Archives of Medical Research最新文献_第8页

Efficacy of Cyclosporin A and Tacrolimus in The Treatment of Endometriosis of Rats 环孢素A联合他克莫司治疗大鼠子宫内膜异位症的疗效观察

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-07-09 DOI: 10.1016/j.arcmed.2025.103258

Cagla Bahar Bulbul , Gulay Turan , Ceyda Sancakli Usta , Ozgur Bulmus , Akin Usta

Background and Aims

The molecular and cellular mechanisms underlying endometriosis are still under investigation. Cyclophilin A (CypA) is an inflammatory marker secreted by various types of cells in an inflammatory condition. During inflammation, CypA exacerbates the inflammatory response by activating calcineurin signaling, which increases cytokine secretion and tissue degradation in the inflammatory region. This study investigated the effect of inhibiting calcineurin signaling in treating endometriosis in rats.

Methods

Thirty-two albino Wistar rats were used in this study. All rats were divided into three groups: cyclosporin A (n = 10), tacrolimus (n = 10) and a control group (n = 12). The cyclosporin A (CsA) group received two intraperitoneal doses two weeks apart, and the tacrolimus group received the same two doses intravenously, also two weeks apart. All studies lasted eight weeks. The processed endometrial tissues were cut in half and embedded in paraffin. Histological sections (5 µm) were stained with Ki-67, Bcl-2, caspase-3 and VEGF.

Results

The endometriotic focus size was 204.7 ± 153.4 mm³, 71.9 ± 85.4 mm³, and 30.6 ± 36.7 mm³ in the control, CsA, and tacrolimus groups, respectively. Compared to the control group, the endometriotic focus size was smaller in the CsA and tacrolimus groups (p = 0.002). Microscopically, Ki-67 (p = 0.010) and VEGF (p = 0.007) immunoreactivity were lower in the CsA and tacrolimus groups than in controls.

Conclusions

The inhibition of calcineurin signaling with CsA or tacrolimus treatment causes regression of the endometriotic focus by decreasing endometriotic cell proliferation and angiogenesis in ectopic endometriotic tissue.

背景和目的子宫内膜异位症的分子和细胞机制仍在研究中。亲环蛋白A （CypA）是一种炎症标志物，由各种类型的细胞在炎症状态下分泌。在炎症过程中，CypA通过激活钙调磷酸酶信号通路加剧炎症反应，从而增加炎症区域的细胞因子分泌和组织降解。本研究探讨抑制钙调磷酸酶信号传导对大鼠子宫内膜异位症的治疗作用。方法以32只白化Wistar大鼠为实验对象。将大鼠分为环孢素A组（n = 10）、他克莫司组（n = 10）和对照组（n = 12）。环孢素A （CsA）组间隔两周接受两次腹腔注射，他克莫司组同样间隔两周接受两次静脉注射。所有的研究都持续了8周。将处理后的子宫内膜组织切成两半，包埋于石蜡中。用Ki-67、Bcl-2、caspase-3和VEGF染色组织学切片（5µm）。结果对照组、CsA组和他克莫司组子宫内膜异位灶大小分别为204.7±153.4 mm3、71.9±85.4 mm3和30.6±36.7 mm3。与对照组相比，CsA组和他克莫司组子宫内膜异位灶的大小更小（p = 0.002）。显微镜下，CsA组和他克莫司组Ki-67 （p = 0.010）和VEGF （p = 0.007）免疫反应性低于对照组。结论CsA或他克莫司对钙调神经磷酸酶信号的抑制可通过降低异位子宫内膜组织中异位细胞的增殖和血管生成而使子宫内膜病灶消退。

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引用次数: 0

Catheter Ablation of Triggers and Arrhythmogenic Epicardial Substrates in Patients With QT Prolongation QT延长患者心外膜底物和诱发心律失常的导管消融

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-07-01 DOI: 10.1016/j.arcmed.2025.103257

Yoga Yuniadi, Dicky A. Hanafy, Sunu B. Raharjo, Dony Y. Hermanto

Background and Aims

Long QT syndrome (LQTS) ablation is currently limited to high-risk or refractory cases, targeting the elimination of triggers such as ventricular premature contraction (VPC). However, the characteristics of the underlying substrate and the role of radiofrequency ablation have not been extensively discussed.

Methods and Results

Eight symptomatic patients with LQTS (all women; aged 36 ± 10.2 years) underwent 3-D endocardial and epicardial mapping of triggers and/or substrates of ventricular arrhythmias. Genetic testing revealed P1093A mutations in the KCNH2 gene, H558R mutations in the SCN5A gene, and K28E mutations in the KCNH2 gene in three patients, respectively. A total of 13 VPC morphologies were identified, including five right ventricular outflow tract (RVOT) VPCs, one basal lateral RV, two from inferoapical RV, one from the lateral to annulus tricuspid, three from basal lateral LV and one from epicardial site of the lateral mitral annulus. Epicardial voltage mapping revealed moderate to extensive areas of scar and low voltage in all patients. The localized abnormal ventricular activities (LAVAs) were recorded in all patients and were successfully ablated. The corrected QT interval (QTc) shortened after the epicardial LAVA elimination (594.9 ± 85.98 ms vs. 490 ± 67.49 ms, p = 0.001). During a mean follow-up period of 288 ± 147.4 d (range 170–492 d), two patients experienced ventricular tachycardia (VT) /ventricular fibrillation (VF) recurrence.

Conclusion

Regional and limited epicardial LAVAs could be identified in patients with LQTS. Radiofrequency ablation of VPC triggers and epicardial LAVAs had a modest effect on preventing future VT/VF recurrences.

背景和目的长QT综合征（LQTS）消融术目前仅限于高危或难治性病例，目的是消除室性早搏（VPC）等诱发因素。然而，底层衬底的特性和射频烧蚀的作用尚未得到广泛讨论。方法与结果8例有症状的LQTS患者(均为女性；年龄36±10.2岁)行心内膜和心外膜三维制图，探查室性心律失常的触发因素和/或底物。基因检测显示，3例患者KCNH2基因分别存在P1093A突变，SCN5A基因存在H558R突变，KCNH2基因存在K28E突变。共鉴定出13个VPC形态，包括5个右心室流出道（RVOT） VPC、1个基底外侧RV、2个根尖下RV、1个三尖瓣环外侧RV、3个基底外侧LV和1个二尖瓣外侧环心外膜部位。心外膜电压测图显示所有患者均有中度至大面积的疤痕和低电压。所有患者均记录局部异常心室活动（LAVAs）并成功消融。心外膜LAVA消除后校正QT间期（QTc）缩短（594.9±85.98 ms vs 490±67.49 ms, p = 0.001）。在平均随访288±147.4 d（范围170-492 d）期间，2例患者出现室性心动过速(VT) /心室颤动（VF）复发。结论LQTS患者可发现区域性和局限性心外膜lava。射频消融VPC触发器和心外膜LAVAs对预防未来VT/VF复发有中等效果。

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引用次数: 0

Association Between ACE Gene I/D Polymorphism and Diabetic Retinopathy in Mexican Population ACE基因I/D多态性与墨西哥人群糖尿病视网膜病变的关系

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-30 DOI: 10.1016/j.arcmed.2025.103252

Karla Barrera-Perales , Héctor Pérez-Cano , Sergio Rojas-Juárez , Oscar Morales-López , Alin Somilleda-Ventura , Miguel Angel Cuevas-Budhart , Rogelio Ivan Silva Rueda

Background and Aims

Diabetic retinopathy (DR) is a significant ocular complication. The insertion/deletion (I/D) polymorphism in the angiotensin-converting enzyme (ACE) gene has been associated with its development.

Objective

To evaluate the relationship between the ACE gene I/D polymorphism and the presence of DR to identify the highest-risk allele.

Methods

79 patients with diabetic retinopathy and 75 healthy controls were studied. Metabolic and anthropometric measurements were performed, and DNA was extracted to identify the polymorphism using C-reactive protein. Fisher’s exact test was used for comparative analysis of allele and genotypic frequencies.

Results

The I/I genotype was more frequent in patients with DR (43 %) and was associated with a 3.22-fold increased risk of developing the disease (p = 0.0123). The I allele frequency was 67 % in patients and 56 % in controls, though no significant difference was found (p = 0.073).

Conclusions

The higher frequency of the I/I genotype in patients with DR suggests that this genotype may be a risk factor for developing the disease in patients with type 2 diabetes (T2DM). Further studies are recommended to confirm these findings.

背景与目的糖尿病视网膜病变（DR）是一种重要的眼部并发症。血管紧张素转换酶（ACE）基因的插入/缺失（I/D）多态性与ACE的发育有关。目的探讨ACE基因I/D多态性与DR存在的关系，以确定高危等位基因。方法对79例糖尿病视网膜病变患者和75例健康对照者进行研究。进行代谢和人体测量，并提取DNA，利用c反应蛋白鉴定多态性。采用Fisher精确检验法对等位基因和基因型频率进行比较分析。结果I/I基因型在DR患者中更为常见（43%），与发病风险增加3.22倍相关（p = 0.0123）。患者I等位基因频率为67%，对照组为56%，差异无统计学意义（p = 0.073）。结论DR患者中I/I基因型的发生率较高，提示该基因型可能是2型糖尿病（T2DM）患者发病的危险因素。建议进一步的研究来证实这些发现。

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引用次数: 0

Endocrine Disruptors and Attention Deficit Hyperactivity Disorder: A Systematic Review 内分泌干扰物与注意缺陷多动障碍：系统综述

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-21 DOI: 10.1016/j.arcmed.2025.103260

Marta Lopez-Garcia , Manuel Martinez-Bebia , Alejandro Lopez-Moro , Nuria Gimenez-Blasi , José Antonio Latorre , Miguel Mariscal-Arcas

The increasing prevalence of attention deficit hyperactivity disorder (ADHD) in children has prompted more research on both genetic and environmental risk factors, including endocrine-disrupting chemicals (EDCs) such as bisphenol A (BPA) and polychlorinated biphenyls (PCBs). This review focuses on studies published between 2013 and December 2023 that explore the potential impact of BPA and PCBs on ADHD. The review draws from databases such as WOS, PubMed, and Scopus. BPA, a chemical commonly used in plastics and resins, has raised concerns due to its potential neurodevelopmental effects, particularly when exposure occurs prenatally. Multiple studies have suggested an association between prenatal BPA exposure and an increased risk of ADHD in offspring, though more research is needed. Similarly, PCBs, which are persistent environmental pollutants primarily found in contaminated food sources, have been linked to cognitive and behavioral issues, including attention deficits and hyperactivity. Both BPA and PCBs have been shown to disrupt neurodevelopment, underscoring the importance of regulating these chemicals to safeguard children’s health. While these findings highlight a potential risk, further studies are required to clarify the underlying mechanisms and the precise role these EDCs play in the development of ADHD and other neurobehavioral disorders.

儿童注意力缺陷多动障碍（ADHD）的日益流行促使人们对遗传和环境风险因素进行了更多的研究，包括双酚A （BPA）和多氯联苯（PCBs）等内分泌干扰化学物质（EDCs）。这篇综述的重点是2013年至2023年12月之间发表的研究，这些研究探讨了双酚a和多氯联苯对多动症的潜在影响。这篇综述来自WOS、PubMed和Scopus等数据库。双酚a是一种常用于塑料和树脂的化学物质，由于其潜在的神经发育影响而引起关注，特别是在产前接触时。尽管还需要更多的研究，但多项研究表明，产前BPA暴露与后代患多动症的风险增加之间存在关联。同样，多氯联苯是一种持久性环境污染物，主要存在于受污染的食物来源中，与认知和行为问题有关，包括注意力缺陷和多动。双酚a和多氯联苯都被证明会破坏神经发育，这强调了调节这些化学物质对保护儿童健康的重要性。虽然这些发现强调了潜在的风险，但需要进一步的研究来阐明这些EDCs在ADHD和其他神经行为障碍发展中的潜在机制和确切作用。

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引用次数: 0

Spatial Approach to Cardiac Electrical Dynamics: Evaluation of Surrogate Biomarkers of Differences in Drug-Induced Multichannel Block 心电动力学的空间方法：药物诱导的多通道阻滞差异的替代生物标志物的评估

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-15 DOI: 10.1016/j.arcmed.2025.103251

Pablo Daniel Cruces , Pedro David Arini

Background and Aims

Torsade de Pointes (TdP), a side effect of many marketed drugs, can lead to sudden cardiac death. Regulatory guidelines require quantification of hERG channel block by QT interval prolongation on ECG, although its predictive value remains low. To propose a novel normalization technique for vectorcardiographic loops, enabling improved derivation of conventional and new indices for the robust identification of multiple cardiac ion channel blockades associated with TdP risk.

Methods

A robust method was developed to obtain angular parameters from ECG loops by normalizing for baseline drift using principal component analysis. Linear (via differentiation) and angular (via quaternion algebra) velocities were assessed to identify differential features between multichannel and selective hERG-blocking drugs. Furthermore, bidirectional baseline correction allowed more accurate extraction of ECG wave extrema and peaks, improving the robustness of the QT interval and other temporal measurements. The proposed dynamic biomarkers were evaluated in 22 subjects enrolled in a clinical trial of four known QT-prolonging drugs.

Results

The two high-risk drugs exhibited drug-induced changes (p < 0.0005) in velocity during ventricular repolarization. Strong calcium or sodium blockers reduced the effect on velocity caused by hERG potassium channel block. A tendency to symmetry of angular values was observed with high-risk drugs. The alternative temporal indices showed a high correlation (r > 0.9) with standard indices. Differences emerged between the T-wave end and the angular velocity marker of ventricular repolarization end.

Conclusion

Spatial analysis of cardiac signals and the new dynamic measures could complement current standards and support safer drug development.

背景和AimsTorsade de Pointes （TdP）是许多上市药物的副作用，可导致心源性猝死。调节指南要求通过心电图QT间期延长来量化hERG通道阻滞，尽管其预测价值仍然很低。提出一种新的矢量心动图回路归一化技术，能够改进传统和新指标的推导，以可靠地识别与TdP风险相关的多个心脏离子通道阻塞。方法利用主成分分析对基线漂移进行归一化，建立了一种鲁棒的心电回路角参数获取方法。评估了线性（通过微分）和角速度（通过四元数代数），以确定多通道和选择性heg阻断药物之间的差异特征。此外，双向基线校正可以更准确地提取心电波极值和峰值，提高QT间期和其他时间测量的稳健性。该动态生物标志物在22名受试者中进行了评估，这些受试者参加了四种已知的延长qt药物的临床试验。结果两种高危药物均表现出药物性改变(p <；0.0005)心室复极时的速度。强钙或钠阻滞剂降低了hERG钾通道阻滞对流速的影响。观察到高危药物的角值趋于对称。各备选时间指标均表现出较高的相关性(r >；0.9)，指标标准。t波端与心室复极端角速度标志存在差异。结论心脏信号的空间分析和新的动态测量方法可以补充现行标准，支持更安全的药物开发。

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引用次数: 0

Health in the Time of Nature Crisis 自然危机时期的健康

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-14 DOI: 10.1016/j.arcmed.2025.103256

Luis Zambrano , Constantino González-Salazar

Human health faces significant challenges due to global changes driven by human activities, such as climate change and biodiversity loss. These phenomena can impact the quality of life both independently and together. The United Nations Environmental Program has labeled these changes as a “nature crisis” because they affect various aspects of human life. In this context, health issues can be categorized as direct or indirect effects of the nature crisis. Direct effects: i. Temperature change: Heat waves are rapidly increasing mortality rates. ii. Hydrometeorological hazards: Floods can compromise water quality, creating health risks. iii. Air pollution: Climate change can increase the mobility of pollutants, worsening air quality. Indirect effects: i. Vector-borne diseases: For example, changes in weather patterns can alter the distribution of vectors, such as mosquitoes, affecting disease transmission. ii. Water-borne diseases: Increased incidence of diarrheal diseases can occur as water quality deteriorates. iii. Food-borne diseases: For instance, climate change can increase pathogens in agricultural products, posing health risks. Health impacts vary by regions, and vulnerable populations often have lower adaptive capacities. Health policies must be tailored globally and locally to address these issues, emphasizing protection for the most at-risk groups. Collaboration between the health and environmental sectors is essential to solve these growing problems. However, current adaptation policies are constantly challenged by the nature crisis. Therefore, humanity must intensify its efforts to mitigate climate change and reduce land use changes to preserve biodiversity.

由于气候变化和生物多样性丧失等人类活动驱动的全球变化，人类健康面临重大挑战。这些现象可以单独或共同影响生活质量。联合国环境规划署将这些变化称为“自然危机”，因为它们影响了人类生活的各个方面。在这方面，健康问题可分为自然危机的直接或间接影响。直接影响：i.温度变化：热浪正在迅速增加死亡率。2。水文气象灾害：洪水会损害水质，造成健康风险。3。空气污染：气候变化会增加污染物的流动性，使空气质量恶化。间接影响：i.病媒传播的疾病：例如，天气模式的变化可以改变蚊子等病媒的分布，从而影响疾病的传播。2。水媒疾病：随着水质恶化，腹泻病的发病率会增加。3。食源性疾病：例如，气候变化会增加农产品中的病原体，构成健康风险。对健康的影响因区域而异，弱势群体的适应能力往往较低。必须在全球和地方调整卫生政策，以解决这些问题，强调保护风险最大的群体。卫生和环境部门之间的合作对于解决这些日益严重的问题至关重要。然而，当前的适应政策不断受到自然危机的挑战。因此，人类必须加紧努力，减缓气候变化，减少土地利用变化，以保护生物多样性。

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引用次数: 0

Interdisciplinary Vocational Training for Resilient, Integrated, and Person-Centered Health Systems 跨学科的职业培训弹性，综合的，以人为本的卫生系统

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-14 DOI: 10.1016/j.arcmed.2025.103243

Mónica Valenzuela , Osvaldo Artaza , Javier Santa Cruz , Marcelo Fagalde , Mónica Espinoza , Sandra Oyarzo , Erich V. De Paula , Rogelio Pizzi

引用次数: 0

Increased LDH Remains a Crucial Prognostic Factor in Patients With Multiple Myeloma LDH升高仍然是多发性骨髓瘤患者预后的关键因素

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-09 DOI: 10.1016/j.arcmed.2025.103239

Ramiro Espinoza-Zamora , Nidia Paulina Zapata-Canto , Lizbeth Deyanir Aguilera-Urbina , Judith Cruz-Velazquez , Elba Reyes-Maldonado , Jorge Vela-Ojeda

Background and Aims

Multiple myeloma is the second most common hematologic cancer and remains incurable. Several prognostic factors have been identified, but many are costly and inaccessible to most hematology centers. To explore the clinical, laboratory, and cytogenetic factors that influence survival in patients with newly diagnosed multiple myeloma.

Methods

The research included 286 patients treated with different regimens: 64.5 % received thalidomide-based combinations, while 35.5 % were treated with proteasome inhibitor combinations.

Results

Stringent complete remission was achieved in 15.5 %, complete remission in 30.5 %, very good partial response in 41 %, and partial response in 5 %. Progression-free survival (PFS) and overall survival (OS) were lower in patients with high lactate dehydrogenase (LDH), renal disease, t(4;14), RB1 mutation, and in those who did not achieve complete remission or were not treated with transplantation and proteasome inhibitors. Elevated LDH was identified as the most significant independent prognostic factor. A scoring system based on LDH, renal disease, t(4;14), and RB1 mutation was developed and showed differences in PFS and OS based on the score (0,1,2,3, or 4,5 points).

Conclusions

An elevated LDH level was the most significant prognostic factor. A simple scoring system is suggested, especially for patients without access to expensive cytogenetic testing.

背景与目的多发性骨髓瘤是第二常见的血液病，目前仍无法治愈。已经确定了几个预后因素，但许多因素昂贵且大多数血液学中心无法获得。探讨影响新诊断多发性骨髓瘤患者生存的临床、实验室和细胞遗传学因素。方法采用不同方案治疗的286例患者，其中以沙利度胺为主的联合用药占64.5%，蛋白酶体抑制剂联合用药占35.5%。结果严格完全缓解者占15.5%，完全缓解者占30.5%，非常好部分缓解者占41%，部分缓解者占5%。患有高乳酸脱氢酶（LDH）、肾脏疾病、t（4;14）、RB1突变、未达到完全缓解或未接受移植和蛋白酶体抑制剂治疗的患者的无进展生存期（PFS）和总生存期（OS）较低。LDH升高被认为是最重要的独立预后因素。建立了基于LDH、肾病、t（4;14）和RB1突变的评分系统，并根据评分（0,1,2,3或4,5分）显示PFS和OS的差异。结论LDH水平升高是影响预后的最重要因素。建议采用一种简单的评分系统，特别是对于无法获得昂贵的细胞遗传学检测的患者。

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引用次数: 0

Semaphorin 7A Induces Liver Inflammation and Promotes Parenteral Nutrition-Associated Cholestasis via ITGβ1/NF-κB Pathway 信号蛋白7A通过itg - β1/NF-κB通路诱导肝脏炎症和促进肠外营养相关性胆汁淤积

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-07 DOI: 10.1016/j.arcmed.2025.103244

Leilei Shen, Xiaodong Sun, Ruixue Zheng, Min Tao, Sheng Chen

Objective

To investigate the mechanistic role of semaphorin 7A (Sema7A) in neonatal parenteral nutrition-associated cholestasis (PNAC).

Methods

First, we measured the expression levels of Sema7A and inflammatory factors in both neonates with PNAC and rat models. Then, to investigate the mechanism underlying the regulatory role of Sema7A in hepatic inflammatory injury, we assessed NF-κB pathway activation and monitored inflammatory factor variations following Sema7A/integrin β1 (ITGβ1) inhibition and overexpression in rat models and isolated primary Kupffer cells. Furthermore, liver pathology and cholestatic changes were systematically examined by Sema7A manipulation (inhibition and overexpression) in animal models.

Results

Neonates and rats with PNAC showed increased levels of TNF-α and IL-1β, and decreased levels of IL-4 and IL-10. Accordingly, Sema7A, ITGβ1, and P65/p-P65 mRNA and protein expression were elevated. In vitro, Sema7A overexpression activated the NF-κB pathway, which was reversible by ITGβ1 inhibition; conversely, Sema7A knockdown attenuated NF-κB activation, which was partially reversible by ITGβ1 overexpression. In vivo, Sema7A overexpression worsened liver injury and cholestasis through activation of the NF-κB pathway, while its inhibition ameliorated these effects.

Conclusions

Sema7A activates the NF-κB signaling pathway in an ITGβ1-dependent manner and exacerbates PN-induced liver injury and cholestasis. Targeting Sema7A may provide a therapeutic strategy to alleviate neonatal PNAC.

目的探讨信号蛋白7A （Sema7A）在新生儿肠外营养相关性胆汁淤积症（PNAC）中的作用机制。方法首先，我们测量了Sema7A和炎症因子在PNAC新生儿和大鼠模型中的表达水平。然后，为了研究Sema7A在肝脏炎症损伤中的调节作用机制，我们在大鼠模型和分离的原代库普弗细胞中评估了NF-κB通路的激活情况，并监测了Sema7A/整合素β1 （ITGβ1）抑制和过表达后的炎症因子变化。此外，在动物模型中，通过Sema7A操作（抑制和过表达）系统地检查肝脏病理和胆汁淤积变化。结果新生儿及PNAC大鼠血清TNF-α、IL-1β水平升高，IL-4、IL-10水平降低。Sema7A、ITGβ1、P65/p-P65 mRNA和蛋白表达升高。在体外，Sema7A过表达激活了NF-κB通路，该通路可通过ITGβ1抑制而可逆；相反，Sema7A敲低会减弱NF-κB的激活，这是ITGβ1过表达部分可逆的。在体内，Sema7A过表达通过激活NF-κB通路加重肝损伤和胆汁淤积，而抑制Sema7A可改善这些作用。结论sema7a以itg β1依赖的方式激活NF-κB信号通路，加重pn诱导的肝损伤和胆汁淤积。靶向Sema7A可能提供缓解新生儿PNAC的治疗策略。

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引用次数: 0

Rivaroxaban Prophylaxis in Peripherally Inserted Central Catheter-Related Thrombosis in Breast Cancer Patients 利伐沙班预防乳腺癌患者外周插入中心导管相关血栓形成

IF 4.7 3区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Archives of Medical Research

Pub Date : 2025-06-07 DOI: 10.1016/j.arcmed.2025.103242

Die Sang , Shiyu Li , Shanmin Fan , Jintao Zhang , Yanfang Su , Xiaoyan Zhang , Yinfeng Wang , Huachao Feng , Yuzhi Hao , Yujuan Liu , Man Li , Peng Yuan

Objective

To evaluate the efficacy and safety of rivaroxaban in preventing catheter-related thrombosis (CRT) in breast cancer patients undergoing chemotherapy with peripherally inserted central catheters (PICC).

Methods

A prospective cohort study enrolled breast cancer patients who underwent PICC placement for chemotherapy at the San Huan Cancer Hospital from November 2021 to August 2023. The treatment group received 10 mg of oral rivaroxaban daily for 2 months along with routine grip strength training, while the control group received grip strength training only. CRT occurrence was confirmed by vascular ultrasound, and group comparisons were made using the χ² test, with logistic regression analyzing CRT risk factors.

Results

Of 314 patients, 181 received treatment and 133 were in the control group. The treatment group had a significantly lower incidence of CRT (2.2 %, 4/181) compared to the control group (12.0 %, 16/133) (p < 0.001). Univariate analysis showed a higher risk of CRT in patients in the non-prophylaxis group (p = 0.002), patients aged ≥50 years (p = 0.014), and those with prior endocrine therapy (p = 0.030). Multivariate analysis identified rivaroxaban prophylaxis (p = 0.009) and age (p = 0.026) as independent risk factors for thrombosis. The use of rivaroxaban for prophylactic anticoagulation was safe. All CRT-diagnosed patients completed their antitumor therapy without new thrombosis or pulmonary embolism.

Conclusion

Two months of rivaroxaban prophylaxis effectively and safely reduce CRT incidence in breast cancer patients with PICC.

目的评价利伐沙班预防乳腺癌外周中心置管（PICC）化疗患者导管相关性血栓形成（CRT）的有效性和安全性。方法前瞻性队列研究纳入2021年11月至2023年8月在三环肿瘤医院接受PICC放置化疗的乳腺癌患者。治疗组每日口服利伐沙班10mg，疗程2个月，同时进行常规握力训练；对照组仅进行握力训练。经血管超声确认发生CRT，组间比较采用χ2检验，logistic回归分析CRT危险因素。结果314例患者中，治疗组181例，对照组133例。治疗组CRT发生率（2.2%,4/181）明显低于对照组（12.0%,16/133）(p <；0.001)。单因素分析显示，非预防组（p = 0.002）、年龄≥50岁组（p = 0.014）和既往接受内分泌治疗的患者（p = 0.030）发生CRT的风险较高。多因素分析发现利伐沙班预防（p = 0.009）和年龄（p = 0.026）是血栓形成的独立危险因素。利伐沙班用于预防性抗凝是安全的。所有经ct诊断的患者均完成了抗肿瘤治疗，无新的血栓形成或肺栓塞。结论利伐沙班预防治疗2个月可有效、安全地降低乳腺癌PICC患者的CRT发生率。

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