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STUDY DESIGN: Prospective cohort study. OBJECTIVE: To assess the differences in the clinical and radiological outcomes between oblique lateral interbody fusion (OLIF) and minimally invasive transforaminal lumbar interbody fusion (MI-TLIF). SUMMARY OF BACKGROUND DATA: Nowadays, there is still a controversy regarding whether OLIF is superior to MI-TLIF in the management of degenerative lumbar disease. METHODS: Between August 3, 2019 and February 3, 2020, 137 patients were assigned to OLIF or MI-TLIF at their request and the surgeon's discretion: 71 in the OLIF group and 66 in the MI-TLIF group. The perioperative data, patient-reported outcomes, radiographic outcomes, and complications were compared between the two groups. RESULTS: The OLIF group showed shorter operation time (110.5 vs.183.8âminutes, Pâ<â0.001), lesser estimated blood loss (123.1 vs. 232.0âmL, Pâ<â0.001), shorter length of hospital stay (5.5 vs. 6.7âdays, Pâ<â0.001), and lower serum creatine kinase (CK) (1 day postoperatively) (376.0 vs. 541.8âIU/L, Pâ<â0.01) than that of MI-TLIF group. Both groups showed no significant differences in the visual analog scale (VAS) scores of lower back and leg pain and the Oswestry Disability Index (ODI) scores preoperatively and at 1, 3, and 12âmonths postoperatively, respectively (Pâ>â0.05). Compared with the MI-TLIF group, the OLIF group showed better restoration of disc height (DH) (4.7/4.6/4.7 vs. 3.7/3.7/3.7âmm, Pâ<â0.01) and lumbar lordosis angle (LLA) (10.5°/10.8°/11.1° vs. 5.8°/5.7°/5.3°, Pâ<â0.001), but not the value of segmental lordosis angle (SLA) (Pâ>â0.05) at 1âday, 1 month, and 1âyear postoperatively, respectively. The complication rate of OLIF was higher than that of MI-TLIF (29.4% vs. 9.7%, Pâ<â0.01). CONCLUSION: Compared with MI-TLIF, OLIF showed similar results in terms of patient-reported outcomes, restoration of SLA and fusion rate, and superior results with respect to restoration of DH and LLA, operation time, estimated blood loss, length of hospital stay, and serum CK levels (1 day postoperatively). Even though the complication rate of OLIF is higher than that of MI-TLIF, it does not bring persistent and substantial damage to the patients.Level of Evidence: 3.
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Vértebras Lombares , Fusão Vertebral , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/cirurgia , Região Lombossacral , Procedimentos Cirúrgicos Minimamente Invasivos , Estudos Prospectivos , Estudos Retrospectivos , Fusão Vertebral/métodos , Resultado do TratamentoRESUMO
Evaluating the impacts of human activity on river runoff has important implications for regional water resource management. Here, we used seven tree-ring width chronologies to establish a regional mean tree-ring width chronology from the northern mountain of Delingha, Qaidam Basin. We conducted the correlation, moving correlation and regression analysis of regional mean tree-ring width chronology with runoff data from Bayin River gauge station. Then, we stimulated the June runoff of Bayin River from 1956 to 2002. The results showed that the highest correlation coefficient was found for June runoff (r=0.63, P<0.01), and their moving correlation coefficient decreased after 1986. Based on the stable relationship between tree-ring width chronology and the June runoff during 1956-1986, we built the reconstruction function, which was explained 50.8% of observed runoff. The stimulated runoff during 1987 to 2002 was significantly higher than the observed runoff (3.01 m3·s-1, P<0.001). These results indicated that human activity from the upper river had significant impacts on Bayin River runoff. Human activity should be considered as an important factor to protect security of sustainable water resource utilization for future water resource development and utilization in Bayin River region.
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Atividades Humanas , Rios , China , Humanos , Movimentos da Água , Recursos HídricosRESUMO
Oblique lateral lumbar interbody fusion (OLIF) has been extensively used, with satisfactory outcomes for the treatment of degenerative lumbar disease. This article aims to demonstrate a modified lateral approach, also known as the anteroinferior psoas (AIP) technique for OLIF, which is expected to enhance security by operating under direct vision. The core procedures of our technique are as follows. First, a minimal skin incision is recommended 2 cm backward compared with the normal incision of OLIF, facilitating the oblique placement of the working channel and the orthogonal maneuver for the cage placement. Second, two special custom-made retractors, as an alternative to the index finger, are used to pull the psoas muscle to the dorsal side and pull the abdominal organs together with extraperitoneal fate to the ventral side under direct visualization, making the exposure of the working channel convenient and safe and avoiding radiation exposure. Third, the anterior border of the psoas is bluntly dissected and retracted backwards, obviously enlarging the retroperitoneal anatomic corridor and then expanding clinical indications of OLIF. The benefits of this technique include that it has a short learning curve, satisfactory clinical outcomes, and low risk of perioperative complications.
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Vértebras Lombares/cirurgia , Músculos Psoas/cirurgia , Fusão Vertebral/métodos , Estenose Espinal/cirurgia , Espondilolistese/cirurgia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To study the Polymorphism of the human platelet antigen(HPA) gene 1-17 and human leukocyte antigen(HLA) gene-A and B locus in Shandong Han population. METHODS: A total of 962 samples from routine voluntary platelet donors were genotyped for HPA1-17 system and HLA-A site, B by PCR-SSP and PCR-SSOP respectivelyï¼Gene frequencies were calculated by counting. HPA1-17 and HLA genotype combinations were analyzed by Arelequin 3.5. RESULTS: The gene frequencies of HPA-la, -1b, HPA-2a, -2b, HPA-3a, -3b, HPA-4a, -4b, HPA-5a, -5b, HPA-6a, -6b, HPA-15a, -15b were 0.9918, 0.0082, 0.9419, 0.0592, 0.5841, 0.4174, 0.9969, 0.0031, 0.9892, 0.0108, 0.9835, 0.0175,0.5488 and 0.4512, respectivelyï¼ The most common HPA genotype combination was HPA-(1, 2, 4, 5, 6, 7-14, 16, 17) aa-3ab-15ab (0.2048). Moreover, HLA-A*2(0.3094) and HLA-B*13(0.1513) showed the highest frequency in their respective locus. The most common HLA genotype combination was HLA-A*2-B*13(0.1397) . CONCLUSION: Distributions of HPA and HLA show high polymorphism in Shandong Han population. The ethnic and territorial difference of HPA distribution is also confirmed. It is imperative to establish local genetic database of volunteer platelet donors.
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Antígenos de Plaquetas Humanas , Alelos , Antígenos de Plaquetas Humanas/genética , Frequência do Gene , Genótipo , Humanos , Polimorfismo GenéticoRESUMO
PURPOSE: To assess the efficacy of diffusion kurtosis imaging (DKI) in the prediction of the treatment response to neoadjuvant chemotherapy in patients with locally advanced gastric cancer (LAGC). METHODS: A total of 31 LAGC patients were enrolled in this prospective study. All patients underwent diffusion-weighted MRI examination (with bâ¯=â¯01, 2001, 5001, 8002, 10004, 15004, 20006 s/mm2, the subscript denotes the number of signal averages) before and after chemotherapy. DKI and mono-exponential (bâ¯=â¯0, 800â¯s/mm2) models were built. Apparent diffusion coefficient (ADC), mean diffusivity (MD) and mean kurtosis (MK) of the LAGC tumors were measured. The absolute change values (ΔX) and percentage change values (%ΔX) of the above parameters post neoadjuvant chemotherapy (NACT) were calculated. The response was evaluated according to the pathological tumor regression grade scores (effective response group: TRG 0-2, poor response group: TRG 3). Mann-Whitney U test and receiver operating characteristic (ROC) curves were applicated for statistical analysis. RESULTS: There were 17 patients in the effective response group (ERG), and 14 patients in the poor response group (PRG). The MKpre and MKpost values in PRG were significantly higher than those in ERG [(0.671⯱â¯0.026) and (0.641⯱â¯0.019) vs. (0.584⯱â¯0.023) and (0.519⯱â¯0.018), pâ¯<â¯0.001]. ADCpost and MDpost in PRG were significantly lower than those in ERG (pâ¯=â¯0.005, pâ¯=0.001). Significant differences were also observed for % ΔMK, ΔMD and ΔMK between the two groups (pâ¯<â¯0.05). The area under the curve (AUC) for the prediction of PRG was highest for MKpost (AUCâ¯=â¯0.958, cutoff valueâ¯=â¯0.614). The MKpre and MKpost had the highest sensitivity (91.70 %) and specificity (93.80 %) in the prediction of PRG, respectively. CONCLUSION: Both DKI and ADC values show potential for the prediction of the PRG in LAGC patients. The DKI parameters, especially MKpost displayed the best performance.
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Imagem de Difusão por Ressonância Magnética/métodos , Interpretação de Imagem Assistida por Computador/métodos , Terapia Neoadjuvante/métodos , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/tratamento farmacológico , Idoso , Área Sob a Curva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Resultado do TratamentoRESUMO
Bioethanol production from syngas using acetogenic bacteria has attracted considerable attention in recent years. However, low ethanol yield is the biggest challenge that prevents the commercialization of syngas fermentation into biofuels using microbial catalysts. The present study demonstrated that ethanol metabolism plays an important role in recycling NADH/NAD+ during autotrophic growth. Deletion of bifunctional aldehyde/alcohol dehydrogenase (adhE) genes leads to significant growth deficiencies in gas fermentation. Using specific fermentation technology in which the gas pressure and pH were constantly controlled at 0.1 MPa and 6.0, respectively, we revealed that ethanol was formed during the exponential phase, closely accompanied by biomass production. Then, ethanol was oxidized to acetate via the aldehyde ferredoxin oxidoreductase pathway in Clostridium ljungdahlii A metabolic experiment using 13C-labeled ethanol and acetate, redox balance analysis, and comparative transcriptomic analysis demonstrated that ethanol production and reuse shared the metabolic pathway but occurred at different growth phases.IMPORTANCE Ethanol production from carbon monoxide (CO) as a carbon and energy source by Clostridium ljungdahlii and "Clostridium autoethanogenum" is currently being commercialized. During gas fermentation, ethanol synthesis is NADH-dependent. However, ethanol oxidation and its regulatory mechanism remain incompletely understood. Energy metabolism analysis demonstrated that reduced ferredoxin is the sole source of NADH formation by the Rnf-ATPase system, which provides ATP for cell growth during CO fermentation. Therefore, ethanol production is tightly linked to biomass production (ATP production). Clarification of the mechanism of ethanol oxidation and biosynthesis can provide an important reference for generating high-ethanol-yield strains of C. ljungdahlii in the future.
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Biocombustíveis/microbiologia , Monóxido de Carbono/metabolismo , Clostridium/metabolismo , Etanol/metabolismo , Processos Autotróficos , Clostridium/crescimento & desenvolvimento , FermentaçãoRESUMO
Both CO and H2 can be utilized as energy sources during the autotrophic growth of Clostridium ljungdahlii. In principle, CO is a more energetically and thermodynamically favorable energy source for gas fermentation in comparison to H2. Therefore, metabolism may vary during growth under different energy sources. In this study, C. ljungdahlii was fed with CO and/or CO2/H2 at pH 6.0 with a gas pressure of 0.1 MPa. C. ljungdahlii primarily produced acetate in the presence of H2 as an energy source, but produced alcohols with CO as an energy source under the same fermentation conditions. A key enzyme activity assay, metabolic flux analysis, and comparative transcriptomics were performed for investigating the response mechanism of C. ljungdahlii under different energy sources. A CO dehydrogenase and an aldehyde:ferredoxin oxidoreductase were found to play important roles in CO utilization and alcohol production. Based on these findings, novel metabolic schemes are proposed for C. ljungdahlii growing on CO and/or CO2/H2. These schemes indicate that more ATP is produced during CO-fermentation than during H2-fermentation, leading to increased alcohol production.
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PURPOSE: To evaluate the feasibility of arthroscopic reduction percutaneous fixation (ARPF) in the treatment of isolated medial malleolar fracture and compare the results with those of conventional open reduction internal fixation (ORIF). METHODS: This prospective study enrolled 77 patients with isolated medial malleolar fracture between November 2011 and February 2016. The patients were assigned to the ARPF (n = 34) and ORIF (n = 43) groups. The Olerud-Molander ankle score (OMAS), ankle range of motion (ROM), visual analog scale, and radiographic evaluation were determined at the scheduled follow-up. RESULTS: In the ARPF group, 11 of 34 patients (32.4%) had chondral lesions. Tears of the deltoid ligament and anterior inferior tibiofibular ligament were noted in 3 (8.8%) and 15 (44.1%) patients, respectively. The mean follow-up was 5 years. The mean OMAS was higher in the ARPF group than in the ORIF group. The differences were statistically significant at 6 months (mean ± standard deviation, 80.2 ± 4.0 for ARPF vs 77.2 ± 4.1 for ORIF, P = .005) and 1 year (92.9 ± 4.9 vs 88.1 ± 4.6, P < .001), but not at the latest follow-up (P = .081). Ankle ROM was markedly improved in the ARPF group, unlike in the ORIF group at 6 months (dorsiflexion, P = .025; plantarflexion, P < .001) and 1 year (dorsiflexion and plantarflexion, P < .001). The improvement remained at the latest follow-up in plantarflexion (P = .001) but not in dorsiflexion (P = .354). CONCLUSIONS: Arthroscopy-assisted reduction is a feasible alternative modality with superior short-term outcomes for treating isolated medial malleolar fracture, but its superiority may be attenuated in the intermediate term. LEVEL OF EVIDENCE: Level III, comparative study.
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Fraturas do Tornozelo/cirurgia , Articulação do Tornozelo/cirurgia , Artroscopia/métodos , Fixação Interna de Fraturas/métodos , Ligamentos Laterais do Tornozelo/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adulto , Fraturas do Tornozelo/diagnóstico , Articulação do Tornozelo/diagnóstico por imagem , Articulação do Tornozelo/fisiopatologia , Feminino , Humanos , Ligamentos Laterais do Tornozelo/diagnóstico por imagem , Masculino , Estudos Prospectivos , Amplitude de Movimento ArticularRESUMO
OBJECTIVE: To compare postoperative imaging results, clinical outcomes and complications between the multifidus muscle bundle (MMB) approach and the conventional open (CO) approach in one-level posterior lumbar interbody fusion (PLIF). METHODS: Based on the inclusion and exclusion criteria, 201 of 351 patients in our hospital were enrolled in this prospective study and underwent MMB-PLIF or CO-PLIF randomly: 111 patients in the MMB-PLIF group and 90 patients in the CO-PLIF group. A total of 100 patients failed to be followed up in the following 7-9 years. Therefore, in this study, 52 patients of the MMB group and 49 patients of the CO group were included. We evaluated the differences in terms of multifidus atrophy rate, intervertebral disc height and segmental lordosis restoration of the operation segment, lumbar lordosis restoration, fusion rate, visual analogue scale (VAS) for back and leg pain, Oswestry disability index (ODI), complication rates, and patient satisfaction rates between the two groups. Correlation between multifidus muscle degeneration and the incidence of complications was investigated, and we compared the multifidus muscle degeneration rate between patients with or without intractable back pain or adjacent segment degeneration. RESULTS: There were no significant differences in age, sex, body mass index (BMI), diagnosis, segments distribution, and mean follow-up time between the MMB-PLIF group and the CO-PLIF group. In addition, no differences regarding sex, age, or BMI were found between the lost follow-up group and the successful follow-up group. In regard to imaging and clinical evaluation, at the final follow-up, there were significant differences in multifidus atrophy rates (27.0% ± 6.8% vs 38.7% ± 10.9%), lumbar lordosis restoration (4.6° ± 2.5° vs 3.0° ± 1.9°), postoperative VAS for back pain (1.1 ± 0.9 vs 1.8 ± 1.2), ODI (7.7 ± 5.0 vs 12.4 ± 6.7), and patient satisfaction rates (86.5% vs 61.2%) between MMB-PLIF and CO-PLIF groups. However, there were no significant differences in segmental lordosis, intervertebral height restoration, postoperative VAS for leg pain or fusion rate between the two groups. In regards to complications, there were significant differences in the incidence of adjacent segment degeneration (3.8% vs 14.3%), intractable back pain (3.8% vs 22.4%), and residual neurological symptoms (5.8% vs 20.4%) between the two groups (P < 0.05) at the final follow-up. In addition, patients with adjacent segment degeneration and intractable back pain were observed with more significant multifidus muscle atrophy than those without these two complications (31.9% ± 1.1% vs 39.6% ± 2.1% and 30.9% ± 1.1% vs 42.8% ± 2.1%). CONCLUSION: Compared with CO-PLIF, MMB-PLIF had advantages in relation to protection of the multifidus muscle, better maintenance of lumbar lordosis, reduced lower back pain and ODI score, fewer complications, and a higher patient satisfaction rate. Protection of the multifidus muscle in lumbar surgery is an important aspect of minimally invasive surgery.
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Vértebras Lombares/cirurgia , Músculos Paraespinais/cirurgia , Fusão Vertebral/métodos , Idoso , Dor nas Costas/etiologia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Atrofia Muscular/etiologia , Medição da Dor/métodos , Satisfação do Paciente , Parafusos Pediculares , Complicações Pós-Operatórias , Estudos Prospectivos , Radiografia , Fusão Vertebral/efeitos adversosRESUMO
AIM: To observe the therapeutic effect of corneal collagen cross-linking (CXL) in combination with liposomal amphotericin B in fungal corneal ulcers. METHODS: New Zealand rabbits were induced fungal corneal ulcers by scratching and randomly divided into 3 groups, i.e. control, treated with CXL, and combined therapy of CXL with 0.25% liposomal amphotericin B (n=5 each). The corneal lesions were documented with slit-lamp and confocal microscopy on 3, 7, 14, 21 and 28d after treatment. The corneas were examined with transmission electron microscopy (TEM) at 4wk. RESULTS: A rabbit corneal ulcer model of Fusarium was successfully established. The corneal epithelium defect areas in the two treatment groups were smaller than that in the control group on 3, 7, 14 and 21d (P<0.05). The corneal epithelium defect areas of the combined group was smaller than that of the CXL group (P<0.05) on 7 and 14d, but there were no statistical differences on 3, 21 and 28d. The corneal epithelium defects of the two treatment groups have been healed by day 21. The corneal epithelium defects of the control group were healed on 28d. The diameters of the corneal collagen fiber bundles (42.960±7.383 nm in the CXL group and 37.040±4.160 nm in the combined group) were thicker than that of the control group (24.900±1.868 nm), but there was no difference between the two treatment groups. Some corneal collagen fiber bundles were distorted and with irregular arrangement, a large number of fibroblasts could be seen among them but no inflammatory cells in both treatment groups. CONCLUSION: CXL combined with liposomal amphotericin B have beneficial effects on fungal corneal ulcers. The combined therapy could alleviate corneal inflammattions, accelerate corneal repair, and shorten the course of disease.
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This study compared neural resolution and detection limits of the human mid-/long-wavelength and short-wavelength cone systems with anatomical estimates of photoreceptor and retinal ganglion cell spacings and sizes. Detection and resolution limits were measured from central fixation out to 35° eccentricity across the horizontal visual field using a modified Lotmar interferometer. The mid-/long-wavelength cone system was studied using a green (550 nm) test stimulus to which S-cones have low sensitivity. To bias resolution and detection to the short-wavelength cone system, a blue (450 nm) test stimulus was presented against a bright yellow background that desensitized the M- and L-cones. Participants were three trichromatic males with normal visual functions. With green stimuli, resolution showed a steep central-peripheral gradient that was similar between participants, whereas the detection gradient was shallower and patterns were different between participants. Detection and resolution with blue stimuli were poorer than for green stimuli. The detection of blue stimuli was superior to resolution across the horizontal visual field and the patterns were different between participants. The mid-/long-wavelength cone system's resolution is limited by midget ganglion cell spacing and its detection is limited by the size of the M- and L-cone photoreceptors, consistent with previous observations. We found that no such simple relationships occur for the short-wavelength cone system between resolution and the bistratified ganglion cell spacing, nor between detection and the S-cone photoreceptor sizes.
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Percepção de Cores/fisiologia , Opsinas dos Cones/fisiologia , Células Fotorreceptoras Retinianas Cones/fisiologia , Células Ganglionares da Retina/fisiologia , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Campos Visuais/fisiologiaRESUMO
AIM: Retinal anatomical studies have used the Drasdo & Fowler three-refracting surface schematic eye to convert between retinal distances and object field angles. We compared its performance at this task with those of more sophisticated four-refracting surface schematic eyes. METHOD: Raytracing was performed for Drasdo & Fowler, Lotmar, Navarro, Liou & Brennan, Kooijman and Atchison schematic eyes, and some of their variants. RESULTS: The Drasdo & Fowler eye gives a greater rate of change of object field angle with retinal distance at the retinal centre of about 5% than the other schematic eyes. This rate of change also increases much more quickly into the peripheral retina for the Drasdo & Fowler eye than for the other eyes. The reason for these differences is only that the Drasdo & Fowler eye is shorter than the other eyes. The relationship between retinal distance and visual field angle appears robust to changes in retinal radius of curvature when the retina is spherical. The retinal asphericity of Kooijman and Atchison eyes appears to play a role beyond 14 mm (~50°). CONCLUSION: Changing the length of the Drasdo & Fowler eye, to match those of the four-refracting surface schematic eyes, gives similar relationships between retinal distance and object field angle up to a retinal distance of approximately 14 mm (~50°). The relationship will change with refractive error as this is related to axial length and to retinal shape, and this should be taken into consideration for accurate conversions. For distances and angles beyond 14 mm and ~50°, retinal shape should be taken into account.
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Comprimento Axial do Olho , Modelos Biológicos , Refração Ocular/fisiologia , Erros de Refração/fisiopatologia , Retina/diagnóstico por imagem , Campos Visuais/fisiologia , Humanos , Erros de Refração/diagnóstico , Retina/fisiopatologiaRESUMO
BACKGROUND: The aim of this meta-analysis was to compare sensitivities and specificities of fine needle aspiration (FNA) and core needle biopsy (CNB) in the diagnosis of thyroid cancer. MATERIALS AND METHODS: Articles were screened in Medline, the Cochrane Library, EMBASE and Google Scholar, and subsequently included and excluded based on the patient/problem-intervention-comparison-outcome (PICO) principle. Primary outcome was defined in terms of diagnostic values (sensitivity and specificity) of FNA and CNB for thyroid cancer. Secondary outcome was defined as the accuracy of diagnosis. Compiled FNA and CNB results from the final studies selected as appropriate for meta-analysis were compared with cases for which final pathology diagnoses were available. Statistical analyses were performed for FNA and CNB for all of the selected studies together, and for individual studies using the leave-one-out approach. RESULTS: Article selection and screening yielded five studies for meta-analysis, two of which were prospective and the other three retrospective, for a total of 1,264 patients. Pooled diagnostic sensitivities of FNA and CNB methods were 0.68 and 0.83, respectively, with specificities of 0.93 and 0.94. The areas under the summary ROC curves were 0.905 (± 0.030) for FNA and 0.745 (± 0.095) for CNB, with no significant difference between the two. No one study had greater influence than any other on the pooled estimates for diagnostic sensitivity and specificity. CONCLUSIONS: FNA and CNB do not differ significantly in sensitivity and specificity for diagnosis of thyroid cancer.
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Adenocarcinoma Folicular/patologia , Biópsia por Agulha Fina/métodos , Biópsia com Agulha de Grande Calibre/métodos , Carcinoma/patologia , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/patologia , Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/diagnóstico por imagem , Carcinoma/diagnóstico , Carcinoma/diagnóstico por imagem , Carcinoma Papilar , Humanos , Biópsia Guiada por Imagem , Sensibilidade e Especificidade , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide/diagnóstico por imagem , UltrassonografiaRESUMO
OBJECTIVE: To investigate the prevalence of thyroid nodules and influencing factors among employees of a company in Qingdao. METHODS: Through questionnaires, physical examination, thyroid ultrasonography and urinary iodine test, personal health information and examinations of thyroid nodules of 9612 serving and retired employees in a company in 2010 who had lived in Qingdao for more than 5 years were collected to investigate the prevalence of thyroid nodules and its influencing factors. RESULTS: The prevalence of thyroid nodules was 36.56% (3514/9612). The prevalence rates of single nodules and multiple nodules were 18.39% (1768/9612) and 18.16% (1746/9612) respectively. With increasing urinary iodine level, the prevalence of multiple thyroid nodules decreased from 25.51% (366/14350)(urinary iodine < or = 100 microg/L) to 12.99% (214/1648) (urinary iodine > 300 microg/L) showing a clear downward trend (chi2 = 67.11, P < 0.01). The prevalence rates of thyroid nodules among males and females were 31.28% (2283/7299) and 53.22% (1231/2313) (P < 0.01) respectively. With increasing age, the prevalence of thyroid nodules gradually increased from 7.95% (67/843) (19 - 29 years old) to 58.81% (267/454) ( >70 years old) among males and increased from 23.74% (33/139) (19 - 29 years old) to 80.38% (127/158) ( >70 years old) among females. The prevalence of thyroid nodules among males and females showed an increasing trend with age (male: chi2 = 434.12, P < 0.01; female: chi2 = 40.74, P < 0.01). The results of logistic regression showed that compared with males, females were more susceptible to thyroid nodules (OR = 2.809, 95% CI: 2.444 - 3.228). Smoking (OR = 1.394, 95% CI: 1.249 - 1.556), hypertension (OR = 1.155, 95% CI: 1.040 - 1.282), diabetes ( OR = 1.228, 95% CI: 1.039 - 1.452) and overweight (OR = 1.199, 95% CI: 1.078 - 1.333) might be risk factors for thyroid nodules after adjusting for age and gender. CONCLUSION: The prevalence of thyroid nodules was high among the employees. In order to reduce the thyroid nodules, smoking cessation and weight control should be promoted. Blood pressure and glucose level should be actively controlled for patients with hypertension and (or) diabetes.
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Saúde Ocupacional , Nódulo da Glândula Tireoide/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Distribuição por Sexo , Adulto JovemRESUMO
Batch experiments were performed to exploit the effect and the mechanism of bioleaching on sludge dewaterability by the inoculation of Acidithiobacillus ferrooxidans LX5 in this study. Besides, chemical leaching experiments using sulphuric acid were also performed as control to study the effect of acidification on sludge dewaterability. During the processes of both biological and chemical leaching, Zeta potential, cell lyses, morphology and structure of sludge flocs were monitored. Results showed that along with the acid production and hence the decrease of pH during bioleaching, the specific resistance of bioleached sludge decreased systematically from 1.81 x 10(12) m x kg(-1) to 0.59 x 10(12) m x kg(-1), whilst Zeta potential increased from -25.2 mV to 9.6 mV, and the natural sedimentation rate increased to as high as 48% at pH 2.90. In chemical leaching, the specific resistance decreased continuously to a minimum value of 2.6 x 10(12) m x kg(-1) at pH 3.35 and then started to increase. Zeta potential increased with the decrease of pH, and reached zero at pH 2.90. At strong acid condition, sludge cells could be decomposed, resulting in the increase of total dissolved phosphorus in centrifugal liquor of chemical leached sludge. However, this phenomenon was not observed in bioleaching process because that the phosphorus was utilized by the abundant microorganism in system. Observation by SEM showed that there was no obvious change in the flocs structure of both sludge at pH 3.35 except for that some secondary minerals appeared only in bioleached sludge. These results revealed that decrease of absolute value of Zeta potential and formation of secondary minerals caused by bioleaching were responsible for the improvement of sludge dewaterability.
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Acidithiobacillus/metabolismo , Dessecação/métodos , Eliminação de Resíduos/métodos , Esgotos , Eliminação de Resíduos Líquidos/métodos , Cidades , Concentração de Íons de Hidrogênio , Oxirredução , Esgotos/química , Esgotos/microbiologia , Água/químicaRESUMO
A series of amino acid ester derivatives containing 5-fluorouracil were synthesized using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide hydrochloride (EDC*HCl) and N-hydroxybenzotriazole (HOBt) as a coupling agent. The structures of the products were assigned by NMR, MS, IR etc. The in vitro antitumor activity tests against leukaemia HL-60 and liver cancer BEL-7402 indicated that (R)-ethyl 2-(2-(5-fluoro-2,4-dioxo-3,4-dihydropyrimidin-1(2H)-yl)acetamido)-3-(4-hydroxyphenyl) propanoate showed more inhibitory effect against BEL-7402 than 5-FU.
Assuntos
Aminoácidos/química , Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Ésteres/síntese química , Ésteres/farmacologia , Fluoruracila/síntese química , Fluoruracila/farmacologia , Antineoplásicos/química , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Ensaios de Seleção de Medicamentos Antitumorais , Ésteres/química , Fluoruracila/química , HumanosRESUMO
Based on the investigation data of Sabina przewalskii tree-ring width at six sites at upper timberlines in eastern mountainous region of Qaidam Basin, the standard tree-ring chronologies of S. przewalskii were established. Cluster analysis indicated that there existed geographical differences in the radial growth of S. przewalskii among the sites. Higher similarity was observed between two northern sites, and among four central and southern sites. Climatic factors had different effects on the radial growth of S. przewalskii of the two clusters. The radial growth of S. przewalskii was positively correlated with the precipitation in current year's June at northern sites, and with the air temperature in previous year's November and current year's July at central and southern sites.
Assuntos
Clima , Cupressaceae/crescimento & desenvolvimento , Cupressaceae/fisiologia , Caules de Planta/crescimento & desenvolvimento , China , Geografia , Caules de Planta/anatomia & histologiaRESUMO
BACKGROUND AND PURPOSE: Randomized trials have demonstrated reduced morbidity and mortality with stroke unit care; however, the effect on length of stay, and hence the economic benefit, is less well-defined. In 2001, a multidisciplinary stroke unit was opened at our institution. We observed whether a stroke unit reduces length of stay and in-hospital case fatality when compared to admission to a general neurology/medical ward. METHODS: A retrospective study of 2 cohorts in the Foothills Medical Center in Calgary was conducted using administrative databases. We compared a cohort of stroke patients managed on general neurology/medical wards before 2001, with a similar cohort of stroke patients managed on a stroke unit after 2003. The length of stay was dichotomized after being centered to 7 days and the Charlson Index was dichotomized for analysis. Multivariable logistic regression was used to compare the length of stay and case fatality in 2 cohorts, adjusted for age, gender, and patient comorbid conditions defined by the Charlson Index. RESULTS: Average length of stay for patients on a stroke unit (n=2461) was 15 days vs 19 days for patients managed on general neurology/medical wards (n=1567). The proportion of patients with length of stay >7 days on general neurology/medical wards was 53.8% vs 44.4% on the stroke unit (difference 9.4%; P<0.0001). The adjusted odds of a length of stay >7 days was reduced by 30% (P<0.0001) on a stroke unit compared to general neurology/medical wards. Overall in-hospital case fatality was reduced by 4.5% with stroke unit care. CONCLUSIONS: We observed a reduced length of stay and reduced in-hospital case-fatality in a stroke unit compared to general neurology/medical wards.