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1.
Zhonghua Er Ke Za Zhi ; 62(7): 681-685, 2024 Jul 02.
Artigo em Chinês | MEDLINE | ID: mdl-38955688

RESUMO

Objective: To evaluate the effectiveness and safety of treatment with Burosumab in pediatric X-linked hypophosphatemia (XLH) patients. Methods: In this retrospective case study, 4 children with pediatric XLH, who were treated with Burosumab in Beijing Children's Hospital, Capital Medical University and Shandong Provincial Hospital affiliated to Shandong First Medical University from July 2022 to December 2023, were selected as the study objects. We collected and analyzed their clinical characteristics, biochemical indicators, imaging results, and treatment. The children were followed up every 3 months until December 2023, and the clinical outcomes and adverse drug reactions after treatment were evaluated. Results: Of the 4 patients, 3 were males and 1 was female; they were aged 6.7, 2.9, 2.1, and 2.3 years, respectively. Three patients had previously received treatment with phosphate supplements and active vitamins, but their wadding gait and lower limb deformities did not improve significantly, neither did their imaging changes of active richets. The initial dose of Burosumab in the 4 patients was 0.8 mg/kg, administered subcutaneously every 2 weeks, with a treatment course of 0.8-1.3 years. The fasting serum phosphorus and tubular maximum reabsorption of phosphate/glomerular filtration rate (TmP/GFR) of the 4 patients before treatment were 0.72, 0.95, 0.81, 0.66 mmol/L and 0.67, 0.85, 0.87, 0.61 mmol/L, respectively. At the last follow-up, the fasting serum phosphorus and TmP/GFR levels were significantly increased (0.96, 1.09, 1.09, 0.90 mmol/L, and 0.85, 0.79, 1.03, 0.98 mmol/L, respectively). Among them, only the TmP/GFR level (1.17 mmol/L) in case 2 achieved normal values at 3 months post-therapy, while the rest did not reach the normal range for children of the same age. After treatment, the alkaline phosphatase levels of all patients gradually decreased (the values were 461, 240, 423, and 237 U/L, respectively), and the ALP levels in cases 2 and 4 returned to normal at the last visit. Case 4 showed a slight increase in parathyroid hormone (PTH) levels after 9 months of treatment, while the PTH levels in the rest 3 cases remained normal. Case 1 underwent a 6-minute walking test, and the walking distance increased from 245 m to 570 m. Abnormal gait, lower limb deformity, and the severity of rickets in the 4 patients had all improved. No adverse drug reactions such as nephrocalcinosis, local skin injection reaction, hyperphosphatemia, or vitamin D deficiency were observed. Conclusion: Burosumab can improve clinical symptoms in children with XLH with a good safety profile.


Assuntos
Anticorpos Monoclonais Humanizados , Raquitismo Hipofosfatêmico Familiar , Humanos , Masculino , Feminino , Raquitismo Hipofosfatêmico Familiar/tratamento farmacológico , Anticorpos Monoclonais Humanizados/efeitos adversos , Anticorpos Monoclonais Humanizados/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Criança , Estudos Retrospectivos , Pré-Escolar , Resultado do Tratamento
2.
Zhonghua Yu Fang Yi Xue Za Zhi ; 58(6): 799-805, 2024 Jun 06.
Artigo em Chinês | MEDLINE | ID: mdl-38955726

RESUMO

Objective: To explore the distribution of allergen-specific IgE (sIgE) for children with atopic dermatitis in Tianjin City and provide the evidences of clinical diagnosis and treatment. Methods: A retrospective cross-sectional study was conducted to analyze the children who were suspected of atopic dermatitis and tested for serum sIgE in the Tianjin Children's Hospital from March 2021 to February 2023. Using first detection results only, a total of 1 841 serum samples were tested for twenty common allergens. The method was the enzyme-linked immune capture assay. The allergen epidemiological characteristics were statistically analyzed by Chi square test based on the children's characteristics and factors such as different sexes, ages and seasons by the mass data. Results: Among the 1 841 cases, the results showed that 1 247 (67.73%) were sensitized to at least 1 allergen-sIgE, comprising to 49.86% (918/1 841) to food allergen-sIgE and 47.96% (883/1 841) to aeroallergen-sIgE. The top three food allergens-sIgE were egg 32.10% (591/1 841), milk 25.91% (477/1 841) and wheat flour 14.61% (269/1 841); the top three positive rates of aeroallergens-sIgE were house dust 24.33% (448/1 841), alternaria 20.59% (379/1 841) and dermatophagoides farinae 14.83% (273/1 841). The positive rates of food allergens-sIgE were the highest in the 1-3 years old group (64.11%, 434/677) (χ2=122.854, P<0.001), while the positive rates of aeroallergens-sIgE were higher in the 11-14 years old group (71.26%, 62/87) (χ2=134.968, P<0.001). No seasonal difference was revealed in the overall positive rate of food allergen-sIgE and aeroallergen-sIgE (χ2=4.047, P=0.256; χ2=7.549, P=0.056). The positive rates of soybean-sIgE and milk-sIgE were the highest in summer (χ2=11.329, P=0.010; χ2=28.720, P<0.001), whereas alternaria-sIgE and mugwort-sIgE were the highest in summer and autumn, respectively (χ2=8.462, P=0.037; χ2=10.641, P=0.014). Among the 1 841 cases, 32.21% were sensitized to three or more allergens-sIgE. The sIgE concentration levels of egg, milk and house dust were mainly level 1 to 2, and the proportions of level 3 and above were all under 15%; although the positive rates of crab, shrimp, and peanut were low, the proportions of grade 3 and above were all beyond 30%. Children sensitized to alternaria, dermatophagoides farinae, mugwort, and cat dander had higher sIgE concentration levels, which were 68.07%, 49.45%, 56.57% and 47.83% respectively. Conclusions: This study can reflect the epidemic characteristics of allergen-sIgE in children with atopic dermatitis in Tianjin region to a certain extent. Allergen-sIgE positivity in patients differed by age, and there were seasonal differences and grade distribution differences in the positive rates of some allergens-sIgE. It is necessary to reasonably avoid the high-risk allergens according to the epidemiological characteristics and clinical symptoms, which provide valuable information for the prevention, diagnosis and treatment of atopic dermatitis.


Assuntos
Alérgenos , Dermatite Atópica , Imunoglobulina E , Humanos , Dermatite Atópica/imunologia , Estudos Transversais , Alérgenos/imunologia , Criança , Estudos Retrospectivos , Imunoglobulina E/imunologia , Imunoglobulina E/sangue , Pré-Escolar , Masculino , Feminino , China , Adolescente , Lactente , Hipersensibilidade Alimentar/imunologia
3.
Zhonghua Yan Ke Za Zhi ; 60(7): 566-569, 2024 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-38955758

RESUMO

Fundus imaging plays a pivotal role in diagnosing retinal and choroidal diseases. Optical coherence tomography angiography (OCTA), by capturing signals to reconstruct vascular structures, offers a clear depiction of retinal vasculature with notable advantages such as rapid scanning and non-invasiveness. Although OCTA, due to its underlying principles, cannot dynamically assess vascular function, exploring its future applications and potential to eventually replace traditional fundus angiography remains a key focus in the medical community. OCTA provides multiple parameters that conventional fundus angiography cannot obtain. With the expanding coverage area of OCTA scans and improvements in artifact elimination, the detection rate of various retinal and choroidal diseases has significantly increased, making the widespread clinical application of OCTA an inevitable trend. Although ultra-widefield OCTA cannot yet fully replace angiography in clinical practice, with continued clinical practice, expanded clinical research, and ongoing technological innovation, OCTA is expected to gradually replace fundus angiography in the future.


Assuntos
Angiofluoresceinografia , Fundo de Olho , Doenças Retinianas , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Humanos , Angiofluoresceinografia/métodos , Doenças Retinianas/diagnóstico por imagem , Doenças da Coroide/diagnóstico por imagem , Vasos Retinianos/diagnóstico por imagem
4.
Public Health Action ; 14(2): 76-81, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38957503

RESUMO

OBJECTIVE: To identify individual-level early warning indicators of virologic failure in HIV patients receiving antiretroviral therapy (ART) in South Africa. DESIGN: A matched case-control study of individuals with and without virologic failure (VF) (>5 months on ART and HIV-1 plasma viral load >1,000 copies/mL) was conducted between June 2014 and June 2018. Of the 1,000 participants enrolled in the parent cohort, 96 experienced VF, and 199 additional controls were identified from the parent cohort and matched 1:2 (some matched 1:3) for sex, age, ART duration, and site. Participants were interviewed while clinical, pharmacy refill, laboratory, and objective pharmacological data were obtained. Multivariate conditional logistic regression models were constructed using model selection to identify factors associated with VF. Significant determinants of VF were identified using an alpha level of 0.05. RESULTS: In a full conditional model, higher cumulative ART adherence, quantified using tenofovir-diphosphate concentrations in dried blood spots (OR 0.26) and medication possession ratio (OR 0.98) were protective against VF, whereas an increase in total depression score (OR 1.20) was predictive of VF. CONCLUSION: This analysis demonstrates the importance of depression as a key individual-level early warning indicator of VF. Efforts to address mental health concerns among patients with people living with HIV could improve virologic suppression.


OBJECTIF: Identifier les indicateurs d'alerte précoce au niveau individuel de l'échec virologique chez les patients séropositifs recevant un traitement antirétroviral (TAR) en Afrique du Sud. MÉTHODE: Une étude cas-témoins appariée de personnes avec et sans échec virologique (FV, pour l'anglais « virologic failure ¼) (>5 mois sous ART et charge virale plasmatique du VIH-1 >1 000 copies/ml) a été menée entre juin 2014 et juin 2018. Sur les 1 000 participants inscrits dans la cohorte parente, 96 ont présenté une FV et 199 témoins supplémentaires ont été identifiés dans la cohorte parentale et appariés 1:2 (certains appariés 1:3) pour le sexe, l'âge, la durée du TAR et le site. Les participants ont été interrogés pendant que des données cliniques, de renouvellement de pharmacie, de laboratoire et pharmacologiques objectives ont été obtenues. Des modèles de régression logistique conditionnelle multivariée ont été construits à l'aide d'une sélection de modèles pour identifier les facteurs associés à la FV. Les déterminants significatifs de la FV ont été identifiés à l'aide d'un niveau alpha de 0,05. RÉSULTATS: Dans un modèle conditionnel complet, une observance cumulative plus élevée du TAR, quantifiée à l'aide des concentrations de ténofovir-diphosphate dans les gouttes de sang séché (OR 0,26) et du ratio de possession de médicaments (OR 0,98) protégeait contre la FV, tandis qu'une augmentation du score de dépression totale (OR 1,20) était prédictive de la FV. CONCLUSION: Cette analyse démontre l'importance de la dépression en tant qu'indicateur précoce clé au niveau individuel de la FV. Les efforts visant à résoudre les problèmes de santé mentale chez les personnes vivant avec le VIH pourraient améliorer la suppression virologique.

6.
Zhonghua Xue Ye Xue Za Zhi ; 45(4): 391-395, 2024 Apr 14.
Artigo em Chinês | MEDLINE | ID: mdl-38951069

RESUMO

The aim of this study was to investigate the effects of polyphyllin Ⅶ (PP Ⅶ) on proliferation, apoptosis, and cell cycle of diffuse large B-cell lymphoma (PLBCL) cell lines U2932 and SUDHL-4. The DLBCL cell lines were divided into a control group and a PPⅦ group, and experiments were conducted using MTT assay, flow cytometry, and Western blotting.Results showed that compared with the control group, PPⅦ significantly inhibited the proliferation of U2932 and SUDHL-4 cells (P<0.05). Apoptosis assays demonstrated that treatment with 0.50 and 1.00 µmol/L PP Ⅶ significantly increased the apoptosis rates of both cell lines (P<0.05), upregulated apoptosis-related proteins, and downregulated Bcl-2 protein level (P<0.05). Cell cycle analysis revealed that PPⅦ treatment led to an increase in G0/G1-phase cells (P<0.05) and a decrease in G2/M-phase cells (P<0.05), significantly downregulated cyclin D1, CDK4, CDK6, and survivin protein expression (P<0.05). In conclusion, PPⅦ exerted anti-lymphoma effects by inhibiting proliferation, promoting apoptosis, and inducing G0/G1 phase arrest in DLBCL cells.


Assuntos
Apoptose , Ciclo Celular , Proliferação de Células , Linfoma Difuso de Grandes Células B , Humanos , Linfoma Difuso de Grandes Células B/metabolismo , Apoptose/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Linhagem Celular Tumoral , Ciclo Celular/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Diosgenina/farmacologia , Diosgenina/análogos & derivados , Ciclina D1/metabolismo , Quinase 4 Dependente de Ciclina/metabolismo
8.
Zhonghua Gan Zang Bing Za Zhi ; 32(6): 525-531, 2024 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-38964895

RESUMO

Objective: This study aims to compare the antiviral treatment similarities and differences in the population covered by the 2024 version of the World Health Organization's (WHO) hepatitis B prevention and treatment guidelines and the current Chinese hepatitis B prevention and treatment guidelines, so as to explore their impact on the indications for antiviral therapy in Chinese patients with chronic hepatitis B (CHB). Methods: The information of patients with chronic hepatitis B virus infection who did not receive antiviral treatment was collected through the registration database of the China Clinical Research Platform for Hepatitis B Elimination. Descriptive statistics were conducted on the demographic, blood, biochemical, and virological levels of patients according to the treatment recommendations of the two versions of the guidelines. The Mann-Whitney U test and χ2 test were used to compare the differences and proportional distribution of the treatment populations covered by the two guidelines. The χ2 test was used to analyze the coverage rate of different antiviral treatment indications. Results: A total of 21,134 CHB patients without antiviral treatment were enrolled. 69.4% of patients met the 2024 versions of the WHO guidelines' recommendations. 85.0% of patients met the current Chinese hepatitis B prevention and treatment guidelines. The WHO guidelines for antiviral therapy indications were met in younger patients with higher levels of ALT, AST, and APRI scores, as well as greater proportion of patients with higher viral loads (P<0.001). The WHO guidelines recommended a cut-off value of APRI>0.5, which raised the proportion of patients on antiviral therapy from 6.6% to 30.9%. 45.7% of patients met the antiviral indications for HBV DNA >2000 IU/ml with abnormal transaminase (ALT>30 U/L for males and ALT>19 U/L for females). The reduced APRI diagnostic cut-off value and ALT treatment threshold had further increased the treatment coverage rate by 91.6% in patients with chronic HBV infection in line with the 2024 versions of WHO guidelines. Conclusion: The reduction of the APRI diagnostic cut-off value and the ALT treatment threshold, based on the current hepatitis B guidelines of China, will further improve the treatment coverage of CHB patients.


Assuntos
Antivirais , Hepatite B Crônica , Guias de Prática Clínica como Assunto , Organização Mundial da Saúde , Humanos , Antivirais/uso terapêutico , Hepatite B Crônica/tratamento farmacológico , Adulto , Feminino , Masculino , China/epidemiologia , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Idoso , População do Leste Asiático
9.
Artigo em Chinês | MEDLINE | ID: mdl-38964911

RESUMO

Objective: To establish collection methods and laboratory testing methods for qualitative and quantitative analysis of 9 typical active pharmaceutical ingredient in the workplace air. Methods: In December 2021, a mixed solution of nine analytes was prepared and then dispersed in aerosol state to simulate sampling. Glass fiber filter membrane was selected as air collector and collected active pharmaceutical ingredient in the air at a rate of 2.0 L/min for 15 minutes. Then, the obtained filter membrane samples were eluted with 25%ACN/75%MeOH. Finally, the eluent was qualitatively and quantitatively analyzed with liquid chromatography-triple quadrupole mass spectrometer. Results: This method could effectively collect active pharmaceutical ingredient in the air, with an average sampling efficiency of more than 98.5%. The linear correlation coefficient r was greater than 0.9990. The lower limit of quantification for each analyte ranged from 0.6~500.0 ng/ml, and the average recovery rate ranged from 97.6%~102.5%. Conclusion: This method could simultaneously collect 9 active pharmaceutical ingredient in the workplace air, and could provide accurate qualitative and quantitative analysis in subsequent laboratory tests.


Assuntos
Poluentes Ocupacionais do Ar , Monitoramento Ambiental , Local de Trabalho , Poluentes Ocupacionais do Ar/análise , Monitoramento Ambiental/métodos , Preparações Farmacêuticas/análise , Cromatografia Líquida/métodos , Exposição Ocupacional/análise
10.
Zhonghua Yi Xue Za Zhi ; 104(27): 2556-2562, 2024 Jul 16.
Artigo em Chinês | MEDLINE | ID: mdl-38978381

RESUMO

Objective: To investigate the clinical features of septic shock in children with hematological malignancies compared with those without malignant tumor in the pediatric intensive care unit (PICU). Methods: This retrospective study enrolled children with septic shock at the PICU of Capital Institute of Pediatrics' Children's Hospital from June 2015 to July 2022. According to the presence of hematological malignancies, patients were divided into the hematological malignancies group and without malignant tumor group. Clinical data were compared between the two groups, and logistic regression analysis was used to identify related factors for mortality. Results: A total of 164 children (97 males and 67 females) with a median age of 3.6 (interquartile range 0.8, 7.8) years were enrolled, including 75 (45.7%) patients with hematological malignancies and 89 (54.3%) patients without malignant tumors. Patients in the hematological malignancies group were older [6.0(3.6, 9.4) years vs 1.2 (0.4, 4.3) years, P<0.001] and more experienced hospital-acquired infections [48.0%(36/75) vs 21.3%(19/89),P=0.001], compared with patients without malignant tumors. Surgical emergencies were more frequent in patients without malignant tumors (32.6% vs 14.7%, P=0.013). Patients with hematological malignancies mainly had blood stream infections (58.7%), with Gram-negative bacilli (46.7%), meanwhile, patients without malignant tumors more experienced Gram-positive cocci infections (22.5%) of the respiratory system (40.4%) or digestive system (28.1%). There were significant differences regarding the infection sites (P<0.001) and pathogens (P=0.001). The types of antibacterial agents (P<0.001) and the frequency of noradrenaline (P=0.013) used in patients with hematological malignancies were significantly higher than those without malignant tumors. Patients with hematological malignancies had a higher incidence of multiple organ dysfunction (MODS) [100.0%(75/75) vs 80.9%(72/89), P<0.001] and higher 28-day mortality [34.8%(23/66) vs 19.0%(15/79),P=0.048]. Multivariate logistic regression analysis showed that Pediatric Critical Illness Score (PCIS) was an independent factor for death (odds ratio, OR=1.387, 95%CI: 1.161-1.657, P<0.001) in patients with hematological malignancies, and PCIS (OR=1.419, 95%CI: 1.140-1.767, P=0.002) and the 6-hour lactate clearance rate (OR=65.857, 95%CI: 2.953-1 468.638, P=0.008) were independent factors for death in patients without malignant tumors. Conclusions: Children with hematological malignancies were older, more frequently experienced bloodstream infections, and had a higher incidence of MODS and higher 28-day mortality. PCIS is related to poor prognosis of septic shock in children.


Assuntos
Neoplasias Hematológicas , Choque Séptico , Humanos , Masculino , Feminino , Estudos Retrospectivos , Criança , Pré-Escolar , Neoplasias Hematológicas/complicações , Lactente , Unidades de Terapia Intensiva Pediátrica , Modelos Logísticos
11.
Artigo em Chinês | MEDLINE | ID: mdl-38965848

RESUMO

Objective: To evaluate the predictive efficacy of sinus CT radiomics for treatment outcomes in nasal polyp patients undergoing endoscopic sinus surgery. Methods: A retrospective cohort study was conducted at the First Affiliated Hospital of Sun Yat-sen University, including 194 patients with nasal polyps treated between January 2015 and December 2019. The cohort comprised 132 males and 62 females, aged 16 to 75 years. Patients were divided into a training set (n=135) and an internal validation set (n=59). An external validation set (n=34), consisting of 22 males and 12 females aged 16 to 59 years, was included from January 2020 to December 2021. Disease control was evaluated using the criteria from the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020). Radiomic features were extracted from sinus CT images and analyzed using the least absolute shrinkage and selection operator (LASSO) regression. Models combining radiomic and clinical features were developed to predict treatment efficacy. Results: The radiomics and combined models, based on four selected features, outperformed the clinical feature model in the training set, with AUC values of 0.901 and 0.915, versus 0.874, respectively. In the internal validation set, AUCs were 0.839, 0.832, and 0.716. Despite reduced AUCs in the external set, the radiomics model maintained good generalizability (0.748, 0.764, 0.620). Decision curve analysis showed significant clinical benefits in both radiomics and combined models. Conclusion: The CT-based radiomics model demonstrates significant predictive power in identifying refractory nasal polyps, suggesting its potential for clinical application in treatment outcome prediction.


Assuntos
Pólipos Nasais , Tomografia Computadorizada por Raios X , Humanos , Masculino , Feminino , Pólipos Nasais/diagnóstico por imagem , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto , Tomografia Computadorizada por Raios X/métodos , Adolescente , Idoso , Resultado do Tratamento , Adulto Jovem , Endoscopia/métodos , Sinusite/diagnóstico por imagem , Radiômica
12.
Nan Fang Yi Ke Da Xue Xue Bao ; 44(5): 810-817, 2024 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-38862438

RESUMO

OBJECTIVE: To explore the neuroprotective effect of coenzyme Q10 and its possible mechanism in mice with chronic restraint stress (CRS). METHODS: Mouse models of CRS were treated with intraperitoneal injections of coenzyme Q10 at low, moderate and high doses (50, 100 and 200 mg/kg, respectively, n=8), VX765 (a caspase-1 specific inhibitor, 50 mg/kg, n=8), or fluoxetine (10 mg/kg, n=8) on a daily basis for 4 weeks, and the changes in depression-like behaviors of the mice were assessed by sugar water preference test, forced swimming test and tail suspension test. The expression of glial fibrillary acidic protein (GFAP) in the hippocampus of the mice was detected using immunohistochemistry, and the number of synaptic spines was determined with Golgi staining. Western blotting was performed to detect the changes in the expressions of GFAP and pyroptosis-related proteins in the hippocampus, and the colocalization of neurons and caspase-1 p10 was examined with immunofluorescence assay. RESULTS: Compared with the normal control mice, the mouse models of CRS showed significantly reduced sugar water preference and increased immobility time in forced swimming and tail suspension tests (P < 0.05), and these depression-like behaviors were obviously improved by treatment with coenzyme Q10, VX765 or FLX. The mouse models showed a significantly decreased positive rate of GFAP and lowered GFAP protein expression in the hippocampus with obviously decreased synaptic spines, enhanced expressions of GSDMD-N, caspase-1 and IL-1ß, and increased colocalization of neurons and caspase-1 p10 (all P < 0.05). All these changes were significantly ameliorated in the mouse models after treatment with Q10. CONCLUSION: Coenzyme Q10 can alleviate depression-like behaviors in mice with CRS by down-regulating the pyroptosis signaling pathway.


Assuntos
Depressão , Modelos Animais de Doenças , Hipocampo , Piroptose , Restrição Física , Transdução de Sinais , Estresse Psicológico , Ubiquinona , Animais , Camundongos , Piroptose/efeitos dos fármacos , Depressão/tratamento farmacológico , Depressão/etiologia , Depressão/metabolismo , Ubiquinona/análogos & derivados , Ubiquinona/farmacologia , Ubiquinona/uso terapêutico , Hipocampo/metabolismo , Hipocampo/efeitos dos fármacos , Transdução de Sinais/efeitos dos fármacos , Estresse Psicológico/tratamento farmacológico , Regulação para Baixo/efeitos dos fármacos , Caspase 1/metabolismo , Proteína Glial Fibrilar Ácida/metabolismo , Comportamento Animal/efeitos dos fármacos , Masculino , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 45(6): 802-808, 2024 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-38889979

RESUMO

Objective: To explore the association between triglyceride glucose index (TyG)- waist to height ratio (WHtR)(TyG-WHtR) and cognitive impairment in middle-aged and elderly population. Methods: A cohort database was constructed using the data from the China Health and Retirement Longitudinal Study, with 8 946 participants in 2011 and 2015 as the baseline population. Cox proportional hazards regression models were used to estimate the association between TyG-WHtR levels at baseline and the risk of cognitive impairment in middle-aged and elderly population. The analysis was stratified by age and gender, respectively. Results: A total of 8 946 participants were included, with an average follow-up of 7.08 person-years and incidence density of cognitive impairment for 21.15 per 1 000 person-years. Compared with the Q1 level of TyG-WHtR, its Q3 and Q4 level increased the risk of cognitive impairment by 32% (HR=1.32, 95%CI: 1.09-1.60) and 47% (HR=1.47, 95%CI: 1.14-1.91), respectively. Trend test showed that the risk of cognitive impairment increased with the increase of TyG-WHtR level, and there was a dose-response relationship (P=0.001). Stratified analysis showed that in the population aged 45-59 years, compared with the Q1 level of TyG-WHtR, its Q3 level increased the risk of cognitive impairment by 34% (HR=1.34, 95%CI: 1.02-1.78). In the population aged 60 years and above, compared with the Q1 level, its Q3 and Q4 level increased the risk of cognitive impairment by 31% (HR=1.31, 95%CI: 1.01-1.72) and 63% (HR=1.63, 95%CI: 1.15-2.31), respectively. In the male group, there was no significant association between TyG-WHtR level and the risk of cognitive impairment (P>0.05). In the female group, compared with the Q1 level of TyG-WHtR, its Q4 level increased the risk of cognitive impairment by 76% (HR=1.76, 95%CI: 1.26-2.46). Conclusions: Middle-aged and elderly population with a higher TyG-WHtR level may increase the risk of cognitive impairment, and there were age and sex differences. Early cardiovascular health management and scientific and reasonable weight management are of great significance to preventing cognitive impairment.


Assuntos
Disfunção Cognitiva , Triglicerídeos , Humanos , China/epidemiologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/sangue , Pessoa de Meia-Idade , Idoso , Feminino , Masculino , Triglicerídeos/sangue , Estudos Longitudinais , Fatores de Risco , Estudos de Coortes , Razão Cintura-Estatura , Glicemia/análise , Modelos de Riscos Proporcionais
14.
Zhonghua Wei Chang Wai Ke Za Zhi ; 27(6): 579-582, 2024 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-38901990

RESUMO

Total mesorectal excision is the standard procedure for the treatment of low and medium rectal cancer. Anastomotic leakage has always been one of the serious complications in these patients. Blood supply, tension and intestinal condition are important factors affecting anastomotic quality. How to optimize the surgical technique and reduce the occurrence of anastomotic leakage is the goal of surgeons. Based on traditional total mesorectal excision, we integrated several surgical techniques, including (1) Preserving the left colic artery; (2) High ligation of the inferior mesenteric vein; (3) Patterned mobilization of the spleen flexure and left transverse colon; (4) Multi-plane mesocolic tailoring; (5) Selective anastomosis suturing, and proposed the concept of multi-technique integrated total mesorectal resection (MTI-TME). The application of MTI-TME in clinical practice and significance was discussed.


Assuntos
Anastomose Cirúrgica , Neoplasias Retais , Humanos , Neoplasias Retais/cirurgia , Anastomose Cirúrgica/métodos , Fístula Anastomótica/prevenção & controle , Reto/cirurgia
15.
Tech Coloproctol ; 28(1): 64, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844577

RESUMO

BACKGROUND: This study aimed to investigate the safety and feasibility of indocyanine green near-infrared fluorescence (ICG-NIR) fluorescence-guided video-endoscopic inguinal lymphadenectomy (VEIL) for rectal cancer with inguinal lymph node metastasis (ILNM). METHODS: A retrospective analysis was conducted on 11 patients with rectal cancer who underwent ICG-NIR fluorescence-guided VEIL, assessing various parameters such as operation time, intraoperative bleeding, number of harvested lymph nodes, intraoperative and postoperative complications, and follow-up. RESULTS: Regarding surgical procedures for ILNM, unilateral surgery was performed in 7 cases (54.5%) and bilateral surgery in 4 cases (45.5%). Among these 15 ICG-NIR-guided VEIL surgeries in 11 patients, positive fluorescence visualization was achieved in 13 operations (86.7%). The median estimated blood loss was 10 ml, and the median operation time was 90 min. One case (6.7%) required conversion to open surgery. The median duration of the drain tube was 12 days, and the median length of postoperative hospital stay was 20 days. Postoperative complications were observed, including incisional infection in 2 cases (18.2%), lymphatic leakage in 5 cases (45.5%), urinary infection in 1 case (9.1%), and pneumonia in 3 cases (27.3%). Complications such as skin necrosis, lower limb venous thrombosis, lower limb swelling, or impaired movement were observed during the postoperative follow-up period. No cases of primary lesion, groin, or pelvic lymph node recurrence were observed. CONCLUSION: ICG-NIR fluorescence-guided VEIL is a safe and feasible surgical treatment for rectal cancer with ILNM. ICG fluorescence guidance holds promise as a more personalized and precise approach for VEIL in rectal cancer surgery.


Assuntos
Estudos de Viabilidade , Verde de Indocianina , Canal Inguinal , Excisão de Linfonodo , Metástase Linfática , Duração da Cirurgia , Neoplasias Retais , Cirurgia Vídeoassistida , Humanos , Neoplasias Retais/cirurgia , Neoplasias Retais/patologia , Masculino , Excisão de Linfonodo/métodos , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Cirurgia Vídeoassistida/métodos , Canal Inguinal/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Linfonodos/patologia , Linfonodos/cirurgia , Linfonodos/diagnóstico por imagem , Corantes , Fluorescência
16.
Nan Fang Yi Ke Da Xue Xue Bao ; 44(5): 876-884, 2024 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-38862445

RESUMO

OBJECTIVE: To investigate the mechanisms that mediate the neuroprotective effect of the intestinal microbial metabolite sodium butyrate (NaB) in a mouse model of Parkinson's disease (PD) via the gut-brain axis. METHODS: Thirty-nine 7-week-old male C57BL/6J mice were randomized equally into control group, PD model group, and NaB treatment group. In the latter two groups, PD models were established by intraperitoneal injection of 30 mg/kg 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) once daily for 5 consecutive days, and normal saline was injected in the control group. After modeling, the mice received daily gavage of NaB (300 mg/kg) or an equal volume of saline for 14 days. Behavioral tests were carried out to assess the changes in motor function of the mice, and Western blotting was performed to detect the expressions of tyrosine hydroxylase (TH) and α-synuclein (α-syn) in the striatum and nuclear factor-κB (NF-κB), tumor necrosis factor (TNF-α), interleukin 6 (IL-6), and the tight junction proteins ZO-1, Occludin, and Claudinin the colon. HE staining was used to observe inflammatory cell infiltration in the colon of the mice. RNA sequencing analysis was performed to identify the differentially expressed genes in mouse colon tissues, and their expressions were verified using qRT-PCR and Western blotting. RESULTS: The mouse models of PD with NaB treatment showed significantly increased movement speed and pulling strength of the limbs with obviously upregulated expressions of TH, Occludin, and Claudin and downregulated expressions of α-syn, NF-κB, TNF-α, and IL-6 (all P < 0.05). HE staining showed that NaB treatment significantly ameliorated inflammatory cell infiltration in the colon of the PD mice. RNA sequencing suggested that Bmal1 gene probably mediated the neuroprotective effect of NaB in PD mice (P < 0.05). CONCLUSION: NaB can improve motor dysfunction, reduce dopaminergic neuron loss in the striatum, and ameliorate colonic inflammation in PD mice possibly through a mechanism involving Bmal1.


Assuntos
Ácido Butírico , Modelos Animais de Doenças , Camundongos Endogâmicos C57BL , Fármacos Neuroprotetores , Doença de Parkinson , Animais , Camundongos , Ácido Butírico/farmacologia , Ácido Butírico/uso terapêutico , Masculino , Fármacos Neuroprotetores/farmacologia , Fármacos Neuroprotetores/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Doença de Parkinson/metabolismo , alfa-Sinucleína/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , NF-kappa B/metabolismo , Interleucina-6/metabolismo , Tirosina 3-Mono-Oxigenase/metabolismo , Tirosina 3-Mono-Oxigenase/genética , 1-Metil-4-Fenil-1,2,3,6-Tetra-Hidropiridina , Corpo Estriado/metabolismo , Ocludina/metabolismo , Ocludina/genética , Eixo Encéfalo-Intestino
17.
Zhonghua Bing Li Xue Za Zhi ; 53(6): 541-545, 2024 Jun 08.
Artigo em Chinês | MEDLINE | ID: mdl-38825897

RESUMO

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of pseudocarcinomatous hyperplasia of the fallopian tubes. Methods: Sixteen cases of pseudocarcinomatous hyperplasia of the fallopian tubes diagnosed at Obstetrics and Gynecology Hospital of Fudan University from January 2011 to January 2024 were collected.The pathological sections were reviewed, the clinical and pathological data were consulted, and immunohistochemical examination was conducted along with follow-up. Results: The patients were aged from 19 to 57 years, with an average age of 41 and a median age of 38. Among the 16 cases, 4 were located in the right fallopian tubes, 6 in the left fallopian tubes, while the remaining cases presented bilaterally. The general manifestations were tubal edema, crispness and purulent secretion in the lumen. Morphologically, the fallopian tube mucosa exhibited a significant infiltration of neutrophils, lymphocytes and plasma cells. The epithelial cells of the fallopian tube displayed evident proliferation, stratification and disorganized arrangement leading to formation of small glandular cavity with back-to-back, fissure-like and sieve-like structures. Immunohistochemical analysis revealed positivity for CK7 and WT1, along with wild-type p53 expression, Ki-67 index ranged from 5% to 20%. During the follow-up period ranging from 1 to 156 months, all the patients remained free of disease. Conclusions: Pseudocarcinomatous hyperplasia of the fallopian tube is a rare non-neoplastic lesion, which can lead to epithelial hyperplasia and atypical hyperplasia. The most important significance of recognizing this lesion lies in avoiding misdiagnosis of fallopian tube cancer during intraoperative and postoperative pathological examination. This ensures that clinicians can administer correct clinical interventions.


Assuntos
Tubas Uterinas , Hiperplasia , Humanos , Feminino , Adulto , Hiperplasia/patologia , Pessoa de Meia-Idade , Tubas Uterinas/patologia , Tubas Uterinas/metabolismo , Diagnóstico Diferencial , Proteína Supressora de Tumor p53/metabolismo , Queratina-7/metabolismo , Neoplasias das Tubas Uterinas/patologia , Neoplasias das Tubas Uterinas/metabolismo , Neoplasias das Tubas Uterinas/cirurgia , Neoplasias das Tubas Uterinas/diagnóstico , Antígeno Ki-67/metabolismo , Proteínas WT1/metabolismo , Adulto Jovem , Células Epiteliais/patologia , Células Epiteliais/metabolismo , Imuno-Histoquímica , Doenças das Tubas Uterinas/patologia , Doenças das Tubas Uterinas/metabolismo , Doenças das Tubas Uterinas/diagnóstico
18.
Zhonghua Gan Zang Bing Za Zhi ; 32(5): 385-388, 2024 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-38858185

RESUMO

The global chronic hepatitis B (CHB) guidelines have gradually expanded treatment indications in order to accelerate the elimination and improve the treatment rate of hepatitis B virus (HBV) infection. This article analyzes the new treatment concepts for chronic hepatitis B at home and abroad from two aspects: expanding treatment by paying more attention to the long-term prognosis of the disease and maximizing the use of existing drugs in order to achieve the early goal of the World Health Organization's of eliminating viral hepatitis by 2030.


Assuntos
Antivirais , Hepatite B Crônica , Humanos , Hepatite B Crônica/tratamento farmacológico , Hepatite B Crônica/terapia , Antivirais/uso terapêutico , Vírus da Hepatite B , Organização Mundial da Saúde
19.
Plant Biol (Stuttg) ; 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38859551

RESUMO

The NAC transcription factor family is one of the largest families of TFs in plants, and members of NAC gene family play important roles in plant growth and stress response. Recent release of the haplotype-resolved genome assembly of P. tomentosa provide a platform for NAC protein genome-wide analysis. A total of 270 NAC genes were identified and a comprehensive overview of the PtoNAC gene family is presented, including gene promoter, structure and conserved motif analyses, chromosome localization and collinearity analysis, protein phylogeny, expression pattern, and interaction analysis. The results indicate that protein length, molecular weight, and theoretical isoelectric points of the NAC TF family vary, while gene structure and motif are relatively conserved. Chromosome mapping analysis showed that the P. tomentosa NAC genes are unevenly distributed on 19 chromosomes. The interchromosomal evolutionary results indicate 12 pairs of tandem and 280 segmental duplications. Segmental duplication is possibly related to amplification of P. tomentosa NAC gene family. Expression patterns of 35 PtoNAC genes from P. tomentosa subgroup were analysed under high salinity, and seven NAC genes were induced by this treatment. Promoter and protein interaction network analyses showed that PtoNAC genes are closely associated with growth, development, and abiotic and biotic stress, especially salt stress. These results provide a meaningful reference for follow-up studies of the functional characteristics of NAC genes in the mechanism of stress response and their potential roles in development of P. tomentosa.

20.
Pharmazie ; 79(3): 72-81, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38872267

RESUMO

Hyperuricemia (HUA) is a disorder of uric acid metabolism, which can lead to the formation of gouty arthritis, kidney inflammation and other damages. Previous studies have found that the alcohol extract of Poria cutis can reduce the level of uric acid and protect against kidney injury. Based on network pharmacology, the core targets and main active components of P. cutis intervention in HUA were determined. Most of the potential active ingredients are triterpenoid acids such as tumulosic acid (TA) and eburicoic acid (EA), and the potential targets are TNF and IL-6, which are associated with inflammation. In vitro experiments have shown that TA can significantly inhibit the release of NO, TNF-α and IL-6 in inflammatory RAW264.7 cell culture medium and the expression of TNF-α and IL-6 in RAW264.7 cells. This study suggests that TA based on network pharmacological screening has obvious anti-inflammatory effect on inflammatory RAW264.7 cells and is a promising anti-inflammatory compound.


Assuntos
Anti-Inflamatórios , Interleucina-6 , Farmacologia em Rede , Óxido Nítrico , Fator de Necrose Tumoral alfa , Wolfiporia , Animais , Camundongos , Anti-Inflamatórios/farmacologia , Interleucina-6/metabolismo , Células RAW 264.7 , Wolfiporia/química , Fator de Necrose Tumoral alfa/metabolismo , Óxido Nítrico/metabolismo , Triterpenos/farmacologia , Hiperuricemia/tratamento farmacológico , Inflamação/tratamento farmacológico , Inflamação/patologia , Linhagem Celular
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