目的探讨CT影像学联合细胞角蛋白19片段抗原对周围性肺癌患者的临床诊断价值。方法经诊断、纳入与排除后共有80例(2010年1月至2018年1月)周围性肺癌患者参与本研究。所有患者接受CT、CY-FRA21-1及病理检查。结果不同病灶大小、侵袭、肿...目的探讨CT影像学联合细胞角蛋白19片段抗原对周围性肺癌患者的临床诊断价值。方法经诊断、纳入与排除后共有80例(2010年1月至2018年1月)周围性肺癌患者参与本研究。所有患者接受CT、CY-FRA21-1及病理检查。结果不同病灶大小、侵袭、肿瘤边缘形态、积液、淋巴结转移CT影像学特征的CYFRA21-1水平差异比较有统计血意义(P<0.05)。病灶>3cm的CYFRA21-1水平大于≤3cm、侵袭CYFRA21-1水平大于未侵袭、粗糙肿瘤边缘形态CYFRA21-1水平大于光滑、分叶CYFRA21-1水平大于未分叶、有积液CYFRA21-1水平大于无积液、有淋巴结转移CYFRA21-1水平大于无淋巴结转移。血管断面、钙化及胸膜凹陷征CYFRA21-1水平差异比较无统计学意义(P>0.05)。CT诊断周围性肺癌正确率为66.25%,CYFRA21-1诊断正确性为52.50%,联合诊断正确率为92.50%。联合诊断正确率显著高于单CT、 CY F R A 2 1-1(P<0.05)。周围性肺癌以腺癌常见(73.75%),鳞癌26.25%。血管断面中腺癌(79.53%),鳞癌24.07%。>3cm病灶中腺癌72.09%,鳞癌27.91%。侵袭影像中腺癌78.85%,鳞癌21.15%。肿瘤形态粗糙征中腺癌59.38%,鳞癌40.63%。分叶征中腺癌72.22%,鳞癌21.78%。胸膜凹陷中腺癌86.67%,鳞癌13.33%。积液征中腺癌89.74%,鳞癌10.53%。钙化征中腺癌78.95%,鳞癌20.05%。淋巴结转移征腺癌98.33%,鳞癌1.67%。结论 CT影像学联合细胞角蛋白19片段抗原能提高周围性肺癌诊断正确性,减少误诊及错诊,能指导临床。展开更多
AIM:To determine the prevalence of celiac disease in a randomly selected population sample. METHODS:A total of 2157 subjects (1036 males; 1121 females) participating in a population-based cross-sectional study underwe...AIM:To determine the prevalence of celiac disease in a randomly selected population sample. METHODS:A total of 2157 subjects (1036 males; 1121 females) participating in a population-based cross-sectional study underwent laboratory testing for tissue transglutaminase and antibodies to immunoglobulin A, endomysium and antigliadin. In a second step, all subjects who had been examined serologically were surveyed using a questionnaire that included questions specific to celiac disease. Subjects with positive antibody titers and those with histories positive for celiac disease then underwent biopsy. At the first follow up, antibody titers were again determined in these subjects and subjects were questioned regarding symptoms specific for celiac disease and disorders associated with celiac disease. The second follow up consisted of a telephone interview with subjects positive for celiac disease.RESULTS:Antibody tests consistent with celiac disease were reported in eight subjects, corresponding to an overall prevalence of 1:270 (8/2157). The prevalence among women was 1:224 and 1:518 in men. Classical symptoms were observed in 62.5% of subjects. Atypical celiac disease was present in 25.0%, and transient celiac disease in 12.5%. False-negative test results were returned in three subjects. This yields a sensitivity and specificity of 62.5% and 50.0%, respectively, for tissue transglutaminase immunoglobulin-A antibody; of 62.5% and 71.4% respectively, for endomysium antibody; and of 62.5% and 71.4%, respectively, for antigliadin antibody.CONCLUSION:The prevalence rate in our collective lies within the middle tertile of comparable studies in Europe. The use of a single antibody test for screening purposes must be called into question.展开更多
With the global warming and climate change in recent years, heat stress has become one of the major abiotic factors constraining production and productivity of crops in many regions around the world. Although the plan...With the global warming and climate change in recent years, heat stress has become one of the major abiotic factors constraining production and productivity of crops in many regions around the world. Although the plants have developed some adaptive behaviors and avoidance mechanisms against heat stress, they will be hurt under extreme high temperature. Exogenous compounds could enhance plant growth and development, antioxidant enzymes activities, chlorophyll and nutrient contents under stress conditions. Meanwhile, application of exogenous compounds sustains physiological and biochemical process and prevents plants from physiological changes under stress conditions. In this review, effects of heat stress upon crops, and the functions of hormones in plant adaptation to heat stress are simply stated. Then, we intend to appraise how various phytohomrnones that are related to plant adaptation to heat stress. The role of abscisic acid(ABA), salicylic acid(SA) and polyamines(putrescine and spermine) under heat stress conditions are mainly discussed.展开更多
Therapeutic drug monitoring(TDM)has emerged as a valuable tool for optimizing the use of biologics in inflammatory bowel disease(IBD).However,variations in focus,methodology,and recommendations among relevant guidelin...Therapeutic drug monitoring(TDM)has emerged as a valuable tool for optimizing the use of biologics in inflammatory bowel disease(IBD).However,variations in focus,methodology,and recommendations among relevant guidelines and consensuses have contributed to inconsistencies in their quality.This guideline synthesizes current evidence to standardize TDM of biologics in IBD,and improve patient outcomes.This multidisciplinary guideline was developed in collaboration with pharmacy,gastroenterology,and pharmacology associations in China.The guideline development group included 9 experts in clinical pharmacy,4 experts in TDM,8 gastroenterologists,and 2 methodologists.A comprehensive search was conducted across PubMed,Embase,Web of Science,the Cochrane Library databases,as well as key gastroenterology-relevant guideline websites.The Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)approach was utilized,and this guideline was registered on the Guideline International Network website.Internal and external reviews were conducted.We proposed 5 clinical questions under two overarching themes.Based on the current evidence and the clinical opinions of the core working group members,the initial recommendations were made.Following comprehensive internal and external review processes,14 recommendations(1 strong and 13 weak)were finalized for the clinical questions.To our knowledge,this is the first evidence-based clinical practice guideline on TDM in patients with IBD developed using the GRADE approach.It addresses five key questions:whether TDM leads to better therapeutic outcomes than conventional treatment,what indicators should be monitored,when TDM should be initiated,what the therapeutic drug trough concentration thresholds are,and which TDM method(proactive or reactive)can better improve therapeutic outcomes.展开更多
Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases,but no effective anti-fibrotic therapy is currently available.Glucagon receptor(GCGR)and glucagon-like peptide 1 receptor(GLP1R)ar...Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases,but no effective anti-fibrotic therapy is currently available.Glucagon receptor(GCGR)and glucagon-like peptide 1 receptor(GLP1R)are both peptide hormone receptors involved in energy metabolism of epithelial cells.However,their role in intestinal fibrosis and the underlying mechanisms remain largely unexplored.Herein GCGR and GLP1R were found to be reduced in the stenotic ileum of patients with Crohn’s disease as well as in the fibrotic colon of mice with chronic colitis.The downregulation of GCGR and GLP1R led to the accumulation of the metabolic byproduct lactate,resulting in histone H3K9 lactylation and exacerbated intestinal fibrosis through epithelial-to-mesenchymal transition(EMT).Dual activating GCGR and GLP1R by peptide 1907B reduced the H3K9 lactylation in epithelial cells and ameliorated intestinal fibrosis in vivo.We uncovered the role of GCGR/GLP1R in regulating EMT involved in intestinal fibrosis via histone lactylation.Simultaneously activating GCGR/GLP1R with the novel dual agonist peptide 1907B holds promise as a treatment strategy for alleviating intestinal fibrosis.展开更多
Background:Although selecting the appropriate patients for vedolizumab(VDZ)treatment was challenging,this multicenter,retrospective study evaluated the real-world effectiveness of VDZ and identified the patients who w...Background:Although selecting the appropriate patients for vedolizumab(VDZ)treatment was challenging,this multicenter,retrospective study evaluated the real-world effectiveness of VDZ and identified the patients who would benefit from VDZ therapy.Methods:A total of 264 patients from three tertiary care centers specializing in inflammatory bowel disease were treated with VDZ.The outcomes assessed included steroid-free remission,clinical remission,objective response,and remission at Weeks 26 and 52.Least Absolute Shrinkage and Selection Operator regression and multivariate analyses were performed to identify independent predictors,and a nomogram was developed to predict steroid-free remission at Week 26.Results:The rates of steroid-free remission and clinical remission were 46.6%and 47.0%at Week 26,and both were 38.6%at Week 52.Objective response and remission were achieved in 41.5%and 14.8%of patients at Week 26,compared with 20.7%and 11.4%at Week 52.Bio-naïve patients without active intestinal fistula,and with low inflammation burden(Crohn’s Disease Activity Index≤220 and C-reactive protein≤10 mg/L)showed the highest rates of steroid-free remission and objective remission at both time points(all P<0.05),along with a superior therapeutic continuation(P<0.001).The nomogram,incorporating these factors,effectively predicted steroid-free remission at Week 26(area under the curve=0.830)and Week 52(area under the curve=0.702).VDZ was well tolerated with an adverse reaction rate of 4.2%and no serious adverse events.Conclusions:VDZ was effective and safe in treating Crohn’s disease.Patients who were bio-naïve,without active intestinal fistulas,and who had milder baseline disease activity were more likely to benefit from VDZ therapy.展开更多
Introduction Since peroral endoscopic myotomy(POEM)for the treatment of achalasia was first introduced by Inoue et al.[1]in 2010,various endoscopic knives including the Triangular-tip knife have been used during the p...Introduction Since peroral endoscopic myotomy(POEM)for the treatment of achalasia was first introduced by Inoue et al.[1]in 2010,various endoscopic knives including the Triangular-tip knife have been used during the procedure[2].To date,the investigation on endoscopic knives with good performance and low expense is still underway for patients with achalasia.In this case,we successfully carried out POEMassisted by a snare tip in a patient with achalasia.展开更多
文摘目的探讨CT影像学联合细胞角蛋白19片段抗原对周围性肺癌患者的临床诊断价值。方法经诊断、纳入与排除后共有80例(2010年1月至2018年1月)周围性肺癌患者参与本研究。所有患者接受CT、CY-FRA21-1及病理检查。结果不同病灶大小、侵袭、肿瘤边缘形态、积液、淋巴结转移CT影像学特征的CYFRA21-1水平差异比较有统计血意义(P<0.05)。病灶>3cm的CYFRA21-1水平大于≤3cm、侵袭CYFRA21-1水平大于未侵袭、粗糙肿瘤边缘形态CYFRA21-1水平大于光滑、分叶CYFRA21-1水平大于未分叶、有积液CYFRA21-1水平大于无积液、有淋巴结转移CYFRA21-1水平大于无淋巴结转移。血管断面、钙化及胸膜凹陷征CYFRA21-1水平差异比较无统计学意义(P>0.05)。CT诊断周围性肺癌正确率为66.25%,CYFRA21-1诊断正确性为52.50%,联合诊断正确率为92.50%。联合诊断正确率显著高于单CT、 CY F R A 2 1-1(P<0.05)。周围性肺癌以腺癌常见(73.75%),鳞癌26.25%。血管断面中腺癌(79.53%),鳞癌24.07%。>3cm病灶中腺癌72.09%,鳞癌27.91%。侵袭影像中腺癌78.85%,鳞癌21.15%。肿瘤形态粗糙征中腺癌59.38%,鳞癌40.63%。分叶征中腺癌72.22%,鳞癌21.78%。胸膜凹陷中腺癌86.67%,鳞癌13.33%。积液征中腺癌89.74%,鳞癌10.53%。钙化征中腺癌78.95%,鳞癌20.05%。淋巴结转移征腺癌98.33%,鳞癌1.67%。结论 CT影像学联合细胞角蛋白19片段抗原能提高周围性肺癌诊断正确性,减少误诊及错诊,能指导临床。
文摘AIM:To determine the prevalence of celiac disease in a randomly selected population sample. METHODS:A total of 2157 subjects (1036 males; 1121 females) participating in a population-based cross-sectional study underwent laboratory testing for tissue transglutaminase and antibodies to immunoglobulin A, endomysium and antigliadin. In a second step, all subjects who had been examined serologically were surveyed using a questionnaire that included questions specific to celiac disease. Subjects with positive antibody titers and those with histories positive for celiac disease then underwent biopsy. At the first follow up, antibody titers were again determined in these subjects and subjects were questioned regarding symptoms specific for celiac disease and disorders associated with celiac disease. The second follow up consisted of a telephone interview with subjects positive for celiac disease.RESULTS:Antibody tests consistent with celiac disease were reported in eight subjects, corresponding to an overall prevalence of 1:270 (8/2157). The prevalence among women was 1:224 and 1:518 in men. Classical symptoms were observed in 62.5% of subjects. Atypical celiac disease was present in 25.0%, and transient celiac disease in 12.5%. False-negative test results were returned in three subjects. This yields a sensitivity and specificity of 62.5% and 50.0%, respectively, for tissue transglutaminase immunoglobulin-A antibody; of 62.5% and 71.4% respectively, for endomysium antibody; and of 62.5% and 71.4%, respectively, for antigliadin antibody.CONCLUSION:The prevalence rate in our collective lies within the middle tertile of comparable studies in Europe. The use of a single antibody test for screening purposes must be called into question.
基金Supported by Natural Science Foundation of Hubei Province(2013CFA011)
文摘With the global warming and climate change in recent years, heat stress has become one of the major abiotic factors constraining production and productivity of crops in many regions around the world. Although the plants have developed some adaptive behaviors and avoidance mechanisms against heat stress, they will be hurt under extreme high temperature. Exogenous compounds could enhance plant growth and development, antioxidant enzymes activities, chlorophyll and nutrient contents under stress conditions. Meanwhile, application of exogenous compounds sustains physiological and biochemical process and prevents plants from physiological changes under stress conditions. In this review, effects of heat stress upon crops, and the functions of hormones in plant adaptation to heat stress are simply stated. Then, we intend to appraise how various phytohomrnones that are related to plant adaptation to heat stress. The role of abscisic acid(ABA), salicylic acid(SA) and polyamines(putrescine and spermine) under heat stress conditions are mainly discussed.
基金National Key Research and Development Program of China(grant number 2023YFF1205000).
文摘Therapeutic drug monitoring(TDM)has emerged as a valuable tool for optimizing the use of biologics in inflammatory bowel disease(IBD).However,variations in focus,methodology,and recommendations among relevant guidelines and consensuses have contributed to inconsistencies in their quality.This guideline synthesizes current evidence to standardize TDM of biologics in IBD,and improve patient outcomes.This multidisciplinary guideline was developed in collaboration with pharmacy,gastroenterology,and pharmacology associations in China.The guideline development group included 9 experts in clinical pharmacy,4 experts in TDM,8 gastroenterologists,and 2 methodologists.A comprehensive search was conducted across PubMed,Embase,Web of Science,the Cochrane Library databases,as well as key gastroenterology-relevant guideline websites.The Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)approach was utilized,and this guideline was registered on the Guideline International Network website.Internal and external reviews were conducted.We proposed 5 clinical questions under two overarching themes.Based on the current evidence and the clinical opinions of the core working group members,the initial recommendations were made.Following comprehensive internal and external review processes,14 recommendations(1 strong and 13 weak)were finalized for the clinical questions.To our knowledge,this is the first evidence-based clinical practice guideline on TDM in patients with IBD developed using the GRADE approach.It addresses five key questions:whether TDM leads to better therapeutic outcomes than conventional treatment,what indicators should be monitored,when TDM should be initiated,what the therapeutic drug trough concentration thresholds are,and which TDM method(proactive or reactive)can better improve therapeutic outcomes.
基金supported by the National Key R&D Program of China(2023YFC2507300)the National Natural Science Foundation of China(82273761,81970483,82170537 and 82222010)the Medical Innovation and Development Project of Lanzhou University(lzuyxcx-2022-156,China).
文摘Intestinal fibrosis is a significant clinical challenge in inflammatory bowel diseases,but no effective anti-fibrotic therapy is currently available.Glucagon receptor(GCGR)and glucagon-like peptide 1 receptor(GLP1R)are both peptide hormone receptors involved in energy metabolism of epithelial cells.However,their role in intestinal fibrosis and the underlying mechanisms remain largely unexplored.Herein GCGR and GLP1R were found to be reduced in the stenotic ileum of patients with Crohn’s disease as well as in the fibrotic colon of mice with chronic colitis.The downregulation of GCGR and GLP1R led to the accumulation of the metabolic byproduct lactate,resulting in histone H3K9 lactylation and exacerbated intestinal fibrosis through epithelial-to-mesenchymal transition(EMT).Dual activating GCGR and GLP1R by peptide 1907B reduced the H3K9 lactylation in epithelial cells and ameliorated intestinal fibrosis in vivo.We uncovered the role of GCGR/GLP1R in regulating EMT involved in intestinal fibrosis via histone lactylation.Simultaneously activating GCGR/GLP1R with the novel dual agonist peptide 1907B holds promise as a treatment strategy for alleviating intestinal fibrosis.
基金supported by National Key R&D Program of China[grant number 2023YFC2507300]Guangdong Basic and Applied Basic Research Foundation[grant number 2025A1515011779]+3 种基金the Fundamental Research Funds for the Central Universities,Sun Yat-sen University[grant number 24qnpy172]Key-Area Research and Development Program of Guangdong Province[grant number 2023B1111040003]the program of Guangdong Provincial Clinical Research Center for Digestive Diseases[grant number 2020B1111170004]National Key Clinical Discipline.
文摘Background:Although selecting the appropriate patients for vedolizumab(VDZ)treatment was challenging,this multicenter,retrospective study evaluated the real-world effectiveness of VDZ and identified the patients who would benefit from VDZ therapy.Methods:A total of 264 patients from three tertiary care centers specializing in inflammatory bowel disease were treated with VDZ.The outcomes assessed included steroid-free remission,clinical remission,objective response,and remission at Weeks 26 and 52.Least Absolute Shrinkage and Selection Operator regression and multivariate analyses were performed to identify independent predictors,and a nomogram was developed to predict steroid-free remission at Week 26.Results:The rates of steroid-free remission and clinical remission were 46.6%and 47.0%at Week 26,and both were 38.6%at Week 52.Objective response and remission were achieved in 41.5%and 14.8%of patients at Week 26,compared with 20.7%and 11.4%at Week 52.Bio-naïve patients without active intestinal fistula,and with low inflammation burden(Crohn’s Disease Activity Index≤220 and C-reactive protein≤10 mg/L)showed the highest rates of steroid-free remission and objective remission at both time points(all P<0.05),along with a superior therapeutic continuation(P<0.001).The nomogram,incorporating these factors,effectively predicted steroid-free remission at Week 26(area under the curve=0.830)and Week 52(area under the curve=0.702).VDZ was well tolerated with an adverse reaction rate of 4.2%and no serious adverse events.Conclusions:VDZ was effective and safe in treating Crohn’s disease.Patients who were bio-naïve,without active intestinal fistulas,and who had milder baseline disease activity were more likely to benefit from VDZ therapy.
基金supported by the Natural Science Foundation of Guangdong Province[2015A030313116]Science and Technology Planning Project of Guangdong Province[2016A020215041]the Junior Teacher Cultivation Project of Sun Yat-sen University[15ykpy18].
文摘Introduction Since peroral endoscopic myotomy(POEM)for the treatment of achalasia was first introduced by Inoue et al.[1]in 2010,various endoscopic knives including the Triangular-tip knife have been used during the procedure[2].To date,the investigation on endoscopic knives with good performance and low expense is still underway for patients with achalasia.In this case,we successfully carried out POEMassisted by a snare tip in a patient with achalasia.
