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1.
J Cardiothorac Surg ; 19(1): 404, 2024 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-38943205

RESUMO

BACKGROUND: Today, the detection rate of lung nodules is increasing. Some of these nodules may become malignant. Thus, timely resection of potentially malignant nodules is essential. However, Identifying the location of nonsurface or soft-textured nodules during surgery is challenging. Various localization techniques have been developed to accurately identify lung nodules. Common methods include preoperative CT-guided percutaneous placement of hook wires and microcoils. Nonetheless, these procedures may cause complications such as pneumothorax and haemothorax. Other methods regarding localization of pulmonary nodules have their own drawbacks. We conducted a clinical study which was retrospective to identify a safe, accurate and suitable method for determining lung nodule localization. To evaluate the clinical value of CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization in thoracoscopic lung nodule resection. METHODS: We retrospectively collected the clinical data of 120 patients who underwent lung nodule localization and resection surgery at the Department of Thoracic Surgery, First Affiliated Hospital of Bengbu Medical College, from January 2020 to January 2022. Among them, 30 patients underwent CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization, 30 patients underwent only CT-assisted body surface localization, 30 patients underwent only intraoperative stereotactic anatomical localization, and 30 patients underwent CT-guided percutaneous microcoil localization. The success rates, complication rates, and localization times of the four lung nodule localization methods were statistically analysed. RESULTS: The success rates of CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization and CT-guided percutaneous microcoil localization were both 96.7%, which were significantly higher than the 70.0% success rate in the CT-assisted body surface localization group (P < 0.05). The complication rate in the combined group was 0%, which was significantly lower than the 60% in the microcoil localization group (P < 0.05). The localization time for the combined group was 17.73 ± 2.52 min, which was significantly less than that (27.27 ± 7.61 min) for the microcoil localization group (P < 0.05). CONCLUSIONS: CT-assisted body surface localization combined with intraoperative stereotactic anatomical localization is a safe, painless, accurate, and reliable method for lung nodule localization.


Assuntos
Neoplasias Pulmonares , Tomografia Computadorizada por Raios X , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X/métodos , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Idoso , Nódulo Pulmonar Solitário/cirurgia , Nódulo Pulmonar Solitário/diagnóstico por imagem , Cirurgia Torácica Vídeoassistida/métodos , Técnicas Estereotáxicas , Cirurgia Assistida por Computador/métodos
2.
Hepatobiliary Surg Nutr ; 13(3): 412-424, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38911192

RESUMO

Background: The application of Pringle maneuver (PM) during hepatectomy reduces intraoperative blood loss and the need for perioperative transfusion, but its effect on long-term recurrence and survival for patients with hepatocellular carcinoma (HCC) remains controversial. We sought to determine the association between the application of PM and post-hepatectomy oncologic outcomes for patients with HCC. Methods: Patients who underwent curative hepatectomy for HCC at 9 Chinese hospitals from January 2010 to December 2018 were identified. Using two propensity score methods [propensity score matching (PSM) and inverse probability of treatment weight (IPTW)], cumulative recurrence rate and cancer-specific mortality (CSM) were compared between the patients in the PM and non-PM groups. Multivariate competing-risks regression models were performed to adjust for the effect of non-cancer-specific mortality and other prognostic risk factors. Results: Of the 2,798 included patients, 2,404 and 394 did and did not adopt PM (the PM and non-PM groups), respectively. The rates of intraoperative blood transfusion, postoperative 30-day mortality and morbidity were comparable between the two groups (all P>0.05). In the PSM cohort by the 1:3 ratio, compared to 382 patients in the non-PM group, 1,146 patients in the PM group also had the higher cumulative 5-year recurrence rate and CSM (63.9% and 39.1% vs. 55.3% and 31.6%, both P<0.05). Similar results were also yielded in the entire cohort and the IPTW cohort. Multivariate competing-risks regression analyses demonstrated that no application of the PM was independently associated with lower recurrence rate and CSM based on various analytical cohorts [hazard ratio (HR), 0.82 and 0.77 in the adjusted entire cohort, HR 0.80 and 0.73 in the PSM cohort, and HR 0.80 and 0.76 in the IPTW cohort, respectively]. Conclusions: The findings suggested that no application of PM during hepatectomy for patients with HCC reduced the risk of postoperative recurrence and cancer-specific death by approximately 20-25%.

3.
Int J Parasitol ; 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38936501

RESUMO

Establishing an intact intracellular parasitophorous vacuole (PV) that enables efficient nutrient uptake and protein trafficking is essential for the survival and proliferation of Toxoplasma gondii. Although the PV membrane (PVM)-localized dense granule protein 17 (GRA17) and GRA23 mediate the permeability of the PVM to small molecules, including nutrient uptake and excretion of metabolic by-products, the molecular mechanism by which T. gondii acquires nutrients remains unclear. In this study, we showed that the secreted protein GRA47 contributed to normal PV morphology, PVM permeability to small molecules, growth, and virulence in T. gondii. Co-immunoprecipitation analysis demonstrated potential interaction of GRA47 with GRA72, and the loss of GRA72 affected PV morphology, parasite growth and infectivity. To investigate the biological relationship among GRA47, GRA72, GRA17 and GRA23, attempts were made to construct strains with double gene deletion and overexpressing strains. Only Δgra23Δgra72 was successfully constructed. This strain exhibited a significant increase in the proportion of aberrant PVs compared with the Δgra23 strain. Overexpressing one of the three related GRAs partially rescued PVs with aberrant morphology in Δgra47, Δgra72 and Δgra17, while the expression of the Plasmodium falciparum PVM protein PfExp2, an ortholog of GRA17 and GRA23, fully rescued the PV morphological defect in all three Δgra strains. These results suggest that these GRA proteins may not be functionally redundant but rather work in different ways to regulate nutrient acquisition. These findings highlight the versatility of the nutrient uptake mechanisms in T. gondii, which may contribute to the parasite's remarkable ability to grow in different cellular niches in a very broad range of hosts.

4.
Shock ; 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38904460

RESUMO

ABSTRACT: Sepsis, a complex and multifaceted condition, is a common occurrence with serious implications for critically ill patients in the Intensive Care Unit (ICU). The YWHAH gene encodes the 14-3-3n protein, a member of the 14-3-3 protein family. While existing research primarily focuses on the role of 14-3-3n in conditions such as schizophrenia and various cancers, our study revealed that the expression of the YWHAH gene remained relatively stable in both infected individuals and healthy controls. Through Venn plot analysis following weighted gene correlation network analysis (WGCNA), we observed a potential association between elevated YWHAH expression and the transition from infection to sepsis. In a comprehensive analysis of public single-cell transcriptome databases, the expression of YWHAH was found to be distinctive in cases of sepsis and infection. These findings were corroborated through an in vitro analysis utilizing real-time polymerase chain reaction. This study represents the initial identification of variations in YWHAH gene expression between patients with infection and sepsis, potentially offering insights for the development of early detection and treatment strategies for sepsis.

5.
Parasit Vectors ; 17(1): 178, 2024 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-38576040

RESUMO

BACKGROUND: To successfully replicate within the host cell, Toxoplasma gondii employs several mechanisms to overcome the host cell defenses and mitigate the harmful effects of the free radicals resulting from its own metabolic processes using effectors such as thioredoxin proteins. In this study, we characterize the location and functions of a newly identified thioredoxin in T. gondii, which was named Trx4. METHODS: We characterized the functional role of Trx4 in T. gondii Type I RH and Type II Pru strains by gene knockout and studied its subcellular localization by endogenous protein HA tagging using CRISPR-Cas9 gene editing. The enzyme-catalyzed proximity labeling technique, the TurboID system, was employed to identify the proteins in proximity to Trx4. RESULTS: Trx4 was identified as a dense granule protein of T. gondii predominantly expressed in the parasitophorous vacuole (PV) and was partially co-localized with GRA1 and GRA5. Functional analysis showed that deletion of trx4 markedly influenced the parasite lytic cycle, resulting in impaired host cell invasion capacity in both RH and Pru strains. Mutation of Trx domains in Trx4 in RH strain revealed that two Trx domains were important for the parasite invasion. By utilizing the TurboID system to biotinylate proteins in proximity to Trx4, we identified a substantial number of proteins, some of which are novel, and others are previously characterized, predominantly distributed in the dense granules. In addition, we uncovered three novel proteins co-localized with Trx4. Intriguingly, deletion of trx4 did not affect the localization of these three proteins. Finally, a virulence assay demonstrated that knockout of trx4 resulted in a significant attenuation of virulence and a significant reduction in brain cyst loads in mice. CONCLUSIONS: Trx4 plays an important role in T. gondii invasion and virulence in Type I RH strain and Type II Pru strain. Combining the TurboID system with CRISPR-Cas9 technique revealed many PV-localized proximity proteins associated with Trx4. These findings suggest a versatile role of Trx4 in mediating the processes that occur in this distinctive intracellular membrane-bound vacuolar compartment.


Assuntos
Toxoplasma , Animais , Camundongos , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , Antígenos de Protozoários/genética , Virulência/genética , Fatores Imunológicos/metabolismo , Tiorredoxinas/genética
7.
Gastroenterol Res Pract ; 2024: 8236616, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38590392

RESUMO

Aim: To compare the clinical characteristics of survival and nonsurvival patients with severe acute pancreatitis (SAP) and explore the risk of mortality in SAP patients. Methods: This was a single-center retrospective study performed in a severe acute pancreatitis diagnosis and treatment center. According to the outcome, SAP patients were divided into survival group and nonsurvival group. One-way ANOVA or independent t-test was used to compare the clinical characteristics of two groups of patients. Multivariate retrospective analysis was used to identify risk factors for mortality in SAP patients. Results: A total of 486 SAP patients were included in the study, and the 90-day mortality for SAP patients was 13.58%. The common etiologies of SAP are biliary tract diseases (69.75%) and hyperlipidemia (17.28%). The most common complications caused by SAP were organ failure (55.14%), ARDS (50.62%), AKI (30.45%), sepsis (27.16%), and abdominal fluid collection (27.57%). There were differences in age, complications, and medical intervention between the nonsurvival group and the survival group. The main causes of death were infection (46.97%), abdominal bleeding (28.79%), and organ failure (9.09%). The binary logistic regression analysis showed that there were significant differences in age, AKI, sepsis, abdominal hemorrhage, organ failure, laparotomy, creatinine, and APTT between the nonsurvival group and the survival group. Conclusion: Age, AKI, sepsis, abdominal hemorrhage, and organ failure are risk factors for mortality in SAP patients. SAP patients with high creatinine and prolonged APTT upon admission require doctors to be vigilant. The main cause of death in SAP patients is pancreatitis-related organ failure and secondary infection.

8.
J Hazard Mater ; 470: 134214, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38603908

RESUMO

Fe(II) regeneration is decisive for highly efficient H2O2-based Fenton-like processes, but the role of cobalt-containing reactive sites in promoting Fe(II) regeneration was overlooked. Herein, a single atom Co-N-C catalyst was employed in Fe(II)/H2O2 system to promote the degradation of diverse organic contaminants. The EPR and quenching experiments indicated Co-N-C significantly enhanced the generation of superoxide species, and accelerated hydroxyl radical generation for pollutant degradation. The electrochemical and surface composition analyses demonstrated the enhanced H2O2 activation and Fe(III)/Fe(II) recycling on the catalyst. Furthermore, in-situ Raman characterization with shell-isolated gold nanoparticles was employed to visualize the interfacial reactive intermediates and their time-resolved interaction. The accumulation of interfacial CoOOH* was confirmed when Co-N-C activated H2O2 alone, but it rapidly transformed into FeOOH* upon Fe(II) addition. Besides, the temporal variation of OOH* intermediates and the relative intensity of Co(III)-O and Co(IV)=O peaks depicted the dynamic interaction of reactive intermediates along the H2O2 consumption. With this basis, we proposed a mechanism of interfacial OOH* mediated Fe(II) regeneration, which overcame the kinetical limitation of Fe(II)/H2O2 system. Therefore, this study provided a primary effort to elucidate the overlooked role of interfacial CoOOH* in the Fenton-like processes, which may inspire the design of more efficient catalysts.

9.
Arch Biochem Biophys ; 753: 109918, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38301949

RESUMO

OBJECTIVE: Our previous study found that overexpression of uncoupling protein-2 (UCP2) had a protective effect on lipopolysaccharide (LPS)-induced sepsis cardiomyocytes. The aim of this study was to explore the effect and mechanism of uncoupling protein-2 (UCP2) on myocardial ischemia-reperfusion injury. METHODS: In this study, we established hypoxia-reoxygenation (HR) injury model in rats and isolated cardiomyocytes of newborn rats. We also carried out following methods which include virus transfection technology, cell counting Kit-8 (CCK8), flow cytometry, enzyme linked immunosorbent assay (ELISA), Western blot (WB), quantitative reverse transcription PCR (RT qPCR), transmission electron microscopy, fluorescence colocalization and immunoprecipitation. MAIN RESULTS: The results of this study showed that hypoxia-reoxygenation treatment in cardiomyocytes increased UCP2, myocardial enzyme and myocardial apoptosis and weakened cardiomyocyte viability. We observed increased cardiomyocyte viability and mitochondrial membrane potential, decreased myocardial enzyme and myocardial apoptosis, Inhibition of oxidative stress when UCP2 was overexpressed in cardiomyocytes. It also can Increase ATP and stabilize mitochondrial dynamics. Further studies founded that Sirtuin-3(SIRT3) changed with the expression of UCP2, which was confirmed by fluorescence co-localization and immunoprecipitation. CONCLUSIONS: Our findings revealed that UCP2 and SIRT3 were important targets of anti-myocardial injury by inhibiting cellular oxidative stress and stabilizing mitochondrial dynamics.


Assuntos
Sirtuína 3 , Animais , Ratos , Hipóxia , Dinâmica Mitocondrial , Estresse Oxidativo , Sirtuína 3/genética , Sirtuína 3/metabolismo , Proteína Desacopladora 2/genética , Proteína Desacopladora 2/metabolismo
10.
Nat Commun ; 15(1): 793, 2024 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-38278808

RESUMO

Sexual development in Toxoplasma gondii is a multistep process that culminates in the production of oocysts, constituting approximately 50% of human infections. However, the molecular mechanisms governing sexual commitment in this parasite remain poorly understood. Here, we demonstrate that the transcription factors AP2XI-2 and AP2XII-1 act as negative regulators, suppressing merozoite-primed pre-sexual commitment during asexual development. Depletion of AP2XI-2 in type II Pru strain induces merogony and production of mature merozoites in an alkaline medium but not in a neutral medium. In contrast, AP2XII-1-depleted Pru strain undergoes several rounds of merogony and produces merozoites in a neutral medium, with more pronounced effects observed under alkaline conditions. Additionally, we identified two additional AP2XI-2-interacting proteins involved in repressing merozoite programming. These findings underscore the intricate regulation of pre-sexual commitment by a network of factors and suggest that AP2XI-2 or AP2XII-1-depleted Pru parasites can serve as a model for studying merogony in vitro.


Assuntos
Toxoplasma , Animais , Humanos , Toxoplasma/metabolismo , Merozoítos/metabolismo , Fatores de Transcrição/genética , Fatores de Transcrição/metabolismo , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo
11.
Kaohsiung J Med Sci ; 40(1): 35-45, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37877496

RESUMO

Sepsis-induced myocardial injury is one of the most difficult complications of sepsis in intensive care units. Annexin A1 (ANXA1) short peptide (ANXA1sp) protects organs during the perioperative period. However, the protective effect of ANXA1sp against sepsis-induced myocardial injury remains unclear. We aimed to explore the protective effects and mechanisms of ANXA1sp against sepsis-induced myocardial injury both in vitro and in vivo. Cellular and animal models of myocardial injury in sepsis were established with lipopolysaccharide. The cardiac function of mice was assessed by high-frequency echocardiography. Elisa assay detected changes in inflammatory mediators and markers of myocardial injury. Western blotting detected autophagy and mitochondrial biosynthesis-related proteins. Autophagic flux changes were observed by confocal microscopy, and autophagosomes were evaluated by TEM. ATP, SOD, ROS, and MDA levels were also detected.ANXA1sp pretreatment enhanced the 7-day survival rate, improved cardiac function, and reduced TNF-α, IL-6, IL-1ß, CK-MB, cTnI, and LDH levels. ANXA1sp significantly increased the expression of sirtuin-3 (SIRT3), mitochondrial biosynthesis-related proteins peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α), and mitochondrial transcription factor A (TFAM). ANXA1sp increased mitochondrial membrane potential (△Ψm), ATP, and SOD, and decreased ROS, autophagy flux, the production of autophagosomes per unit area, and MDA levels. The protective effect of ANXA1sp decreased significantly after SIRT3 silencing in vitro and in vivo, indicating that the key factor in ANXA1sp's protective role is the upregulation of SIRT3. In summary, ANXA1sp attenuated sepsis-induced myocardial injury by upregulating SIRT3 to promote mitochondrial biosynthesis and inhibit oxidative stress and autophagy.


Assuntos
Sepse , Sirtuína 3 , Camundongos , Animais , Sirtuína 3/genética , Sirtuína 3/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Regulação para Cima/genética , Mitocôndrias/metabolismo , Estresse Oxidativo , Trifosfato de Adenosina/metabolismo , Trifosfato de Adenosina/farmacologia , Autofagia/genética , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , Sepse/complicações , Sepse/genética , Sepse/metabolismo
12.
Int J Parasitol ; 54(2): 109-121, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37832712

RESUMO

Pathogenicity of the zoonotic pathogen Toxoplasma gondii largely depends on the secretion of effector proteins into the extracellular milieu and host cell cytosol, including the dense granule proteins (GRAs). The protein-encoding gene TGME49_299780 was previously identified as a contributor to parasite fitness. However, its involvement in parasite growth, virulence and infectivity in vitro and in vivo remains unknown. Here, we comprehensively examined the role of this new protein, termed GRA76, in parasite pathogenicity. Subcellular localization revealed high expression of GRA76 in tachyzoites inside the parasitophorous vacuole (PV). However, its expression was significantly decreased in bradyzoites. A CRISPR-Cas9 approach was used to knock out the gra76 gene in the T. gondii type I RH strain and type II Pru strain. The in vitro plaque assays and intracellular replication showed the involvement of GRA76 in replication of RH and Pru strains. Deletion of the gra76 gene significantly decreased parasite virulence, and reduced the brain cyst burden in mice. Using RNA sequencing, we detected a significant increase in the expression of bradyzoite-associated genes such as BAG1 and LDH2 in the PruΔgra76 strain compared with the wild-type Pru strain. Using an in vitro bradyzoite differentiation assay, we showed that loss of GRA76 significantly increased the propensity for parasites to form bradyzoites. Immunization with PruΔgra76 conferred partial protection against acute and chronic infection in mice. These findings show the important role of GRA76 in the pathogenesis of T. gondii and highlight the potential of PruΔgra76 as a candidate for a live-attenuated vaccine.


Assuntos
Toxoplasma , Animais , Camundongos , Toxoplasma/genética , Virulência/genética , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo
13.
PLoS Pathog ; 19(12): e1011831, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38091362

RESUMO

Protein phosphatases are post-translational regulators of Toxoplasma gondii proliferation, tachyzoite-bradyzoite differentiation and pathogenesis. Here, we identify the putative protein phosphatase 6 (TgPP6) subunits of T. gondii and elucidate their role in the parasite lytic cycle. The putative catalytic subunit TgPP6C and regulatory subunit TgPP6R likely form a complex whereas the predicted structural subunit TgPP6S, with low homology to the human PP6 structural subunit, does not coassemble with TgPP6C and TgPP6R. Functional studies showed that TgPP6C and TgPP6R are essential for parasite growth and replication. The ablation of TgPP6C significantly reduced the synchronous division of the parasite's daughter cells during endodyogeny, resulting in disordered rosettes. Moreover, the six conserved motifs of TgPP6C were required for efficient endodyogeny. Phosphoproteomic analysis revealed that ablation of TgPP6C predominately altered the phosphorylation status of proteins involved in the regulation of the parasite cell cycle. Deletion of TgPP6C significantly attenuated the parasite virulence in mice. Immunization of mice with TgPP6C-deficient type I RH strain induced protective immunity against challenge with a lethal dose of RH or PYS tachyzoites and Pru cysts. Taken together, the results show that TgPP6C contributes to the cell division, replication and pathogenicity in T. gondii.


Assuntos
Parasitos , Fosfoproteínas Fosfatases , Toxoplasma , Animais , Humanos , Camundongos , Domínio Catalítico , Ciclo Celular/genética , Divisão Celular , Parasitos/metabolismo , Proteínas de Protozoários/genética , Proteínas de Protozoários/metabolismo , Toxoplasma/metabolismo , Virulência/genética , Fosfoproteínas Fosfatases/genética , Fosfoproteínas Fosfatases/metabolismo
14.
Rev. esp. enferm. dig ; 115(12): 744-745, Dic. 2023. ilus
Artigo em Inglês | IBECS | ID: ibc-228734

RESUMO

A 29-year-old male presented with recurrent mucous bloody stools for more than a year. Colonoscopy revealed ill-defined, mildly congested and edematous mucosa with scattered erosion spots in the lower rectum, highly suspicious for proctitis. Histopathology showed diffuse infiltration of small to medium-sized lymphoid cells in the lamina propria. Immunohistochemistry indicated these cells were positive for CD20, CD79a, CD19, kappa and lambda light chains (partial), and negative for CD3, CD5, CD10, cyclin D and BCL-6. These results were consistent with mucosa-associated lymphoid tissue (MALT) lymphoma. Further investigations consisting of upper endoscopy, bone marrow biopsy, and whole-body PET/CT scan did not detect any extrarectal lesions. Based on these findings, the diagnosis of stage I primary rectal MALT lymphoma was made. The patient underwent 15 fractions of radiotherapy with a total dose of 30 Gy. His symptoms were alleviated following the treatment. A follow-up colonoscopy performed 3 months later showed complete resolution of the lesion.(AU)


Assuntos
Humanos , Masculino , Adulto , Biópsia , Linfoma de Células B/diagnóstico por imagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Proctite/diagnóstico , Reto/patologia , Radioterapia , Fezes , Resultado do Tratamento , Pacientes Internados , Exame Físico , Avaliação de Sintomas
15.
BMC Infect Dis ; 23(1): 792, 2023 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-37964211

RESUMO

BACKGROUND: Cancer case during pregnancy is rare, but it is the second leading cause of maternal mortality. CASE PRESENTATION: A-32-year old pregnant woman with a gestational age of 37 weeks was admitted to the hospital due to repeated coughing for 5 months. She received Veno-Venous Extracorporeal Membrane Oxygenation (V-V ECMO) treatment for severe hypoxemia after delivery. She was diagnosed with non-small cell lung cancer (NSCLC) with bone metastasis and pneumocystis pneumonia (PCP). She subsequently received anti-tumor therapy and anti-infective therapy. After treatment, her condition improved and she was weaned from ECMO. Two weeks after weaning ECMO, her condition worsened again. Her family chose palliative treatment, and she ultimately died. CONCLUSIONS: NSCLC is rare during pregnancy. At present, there is still a lack of standardized methods to manage these cases. For theses cases, the clinician should be wary of opportunistic infections, such as pneumocystis jirovecii (P. jirovecii) and Elizabethkingia spp. Specialized medical teams with abundant experience and multidisciplinary discussions from the perspectives of the patient's clinical characteristics as well as preferences are crucial for developing individualized and the best approach.


Assuntos
Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Pneumocystis carinii , Pneumonia por Pneumocystis , Humanos , Gravidez , Feminino , Recém-Nascido , Pneumonia por Pneumocystis/diagnóstico , Pneumonia por Pneumocystis/tratamento farmacológico , Gestantes , Neoplasias Pulmonares/complicações
16.
BMC Surg ; 23(1): 323, 2023 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-37875843

RESUMO

PURPOSE: With increasing life expectancy, the number of elderly patients (≥ 65 years) with hepatocellular carcinoma (HCC) has steadily increased. Hepatectomy remains the first-line treatment for HCC patients. However, the prognosis of hepatectomy for elderly patients with HCC remains unclear. METHODS: Clinical and follow-up data from 1331 HCC patients who underwent surgery between 2008 and 2020 were retrospectively retrieved from a multicentre database. Patients were divided into elderly (≥ 65 years) and non-elderly (< 65 years) groups, and PSM was used to balance differences in the baseline characteristics. The postoperative major morbidity and cancer-specific survival (CSS) of the two groups were compared and the independent factors that were associated with the two study endpoints were identified by multivariable regression analysis. RESULTS: Of the 1331 HCC patients enrolled in this study, 363 (27.27%) were elderly, while 968 (72.73%) were not. After PSM, 334 matched samples were obtained. In the propensity score matching (PSM) cohort, a higher rate of major morbidity was found in elderly patients (P = 0.040) but the CSS was similar in the two groups (P = 0.087). Multivariate analysis revealed that elderly age was not an independent risk factor associated with high rates of major morbidity (P = 0.117) or poor CSS (P = 0.873). The 1-, 3- and 5-year CSS rates in the elderly and non-elderly groups were 91.0% versus 86.2%, 71.3% versus 68.8% and 55.9% versus 58.0%, respectively. Preoperative alpha fetoprotein (AFP) level, Child‒Pugh grade, intraoperative blood transfusion, extended hemi hepatectomy, and tumour diameter could affect the postoperative major morbidity and preoperative AFP level, cirrhosis, Child‒Pugh grade, macrovascular invasion, microvascular invasion (MVI), satellite nodules, and tumor diameter were independently and significantly associated with CSS. CONCLUSION: Age itself had no significant effect on the prognosis of elderly patients with HCC after hepatectomy. Hepatectomy can be safely performed in elderly patients after cautious perioperative management.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Idoso , Pessoa de Meia-Idade , Carcinoma Hepatocelular/cirurgia , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/cirurgia , Neoplasias Hepáticas/patologia , alfa-Fetoproteínas/análise , Hepatectomia , Pontuação de Propensão , Estudos Retrospectivos , Recidiva Local de Neoplasia/cirurgia , Prognóstico
17.
Medicine (Baltimore) ; 102(43): e35702, 2023 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-37904478

RESUMO

RATIONALE: Invasive pulmonary aspergillosis (IPA) is an uncommon but life-threatening disease. The disease often occurs in immunocompromised patients or critically ill patients. Here, we reported that IPA occurred in a non-immunocompromised host. PATIENT CONCERNS: A 45-year-old man was admitted to the hospital for 1 week due to fever and cough. He was engaged in waste recycling and lived in a dark and humid environment for a long time. DIAGNOSIS: Invasive pulmonary aspergillosis. INTERVENTIONS: Next generation sequencing and pathological examination of alveolar lavage fluid indicated aspergillus infection. He received voriconazole infusion after admission. After 5 weeks of antifungal treatment, his condition improved significantly and discharged. OUTCOME: One week after discharge, his condition deteriorated again and returned to the hospital. Unfortunately, he died. LESSON: The immunocompetent adults can develop invasive pulmonary aspergillosis if they are exposed to high-risk environments. IPA in non-immunocompromised host should arouse the vigilance of clinicians.


Assuntos
Aspergilose , Aspergilose Pulmonar Invasiva , Masculino , Adulto , Humanos , Pessoa de Meia-Idade , Aspergilose Pulmonar Invasiva/diagnóstico , Aspergilose Pulmonar Invasiva/tratamento farmacológico , Voriconazol/uso terapêutico , Antifúngicos/uso terapêutico , Aspergilose/diagnóstico , Hospedeiro Imunocomprometido
18.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue ; 35(9): 980-983, 2023 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-37803959

RESUMO

OBJECTIVE: To investigate the effect of hyperoxia on intestinal metabolomics in mice. METHODS: Sixteen 8-week-old male C57BL/6 mice were randomly divided into hyperoxia group and control group, with 8 mice in each group. The hyperoxia group was exposed to 80% oxygen for 14 days. Mice were anesthetized and euthanized, and cecal contents were collected for untargeted metabolomics analysis by liquid chromatography-mass spectrometry (LC-MS) combined detection. Orthogonal partial least square discriminant analysis (OPLS-DA), volcano plot analysis, heat map analysis, and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to analyze the effects of hyperoxia on metabolism. RESULTS: (1) OPLS-DA analysis showed that R2Y was 0.967 and Q2 was 0.796, indicating that the model was reliable. (2) Volcano plot and heat map analysis showed significant statistical differences in the expression levels of metabolites between the two groups, with 541 up-regulated metabolites, 64 down-regulated metabolites, and 907 no differences, while the elevated 5-hydroxy-L-lysine was the most significant differential metabolite induced by high oxygen. (3) KEGG pathway enrichment analysis showed that porphyrin and chlorophyll metabolism (P = 0.005), lysine degradation (P = 0.047), and aromatic compound degradation (P = 0.024) were the targets affected by hyperoxia. (4) Differential analysis of metabolic products through KEGG enrichment pathway showed that hyperoxia had a significant impact on the metabolism of porphyrin and chlorophyll, lysine, and aromatic compounds such as benzene and o-cresol. CONCLUSIONS: Hyperoxia significantly induces intestinal metabolic disorders. Hyperoxia enhances the metabolism of porphyrins and chlorophyll, inhibits the degradation of lysine, and delays the degradation of aromatic compounds such as benzene and o-cresol.


Assuntos
Hiperóxia , Doenças Metabólicas , Porfirinas , Camundongos , Masculino , Animais , Lisina , Benzeno , Camundongos Endogâmicos C57BL , Oxigênio , Clorofila , Biomarcadores/metabolismo
19.
Rev Esp Enferm Dig ; 115(12): 744-745, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37706448

RESUMO

A 29-year-old male presented with recurrent mucous bloody stools for more than a year. Colonoscopy revealed ill-defined, mildly congested and edematous mucosa with scattered erosion spots in the lower rectum, highly suspicious for proctitis. Histopathology showed diffuse infiltration of small to medium-sized lymphoid cells in the lamina propria. Immunohistochemistry indicated these cells were positive for CD20, CD79a, CD19, kappa and lambda light chains (partial), and negative for CD3, CD5, CD10, cyclin D and BCL-6. These results were consistent with mucosa-associated lymphoid tissue (MALT) lymphoma. Further investigations consisting of upper endoscopy, bone marrow biopsy, and whole-body PET/CT scan did not detect any extrarectal lesions. Based on these findings, the diagnosis of stage I primary rectal MALT lymphoma was made. The patient underwent 15 fractions of radiotherapy with a total dose of 30 Gy. His symptoms were alleviated following the treatment. A follow-up colonoscopy performed 3 months later showed complete resolution of the lesion.


Assuntos
Linfoma de Zona Marginal Tipo Células B , Proctite , Masculino , Humanos , Adulto , Linfoma de Zona Marginal Tipo Células B/diagnóstico por imagem , Reto/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Proctite/diagnóstico , Biópsia
20.
Wilderness Environ Med ; 34(4): 558-561, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37718215

RESUMO

Reports of paedoptera dermatitis are commonly found in tropical and subtropical regions, while reports in China are rare. In September 2022, an outbreak of paedoptera dermatitis occurred in a minority autonomous county in southwestern China. Here, we report 134 patients with paedoptera dermatitis who were treated at the People's Hospital of Sandu Shui Autonomous County. The skin lesions of these patients were mostly located on the face, neck, trunk, or multiple sites. The skin lesions were mainly distributed in patches and were characterized by vesicular linear or "kissing" lesions. Most patients felt burning pain, and few patients felt pruritus. The treatments with oral antihistamines, calamine lotion, steroids, and antibiotics were effective. For patients with ocular involvement, treatments with oral prednisone and bufexamac cream were effective. All patients recovered within 2 wk. There is a possibility of another outbreak of paedoptera dermatitis in the region. Awareness of the condition and its clinical features will prevent misdiagnosis. Early diagnosis and timely treatment lead to a better prognosis for paederus dermatitis. Simple preventive measures can be undertaken based on the behavioral pattern of this nocturnal beetle.


Assuntos
Besouros , Dermatite , Animais , Humanos , Surtos de Doenças , Hospitais , China/epidemiologia , Dermatite/tratamento farmacológico , Dermatite/epidemiologia , Dermatite/etiologia
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