Systemic

系统
  • 文章类型: Journal Article
    葡萄膜炎,严重视力障碍的显著原因,常表现为感染性或非感染性自身免疫性葡萄膜炎(AU),后者通常与年轻个体和全身性疾病有关。尽管条件的广泛影响,对其发病机制的理解存在很大差距,临床表现,和治疗反应,特别是关于全身性疾病相关葡萄膜炎。
    本研究旨在通过广泛检查AU患者的人口统计学和临床特征来弥合这些差距。从而为未来的研究提供信息,和治疗策略,改善患者预后。
    这项回顾性观察性研究分析了2018年1月至2022年12月在大马士革的261例系统性疾病相关葡萄膜炎患者,叙利亚。使用葡萄膜炎命名标准化工作组标准进行诊断,该研究在治疗后24个月评估了定制的治疗效果,除了全面的眼科检查,实验室评估,和射线照相评估。
    在我们的研究中,纳入87例系统性疾病相关自身免疫性葡萄膜炎(SDA-AU)患者。妇女占这一群体的64.36%,男性的诊断平均年龄为39.8±17.9岁(范围7-71岁),男性为43.8±15.4岁(范围11-69岁)。报告最多的症状是疼痛的红眼(52.87%)。32.18%的患者出现症状突然,而67.81%的人报告说是逐步发展的。33.33%的患者出现并发症,包括白内障(占并发症的41.37%)和青光眼(17.24%)。实验室评估显示66.66%的患者炎症标志物升高。经过24个月的评估,48.27%的患者达到完全缓解,37.93%表现出显著改善,而13.79%的病例病情恶化。
    我们的研究结果表明,AU在该队列中的出现通常先于全身性疾病的诊断,确认葡萄膜炎的早期和准确诊断对于检测潜在的全身状况的重要作用。总之,我们的研究强调了综合和多学科方法在SD-AU管理中的重要性,改善患者的预后和生活质量。
    UNASSIGNED: Uveitis, a notable cause of severe visual impairment, is frequently characterized as infectious or noninfectious autoimmune uveitis (AU), the latter of which is commonly associated with younger individuals and systemic diseases. Despite the condition\'s widespread impact, there are substantial gaps in the comprehension of its pathogenesis, clinical presentation, and therapeutic response, particularly concerning systemic disease-associated uveitis.
    UNASSIGNED: The current study aims to bridge these gaps through an extensive examination of demographic and clinical features in AU patients, thereby informing future research, and therapeutic strategies, and improving patient outcomes.
    UNASSIGNED: This retrospective observational study analyzed 261 patients with systemic disease-associated uveitis from January 2018 to December 2022 in Damascus, Syria. With diagnoses made using the Standardization of Uveitis Nomenclature Working Group Criteria, the study evaluated tailored treatment efficacy at the 24-month post-treatment mark, alongside comprehensive ophthalmic examinations, laboratory evaluations, and radiographic assessments.
    UNASSIGNED: In our study, included 87 patients with Systemic Disease-Associated Autoimmune Uveitis (SDA-AU). Women represented 64.36% of this group, and the mean age at diagnosis was 39.8±17.9 years (range 7-71) for men and 43.8±15.4 years (range 11-69). The most reported symptom was a painful red eye (52.87%). The onset of symptoms was sudden for 32.18% of patients, while 67.81% reported gradual development. Complications occurred in 33.33% of patients, including cataracts (41.37% of those with complications) and glaucoma (17.24%). Laboratory evaluations showed elevated inflammation markers in 66.66% of patients. Upon the 24-month assessment, 48.27% of patients achieved complete remission, 37.93% showed significant improvement, while disease worsened in 13.79% of cases.
    UNASSIGNED: Our findings demonstrated that the presentation of AU in this cohort frequently precedes the diagnosis of systemic diseases, affirming the vital role of an early and accurate diagnosis of uveitis for the detection of underlying systemic conditions. In conclusion, our study underlines the significance of a comprehensive and multidisciplinary approach in the management of SD-AU, leading to improved prognosis and quality of life for patients.
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  • 文章类型: Journal Article
    本研究考察了网络暴力与网络性犯罪之间的关系,特别关注这些犯罪作为青少年的系统性问题。该研究强调了网络性犯罪的严重影响,以非自愿分享露骨色情内容为特征。它研究了可能导致目睹网络性犯罪的各种因素,包括接触暴力在线内容,网络暴力的个人经历(无论是作为受害者还是犯罪者),以及家长和教师干预的作用。利用韩国通信委员会进行的全国性调查的数据,该研究分析了2021年9016名青少年和2022年9693名青少年的反应。这项分析揭示了目睹网络性犯罪的重要预测因素,并研究了对网络暴力的看法和权威人物的干预如何影响青少年对网络性犯罪作为系统性或个人问题的看法。女性受到不成比例的影响,调查结果强调了网络暴力的性别方面。此外,这些见解表明,将网络暴力视为一个严重问题会导致将网络性犯罪视为需要社会干预的系统性问题。该研究倡导加强数字素养教育和系统变革,以保护青少年免受网络暴力和性犯罪的广泛威胁。
    This study examines the relationship between cyber violence and cyber sex crimes, specifically focusing on these crimes as systemic issues among adolescents. The research highlights the severe impact of cyber sex crimes, characterized by the non-consensual sharing of sexually explicit content. It examines various factors that may contribute to witnessing cyber sex crimes, including exposure to violent online content, personal experiences of cyber violence (either as a victim or perpetrator), and the role of parental and teacher interventions. Utilizing data from a nationwide survey conducted by the Korea Communications Commission, the study analyzes responses from 9016 adolescents in 2021 and 9693 in 2022. This analysis reveals significant predictors of witnessing cyber sex crimes and examines how perceptions of cyber violence and interventions of authoritative figures may influence adolescents\' perception of cyber sex crimes as either systemic or individual issues. With females disproportionately affected, the findings underscore a gendered aspect of cyber violence. Furthermore, these insights suggest that perceiving cyber violence as a serious issue leads to viewing cyber sex crimes as systemic problems necessitating societal intervention. The study advocates for enhanced digital literacy education and systemic changes to protect adolescents from the widespread threats of cyber violence and sex crimes.
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  • 文章类型: Journal Article
    患有系统性硬化症(SSc)的人面临身体活动的障碍。很少有研究描述SSc中的身体活动,没有人在COVID-19期间纵向探索身体活动。我们评估了2020年4月至2022年3月SSc患者的身体活动。
    硬皮病以患者为中心的干预网络(SPIN)COVID-19队列于2020年4月启动,其中包括来自正在进行的SPIN队列和外部入组的参与者。参与者在2020年7月之前每两周完成一次测量,然后每4周完成一次测量(28次评估)。身体活动是通过自我报告的国际身体活动问卷-老年人进行评估的。分析包括评估中身体活动的估计平均值和95%置信区间。缺失的数据被归入主要分析。敏感性分析包括仅评估28项可能评估中超过21项完成90%项目的参与者(“完成者”),并按性别进行分层分析。年龄,国家和SSc亚型。
    共有800人注册了SSc。平均年龄为55.6岁(标准差(SD)=12.6)。从2020年4月到2021年3月,身体活动显着下降(标准化平均差(SMD)=-0.17,95%置信区间(CI)=-0.26至-0.07),从2021年3月到2022年3月稳定(SMD=-0.05,95%CI=-0.15至0.05)。完成者和亚组的结果相似。在评估中,符合世界卫生组织最低体力活动建议的参与者比例为每周至少150分钟的中等至剧烈活动,范围为63%至82%。
    体力活动减少了相对较小的量,平均而言,在大流行期间。大多数参与者达到了推荐的身体活动水平。
    UNASSIGNED: People with systemic sclerosis (SSc) face barriers to physical activity. Few studies have described physical activity in SSc, and none have explored physical activity longitudinally during COVID-19. We evaluated physical activity from April 2020 to March 2022 among people with SSc.
    UNASSIGNED: The Scleroderma Patient-centred Intervention Network (SPIN) COVID-19 Cohort was launched in April 2020 and included participants from the ongoing SPIN Cohort plus external enrolees. Participants completed measures bi-weekly through July 2020, then every 4 weeks afterwards (28 assessments). Physical activity was assessed via the self-reported International Physical Activity Questionnaire-Elderly. Analyses included estimated means with 95% confidence intervals for physical activity across assessments. Missing data were imputed for main analyses. Sensitivity analyses included evaluating only participants who completed >90% of items for >21 of 28 possible assessments (\'completers\') and stratified analyses by sex, age, country and SSc subtype.
    UNASSIGNED: A total of 800 people with SSc enrolled. Mean age was 55.6 (standard deviation (SD) = 12.6) years. Physical activity significantly decreased from April 2020 to March 2021 (standardized mean difference (SMD) = -0.17, 95% confidence interval (CI) = -0.26 to -0.07) and was stable from March 2021 to March 2022 (SMD = -0.05, 95% CI = -0.15 to 0.05). Results were similar for completers and subgroups. The proportion of participants who met World Health Organization minimum physical activity recommendations of at least 150 min of moderate-to-vigorous activity per week ranged from 63% to 82% across assessments.
    UNASSIGNED: Physical activity decreased by a relatively small amount, on average, across the pandemic. Most participants met recommended physical activity levels.
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  • 文章类型: Journal Article
    肥胖是一种复杂的疾病,与各种物种中代谢紊乱发展和细胞功能障碍的风险增加有关。本研究的目的是研究肥胖对老母马代谢健康的影响,以及测试饮食补充与旨在改善马代谢和胃肠道健康的复杂营养素混合物或单独使用L-肉碱的能力减轻肥胖的负面影响。将母马(n=19,17.9±3.7岁)分为三组之一:正常体重(NW,n=6),肥胖(OB,n=7)或肥胖喂养复杂的饮食补充剂12周(OBD,n=6)。在12周完成样本采集后,OB母马单独接受L-肉碱再接受6周。母马的肥胖与胰岛素失调显著相关,肌肉线粒体功能降低,与NW相比,骨骼肌氧化能力降低,ROS产生更大。饲喂复杂饮食补充剂的肥胖母马具有更好的胰岛素敏感性,大细胞脂质代谢,与OB相比,肌肉氧化能力更高,ROS产生减少。单独补充L-肉碱并没有显著改变胰岛素信号,但随着ROS的减少,脂质代谢和肌肉氧化能力得到改善。总之,肥胖与老年母马的胰岛素失调和骨骼肌代谢改变有关。然而,饮食干预是改善老年母马代谢状态和骨骼肌线粒体功能的有效策略。
    Obesity is a complex disease associated with augmented risk of metabolic disorder development and cellular dysfunction in various species. The goal of the present study was to investigate the impacts of obesity on the metabolic health of old mares as well as test the ability of diet supplementation with either a complex blend of nutrients designed to improve equine metabolism and gastrointestinal health or L-carnitine alone to mitigate negative effects of obesity. Mares (n = 19, 17.9 ± 3.7 years) were placed into one of three group: normal-weight (NW, n = 6), obese (OB, n = 7) or obese fed a complex diet supplement for 12 weeks (OBD, n = 6). After 12 weeks and completion of sample collections, OB mares received L-carnitine alone for an additional 6 weeks. Obesity in mares was significantly associated with insulin dysregulation, reduced muscle mitochondrial function, and decreased skeletal muscle oxidative capacity with greater ROS production when compared to NW. Obese mares fed the complex diet supplement had better insulin sensivity, greater cell lipid metabolism, and higher muscle oxidative capacity with reduced ROS production than OB. L-carnitine supplementation alone did not significantly alter insulin signaling, but improved lipid metabolism and muscle oxidative capacity with reduced ROS. In conclusion, obesity is associated with insulin dysregulation and altered skeletal muscle metabolism in older mares. However, dietary interventions are an effective strategy to improve metabolic status and skeletal muscle mitochondrial function in older mares.
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  • 文章类型: Journal Article
    本文提供了一个完整的协议,用于研究吸入百草枯(PQ)的影响,一种对全身和肺部有负面影响的有毒除草剂。该方案旨在评估雾化PQ暴露对动物模型中肺和全身损伤的影响,这将为PQ引起的肺和全身损伤的治疗干预提供重要信息。该协议涉及以下关键组件:1.研究组:通过包括对照,未经处理的雾化PQ暴露,并在实验中用各种试剂组处理PQ暴露的动物,可以评估每组的肺和全身损伤,并且可以在组间比较不同的测量参数。2.PQ暴露:PQ暴露组中的动物接受PQ雾化吸入,模拟使用这种除草剂的农民的职业或意外暴露。3.评估措施:确定肺和全身损伤的程度及其生理效应,几项评估,如生化标志物,组织病理学分析,和功能测试,使用。该协议通过使用标准化方法和数据收集提供可靠和准确的结果。PQ暴露对肺和全身损伤的影响可以通过对收集的数据进行统计分析来评估,这也使得更容易识别可能的保护剂或干预措施。这种全面的评估方案为研究PQ诱导的肺和全身损伤背后的机制以及评估预防或治疗策略在最小化其不良反应方面的有效性提供了必要的基础。
    This paper provides a complete protocol for studying the effects of inhaled paraquat (PQ), a toxic herbicide that has negative effects systemically and on the lungs. The protocol aims to evaluate the effects of aerosolized PQ exposure on lung and systemic injury in an animal model, which will provide significant information for therapeutic interventions for PQ-induced pulmonary and systemic damage. The protocol involves the following key components: 1. Study groups: By including control, non-treated aerosolized PQ-exposed, and treated PQ-exposed animals with various agent groups in the experiment, lung and systemic injury in each group could be evaluated, and different measured parameters could be compared among groups. 2. PQ exposure: Animals in the PQ-exposed groups are subjected to PQ aerosol inhalation, simulating occupational or accidental exposure in farmers working with this herbicide. 3. Assessment measures: To determine the degree of lung and systemic injury and its physiological effects, several assessments, such as biochemical markers, histopathological analysis, and functional tests, are used. The protocol offers reliable and accurate results by using standardized methods and data collection. The effect of PQ exposure on lung and systemic injury could be evaluated by statistical analysis of the collected data, which also makes it easier to identify possible protective agents or interventions. This comprehensive evaluation protocol provides an essential basis for studying the mechanisms behind PQ-induced lung and systemic injury and assessing the effectiveness of preventative or therapeutic strategies in minimizing its adverse effects.
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  • 文章类型: Journal Article
    四倍体,细胞具有四组同源染色体的情况,可以是天然的生理状况或病理生理状况,例如癌细胞或应激诱导的四倍体化。它对癌症发展的贡献是众所周知的。然而,在提出的解释原因的许多模型中,恶性细胞转化的机制和步骤,只有少数人将四倍体化整合到系统的多步骤致癌方法中。因此,我们将i)描述四倍体的分子和细胞特征;ii)评估应激诱导的四倍体在癌症发展中的贡献;iii)以系统性细胞为中心的方法将四倍体定位为导致癌症发展的亚稳态;iiii)考虑知识差距和未来观点。现有数据表明,应激诱导的四倍体化/多倍体化导致p53稳定,细胞周期停滞,随后是细胞衰老或凋亡,抑制四倍体细胞的增殖。然而,如果四倍体细胞逃脱了G1-四倍体检查点,它可能导致四倍体细胞不受控制的增殖,微核诱导,非整倍体和去分裂。此外,四倍体化有利于3D染色质变化和表观遗传效应。遗传和表观遗传变化的组合效应允许致癌基因表达和癌症进展的表达。此外,由于微核诱导炎症,这反过来可能会诱导额外的四倍体化,四倍体遗传不稳定性导致致癌恶性循环。多倍体细胞是二倍体和非整倍体之间的亚稳态中间体的概念并不是新的。亚稳态表示动态系统内的中间能量状态,而不是系统的至少能量状态。同时考虑遗传/表观遗传变化和应激诱导的四倍体化可能引起的熵水平,为描述癌症发展提供了一种新的系统方法。
    Tetraploidy, a condition in which a cell has four homologous sets of chromosomes, may be a natural physiological condition or pathophysiological such as in cancer cells or stress induced tetraploidisation. Its contribution to cancer development is well known. However, among the many models proposed to explain the causes, mechanisms and steps of malignant cell transformation, only few integrate tetraploidization into a systemic multistep approach of carcinogenesis. Therefore, we will i) describe the molecular and cellular characteristics of tetraploidy; ii) assess the contribution of stress-induced tetraploidy in cancer development; iii) situate tetraploidy as a metastable state leading to cancer development in a systemic cell-centered approach; iiii) consider knowledge gaps and future perspectives. The available data shows that stress-induced tetraploidisation/polyploidisation leads to p53 stabilisation, cell cycle arrest, followed by cellular senescence or apoptosis, suppressing the proliferation of tetraploid cells. However, if tetraploid cells escape the G1-tetraploidy checkpoint, it may lead to uncontrolled proliferation of tetraploid cells, micronuclei induction, aneuploidy and deploidisation. In addition, tetraploidization favors 3D-chromatin changes and epigenetic effects. The combined effects of genetic and epigenetic changes allow the expression of oncogenic gene expression and cancer progression. Moreover, since micronuclei are inducing inflammation, which in turn may induce additional tetraploidization, tetraploidy-derived genetic instability leads to a carcinogenic vicious cycle. The concept that polyploid cells are metastable intermediates between diploidy and aneuploidy is not new. Metastability denotes an intermediate energetic state within a dynamic system other than the system\'s state at least energy. Considering in parallel the genetic/epigenetic changes and the probable entropy levels induced by stress-induced tetraploidisation provides a new systemic approach to describe cancer development.
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  • 文章类型: Case Reports
    IgG4相关疾病是一种罕见且新兴的病理,以伪肿瘤的出现为特征。由于模仿其他病理的能力,将其视为多系统过程的鉴别诊断至关重要。诊断很有挑战性,需要多学科的方法,尽量减少相关的发病率和死亡率。
    IgG4相关疾病(IgG4-RD)是一种罕见的疾病,新兴,系统和慢性病理学,其特征是由于IgG4阳性浆细胞的组织浸润而出现假瘤,从而促进组织的嗜酸性粒细胞炎症并随后纤维化。我们介绍一个男性的案例,45岁的病人,他的家庭医生在女儿的儿童健康咨询中发现了明显的体重减轻和皮肤苍白。当被质疑时,患者以饱胀的感觉转述了左软骨下餐后不适的抱怨,减肥,持续一个月的慢性疲劳和多汗症。在体检时,他脸色苍白,触诊左侧软骨下有疼痛。实验室数据显示炎症标志物增加,腹部超声和CT显示上象限有许多肿大的淋巴结,引起对恶性淋巴增生过程的关注。血清学,成像,临床和腹腔镜切除活检显示IgG4相关疾病的特征,并排除恶性淋巴增生性疾病.对口服泼尼松龙30mg/天治疗的即时反应也有助于诊断确认。由于难治性疾病后逐渐减少泼尼松龙,利妥昔单抗的二线治疗开始.在6年的随访中,患者出现了以出现全身症状为特征的多次加重,通过病理学保持密切的临床和影像学随访,传染病,和家庭医学专家。
    UNASSIGNED: IgG4-related disease is a rare and emerging pathology, characterized by the appearance of pseudotumors. Due to the ability to mimic other pathologies, it is essential to consider it as a differential diagnosis in multisystemic processes. The diagnosis is challenging, requiring a multidisciplinary approach, to minimize the associated morbidity and mortality.
    UNASSIGNED: IgG4-related disease (IgG4-RD) is a rare, emerging, systemic and chronic pathology, characterized by the appearance of pseudotumors resulting from tissue infiltration by IgG4-positive plasma cells that promote eosinophilic inflammation of the tissue with subsequent fibrosis. We present the case of a male, 45-year-old patient, with marked weight loss and skin pallor detected by his family doctor during a child health consultation of his daughter. When questioned, the patient referred complaints of postprandial discomfort in the left hypochondrium with a feeling of fullness, weight loss, chronic fatigue and hyperhidrosis that had lasted for a month. On physical examination, he was pale, and had pain at palpation of the left hypochondrium. Laboratory data showed increased inflammation markers, abdominal ultrasound and CT demonstrated numerous enlarged lymph nodes in the upper quadrants, raising concern for a malignant lymphoproliferative process. Serological, imaging, clinical and laparoscopic excisional biopsy revealed features of IgG4-related disease and excluded malignant lymphoproliferative disease. The immediate response to treatment with oral prednisolone 30 mg/day also contributed for diagnosis confirmation. Due to refractory disease after gradual prednisolone reduction, second-line therapy with rituximab was initiated. Over the 6 years of follow-up, the patient presented multiple exacerbations characterized by the emergence of systemic symptoms, being maintained under close clinical and imaging follow-up by reumathology, infectious diseases, and family medicine specialists.
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  • 文章类型: Journal Article
    PV-10是玫瑰孟加拉钠的10%制剂,对各种肿瘤具有有效的免疫治疗和抗癌活性,包括转移性黑色素瘤和难治性神经母细胞瘤。目前,PV-10正在进行难治性转移性神经内分泌癌和黑色素瘤的临床试验。然而,尚未进行PV-10活性及其针对表型和分子多样性成人实体瘤的机制的临床前研究。在一组来源于乳腺的人类细胞系中,结直肠,头部和颈部,和睾丸癌,我们证明PV-10通过涉及caspase介导的PARP裂解的凋亡和自噬途径诱导细胞毒性,SQSTM1/p62下调,Beclin-1上调。用PV-10处理也一致地减少WNK1的磷酸化,这与癌细胞迁移和自噬抑制有关。通过伤口愈合试验,PV-10处理抑制了癌细胞的迁移。最后,通过病灶内或全身给药,在用PV-10治疗的荷瘤小鼠中也注意到肿瘤生长的显著抑制.除了已知的PV-10介导的肿瘤特异性细胞毒性作用,我们确定了PV-10的机制,并为其对自噬和转移的影响提供了新的见解.我们的数据为将来制定PV-10的临床研究提供了必要的基于机制的证据和活性生物标志物。
    PV-10 is a 10% formulation of rose bengal sodium that has potent immunotherapeutic and anti-cancer activity against various tumors, including metastatic melanoma and refractory neuroblastoma. Currently, PV-10 is undergoing clinical testing for refractory metastatic neuroendocrine cancer and melanomas. However, preclinical investigation of PV-10 activity and its mechanisms against phenotypically and molecularly diverse adult solid tumors had not been conducted. In a panel of human cell lines derived from breast, colorectal, head and neck, and testicular cancers, we demonstrated that PV-10 induces cytotoxicity by apoptotic and autophagic pathways involving caspase-mediated PARP cleavage, downregulation of SQSTM1/p62, and upregulation of beclin-1. Treatment with PV-10 also consistently reduced phosphorylation of WNK1, which has been implicated in cancer cell migration and autophagy inhibition. By wound healing assay, PV-10 treatment inhibited the migration of cancer cells. Finally, significant inhibition of tumor growth was also noted in tumor-bearing mice treated with PV-10 by intralesional or systemic administration. In addition to known PV-10-mediated tumor-specific cytotoxic effects, we identified the mechanisms of PV-10 and provide new insights into its effect on autophagy and metastasis. Our data provide essential mechanism-based evidence and biomarkers of activity to formulate clinical studies of PV-10 in the future.
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  • 文章类型: Journal Article
    骨骼肌由参与体内平衡的多种组织和非组织驻留细胞组成。特别是,肌肉干细胞生态位是一个动态系统,需要细胞之间的直接和间接通信,涉及本地和远程提示。生态位内部的相互作用必须及时发生,以维持或恢复稳态生态位。例如,受伤后,促肌源性提示过早传递会影响肌肉干细胞增殖,延迟修复过程。在利基内,肌纤维,内皮细胞,血管周细胞(周细胞,平滑肌细胞),纤维脂肪原祖细胞,成纤维细胞,和免疫细胞彼此非常接近。每个细胞行为,膜剖面,分泌组可干扰肌肉干细胞命运和骨骼肌再生。最重要的是,肌肉干细胞生态位也可以通过肌肉外(远程)提示来修饰,因为其他组织可以通过循环因子的产生或细胞的递送来作用于肌肉再生。在这次审查中,我们重点介绍了最近的出版物,这些出版物证明了肌肉干细胞小生境的本地和远程效应。
    Skeletal muscle is composed of a variety of tissue and non-tissue resident cells that participate in homeostasis. In particular, the muscle stem cell niche is a dynamic system, requiring direct and indirect communications between cells, involving local and remote cues. Interactions within the niche must happen in a timely manner for the maintenance or recovery of the homeostatic niche. For instance, after an injury, pro-myogenic cues delivered too early will impact on muscle stem cell proliferation, delaying the repair process. Within the niche, myofibers, endothelial cells, perivascular cells (pericytes, smooth muscle cells), fibro-adipogenic progenitors, fibroblasts, and immune cells are in close proximity with each other. Each cell behavior, membrane profile, and secretome can interfere with muscle stem cell fate and skeletal muscle regeneration. On top of that, the muscle stem cell niche can also be modified by extra-muscle (remote) cues, as other tissues may act on muscle regeneration via the production of circulating factors or the delivery of cells. In this review, we highlight recent publications evidencing both local and remote effectors of the muscle stem cell niche.
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  • 文章类型: Journal Article
    恶性高血压(MHT)是一种高血压急症,伴有血压(BP)过度升高和疾病进展加速。MHT的特点是急性微血管损伤和影响视网膜的自动调节失败,大脑,心,肾,和血管树。必须在数小时内降低血压以减轻患者风险。绝对BP水平和BP上升的速度都决定了靶器官损害的风险。不坚持抗高血压方案仍然是MHT的最常见原因,尽管抗血管生成和免疫抑制剂治疗也可以引发高血压急症。根据临床表现,肠胃外或口服治疗可用于开始降低BP。MHT中基于证据的结果数据参差不齐或缺乏。通过有效的治疗,MHT的预后有所改善;然而,患者仍处于心血管和肾脏不良结局的高风险.在这次审查中,我们总结了当前关于流行病学的观点,发病机制,和MHT的管理;突出研究差距;并提出改善成果的策略。
    Malignant hypertension (MHT) is a hypertensive emergency with excessive blood pressure (BP) elevation and accelerated disease progression. MHT is characterized by acute microvascular damage and autoregulation failure affecting the retina, brain, heart, kidney, and vascular tree. BP must be lowered within hours to mitigate patient risk. Both absolute BP levels and the pace of BP rise determine risk of target-organ damage. Nonadherence to the antihypertensive regimen remains the most common cause for MHT, although antiangiogenic and immunosuppressant therapy can also trigger hypertensive emergencies. Depending on the clinical presentation, parenteral or oral therapy can be used to initiate BP lowering. Evidence-based outcome data are spotty or lacking in MHT. With effective treatment, the prognosis for MHT has improved; however, patients remain at high risk of adverse cardiovascular and kidney outcomes. In this review, we summarize current viewpoints on the epidemiology, pathogenesis, and management of MHT; highlight research gaps; and propose strategies to improve outcomes.
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