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1.
Aging (Albany NY) ; 16(11): 9876-9898, 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38843385

RESUMO

Estrogen is thought to have a role in slowing down aging and protecting cardiovascular and cognitive function. However, high doses of estrogen are still positively associated with autoimmune diseases and tumors with systemic inflammation. First, we administered exogenous estrogen to female mice for three consecutive months and found that the aorta of mice on estrogen develops inflammatory manifestations similar to Takayasu arteritis (TAK). Then, in vitro estrogen intervention was performed on mouse aortic vascular smooth muscle cells (MOVAS cells). Stimulated by high concentrations of estradiol, MOVAS cells showed decreased expression of contractile phenotypic markers and increased expression of macrophage-like phenotypic markers. This shift was blocked by tamoxifen and Krüppel-like factor 4 (KLF4) inhibitors and enhanced by Von Hippel-Lindau (VHL)/hypoxia-inducible factor-1α (HIF-1α) interaction inhibitors. It suggests that estrogen-targeted regulation of the VHL/HIF-1α/KLF4 axis induces phenotypic transformation of vascular smooth muscle cells (VSMC). In addition, estrogen-regulated phenotypic conversion of VSMC to macrophages is a key mechanism of estrogen-induced vascular inflammation, which justifies the risk of clinical use of estrogen replacement therapy.


Assuntos
Estrogênios , Subunidade alfa do Fator 1 Induzível por Hipóxia , Fator 4 Semelhante a Kruppel , Fatores de Transcrição Kruppel-Like , Macrófagos , Músculo Liso Vascular , Proteína Supressora de Tumor Von Hippel-Lindau , Animais , Fatores de Transcrição Kruppel-Like/metabolismo , Fatores de Transcrição Kruppel-Like/genética , Macrófagos/metabolismo , Macrófagos/efeitos dos fármacos , Camundongos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Subunidade alfa do Fator 1 Induzível por Hipóxia/genética , Músculo Liso Vascular/metabolismo , Músculo Liso Vascular/patologia , Músculo Liso Vascular/efeitos dos fármacos , Feminino , Estrogênios/farmacologia , Proteína Supressora de Tumor Von Hippel-Lindau/metabolismo , Proteína Supressora de Tumor Von Hippel-Lindau/genética , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/efeitos dos fármacos , Transdiferenciação Celular/efeitos dos fármacos , Fenótipo , Aorta/patologia , Aorta/efeitos dos fármacos , Inflamação/metabolismo
2.
J Cell Mol Med ; 28(11): e18370, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38818568

RESUMO

The Finkel-Biskis-Jinkins Osteosarcoma (c-Fos; encoded by FOS) plays an important role in several cardiovascular diseases, including atherosclerosis and stroke. However, the relationship between FOS and venous thromboembolism (VTE) remains unknown. We identified differentially expressed genes in Gene Expression Omnibus dataset, GSE48000, comprising VTE patients and healthy individuals, and analysed them using CIBERSORT and weighted co-expression network analysis (WGCNA). FOS and CD46 expressions were significantly downregulated (FOS p = 2.26E-05, CD64 p = 8.83E-05) and strongly linked to neutrophil activity in VTE. We used GSE19151 and performed PCR to confirm that FOS and CD46 had diagnostic potential for VTE; however, only FOS showed differential expression by PCR and ELISA in whole blood samples. Moreover, we found that hsa-miR-144 which regulates FOS expression was significantly upregulated in VTE. Furthermore, FOS expression was significantly downregulated in neutrophils of VTE patients (p = 0.03). RNA sequencing performed on whole blood samples of VTE patients showed that FOS exerted its effects in VTE via the leptin-mediated adipokine signalling pathway. Our results suggest that FOS and related genes or proteins can outperform traditional clinical markers and may be used as diagnostic biomarkers for VTE.


Assuntos
Biologia Computacional , MicroRNAs , Neutrófilos , Proteínas Proto-Oncogênicas c-fos , Tromboembolia Venosa , Humanos , MicroRNAs/genética , MicroRNAs/sangue , MicroRNAs/metabolismo , Neutrófilos/metabolismo , Tromboembolia Venosa/genética , Tromboembolia Venosa/metabolismo , Tromboembolia Venosa/sangue , Biologia Computacional/métodos , Proteínas Proto-Oncogênicas c-fos/genética , Proteínas Proto-Oncogênicas c-fos/metabolismo , Regulação da Expressão Gênica , Masculino , Perfilação da Expressão Gênica , Redes Reguladoras de Genes , Feminino , Biomarcadores/sangue , Biomarcadores/metabolismo
3.
Am J Med Sci ; 367(5): 296-303, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38278361

RESUMO

Traditionally, red blood cells (RBCs) have been perceived as passive entities within the fibrin network, without any significant role in the pathophysiology of venous thromboembolism (VTE). This review explores the involvement of RBCs in the VTE process, summarizing previous study findings and providing a comprehensive review of the latest theories. At first, it explores the influence of abnormal RBC counts (as seen in polycythemia vera and with erythropoietin use) and the exposure of RBCs to phosphatidylserine (Ptd-L-Ser) in the pathophysiology of VTE. The mechanisms of endothelial injury induced by RBCs and their adhesion to the endothelium under different disease models are then demonstrated. We explore the role of physical and chemical interactions between RBCs and platelets, as well as the interactions between RBCs and neutrophils - particularly the neutrophil extracellular traps (NETs) released by neutrophils - in the process of VTE. Additionally, we investigate the effect of RBCs on thrombin activation through two pathways, namely, the FXIIa-FXI-FIX pathway and the prekallikrein-dependent pathway. Lastly, we discuss the impact of RBCs on clot volume. In conclusion, we propose several potential methods aimed at unraveling the role of RBCs and their interaction with other components in the vascular system in the pathogenesis of VTE.


Assuntos
Trombose , Tromboembolia Venosa , Humanos , Trombose/metabolismo , Eritrócitos/metabolismo , Plaquetas , Neutrófilos
4.
J Inflamm Res ; 16: 5629-5646, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38046404

RESUMO

Background: Contrast-induced acute kidney injury (CI-AKI) is considered to be the third leading cause of hospital-acquired kidney injury. Current studies mostly suggest that contrast agents mainly harm renal tubular epithelial cells, but we hypothesized that the development of CI-AKI should be the result of the interaction of renal vascular and tubular injury. Methods: First we constructed a CI-AKI mouse model and verified the success of the model by pathological injury and serum creatinine level. Immunohistochemistry, protein quantification and qRT-PCR were used to detect the location and level of expression of neutrophil extracellular traps (NETs) in the kidney. Then, we blocked the in vivo accumulation of NETs using GSK484 and DNase I and detected the expression of NETs and the damage of glomerular and peritubular capillaries. Results: We first identified the presence of NETs in CI-AKI mice, and NETs were mainly accumulated in glomeruli and peritubular capillaries. The expression of NETs was positively correlated with the severity of CI-AKI kidney. After inhibition of NETs release or promotion of NETs degradation by drugs, renal vascular endothelial cell injury was reduced and renal pathological changes and creatinine levels were reversed in CI-AKI mice. In addition, inhibition of NETs reduced apoptosis and pyroptosis of renal cells and attenuated inflammation in vivo. Conclusion: These findings suggest that NETs are involved in the development of CI-AKI by damaging glomerular and peritubular capillary endothelial cells. This study will provide a new strategy for clinical prevention and treatment of CI-AKI.

5.
Ann Vasc Surg ; 96: 232-240, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37169250

RESUMO

BACKGROUND: We compared the early and midterm (31, 3-63 months) outcomes of conservative treatment, bare stent treatment (BST), and bare stent-assisted coiling treatment (BSACT) to determine the most effective treatment for patients with symptomatic isolated superior mesenteric artery dissection (SISMAD). METHODS: Consecutive patients with SISMAD admitted to the study hospital between January 2016 and December 2021 were included in this retrospective study. Their demographic data, clinical findings, treatment options, early outcomes, and follow-up results were analyzed. RESULTS: A total of 121 patients were included in the study (23 with conservative treatment, 42 with BST, and 56 with BSACT). Symptoms were relieved in 91.3% of conservative patients, whereas all patients (100%) with BST or BSACT had symptom relief (P = 0.035). There was no significant difference in the length of hospital stay between the 2 endovascular treatments (P = 0.9051), but hospital stay was significantly shorter compared to conservative treatment (P < 0.0001). The cumulative rate of complete remodeling was 100% for BSACT versus 46.3% for BST (P < 0.0001) versus 42.9% for conservative patients (P < 0.0001). There were no significant differences between the last 2 groups (P = 0.3925). The prevalence of adverse events for abdominal pain recurrence and aneurysm formation was also significantly lower in the BSACT group at follow-up. CONCLUSIONS: BSACT for SISMAD has a preferable early outcome. The cumulative complete remodeling rate and the event-free survival rate are satisfactory at midterm follow-up. BSACT is an effective approach for SISMAD.


Assuntos
Tratamento Conservador , Artéria Mesentérica Superior , Humanos , Artéria Mesentérica Superior/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Tratamento Conservador/efeitos adversos , Stents
6.
Phlebology ; 38(3): 157-164, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36627819

RESUMO

OBJECTIVE: In this study, we present our early outcomes of cyanoacrylate ablation (CA) versus endovenous laser ablation (EVLA) for the treatment of great saphenous vein (GSV) insufficiency in the Chinese mainland population. METHODS: We retrospectively analyzed 108 patients (53 patients in the CA group and 55 patients in the EVLA group) with GSV insufficiency who were treated with CA and EVLA between May 2020 and May 2021. The Venous Clinical Severity Score and Aberdeen Varicose Vein Questionnaire were used to assess clinical symptoms and quality of life, respectively. Total closure rates and procedure-related adverse events were also recorded in both groups. RESULTS: There was no significant difference between patients treated with CA or EVLA in terms of demographic and clinical characteristics. The average procedure time was 17 min in the CA group and 35 min in the EVLA group (p < 0.001). The CA group had lower pain scores during the procedure and 3 days afterward than the EVLA group (p < 0.001). At month 12, the CA group had a 90.4% closure rate, while the EVLA group had an 83.0% closure rate, with no significant difference between the two groups (p > 0.05). There was no significant difference in the Venous Clinical Severity Score or Aberdeen Varicose Vein Questionnaire score between the groups (p > 0.05). During follow-up, neither group experienced any significant adverse events, such as pulmonary embolism or deep venous thrombosis. The incidence of ecchymosis and paresthesia was significantly lower in the CA group than in the EVLA group (p < 0.05). CONCLUSIONS: Cyanoacrylate ablation has a high feasibility profile and is an effective approach to accomplish complete GSV target vein closure at early follow-up in the Chinese patients. Compared to EVLA, the improvement in quality-of-life outcomes is also sustained and similar, with less pain and fewer complications due to the absence of tumescence anesthesia and postprocedural compression stockings.


Assuntos
Terapia a Laser , Varizes , Insuficiência Venosa , Humanos , Cianoacrilatos , Veia Safena/cirurgia , Insuficiência Venosa/cirurgia , Adesivos , Estudos Retrospectivos , Qualidade de Vida , População do Leste Asiático , Resultado do Tratamento , Terapia a Laser/métodos , Varizes/cirurgia , Dor/etiologia
7.
Vascular ; 31(5): 981-988, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35466837

RESUMO

BACKGROUND: To retrospectively analyze the short-term outcomes of catheter-based versus direct foam sclerotherapy when combined with high ligation (HL) for the treatment of great saphenous vein (GSV) incompetence. METHODS: From July 2018 to October 2019, a total of 82 lower limbs of 70 patients with GSV incompetence received HL combined with catheter-based foam sclerotherapy (CFS group) or direct foam sclerotherapy (DFS group) for GSV proximal trunk. Among them, 40 limbs of 36 patients were treated with CFS, and 42 limbs of 34 patients were treated with DFS. The occlusion of GSV proximal trunk was evaluated with venous duplex ultrasound examinations; Venous Clinical Severity Scores (VCSS) was used to assess clinical improvement; Aberdeen Varicose Veins Questionnaire (AVVQ) was used to assess quality-of-life scores; and Complications was used for the safety evaluation. RESULTS: At day 7 post-operatively, complete occlusion of proximal trunk of the GSV was achieved in 92.5% legs of the CFS group and 71.4% of the DFS group (p = 0.014). Additionally, anterograde flow was found in 7.5% legs of the CFS group and 26.2% of the DFS group (p = 0.025). No significant differences in the occurrence of complications were observed between the two groups. The median follow-up was 285.5 days in the DFS group and 318 days in the CFS group (p = 0.140). VCSS and AVVQ reduction were significant in both CFS group and DFS group (5.3 ± 2.5, 5.5 ± 2.4, p < 0.001 for VCSS; 15.9 ± 8.0, 16.3 ± 8.6, p < 0.001 for AVVQ), but no significant difference were observed between two groups (p = 0.655 for VCSS, p = 0.934 for AVVQ). CONCLUSIONS: Although the occlusion of great saphenous vein proximal trunk were different, two modalities result in similar clinical and quality-of-life improvements. DFS is a feasible alternative to CFS when combined with HL.


Assuntos
Varizes , Insuficiência Venosa , Humanos , Escleroterapia/efeitos adversos , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Varizes/diagnóstico por imagem , Varizes/terapia , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/terapia , Insuficiência Venosa/etiologia
8.
J Vasc Surg Venous Lymphat Disord ; 11(1): 52-60, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35961631

RESUMO

BACKGROUND: Recurrent events after a first symptomatic deep venous thrombosis (DVT) are relatively frequent, but little is known about contralateral recurrent DVT (RDVT). METHODS: We retrospectively reviewed the medical records of patients with a first symptomatic lower extremity DVT between January 2017 and April 2021. The incidence, demographics, risk factors, and prognosis of RDVT were analyzed, with differences compared between patients with contralateral RDVT and those with ipsilateral RDVT. RESULTS: In 570 consecutive patients with DVT, 28 patients (4.91%) developed contralateral RDVT, and 49 patients (8.60%) developed ipsilateral RDVT during a mean follow-up of 27.62 ± 14.84 months. Contralateral RDVT was more frequently found in the right lower extremity, whereas ipsilateral RDVT had more left lower extremity involvement. The median follow-up was 12 months until ipsilateral RDVT and 26.5 months until contralateral RDVT. In multivariate Cox analysis, inherited thrombophilia, stent extension with 50% to 100% coverage, autoimmune disease and anticoagulation noncompliance were identified as risk factors for contralateral RDVT. During follow-up, 5 patients (17.86%) with contralateral RDVT and 10 patients (20.41%) with ipsilateral RDVT died (P > .05), with 12 of 15 dying of an underlying malignancy. CONCLUSIONS: The incidence of contralateral RDVT after a first symptomatic DVT is relatively low, and contralateral DVT is strongly associated with stent extension with 50% to 100% coverage, autoimmune disease, anticoagulation noncompliance, and inherited thrombophilia. Compared with ipsilateral RDVT, contralateral RDVT occurs later and is more often in the right lower extremity. Survival following contralateral RDVT is similar to survival following ipsilateral RDVT, with underlying malignancy being the leading cause of death.


Assuntos
Doenças Autoimunes , Trombofilia , Trombose Venosa , Humanos , Incidência , Estudos Retrospectivos , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/epidemiologia , Trombose Venosa/terapia , Fatores de Risco , Extremidade Inferior , Prognóstico , Anticoagulantes/uso terapêutico , Doenças Autoimunes/complicações
9.
BMC Plant Biol ; 22(1): 512, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36324083

RESUMO

BACKGROUND: Calcineurin B-like proteins (CBLs) are ubiquitous Ca2+ sensors that mediate plant responses to various stress and developmental processes by interacting with CBL-interacting protein kinases (CIPKs). CBLs and CIPKs play essential roles in acclimatization of crop plants. However, evolution of these two gene families in the genus Medicago is poorly understood. RESULTS: A total of 68 CBL and 135 CIPK genes have been identified in five genomes from Medicago. Among these genomes, the gene number of CBLs and CIPKs shows no significant difference at the haploid genome level. Phylogenetic and comprehensive characteristic analyses reveal that CBLs and CIPKs are classified into four clades respectively, which is validated by distribution of conserved motifs. The synteny analysis indicates that the whole genome duplication events (WGDs) have contributed to the expansion of both families. Expression analysis demonstrates that two MsCBLs and three MsCIPKs are specifically expressed in roots, mature leaves, developing flowers and nitrogen fixing nodules of Medicago sativa spp. sativa, the widely grown tetraploid species. In particular, the expression of these five genes was highly up-regulated in roots when exposed to salt and drought stress, indicating crucial roles in stress responses. CONCLUSIONS: Our study leads to a comprehensive understanding of evolution of CBL and CIPK gene families in Medicago, but also provides a rich resource to further address the functions of CBL-CIPK complexes in cultivated species and their closely related wild relatives.


Assuntos
Secas , Proteínas de Plantas , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo , Medicago/metabolismo , Filogenia , Proteínas Serina-Treonina Quinases/genética , Cloreto de Sódio/metabolismo , Estresse Fisiológico/genética , Regulação da Expressão Gênica de Plantas , Proteínas de Ligação ao Cálcio/genética
10.
J Immunol Res ; 2022: 1993023, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35785035

RESUMO

Necroptosis is a form of programmed cell death that has recently been shown to be important in the progression of head and neck cancer (HNC). Noncoding RNAs (ncRNAs) are known to function in cell death and tumor formation. In this study, we focused on microRNAs (miRNA) that play roles in necroptosis and the progression of HNC. We collected miRNA expression data, related clinical data of patients with HNC, and miRNA data related to necroptosis. A prognostic multimiRNA molecular marker was generated based on differential expression analysis and univariate and multivariate Cox regression analyses. Target genes of the prognosis-related miRNAs were identified, and their functions were evaluated by Gene Ontology Enrichment Analysis to reveal the processes the miRNAs may be involved in. Eight potentially prognostic miRNAs were identified through differential expression analysis: miR-331-3p, miR-181d-5p, miR-181b-5p, miR-500a-3p, miR-425-5p, miR-181a-5p, miR-141-3p, and miR-200a-5p. Multivariate Cox regression identified the risk score as an independent prognostic factor (univariate Cox regression results: hazard ratio (HR): 2.2028, 95% confidence interval (CI): 1.2640-3.8388, P = 0.0053; multivariate Cox regression results: HR: 2.4168, 95% CI: 1.3743-4.2501, P = 0.0022). Survival curve analysis revealed that patients with a high risk score had a bad prognosis (P = 0.0109). A receiver operating characteristic curve showed that the model has a certain prediction ability. We identified 187 miRNA-related genes, which were enriched in "cell cycle" and "cellular senescence." In conclusion, this study identified eight novel miRNA markers for predicting the prognosis of patients with HNC and paved the way for future research on necroptosis-related genes.


Assuntos
Carcinoma , Neoplasias de Cabeça e Pescoço , MicroRNAs , Biomarcadores , Biologia Computacional , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/genética , Humanos , MicroRNAs/genética , Necroptose/genética
11.
J Laparoendosc Adv Surg Tech A ; 31(8): 931-936, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33021459

RESUMO

Background: Giant inguinal hernia (GIH) is a rare disease but it can cause serious complications, such as intestinal obstruction and strangulation. Few studies have explored surgical treatment with respect to the transabdominal preperitoneal (TAPP) approach or measures to reduce the occurrence of postoperative seroma. Purpose: To investigate the safety and efficacy of the TAPP approach with negative pressure drainage in GIHs. Methods: From January 2017 to December 2019, 32 patients who underwent TAPP procedures with negative pressure drainage for GIHs at our hospital were reviewed. Demographic information, surgical characteristics, and follow-up data were obtained. Results: The mean age of the patients was 66, and more than half of them had medical comorbidities. All GIHs were defined as Type 1 and were successfully repaired through the TAPP approach with negative pressure drainage. The mean operative time was 146 minutes (range 122-251). After surgery, the mean drainage time was 7 days (range 5-10 days), and the mean volume of drainage in each patient was 820 mL (range 655-1020 mL). Complications occurred in 3 cases. For 1 case, the inferior epigastric artery was injured during surgery. A seroma was observed in 1 patient, which occurred 2 days after removal of the drainage tube. Finally, 1 patient developed an umbilical puncture site infection, and the wound healed after changing the dressing. The mean follow-up was 13 months (range 1-32), and there was no recurrence or mesh infection during that time. Conclusion: TAPP is a safe and effective approach for treating Type 1 GIHs with low operative complications. Negative pressure drainage through the scrotum to the preperitoneal space may reduce the incidence of seroma. Recurrence of hernias was not observed, and chronic pain seldom occurred during the follow-up period in our study.


Assuntos
Hérnia Inguinal , Laparoscopia , Drenagem , Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Humanos , Masculino , Recidiva , Telas Cirúrgicas , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(43): e17078, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651835

RESUMO

To investigate the feasibility, efficacy, and safety of laparoscopic totally extraperitoneal (TEP) repair in patients with inguinal hernia accompanied by liver cirrhosis.Between October 2015 and May 2018, 17 patients with liver cirrhosis who underwent TEP repair were included in this study. The baseline characteristics, perioperative data, and recurrence were retrospectively reviewed.Seventeen patients with a mean duration of 18.23 ± 16.80 months were enrolled. All TEP repairs were successful without conversion to trans-abdominal pre-peritoneal (TAPP) surgery or open repair, but 4 patients had peritoneum rupture during dissection. The mean operation time was 54.23 ±â€Š10.51 minutes for unilateral hernia and 101.25 ±â€Š13.77 minutes for bilateral hernias. We found 2 cases with contralateral inguinal hernia and 2 cases with obturator hernia during surgery. The rate of complication was 17.65% (3/17), 2 of 3 cases were Child-Turcotte-Pugh C with large ascites. During a follow-up of 19.29 ±â€Š9.01 months, no patients had recurrence and chronic pain, but 2 patients died because of the progression of underlying liver disease.Early and elective inguinal hernia repair is feasible and effective for patients with liver cirrhosis. TEP is a feasible and safe repair option for cirrhotic patients in experienced hands.


Assuntos
Ascite/cirurgia , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Laparoscopia/métodos , Cirrose Hepática/cirurgia , Abdome/cirurgia , Adulto , Idoso , Ascite/complicações , Conversão para Cirurgia Aberta/estatística & dados numéricos , Estudos de Viabilidade , Feminino , Hérnia Inguinal/etiologia , Herniorrafia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Peritônio/cirurgia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
13.
Medicine (Baltimore) ; 98(31): e16585, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374026

RESUMO

RATIONALE: Hypercoagulability can lead to thromboembolic events that are a life-threatening complication of nephrotic syndrome (NS). Conventional anticoagulants are first-line treatment in the presence of demonstrated thrombosis in NS. Direct-acting oral anticoagulants (DOACs) have provided useful alternatives for the prevention and treatment of thromboembolic events. PATIENT CONCERNS: A 59-year-old male developed lower limbs deep vein thrombosis (DVT) during the early course of NS but presented poor response to oral therapeutic doses of rivaroxaban. The decision was made to switch from rivaroxaban to heparin and subsequently bridged to warfarin. The patient presented significant clinical symptom improvement. DIAGNOSIS: NS with Lower limbs DVT. INTERVENTIONS: Rivaroxaban was discontinued and switch to heparin and subsequently bridged to warfarin. OUTCOMES: Venography result of both lower limb vein showed the venous wall was smooth without obvious stenosis or obstruction. Edema of the patient's lower limbs gradually improved and disappeared. LESSONS: The existing published data on the application of DOACs in NS are limited. DOACs have an immediate anticoagulant effect and have demonstrated safety and efficacy and required no routine monitoring, however, application of these agents in NS likely requires further investigation before widespread adoption.


Assuntos
Anticoagulantes/uso terapêutico , Síndrome Nefrótica/complicações , Rivaroxabana/uso terapêutico , Trombose Venosa/tratamento farmacológico , Trombose Venosa/etiologia , Varfarina/uso terapêutico , Anticoagulantes/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/tratamento farmacológico , Rivaroxabana/administração & dosagem , Trombofilia/tratamento farmacológico , Trombofilia/etiologia , Varfarina/administração & dosagem
14.
J Food Sci Technol ; 56(7): 3195-3204, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31274887

RESUMO

Peanuts with fungal contamination may contain aflatoxin, a highly carcinogenic substance. We propose the use of hyperspectral imaging to quickly and noninvasively identify fungi-contaminated peanuts. The spectral data and spatial information of hyperspectral images were exploited to improve identification accuracy. In addition, successive projection was adopted to select the bands sensitive to fungal contamination. Furthermore, the joint sparse representation based classification (JSRC), which considers neighboring pixels as belonging to the same class, was adopted, and the support vector machine (SVM) classifier was used for comparison. Experimental results show that JSRC outperforms SVM regarding robustness against random noise and considering pixels at the edge of the peanut kernel. The classification accuracy of JSRC reached 99.2% and 98.8% at pixel scale, at least 98.4% and 96.8% at kernel scale for two peanut varieties, retrieving more accurate and consistent results than SVM. Moreover, fungi-contaminated peanuts were correctly marked in both learning and test images.

15.
Thorac Cardiovasc Surg ; 67(2): 120-124, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-29290081

RESUMO

BACKGROUND: Postoperative atrial fibrillation (POAF) is associated with increased morality rate, prolonged hospitalization, and reduced long-term survival after surgery. Thus, prediction of POAF is important to assess surgical risk and provide prophylaxis. METHODS: It was a prospective study of 207 consecutive patients who underwent a routine preoperative laboratory testing before thoracic surgery from October 2016 to May 2017. Comprehensive data were collected. Then stepwise multivariate logistic regression analysis was adopted to identify significant risk factors associated with POAF from various variables. RESULTS: As results, three variables as follows: male gender, open thoracotomy, and B-type natriuretic peptide (BNP) exceeding 59 pg/mL were considered as independent risk factors associated with POAF (p < 0.05). CONCLUSION: In patients undergoing noncardiac thoracic surgery, we found that an elevated preoperative BNP level (with the level of 59 pg/mL as a cutoff), male gender, and open-chest surgeries were significant risk factors for POAF. The identification of patients who are prone to develop POAF will provide prevention strategies to reduce this complication.


Assuntos
Fibrilação Atrial/etiologia , Peptídeo Natriurético Encefálico/sangue , Procedimentos Cirúrgicos Torácicos/efeitos adversos , Idoso , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Biomarcadores/sangue , Esofagectomia/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonectomia/efeitos adversos , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Cirurgia Torácica Vídeoassistida/efeitos adversos , Procedimentos Cirúrgicos Torácicos/métodos , Toracotomia/efeitos adversos , Resultado do Tratamento , Regulação para Cima
16.
J Vasc Surg Venous Lymphat Disord ; 6(6): 681-688, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30126796

RESUMO

OBJECTIVE: The objective of this study was to evaluate the feasibility, efficacy, and safety of catheter-directed thrombolysis (CDT) through an anterior tibial vein approach for acute extensive lower extremity deep venous thrombosis (DVT). METHODS: There were 125 consecutive patients with acute extensive lower extremity DVT who received CDT through an anterior tibial vein approach between October 2014 and June 2017. The patients with iliac vein compression syndrome were treated with balloon dilation and stent implantation after CDT. The thrombus score differences, limb circumference differences, venous patency, and complications were retrospectively analyzed. RESULTS: The anterior tibial vein approach was successfully achieved in 118 patients (94.40% [118/125]). The mean thrombolysis time was 5.28 ± 1.10 days, and the average dose of urokinase was 3,903,400 ± 766,900 IU. Metal stents were placed in 50 patients (42.37% [50/118]). There were 109 patients (92.37% [109/118]) who had successful lysis (grade II and grade III lysis); 31 patients (91.18% [31/34]) achieved grade III lysis (no residual thrombus) within 3 days of symptom onset. In contrast, only 33.96% (18/53) of those treated within 4 to 7 days and 9.68% (3/31) of those treated after 7 days achieved grade III lysis. Compared with findings before CDT, the limb circumference above and below the knee was significantly reduced (7.22 ± 2.54 cm vs 1.58 ± 0.75 cm and 5.14 ± 1.41 cm vs 1.19 ± 0.49 cm, respectively). The incidence of bleeding was 10.17% (12/118). Six patients had puncture site bleeding, and three patients suffered major bleeding. One puncture site infection and two catheter-directed infections were observed during treatment. Two patients had accidental anterior tibial artery injury and recovered without complications, and no nerve injury occurred. During a follow-up of 19.39 ± 7.47 months (6-32 months), femoral venous insufficiency and popliteal venous insufficiency were present in 21.65% (21/97) and 30.93% (30/97) of the patients. The overall patency and post-thrombotic syndrome rates were 83.51% (81/97) and 21.65% (21/97). CONCLUSIONS: CDT through an anterior tibial vein approach is a feasible, effective, and safe method for acute extensive lower extremity DVT patients. In addition, the anterior tibial vein approach can be an alternative to the traditional CDT approach.


Assuntos
Fibrinolíticos/administração & dosagem , Terapia Trombolítica/métodos , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Trombose Venosa/tratamento farmacológico , Adulto , Idoso , Estudos de Viabilidade , Feminino , Fibrinolíticos/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Síndrome Pós-Trombótica/etiologia , Recidiva , Estudos Retrospectivos , Terapia Trombolítica/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Ativador de Plasminogênio Tipo Uroquinase/efeitos adversos , Grau de Desobstrução Vascular , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/fisiopatologia , Adulto Jovem
17.
Ann Vasc Surg ; 50: 30-37, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29518514

RESUMO

BACKGROUND: To compare the clinical efficacy and safety of catheter-directed thrombolysis (CDT) using the anterior tibial vein approach (ATVA) and popliteal vein approach (PVA) for acute lower-extremity deep venous thrombosis (LEDVT). METHODS: From March 2014 to October 2015, 63 patients with unilateral acute extensive LEDVT were enrolled in this study: 36 patients received CDT via the PVA group, and 27 patients received CDT via the ATVA group. Limb circumference, thrombus score, complications, thrombolytic time, and the amount of thrombolytic agents administered were recorded. Postthrombotic syndrome (PTS) and venous insufficiency were assessed at 1 year after treatment. RESULTS: Thrombus scores were significantly decreased in both groups after CDT therapy (each P < 0.001). There was no significant difference in the detumescence and thrombolytic rates, thrombolytic times and administered amounts of thrombolytic agents between the 2 groups (each P > 0.050). The limb circumference difference below the knee in the ATVA group was lower than that in the PVA group (P = 0.029), and the ATVA resulted in fewer complications, especially sheath bleeding (P = 0.025). At the 1-year follow-up, popliteal venous insufficiency was present in 36.11% of the PVA group and 25.93% of the ATVA group (P = 0.390). In addition, PTS was observed in 13.89% of the PVA group compared with 7.41% of the ATVA group (P = 0.268). CONCLUSIONS: CDT is an effective and safe method for treating acute LEDVT. The ATVA is an effective and feasible approach for CDT with a lower incidence of complications than the PVA.


Assuntos
Cateterismo Periférico , Fibrinolíticos/administração & dosagem , Veia Poplítea , Terapia Trombolítica/métodos , Trombose Venosa/tratamento farmacológico , Adulto , Idoso , Estudos de Viabilidade , Feminino , Fibrinolíticos/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Veia Poplítea/diagnóstico por imagem , Veia Poplítea/fisiopatologia , Síndrome Pós-Trombótica/etiologia , Estudos Retrospectivos , Terapia Trombolítica/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Insuficiência Venosa/etiologia , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/fisiopatologia
18.
Food Chem ; 220: 393-399, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-27855916

RESUMO

It's well-known fungi-contaminated peanuts contain potent carcinogen. Efficiently identifying and separating the contaminated can help prevent aflatoxin entering in food chain. In this study, shortwave infrared (SWIR) hyperspectral images for identifying the prepared contaminated kernels. Feature selection method of analysis of variance (ANOVA) and feature extraction method of nonparametric weighted feature extraction (NWFE) were used to concentrate spectral information into a subspace where contaminated and healthy peanuts can have favorable separability. Then, peanut pixels were classified using SVM. Moreover, image segmentation method of region growing was applied to segment the image as kernel-scale patches and meanwhile to number the kernels. The result shows that pixel-wise classification accuracies are 99.13% for breed A, 96.72% for B and 99.73% for C in learning images, and are 96.32%, 94.2% and 97.51% in validation images. Contaminated peanuts were correctly marked as aberrant kernels in both learning images and validation images.


Assuntos
Aflatoxinas/análise , Arachis/química , Fungos/isolamento & purificação , Análise Espectral/métodos , Arachis/microbiologia
19.
J Thorac Dis ; 8(5): 894-900, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27162664

RESUMO

BACKGROUND: Non-small cell lung cancer (NSCLC) remains the most life-threatening cancer in the world. The aim of the current study was to investigate the value of miR-452 for the prognosis of patients with NSCLC. METHODS: Real-time quantitative PCR (qRT-PCR) was used to test the expression level of miR-452 in 161 paired clinical NSCLC tissues and their adjacent tissues. Survival curves were made and the log rank test was used to analyze the survival difference between both groups with higher and lower expression level of miR-452. Univariate and multivariate Cox regression analyses were finally used to determine the independent factors for overall survival (OS) and disease-free survival (DFS) times. RESULTS: The miR-452 expressions in tumor samples (n=161) were comparably lower than those in the adjacent tissues. miR-452 expression levels were significantly associated with tumor differentiation grade, tumor size and lymph nodes metastasis. Furthermore, Kaplan-Meier survival curves showed that patients with higher expression of miR-452 was confirmed to have more favorable OS (P=0.004) and DFS (P=0.026). Multivariate survival analysis verified that miR-452 expression level, as well as lymph nodes metastasis, was an independent predictor of both OS and DFS for NSCLC patients. CONCLUSIONS: Our study demonstrated that miR-452 functioned as a novel diagnostic biomarker and a promising prognostic predictor for NSCLC patients.

20.
J Thorac Dis ; 8(5): 966-76, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27162673

RESUMO

BACKGROUND: There is controversy regarding the impact of different depths of submucosal invasion on lymph node metastasis (LNM) and overall survival (OS). We evaluated the impact of depth of submucosal invasion on the presence of metastatic lymphadenopathy and survival in a Chinese population with esophageal squamous cell carcinoma (ESCC). METHODS: A total of 258 patients who underwent esophagectomy from November 2009 to March 2014 were studied. Demographics of patients, tumor characteristics, and surgical information were retrospectively collected through medical records. Submucosal invasion was equally categorized into inner one-third (sm1), middle one-third (sm2), and deep one-third (sm3) invasion by pathologists. The patients were observed at the outpatient department in accordance with appointed time and recurrence, and deaths were recorded. The median follow-up duration was 26 months and the deadline was April 2015. Cancer characteristics and its association with LNM and OS were analyzed. RESULTS: The study included 75 (29.1%) sm1, 73 (28.3%) sm2, and 110 (42.6%) sm3 patients, and the rates of LNM were 12% (9/75), 11% (8/73), and 20.9% (23/110), respectively. sm3 might be associated with regional LNM (univariate analysis, P=0.041). Tumor volume >1.856 cm(3) (P=0.022) and lymphovascular invasion (LVI) (P=0.004) predicted LNM using multivariate analysis. No significant differences in distant metastases were observed according to the depth of invasion. Only metastatic lymph nodes predicted OS (P<0.001) rather than the depth of invasion. CONCLUSIONS: Submucosal ESCC showed a substantial rate of LNM. In T1b ESCC, after adjusting for possible covariates, depth of invasion does not predict LNM or OS.

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