BACKGROUND Heterotopic gastric mucosa(HGM)is the most common type of epithelial heterotopia,which can occur in any part of the gastrointestinal tract.The duodenum is one of the common sites of HGM.HGM is usually consi...BACKGROUND Heterotopic gastric mucosa(HGM)is the most common type of epithelial heterotopia,which can occur in any part of the gastrointestinal tract.The duodenum is one of the common sites of HGM.HGM is usually considered benign,and malignant transformation of HGM in the duodenum is extremely rare.CASE SUMMARY We reported a middle-aged man admitted to the hospital due to abdominal pain,whose gastroduodenoscopy revealed a polypoid uplift in the duodenum.The attending physician directly removed the lesion using a snare,histopathological analysis demonstrated multidirectional cellular differentiation on the basis of duodenal HGM.The hematoxylin and eosin stains of the duodenal lesion demonstrated HGM,the superficial mucosa exhibited gastric foveolar-type epithelium,numerous mucous glands were identified beneath the foveolar region.Additionally,focal areas displayed several signet-ring cell changes.Gastric foveolartype epithelium was diffusely positivity for MUC5AC and Ki67.Numerous mucous gland was positivity for MUC6,partially positive for MUC2,pepsinogen I and H^(+)/K^(+)ATPase.It was eventually diagnosed gastric adenocarcinoma of fundic gland mucosa on the basis of duodenal HGM.CONCLUSION We reported the first case of gastric adenocarcinoma of fundic gland mucosa arising in the duodenum on the basis of HGM.Although HGM is mostly benign,there is also a risk of carcinogenesis.展开更多
BACKGROUND Colorectal cancer is the third most common malignancy and the fourth leading cause of cancer-related deaths worldwide.Several studies have shown an association between gut microbiota and colorectal cancer.G...BACKGROUND Colorectal cancer is the third most common malignancy and the fourth leading cause of cancer-related deaths worldwide.Several studies have shown an association between gut microbiota and colorectal cancer.Gut microbiota is unique and can be influenced by geographic factors and habits.This study aimed to determine the diversity and composition of colonic mucosal microbiota in patients with and without colorectal cancer.AIM To determine the diversity and composition of colonic mucosal microbiota in patients with and without colorectal cancer in Indonesia.METHODS This case-control study included 59 subjects(35 colorectal cancer patients and 24 non-colorectal cancer patients indicated for colonoscopy at Dr.Cipto Mangunkusumo Gastrointestinal Endoscopy Center and Fatmawati Hospital.Microbiota examination was performed using 16S rRNA sequencing.Bioinformatics analysis was performed using the wf-metagenomics pipeline from EPI2Me-Labs(Oxford Nanopore Technologies platform).RESULTS Patients with colorectal cancer had a higher median index value on the Shannon index(3.28 vs 2.82,P>0.05)and a lower value on the Simpson index(0.050 vs 0.060,P>0.05).Significant differences in beta diversity were observed at the genus(P=0.002)and species levels(P=0.001).Firmicutes,Proteobacteria,Bacteroidetes,and Fusobacteria were the dominant phyla.The genera Bacteroides,Campylobacter,Peptostreptococcus,and Parvimonas were found more frequently in colorectal cancer,while Faecalibacterium,Haemophilus,and Phocaeicola were more frequently found in non-colorectal cancer.The relative abundance of Fusobacterium nucleatum,Bacteroides fragilis,Enterococcus faecalis,Campylobacter hominis,and Enterococcus faecalis species was significantly elevated in patients with colorectal cancer.Meanwhile,Faecalibacterium prausnitzii,Faecalibacterium duncaniae,and Prevotella copri were more commonly found in non-colorectal cancer.CONCLUSION Patients with colorectal cancer exhibit distinct differences in the composition and diversity of their colonic mucosal microbiota compared to those with non-colorectal cancer.This study was reviewed and approved by the Ethics Committee of Faculty of Medicine,Universitas Indonesia(No.KET-1517/UN2.F1/ETIK/PPM.00.02/2023).展开更多
A case-control study on the differences in colonic mucosa-associated microbiotas between patients with and without colorectal cancer(CRC)in the Indonesian population was recently published.The geographical distributio...A case-control study on the differences in colonic mucosa-associated microbiotas between patients with and without colorectal cancer(CRC)in the Indonesian population was recently published.The geographical distribution characteristics of the gut microbiota in the carcinogenic microenvironment are closely related to disease progression.Therefore,the results of that study are of great significance for determining the pathogenesis of CRC in the Indonesian region and for clinically diagnosing and treating CRC.While acknowledging the strengths of the study,its limitations should also be addressed.Future case-control studies of the gut microbiota based on specific populations should be further refined to provide more optimized guidance for clinical precision treatment.展开更多
BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondar...BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondary infections if not promptly excised.CASE SUMMARY We report the case of a 52-year-old female patient who was stung in her mouth by a honeybee,causing a local irritation.The patient presented with a one-month history of pain,swelling,and redness in the left buccal mucosa.Inadvertently retained,the stinger was discovered during a clinical evaluation following initial treatment for facial swelling and erythema.After the stinger was removed,the patient’s symptoms resolved without complications.CONCLUSION This case emphasizes the importance of thorough examination and prompt management of insect stings to prevent prolonged discomfort and potential complications.展开更多
BACKGROUND Endoscopic mucosa resection(EMR)is an important minimally invasive surgical method for treating early digestive tract tumors.In recent years,the crucial role of intestinal microbiota in disease occurrence a...BACKGROUND Endoscopic mucosa resection(EMR)is an important minimally invasive surgical method for treating early digestive tract tumors.In recent years,the crucial role of intestinal microbiota in disease occurrence and development has attracted increasing attention.However,the changes in intestinal microbiota after EMR and the effect of dietary fiber intervention on microbiota recovery remain insufficiently elucidated.AIM To investigate the effects of dietary fiber intervention on intestinal microbiota recovery in patients undergoing EMR and evaluate its potential to improve postoperative outcomes and intestinal microecological balance.METHODS This retrospective study analyzed intestinal microbiota sequencing and dietary fiber intervention in patients with EMR.Patients who underwent EMR surgery between 2020 and 2023 were selected and divided into a routine follow-up group and a dietary fiber intervention group.High-throughput 16S rRNA gene sequencing was performed to detect changes in patient intestinal microbiota,and microbiota diversity,structure,and function in different intervention groups were compared and analyzed.RESULTS A total of 86 patients with EMR were included in the study.Results showed that:(1)Intestinal microbiota diversity significantly decreased after EMR surgery,with notable changes in the proportion of Gram-negative bacilli and anaerobic bacteria;(2)The microbiota recovery rate in the dietary fiber intervention group was significantly higher than that in the control group,with a significantly higher microbiota diversity index(P<0.05);and(3)The abundance of lactobacilli and bifidobacteria in the intervention group increased substantially,and intestinal barrier-related functional gene expression was upregulated.CONCLUSION Dietary fiber intervention can effectively promote intestinal microbiota recovery in patients with EMR,improve intestinal microecological balance,and provide a new intervention strategy for clinical post-EMR patient rehabilitation.展开更多
Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease(MASLD),a condition that currently represents the most common cause of chron...Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease(MASLD),a condition that currently represents the most common cause of chronic liver disease worldwide.Within this axis,the duodenum serves not only as a site of nutrient absorption but also as a metabolic sensor capable of influencing systemic and hepatic homeostasis.We have read with great interest the recent study by Yu et al,investigating the effects of duodenal mucosal ablation(DMA)by irreversible electroporation in a rat model of MASLD.The authors reported remarkable reductions in hepatic lipid content,improvements in serum lipid profiles,and both structural and functional changes in the intestinal mucosa,including alterations in enteroendocrine signaling.These results corroborate the pivotal role of the gut-liver axis in the pathogenesis of MASLD and highlight the potential of minimally invasive approaches targeting the proximal intestine.In this letter,we discuss the broader implications of these findings,emphasizing the translational relevance of intestinal modulation strategies in the comprehensive treatment of MASLD.展开更多
The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across ...The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across the buccal mucosa remains challenging[1].Currently,the gold standard for determining buccal drug permeability is the vertical Franz diffusion cell(FDC),which is using freshly excised tissue[2].展开更多
Background:Parkinson’s disease(PD)is a neurodegenerative disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra(SN).Activation of the neuroinflammatory response has a pivotal role ...Background:Parkinson’s disease(PD)is a neurodegenerative disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra(SN).Activation of the neuroinflammatory response has a pivotal role in PD.Mesenchymal stem cells(MSCs)have emerged as a promising therapeutic approach for various nerve injuries,but there are limited reports on their use in PD and the underlying mechanisms remain unclear.Methods:We investigated the effects of clinical-grade hypoxia-preconditioned olfactory mucosa(hOM)-MSCs on neural functional recovery in both PD models and patients,as well as the preventive effects on mouse models of PD.To assess improvement in neuroinflammatory response and neural functional recovery induced by hOM-MSCs exposure,we employed single-cell RNA sequencing(scRNA-seq),assay for transposase accessible chromatin with high-throughput sequencing(ATAC-seq)combined with full-length transcriptome isoform-sequencing(ISO-seq),and functional assay.Furthermore,we present the findings from an initial cohort of patients enrolled in a phaseⅠfirstinhuman clinical trial evaluating the safety and efficacy of intraspinal transplantation of hOM-MSC transplantation into severe PD patients.Results:A functional assay identified that transforming growth factor-β1(TGF-β1),secreted from hOM-MSCs,played a critical role in modulating mitochondrial function recovery in dopaminergic neurons.This effect was achieved through improving microglia immune regulation and autophagy homeostasis in the SN,which are closely associated with neuroinflammatory responses.Mechanistically,exposure to hOM-MSCs led to an improvement in neuroinflammation and neural function recovery partially mediated by TGF-β1 via activation of the anaplastic lymphoma kinase/phosphatidylinositol-3-kinase/protein kinase B(ALK/PI3K/Akt)signaling pathway in microglia located in the SN of PD patients.Furthermore,intraspinal transplantation of hOM-MSCs improved the recovery of neurologic function and regulated the neuroinflammatory response without any adverse reactions observed in patients with PD.Conclusions:These findings provide compelling evidence for the involvement of TGF-β1 in mediating the beneficial effects of hOM-MSCs on neural functional recovery in PD.Treatment and prevention of hOM-MSCs could be a promising and effective neuroprotective strategy for PD.Additionally,TGF-β1 may be used alone or combined with hOM-MSCs therapy for treating PD.展开更多
Objective Esophageal and gastric lesions are effectively managed with minimally invasive upper endoscopic procedures such as endoscopic mucosa resection(EMR)and endoscopic submucosal dissection(ESD),offering patients ...Objective Esophageal and gastric lesions are effectively managed with minimally invasive upper endoscopic procedures such as endoscopic mucosa resection(EMR)and endoscopic submucosal dissection(ESD),offering patients alternatives to invasive interventions.While ESD is well established in Eastern Asia,its adoption in Denmark for superficial esophageal cancer is recent.This study presents real-world data on the feasibility,safety,and hospitalization duration associated with ESD and EMR for esophageal and gastric lesions.Methods A retrospective analysis was conducted on patients who underwent ESD or EMR at a specialized center in Denmark from October 2016 to June 2022.Data on treatment,indication,lesion location,hospitalization duration,procedure duration,specimen size,complications,recurrence,and one-year overall survival were collected.Statistical comparisons utilized the Mann-Whitney U test,independent sample median test,and chi-squared test.Results The study included 130 patients(144 procedures):72 underwent ESD and 58 underwent EMR.Compared with EMR,ESD resulted in greater percentages of en bloc and R0 resections(98.8%vs.64.1%,p<0.001;and 83.9%vs.23.8%,p<0.001),greater complication rates(28.7%vs.3.1%,p<0.001)and longer procedure times(119.5 min vs.37.0 min,p<0.001).The ESD procedure time significantly decreased over time(p=0.01).The local recurrence rates were 14.5%for ESD and 23.8%for EMR(p=0.767).The one-year overall survival rates were similar between the groups(95.8%vs.94.8%,p=0.553).Conclusion Both ESD and EMR are safe and viable for treating esophageal and gastric lesions.ESD offers advantages but requires more time and skill.These findings support the literature,emphasizing the importance of considering patient-specific factors and surgeon proficiency in selecting the appropriate procedure.展开更多
BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capil...BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.展开更多
Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6)...Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.展开更多
Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal ...Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.展开更多
Tuberculous otitis media(TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of severa...Tuberculous otitis media(TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.展开更多
Lactobacillus are considered promising therapeutic methods for nonalcoholic fatty liver disease(NAFLD).The effects of two strains of Ltmosilactobacillus mucosae on NAFLD were investigated in this study.Fourweek-old ma...Lactobacillus are considered promising therapeutic methods for nonalcoholic fatty liver disease(NAFLD).The effects of two strains of Ltmosilactobacillus mucosae on NAFLD were investigated in this study.Fourweek-old male C57BL/6J mice were divided into 4 groups(n=8 per group,Control,Model,FZJTZ26M3,FGSYC17L3).L.mucosae FZJTZ26M3 reduced the mice 's body weight,liver weight,and adipose tissue weight after 12 weeks of therapy.According to serum analysis,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol significantly decreased after L.mucosae FZJTZ26M3 intervention.Liver pathology showed that L.mucosae FZJTZ26M3 was effective to ameliorate lipid deposition in NAFLD mice.Additionally,the expression of the gene related to lipid metabolism in the liver and adipose tissue was analyzed,and the results indicated that L.mucosae FZJTZ26M3 could alleviate NAFLD by regulating lipid metabolism.Furthermore,the results of 16S rRNA gene sequencing revealed a drop in the relative abundance of Ruminococcaceae,which is linked to inflammation,but the relative abundance of a potential probiotic Akkermansia significantly increased after L.mucosae FZJTZ26M3 intervention.Generally,L.mucosae FZJTZ26M3 could be a candidate to prevent NAFLD.展开更多
BACKGROUND Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions,including colorectal adenoma.Screening colonoscopy frequently reveals chicken skin mucosa(CSM;white or yellow-white speckled muc...BACKGROUND Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions,including colorectal adenoma.Screening colonoscopy frequently reveals chicken skin mucosa(CSM;white or yellow-white speckled mucosa)surrounding colo-rectal polyps,caused by macrophages engulfing and accumulating the lipids decomposed by colon cells or adjacent tumors.CSM-positive colorectal polyps are associated with various diseases;however,their prognosis varies greatly.Cold snare polypectomy is commonly used to resect lesions up to 10 to 15 mm in diameter without signs of submucosal invasion but is controversial for CSM-positive colorectal polyps.Improved imaging is required to diagnose and treat CSM-positive colorectal polyps.METHODS This retrospective cohort study included 177 patients with CSM-positive colorectal polyps diagnosed using endoscopy.All patient-related information was extracted from the Goldisc soft-clinic DICOM system or electronic medical record system.Based on the pathological results,patients were classified as non-neoplastic polyps(five juvenile polyps),neoplastic polyps,non-invasive high-grade neoplasia(NHGN),or submucosal invasive carcinoma(SM stage cancer).We analyzed and compared the clinical features,suspected risk factors for malignant transformation of neoplastic polyps,and early infiltration of sub-mucosal carcinoma.RESULTS The diameters of NHGN and SM polyps were much smaller than those of neoplastic polyps.Most NHGN polyps had a deeper red mucosal color.On logistic regression analyses,diameter and deeper red mucosal color were independent risk factors for malignant transformation of neoplastic polyps.Type 1 CSM was more common in high-grade intraepithelial neoplasia and SM;type 2 CSM was more common in neoplastic polyps.Logistic regression analyses revealed no significant differences in the malignant transformation of neoplastic polyps or early submucosal invasion of CSM-positive colorectal cancer.Changes in the CSM mucosa surrounding neoplastic polyps and submucosal invasion of colorectal cancer disappeared within 12 months.No tumor recurrence was found during either partial or complete endoscopic resection of the CSM.CONCLUSION CSM-positive colorectal polyps>1 cm in diameter or with deeper red mucosa may be related to NHGN.Resection of CSM surrounding colorectal adenomas did not affect tumor recurrence.展开更多
BACKGROUND Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars.Consequently,the application of regenerative treatment using the modified wedge-flap technique ...BACKGROUND Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars.Consequently,the application of regenerative treatment using the modified wedge-flap technique is considered impractical for these specific dental conditions.CASE SUMMARY This article proposes a modified surgical procedure aimed at exposing the distal intrabony defect by making a vertical incision in the keratinized buccal gingiva.The primary objective is to maintain gingival flap stability,thereby facilitating periodontal regeneration.The described technique was successfully employed in a case involving the left mandibular second molar,which presented with an intrabony defect without keratinized gingiva at the distal site.In this case,an incision was made on the disto-buccal gingival tissue,creating a tunnel-like separation of the distal non-keratinized soft tissue to expose the intrabony defect.Subsequently,bone grafting and guided tissue regeneration surgeries were performed,resulting in satisfactory bone fill at 9 mo postoperatively.CONCLUSION This technique offers a regenerative opportunity for the intrabony defects beneath non-keratinized mucosa and is recommended for further research.展开更多
AIM:To explore the role of positron emission tomographycomputed tomography(PET-CT)examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma(OAML).METHODS:The general clini...AIM:To explore the role of positron emission tomographycomputed tomography(PET-CT)examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma(OAML).METHODS:The general clinical data,postoperative PET-CT results,treatment regimens,and the prognosis of 21 histopathologically confirmed OAML patients between October 2017 and September 2021 were collected.Among the 21 patients,five patients underwent surgical treatment alone,13 patients underwent surgical treatment combined with radiotherapy,and three patients underwent surgical treatment combined with chemotherapy.RESULTS:The follow-up period ranged from 8 to 79mo,with four cases of recurrence and no deaths.Through PETCT examination,two patients exhibited both local ocular metabolic elevation and systemic metastasis,and one of these patients had cervical lymph node metastasis,while the other had submandibular and parotid gland metastasis.Nine patients showed only local ocular metabolic elevation,while 10 patients had no abnormal metabolic activity locally.CONCLUSION:PET-CT examination plays a crucial role in detecting residual lesions and recurrence following tumor resection,aiding in precise disease staging,and facilitating the development of personalized treatment plans,ultimately improving patient prognosis.展开更多
As the gastrointestinal tract may also be a crucial entry or interaction site of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the role of the gut mucosal immune system as a first-line physical and immun...As the gastrointestinal tract may also be a crucial entry or interaction site of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the role of the gut mucosal immune system as a first-line physical and immunological defense is critical.Furthermore,gastrointestinal involvement and symptoms in coronavirus disease 2019(COVID-19)patients have been linked to worse clinical outcomes.This review discusses recent data on the interactions between the virus and the immune cells and molecules in the mucosa during the infection.By carrying out appropriate investigations,the mucosal immune system role in SARS-CoV-2 infection in therapy and prevention can be established.In line with this,COVID-19 vaccines that stimulate mucosal immunity against the virus may have more advantages than the others.展开更多
AIM To study the effect of Helicobacter pylori ( H. pylori ) infection on gastric epithelial proliferation in the progression from normal mucosa to gastric carcinoma. METHODS Gastric biopsy specimens from nor...AIM To study the effect of Helicobacter pylori ( H. pylori ) infection on gastric epithelial proliferation in the progression from normal mucosa to gastric carcinoma. METHODS Gastric biopsy specimens from normal controls ( n =11), superficial gastritis ( n =32), atrophic gastritis with intestinal metaplasia ( n =83), dysplasia ( n =25) and gastric carcinoma ( n =10) were studied by immunohistochemical staining of proliferating cell nuclear antigen (PCNA). RESULTS The gastric epithelial proliferation, expressed as PCNA labeling index (LI)%, was progressively increased in successive stages from normal mucosa to gastric carcinoma regardless of H. pylori status. There was significant difference in PCNA LI% among all groups ( P <0 01). The analysis pursuing the effect of H. pylori infection on gastric epithelial proliferation in the progression from normal mucosa to gastric carcinoma showed that in superficial gastritis and mild atrophic gastritis groups, PCNA LI% in H. pylori positive patients were 13 14±1 6 and 19 68±2 22 respectively, significantly higher than 6 95±0 78 and 11 34±1 89 in H. pylori negative patients ( P <0 01); but there was no such difference in other groups ( P >0 05). CONCLUSION H. pylori infection causes increased gastric epithelial proliferation in the stages of superficial and mild atrophic gastritis and may play a part in triggering gastric carcinogenesis.展开更多
Objective To study the effect of the serum derived from the rats treated with electroacupunctre at Stomach Meridian acupoints on the EGFR signal transduction pathway in gastric mucosal cells. Methods Sixty rats were r...Objective To study the effect of the serum derived from the rats treated with electroacupunctre at Stomach Meridian acupoints on the EGFR signal transduction pathway in gastric mucosal cells. Methods Sixty rats were randomly divided into 5 groups： model group, Stomach （ST） Meridian group, Gallbladder （GB） Meridian group, ST＋ PD153035 group and GB＋ PD153035 group. Water-immersion and restrained stress method was adopted for preparation of the stress-induced gastric ulcer rat model, and the gastric mucosa cells were separated by using pronase digestion method. Gastric mucosa cells were incubated respectively with PD153035, EGFR inhibitor and the serum; PLCγ-1＇s expression level in gastric mucosa cells was tested by enzyme-linked immunosorbant assay （ELISA）, and PKC activity by isotope mingling method; and reverse transcription polymerase chain reaction assay （RT-PCR） was used for testing expression level of c-myc gene. Results The expression levels of PLCγ-1 ,PKC and c- myc gene were lower in gastric mucosa cells in the model group; there were relatively high expression levels of PLCγ-1 ,PKC and c-myc gene in the ST Meridian group and the GB Meridian group, with the highest expression levels of PLCγ-1 ,PKC and c-myc gene in the ST Meridian, and with a significant difference between the ST Meridian group and the GB Meridian group （P〈0.01 ） ; and relative lower expression levels of PLCγ-1, PKC and c-myc gene were seen in the ST ＋ PD153035 group and the GB ＋ PD153035 group; and there was a significant difference between the ST Meridian group and the ST ＋ PD153035 group （P〈0.01）. Conclusion There was a close correlation between the healing effect of electroacupuncture and activation of the EGFR signal transduction pathway in the impaired gastric mucosa cells, which was also one proof for the TCM theory： ＂There is relative specificity between the meridians and viscera＂.展开更多
文摘BACKGROUND Heterotopic gastric mucosa(HGM)is the most common type of epithelial heterotopia,which can occur in any part of the gastrointestinal tract.The duodenum is one of the common sites of HGM.HGM is usually considered benign,and malignant transformation of HGM in the duodenum is extremely rare.CASE SUMMARY We reported a middle-aged man admitted to the hospital due to abdominal pain,whose gastroduodenoscopy revealed a polypoid uplift in the duodenum.The attending physician directly removed the lesion using a snare,histopathological analysis demonstrated multidirectional cellular differentiation on the basis of duodenal HGM.The hematoxylin and eosin stains of the duodenal lesion demonstrated HGM,the superficial mucosa exhibited gastric foveolar-type epithelium,numerous mucous glands were identified beneath the foveolar region.Additionally,focal areas displayed several signet-ring cell changes.Gastric foveolartype epithelium was diffusely positivity for MUC5AC and Ki67.Numerous mucous gland was positivity for MUC6,partially positive for MUC2,pepsinogen I and H^(+)/K^(+)ATPase.It was eventually diagnosed gastric adenocarcinoma of fundic gland mucosa on the basis of duodenal HGM.CONCLUSION We reported the first case of gastric adenocarcinoma of fundic gland mucosa arising in the duodenum on the basis of HGM.Although HGM is mostly benign,there is also a risk of carcinogenesis.
文摘BACKGROUND Colorectal cancer is the third most common malignancy and the fourth leading cause of cancer-related deaths worldwide.Several studies have shown an association between gut microbiota and colorectal cancer.Gut microbiota is unique and can be influenced by geographic factors and habits.This study aimed to determine the diversity and composition of colonic mucosal microbiota in patients with and without colorectal cancer.AIM To determine the diversity and composition of colonic mucosal microbiota in patients with and without colorectal cancer in Indonesia.METHODS This case-control study included 59 subjects(35 colorectal cancer patients and 24 non-colorectal cancer patients indicated for colonoscopy at Dr.Cipto Mangunkusumo Gastrointestinal Endoscopy Center and Fatmawati Hospital.Microbiota examination was performed using 16S rRNA sequencing.Bioinformatics analysis was performed using the wf-metagenomics pipeline from EPI2Me-Labs(Oxford Nanopore Technologies platform).RESULTS Patients with colorectal cancer had a higher median index value on the Shannon index(3.28 vs 2.82,P>0.05)and a lower value on the Simpson index(0.050 vs 0.060,P>0.05).Significant differences in beta diversity were observed at the genus(P=0.002)and species levels(P=0.001).Firmicutes,Proteobacteria,Bacteroidetes,and Fusobacteria were the dominant phyla.The genera Bacteroides,Campylobacter,Peptostreptococcus,and Parvimonas were found more frequently in colorectal cancer,while Faecalibacterium,Haemophilus,and Phocaeicola were more frequently found in non-colorectal cancer.The relative abundance of Fusobacterium nucleatum,Bacteroides fragilis,Enterococcus faecalis,Campylobacter hominis,and Enterococcus faecalis species was significantly elevated in patients with colorectal cancer.Meanwhile,Faecalibacterium prausnitzii,Faecalibacterium duncaniae,and Prevotella copri were more commonly found in non-colorectal cancer.CONCLUSION Patients with colorectal cancer exhibit distinct differences in the composition and diversity of their colonic mucosal microbiota compared to those with non-colorectal cancer.This study was reviewed and approved by the Ethics Committee of Faculty of Medicine,Universitas Indonesia(No.KET-1517/UN2.F1/ETIK/PPM.00.02/2023).
基金Supported by the Beijing High Level Public Health Technology Talent Construction Project,No.backbone-03-04.
文摘A case-control study on the differences in colonic mucosa-associated microbiotas between patients with and without colorectal cancer(CRC)in the Indonesian population was recently published.The geographical distribution characteristics of the gut microbiota in the carcinogenic microenvironment are closely related to disease progression.Therefore,the results of that study are of great significance for determining the pathogenesis of CRC in the Indonesian region and for clinically diagnosing and treating CRC.While acknowledging the strengths of the study,its limitations should also be addressed.Future case-control studies of the gut microbiota based on specific populations should be further refined to provide more optimized guidance for clinical precision treatment.
文摘BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondary infections if not promptly excised.CASE SUMMARY We report the case of a 52-year-old female patient who was stung in her mouth by a honeybee,causing a local irritation.The patient presented with a one-month history of pain,swelling,and redness in the left buccal mucosa.Inadvertently retained,the stinger was discovered during a clinical evaluation following initial treatment for facial swelling and erythema.After the stinger was removed,the patient’s symptoms resolved without complications.CONCLUSION This case emphasizes the importance of thorough examination and prompt management of insect stings to prevent prolonged discomfort and potential complications.
文摘BACKGROUND Endoscopic mucosa resection(EMR)is an important minimally invasive surgical method for treating early digestive tract tumors.In recent years,the crucial role of intestinal microbiota in disease occurrence and development has attracted increasing attention.However,the changes in intestinal microbiota after EMR and the effect of dietary fiber intervention on microbiota recovery remain insufficiently elucidated.AIM To investigate the effects of dietary fiber intervention on intestinal microbiota recovery in patients undergoing EMR and evaluate its potential to improve postoperative outcomes and intestinal microecological balance.METHODS This retrospective study analyzed intestinal microbiota sequencing and dietary fiber intervention in patients with EMR.Patients who underwent EMR surgery between 2020 and 2023 were selected and divided into a routine follow-up group and a dietary fiber intervention group.High-throughput 16S rRNA gene sequencing was performed to detect changes in patient intestinal microbiota,and microbiota diversity,structure,and function in different intervention groups were compared and analyzed.RESULTS A total of 86 patients with EMR were included in the study.Results showed that:(1)Intestinal microbiota diversity significantly decreased after EMR surgery,with notable changes in the proportion of Gram-negative bacilli and anaerobic bacteria;(2)The microbiota recovery rate in the dietary fiber intervention group was significantly higher than that in the control group,with a significantly higher microbiota diversity index(P<0.05);and(3)The abundance of lactobacilli and bifidobacteria in the intervention group increased substantially,and intestinal barrier-related functional gene expression was upregulated.CONCLUSION Dietary fiber intervention can effectively promote intestinal microbiota recovery in patients with EMR,improve intestinal microecological balance,and provide a new intervention strategy for clinical post-EMR patient rehabilitation.
文摘Targeting the gut-liver axis has emerged as a promising strategy in the treatment of metabolic dysfunction-associated steatotic liver disease(MASLD),a condition that currently represents the most common cause of chronic liver disease worldwide.Within this axis,the duodenum serves not only as a site of nutrient absorption but also as a metabolic sensor capable of influencing systemic and hepatic homeostasis.We have read with great interest the recent study by Yu et al,investigating the effects of duodenal mucosal ablation(DMA)by irreversible electroporation in a rat model of MASLD.The authors reported remarkable reductions in hepatic lipid content,improvements in serum lipid profiles,and both structural and functional changes in the intestinal mucosa,including alterations in enteroendocrine signaling.These results corroborate the pivotal role of the gut-liver axis in the pathogenesis of MASLD and highlight the potential of minimally invasive approaches targeting the proximal intestine.In this letter,we discuss the broader implications of these findings,emphasizing the translational relevance of intestinal modulation strategies in the comprehensive treatment of MASLD.
文摘The administration of drugs via the buccal route has attracted much attention in recent years.However,the development of delivery systems that adhere well in moist conditions while releasing drugs successfully across the buccal mucosa remains challenging[1].Currently,the gold standard for determining buccal drug permeability is the vertical Franz diffusion cell(FDC),which is using freshly excised tissue[2].
基金supported by the Key Research and Development Program of Hunan Province of China(2020SK2102)the Hunan Provincial Natural Science Foundation of China(2023JJ40420)+5 种基金the Changsha Municipal Natural Science Foundation(kq2208154)the Scientific Research Project of Hunan Provincial Health Commission(B202304088074)the Scientific Research Project of Hunan Provincial Health Commission(202203105045)the National Natural Science Foundation of China(82301435,82201484)the Hunan Provincial Natural Science Foundation of China(2024JJ4083)the Graduate Research and Innovation Project of Hunan Education Department(CX20220528).
文摘Background:Parkinson’s disease(PD)is a neurodegenerative disorder characterized by the degeneration of dopaminergic neurons in the substantia nigra(SN).Activation of the neuroinflammatory response has a pivotal role in PD.Mesenchymal stem cells(MSCs)have emerged as a promising therapeutic approach for various nerve injuries,but there are limited reports on their use in PD and the underlying mechanisms remain unclear.Methods:We investigated the effects of clinical-grade hypoxia-preconditioned olfactory mucosa(hOM)-MSCs on neural functional recovery in both PD models and patients,as well as the preventive effects on mouse models of PD.To assess improvement in neuroinflammatory response and neural functional recovery induced by hOM-MSCs exposure,we employed single-cell RNA sequencing(scRNA-seq),assay for transposase accessible chromatin with high-throughput sequencing(ATAC-seq)combined with full-length transcriptome isoform-sequencing(ISO-seq),and functional assay.Furthermore,we present the findings from an initial cohort of patients enrolled in a phaseⅠfirstinhuman clinical trial evaluating the safety and efficacy of intraspinal transplantation of hOM-MSC transplantation into severe PD patients.Results:A functional assay identified that transforming growth factor-β1(TGF-β1),secreted from hOM-MSCs,played a critical role in modulating mitochondrial function recovery in dopaminergic neurons.This effect was achieved through improving microglia immune regulation and autophagy homeostasis in the SN,which are closely associated with neuroinflammatory responses.Mechanistically,exposure to hOM-MSCs led to an improvement in neuroinflammation and neural function recovery partially mediated by TGF-β1 via activation of the anaplastic lymphoma kinase/phosphatidylinositol-3-kinase/protein kinase B(ALK/PI3K/Akt)signaling pathway in microglia located in the SN of PD patients.Furthermore,intraspinal transplantation of hOM-MSCs improved the recovery of neurologic function and regulated the neuroinflammatory response without any adverse reactions observed in patients with PD.Conclusions:These findings provide compelling evidence for the involvement of TGF-β1 in mediating the beneficial effects of hOM-MSCs on neural functional recovery in PD.Treatment and prevention of hOM-MSCs could be a promising and effective neuroprotective strategy for PD.Additionally,TGF-β1 may be used alone or combined with hOM-MSCs therapy for treating PD.
文摘Objective Esophageal and gastric lesions are effectively managed with minimally invasive upper endoscopic procedures such as endoscopic mucosa resection(EMR)and endoscopic submucosal dissection(ESD),offering patients alternatives to invasive interventions.While ESD is well established in Eastern Asia,its adoption in Denmark for superficial esophageal cancer is recent.This study presents real-world data on the feasibility,safety,and hospitalization duration associated with ESD and EMR for esophageal and gastric lesions.Methods A retrospective analysis was conducted on patients who underwent ESD or EMR at a specialized center in Denmark from October 2016 to June 2022.Data on treatment,indication,lesion location,hospitalization duration,procedure duration,specimen size,complications,recurrence,and one-year overall survival were collected.Statistical comparisons utilized the Mann-Whitney U test,independent sample median test,and chi-squared test.Results The study included 130 patients(144 procedures):72 underwent ESD and 58 underwent EMR.Compared with EMR,ESD resulted in greater percentages of en bloc and R0 resections(98.8%vs.64.1%,p<0.001;and 83.9%vs.23.8%,p<0.001),greater complication rates(28.7%vs.3.1%,p<0.001)and longer procedure times(119.5 min vs.37.0 min,p<0.001).The ESD procedure time significantly decreased over time(p=0.01).The local recurrence rates were 14.5%for ESD and 23.8%for EMR(p=0.767).The one-year overall survival rates were similar between the groups(95.8%vs.94.8%,p=0.553).Conclusion Both ESD and EMR are safe and viable for treating esophageal and gastric lesions.ESD offers advantages but requires more time and skill.These findings support the literature,emphasizing the importance of considering patient-specific factors and surgeon proficiency in selecting the appropriate procedure.
文摘BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.
文摘Objective: To investigate the effects of different concentrations of β-glucan on the repair of damaged vaginal mucosa, the expression of vascular endothelial growth factor (VEGF), and the inflammatory factor-6 (IL-6) in vaginal tissues. Methods: Thirty-six adult female specific pathogen free (SPF)-grade Wistar rats were randomly divided into 3 phase groups with 12 rats each. Vaginal inflammation rat models were established by injecting phenol gel into the vagina of each rat at a dose of 0.1 ml/100g body weight. After modeling, rats were divided into 4 groups based on different concentrations of the test agent. The control group was injected with 0.5 ml of saline, experimental group A was injected with 0.375 ml saline 0.125 ml β-glucan, experimental group B was injected with 0.25 ml saline 0.25 ml β-glucan, and experimental group C was injected with 0.50 ml β-glucan. The injection sites were selected at the 3 o’clock and 9 o’clock positions of the vagina. Rats were sacrificed at 7-, 14-, and 28-days post-injection, and tissue samples were collected from the injection sites and prepared for histological analysis. New blood vessels and fibroblast numbers in the tissues were observed after Hematoxylin-eosin (HE) staining. The expression levels of VEGF and IL-6 in the tissues were measured using quantificational reverse transcription polymerase chain reaction (qRT-PCR). Results: Histological examination of vaginal tissue specimens at 7-, 14-, and 28-days post-injection showed that on day 7, there were no significant changes in the experimental groups compared to the control group. However, on days 14 and 28, the experimental groups showed more new blood vessels, macrophages, and fibroblasts with increased activity compared to the control group. The expression levels of VEGF in vaginal tissues were elevated on days 14 and 28 in the experimental groups. The comparison of IL-6 levels in vaginal tissues on day 28 showed that serum IL-6 levels returned to normal, and there was no statistically significant difference between the experimental and control groups. Conclusion: In the 3 experimental phases, the increase in VEGF levels in vaginal tissues on day 14 post-injection was more pronounced with higher concentrations of β-glucan, and IL-6 levels returned to normal on day 28. β-Glucan can enhance VEGF levels in damaged vaginal tissues, promote the repair of damaged vaginal tissues, and higher concentrations of β-glucan have a better effect.
文摘Objective:Secondary pyeloplasty for recurrent ureteropelvic junction obstructions may be a safe and feasible surgical option for patients.This study aimed to demonstrate outcomes of utilizing a non-transecting buccal mucosa graft ureteroplasty for management of recurrent ureteropelvic junction obstruction after prior failed pyeloplasty.Methods:We performed a retrospective review of our Collaborative of Reconstructive Robotic Ureteral Surgery database for all consecutive patients who underwent buccal mucosa graft ureteroplasty between April 2012 and June 2022 for management of recurrent ureteropelvic junction obstructions after prior failed pyeloplasty.The primary outcome included surgical success which was defined as the absence of flank pain and no obstruction on imaging.Results:Overall,ten patients were included in our analysis.The median stricture length was 2.5(interquartile range[IQR]1.8-4.0)cm.The median operative time was 230.5(IQR 199.5-287.0)min and median estimated blood loss was 50.0(IQR 28.8-102.5)mL.At a median follow-up of 10.3(IQR 6.2-14.8)months,80%of patients were surgically successful and there were no major(ClavieneDindo Grade>2)complications.Conclusion:Buccal mucosa graft ureteroplasty is a valuable non-transecting surgical option for patients with recurrent ureteropelvic junction obstructions who failed prior pyeloplasty and has comparable outcomes to the literature regarding standard transecting techniques.
文摘Tuberculous otitis media(TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.
基金supported by the National Natural Science Foundation of China (32021005, 31820103010)111 project (BP0719028)the Collaborative Innovation Center of Food Safety and Quality Control in Jiangsu Province。
文摘Lactobacillus are considered promising therapeutic methods for nonalcoholic fatty liver disease(NAFLD).The effects of two strains of Ltmosilactobacillus mucosae on NAFLD were investigated in this study.Fourweek-old male C57BL/6J mice were divided into 4 groups(n=8 per group,Control,Model,FZJTZ26M3,FGSYC17L3).L.mucosae FZJTZ26M3 reduced the mice 's body weight,liver weight,and adipose tissue weight after 12 weeks of therapy.According to serum analysis,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol significantly decreased after L.mucosae FZJTZ26M3 intervention.Liver pathology showed that L.mucosae FZJTZ26M3 was effective to ameliorate lipid deposition in NAFLD mice.Additionally,the expression of the gene related to lipid metabolism in the liver and adipose tissue was analyzed,and the results indicated that L.mucosae FZJTZ26M3 could alleviate NAFLD by regulating lipid metabolism.Furthermore,the results of 16S rRNA gene sequencing revealed a drop in the relative abundance of Ruminococcaceae,which is linked to inflammation,but the relative abundance of a potential probiotic Akkermansia significantly increased after L.mucosae FZJTZ26M3 intervention.Generally,L.mucosae FZJTZ26M3 could be a candidate to prevent NAFLD.
基金the Science and Technology Plan Project of Chengdu Municipal Health Commission,No.2019007.
文摘BACKGROUND Lipid metabolism reprogramming is suspected to exist in pre-cancerous lesions,including colorectal adenoma.Screening colonoscopy frequently reveals chicken skin mucosa(CSM;white or yellow-white speckled mucosa)surrounding colo-rectal polyps,caused by macrophages engulfing and accumulating the lipids decomposed by colon cells or adjacent tumors.CSM-positive colorectal polyps are associated with various diseases;however,their prognosis varies greatly.Cold snare polypectomy is commonly used to resect lesions up to 10 to 15 mm in diameter without signs of submucosal invasion but is controversial for CSM-positive colorectal polyps.Improved imaging is required to diagnose and treat CSM-positive colorectal polyps.METHODS This retrospective cohort study included 177 patients with CSM-positive colorectal polyps diagnosed using endoscopy.All patient-related information was extracted from the Goldisc soft-clinic DICOM system or electronic medical record system.Based on the pathological results,patients were classified as non-neoplastic polyps(five juvenile polyps),neoplastic polyps,non-invasive high-grade neoplasia(NHGN),or submucosal invasive carcinoma(SM stage cancer).We analyzed and compared the clinical features,suspected risk factors for malignant transformation of neoplastic polyps,and early infiltration of sub-mucosal carcinoma.RESULTS The diameters of NHGN and SM polyps were much smaller than those of neoplastic polyps.Most NHGN polyps had a deeper red mucosal color.On logistic regression analyses,diameter and deeper red mucosal color were independent risk factors for malignant transformation of neoplastic polyps.Type 1 CSM was more common in high-grade intraepithelial neoplasia and SM;type 2 CSM was more common in neoplastic polyps.Logistic regression analyses revealed no significant differences in the malignant transformation of neoplastic polyps or early submucosal invasion of CSM-positive colorectal cancer.Changes in the CSM mucosa surrounding neoplastic polyps and submucosal invasion of colorectal cancer disappeared within 12 months.No tumor recurrence was found during either partial or complete endoscopic resection of the CSM.CONCLUSION CSM-positive colorectal polyps>1 cm in diameter or with deeper red mucosa may be related to NHGN.Resection of CSM surrounding colorectal adenomas did not affect tumor recurrence.
基金Supported by Program for New Clinical Techniques and Therapies of Peking University School and Hospital of Stomatology,No.PKUSSNCT-23B10.
文摘BACKGROUND Intrabony defects beneath non-keratinized mucosa are frequently observed at the distal site of terminal molars.Consequently,the application of regenerative treatment using the modified wedge-flap technique is considered impractical for these specific dental conditions.CASE SUMMARY This article proposes a modified surgical procedure aimed at exposing the distal intrabony defect by making a vertical incision in the keratinized buccal gingiva.The primary objective is to maintain gingival flap stability,thereby facilitating periodontal regeneration.The described technique was successfully employed in a case involving the left mandibular second molar,which presented with an intrabony defect without keratinized gingiva at the distal site.In this case,an incision was made on the disto-buccal gingival tissue,creating a tunnel-like separation of the distal non-keratinized soft tissue to expose the intrabony defect.Subsequently,bone grafting and guided tissue regeneration surgeries were performed,resulting in satisfactory bone fill at 9 mo postoperatively.CONCLUSION This technique offers a regenerative opportunity for the intrabony defects beneath non-keratinized mucosa and is recommended for further research.
基金Supported by the Beijing Science and Technology Rising Star Program-Cross-cooperation Project(No.20220484218)the Tai’an City Science and Technology Innovation Development Project(No.2021NS207).
文摘AIM:To explore the role of positron emission tomographycomputed tomography(PET-CT)examination in the diagnosis and treatment of ocular adnexal mucosa associated lymphoid tissue lymphoma(OAML).METHODS:The general clinical data,postoperative PET-CT results,treatment regimens,and the prognosis of 21 histopathologically confirmed OAML patients between October 2017 and September 2021 were collected.Among the 21 patients,five patients underwent surgical treatment alone,13 patients underwent surgical treatment combined with radiotherapy,and three patients underwent surgical treatment combined with chemotherapy.RESULTS:The follow-up period ranged from 8 to 79mo,with four cases of recurrence and no deaths.Through PETCT examination,two patients exhibited both local ocular metabolic elevation and systemic metastasis,and one of these patients had cervical lymph node metastasis,while the other had submandibular and parotid gland metastasis.Nine patients showed only local ocular metabolic elevation,while 10 patients had no abnormal metabolic activity locally.CONCLUSION:PET-CT examination plays a crucial role in detecting residual lesions and recurrence following tumor resection,aiding in precise disease staging,and facilitating the development of personalized treatment plans,ultimately improving patient prognosis.
文摘As the gastrointestinal tract may also be a crucial entry or interaction site of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the role of the gut mucosal immune system as a first-line physical and immunological defense is critical.Furthermore,gastrointestinal involvement and symptoms in coronavirus disease 2019(COVID-19)patients have been linked to worse clinical outcomes.This review discusses recent data on the interactions between the virus and the immune cells and molecules in the mucosa during the infection.By carrying out appropriate investigations,the mucosal immune system role in SARS-CoV-2 infection in therapy and prevention can be established.In line with this,COVID-19 vaccines that stimulate mucosal immunity against the virus may have more advantages than the others.
文摘AIM To study the effect of Helicobacter pylori ( H. pylori ) infection on gastric epithelial proliferation in the progression from normal mucosa to gastric carcinoma. METHODS Gastric biopsy specimens from normal controls ( n =11), superficial gastritis ( n =32), atrophic gastritis with intestinal metaplasia ( n =83), dysplasia ( n =25) and gastric carcinoma ( n =10) were studied by immunohistochemical staining of proliferating cell nuclear antigen (PCNA). RESULTS The gastric epithelial proliferation, expressed as PCNA labeling index (LI)%, was progressively increased in successive stages from normal mucosa to gastric carcinoma regardless of H. pylori status. There was significant difference in PCNA LI% among all groups ( P <0 01). The analysis pursuing the effect of H. pylori infection on gastric epithelial proliferation in the progression from normal mucosa to gastric carcinoma showed that in superficial gastritis and mild atrophic gastritis groups, PCNA LI% in H. pylori positive patients were 13 14±1 6 and 19 68±2 22 respectively, significantly higher than 6 95±0 78 and 11 34±1 89 in H. pylori negative patients ( P <0 01); but there was no such difference in other groups ( P >0 05). CONCLUSION H. pylori infection causes increased gastric epithelial proliferation in the stages of superficial and mild atrophic gastritis and may play a part in triggering gastric carcinogenesis.
基金Supported by the Natural Science Foundation of Jiangxi Province (No :2008 GZY0022)the Technology Plan of Jiangxi Provincial Department of Education (No :GJJ09280)
文摘Objective To study the effect of the serum derived from the rats treated with electroacupunctre at Stomach Meridian acupoints on the EGFR signal transduction pathway in gastric mucosal cells. Methods Sixty rats were randomly divided into 5 groups： model group, Stomach （ST） Meridian group, Gallbladder （GB） Meridian group, ST＋ PD153035 group and GB＋ PD153035 group. Water-immersion and restrained stress method was adopted for preparation of the stress-induced gastric ulcer rat model, and the gastric mucosa cells were separated by using pronase digestion method. Gastric mucosa cells were incubated respectively with PD153035, EGFR inhibitor and the serum; PLCγ-1＇s expression level in gastric mucosa cells was tested by enzyme-linked immunosorbant assay （ELISA）, and PKC activity by isotope mingling method; and reverse transcription polymerase chain reaction assay （RT-PCR） was used for testing expression level of c-myc gene. Results The expression levels of PLCγ-1 ,PKC and c- myc gene were lower in gastric mucosa cells in the model group; there were relatively high expression levels of PLCγ-1 ,PKC and c-myc gene in the ST Meridian group and the GB Meridian group, with the highest expression levels of PLCγ-1 ,PKC and c-myc gene in the ST Meridian, and with a significant difference between the ST Meridian group and the GB Meridian group （P〈0.01 ） ; and relative lower expression levels of PLCγ-1, PKC and c-myc gene were seen in the ST ＋ PD153035 group and the GB ＋ PD153035 group; and there was a significant difference between the ST Meridian group and the ST ＋ PD153035 group （P〈0.01）. Conclusion There was a close correlation between the healing effect of electroacupuncture and activation of the EGFR signal transduction pathway in the impaired gastric mucosa cells, which was also one proof for the TCM theory： ＂There is relative specificity between the meridians and viscera＂.
