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1.
Pancreas ; 48(10): 1343-1347, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31688599

RESUMO

OBJECTIVE: This study was designed to assess the diagnostic accuracy of standard nonsecretin-enhanced preprocedural magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) in patients with and without pancreas divisum. METHODS: Patients undergoing MRI/MRCP followed by endoscopic retrograde cholangiopancreatography with between 2009 and 2016 were reviewed. The diagnostic accuracy of the MRI/MRCP was evaluated against the pancreatography. A subsequent independent blinded re-review performed by an expert abdominal radiologist was also evaluated. Multivariate binary logistic regression was performed to assess the impact of clinicopathologic factors on the diagnostic accuracy. RESULTS: A total of 189 patients were included in analysis. The sensitivity, specificity, positive predictive value, and negative predictive value of MRI/MRCP for pancreas divisum were 63%, 97%, 94%, and 82% initially and 81%, 91%, 91%, and 82% on the expert review. Motion artifact, the presence of pancreatic tumor, and pancreatic necrosis were not found to significantly impact the accuracy. A normal diameter pancreatic duct (P = 0.04) and complete divisum anatomy were correlated with improved accuracy (P = 0.001). CONCLUSIONS: Although expert review, normal duct diameter, and complete divisum are associated with increased sensitivity, pancreas divisum may be uncharacterized by preprocedural MRI in 19% to 37% of patients before the index endoscopic retrograde cholangiopancreatography.

2.
Endoscopy ; 2019 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-31634922

RESUMO

BACKGROUND: Symptomatic epiphrenic diverticula are mostly treated with laparoscopic diverticulectomy. Our study aimed to demonstrate the safety and efficacy of submucosal tunneling endoscopic septum division (STESD) for treatment of symptomatic epiphrenic diverticula. METHODS: Data from patients with epiphrenic diverticula who had undergone STESD were retrospectively reviewed. The parameters analyzed were the modified Eckardt score, total procedure time, length of hospital stay (LOS), number of clips used, adverse events, and patient satisfaction. RESULTS: A total of eight patients (5 men; mean [standard deviation (SD)] age 66.25 [7.17] years) were enrolled in our study. The mean (SD) size of epiphrenic diverticula was 3.68 (1.59) cm. The mean (SD) procedure time was 52.87 (22.47) minutes, with a median number of six clips being applied. The modified Eckardt score significantly decreased post-procedure (P < 0.001). The mean (SD) LOS was 5.87 (0.83) days. No adverse events or symptom recurrences were reported. CONCLUSION: STESD is a safe and effective technique to be performed in the submucosal tunnel for the management of patients with epiphrenic diverticula.

3.
Curr Opin Plant Biol ; 52: 140-148, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31654843

RESUMO

Communication between plants and pathogens requires the transport of regulatory molecules across cellular boundaries, which is essential for host defense and pathogen virulence. Previous research has largely focused on protein transport, but, which other molecules function in communication, and how they are transported remains under explored. Recent studies discovered that small RNAs (sRNAs) are transported between plants and pathogens, which can silence target genes in the interacting organisms and regulate host immunity and pathogen infection, a mechanism called 'cross-kingdom RNA interference (RNAi)'. Further studies indicate that plant extracellular vesicles (EVs) are essential for sRNA trafficking and host-pathogen communication. This review will focus on the latest advances in our understanding of plant EVs and their roles in transporting regulatory molecules, especially sRNAs, between hosts and pathogens.

4.
Mol Cancer ; 18(1): 145, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623628

RESUMO

BACKGROUND: Circular RNAs (circRNAs) have recently been identified as potential functional modulators of the cellular physiology processes. The study aims to uncover the potential clinical value and driving molecular mechanisms of circRNAs in gallbladder cancer (GBC). PATIENTS AND METHODS: We performed RNA sequencing from four GBC and paired adjacent normal tissues to analyze the circRNA candidates. Quantitative real-time polymerase chain reaction (QRT-PCR) was used to measure the circFOXP1 expression from 40 patient tissue samples. Short hairpin RNA mediated knockdown or exogenous expression of circFOXP1 combined with in vitro and in vivo assays were performed to prove the functional significance of circFOXP1. Double luciferase reporter, RNA immunoprecipitation (RIP) and RNA pull-down assays were also performed. RESULTS: By performing RNA sequencing from GBC and paired adjacent normal tissues to analyze the circRNA candidates, we identified that circFOXP1 (hsa_circ_0008234) expression was significantly upregulated in GBC tissues and positively associated with lymph node metastasis, advanced TNM stage and poor prognosis in patients. Short hairpin RNA mediated knockdown or exogenous expression of circFOXP1 combined with in vitro assays demonstrated that circFOXP1 has pleiotropic effects, including promotion of cell proliferation, migration, invasion, and inhibition of cell apoptosis in GBC. In vivo, circFOXP1 promoted tumor growth. Mechanistically, double luciferase reporter, RNA immunoprecipitation (RIP) and biotin-labeled RNA pull-down assays clarified that circFOXP1 interacted with PTBP1 that could bind to the 3'UTR region and coding region (CDS) of enzyme pyruvate kinase, liver and RBC (PKLR) mRNA (UCUU binding bites) to protect PKLR mRNA from decay. Additionally, circFOXP1 acted as the sponge of miR-370 to regulate PKLR, resulting in promoting Warburg effect in GBC progression. CONCLUSIONS: These results demonstrated that circFOXP1 serve as a prognostic biomarker and critical regulator in GBC progression and Warburg effect, suggesting a potential target for GBC treatment.

5.
J Dig Dis ; 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31498966

RESUMO

Dysfunction of gastrointestinal (GI) sphincters, including the lower esophageal sphincter (LES) at the esophagogastric junction (EGJ) and the pyloric sphincter, plays a vital role in GI motility disorders, such as achalasia, gastroesophageal reflux disease (GERD), gastroparesis, and fecal incontinence. Using multi-detector high-resolution impedance planimetry, the functional luminal imaging probe (FLIP) system measures simultaneous data on tissue distensibility and luminal geometry changes in the sphincter in a real-time manner. In this review we focus on the emerging data on FLIP, which can be used as an innovative diagnostic method during endoscopic or surgical procedures in GI motility disorders. Subsequent large, prospective, standardizing studies are needed to validate these findings before it can be put to routine clinical use.

6.
J Mater Chem B ; 7(31): 4821-4832, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31389959

RESUMO

Preparation of stable and effective artificial oxygen carriers (AOCs) is a promising strategy to temporarily replace transfused blood and solve tissue hypoxia. Developing hemoglobin (Hb) loaded particles is one of the main ways to prepare suitable AOCs. Particles with a hierarchical micro/nanostructure can be loaded with plenty of proteins and have attracted great attention. Therefore, multiwall carbon nanotubes (MWCNTs) were chosen to fabricate AOCs. To improve the Hb-loading capacity of MWCNTs, functionalized MWCNTs, including carboxyl-functionalized MWCNTs (MWCNT-COOH), amino-functionalized MWCNTs (MWCNT-NH2), and heparin-conjugated MWCNTs (MWCNT-Hep), were prepared. Then, in this study, Hb was coupled to the functionalized MWCNTs to fabricate the AOCs. The functionalized MWCNTs and the AOCs were characterized by FTIR, SEM, TEM, and zeta potential analysis. The oxygen/Hb-loading capacity of the AOCs was also measured. The adverse effects of the AOCs on human umbilical vein endothelial cells (HUVECs) and human red blood cells (RBCs) were evaluated. The results showed that (1) the functional groups were grafted on the surface of the MWCNTs, and Hb was bound to the functionalized MWCNTs, thus the AOCs were successfully prepared; (2) MWCNT-Hep-Hb had the most stable dispersibility (i.e., the most negative zeta potential) in 0.9 wt% NaCl solution (MWCNT-Hep-Hb < MWCNT-COOH-Hb < MWCNT-Hb < MWCNT-NH2-Hb < 0); (3) MWCNT-Hep had the best Hb-loading capability, which was three times that of purified MWCNTs; (4) with concentrations increased up to 400 µg mL-1, MWCNT-Hep-Hb still had the highest cell viability (97.63% > 80%, ISO 10993-5:2009) and excellent blood biocompatibility. Therefore, MWCNT-Hep-Hb might be a satisfactory candidate as a blood substitute.

7.
Clin Endosc ; 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31273969

RESUMO

Background/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While some physicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicated in patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAP in the US. Methods: An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use was approved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practice patterns in the management of RAP in multiple clinical scenarios. Results: The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomial logistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) for offering ERCP. Conclusions: A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centers in the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendation for ERCP.

8.
Endoscopy ; 51(8): 715-721, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31174225

RESUMO

BACKGROUND: Multiple studies have examined the use of lumen-apposing metal stents (LAMSs) for the drainage of peripancreatic fluid collections. Data on the use of LAMSs for postoperative fluid collections (POFCs) are scarce. POFCs may lead to severe complications without appropriate treatment. We aimed to study the outcomes (technical success, clinical success, rate/severity of adverse events, length of stay, recurrence) of the use of LAMSs for the drainage of POFCs. METHODS: This international, multicenter, retrospective study involved 19 centers between January 2012 and October 2017. The primary outcome was clinical success. Secondary outcomes included technical success and rate/severity of adverse events using the ASGE lexicon. RESULTS: A total of 62 patients were included during the study period. The most common etiology of the POFCs was distal pancreatectomy (46.8 %). The mean (standard deviation) diameter was 84.5 mm (30.7 mm). The most common indication for drainage was infection (48.4 %) and transgastric drainage was the most common approach (82.3 %). Technical success was achieved in 60/62 patients (96.8 %) and clinical success in 57/62 patients (91.9 %) during a median (interquartile range) follow-up of 231 days (90 - 300 days). Percutaneous drainage was needed in 8.1 % of patients. Adverse events occurred intraoperatively in 1/62 patients (1.6 %) and postoperatively in 7/62 (11.3 %). There was no procedure-related mortality. CONCLUSION: This is the largest study on the use of LAMSs for POFCs. It suggests good clinical efficacy and safety of this approach. The use of LAMSs in the management of POFCs is a feasible alternative to percutaneous and surgical drainage.

9.
Can J Gastroenterol Hepatol ; 2019: 1083053, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31187025

RESUMO

Background and Aims: ESE (endoscopic submucosal excavation) is widely used for the treatment of digestive diseases. The dental floss traction (DFT) method has been successfully used to facilitate ESE to resect mucosal lesions such as early gastric cancer. DFT has not been used in ESE to remove submucosal masses. This study aimed to examine the efficacy of DFT-assisted ESE (DFT- ESE) for the removal of submucous masses. Methods: From March 2017 to May 2017, a total of 12 patients with gastric submucosal masses at the First Affiliated Hospital of Nanchang University, Jiangxi, China, were enrolled. The tumor characteristics, en bloc resection rates, complications, and outcomes on follow-up were evaluated for all patients. Results: The 12 submucosal tumors were completely removed by DFT- ESE. Nine were gastrointestinal stromal tumors. Two were Schwannoma, located in the greater curvature of the gastric corpus. One was gastric ectopic pancreas. All the resected tumors were removed completely with intact tumor capsules. There was no more bleeding or perforation after the endoscopic closure of the perforation or the wound after the DFT-ESE, and no recurrences were identified at the time of follow-up. Conclusions: The DFT method efficiently and safely facilitated the ESE procedure during the resection of gastric submucosal tumors. This study was registered with Chinese Clinical Trial Registry under Registration number ChiCTR-OOC-15005833).

10.
Opt Express ; 27(13): 17859-17867, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31252738

RESUMO

We demonstrate experimentally that flat and broadband chaotic signals can be easily generated by combining a multi-mode laser diode subject to optical feedback with a band-pass filter. Measurements are made of the RF spectra of multi-mode and single-mode outputs from an external cavity Fabry-Perot (FP) semiconductor laser before and after the filtering procedure. In this way it is found that in the chaos regime the low-frequency energy of the single-mode output is enhanced by about 25 dB comparing with that of the multi-mode output. Moreover, the associated 3-dB chaos bandwidth can reach around 6 GHz for the single mode case. Numerical demonstrations show mode competition is the physical origin of the low-frequency enhancement in the single-mode chaotic outputs.

11.
Am J Gastroenterol ; 114(5): 718-725, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31082838

RESUMO

Most gastrointestinal (GI) subepithelial tumors (SETs) are identified incidentally during endoscopic examination and are located in the stomach. Some SETs are malignant or have the potential to become malignant. Tumors originating from deeper layers, such as the muscularis propria or serosa, are not easy to diagnose and resect. Current guidelines recommend yearly endoscopic surveillance of SETs smaller than 2 cm. This recommendation may not be cost-effective in managing GI SETs. Endoscopic resection results not only in obtaining sufficient tissue for pathological diagnosis but also in resection and curing the tumor. Many different endoscopic methods for resection of GI SETs have been published in the literature. To avoid confusion, we have divided these methods into standard endoscopic submucosal dissection, modified endoscopic submucosal dissection, submucosal tunneling endoscopic resection, and nonexposed and exposed endoscopic full-thickness resection. These procedures offer less invasive approaches than surgery for resection of GI SETs and may be the most cost-effective in taking care of patients with GI SETs.

12.
Mol Cancer ; 18(1): 82, 2019 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953511

RESUMO

BACKGROUND: Gallbladder cancer is the most common biliary tract malignancy and not sensitive to chemotherapy. Autophagy is an important factor prolonging the survival of cancer cells under chemotherapeutic stress. We aimed to investigate the role of long non-coding RNAs (lncRNAs) in autophagy and chemoresistance of gallbladder cancer cells. METHODS: We established doxorubicin (Dox)-resistant gallbladder cancer cells and used microarray analysis to compare the expression profiles of lncRNAs in Dox-resistant gallbladder cancer cells and their parental cells. Knockdown or exogenous expression of lncRNA combined with in vitro and in vivo assays were performed to prove the functional significance of lncRNA. The effects of lncRNA on autophagy were assessed by stubRFP-sensGFP-LC3 and western blot. We used RNA pull-down and mass spectrometry analysis to identify the target proteins of lncRNA. RESULTS: The drug-resistant property of gallbladder cancer cells is related to their enhanced autophagic activity. And we found a lncRNA ENST00000425894 termed gallbladder cancer drug resistance-associated lncRNA1 (GBCDRlnc1) that serves as a critical regulator in gallbladder cancer chemoresistance. Furthermore, we discovered that GBCDRlnc1 is upregulated in gallbladder cancer tissues. Knockdown of GBCDRlnc1, via inhibiting autophagy at initial stage, enhanced the sensitivity of Dox-resistant gallbladder cancer cells to Dox in vitro and in vivo. Mechanically, we identified that GBCDRlnc1 interacts with phosphoglycerate kinase 1 and inhibits its ubiquitination in Dox-resistant gallbladder cancer cells, which leads to the down-regulation of autophagy initiator ATG5-ATG12 conjugate. CONCLUSIONS: Our findings established that the chemoresistant driver GBCDRlnc1 might be a candidate therapeutic target for the treatment of advanced gallbladder cancer.


Assuntos
Autofagia/genética , Neoplasias da Vesícula Biliar/genética , Regulação Neoplásica da Expressão Gênica , Fosfoglicerato Quinase/genética , RNA Longo não Codificante/genética , Idoso , Animais , Antibióticos Antineoplásicos/farmacologia , Autofagia/efeitos dos fármacos , Proteína 12 Relacionada à Autofagia/genética , Proteína 12 Relacionada à Autofagia/metabolismo , Proteína 5 Relacionada à Autofagia/genética , Proteína 5 Relacionada à Autofagia/metabolismo , Linhagem Celular Tumoral , Doxorrubicina/farmacologia , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Neoplasias da Vesícula Biliar/tratamento farmacológico , Neoplasias da Vesícula Biliar/metabolismo , Neoplasias da Vesícula Biliar/patologia , Humanos , Masculino , Camundongos , Camundongos Nus , Proteínas Associadas aos Microtúbulos/genética , Proteínas Associadas aos Microtúbulos/metabolismo , Pessoa de Meia-Idade , Oligorribonucleotídeos/genética , Oligorribonucleotídeos/metabolismo , Fosfoglicerato Quinase/metabolismo , RNA Longo não Codificante/agonistas , RNA Longo não Codificante/antagonistas & inibidores , RNA Longo não Codificante/metabolismo , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Transdução de Sinais , Ubiquitinação/efeitos dos fármacos , Ensaios Antitumorais Modelo de Xenoenxerto
13.
Medicine (Baltimore) ; 98(17): e15288, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027089

RESUMO

RATIONALE: Anterior clinoidectomy is an important technique for neurovascular and skull base surgery. Until now, extradural anterior clinoidectomies have been performed under a microscope in almost all clinical cases, with only one clinical case performed an extradural pathological anterior clinoid process resection using neuroendoscopy. Additionally, no normal ACP resections have been performed extradurally via neuroendoscopy, especially for aneurysms. We tried to perform extradural anterior clinoidectomies by neuroendoscopy. PATIENT CONCERNS: A 63-year-old woman was admitted to hospital presented with sudden onset of headache without any accompanying neurological deficit. A computed tomography (CT) scan of the head revealed a subarachnoid hemorrhage, which was positioned mainly in the left slyvian fissure and interpeduncular and basilar cisterns. DIAGNOSES: 1. Left side posterior communicating artery aneurysm; 2. subarachnoid hemorrhage. INTERVENTIONS: Extradural anterior clinoidectomy and aneurysm clipping were performed using transcranial neuroendoscopic approaches. OUTCOMES: The patient recovered well after the procedure, and the post-operative image view revealed that the ACP had been removed and that the clip was located just at the ACP area. LESSONS: This case provided the first evidence that extradural anterior clinoidectomy could be performed by transcranial neuroendoscopic approach.


Assuntos
Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/cirurgia , Neuroendoscopia/métodos , Hemorragia Subaracnóidea/complicações , Hemorragia Subaracnóidea/cirurgia , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Pessoa de Meia-Idade , Hemorragia Subaracnóidea/tratamento farmacológico
14.
Medicine (Baltimore) ; 98(17): e15304, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31027095

RESUMO

RATIONALE: Posterior inferior cerebellar artery (PICA) aneurysms are rare and heterogeneous in both location and morphology, and the management of proximal PICA aneurysms is challenging. In 2011, Joaquim reported a successfully treated VA-PICA ruptured aneurysm using a pure endoscopic endonasal transclival approach for the first time. However, the patient suffered CSF rhinorrhea and underwent an additional operation to repair the CSF leak. In this case report, we describe the treatment of proximal PICA aneurysm by transcranial neuroendoscopic approach. PATIENT CONCERNS: A 68-year-old woman presented with a sudden onset of severe headache followed by loss of consciousness and computed tomography of the head showed a mild SAH, located predominantly in the posterior fossa. Clinical signs and symptoms included headache and a positive meningeal irritation sign; no other neurological symptoms were found. DIAGNOSIS: A 3-dimensional CT angiography revealed the diagnosis as left VA-PICA junction aneurysm. INTERVENTIONS: After a medical treatment, the patient regained consciousness and the aneurysm was treated by pure neuroendoscopy via a modified far-lateral surgical approach. OUTCOMES: The patient recovered well after the procedure, and the post-operation image view shows a proper placement of the clip, obliteration of the aneurysm, and the parental artery was unobstructed. LESSONS: To our best knowledge, this is the first reported case of treating aneurysm by neuroendoscopic transcranial approach and the second reported case treated by endoscopy. In the present report, we propose that ruptured VA-PICA junction aneurysms could be treated by a pure transcranial neuroendoscopic approach. The advantages of this approach included no risk of CSF rhinorrhea compared with the endoscopic endonasal transclival approach.


Assuntos
Aneurisma Roto/cirurgia , Aneurisma Intracraniano/cirurgia , Neuroendoscopia/métodos , Idoso , Rinorreia de Líquido Cefalorraquidiano/etiologia , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Feminino , Humanos , Neuroendoscopia/efeitos adversos
15.
World J Gastroenterol ; 25(8): 909-922, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30833798

RESUMO

Per oral endoscopic pyloromyotomy (POP), also known as gastric per-oral endoscopic myotomy (GPOEM), is a novel procedure with promising potential for the treatment of gastroparesis. As more data emerge and the procedure is becoming more recognized in clinical practice, its safety and efficacy need to be carefully evaluated. Appropriate patient selection for favorable clinical success prediction after GPOEM also needs additional research. This review aims to systemically summarize the existing data on clinical outcomes of POP. Symptomatologic responses to the procedure, its adverse effects, procedural techniques, and predictive factors of clinical success are also discussed.


Assuntos
Gastroparesia/cirurgia , Gastroscopia/métodos , Seleção de Pacientes , Piloromiotomia/métodos , Humanos , Resultado do Tratamento
16.
Toxicon ; 161: 17-22, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30826469

RESUMO

Deoxynivalenol (DON) contamination is indicated as a worldwide problem since it causes economic losses for the grain and is a potential threat to both animal and human health. This study concentrated on DON-induced oxidative damage and the accompanying nuclear factor erythroid 2-related factor 2 (Nrf2) translocation during DON-induced maternal hepatotoxicity. The 0, 1.0 and 2.5 mg/kg/day of DON were used as doses for the experiment during gestation days. DON slightly increased the levels of ALT and AST in GD12.5 d instead of GD18.5 d. Oxidative stress and anti-oxidization system were both found to be activated in the experiment which marked by ROS, MDA and GSH increasing, especially on GD12.5 d. The levels of HO-1 were significantly increased by DON exposure at different two time points. Moreover, Nrf2 translocation appeared both in GD 12.5 d and GD 18.5 d. In conclusion, DON-induced ROS accumulation may cause maternal liver damage in the initial stages, but the related stimulation of Nrf2/HO-1 pathway improves the removal of ROS and decreases the level of oxidative stress thereby protecting the liver damage. Therefore, upregulating the Nrf2-dependent response is one of the potential methods that protects maternal liver from DON-induced oxidative damage.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/metabolismo , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Complicações na Gravidez/induzido quimicamente , Complicações na Gravidez/metabolismo , Tricotecenos/toxicidade , Alanina Transaminase/metabolismo , Animais , Aspartato Aminotransferases/metabolismo , Proteínas de Transporte , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Feminino , Glutationa/metabolismo , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Camundongos , Camundongos Endogâmicos C57BL , Gravidez , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais , Superóxido Dismutase/metabolismo
17.
Nat Commun ; 10(1): 642, 2019 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-30718497

RESUMO

The original version of this Article contained an error in the spelling of the author Beixin Mo, which was incorrectly given as Beixing Mo. This has now been corrected in both the PDF and HTML versions of the Article.

18.
Gastrointest Endosc ; 89(5): 969-976, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30653937

RESUMO

BACKGROUND AND AIMS: Gastric per-oral endoscopic pyloromyotomy (GPOEM) is a novel procedure with promising potential for the treatment of gastroparesis but with limited data regarding predictors of clinical response. This study aims to evaluate the safety and efficacy of the procedure and explore the impact of duration and etiology (diabetic vs nondiabetic) of gastroparesis on clinical outcome as measured by the Gastroparesis Cardinal Symptom Index (GCSI). METHODS: A single-center retrospective longitudinal study at a tertiary care hospital was performed over an 18-month period. Forty patients with refractory gastroparesis (25 nondiabetic and 15 diabetic patients) were included. RESULTS: GCSI significantly improved throughout the study period (F[2.176, 17.405] = 10.152, P = .001). The nausea/vomiting subscale showed sustained improvement through 18 months (F[2.213, 17.704] = 15.863, P < .00001). There was no significant improvement in bloating (F[2.099, 16.791] = 1.576, P = .236). Gastric scintigraphy retention was significantly reduced by 41.7% (t = -7.90; P < .00001). Multivariate linear regression modeling revealed a significant correlation between the duration of disease and a GCSI improvement at 12 months (P = .02), with a longer duration of disease associated with a poorer long-term response. The etiology of gastroparesis was not associated with clinical improvement (P = .16). Adverse events (7.5%) included 1 capnoperitoneum, 1 periprocedure chronic obstructive pulmonary disease exacerbation, and 1 mucosotomy closure site disruption. CONCLUSIONS: GPOEM appears to be a safe and effective minimally invasive therapy for refractory gastroparesis, especially for patients with predominant nausea/vomiting and shorter duration of disease, regardless of the etiology. We propose the clinical criteria for undergoing GPOEM should be a GCSI of at least 2.0 and a gastric retention of greater than 20%.

19.
Dig Dis Sci ; 64(6): 1486-1492, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30560333

RESUMO

BACKGROUND: Huntingtin-associated protein 1 (HAP1) is a neuronal protein that is predominantly expressed in neurons in the brain. HAP1 is critical for maintenance of neuronal survival as well as regulation of food intake and body weight in animals. In addition to the criticalrole of HAP1 in the central nervous system, HAP1 is also found in endocrine cells, raising an interesting issue of whether HAP1 is expressed in the digestive system. AIMS: To examine the expression and localization of HAP1 in the human gastrointestinal tract and to compare the differences of the HAP1 expression between benign and malignant tissues in the digestive system. METHODS: We used Western blot and immunohistochemistry to examine the expression and distribution of HAP1 in the human gastrointestinal tract tissues. RESULTS: We observed that the presence of HAP1-positive cells in the gastrointestinal tract was not uniform with immunohistochemistry staining. Western blot revealed that only one isoform (75KD) HAP1 was present in the human gastrointestinal system. Interestingly, the expression of HAP1 was higher in the stomach than other regions of the gastrointestinal tract and was at the lowest level in the intestine. We also found that HAP1 was unlikely altered in benign gastric polyps, but was downregulated in pancreatic cancer. CONCLUSIONS: This is the first study showing the differential expression and location of HAP1 in the human digestive system. These findings suggested that HAP1 may have cell-type-dependent function in the gastrointestinal tract and may serve as a diagnostic marker for pancreatic cancer.

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