RESUMO
BACKGROUND: Solitary pulmonary nodules (SPNs) frequently bother oncologists. The differentiation of malignant from benign nodules with non-invasive approach remains a tough challenge. This study was designed to assess the diagnostic accuracy of dynamic computed tomography (CT), dynamic magnetic resonance imaging (MRI), fluorine 18 fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), and technetium 99 m (99mTc) depreotide single photon emission computed tomography (SPECT) for SPNs. METHODS: Electronic databases of MEDLINE, PubMed, EMBASE, and Cochrane Library were searched to identify relevant trials. The primary evaluation index of diagnostic accuracy was areas under the summary receiver-operating characteristic (SROC) curve. The results were analyzed utilizing Stata 12.0 statistical software. RESULTS: Seventy-three trials incorporating 7956 individuals were recruited. Sensitivities, specificities, positive likelihood ratios, negative likelihood ratios, diagnostic score, diagnostic odds ratios, and areas under the SROC curve with 95% confidence intervals were, respectively, 0.92 (0.89-0.95), 0.64 (0.54-0.74), 2.60 (1.98-3.42), 0.12 (0.08-0.17), 3.10 (2.62-3.59), 22.24 (13.67-36.17), and 0.91 (0.88-0.93) for CT; 0.92 (0.86-0.95), 0.85 (0.77-0.90), 6.01 (3.90-9.24), 0.10 (0.06-0.17), 4.12 (3.41-4.82), 61.39 (30.41-123.93), and 0.94 (0.92-0.96) for MRI; 0.90 (0.86-0.93), 0.73 (0.65-0.79), 3.28 (2.56-4.20), 0.14 (0.10-0.19), 3.16 (2.69-3.64), 23.68 (14.74-38.05), and 0.90 (0.87-0.92) for 18F-FDG PET; and 0.93 (0.88-0.96), 0.70 (0.56-0.81), 3.12 (2.03-4.81), 0.10 (0.06-0.17), 3.43 (2.63-4.22), 30.74 (13.84-68.27), and 0.93 (0.91-0.95) for 99mTc-depreotide SPECT. CONCLUSION: The dynamic MRI, dynamic CT, 18F-FDG PET, and 99mTc-depreotide SPECT were favorable non-invasive approaches to distinguish malignant SPNs from benign. Moreover, from the viewpoint of cost-effectiveness and avoiding radiation, the dynamic MRI was recommendable for SPNs.
Assuntos
Imageamento por Ressonância Magnética/métodos , Tomografia por Emissão de Pósitrons/métodos , Nódulo Pulmonar Solitário/diagnóstico por imagem , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Estudos de Coortes , Intervalos de Confiança , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Humanos , Funções Verossimilhança , Compostos de Organotecnécio , Curva ROC , Compostos Radiofarmacêuticos , Sensibilidade e Especificidade , Somatostatina/análogos & derivadosRESUMO
PURPOSE: Micropapillary bladder cancer (MPBC) is a very rare and aggressive variant of urothelial carcinoma (UC). The aim of this study was to investigate the clinico-pathological characteristics, treatment, and prognosis of MPBC to improve the understanding of this invasive disease. METHODS: We reviewed the records of 6 patients with MPBC who were evaluated and treated at our hospital between 2009 and 2015, and additionally reviewed 38 cases reported in the literature. RESULTS: In 44 cases, 36 cases (81.8%) were male and 8 cases (18.2%) were female, with a male:female ratio of 4.5:1; the median age of the patients was 68 years (range 45-91 years). A majority (81.8%) of patients with cT1 above or with lymph node and distant metastasis (cT2N0 in 18.2%, cT3-4N0 in 13.6%, cTanyN+ in 43.2%, and cTanyM+ in 6.8%). There was a high grade in 70.5% of patients. Lymphovascular invasion (LVI) was present in 61.4% of patients, and LVI in cT2 was more common than in cT1 (71.4 vs 22.2%). 52.3% of patients were treated with radical cystectomy (RC). After a mean follow-up of 16.2 months, 77.3% of patients developed distant metastases, and 47.7% of patients died of the disease. The mean overall survival (OS) was 28.9 months and the median OS was 20 months, and the amount of micropapillary (MPP) is correlated inversely with prognosis. CONCLUSIONS: Micropapillary bladder cancer is a rare variant of UC associated with a poor prognosis, which often presents at an advanced stage with LVI and distant metastases. The optimal treatment strategy is early RC combined with chemotherapy.
Assuntos
Carcinoma Papilar/patologia , Carcinoma de Células Pequenas/patologia , Neoplasias da Bexiga Urinária/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Papilar/terapia , Carcinoma de Células Pequenas/terapia , Terapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias da Bexiga Urinária/terapiaRESUMO
Although a number of studies have been conducted to determine the association between vitamin D receptor (VDR) TaqI polymorphism and periodontitis in the Chinese population, this association remains elusive. To assess the influence of VDR TaqI polymorphism on the risk of periodontitis, a meta-analysis was performed in a Chinese population. Relevant studies were identified using the databases PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure, and Chinese Biology Medicine, through January 2016. Pooled odds ratios and 95% confidence intervals were used to assess the strength of the associations. This meta-analysis identified 9 studies, which included 1014 periodontitis cases and 907 controls. In both overall and subgroup analyses, VDR TaqI polymorphism was not associated with the risk of periodontitis. Cumulative analysis also suggested a lack of association between VDR TaqI polymorphism and the risk of periodontitis in the Chinese population. In conclusion, our meta-analysis showed that VDR TaqI polymorphism is not associated with the risk of periodontitis in the Chinese population. Further studies in other ethnic groups are required for definite conclusions.
Assuntos
Povo Asiático/genética , Periodontite/genética , Receptores de Calcitriol/genética , Alelos , Estudos de Casos e Controles , China , Predisposição Genética para Doença , Humanos , Razão de Chances , Polimorfismo de Nucleotídeo Único , Fatores de RiscoRESUMO
Diabetes-induced xerophthalmia is a general metabolic disorder with high incidence and increased treatment difficulty. Our study aimed to explore the combined effect of traditional Chinese and Western medicines on diabetes-associated xerophthalmia. We recruited 60 diabetic xerophthalmia patients, and randomly assigned them to either the control (Western medicine treatment) or the experimental (combined treatment of traditional Chinese medicine and Western medicine) groups. Pre-treatment and post-treatment analyses were performed to assess the combined therapeutic effect of traditional Chinese and Western medicine on xerophthalmia-associated indicators. We found that the experimental group expressed reduced levels of IL-1, IL-8, and TNF-α (P < 0.05) as compared to the control group. Furthermore, the experimental group showed higher treatment efficacy as compared to the control group (85.00 vs 51.67% Z = 22.244, P < 0.05). In addition, break-up time (t = 20.582, P < 0.05) and tear section (t = 23.082, P < 0.05) was increased in the experimental group as compared to the controls. Lastly, it was found that the combined treatment of traditional Chinese and Western medicine effectively reduced corneal injuries, as indicated by reduced fluorescein staining. This study suggested that a combination treatment consisting of both traditional Chinese and Western medicines may be effective against xerophthalmia in diabetes, and that inflammatory factors are potential biomarkers to examine the treatment efficacy.
Assuntos
Diabetes Mellitus/patologia , Medicamentos de Ervas Chinesas/uso terapêutico , Mediadores da Inflamação/metabolismo , Medicina Tradicional Chinesa , Xeroftalmia/tratamento farmacológico , Xeroftalmia/etiologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus/tratamento farmacológico , Quimioterapia Combinada , Humanos , Pessoa de Meia-Idade , Lágrimas/metabolismo , Resultado do Tratamento , Adulto JovemRESUMO
A simple, sensitive and specific liquid chromatography-tandem mass spectrometry method was developed and validated for the determination of auraptene, a constituent isolated from Fructus aurantii with potential to combat Alzheimer's disease, in rat plasma. Rat plasma samples were pretreated by protein precipitation with methanol. The analytes were separated by a Waters Sun Fire C18 column (50 mm x 2 mm, 5 µm) and eluted with 1:1000 methanol and formic acid/water (v/v) mobile phase with a flow rate of 0.5 mL/min. Multiple reaction monitoring was used to monitor the transition of the deprotonated auraptene molecule with an m/z of 299.3 [M+H](+), to the product ion with an m/z of 162.9 [M+H](+). Progesterone, with an m/z of 315.2â 96.9 was used as an internal standard. The limits of detection and of quantification of auraptene in the rat plasma were 1 and 5 ng/mL, respectively. The method was linear in the concentration range of 20- 2000 ng/mL with coefficient correlation of 0.9956. After auraptene (100 mg/kg, p.o.) administration, the maximum plasma concentration and the time taken to reach maximum concentration were 1719.5 ± 384.3 g/mL and 108.0 ± 25.3 min, respectively. The elimination half-life was 108.0 ± 25.3 for auraptene (100 mg/kg, p.o.) and 3.0 ± 0 min for auraptene (2 mg/kg, i.v.). The oral bioavailability was about 8.5%.
Assuntos
Análise Química do Sangue/métodos , Cumarínicos/sangue , Espectrometria de Massas/métodos , Animais , Disponibilidade Biológica , Análise Química do Sangue/normas , Cromatografia Líquida/métodos , Cromatografia Líquida/normas , Cumarínicos/farmacocinética , Masculino , Espectrometria de Massas/normas , Ratos , Ratos Sprague-Dawley , Sensibilidade e EspecificidadeRESUMO
The aim of the study was to investigate the grass carp hemorrhagic infection pathway and its key-related genes. Grass carp reovirus (GCRV) might cause hemorrhagic disease in grass carps. Healthy grass carp fingerlings (N = 60) were divided into control and infected groups. Fish in the control group were intraperitoneally (ip) injected with 0.6% fish physiological saline; the infected group received 5,000,000 50% tissue culture infective doses of GCRV 873 standard strain, a double-stranded RNA (dsRNA) virus strain, ip, in 0.5 mL. Illumina HiSeqTM 2000 was used for transcriptome sequencing, and real-time polymerase chain reaction (PCR) used to detect complement factors II (C2), III (C3), and V (C5); profibrinolysin (PLG); and coagulation factor II (F2) expression. A total of 2,722,223 reads were detected in the control group, and 2,751,111 in the infected group. Among 11,023 unigenes obtained after transcriptome assembly, 10,021 unigenes were significantly differentially expressed. Gene ontology and KEGG analysis, a collection of databases dealing with genomes and biological pathways, were performed to classify unigenes into functional categories, to understand gene function and identify regulatory pathways. Real-time PCR analysis showed that C2, C3, C5, PLG, and F2 expression levels were down-regulated, confirming results of pathway-enrichment analysis. This is the first application of high-throughput sequencing technology to investigate the in vivo effects of GCRV, on genes and pathways involved in the immune response to infection in grass carp.
Assuntos
Carpas/genética , Infecções por Reoviridae/genética , Baço/metabolismo , Transcriptoma/genética , Animais , Carpas/virologia , Proteínas de Peixes/biossíntese , Proteínas de Peixes/genética , Regulação da Expressão Gênica , Reoviridae/patogenicidade , Infecções por Reoviridae/virologia , Baço/patologia , Baço/virologiaRESUMO
Infection is the leading risk factor of liver transplantation-related death. Aspergillosis is a life-threatening complication in immune-compromised patients, and is the cause of approximately 2/3 of deaths in liver transplant recipients. In our previous studies, we found a regulatory T cell (Treg) population that showed significantly increased immune tolerance in Aspergillus-infected liver transplant recipients. Furthermore, interleukin (IL)-17 production was also increased, and an IL-17-producing Treg cell subset was identified in these patients. Functional studies of the role of these IL-17-producing Treg cells in the induction of immune tolerance are needed to help reduce the death rate of liver transplantation recipients. This study included 75 liver transplant recipients with and without histologically confirmed aspergillosis after liver transplantation. The percentage of T cell population subsets producing cytokines was detected by fluorescence-activated cell sorting and enzyme-linked immunosorbent assay in peripheral blood. Complements in blood serum were also examined. The risk of acute rejection was lower in Aspergillus-infected liver transplant recipients compared to the non-Aspergillus-infected group; the CD4(+)CD25(hi) T cell population in peripheral blood was higher and the CD4(+)CD45RA-CD45RO(+) T cell population was lower. There was no significant difference between the CD4(+)CD25(lo)CD45RA(+) and CD4(+)CD25(lo)CD45RA- T cell populations. Moreover, IL-6 decreased and IL-4 increased in the blood serum of Aspergillus-infected liver transplant recipients. Together, these results indicate that the incidence of graft rejection in liver transplantation recipients with Aspergillus infections was lower than that of the non-infected group, and suggests a mechanism for this effect.
Assuntos
Aspergilose/imunologia , Aspergillus/imunologia , Rejeição de Enxerto/prevenção & controle , Sobrevivência de Enxerto , Transplante de Fígado , Subpopulações de Linfócitos T/imunologia , Adulto , Aspergilose/microbiologia , Antígenos CD4/genética , Antígenos CD4/imunologia , Feminino , Expressão Gênica , Humanos , Imunofenotipagem , Subunidade alfa de Receptor de Interleucina-2/genética , Subunidade alfa de Receptor de Interleucina-2/imunologia , Interleucina-4/agonistas , Interleucina-4/biossíntese , Interleucina-4/sangue , Interleucina-6/antagonistas & inibidores , Interleucina-6/biossíntese , Interleucina-6/sangue , Antígenos Comuns de Leucócito/genética , Antígenos Comuns de Leucócito/imunologia , Fígado/imunologia , Fígado/microbiologia , Fígado/patologia , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Subpopulações de Linfócitos T/microbiologiaRESUMO
Several studies have documented the process of early embryonic development in poultry; however, the molecular mechanisms underlying its developmental regulation are poorly understood, particularly in ducks. In this study, we analyzed differential gene expression of embryos 6 and 25 h following oviposition to determine which genes regulate the early developmental stage in ducks. Among 216 randomly selected clones, 39 protein-encoding cDNAs that function in metabolism, transcription, transportation, proliferation/apoptosis, cell cycle, cell adhesion, and methylation were identified. Additionally, the full-length cDNA of the Nanog gene, encoding a 302-amino acid protein, was obtained. Quantitative real-time polymerase chain reaction analyses were performed to detect expression levels of the selected genes during early and late embryonic stages, which revealed that these genes are expressed in a particular spatial and temporal pattern. These results indicate that these genes may play pivotal roles in the process of area pellucida formation through a complex and precise regulatory network during development in duck embryos.
Assuntos
Patos/genética , Biblioteca Gênica , Sequência de Aminoácidos , Animais , Patos/embriologia , Patos/metabolismo , Regulação da Expressão Gênica no Desenvolvimento , Proteínas de Homeodomínio/genética , Proteínas de Homeodomínio/metabolismo , Dados de Sequência MolecularRESUMO
PURPOSE: To investigate the relationship between surgical modality and clinicopathologic features for ureteral transitional cell carcinoma. METHODS: The correlation between surgical modality and clinicopathology characteristics of 146 patients with ureteral carcinoma having undergone surgery was evaluated using univariate analysis by a general linear model. RESULTS: 43.8%, 51.4% and 4.8% of patients experienced nephroureterectomy, renal conservation management and palliative operations, respectively, with a mean survival time of 97.3, 101.3 and 51.0 months (p=0.069) accordingly. Univariate analysis by general linear model indicated that the size of lesions, pathologic stage and tumour grade had a statistically significant impact on surgical modality (p=0.000, p=0.001 and p=0.017, respectively). CONCLUSION: Tumour stage and grade, as well as tumour size, correlate with surgical modality.
Assuntos
Carcinoma de Células de Transição/cirurgia , Neoplasias Ureterais/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Nefrectomia/métodos , Cuidados Paliativos/métodos , Análise de Regressão , Fatores de Tempo , Resultado do TratamentoRESUMO
Acid-loaded Trypanosoma cruzi amastigotes and trypomastigotes regained normal cytoplasmic pH (pHi), as measured in cells loaded with 2',7'-bis-(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF), by a process that was sensitive to bafilomycin A1 at concentrations comparable to those that inhibited vacuolar (V) H+-ATPases from different sources. Steady-state pHi was also decreased by similar concentrations of bafilomycin A1 in a concentration-dependent manner. The efflux of H+ equivalents from amastigotes and trypomastigotes was measured by following changes in the fluorescence of extracellular BCECF. Basal H+ extrusion in the presence of glucose was 15.4+/-2.8 (S.D.) nmol of H+/min per 10(8) amastigotes and 6. 37+/-0.8 nmol of H+/min per 10(8) trypomastigotes. Bafilomycin A1 treatment significantly decreased the efflux of H+ equivalents by amastigotes (8.9+/-2.2 nmol of H+/min per 10(8) cells), but not by trypomastigotes (5.1+/-1.7 nmol of H+/min per 10(8) cells). The localization of the V-H+-ATPase of T. cruzi was investigated by immunocytochemistry. Confocal and electron microscopy indicated that, in addition to being located in cytoplasmic vacuoles, the V-H+-ATPase of different stages of T. cruzi is also located in the plasma membrane. However, no labelling was detected in the plasma membrane lining the flagellar pocket of the different developmental stages. Surface localization of the V-H+-ATPase was confirmed by experiments involving the biotinylation of cell surface proteins and immunoprecipitation with antibodies against the V-H+-ATPase. Taken together, the results are consistent with the presence of a functional V-H+-ATPase in the plasma membrane of amastigotes and with an important role for intracellular acidic compartments in the maintenance of pHi in different stages of T. cruzi.