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BACKGROUND: Discussed based on the network interactive platform of structured care for patients with chronic renal failure (CRF) in the process of hemodialysis. OBJECTIVE: This study seeks to elucidate the application value of structured nursing, deployed through network interaction platforms, in sustaining patients undergoing maintenance hemodialysis. METHODS: A total of 62 patients diagnosed with Chronic Renal Failure (CRF) between April 2022 and August 2023 were randomly allocated into two distinct care groups: conventional and structured nursing care based on a web-interactive platform. Both cohorts were comparatively analyzed with respect to psychological states, quality of life within therapeutic interventions, and relationships with complications. Renal function indicators, including Creatinine Clearance (Ccr), Serum Creatinine (SCr), and Blood Urea Nitrogen (BUN), were subjected to Pearson analysis to appraise their predictive value in prognostication, while Receiver Operating Characteristic (ROC) curve analysis was constructed to further discern their diagnostic precision. RESULTS: Post-intervention, notable improvements were observed in the emotional states of patients in both cohorts, with the structured care group exhibiting significantly lower Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) scores (p< 0.05). Furthermore, patients under the web-interactive structured nursing regimen demonstrated superior overall adherence, a reduced incidence rate of complications, and markedly higher scores in quality of life assessments compared to those under conventional care (p< 0.05). The derived cut-off values for Ccr, SCr, and BUN were 32.5 ml/min, 251.5 umol/L, and 14.5 mmol/L, respectively, with sensitivities and specificities pegged at 0.645% and 0.645% for Ccr, 0.774% and 0.548% for SCr, and 0.774% and 0.774% for BUN. The corresponding areas under the ROC curve (AUC) for each parameter were 0.816, 0.653, and 0.856, respectively. CONCLUSION: Comprehensive hemodialysis care for patients with chronic renal failure can improve self-care ability to improve quality of life and reduce the incidence of complications, which has great potential for clinical progress and is worthy of further research.

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BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a malignant tumor originating from the epithelium of the pancreatic duct. Neoadjuvant chemotherapy FOLFIRINOX (a combination of oxaliplatin, irinotecan, and 5-fluorouracil/leucovorin) is considered to be the most effective regimen for patients with resected pancreatic cancer. METHODS: This article reports a case of a pancreatic ductal adenocarcinoma patient who exhibited regular periodic fluctuations in the serum iron level during FOLFIRINOX. RESULTS: It indicates that an unexplained increase in serum iron levels after each cycle of FOLFIRINOX is non-cell destructive and due to a reduction in iron consumption, after ruling out other potential causes. CONCLUSIONS: FOLFIRINOX in pancreatic cancer patients may cause an elevation of serum iron levels.

Asunto(s)

Carcinoma Ductal Pancreático , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Pancreáticas/patología , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Neoadyuvante , Fluorouracilo/uso terapéutico , Carcinoma Ductal Pancreático/tratamiento farmacológico , Carcinoma Ductal Pancreático/patología , Leucovorina/uso terapéutico , Estudios Retrospectivos

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OBJECTIVES: To present a method combining ultrasound (US) and contrast-enhanced ultrasound (CEUS) features for differential diagnosis of cervical tuberculous lymphadenitis (CTL) and primary lymphoma. METHODS: A total of 155 patients with CTL (n = 49) and lymphoma (n = 106) who underwent US and CEUS were retrospectively included. The features extracted from US and CEUS and the significant clinical data were created three models using the least absolute shrinkage and selection operator and logistic regression analysis. The diagnostic performance of the models was assessed using the area under the curve (AUC). RESULTS: The combined model outperformed US model and CEUS model in distinguish CTL from lymphoma achieved favorable performances in training set and validation set with AUCs of 0.958 and 0.946 as well as high accuracies (91.7% and 87.2%), sensitivities (95.9% and 84.4%) and specificities (82.4% and 93.3%). Delong's test showed that among the three models, combined model was significantly different from the other two models in training set (p = 0.011 and 0.029, respectively) and validation set (p = 0.018 and 0.001, respectively). CONCLUSIONS: A combination of US and CEUS achieved good diagnostic performance in differentiating lymphoma and CTL, which might aid in clinical decision-making.

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Linfoma , Tuberculosis Ganglionar , Humanos , Ganglios Linfáticos/patología , Estudios Retrospectivos , Ultrasonografía/métodos , Linfoma/diagnóstico por imagen , Linfoma/patología

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Objective: To explore the diagnostic value of abdominal B-ultrasound in the diagnosis of congenital heart disease complicated with extracardiac malformations in the second trimester of pregnancy. Methods: 50 pregnant women with congenital cardiac malformations and extracardiac malformations diagnosed in our hospital from 2015 to 2019 were retrospectively analyzed. The diagnostic results and the types of congenital heart disease complicated with extracardiac malformations were compared to analyze the diagnostic value of abdominal B-ultrasound. Results: In the diagnosis of 50 fetuses with congenital heart disease and extracardiac malformation, the tetralogy of Fallot syndrome accounts for the largest proportion. Abdominal B-ultrasound in the second trimester was associated with a higher detection rate of fetal heart malformation (72%) versus in the third trimester (40%) (P < 0.05). The single atrium and single ventricle had the highest diagnostic accuracy of fetal congenital heart malformation in the second trimester. The highest success rate of detection at different gestational weeks was observed at the 14th gestational week (P < 0.05). Four-chamber cardiac section (4CV) had the lowest diagnostic accuracy (62%) for cardiac malformations, and the 4CV + three-vessel-trachea plane (3VVT) had the highest diagnostic accuracy (90%) for cardiac malformations. Conclusion: Abdominal B-ultrasound features a high diagnostic value for congenital heart disease complicated with extracardiac malformations in the second trimester of pregnancy, and the second trimester is the optimal detection timing with the highest detection accuracy.

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OBJECTIVES: Non-communicating rudimentary horn pregnancy is a rare condition associated with serious complications and consequences. MATERIAL AND METHODS: We reported a case of a 44-day non-communicating rudimentary horn pregnancy who was diagnosed by three-dimensional ultrasound (3D-US) and pelvic magnetic resonance imaging (MRI), followed by treatment via laparoscopic resection. RESULTS: The 3D-US and pelvic MRI scan showed a consistent result. Serious complications and consequences were avoided. Postoperative diagnosis showed that the malformation was classified as type IIc. CONCLUSIONS: For such diagnosis as a unicornuate uterus with a rudimentary horn, if there are no symptoms, it cannot be treated. Once pregnancy is in the rudimentary horn, 3D-US or MRI should be conducted to determine the implantation location of the pregnancy capsule and the operation should be performed as soon as possible to avoid uterine rupture. Laparoscopic surgery can be chosen in the early stage.

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The purpose of the research is to study the bioactive constituents of Callicarpa nudiflora. From the 65% ethanol extract of C. nudiflora leaves, ten compounds were isolated by macroporous adsorption resin, Sephadex LH-20, ODS, silica gel, and preparative HPLC. These compounds were identified as callicapene M6(1), sterebin A(2), isomartynoside(3), crenatoside(4), luteolin-7-O-neohesperidoside(5), apigenin-7-O-ß-D-neohesperidoside(6), isoacteoside(7), acteoside(8),(7R)-campneoside I(9), and(7S)-campneoside I(10) on the basis of NMR, HR-ESI-MS, and optical rotation data. Compound 1 was obtained as a new compound. Compounds 2 and 4 were isolated from the genus Callicarpa for the first time. Compounds 9 and 10 were isolated from C. nudiflora for the first time.

Asunto(s)

Callicarpa , Diterpenos , Cromatografía Líquida de Alta Presión , Estructura Molecular , Hojas de la Planta

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BACKGROUND: There have been few reports on cancer patients with COVID-19 since its outbreak. Our study aimed to understand the clinical features of cancer patients with COVID-19 and determine the impact of surgery and chemotherapy on the patients' conditions. METHODS: Seventy COVID-19 patients from Renmin Hospital of Wuhan University, including 18 cancer patients, were enrolled in this study. Patients were classified into moderate or severe cases of COVID-19 and as well as non-cancer or cancer patients. Cancer patients were further grouped into Group A (prevalent cases with cancer history) and Group B (incident cases who underwent cancer treatment recently). Laboratory results were analyzed to determine whether cancer-related surgery and chemotherapy worsened the condition of cancer patients. The patients presented with clinical symptoms of COVID-19, including fever, dry cough, and polypnea; blood tests also revealed decreased lymphocyte counts and cellular immune function, and examination of CT scans revealed patchy ground-glass opacity of lungs. RESULTS: The results showed a significant difference (P<0.05) in levels of CD3 CD4 T lymphocytes and D-dimer between non-cancer and cancer patients with moderate COVID-19; there was also a significant difference (P<0.05) in levels of D-dimer between non-cancer and cancer patients with severe COVID-19. Except for liver function, there was no significant difference (P>0.05) between cancer patients in Group A and B with moderate COVID-19. A significant difference (P<0.05) in neutrophil-to-lymphocyte ratio (NLR) and CD4 T lymphocytes was observed between cancer patients with moderate COVID-19 and those with severe COVID-19. CONCLUSIONS: The results indicated that chemotherapy and surgery might not worsen the conditions of COVID-19 patients. NLR and CD4 T lymphocyte might be used as effective indicators for the conditions of cancer patients with COVID-19.

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COVID-19 , Neoplasias , Humanos , Linfocitos , Neutrófilos , Estudios Retrospectivos , SARS-CoV-2

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BACKGROUND: The research on the association between coronavirus disease 2019 (COVID-19) and cardiovascular disease (CVD) is still insufficient. AIM: This study aimed to investigate the association between neutrophil/lymphocyte ratio (NLR) and risk of cardiovascular events in patients with COVID-19. METHODS: Our study included 159 patients with COVID-19 who were measured for NLR value within the first 24 hours of admission. They were followed up for 6 months after discharge and then the relationship between levels of NLR and risk of cardiovascular events was assessed. RESULTS: In all included patients with COVID-19, NLR values in patients with cardiovascular events [16.28 (4.95-45.18)] were significantly higher than patients without cardiovascular events [4.75 (2.60-7.47)]. A multivariate logistic regression model revealed that elevated NLR value [increased per SD, 2.41 (1.43-4.29), P<0.001; increased 1 of NLR, 2.05 (1.33-4.01), P=0.010] was significantly and independently associated with increased risk of CVD history on admission after adjustment of related confounding factors. Then, Cox regression analysis revealed that elevated NLR value had a significant association with increased risk of cardiovascular events [increased per SD, 2.36 (1.42-4.36), P<0.001; Increased 1 of NLR, 2.00 (1.30-3.97), P=0.014] after adjustments of these same confounding factors. Furthermore, the ROC curve suggested that NLR value (AUC=0.803, 95% CI=0.731-0.875, P<0.001, sensitivity 81.2%, and specificity 82.6%) has a good predictive value for cardiovascular events during follow-up. CONCLUSION: High NLR value was clinically associated with elevated risk of cardiovascular events in patients with COVID-19, which might be a potential biomarker for predicting cardiovascular events in the current COVID-19 pandemic.

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Ovarian cancer (OC) is one of the most common malignancies with high incidence and mortality and the eighth most common cancer-associated mortality in women worldwide. Aberrant expression of the GINS complex subunit 2 (GINS2) gene and miR-502-5p has been associated with cancer progression. This study aims to investigate the specific molecular mechanism of the miR-502-5p-GINS2 axis in OC. GINS2 and miR-502-5p expression in OC tissues and cell lines was measured using RT-qPCR. Next, we investigated the interaction between miR-502-5p and GINS2 using a luciferase assay. The role of the miR-502-5p-GINS2 axis was detected by assessing cell proliferation, migration, and apoptosis levels, such as caspase-3 activity and caspase-3 protein expression, in the OC cell lines CaOV3 and SKOV3, respectively. MiR-502-5p expression was decreased, and GINS2 expression was dramatically elevated in OC tissues and cells. Upregulation of miR-502-5p expression repressed cellular proliferation and migration levels but increased the cellular apoptosis level. GINS2 overexpression enhanced the proliferation and migration levels but hampered OC cell apoptosis. Moreover, miR-502-5p inhibited GINS2 expression and suppressed OC tumorigenesis. miR-502-5p targeting GINS2 suppressed OC progression by inhibiting cell growth and promoting cell apoptosis. Hence, we provide a comprehensive understanding of OC involving both miR-502-5p and GINS2, which might be effective therapeutic targets for OC patients.

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Proteínas Cromosómicas no Histona/genética , MicroARNs/genética , Neoplasias Ováricas , Apoptosis/genética , Línea Celular Tumoral , Proliferación Celular/genética , Proteínas Cromosómicas no Histona/metabolismo , Regulación hacia Abajo/genética , Femenino , Humanos , MicroARNs/metabolismo , Persona de Mediana Edad , Neoplasias Ováricas/genética , Neoplasias Ováricas/metabolismo , Neoplasias Ováricas/patología

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OBJECTIVES: Induction of labour is a beneficial perinatal procedure, but may be associated with some risks. The aim of this study was to identify factors associated with the need for Caesarean section in women referred for preinduction with dinoprostone and misoprostol. MATERIAL AND METHODS: It was a retrospective cohort study of 560 pregnant women who underwent labour induction for medical reasons. Analyses were performed separately in the dinoprostone and misoprostol group. Above other characteristics, the diameters of the pelvis and abdominal circumference of pregnant women were analysed. RESULTS: There were some mothers' characteristics like age, weight, BMI, presence of hypothyroidism or diabetes, which were not associated with Caesarean section deliveries. Women in the misoprostol group with gestational age less than 38 weeks had an increased risk of Caesarean section (OR 2.189; p = 0.041). The analyses of combined effect of mothers age and parity history showed 6.7 (in dinoprostone group) and over 10 times (in misoprostol group) increased the risk of Caesarean section in nulliparous women over 35 years of age. CONCLUSIONS: The increased risk of Caesarean delivery in the dinoprostone group was combined with the intertrochanteric dimensions such as the mother's height measuring less than 165 cm, nulliparity and hypertension. In the misoprostol group, strong risk factors for Caesarean delivery were mothers aged 35 years or more, gestational age less than 38 weeks and nulliparity and hypertension as in dinoprostone group. The oxytocin infusion had increased the risk of Caesarean section only in the combined dinoprostone and misoprostol group. Further high-quality studies are warranted.

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Misoprostol , Oxitócicos , Administración Intravaginal , Adulto , Estudios de Casos y Controles , Cesárea , Dinoprostona , Femenino , Humanos , Lactante , Trabajo de Parto Inducido/métodos , Misoprostol/efectos adversos , Oxitócicos/efectos adversos , Embarazo , Estudios Retrospectivos

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Hepatic insulin resistance and nonalcoholic steatohepatitis (NASH) could be caused by excessive hepatic lipid accumulation and peroxidation. Vitamin E has become a standard treatment for NASH. However, astaxanthin, an antioxidant carotenoid, inhibits lipid peroxidation more potently than vitamin E. Here, we compared the effects of astaxanthin and vitamin E in NASH. We first demonstrated that astaxanthin ameliorated hepatic steatosis in both genetically (ob/ob) and high-fat-diet-induced obese mice. In a lipotoxic model of NASH: mice fed a high-cholesterol and high-fat diet, astaxanthin alleviated excessive hepatic lipid accumulation and peroxidation, increased the proportion of M1-type macrophages/Kupffer cells, and activated stellate cells to improve hepatic inflammation and fibrosis. Moreover, astaxanthin caused an M2-dominant shift in macrophages/Kupffer cells and a subsequent reduction in CD4(+) and CD8(+) T cell recruitment in the liver, which contributed to improved insulin resistance and hepatic inflammation. Importantly, astaxanthin reversed insulin resistance, as well as hepatic inflammation and fibrosis, in pre-existing NASH. Overall, astaxanthin was more effective at both preventing and treating NASH compared with vitamin E in mice. Furthermore, astaxanthin improved hepatic steatosis and tended to ameliorate the progression of NASH in biopsy-proven human subjects. These results suggest that astaxanthin might be a novel and promising treatment for NASH.

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Antioxidantes/uso terapéutico , Dieta Alta en Grasa , Trastornos del Metabolismo de la Glucosa/tratamiento farmacológico , Resistencia a la Insulina , Enfermedad del Hígado Graso no Alcohólico/tratamiento farmacológico , Vitamina E/uso terapéutico , Animales , Antioxidantes/farmacología , Linfocitos T CD4-Positivos/citología , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/citología , Linfocitos T CD8-positivos/inmunología , Modelos Animales de Enfermedad , Femenino , Humanos , Macrófagos del Hígado/metabolismo , Peroxidación de Lípido/efectos de los fármacos , Hígado/inmunología , Hígado/metabolismo , Hígado/patología , Macrófagos/citología , Macrófagos/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Obesos , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/genética , Proteína 1 de Unión a los Elementos Reguladores de Esteroles/metabolismo , Vitamina E/farmacología , Xantófilas/farmacología , Xantófilas/uso terapéutico

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Excessive hepatic lipid accumulation promotes macrophages/Kupffer cells activation, resulting in exacerbation of insulin resistance and progression of nonalcoholic steatohepatitis (NASH). However, few promising treatment modalities target lipotoxicity-mediated hepatic activation/polarization of macrophages for NASH. Recent epidemiological surveys showed that serum ß-cryptoxanthin, an antioxidant carotenoid, was inversely associated with the risks of insulin resistance and liver dysfunction. In the present study, we first showed that ß-cryptoxanthin administration ameliorated hepatic steatosis in high-fat diet-induced obese mice. Next, we investigated the preventative and therapeutic effects of ß-cryptoxanthin using a lipotoxic model of NASH: mice fed a high-cholesterol and high-fat (CL) diet. After 12 weeks of CL diet feeding, ß-cryptoxanthin administration attenuated insulin resistance and excessive hepatic lipid accumulation and peroxidation, with increases in M1-type macrophages/Kupffer cells and activated stellate cells, and fibrosis in CL diet-induced NASH. Comprehensive gene expression analysis showed that ß-cryptoxanthin down-regulated macrophage activation signal-related genes significantly without affecting most lipid metabolism-related genes in the liver. Importantly, flow cytometry analysis revealed that, on a CL diet, ß-cryptoxanthin caused a predominance of M2 over M1 macrophage populations, in addition to reducing total hepatic macrophage and T-cell contents. In parallel, ß-cryptoxanthin decreased lipopolysaccharide-induced M1 marker mRNA expression in peritoneal macrophages, whereas it augmented IL-4-induced M2 marker mRNA expression, in a dose-dependent manner. Moreover, ß-cryptoxanthin reversed steatosis, inflammation, and fibrosis progression in preexisting NASH in mice. In conclusion, ß-cryptoxanthin prevents and reverses insulin resistance and steatohepatitis, at least in part, through an M2-dominant shift in macrophages/Kupffer cells in a lipotoxic model of NASH.

Asunto(s)

Criptoxantinas/farmacología , Grasas de la Dieta/efectos adversos , Resistencia a la Insulina , Hígado/efectos de los fármacos , Enfermedad del Hígado Graso no Alcohólico/inducido químicamente , Animales , Antioxidantes/farmacología , Grasas de la Dieta/administración & dosificación , Glucosa/metabolismo , Células Estrelladas Hepáticas , Homeostasis , Macrófagos del Hígado , Hígado/metabolismo , Cirrosis Hepática , Masculino , Ratones , Ratones Endogámicos C57BL , Enfermedad del Hígado Graso no Alcohólico/metabolismo , Enfermedad del Hígado Graso no Alcohólico/patología , Obesidad

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This study aimed to investigate the lethal effect of the combination of bluetongue virus (BTV) and radiation on RM-1 murine prostate cancer cells in vitro and in vivo. Various cell lines were infected with BTV and the cytotoxicity was tested by a lactate dehydrogenase (LDH) release bioassay. Additionally, the RM-1 cells were treated with radiation and/or BTV to assess cell viability using the Cell Counting Kit-8 method. The levels of apoptosis of the RM-1 cells were detected by fluorescence-activated cell sorting (FACS). To identify a possible mechanism for the radiation-induced change in the oncolytic activity of BTV, cell cycle analyses were performed. The effects of different schedules of BTV and radiotherapy on cytotoxicity were assessed in vitro and the combined effect was also assessed in tumor models in vivo. The results demonstrated that BTV had a selective cytotoxic effect on RM-1 and PC-3 cancer cells, but did not affect normal cells, specifically, human umbilical vein endothelial cells and smooth muscle cells. The combination of BTV and radiation enhanced the cytotoxicity compared with that of each agent alone and had a synergistic effect in vitro and in vivo. The results of the FACS confirmed that radiotherapy induced apoptosis, as did BTV alone, and the combination treatment generated the most prominent levels of apoptosis, which were the highest in the early stage. The analysis of the cell cycle indicated that the G2-M phase levels increased after irradiation followed by infection with BTV. In conclusion, the combination of BTV and radiotherapy had an enhanced cytotoxic effect on RM-1 cells in vitro and in vivo compared with that of either treatment alone, and demonstrated a synergistic efficacy, in addition to a marked apoptosis-inducing effect. These results support the future investigation of BTV for potential clinical use in patients with prostate cancer.