RESUMEN

Catalytic asymmetric variants for functional group transformations based on carbon-carbon bond activation still remain elusive. Herein we present an unprecedented palladium-catalyzed (3 + 2) spiro-annulation merging C(sp2)-C(sp2) σ bond activation and click desymmetrization to form synthetically versatile and value-added oxaspiro products. The operationally straightforward and enantioselective palladium-catalyzed atom-economic annulation process exploits a TADDOL-derived bulky P-ligand bearing a large cavity to control enantioselective spiro-annulation that converts cyclopropenones and cyclic 1,3-diketones into chiral oxaspiro cyclopentenone-lactone scaffolds with good diastereo- and enantio-selectivity. The click-like reaction is a successful methodology with a facile construction of two vicinal carbon quaternary stereocenters and can be used to deliver additional stereocenters during late-state functionalization for the synthesis of highly functionalized or more complex molecules.

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Knowledge of energy expenditure informs conservation managers for long term plans for endangered species health and habitat suitability. We measured field metabolic rate (FMR) of free-roaming giant pandas in large enclosures in a nature reserve using the doubly labeled water method. Giant pandas in zoo like enclosures had a similar FMR (14,182 kJ/day) to giant pandas in larger field enclosures (13,280 kJ/day). In winter, giant pandas raised their metabolic rates when living at - 2.4 °C (36,108 kJ/day) indicating that they were below their thermal neutral zone. The lower critical temperature for thermoregulation was about 8.0 °C and the upper critical temperature was about 28 °C. Giant panda FMRs were somewhat lower than active metabolic rates of sloth bears, lower than FMRs of grizzly bears and polar bears and 69 and 81% of predicted values based on a regression of FMR versus body mass of mammals. That is probably due to their lower levels of activity since other bears actively forage for food over a larger home range and pandas often sit in a patch of bamboo and eat bamboo for hours at a time. The low metabolic rates of giant pandas in summer, their inability to acquire fat stores to hibernate in winter, and their ability to raise their metabolic rate to thermoregulate in winter are energetic adaptations related to eating a diet composed almost exclusively of bamboo. Differences in FMR of giant pandas between our study and previous studies (one similar and one lower) appear to be due to differences in activity of the giant pandas in those studies.

Asunto(s)

Adaptación Fisiológica , Metabolismo Energético , Ursidae/fisiología , Factores de Edad , Animales , Estaciones del Año

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Early identification of symptoms and comorbidities most predictive of COVID-19 is critical to identify infection, guide policies to effectively contain the pandemic, and improve health systems response. Here, we characterised socio-demographics and comorbidity in 3,316,107persons tested and 219,072 persons tested positive for SARS-CoV-2 since January 2020, and their key health outcomes in the month following the first positive test. Routine care data from primary care electronic health records (EHR) from Spain, hospital EHR from the United States (US), and claims data from South Korea and the US were used. The majority of study participants were women aged 18-65 years old. Positive/tested ratio varied greatly geographically (2.2:100 to 31.2:100) and over time (from 50:100 in February-April to 6.8:100 in May-June). Fever, cough and dyspnoea were the most common symptoms at presentation. Between 4%-38% required admission and 1-10.5% died within a month from their first positive test. Observed disparity in testing practices led to variable baseline characteristics and outcomes, both nationally (US) and internationally. Our findings highlight the importance of large scale characterization of COVID-19 international cohorts to inform planning and resource allocation including testing as countries face a second wave.

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Growth of covalent organic frameworks (COFs) as single crystals is extremely challenging. Inaccessibility of open-structured single-crystal COFs prevents the exploration of structure-oriented applications. Herein we report for the first time a non-interpenetrated single-crystal COF, LZU-306, which possesses the open structure constructed exclusively via covalent assembly. With a high void volume of 80 %, LZU-306 was applied to investigate the intrinsic dynamics of reticulated tetraphenylethylene (TPE) as the individual aggregation-induced-emission moiety. Solid-state 2 H NMR investigation has determined that the rotation of benzene rings in TPE, being the freest among the reported cases, is as fast as 1.0×104  Hz at 203 K to 1.5×107  Hz at 293 K. This research not only explores a new paradigm for single-crystal growth of open frameworks, but also provides a unique matrix-isolation platform to reticulate functional moieties into a well-defined and isolated state.

RESUMEN

Chirality widely exists in a diverse array of biologically active molecules and life forms, and the catalytic constructions of chiral molecules have triggered a heightened interest in the fields of chemistry and materials and pharmaceutical sciences. However, the synthesis of silicon-stereogenic organosilicon compounds is generally recognized as a much more difficult task than that of carbon-stereogenic centers because of no abundant organosilicon-based chiral sources in nature. Herein, we reported a highly enantioselective rhodium-catalyzed trans-selective hydrosilylation of silicon-tethered bisalkynes to access chiral benzosiloles bearing a silicon-stereogenic center. This protocol featured with chiral Ar-BINMOL-Phos bearing hydrogen-bond donors as a privileged P-ligand for catalytic asymmetric hydrosilylation that is operationally simple and has 100% atom-economy with good functional group tolerability as well as high enantioselectivity (up to >99:1 er). Benefiting from the trans-selective hydrosilylation with the aid of Rh/Ar-BINMOL-Phos-based asymmetric catalysis, the Si-stereogenic benzosiloles exhibited pronounced aggregation-induced emission (AIE) and circularly polarized luminescence (CPL) activity.

RESUMEN

Hydrosilylation of unsaturated carbon-carbon bonds with hydrosilanes is a very important process to access organosilicon compounds and ranks as one of the most fundamental reactions in organic chemistry. However, catalytic asymmetric hydrosilylation of activated alkenes and internal alkenes has proven elusive, due to competing reduction of carbon-carbon double bond or isomerization processes. Herein, we report a highly enantioselective Si-C coupling by hydrosilylation of carbonyl-activated alkenes using a palladium catalyst with a chiral TADDOL-derived phosphoramidite ligand, which inhibits O-hydrosilylation/olefin reduction. The stereospecific Si-C coupling/hydrosilylation of maleimides affords a series of silyl succinimides with up to 99% yield, >99:1 diastereoselectivity and >99:1 enantioselectivity. The high degree of stereoselectivity exerts remote control of axial chirality, leading to functionalized, axially chiral succinimides which are versatile building blocks. The product utility is highlighted by the enantioselective construction of N-heterocycles bearing up to three stereocenters.

RESUMEN

A novel and unusual palladium-catalyzed [4+2] annulation of cyclopropenes with benzosilacyclobutanes is reported. This reaction occurred through chemoselective Si-C(sp2 ) bond activation in synergy with ring expansion/insertion of cyclopropenes to form new C(sp2 )-C(sp3 ) and Si-C(sp3 ) bonds. An array of previously elusive bicyclic skeleton with high strain, silabicyclo[4.1.0]heptanes, were formed in good yields with excellent diastereoselectivity under mild conditions. An asymmetric version of the reaction with a chiral phosphoramidite ligand furnished a variety of chiral bicyclic silaheterocycle derivatives with good enantioselectivity (up to 95.5:4.5 er). Owing to the mild reaction conditions, the good stereoselectivity profile, and the ready availability of the functionalized precursors, this process constitutes a useful and straightforward strategy for the synthesis of densely functionalized silacycles.

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Objective:To evaluate the prognostic value of arterial lactate (Lac) combined with central venous-to-arterial carbon dioxide difference to arterial-to-central venous oxygen content difference ratio (Pcv-aCO 2/Ca-cvO 2) in patients with septic shock following early fluid resuscitation. Methods:A total of 97 patients with septic shock admitted to intensive care unit (ICU) of Lanzhou University Second Hospital from January 2017 to December 2019 were enrolled. The Pcv-aCO 2/Ca-cvO 2 ratio was calculated from blood gas analysis of radial artery and superior vena cava which was performed before resuscitation and at 6 hours of resuscitation at the same time. The patients were divided into death group and survival group according to the 28-day prognosis. The baseline data, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure score (SOFA), clinical therapy, lactate clearance rate (LCR) at 6 hours, the length of ICU stay, hemodynamics and oxygen metabolism parameters before and after resuscitation were compared between the two groups. Risk factors were analyzed by multivariate Cox regression for 28-day mortality of patients with septic shock. The receiver operating characteristic (ROC) curve was plotted to assess the prognostic values of these factors for 28-day mortality. Results:① Compared with the survival group, the patients in the death group showed significantly higher levels of APACHEⅡ score (23.96±4.31 vs. 17.70±3.92) and SOFA score (12.74±2.80 vs. 9.23±2.43, both P < 0.01), significantly higher proportions of mechanical ventilation [85.2% (23/27) vs. 50.0% (35/70)] and continuous renal replacement therapy [CRRT; 51.9% (14/27) vs. 25.7% (18/70), both P < 0.05], a significantly more fluid replacement at 6 hours (L: 2.92±0.24 vs. 2.63±0.25, P < 0.01), a significantly lower level of LCR at 6 hours [(11.61±7.76)% vs. (27.67±13.71)%, P < 0.01], and a shorter length of ICU stay (days: 6.37±2.70 vs. 7.67±2.31, P < 0.05). ② Compared with the survival group, the patients before resuscitation in the death group showed a significantly lower level of mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa): 52.63±4.35 vs. 55.74±3.01, P < 0.01], significantly higher levels of Lac and Pcv-aCO 2/Ca-cvO 2 ratio [Lac (mmol/L): 7.13±1.75 vs. 5.22±1.36, Pcv-aCO 2/Ca-cvO 2 ratio: 1.67±0.29 vs. 1.48±0.22, both P < 0.01]; and the patients at 6 hours of resuscitation in the death group showed a significantly lower level of MAP (mmHg: 62.59±4.80 vs. 66.71±3.91, P < 0.01), significantly higher levels of central venous pressure (CVP), Lac, Pcv-aCO 2 and Pcv-aCO 2/Ca-cvO 2 ratio [CVP (mmHg): 10.74±1.40 vs. 8.80±0.75, Lac (mmol/L): 6.36±1.86 vs. 3.90±1.95, Pcv-aCO 2 (mmHg): 7.59±2.02 vs. 4.34±1.37, Pcv-aCO 2/Ca-cvO 2 ratio: 1.87±0.51 vs. 1.03±0.27, all P < 0.01]. ③ Multivariate Cox regression analysis showed that the independent risk factors for 28-day mortality in patients with septic shock were Lac and Pcv-aCO 2/Ca-cvO 2 ratio whether before or at 6 hours of resuscitation [Lac before resuscitation: relative risk ( RR) = 1.434, 95% confidence interval (95% CI) was 1.070-1.922, P = 0.016; Lac at 6 hours of resuscitation: RR = 1.564, 95% CI was 1.202-2.035, P = 0.001; Pcv-aCO 2/Ca-cvO 2 ratio before resuscitation: RR = 2.828, 95% CI was 1.108-4.207, P = 0.038; Pcv-aCO 2/Ca-cvO 2 ratio at 6 hours of resuscitation: RR = 4.386, 95% CI was 2.842-5.730, P = 0.000]. ④ ROC curve analysis showed that Lac and Pcv-aCO 2/Ca-cvO 2 ratio at 6 hours of resuscitation had predictive value for the prognosis of patients with septic shock, the area under ROC curve (AUC) was 0.849 (95% CI was 0.762-0.914) and 0.905 (95% CI was 0.828-0.955), respectively. However, the predictive value of Lac combined with Pcv-aCO 2/Ca-cvO 2 ratio in patients with septic shock was significantly higher than Lac [AUC (95% CI): 0.976 (0.923-0.996) vs. 0.849 (0.762-0.914), Z = 3.354, P = 0.001], the sensitivity was 97.14%, and the specificity was 88.89%. Conclusions:Lac and Pcv-aCO 2/Ca-cvO 2 ratio are independent risk factors for predicting 28-day mortality in patients with septic shock. Lac combined with Pcv-aCO 2/Ca-cvO 2 ratio can assess the prognosis of patients with septic shock more accurately.

RESUMEN

A unique 1,3-dipolar [3+2] cycloaddition of alkyl 4-oxo-4-arylbut-2-enoates bearing two different electron-withdrawing groups was completed by using the silver/(R)-DTBM-Segphos catalyst system, which gives the corresponding fully substituted pyrrolidines with four stereogenic centers in good yields and with excellent enantioselectivities (up to 98% ee).

RESUMEN

Objective To compare the clinical effect of endoscopic thyroidectomy and open thyroidectomy in the treat-ment of benign thyroid diseases. Methods A total of 120 patients with benign thyroid diseases were selected from March 2015 to June 2017 in the Third Affiliated Hospital of Xinxiang Medical University. The patients were divided into endoscopic opera-tion group(n = 62)and open operation group(n = 58)according to the treatment methods. The patients in the open operation group were treated with conventional open thyroidectomy,and the patients in the endoscopic operation group were treated with endoscopic thyroidectomy. The operation time,intraoperative bleeding volume,postoperative drainage volume and hospitalization time were recorded in the two groups;and the intraoperative and postoperative complications were observed. The pain of the pa-tients in the two groups was evaluated by visual analogue scale(VAS)at the time points of 6,12 and 24 hours after operation. The cosmetic satisfaction of the patients in the two groups was evaluated by numerical scoring system(NSS)at the time points of 1 and 3 months after operation. Results The operation time and hospitalization time in the endoscopic operation group were significantly shorter than those in the open operation group(P < 0. 05),and the intraoperative bleeding volume and postopera-tive drainage volume in the endoscopic operation group were significantly lower than those in the open operation group(P <0. 05). The VAS score of pain in the endoscopic operation group was significantly lower than that in the open operation group at the time points of 6,12 and 24 hours after operation(P < 0. 05). The NSS score in the endoscopic operation group was sig-nificantly higher than that in the open operation group at the time points of 1 and 3 months after operation(P < 0. 05). The in-cidence of complications in the endoscopic operation group and the open operation group was 12. 90％(8 / 62)and 39. 66％(23 / 58)respectively,the incidence of complications in the endoscopic operation group was significantly lower than that in the open operation group(χ2 = 11. 210,P < 0. 05). Conclusion Endoscopic thyroidectomy is reliable in the treatment of benign thyroid diseases. It has the advantages of small trauma,short operation time,quick recovery,light postoperative pain,small sur-gical scar and fewer complications and so on.

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Objective To discuss the relationship between serum anti-Phosphalipase A2 receptor (PLA2R) antibodies and glomerular IgG4 subclass in patients with membranous nephropathy and evaluate the diagnostic value of the two markers.Methods Patients diagnosed as membranous nephropathy from October 2011 to April 2014 in Peking Union Medical College Hospital were included and divided into IMN and SMN groups accoding to their clinical diagnosis.Serum anti-PLA2R antibodies and glomerular IgG subclasses were both detected by indirect immunofluorescence assay.Receiver operator characteristic curves were used to evaluate the diagnostic efficiency of anti-PLA2R antibodies and glomerular IgG4.Results Prevalence of serum anti-PLA2R antibodies of IMN patients was 69.5％ (41/59); prevalence of MLN patients was 4.8％ (1/21).Within the IMN group,thirty-five patients showed positive results of both serum anti-PLA2R antibodies and glomerular IgG4; Six patients were positive for serum anti-PLA2R antibodies but negative for glomerular IgG4; Seventeen patients were positive for glomerular IgG4 but negative for serum anti-PLA2R antibodies; one patient was negative for both tests.The sensitivity of serum anti-PLA2R antibody was 69.5％ and the specificity was 95.2％; the sensitivity of glomerular IgG4 was 89.8％ and the specificity was 52.3％.The sensitivity of the combined marker consisting of serum anti-PLA2R antibody and glomerular IgG4 was 59.3％ and the specificity was 100％.Four out of the six patients secondary to HBV infection,one out of the three patients secondary to Sj(o)gren syndrome,one out of the three patients secondary to malignant tumor showed positive results of serum anti-PLA2R antibodies.Conclusions Serum antiPLA2R antibodies were of high prevalence among IMN patients; the prevalence among SMN patients varied with etiologies.Results of serum anti-PLA2R antibodies and glomerular IgG4 were helpful to rule out secondary etiologies in the diagnosis of membrnous nephropathy.

RESUMEN

Several genome-wide association studies (GWAS) have revealed that single nucleotide polymorphisms (SNPs) of ABCG2 and SLC22A12 were strongly associated with serum uric acid (SUA), but those of methylene tetrahydrofolate reductase (MTHFR) were not. However, there were several studies indicating the association with MTHFR C677T polymorphism. This study examined the association with the polymorphism, taking into account the genotypes of ABCG2 Q126X and SLC22A12 W258X. Subjects were 5,028 health checkup examinees of Seirei Preventive Health Care Center (3,416 males and 1,612 females) aged 35 to 69 years, who participated in the Japan Multi-Institutional Collaborative Cohort Study (J-MICC Study). Hyperuricemia was defined as SUA equal to 7 mg/dL or over. The genotype frequency was 35.9% for CC, 48.1% for CT, and 16.0% for TT, being in Hardy-Weinberg equilibrium (p=0.90). Among 4,425 participants with ABCG2 126QQ and SLC22A12 258WW who were not under medication for hyperuricemia, the mean SUA was 5.6 mg/dL, 5.6 mg/dL, and 5.7 mg/dL, respectively. When 114 participants with ABCG2 126QQ and SLC22A12 258WW under medication for hyperuricemia were included in hyperuricemia cases, the sex-age adjusted odds ratio (OR) of hyperuricemia was not significant; OR=1.00 (95% confidence interval, 0.89-1.24) for CT genotype and OR=0.98 (0.84-1.32) for TT genotype, relative to CC genotype. The present study indicated no association between SUA and MTHFR C677T genotype, after the influences of ABCG2 Q126X and SLC22A12 W258X were removed.

Asunto(s)

Transportadoras de Casetes de Unión a ATP/genética , Pueblo Asiatico/genética , Hiperuricemia/genética , Metilenotetrahidrofolato Reductasa (NADPH2)/genética , Proteínas de Neoplasias/genética , Transportadores de Anión Orgánico/genética , Proteínas de Transporte de Catión Orgánico/genética , Polimorfismo de Nucleótido Simple , Ácido Úrico/sangre , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2 , Adulto , Factores de Edad , Anciano , Biomarcadores/sangre , Distribución de Chi-Cuadrado , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Humanos , Hiperuricemia/sangre , Hiperuricemia/etnología , Japón , Modelos Logísticos , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Fenotipo , Factores de Riesgo , Factores Sexuales

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OBJECTIVES: A number of studies have shown that chronic hepatitis B virus infection is implicated in susceptibility to pancreatic cancer. However, the results are still controversial. This meta-analysis aimed to quantitatively assess the relationship between chronic hepatitis B virus infection and incidence of pancreatic cancer of cohort and case-control studies. METHODS: A literature search was performed for entries from 1990 to 2012 using PUBMED and EMBASE. Studies were included if they reported odds ratios (ORs) and corresponding 95% CIs of pancreatic cancer with respect to the infection of hepatitis B virus. RESULTS: Eight studies met the inclusion criteria, which included five case-control studies and three cohort studies. Compared with individuals who have not infection of hepatitis B virus, the pooled OR of pancreatic cancer was 1.403 (95%CI: 1.139-1.729, P=0.001) for patients with hepatitis B virus infection. Sub-group analysis by study design showed that the summary OR was 1.43 (95%CI: 1.06-1.94, P=0.021) when pooling case-control studies and 1.31 (95%CI: 1.00- 1.72, P=0.05) when pooling cohort studies. CONCLUSION: Findings from this meta-analysis suggest that chronic hepatitis B virus infection may increase the risk of pancreatic cancer. This relationship needs to be confirmed by further follow-up studies.

Asunto(s)

Hepatitis B Crónica/epidemiología , Neoplasias Pancreáticas/epidemiología , Estudios de Casos y Controles , Estudios de Cohortes , Intervalos de Confianza , Virus de la Hepatitis B , Humanos , Incidencia , Oportunidad Relativa , Neoplasias Pancreáticas/virología , Factores de Riesgo

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PURPOSE: To evaluate the feasibility and therapeutic efficacy of 1.5 T conventional MR-guided percutaneous interstitial implantation of I-125 radioactive seeds in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: The institutional ethics committee approved this study. After imformed consent was obtained, twenty-three patients suffering from a total of 65 HCC lesions were treated with I-125 seed permanent interstitial implantation under the guidance of a 1.5T conventional magnetic resonance imaging (MRI) system. The FSE T2WI, T1 FSPGR, FIESTA 2D, 3D Dyn T1WI sequences were used to guide an 18 G MR-compatible needle inserted into the lesions to introduce the I-125 seeds. The response evaluation criteria in solid tumors (RECIST) were used to evaluate the curative effect. RESULTS: The needle and I-125 seed were seen clearly on MRI images. The final dose delivered to total decay was 173.46 ± 32.44 Gy (range, 110-270 Gy) as calculated by postoperative TPS. The complete response (CR) was seen in 22 lesions (33.8%), partial response (PR) in 24 lesions (36.9%), stable disease (SD) in 9 lesions (13.8%), and progressive disease (PD) in 10 lesions (15.4%). The post-operative alpha-fetoprotein (AFP) was decreased (t = 3.117, P = 0.005<0.05). Two patients were observed a small area of subcapsular bleeding that did not lead to any symptoms or clinical sequelae. CONCLUSION: MR-guided I-125 implantation for HCC is technically feasible and effective.

Asunto(s)

Braquiterapia/métodos , Carcinoma Hepatocelular/radioterapia , Radioisótopos de Yodo/uso terapéutico , Neoplasias Hepáticas/radioterapia , Imagen por Resonancia Magnética Intervencional/métodos , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Factibilidad , Femenino , Humanos , Radioisótopos de Yodo/administración & dosificación , Masculino , Persona de Mediana Edad , Planificación de la Radioterapia Asistida por Computador , Resultado del Tratamiento

RESUMEN

OBJECTIVE: To evaluate the effect of comprehensive control and management of schistosomiasis at plateaus regions in Yunnan Province. METHODS: Xiaolian and Kangfu villages at plateaus regions where schistosomiasis was endemic were selected as study areas from 2006 to 2011, the schistosomiasis comprehensive control measures were conducted, and these measures included the health education, chemotherapy, stool and water management, grazing forbidden, Oncomelania snail control, etc. combined with the infrastructure of farmland water conservancy, agricultural comprehensive development, adjustment of industry structure, returning farmland to forest, ditch hardening, and aquaculture. RESULTS: At Xiaolian Village, no schistosomiasis patient and livestock were found from 2008; and at Kangfu Village, no schistosomiasis patient was detected from 2006 and no schistosomiasis domestic animal was found from 2008. In 2011, the snail area, percent of frames with living snails, the number of snails, average concentration of living snails, and the highest concentration of living snails descended by 69.99%, 81.86%, 88.86%, 89.71%, 57.95% at Xiaolian Village, and descended by 27.65%, 1.11%, 94.71%, 92.16%, 88.00% at Kangfu Village, respectively, compared with those in 2006. The ratios of infected snail area to snail area were 68.91% in 2006 and 69.13% in 2007 at Xiaolian Village, and 61.73% in 2006 and 43.24% in 2007 at Kangfu Village. There were no infected snails from 2008 in the two villages. CONCLUSION: The comprehensive control and management measures can effectively control the schistosomiasis prevalence at plateaus regions.

Asunto(s)

Control de Enfermedades Transmisibles/métodos , Esquistosomiasis/prevención & control , Esquistosomiasis/veterinaria , Animales , China/epidemiología , Reservorios de Enfermedades/parasitología , Humanos , Ganado/parasitología , Salud Rural , Esquistosomiasis/epidemiología , Esquistosomiasis/parasitología , Caracoles/crecimiento & desarrollo , Caracoles/parasitología

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OBJECTIVE@#To discuss the role of 3D-computed tomography angiography (3D-CTA) technology in reducing injuries of large meningioma surgery.@*METHODS@#3D-CTA preoperative examinations were done in 473 patients with large meningioma (simulated group). The images were analyzed by 3D post-processing workstation. By observing the major intracranial blood vessels, venous sinus, and the compression and invasion pattern in the nerve region, assessing risk level of the surgery, simulating the surgical procedures, the surgical removal plan, surgical routes and tumor blood-supplying artery embolisation plan were performed. Two hundred and fifty seven large meningioma patients who didn't underwent 3D-CTA preoperative examination served as control group. The incidence of postoperative complications, intraoperative blood transfusion and the operation time were compared between these two groups.@*RESULTS@#Compared with the control group, the Simpson's grade I and II resection rate was 80.3% (380/473), similar with that of the control (81.3%, 209/257). The incidence of postoperative complications in 3D-CTA simulated group was 37.0% which was significantly lower than that (48.2%) of the control (P<0.01). The intraoperative blood supply for simulated group and the control was (523.4±208.1) mL and (592.0±263.3) mL, respectively, with significant difference between two groups (P<0.01). And the operation time [(314.8±106.3)] min was significantly lower in simulated group than that in the control [(358.4±147.9) min] (P<0.01).@*CONCLUSION@#Application of 3D-CTA imaging technology in risk level assessment before large-scaled meningioma resection could assist in the rational planning of tumor resectin, surgical routes, and is helpful in reducing injuries and complications and enhancing the prognosis of the patients.

Asunto(s)

Femenino , Humanos , Masculino , Estudios de Casos y Controles , Angiografía Cerebral , Métodos , Imagenología Tridimensional , Tiempo de Internación , Neoplasias Meníngeas , Diagnóstico por Imagen , Cirugía General , Meningioma , Diagnóstico por Imagen , Cirugía General , Tomografía Computarizada Multidetector , Métodos

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Rapid economic development in East Asian countries has inevitably resulted in environmental degradation in the surrounding seas, and concern for the environment and its protection against pollutants is increasing. Identification of sources of contaminants and evaluation of current environmental status are essential to environmental pollution management, but relatively little has been done in the South China Sea (SCS). In order to investigate the abundance, distribution, and sources of Pb within the SCS, stable Pb isotopes and their ratios were employed to assess the contamination status and to differentiate between natural and anthropogenic origins of Pb in the surface sediments. The total Pb concentrations in sediments varied from 4.18 to 58.7 mg kg(-1), with an average concentration of 23.6 ± 8.9 mg kg(-1). The observed Pb isotope ratios varied from 18.039 to 19.211 for (206)Pb/(204)Pb, 15.228 to 16.080 for (207)Pb/(204)Pb, 37.786 to 39.951 for (208)Pb/(204)Pb, 1.176 to 1.235 for (206)Pb/(207)Pb, and 2.468 to 2.521 for (208)Pb/(207)Pb. The majority of these ratios are similar to those reported for natural detrital materials. Combined with Pb enrichment factor values, our results show that Pb found within most of the SCS sediments was mainly derived from natural sources, and that there was not significant Pb pollution from anthropogenic sources before 1998. Further studies are needed to reconstruct deposition history and for trend analysis.

Asunto(s)

Sedimentos Geológicos/química , Plomo/análisis , China , Monitoreo del Ambiente , Isótopos/análisis , Agua de Mar

RESUMEN

PURPOSE: This study was designed to assess the use of artificial pneumothorax with position adjustment to gain a pleural space approach in computed tomographic-guided core biopsy of mediastinal masses. DESCRIPTION: Eleven patients with mediastinal lesions who were undergoing percutaneous core biopsies received an artificial pneumothorax with a 22-gauge lumbar puncture needle. Each patient's position was adjusted to place the lesion as high as possible in the thoracic cavity. Air was injected until the lung was displaced from the path of the biopsy needle. After completion of the biopsy, a comparable volume of air was aspirated. EVALUATION: In all patients, satisfactory displacement of the lung from the biopsy site was achieved with the artificial pneuomothorax procedure enabling the target lesion to be reached. No postoperative air leaks requiring tube drainage were encountered. CONCLUSIONS: Artificial pneumothorax with position adjustment is a safe and effective method that provides access for computed tomographic-guided biopsy of mediastinal lesions without the risks of traversing aerated lung tissue and with a relatively low volume of injected air.

Asunto(s)

Neoplasias del Mediastino/diagnóstico por imagen , Neoplasias del Mediastino/patología , Neumotórax Artificial/métodos , Tomografía Computarizada por Rayos X , Adolescente , Adulto , Anciano , Biopsia con Aguja/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven

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<p><b>OBJECTIVE</b>To evaluate the clinicopathological characteristics and prognosis of breast cancer with estrogen- and progesterone-receptor negative (ER-/PR-) and HER-2 overexpression (HER+++) in a Chinese population.</p><p><b>METHODS</b>The data of patients with ER-/PR- and HER+++ breast cancer treated in our hospital from March 1999 to December 2004 were retrospectively reviewed. The influence of clinicopathological characteristics and molecular markers on the survival was analyzed.</p><p><b>RESULTS</b>A total of 111 breast cancer patients with ER and PR negative but HER+++ were identified, accounting for 4.9% of all the breast cancer patients treated during the same period. There were 25 cases (22.5%) in stage I, 44 (39.6%) in stage II and 36 (32.4%) in stage III, respectively, with a median age of 49 years. Axillary lymph node metastasis was found in 54 cases. The 5-year disease free survival (DFS) and overall survival rates (OS) were 70.7% and 73.1%, respectively. Univariate analysis showed that lymph node status, primary tumor size and pathological stage were prognosis-related factors influencing the DFS and OS. However, by multivariate analysis, only primary tumor size and lymph node status were independent factors influencing survival.</p><p><b>CONCLUSION</b>The breast cancer with estrogen- and progesterone-receptor negative but HER-2 overexpression is a particular subtype of breast cancers, with unfavorable clinicopathological characteristics and poor survival. Lymph node status and primary tumor size are two independent prognostic factors.</p>

Asunto(s)

Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Adulto Joven , Neoplasias de la Mama , Quimioterapia , Metabolismo , Patología , Cirugía General , Carcinoma in Situ , Quimioterapia , Metabolismo , Patología , Cirugía General , Carcinoma Ductal de Mama , Quimioterapia , Metabolismo , Patología , Cirugía General , Quimioterapia Adyuvante , Supervivencia sin Enfermedad , Estudios de Seguimiento , Metástasis Linfática , Mastectomía , Métodos , Estadificación de Neoplasias , Modelos de Riesgos Proporcionales , Receptor ErbB-2 , Metabolismo , Receptores de Estrógenos , Metabolismo , Receptores de Progesterona , Metabolismo , Estudios Retrospectivos , Tasa de Supervivencia , Carga Tumoral

RESUMEN

<p><b>OBJECTIVE</b>To analyze the incidence, clinical and pathological characteristics, survival and prognostic factors of so-called triple negative breast cancer (TNBC) with negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER-2).</p><p><b>METHODS</b>Clinical and pathological as well as follow-up data of TNBC patients between Jan. 1999 to Dec. 2002 were collected and analyzed.</p><p><b>RESULTS</b>Totally, the pathological result of 1175 breast cancer patients were retrospectively reviewed, and 158 patients were found with negative ER, negative PR and HER-2 scored as 0 or 1 + by immunohistochemistry staining. Eventually, only 108 patients with ER-negative, PR-negative and HER-2-negative (score: 0 ) were analyzed. Of the 108 patients, 8 had breast cancer family history, 3 oophoroma family history and one had ever suffered from oophoroma herself. The median age of the 108 TNBC patients was 47.0 years, and 75.0% of them had stage I or II disease. The majority of pathological types were grade II or III invasive ductal carcinomas, and 92.6% of the tumors were staged as T1 or T2. Lymph node metastases were detected in 49. 1% of these patients. Event-free survival, distant metastasis-free survival, local relapse-free survival and overall survival at 5 years were 68.1%, 70.9%, 72.1% and 76.9%, respectively. Though lymph node metastasis and lymph-vascular invasion were all found to be correlated with overall survival, however, only the lymph node metastasis was an independent factor that affected the overall survival revealed by the Cox proportional hazard model analysis.</p><p><b>CONCLUSION</b>Triple negative breast cancer has distinct clinical and pathologic characteristics. The incidence of triple negative breast cancer in Chinese is similar to that in white but lower than that in black women. Most of the triple negative breast cancer in China is composed of sporadic breast cancer. Lymph node metastasis is an important independent prognostic factor. Clinical outcome of this series is similar to that in white women, while better than that in black women after appropriate radiotherapy and anthracycline-based chemotherapy. Further study is still necessary to explore new treatment in order to improve the prognosis of triple negative breast cancer.</p>

Asunto(s)

Adulto , Anciano , Femenino , Humanos , Persona de Mediana Edad , Pueblo Asiatico , Neoplasias de la Mama , Metabolismo , Patología , Carcinoma Ductal de Mama , Metabolismo , Patología , Supervivencia sin Enfermedad , Estudios de Seguimiento , Metástasis Linfática , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Células Neoplásicas Circulantes , Modelos de Riesgos Proporcionales , Receptor ErbB-2 , Metabolismo , Receptores de Estrógenos , Metabolismo , Receptores de Progesterona , Metabolismo , Estudios Retrospectivos , Tasa de Supervivencia