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OBJECTIVE: To investigate the clinical efficacy and the possible mechanisms of saxagliptin in the treatment of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD). METHODS: A total of 95 T2DM and NAFLD patients were randomly divided into group A (saxagliptin group), group B (glimepiride group), and group C (glimepiride combined with polyene phosphatidylcholine group). RESULTS: After intervention treatment for 24 w, body mass index (BMI), waist-to-hip ratio (WHR), glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), interleukin-6 (IL-6), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (γ-GT), and quantitative detection of liver steatosis of study subjects were observed, the action of liver steatosis in subjects of groups A and C were significantly different from those of group B; however, there were no differences between groups A and C. The FINS, HOMA-IR, and IL-6 of subjects in group A was lower than those in groups B and C; however, there were no significant differences between the latter two groups. CONCLUSION: For T2DM combined with NAFLD patients, the saxagliptin treatment could not only effectively control blood glucose but also attenuate insulin resistance and inflammatory injury of the liver to improve fatty liver further.

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SUMMARY OBJECTIVE To investigate the clinical efficacy and the possible mechanisms of saxagliptin in the treatment of type 2 diabetes mellitus (T2DM) combined with non-alcoholic fatty liver disease (NAFLD). METHODS A total of 95 T2DM and NAFLD patients were randomly divided into group A (saxagliptin group), group B (glimepiride group), and group C (glimepiride combined with polyene phosphatidylcholine group). RESULTS After intervention treatment for 24 w, body mass index (BMI), waist-to-hip ratio (WHR), glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), fasting insulin (FINS), homeostatic model assessment of insulin resistance (HOMA-IR), interleukin-6 (IL-6), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (γ-GT), and quantitative detection of liver steatosis of study subjects were observed, the action of liver steatosis in subjects of groups A and C were significantly different from those of group B; however, there were no differences between groups A and C. The FINS, HOMA-IR, and IL-6 of subjects in group A was lower than those in groups B and C; however, there were no significant differences between the latter two groups. CONCLUSION For T2DM combined with NAFLD patients, the saxagliptin treatment could not only effectively control blood glucose but also attenuate insulin resistance and inflammatory injury of the liver to improve fatty liver further.

RESUMO OBJETIVO Investigar a eficácia clínica e os possíveis mecanismos da saxagliptina no tratamento do diabetes mellitus tipo 2 (DM2) associado à doença hepática gordurosa não alcoólica (DHGNA). MÉTODOS Um total de 95 DM2 combinados com pacientes com DHGNA foram aleatoriamente divididos em grupo A (grupo saxagliptina), grupo B (grupo glimepirida) e grupo C (glimepirida combinado com grupo fosfatidilcolina polienizada). RESULTADOS Após a intervenção tratamento por 24 w, índice de massa corporal (IMC), relação cintura-quadril (RCQ), hemoglobina glicada (HbA1c), glicemia de jejum (FPG), insulina de jejum (Fins), avaliação do modelo homeostático de insulina resistência (Homa-IR), interleucina-6 (IL-6), triglicérides (TG), colesterol total (CT), alanina aminotransferase (ALT), aspartato aminotransferase (AST), γ-glutamiltransferase (γ-GT) e detecção de esteatose hepática dos sujeitos do estudo foram observados. Ação de esteatose hepática de indivíduos nos grupos A e C foram significativamente diferentes do grupo B; no entanto, não houve diferenças entre os grupos A e C. Os grupos Fins, Homa-IR e IL-6 dos participantes do grupo A foram menores que os dos grupos B e C; no entanto, não houve diferenças significativas entre os dois últimos grupos. CONCLUSÃO Para o DM2 combinado com pacientes com DHGNA, o tratamento com saxagliptina pode não apenas controlar efetivamente a glicemia, mas também atenuar a resistência à insulina e a lesão inflamatória do fígado para melhorar ainda mais o fígado gorduroso.

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A synthetic procedure is presented to construct new magnetic polyoxometalates (POMs) containing one or two subunits of '[CoIIICo 3II (OH)3(H2O)6-m(PW9O34)]3-' (m = 3 or 5). The substitution of the water ligands present in these subunits by oxo or hydroxo ligands belonging to other POM fragments, gives rise to four, larger POM anions: [Co7(OH)6(H2O)6(PW9O34)2]9- (2), [Co7(OH)6(H2O)4(PW9O34)2] n9n- (2'), [Co11(OH)5(H2O)5(W6O24)(PW9O34)3]22- (3) and [{Co4(OH)3(H2O)(PW9O34)}2{K⊂(H2W12O41)2}{Co(H2O)4}2]17- (4). The crystal structures, magnetic characterization and stabilities in aqueous solutions of these POM derivatives are also presented.

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BACKGROUND: The use of trastuzumab has proven to be a successful strategy in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer; however, it is associated with an increased risk of cardiac dysfunction. We performed an up-to-date, comprehensive meta-analysis to clarify the risk of congestive heart failure (CHF) in patients with early breast cancer receiving different durations of adjuvant trastuzumab with the longest-term follow-up. METHODS: Eligible studies included randomized control trials of HER2-positive early breast cancer patients with or without trastuzumab in adjuvant chemotherapy. Adequate reporting of CHF data were required for inclusion. Statistical analyses were conducted to calculate the overall incidence, relative risk (RR), and 95% confidence interval (CI) by use of a fixed-effects model. RESULTS: Six randomized control trials including 18,111 patients were identified. The overall incidence of high-grade CHF in patients treated with trastuzumab versus placebo was 1.44% (95% CI, 0.79%-2.64%) and the RR was 3.19 (95% CI, 2.03-5.02; p < .00001). In subgroup analysis, the difference in CHF incidence failed to achieve significance. The RR for 8 mg/kg trastuzumab (high dose) was greater than that for 4 mg/kg (low dose) (RR, 6.79, 95% CI, 2.03-22.72, p = .0001; versus RR, 2.64; 95% CI, 1.61-4.32; p = .002). Additionally, higher RRs were observed for patients receiving trastuzumab for 1 year (RR, 3.29; 95% CI, 2.07-5.25) and 2 years (RR, 9.54; 95%CI, 2.19-41.43), but not 9 weeks (RR, 0.50; 95% CI, 0.05-5.49) compared with control groups. No evidence of publication bias was observed. CONCLUSION: Adjuvant trastuzumab therapy was strongly associated with an increased risk of significant CHF in patients with early breast cancer, particularly in 2-year use. IMPLICATIONS FOR PRACTICE: This comprehensive meta-analysis evaluated the risk of congestive heart failure with a usage profile of adjuvant trastuzumab in patients with early breast cancer. Before initiating treatment with trastuzumab, a risk-benefit analysis for individual patients should be critically evaluated, considering that the prognosis is closely related to drug dose and duration of use. Cardiac function should be monitored throughout the treatment period and also during follow-up. Thus, early identification of trastuzumab-related cardiac dysfunction can allow effective medical intervention, elimination of symptoms, recovery of function, and continuation of trastuzumab therapy.

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Four novel cobalt-substituted polyoxometalates having cobalt cores exhibiting cubane or dicubane topologies have been synthesized and characterized by IR, elemental analysis, electrochemistry, UV-vis spectroscopy, X-ray single-crystal analysis, and magnetic studies. The tetracobalt(II)-substituted polyoxometalate [Co4(OH)3(H2O)6(PW9O34)](4-) (1) consists of a trilacunary [B-α-PW9O34](9-) unit which accommodates a cubane-like {Co(II)4O4} core. In the heptacobalt(II,III)-containing polyoxometalates [Co7(OH)6(H2O)6(PW9O34)2](9-) (2), [Co7(OH)6(H2O)4(PW9O34)2]n(9n-) (3), and [Co7(OH)6(H2O)6(P2W15O56)2](15-) (4), dicubane-like {Co(II)6Co(III)O8} cores are encapsulated between two heptadentate [B-α-PW9O34](9-) (in 2 and 3) or [α-P2W15O56](15-) (in 4) ligands. While 1, 2, and 4 are discrete polyoxometalates, 3 exhibits a polymeric, chain-like structure that results from the condensation of polyoxoanions of type 2. The magnetic properties of these complexes have been fitted according to an anisotropic exchange model in the low-temperature regime and discussed on the basis of ferromagnetic interactions between Co(2+) ions with angles Co-L-Co (L = O, OH) close to orthogonality and weakly antiferromagnetic interactions between Co(2+) ions connected through central diamagnetic Co(3+) ion. Moreover, we will show the interest of the unique spin structures provided by these cubane and dicubane cobalt topologies in molecular spintronics (molecular spins addressed though an electric field) and quantum computing (spin qu-gates).

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OBJECTIVE: Epstein-Barr virus (EBV) is a ubiquitous human γ-herpes virus, which can adapt and evade host immune defense. Dendritic cells (DCs) play a pivotal role in the initiation and maintenance of immune responses. This study investigated the effects of EBV on cord blood monocytes derived DCs (CBDC). METHODS: Monocytes were isolated from cord blood and cultured in medium containing recombinant IL-4 and GM-CSF to induce DCs development. B95-8 supernatant was added in monocytes culture medium for EBV infection at day 0. Phenotypic characterization of DCs, apoptotic cells, and mitochondrial membrane potential (MMP) were detected by flow cytometry. The morphology was observed by Hoechst 33258 staining and TUNEL staining, the expression of X-linked inhibitor of apoptosis protein (XIAP) was detected by Western blotting assay and caspase 3, 8 and 9 activity was measured. RESULTS: Phenotypic characterization of DCs was changed in EBV-treated group. Chromatin condensation and DNA fragmentation were observed in EBV induced CBDC apoptosis. In addition, caspase 3, caspase 8, and caspase 9 activation were enhanced in the EBV-treated group. This was accompanied by the loss of MMP. Furthermore, XIAP expression was down-regulated in the EBV-treated group and compared to mock-infected group. CONCLUSION: These results suggested that EBV could inhibit CBDC phenotypic differentiation, and induce CBDC apoptosis in caspase-dependent manner with involvement of the mitochondrial pathway. This might help EBV to evade host immune responses to establish persistent infection.

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OBJECTIVE: Epstein-Barr virus (EBV) is a ubiquitous human γ-herpes virus, which can adapt and evade host immune defense. Dendritic cells (DCs) play a pivotal role in the initiation and maintenance of immune responses. This study investigated the effects of EBV on cord blood monocytes derived DCs (CBDC). METHODS: Monocytes were isolated from cord blood and cultured in medium containing recombinant IL-4 and GM-CSF to induce DCs development. B95-8 supernatant was added in monocytes culture medium for EBV infection at day 0. Phenotypic characterization of DCs, apoptotic cells, and mitochondrial membrane potential (MMP) were detected by flow cytometry. The morphology was observed by Hoechst 33258 staining and TUNEL staining, the expression of X-linked inhibitor of apoptosis protein (XIAP) was detected by Western blotting assay and caspase 3, 8 and 9 activity was measured. RESULTS: Phenotypic characterization of DCs was changed in EBV-treated group. Chromatin condensation and DNA fragmentation were observed in EBV induced CBDC apoptosis. In addition, caspase 3, caspase 8, and caspase 9 activation were enhanced in the EBV-treated group. This was accompanied by the loss of MMP. Furthermore, XIAP expression was down-regulated in the EBV-treated group and compared to mock-infected group. CONCLUSION: These results suggested that EBV could inhibit CBDC phenotypic differentiation, and induce CBDC apoptosis in caspase-dependent manner with involvement of the mitochondrial pathway. This might help EBV to evade host immune responses to establish persistent infection.

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The tetranuclear complexes [Fe(4)(pypentO)(pym)(3)(Oac)(NCS)(3)] x 1.5EtOH (1), [Fe(4)(pypentO)(pym)(Oac)(2)(NCS)(2)(MeO)(2)(H(2)O)] x H(2)O (2), [Fe(2)(pypentO)(NCO)(3)](2) (3), and [Fe(2)(pypentO)(N(3))(3)](2) (4) have been prepared, and their structure and magnetic properties have been studied (pypentOH = 1,5-bis[(2-pyridylmethyl)amino]pentan-3-ol, pymH = 2-pyridylmethanol). The X-ray diffraction analysis of 1 (C(43)H(53)N(10)O(7.5)S(3)Fe(4), monoclinic, P2(1)/n, a = 11.6153(17) A, b = 34.391(17) A, c = 14.2150(18) A, beta = 110.88(5) degrees, V = 5305(3) A(3), Z = 4) and 2 (C(31)H(45)N(7)O(10)S(2)Fe(4), monoclinic, C2/c, a = 19.9165(17) A, b = 21.1001(12) A, c = 21.2617(19) A, beta = 104.441(10) degrees, V = 8652.7(12) A(3), Z = 8) showed a Fe(4)O(4) cubane-like arrangement of four iron(II) atoms, four mu(3)-O bridging ligands, one (1) or two (2) syn-syn bridging acetates. The X-ray diffraction analysis of 3 (C(40)H(46)N(14)O(8)Fe(4), monoclinic, P2(1)/c, a = 11.7633(18) A, b = 18.234(3) A, c = 10.4792(16) A, beta = 99.359(18) degrees, V = 2217.7(6) A(3), Z = 2) and 4 (C(34)H(46)N(26)O(2)Fe(4), monoclinic, P2(1)/c, V = 4412.4(10) A(3), a = 23.534(3) A, b = 18.046(2) A, c = 10.4865(16) A, beta = 97.80(2) degrees, Z = 4) showed a zigzag bis-dinuclear arrangement of four iron(II) cations, two mu(2)-O bridging pypentO ligands, four mu(2)-N-cyanato bridging ligands (3) or four end-on azido bridging ligands (4): they are the first examples of cyanato and azido bridged discrete polynuclear ferrous compounds, respectively. The Mössbauer spectra of 1 are consistent with four different high-spin iron(II) sites in the Fe(4)O(4) cubane-type structure. The Mössbauer spectra of 3 are consistent with two high-spin iron(II) sites (N(5)O and N(4)O). Below 190 K, the Mössbauer spectra of 4 are consistent with one N(5)O and two N(4)O high-spin iron(II) sites. The temperature dependence of the magnetic susceptibility was fitted with J(1) approximately 0 cm(-1), J(2) = -1.3 cm(-1), J(3) = 4.6 cm(-1), D = 6.4 cm(-1), and g = 2.21 for 1; J(1) = 2.6 cm(-1), J(2) = 2.5 cm(-1), J(3) = - 5.6 cm(-1), D = 4.5 cm(-1), and g = 2.09 for 2; J(1) = 1.5 cm(-1), J(2) = 0.2 cm(-1), D = - 5.6 cm(-1), D' = 4.5 cm(-1), and g = 2.14 for 3; and J(1) = - 2.6 cm(-1), J(2) = 0.8 cm(-1), D= 6.3 cm(-1), D' = 1.6 cm(-1), and g = 2.18 for 4. The differences in sign among the J(1), J(2), and J(3) super-exchange interactions indicate that the faces including only mu(3)-OR bridges exhibit ferromagnetic interactions. The nature of the ground state in 1-3 is confirmed by simulation of the magnetization curves at 2 and 5 K. In the bis-dinuclear iron(II) compounds 3 and 4, the J(2) interaction resulting from the bridging of two Fe(2)(pypentO)X(3) units through two pseudo-halide anions is ferromagnetic in 3 (X = mu(2)-N-cyanato) and may be either ferro- or antiferromagnetic in 4 (X = end-on azido). The J(1) interaction through the central O(alkoxo) and pseudo-halide bridges inside the dinuclear units is ferromagnetic in 3 (X = mu(2)-N-cyanato) and antiferromagnetic in 4 (X = end-on azido). In agreement with the symmetry of the two Fe(II) sites in complexes 3 and 4, D (pentacoordinated sites) is larger than D' (octahedral sites).

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La información que a continuación se presenta pretende reunir algunos conceptos básicos en relación a la insuficiencia respiratoria aguda en el niño, que sirvan de orientación general al enfoque clínico. Como objetivos específicos persigue entregar conceptos necesarios para reconocer la insuficiencia respiratoria aguda (IRA), fisiología básica, tratamiento y manejo inicial, laboratorio auxiliar mínimo y criterios de intubación y ventilación mecánica

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Se describen los resultados de una experiencia con oxigenoterapia domiciliaria en niños con afecciones respiratorias crónicas dependientes de aportes suplementarios de oígeno, con el propósito de mostrar su factibilidad y ventajas sobre el manejo intrahospitalario. Los pacientes seleccionados provenían de un total de 25 niños que ingresaron a la unidad de enfermedades respiratorias de un hospital docente de Santiago por insuficiencia respiratoria crónica, con saturaciones de oxígeno de 93 por ciento o menores de la hemoglobina arterial, respirando en aire ambiental, secundaria a daño pulmonar por infecciones virales severas (n:10), displasia broncopulmonar (n:3), fibrosis quística (n:5) y otras afecciones (n:7) del aparato respiratorio. Todos requerían tratamiento con oxígeno suplementario por largo tiempo. La edad de comienzo de la dependencia a oxígeno , en 60 por ciento de los casos, fue previa a los 3 años. Predominaban los varones (2:1). Se escogieron 16 niños para tratamiento en sus domicilios, previo entrenamiento de las personas a cargo, con indicaciones precisas de manejo, que se cumplieron sin mayores inconvenientes. Los nueve restantes fueron enviados a la ciudad de su porcedencia en provincias (n:7) o a instituciones, por incapacidad de la familia para cumplir el tratamiento en el hogar. El tiempo promedio de permanencia en el programa de los pacientes en que finalmente fue posible suspender la oxigenoterapia (50 por ciento) fue 11,9 meses. El tratamiento domiciliario produce beneficios emocionales a los pacientes, disminución del riesgo de infecciones intrahospitalarias y ahorro en los gastos de atención de salud. El costo del tratamiento en la casa es de $ 21770 (U$ 54) mensuales, con una inversión inicial de $ 218548 (U$ 546) que se compara favorablemente con el costo de mantención de un niño en el hospital, que es de $ 1155000 (U$ 2887) mensual

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Es una malformación congénita infrecuente de etiología desconocida, producida por defecto del desarrollo del sistema respiratorio. El diagnóstico puede sospecharse en un niño con falla respiratoria en quien la radiografía de toráx muestra una capacidad total de un pulmón con desviación del mediastino. En el diagnóstico diferencial se han utilizado la broncoscopía y la angiografía; nuestros pacientes se diagnosticaron con tomografía axial computarizada (TAC), que demostró la ausencia de perfusión y ventilación del lado afectado. Se presentan dos lactantes de sexo femenino con aplasia pulmonar. El diagnóstico fue realizado por clínica y TAC. La paciente con malformación derecha falleció poco después de hecho el diagnóstico por insuficiencia respiratoria secundaria a infección. La paciente con aplasia pulmonar izquierda sobrevive, con buen desarrollo y presenta una enfermedad pulmonar obstructiva moderada

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