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1.
J Pain ; 2022 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-35914642

RESUMEN

The rostral anterior cingulate cortex (rACC) has been found to be an important brain region in mediating visceral hypersensitivity. However, the underlying mechanisms remain unclear. This study aimed to explore the role of astrocytes in the maintenance of visceral hypersensitivity induced by chronic water avoidance stress (WAS) as well as the potential signaling pathway that activates astrocytes in the rACC. We found that ACC-reactive astrogliosis resulted in the overexpression of c-fos, TSP-1, and BDNF in stress-related visceral hypersensitivity rats. Visceral hypersensitivity was reversed by pharmacological inhibition of astrocytic activation after WAS, as were the overexpression of c-fos, TSP-1 and BDNF. Activation of the astrocytic Gi-pathway increased the visceral sensitivity and expression of c-fos, TSP-1, and BDNF. Visceral hypersensitivity was also ameliorated by the pharmacological inhibition of ERK and STAT1 phosphorylation after WAS. Furthermore, inhibition of the ERK-STAT1 cascade reduced astrocytic activation. These findings suggest that astrocytic ERK/STAT1 signaling in the rACC contributes to the maintenance of stress-related visceral hypersensitivity. PERSPECTIVE: Visceral hypersensitivity is a key factor in the pathophysiology of irritable bowel syndrome. This study highlights the important role of astrocytic ERK/STAT1 signaling in activating astrocytes in the rostral anterior cingulate cortex, which contributes to visceral hypersensitivity.

2.
Ther Clin Risk Manag ; 18: 561-569, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35602262

RESUMEN

Purpose: To identify pathology discrepancy between forceps biopsies and polypectomy specimens in colorectal polyps, as well as the reliability of biopsy-based treatment strategy. Methods: All endoscopic polypectomy cases with forceps biopsies performed within 6 months were included in the study. The biopsies were compared with polypectomy specimens in terms of concordance of histological diagnosis. A logistic regression model was used to investigate the independent predictors of upgrade in histological diagnosis compared with concordance in histological diagnosis. Results: A total of 1686 paired screening-therapeutic colonoscopies and 1739 paired biopsy-polypectomy specimens were enrolled in the study. The grade of dysplasia in 84.5% of biopsy specimens were concordant to polypectomy specimens, but this proportion decreased to 75.4% when the specimens were classified using tubular or villousness structure. 10.1% and 5.4% of biopsy specimens were upgraded and downgraded in assessing grade of dysplasia, respectively, while 14.3% and 10.3% of biopsy specimens were upgraded and downgraded in assessing tubular or villousness structure, respectively. In subgroup analysis stratified by size of polyps, 9.0% and 10.6% of biopsies obtained from polyps smaller than 10 mm were upgraded in assessing dysplasia and tubular or villousness structure, respectively. This proportion increased to 10.7% and 21.3%, respectively, in biopsies obtained from polyps larger than 10 mm. Larger size of polyps and pedunculated polyps were associated with a higher incidence of upgrade in histological diagnosis. Nearly 25% of biopsy specimens with high-grade dysplasia were identified as adenocarcinoma in polypectomy specimens. Conclusion: The concordance between biopsy and polypectomy specimens is not adequate. The biopsy-based treatment strategy is not reliable and should not be considered as an indicator for further treatment, particularly in large or pedunculated polyps.

3.
Gastroenterol Res Pract ; 2022: 4145810, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35386530

RESUMEN

Objective: Effective therapies for reflux hypersensitivity are lacking. Endoscopic radiofrequency ablation may reduce the sensitivity of the distal esophagus through direct interference with nociceptors or vagal afferent fibers and thus may be useful in reflux hypersensitivity. The aim of this study is to assess the effectiveness and possible mechanisms of endoscopic radiofrequency ablation in reflux hypersensitivity patients. Methods: Patients with reflux hypersensitivity who fulfilled the Rome IV criteria and who wished to receive further treatment were recruited. Endoscopic radiofrequency ablation was delivered to the gastroesophageal junction. Data were collected by questionnaire using a 6-point Likert scale. The primary outcome measure was effect on symptoms including heartburn, regurgitation, and chest pain. The secondary outcomes were degree of satisfaction, medication use, acid exposure time (AET), low esophageal sphincter (LES) pressure, and total reflux episodes. We also assessed positive cell density of transient receptor potential vanilloid type 1 receptor (TRPV1) and calcitonin gene-related peptide (CGRP), both of which are biomarkers of afferent fibers, in biopsies obtained from esophageal mucosa 0.5 cm-1 cm above the Z line. These scales will be administered at baseline, 3-month follow-up, 6-month follow-up, and 12-month follow-up. Results: A total of 22 reflux hypersensitivity patients were enrolled (14 males, median age 50.0 years). A significant improvement in symptom scores (heartburn, regurgitation, and chest pain) was noted at 3 months, 6 months, and 12 months (P < 0.001). Satisfaction with life increased to 72.7% (16/22), 72.7% (16/22), and 68.2% (15/22) at 3, 6, and 12 mo, respectively, compared with baseline (P < 0.001). Nineteen patients reduced their medication use after treatment. Of these, 22.7% (5/22), 31.8% (7/22), and 40.9% (9/22) subjects stopped medication use at 3 mo, 6 mo, and 12 mo, respectively. No statistical differences were noted in AET, LES pressure, or total reflux episodes from preoperation to 12 mo postoperation. After treatment, the positive cell density of both TRPV1 and CGRP decreased significantly; however, only TRPV1 had a positive correlation with heartburn (r = 0.51, P = 0.03) and chest pain (r = 0.77, P < 0.01). Conclusion: Endoscopic radiofrequency ablation was an effective and safe therapeutic option in reflux hypersensitivity patients. Further studies with large sample size are required to validate the role of radiofrequency in reflux hypersensitivity.

4.
Science ; 375(6579): 430-433, 2022 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-35084955

RESUMEN

In thermodynamic equilibrium, current in metallic systems is carried by electronic states near the Fermi energy, whereas the filled bands underneath contribute little to conduction. Here, we describe a very different regime in which carrier distribution in graphene and its superlattices is shifted so far from equilibrium that the filled bands start playing an essential role, leading to a critical-current behavior. The criticalities develop upon the velocity of electron flow reaching the Fermi velocity. Key signatures of the out-of-equilibrium state are current-voltage characteristics that resemble those of superconductors, sharp peaks in differential resistance, sign reversal of the Hall effect, and a marked anomaly caused by the Schwinger-like production of hot electron-hole plasma. The observed behavior is expected to be common to all graphene-based superlattices.

5.
J Gastrointestin Liver Dis ; 30(3): 358-365, 2021 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-34551036

RESUMEN

BACKGROUND AND AIMS: There is still considerable controversy surrounding the relationship between fatigue of endoscopists and the quality of colonoscopy. The aim of this study is to comprehensively explore the association between fatigue and adenoma detection rate (ADR) and cecal intubation rate (CIR). METHODS: The mixed effects logistic regression model was used to explore the relationship between fatigue- related factors including procedure order, session of procedures and the day of week and ADR as well as CIR. RESULTS: When controlling for confounders, the day of week (Monday as reference, Friday, p=0.022; weekends, p=0.015) and session of procedures (P<0.001) were significantly associated with ADR while procedure order (<5 as reference, 6-10, p<0.001; >10, p=0.001) and session of procedures (p=0.004) were independent predictors for CIR. Additionally, there was a significant downward trend on ADR and CIR with the approaching of weekends (p=0.005) and increasing procedure orders (p<0.001), respectively. In the subgroup analysis stratified by gender, age and workload intensity, significant lower ADR was found in the afternoon in all subgroups (male, p<0.001; female, p=0.005; <40 years, p<0.001; ≥40 years, p=0.020; intensity<50 per month, p=0.017; intensity≥50 per month, p<0.001) but the downward trend on ADR as the week progressed was only found in endoscopists with male gender (p=0.011), age<40 (p=0.027) and high workload intensity (p=0.003). Moreover, a significant downward trend on CIR as the procedure order increased was found in all subgroups except endoscopists with age≥40 (male, p=0.005; female, p<0.001; <40 years, p<0.001; intensity<50 per month, p=0.001; intensity≥50 per month, p<0.001). CONCLUSIONS: Colonoscopies in the afternoon will affect ADR negatively while increasing procedure order will cause a lower CIR. Importantly, the significant negative influence of Friday and weekends on ADR was first discovered in this study. Moreover, endoscopists with female gender and advanced age (≥40) but not high workload intensity showed superiority in resistance of fatigue caused by the end of the week and increasing daily procedures.


Asunto(s)
Adenoma , Agotamiento Profesional , Colonoscopía/normas , Neoplasias Colorrectales , Fatiga , Adenoma/diagnóstico por imagen , Adulto , Neoplasias Colorrectales/diagnóstico por imagen , Femenino , Humanos , Masculino , Tamizaje Masivo
6.
Phys Rev Lett ; 126(25): 256803, 2021 Jun 25.
Artículo en Inglés | MEDLINE | ID: mdl-34241524

RESUMEN

Achieving Bloch oscillations of free carriers under a direct current, a long-sought-after collective many-body behavior, has been challenging due to stringent constraints on the band properties. We argue that the flat bands in moiré graphene fulfill the basic requirements for observing Bloch oscillations, offering an appealing alternative to the stacked quantum wells used in previous work aiming to access this regime. Bloch-oscillating moiré superlattices emit a comblike spectrum of incommensurate frequencies, a property of interest for converting direct currents into high-frequency currents and developing broadband amplifiers in terahertz domain. The oscillations can be synchronized through coupling to an oscillator mode in a photonic or plasmonic resonator. Phase-coherent collective oscillations in the resonant regime provide a realization of current-pumped terahertz lasing.

7.
J Gastroenterol Hepatol ; 36(6): 1649-1655, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33105040

RESUMEN

BACKGROUND AND AIM: The number of colonoscopies required to reach satisfactory adenoma detection rate (ADR) is not well established. The aim of this study was to identify the appropriate number of procedures required to attain satisfactory ADR for those well-trained endoscopists who have a cecal intubation rate (CIR) ≥ 90% and start to perform colonoscopy independently. METHODS: All endoscopists with compelete independent colonoscopy data during career in our database were enrolled. The number of procedures required to achieve ADR ≥ 20% was identified by cumulative summation (Cusum), learning curve Cusum (LC-Cusum), and moving average method. Mixed effect logistic regression model was developed to determine the relationship between endoscopist as well as patient-related factors and adenoma detection. RESULTS: A total of 24 943 procedures and 14 endoscopists were enrolled. By Cusum analysis, the interest point was at 207 procedures. By LC-Cusum analysis, 71% (10/14) and 86% (12/14) of endoscopists had attained satisfactory ADR after 200 and 300 procedures, respectively. By moving average method, endoscopists reached a mean ADR of 20% at 216 and 261 procedures over blocks of 50 and 100 procedures, respectively. The total number of procedures, number of daily procedures, patient age and gender, bowel preparation, sedation, and diverticulosis were significantly associated with adenoma detection. CONCLUSIONS: This is the first study to investigate the learning curve of ADR for those well-trained endoscopists who have a CIR ≥ 90% and start to perform colonoscopy independently. Two hundred procedures might be an optimal number required to reach an ADR ≥ 20%.


Asunto(s)
Adenoma/diagnóstico , Competencia Clínica , Colonoscopía/educación , Colonoscopía/estadística & datos numéricos , Neoplasias Colorrectales/diagnóstico , Curva de Aprendizaje , Factores de Edad , Sedación Consciente , Divertículo , Humanos , Modelos Logísticos , Factores Sexuales
8.
Gastroenterol Res Pract ; 2020: 3089094, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33381166

RESUMEN

PURPOSE: To explore the effect of sedation on the quality of colonoscopy. METHODS: The data collected from the Digestive Endoscopy Center of Shanghai Tongji Hospital from March 2012 to June 2019 were retrospectively analyzed. The rate of sedation and quality metrics of colonoscopy such as adenoma detection rate (ADR) and cecal intubation rate (CIR) were calculated. The logistic regression model was used to explore the relationship between sedation and quality metrics of colonoscopy. The interaction effects between experience of endoscopists and sedation on quality of colonoscopy was also investigated in subgroups stratified by total number of colonoscopies during career using the logistic regression model. RESULTS: A total of 63,417 colonoscopies including 11,417 colonoscopies without sedation and 52,000 colonoscopies with sedation were enrolled in our study. The proportion of colonoscopy with sedation was 82.0%. The ADR and CIR were all significantly higher in cases with sedation compared with cases without sedation (ADR, 22.5% vs. 17.0%, p < 0.001; CIR, 94.7% vs. 91.2%, p < 0.001). Multivariate analysis showed that the sedation was an independent factor associated with adenoma detection (OR = 1.448, 95% CI: 1.372~1.529, p < 0.001) and cecal intubation (OR = 1.560, 95% CI: 1.446~1.683, p < 0.001). A total of 14 endoscopists with complete colonoscopy data in our database and corresponding 20,949 colonoscopies data were enrolled for further analysis. The logistic regression model yielded a similar result that sedation was an independent factor on adenoma detection and cecal intubation when the factor, experience of endoscopists, was also entered into the model as a confounder (adenoma detection, OR = 1.408, 95% CI: 1.333~1.487, p < 0.001; cecal intubation, OR = 1.601, 95% CI: 1.482-1.729, p < 0.001). CONCLUSION: Colonoscopy with sedation has a positive effect on ADR and CIR in all endoscopists with different experience of colonoscopy, which makes the quality of colonoscopy better.

9.
Front Pharmacol ; 11: 608199, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33643039

RESUMEN

Ethnopharmacology relevance: Dichondra repens J.R.Forst. and G.Forst (DRF; Convolvulaceae, called Matijin in Chinese), has been traditionally used to treat jaundice, bacillary dysentery, urinary tract infection, edema, contusions, and strains and sprains based on traditional Chinese medicine (TCM) concepts. Aim of study: This paper intends to provide a comprehensive and critical analysis of research on DRF focusing on a relationship between traditional uses and pharmacological effects, evaluating the therapeutic potential of this plant. Methods: Relevant data on DRF were retrieved from available databases. Results: The heat-clearing and detoxifying, and removing the phlegm and turbid urine effects of DRF are linked to its anti-hepatitis B virus (HBV), anti-inflammatory, and hepatoprotective activities. Especially, the hepatoprotective effects of DRF are mainly based on anti-HBV activities of phenylalanine dipeptides Matijin-Su (MTS) and its derivatives derived from this plant. Further, a phase I anti-HBV clinical trial of a candidate compound named bentysrepinine (Y101, Chinese name Tifentai) has been completed. Also, anti-tumor, analgesic, and antibacterial properties have been reported in the extracts and compounds from DRF. Although pharmacy, pharmacodynamics, toxicology, and pharmacokinetics of bentysrepinine have been systemically reported, no studies have reported chemistry, safety, pharmacology of other compounds or extracts systemically. Conclusion: Phenylalanine dipeptide compounds are main components and MTS is a characteristic substance of DRF. The main pharmacological effect of DRF is anti-HBV activity, which is coherent with the traditional use of this plant in China. Except bentysrepinine, few studies have been conducted on toxicities of the extracts or compounds from DRF. Thus, it is still necessary to evaluate safety, chemistry, pharmacology of the extracts or compounds from DRF regarding the link between traditional uses and modern applications before the future clinical trials. Bacterial sepsis, cholecystitis and tumors may be prior therapeutic targets of this plant in the future.

10.
Exp Ther Med ; 18(5): 3291-3298, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31616504

RESUMEN

Esophageal adenocarcinoma (EAC) is the predominant pathological subtype of esophageal cancer in Europe and the USA. The present bioinformatics study analyzed a high-throughput sequencing dataset, GSE94869, to determine differentially expressed genes (DEGs) in order to identify key genes, biological processes and pathways associated with EAC. Functional enrichment analysis was performed using the Database for Annotation Visualization and Integrated Discovery. The co-expression network of the DEGs was established using Weighted Gene Co-Expression Network Analysis and visualized using Cytoscape. A Kaplan-Meier analysis based on The Cancer Genome Atlas (TCGA) database was used to identify prognosis-associated genes. Univariate and multivariate Cox proportional hazard models were used to identify genes with a prognostic value regarding relapse-free survival (RFS), while validation of the differential expression of prognosis-associated genes was performed using a box plot based on data from TCGA and another microarray dataset, GSE26886. A total of 130 DEGs, comprising 82 upregulated and 48 downregulated genes, were identified. The upregulated DEGs were significantly associated with extracellular matrix organization, disassembly, and the phosphoinositide-3 kinase/AKT, Rap1 and Ras signaling pathways, while the downregulated genes were associated with the Wnt signalling pathway. Subsequently, two co-expression modules were established and 20 hub genes were identified. The blue module was associated with the Rap1 signaling pathway, while the turquoise module was associated with the Ras and Rap1 signaling pathways. Among them, methyltransferase like 7B (METTL7B) was associated with RFS. Furthermore, the overexpression of METTL7B in EAC was successfully validated using data from TCGA and GSE26886. The present study identified key genes and provides potential biomarkers for the diagnosis and treatment of EAC.

11.
Onco Targets Ther ; 11: 4327-4337, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30100738

RESUMEN

Purpose: Esophageal adenocarcinoma (EAC) is the most common type of esophageal cancer in Western countries. It is usually detected at an advanced stage and has a poor prognosis. The aim of this study was to identify key genes and miRNAs in EAC. Methods: The mRNA microarray data sets GSE1420, GSE26886, and GSE92396 and miRNA data set GSE16456 were downloaded from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) and differentially expressed miRNAs (DEMs) were obtained using R software. Functional enrichment analysis was performed using the DAVID database. A protein-protein interaction (PPI) network and functional modules were established using the STRING database and visualized by Cytoscape. The targets of the DEMs were predicted using the miRecords database, and overlapping genes between DEGs and targets were identified. The prognosis-related overlapping genes were identified using Kaplan-Meier analysis and Cox proportional hazard analysis based on The Cancer Genome Atlas (TCGA) database. The differential expression of these prognosis-related genes was validated using the expression matrix in the TCGA database. Results: Seven hundred and fifteen DEGs were obtained, consisting of 313 upregulated and 402 downregulated genes. The PPI network consisted of 281 nodes; 683 edges were constructed and 3 functional modules were established. Forty-four overlapping genes and 56 miRNA- mRNA pairs were identified. Five genes, FAM46A, RAB15, SLC20A1, IL1A, and ACSL1, were associated with overall survival or relapse-free survival. FAM46A and IL1A were found to be independent prognostic indicators for overall survival, and FAM46A, RAB15, and SLC20A1 were considered independent prognostic indicators for relapse-free survival. Among them, the overexpression of RAB15 and SLC20A1 and lower expression of ACSL1 were also identified in EAC tissues based on the expression matrix in the TCGA database. Conclusion: These prognosis-related genes and differentially expressed miRNA have provided potential biomarkers for EAC diagnosis and treatment.

12.
Gastroenterol Res Pract ; 2018: 5032657, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29721011

RESUMEN

Aims: To explore the risk factors for rebleeding in acute nonvariceal upper gastrointestinal bleeding patients with high-risk stigmata after endoscopic hemostasis and to develop a new scoring system for them. Methods: A retrospective single-center study was conducted from January 2012 to June 2017. The logistic regression model was used to explore risk factors of poor clinical outcomes. Accuracy of new scoring systems was compared with Rockall score (RS) and Glasgow-Blatchford score (GBS) using receiver operating characteristics curve. Results: Two hundred nine patients were included. In multivariate regression analysis, systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were identified as indicators for rebleeding. New scoring systems with 4 variables and 5 variables based on these 5 risk factors were chosen. The 4-variable scoring system outperformed GBS in predicting rebleeding while 5-variable scoring system outperformed RS and GBS in predicting rebleeding significantly. Score 2 was identified as the best cut-off of these 2 scoring systems. Conclusions: Systolic blood pressure, endoscopic hemostasis method, hemoglobin, blood urea nitrogen, and serum creatinine were all associated with poor clinical outcomes. The new scoring systems had greater accuracy than RS and GBS in predicting rebleeding. Further external validation should be performed to verify the results.

13.
Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi ; 32(3): 382-6, 2016 Mar.
Artículo en Chino | MEDLINE | ID: mdl-26927561

RESUMEN

OBJECTIVE: To investigate the effects of anticoagulants, preservation time and temperature of peripheral blood samples on the culture of cytokine-induced killer (CIK) cells so as to provide the experimental evidences for peripheral blood storage in autologous immunotherapy. METHODS: Four samples of 60 mL peripheral blood were collected. After being added with heparin sodium, cell preservation liquid (sodium citrate) and EDTA solution, they were separately stored under 4°C, 22°C, and 30°C for 0, 4, 8, 24 hours. We divided the orthogonal experiments into 12 groups, and then separated mononuclear cells and induced them into CIK cells. The proliferation efficiency and IFN-γ secretion were compared in the 12 groups. RESULTS: The proliferation of CIK cells was not obvious in EDTA group, but obvious in heparin sodium group and sodium citrate group, especially better in sodium citrate group. The storage time of blood did not have a significant impact on CIK cell culture, however the longer storage time, the lower cell proliferation efficiency. The proliferation efficiency decreased apparently after 16-day culture if preservation time exceeded 8 hours. After the culture period of 16 days, the efficiency of CIK cell proliferation was the highest at 22°C, followed by that at 4°C, and the lowest was at 30°C. It was not apparent that the temperature of blood storage affected CIK cell proliferation within 16-day culture period. CONCLUSION: Both heparin sodium and sodium citrate can be used in blood sample anticoagulation for CIK cell culture. Blood samples are suitable for CIK cell culture which are stored within 24 hours between 4°C and 30°C.


Asunto(s)
Anticoagulantes/farmacología , Conservación de la Sangre/métodos , Células Asesinas Inducidas por Citocinas/citología , Temperatura , Coagulación Sanguínea/efectos de los fármacos , Proliferación Celular , Separación Celular/métodos , Citratos/farmacología , Células Asesinas Inducidas por Citocinas/efectos de los fármacos , Células Asesinas Inducidas por Citocinas/metabolismo , Ácido Edético/farmacología , Heparina/farmacología , Humanos , Inmunoterapia/métodos , Interferón gamma/metabolismo , Interleucina-2/farmacología , Leucocitos Mononucleares/citología , Leucocitos Mononucleares/efectos de los fármacos , Leucocitos Mononucleares/metabolismo , Citrato de Sodio , Factores de Tiempo
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