ABSTRACT
Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.
ABSTRACT
The seat of human intelligence is the human cerebral cortex, which is responsible for our exceptional cognitive abilities. Identifying principles that lead to the development of the large-sized human cerebral cortex will shed light on what makes the human brain and species so special. The remarkable increase in the number of human cortical pyramidal neurons and the size of the human cerebral cortex is mainly because human cortical radial glial cells, primary neural stem cells in the cortex, generate cortical pyramidal neurons for more than 130 days, whereas the same process takes only about 7 days in mice. The molecular mechanisms underlying this difference are largely unknown. Here, we found that bone morphogenic protein 7 (BMP7) is expressed by increasing the number of cortical radial glial cells during mammalian evolution (mouse, ferret, monkey, and human). BMP7 expression in cortical radial glial cells promotes neurogenesis, inhibits gliogenesis, and thereby increases the length of the neurogenic period, whereas Sonic Hedgehog (SHH) signaling promotes cortical gliogenesis. We demonstrate that BMP7 signaling and SHH signaling mutually inhibit each other through regulation of GLI3 repressor formation. We propose that BMP7 drives the evolutionary expansion of the mammalian cortex by increasing the length of the neurogenic period.
Subject(s)
Animals , Mice , Humans , Ependymoglial Cells/metabolism , Hedgehog Proteins/metabolism , Ferrets/metabolism , Cerebral Cortex , Neurogenesis , Mammals/metabolism , Neuroglia/metabolism , Bone Morphogenetic Protein 7/metabolismABSTRACT
The single molecule imaging and technologies that developed in 1990 s have successfully probed the dynamics of single molecule enzyme catalysis in real time in vitro. Ever since then, single molecule enzymology has entered the golden age of rapid developing. Individual features of each enzyme hidden in the overall average have been discovered, and many new catalytic mechanisms have been proposed. Single molecule enzymology sheds light on the dynamic interactions between enzymes and substrates or products, deepening the understanding of biochemical reactions. This review described the recent research progresses of single molecule protease and ribozyme.
ABSTRACT
Objective To investigate the roles of sphingosine kinasel (SPK1) in apoptosis,invasiveness and multidrug resistance of human hepatocellular carcinoma cell line BEL-FU.Methods BEL-FU cells were infected with adenovirus carrying SPK1wT gene and SPK1siRNA (Ad-H1-SPK1) gene.Their effects on biological characteristics of BEL-FU cells were evaluated by MTT,cellular SPK enzyme activity assay,Transwell Migration Technology and Western-blot,respectively.Results AdSPK1wT significantly increased SPK activity but SPK1siRNA(Ad-H1-SPK1) decreased SPK activity.Over expression of SPK1 suppressed the apoptosis induced by DMS(Dimethyl sphingosine,DMS) and enhanced migration of BEL-FU cells.The cells infected with SPK1 siRNA( Ad-H1-SPK1)significantly increased the apoptosis induced by DMS and inhibited the migration of human hepatocellular carcinoma cells.The expression of multidrug resistance-related protein (MRP1) of cells infected with SPK1siRNA (Ad-H1-SPK1) was suppressed significantly compared with the control group,while the expression of MRP1 infected with Ad- SPK1wT was enhanced.Conclusion SPK1 activity is closely associated with apoptosis、migration and multidrug resistance of human hepatocellular carcinoma cells,therefore,it may serve as a new target for HCC treatment.
ABSTRACT
Objective To evaluate the etiology and clinical features of jejunoileum bleeding.Methods Seventy-two patients admitted in 7 hospitals of Shangdong province for jejunoileum bleeding from January 1998 to December 2008 were enrolled in the study. There were 46 males and 26 females with mean age of 47 years (ranged 13-85 years). The jejunoileum bleeding was confirmed by means of endoscopy, images or surgery. The causes, diagnostic methods and major clinical manifestations were retrospectively analyzed. Results The most frequent cause of jejunoileum bleeding was tumor (42/72,58.3 %), followed by enteritis (9/72, 12.5 %), diverticulum ( 7/72, 9. 7%), angiopathy (7/72,9.7%), Crohn's disease (3/72,4.2%). Differences were significant in constituent ratio of cause of jejunoileum hemorrhage between male and female and between jejunum and ileum (P＜0.05).Hematochezia or hematochezia with abdominal pain was the first presentation. The jejunoileum bleeding in 54. 2% patients was diagnosed by laparotomy, 23. 6% by capsule endoscopy, 9.7% by selective angiography, 6.9% by small bowel series and enteroclysis, 2.8% by colonoscopy and 2.8% by push enteroscopy. The complications of jejunoileum bleeding were anemia, intestinal obstruction,peritoneal metastasis, shock, ankylenteron and intestinal perforation. Conclusions Intestinal tumor is the most common cause in jejunoileum bleeding, especially in jejunum. Whereas the enteritis,diverticulum and angiopathy were often found in ileum. The capsule endoscopy and push enteroscopy are recommended in diagnosis of jejunoileum bleeding.
ABSTRACT
OBJECTIVE:To summarize the experience of pharmaceutical care provided by pharmacists of Chinese medicine for AIDS sufferers in our hospital.METHODS:The practical experience of pharmacists of Chinese medicine in providing pharmaceutical care for AIDS sufferers in our hospital was analyzed to achieve rational knowledge from perceptual knowledge.RESULT:To carry out pharmaceutical care for AIDS patients by applying expertise achieved satisfactory effect.CONCLUS-ION:Pharmacists of Chinese medicine should strive to establish a new open pharmaceutical care model,attach great importance to the communication with patients,integrating psychotherapy and humanistic care into the pharmaceutical care all along so as to assure patient's compliance.
ABSTRACT
OBJECTIVE:To explore the method and approach for traditional Chinese pharmacists to play an active role in case of emergent epidemic situation. METHODS:Taking the opportunity of H1N1 flu treatment,the traditional Chinese pharmacists carried out pharmaceutical services such as drug counseling,establishing medication history for typical cases,offering guidance and advice on medication,retrospectively analyzing prescription and consulting records. RESULTS & CONCLUSION:In the differential treatment,pharmacists of traditional Chinese medicine should take full account of patients' individual differences,actively participate in the design of individualized dose scheme and offer medication guidance so as to enhance patients' medication compliance meanwhile enhancing the status of pharmacists of traditional Chinese medicine.
ABSTRACT
AIM To investigate the effect of allicin on the regulation of VEGF mRNA expression in human hepatocellular carcinoma cells. METHODS Hepatocellular carcinoma cells were treated with the concentration 10 ?g?L -1 allicin in culture medium,and then the relative VEGF mRNA level at 8 h in human hepatocellular carcinoma cells was evaluated by reverse transcriptase polymerase chain reaction using HPRT(hypoxanthine phosphoribosyltransferase)as an internal control standard. RESULTS The expression of VEGF gene mRNA was inhibited obviously by allicin. Compared with control group, the relative expression level of VEGF gene mRNA was decreased by about 66 36%( P
ABSTRACT
The location, shape and internal architecture of the sinoatrial node (SAN) were studied histologically in serial section in 15 hearts (7 adults, 8 foetuses). Based on our observation, the human SAN may be divided into four layers, namely, (1) thesinoatrial node artery layer: its outer longitudinal muscular layer of its media partly lacked in the SAN concentrically; (2) the periarterial layer: the cells of this layer surround the artery concentrically; (3) the central layer, making up the main mass of the node: most P cells in which are arranged parallel to the node artery. In adult the diameter of P cells in this layer is 5.18 ?m; (4) the peripheral layer: most transitional cells in this layer radiate from SAN into the atrial muscle. These "tongues of transitional cells" extend mostly into right atrial-muscle and a few into the musculature of superior vena cava. The diameter of transitional cells of this layer in the adult is 7.28 ?m. In the adult the arrangement of dense collagen fibers appears circular in the periarterial layer, longitudinal in the central layer and radiative in the peripheral layer. According to the location, layers of sinoatrial node and the arrangement of the connective tissue, the functional significance and morphological basis of the re-entry are discussed.