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1.
BackgroundCombining hyperthermic intraperitoneal chemotherapy (HIPEC) treatment with early postoperative intraperitoneal chemotherapy (EPIC) may increase postoperative morbidity. This study aims to investigate postoperative morbidity after HIPEC+EPIC compared with HIPEC alone in patients with peritoneal metastases (PM).Materials and methodsThis is a retrospective propensity score matched cohort study. All patients undergoing PM treatment at Uppsala University Hospital between February 2004 and December 2014 were included. Propensity score matching with a 1:1 ratio was performed using sex, primary tumor site, preoperative chemotherapy, peritoneal cancer index, completeness of cytoreduction score, and HIPEC regimen. Length of hospital stay, morbidity, reoperation rate, and readmission rate within 6 months were selected as endpoints.ResultsA total of 390 consecutive patients were divided in two arms: HIPEC+EPIC (n = 115) and HIPEC alone (n = 275). The propensity score matching (n = 190) was successful with balanced covariates: 95 patients/arm. The length of stay (LOS) was longer in the HIPEC + EPIC group in the total cohort (30 vs 24 days, p < 0.001), with a trend towards significance in the propensity matched group (29 vs 25 days, p = 0.062). No other differences in endpoints were found.ConclusionHIPEC+EPIC is associated with a prolonged hospital stay, but with no statistically significant relevant increase in postoperative morbidity, reoperation rate or incidence of readmission.  相似文献   
2.
目的分析维生素D(vitamin D, VitD)在降低PM2.5对肺泡上皮细胞毒性中的影响。 方法采用透射电子显微镜和激光诱导荧光分析对比VitD处理前后,PM2.5的毒性能力。MMT观察VitD处理前后细胞生存率,分析PM2.5对A549的毒性影响。 结果VitD作用后的PM2.5平均粒径减小5.5 nm,颗粒聚结和团聚更为明显,颗粒平均条纹长度增加、弯曲度减小,差异有统计学意义。PM2.5条纹间距无统计学差异,有明显减小,接近0.06 nm。VitD溶液从PM2.5解吸3环和4环多环芳香烃(polycyclic aromatic hydrocarbons, PAHs),减少PM2.5表面附着的致病性PAHs。PM2.5可引起肺上皮细胞A549生存率明显下降,给予VitD干预后,PM2.5对A549细胞生存率的抑制改善了54.7%,PM2.5的生物毒性降低。 结论VitD可减少PM2.5上吸附的致病性PAHs,抑制其致病活性,减小PM2.5对肺上皮细胞的毒性。  相似文献   
3.
目的评估颗粒物(particulate matter,PM)污染对呼吸系统疾病(respiratory disease,RD)住院人数的影响,估计降低PM水平可避免的经济损失,为评估空气污染治理的成本-效益提供依据。方法收集武汉市2015—2019年两家三甲医院RD住院患者资料、同期武汉市PM浓度和气象数据。采用广义相加模型(generalized additive model,GAM)估计PM对RD住院人数的影响,采用疾病成本法(cost of illness approach,COI)估算PM浓度降低带来的可避免经济损失。结果PM污染造成RD住院人数增加,PM2.5和PM10浓度每上升10μg/m3,分别导致RD住院人数上升1.71%和0.71%。其中男性和0~14岁人群受影响较大,PM2.5浓度每上升10μg/m3,男性和0~14岁住院人数分别上升1.97%和2.65%;PM10浓度每上升10μg/m3,男性和0~14岁住院人数分别上升0.87%和0.88%。2015—2019年PM污染造成武汉市6.33万人住院和12.14亿元经济损失。若PM浓度降低至同期世界卫生组织建议值,武汉市每年可避免1.94亿元经济损失和1.01万人住院。结论PM暴露可导致沉重的疾病负担和经济损失,采取有效的措施控制PM浓度,将带来较大的经济效益。  相似文献   
4.

Background

It has been reported that particulate matter (PM) is associated with cardiovascular diseases (CVD) while metabolic syndrome is also an important risk factor for CVD. However, few studies have investigated the epidemiological association between PM and metabolic syndrome.

Objective

To investigate the association between one-year exposure to PM with an aerodynamic diameter <2.5?μm (PM2.5) and the risk of metabolic syndrome in Korean adults without CVD.

Methods

Exposure to PM2.5 was assessed using a Community Multiscale Air Quality (CMAQ) model. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III. Andersen and Gill model with time-varying covariates, considering recurrent events, was used to investigate the association between one-year average PM2.5 and the risk of incident metabolic syndrome in 119,998 adults from the national health screening cohort provided by Korea National Health Insurance from 2009 to 2013.

Results

Higher risk of metabolic syndrome, waist-based obesity, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia were significantly associated with a 10-μg/m3 increase in PM2.5 [adjusted hazard ratio (HR): 1.070, 1.510, 1.499, 1.468, 1.627 and 1.380, respectively]. In addition, the risk of metabolic syndrome associated with PM2.5 exposure was significant in the consistently obese group (obese at baseline and endpoint).

Conclusion

Exposure to one-year average PM2.5 is associated with an increased risk of metabolic syndrome and its components in adults without CVD. These associations are particularly prominent in the consistently obese group (obese at baseline and endpoint). Our findings indicate that PM2.5 affects the onset of MS and its components which may lead to increase the risk of CVD.  相似文献   
5.
目的 探讨环境空气放射性水平及与空气质量的关系。方法 选取2017年9月-12月期间,以SNOW WHITE大流量采样器进行空气样品收集,连续24 h采样,以TBM-3S测量仪对收集的样品滤膜表面进行表面放射性测量,将测得结果分别与空气质量等级、大气中PM2.5、PM10颗粒物浓度进行统计学比较分析。结果 37个大气气溶胶滤膜样品的表面放射性水平为(1.051~2.831)Bq/cm2,平均值为1.802 Bq/cm2;不同空气质量等级间比较大气中放射性水平无显著性差异(P ≥ 0.05),不同颗粒物浓度间比较大气中放射性水平无显著性差异(P ≥ 0.05)。结论 监测期间,空气质量及大气中颗粒物含量的变化,未引起大气中放射性水平的变化,空气质量与大气放射性水平不相关。  相似文献   
6.

Objective

This study aimed to review and compare the analytical and clinical performance of automated indirect immunofluorescence (AIIF) and manual indirect immunofluorescence (MIIF) as anti-nuclear antibody screening assays for patients with systemic rheumatic diseases (SRDs), such as systemic lupus erythematosus (SLE) and systemic sclerosis (SSc).

Methods

A systematic literature search was performed in the Medline, Embase, Cochrane, Web of Science, and Scopus databases for studies published before August 2017. A bivariate random effects model was used to calculate the summary diagnostic values.

Results

Twenty-two studies involving 6913 positive and 1818 negative samples of MIIF, as well as 524 combined SRD, 132 SLE, and 104 SSc patients, and 520 controls were available for meta-analysis. The summary positive concordance (PC) of qualitative result between AIIF and MIIF was 93.7%, whereas PCs of total pattern (68.5%; homogeneous, 52.3%; speckled, 56.5%; nucleolar, 52.7%; centromere, 51.4%; nuclear dot, 11.7%) and titer (77.8%) exhibited significantly lower values. The summary clinical sensitivities of AIIF vs. MIIF were 84.7% vs 78.2% for combined SRDs, 95.5% vs. 93.9% for SLE, and 86.5% vs. 83.7% for SSc, respectively. Meanwhile, the summary specificities of AIIF vs. MIIF were 75.6% vs. 79.6% for combined SRDs, 74.2% vs. 83.3% for SLE, and 74.2% vs. 83.3% for SSc, respectively. Although the differences in sensitivity and specificity between AIIF and MIIF were not significant in most subgroups, the summary specificity of SLE and SSc showed statistically significant changes.

Conclusions

Our systematic meta-analysis demonstrates that AIIF is comparable to MIIF in distinguishing between the positive and negative results, and screening SRDs based on clinical sensitivities and standardization. However, improvements in the pattern and titer recognition and clinical specificities are necessary.  相似文献   
7.
Pulmonary metastasectomy (PM) is an established treatment that can provide improved long-term survival for patients with metastatic tumor(s) in the lung. In the current era, where treatment options other than PM such as stereotactic body radiation therapy (SBRT), immunotherapy, and molecular-targeted therapy are available, thoracic surgeons should review the approach to the preoperative evaluation and the indications. Preoperative evaluation consists of history and physical examinations, physiological tests, and radiological examinations. Radiological examinations serve to identify the differential diagnosis of the pulmonary nodules, evaluate their precise number, location, and features, and search for extra thoracic metastases. The indication of PM should be considered from both physiological and oncological points of view. The general criteria for PM are as follows; (I) the patient has a good general condition, (II) the primary malignancy is controlled, (III) there is no other extrapulmonary metastases, and (IV) the pulmonary lesion(s) are thought to be completely resectable. In addition to the general eligibility criteria of PM, prognostic factors of each tumor type should be considered when deciding the indication for PM. When patients have multiple poor prognostic factors and/or a short disease-free interval (DFI), thoracic surgeons should not hesitate to observe the patient for a certain period before deciding on the indication for PM. A multidisciplinary discussion is needed in order to decide the indication for PM.  相似文献   
8.
目的:探讨p38MAPK基因对PM2.5染毒人肾上皮细胞(HK-2)部分癌基因和凋亡相关基因表达的影响。方法:根据GenBank提供的p38MAPK mRNA序列,设计合成干扰序列,将重组慢病毒载体转染HK-2细胞,构建p38MAPK基因沉默细胞株。分别采用实时荧光定量PCR (qPCR)和Western blot法检测p38MAPK mRNA和蛋白的表达水平鉴定沉默效果。用50 μg/mL的PM2.5混悬液分别染毒正常HK-2细胞和p38MAPK基因沉默细胞24 h,利用荧光定量PCR和Western blot检测癌基因c-myc,c-fos、p53和凋亡相关基因Caspase-8Caspase-9Bcl-2的mRNA和蛋白的相对表达水平。结果:qPCR和Western blot检测结果显示,与正常HK-2细胞比较,p38MAPK基因沉默细胞中p38MAPK mRNA的表达下降了58.50%,p38MAPK蛋白表达水平下降了51.33%(P<0.01)。PM2.5混悬液对HK-2细胞和p38MAPK基因沉默HK-2细胞染毒后,qPCR检测结果显示,与正常HK-2细胞未染毒组比较,正常HK-2细胞PM2.5染毒组中c-mycc-fosCaspase-8Casepase-9基因表达分别升高39.89%、15.12%、19.47%和15.45%,p53和Bcl-2基因表达分别下降21.54%和31.77%,差异均具有统计学意义(P<0.05);与正常HK-2细胞PM2.5染毒组比较,p38MAPK基因沉默HK-2细胞PM2.5染毒组中c-myc、c-fos、p53、Caspase-8和Caspase-9 mRNA表达分别下降了84.55%、63.55%、34.49%、37.19%和54.97%,差异均具有统计学意义(P<0.05)。Western blot检测结果显示,与正常HK-2细胞未染毒组比较,正常HK-2细胞PM2.5染毒组中的c-myc和Caspase-8蛋白表达增加,Bcl-2蛋白表达减少;与正常HK-2细胞PM2.5染毒组比较,p38MAPK基因沉默HK-2细胞PM2.5染毒组中的c-myc、Caspase-8和Bcl-2蛋白表达减少(均为P<0.05)。结论:成功构建了p38MAPK基因沉默细胞株,PM2.5可引起HK-2细胞癌基因和凋亡相关基因表达水平升高,p38MAPK基因可能参与PM2.5对HK-2细胞的毒性作用过程。  相似文献   
9.
10.
目的 研究金华市大气PM2.5对儿童呼吸系统门诊量的影响。方法 采用基于Poisson 分布的广义相加模型(generalized additive mode,GAM),控制气象因素、长期趋势和星期几效应等混杂因素,分析2015-2016年PM2.5浓度和0~14岁儿童呼吸系统门诊量的关系及滞后效应。结果 2015-2016年金华市大气PM2.5日均质量浓度为50.32 μg/m3,PM2.5 浓度与5种气象因素日均值之间存在一定的相关性。Spearman 相关性分析发现大气PM2.5日均浓度与儿童呼吸系统日门诊量之间存在正相关(r=0.298, P<0.05)。广义相加模型结果分析,PM2.5对儿童呼吸系统门诊量存在滞后效应,滞后效应第1 d最强,PM2.5质量浓度每增加10 μg/m3,儿童呼吸系统疾病门诊量增加0.048 8%(95%CI:0.030 1%~0.059 5%)。结论 金华市大气PM2.5浓度升高可导致儿童呼吸系统患病风险增加,应采取措施保护易感人群。  相似文献   
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