P<0.01). Conclusion: Serum sST2 could serve as a satisfactory biomarker for HF-pEF diagnosis, especially for patients with high serum IL-33 concentrations.
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Biomarcadores , Insuficiencia Cardíaca/diagnóstico , Interleucina-33 , Función Ventricular Izquierda , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Interleucinas , Masculino , Persona de Mediana Edad , Péptido Natriurético Encefálico , Fragmentos de Péptidos , Curva ROC , Volumen SistólicoRESUMEN
OBJECTIVE: Clozapine is frequently used to treat schizophrenia in China. Maintenance treatment for clinically stable patients with schizophrenia is usually provided by Chinese primary care physicians, but no study has investigated the frequency of its use prescribed by primary care physicians. This study described the frequency, demographic and clinical characteristics of clozapine treatment and its impact on insight and quality of life (QOL) of patients with schizophrenia treated in primary care in China. METHOD: A total of 623 patients with schizophrenia treated in 22 primary care services in Guangzhou, China in 2013 formed the study sample. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects and QOL were recorded using a standardized protocol and data collection. RESULTS: The frequency of clozapine prescription was 35.6% with a mean daily dose of 127.7±88.2 mg. There were no significant differences between the patients with and without clozapine in either of the QOL domains after controlling the confounding factors. Multiple logistic regression analyses revealed that patients on clozapine had younger age of onset, more hospitalizations, more severe extrapyramidal side effects, but better insight and fewer prescriptions of first generation antipsychotics. CONCLUSIONS: Clozapine use was found to be common and associated with better insight in patients with schizophrenia treated in primary care in China. Further examination of the rationale and appropriateness of clozapine in primary care in China is warranted.
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Pueblo Asiatico/psicología , Clozapina/uso terapéutico , Atención Primaria de Salud , Calidad de Vida , Esquizofrenia/tratamiento farmacológico , Psicología del Esquizofrénico , Antipsicóticos/uso terapéutico , Clozapina/efectos adversos , Utilización de Medicamentos/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Interventional treatment for overt hepatic encephalopathy (OHE), includes non-absorbable disaccharides, neomycin, rifaximin, L-ornithine-L-aspartate and branched chain amino acids (BCAA). However, the optimum regimen remains inconclusive. AIM: To compare interventions in terms of patients' adverse events and major clinical outcomes. METHODS: Literature search of PubMed, Embase, Scopus, and Cochrane Library studies published up to July 31 2014. RCTs of above interventions in OHE patients were included. Network meta-analysis combined direct and indirect evidence to estimate odds ratios (ORs) and mean difference (MD) between treatments and the probabilities of ranking for treatment based on clinical outcomes. RESULTS: Twenty eligible RCTs were included. When compared with observation, only L-ornithine-L-aspartate (OR 3.71, P < 0.001) and BCAA (OR 3.37, P < 0.001) improved clinical efficacy significantly. However, when L-ornithine-L-aspartate was compared with BCAA, non-absorbable disaccharides and neomycin, there was a trend suggesting that L-ornithine-L-aspartate may be the most effective intervention with respect to clinical improvement (OR 1.10), rifaximin (OR 1.31), non-absorbable disaccharides (OR 2.75), neomycin (OR 2.22). In addition, L-ornithine-L-aspartate (MD -20.18, 95% CI -40.12 to -0.27) provided a significant reduction in blood ammonia concentration compared with observation. Neomycin appeared to be associated with more adverse events in comparison with non-absorbable disaccharides (OR 10.15), rifaximin (OR 17.31), L-ornithine-L-aspartate (OR 3.16) or BCAA (OR 7.69). CONCLUSIONS: L-ornithine-L-aspartate treatment may show a trend in superiority for clinical efficacy among standard interventions for OHE. Rifaximin shows the greatest reduction in blood ammonia concentration, and treatment with neomycin demonstrates a higher probability in causing adverse effects among the five compared interventions.
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Aminoácidos de Cadena Ramificada/uso terapéutico , Dipéptidos/uso terapéutico , Disacáridos/uso terapéutico , Encefalopatía Hepática/tratamiento farmacológico , Neomicina/uso terapéutico , Rifamicinas/uso terapéutico , Aminoácidos de Cadena Ramificada/efectos adversos , Amoníaco/sangre , Dipéptidos/efectos adversos , Disacáridos/efectos adversos , Fármacos Gastrointestinales/uso terapéutico , Humanos , Salud Mental , Neomicina/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Rifamicinas/efectos adversos , RifaximinaRESUMEN
BACKGROUND: Some studies demonstrated that physical activity may have beneficial effect on cognitive function. The objective of the study was to estimate the association between physical activity and cognitive function in community-dwelling elderly Chinese in Hong Kong (HK) and Guangzhou (GZ). METHODS: In the neighborhood of HK and GZ, a convenience sample of 557 (260 in HK and 297 in GZ) older persons without dementia aged over 60 years (73.4 ± 6.5) was recruited. Physical activity was measured using a checklist. Information on physical activity participation, cognitive function, and other variables were collected. Multivariate linear regression analyses were performed to evaluate the association between physical activity and cognitive function. RESULTS: Total number of physical activities showed significant association with the delayed recall test (p 0.05) CONCLUSION: Physical activity may not be associated with better cognitive function among elderly Chinese independently of other factors.
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Cognición , Actividad Motora , Anciano , Anciano de 80 o más Años , Lista de Verificación , China/epidemiología , China/etnología , Femenino , Hong Kong/epidemiología , Humanos , Modelos Lineales , Masculino , Recuerdo Mental , Persona de Mediana Edad , Pruebas NeuropsicológicasRESUMEN
BACKGROUND: Major adjuvant therapies for biliary tract cancer (BTC) include fluorouracil, gemcitabine and chemoradiation (CRT), but the optimum regimen remains inconclusive. AIM: To compare these therapies in terms of patient survival rates after resection and toxic effects. METHODS: We searched PubMed for controlled trials comparing the above three therapies with each other or observation alone until 31 January 2014. We estimated the hazard ratios (HRs) for death and odds ratios (ORs) for toxic effects among different therapies. Subgroup analyses based on positive lymph node or resection margin were also performed. RESULTS: Twelve eligible articles were included. Gemcitabine improved 5-year survival (HR 2.12, 95% CI, confidence interval 1.23-4.02, P = 0.01), whereas fluorouracil (HR 1.61, 95% CI 0.74-3.67) and CRT (HR 1.55, 95% CI 0.82-3.32) provided a poorer survival outcome compared with gemcitabine after 1 year. Similarly, for 5-year survival rates, although differing, CRT did not provide a significant improvement in survival (HR 0.46, 95% CI 0.20-0.97) compared with gemcitabine. Fluorouracil did not appear to provide benefit over gemcitabine (HR 1.56, 95% CI 0.77-3.35). CRT was ranked highest for toxic effects including haematological (OR 5.45, 95% CI 0.01-483.85) and nonhaematological (OR 5.77, 95% CI 0.01-3807.40). CONCLUSIONS: Chemotherapy with gemcitabine is the optimum adjuvant treatment with a balanced benefit-toxicity ratio for resected biliary tract cancer. Chemoradiation was more likely to cause toxic effects.
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Antimetabolitos Antineoplásicos/uso terapéutico , Neoplasias del Sistema Biliar/terapia , Quimioradioterapia Adyuvante , Desoxicitidina/análogos & derivados , Fluorouracilo/uso terapéutico , Neoplasias del Sistema Biliar/cirugía , Desoxicitidina/uso terapéutico , Humanos , GemcitabinaRESUMEN
Hypoxia can affect energy metabolism. We examined gene expression and enzyme activity related to mitochondrial energy metabolism, as well as myosin heavy chain (MyHC) types in yaks (Bos grunniens) living at high altitudes. Real-time quantitative PCR assays indicated that the yak has significantly lower levels of carnitine palmitoyltransferase (CPT) mRNA in the biceps femoris and lower levels of uncoupling protein 3 (UCP3) mRNA in both biceps femoris and longissimus dorsi than in Yellow cattle. No significant differences between yak and Yellow cattle were observed in the activities of mitochondrial ß-hydroxyacyl-CoA dehydrogenase, isocitrate dehydrogenase and cytochrome oxidase in the same muscles. Semi-quantitative RT-PCR analysis showed that the MyHC 1 mRNA levels in yak biceps femoris was lower than in Yellow cattle. We conclude that the yak has significantly lower mRNA levels of CPT, UCP3, and MyHC 1 in biceps femoris than in Yellow cattle, suggesting that the yak biceps femoris has lower fatty acid oxidation capacity and greater glycolytic metabolic potential.