A randomized double-blind intervention trial was carried determine whether oral calcium supplementation could lower the proliferation of epithelial cells of the esophagus. 41 subjects identified with precancerous lesi...A randomized double-blind intervention trial was carried determine whether oral calcium supplementation could lower the proliferation of epithelial cells of the esophagus. 41 subjects identified with precancerous lesions by histopathology were randomized to receive oral supplementation of their conventional diets with 0.6 g of calcium as calcium carbonate or placebo. Both at the entry to the study and at the end of the treatment, seven months later, the subjects were examined, with an emphasis on the frequency and distribution of proliferating epithelial cells of the esophagus. Patterns of cell proliferation was defined by dividing the esophageal epithelium into cell columns oriented perpendicularly to the basal cell layer and by comparing the numbers and fractions of tritiated thymidine-labeled epithelial cells in the various cell columns and cell compartments.Before dietary supplementation with calcium, the profile of proliferating epithelial cells in the esophageal compartments in calcium group is similar to that in the placebo group, which is comparable to that previously observed in subjects with high risk for esophageal cancer. Seven months after supplementation having been started, in calcium group, proliferation was significantly reduced and the profile of the esophageal columns approached to that previously observed in subjects at low risk for esophageal cancer, however, in the placebo group, the proliferation and profile maintain at the same level as that before supplementation. Our findings indicate that oral calcium supplementation induces a more quiescent equilibrium in epithelial-cell proliferation in the esophageal mucosa of the subjects at high-risk for esophageal cancer, similar to that observed in subjects at low risk.展开更多
Objectives To compare the efficacy and safety of upstream tirofiban with downstream tirofiban in patients with non- ST-segment elevation acute coronary syndromes （NSTE-ACS） at high-risk undergoing percutaneous coron...Objectives To compare the efficacy and safety of upstream tirofiban with downstream tirofiban in patients with non- ST-segment elevation acute coronary syndromes （NSTE-ACS） at high-risk undergoing percutaneous coronary intervention （PCI）. Methods Two hundred and four patients with NSTE-ACS at high-risk undergoing PCI were randomized to upstream （4 -6 hours before coronary angiography） tirofiban or downstream （with the guidewire crossing the lesion） tirofiban. We evaluated myocardial damage after PCI by qualitatively analyzing cardiac troponin I （cTnI） and MB isoenzyme of creatine kinase （CK-MB）. Platelet aggregation inhibition and thrombolysis in myocardial infarction （TIMI） flow grade were assessed. The incidences of major adverse cardiac events （MACE） at 24-hour, 90-day and 180-day after PCI were followed up. The incidences of bleeding complications and thrombocytopenia during tirofiban administration were recorded. Results There were 102 patients with NSTE-ACS randomly assigned to upstream group and downstream group respectively. The peak serum levels of cTnI within 48 hours after PCI were significantly lower with upstream tirofiban than downstream tirofiban （0.34 vs 0. 61 ; P 〈 0.05 ）. Post-procedural cTnI elevation within 48 hours was significantly less frequent among patients who received upstream tirofiban than downstream tirofiban （63 % vs 82%, P 〈 0. 05 ）. The peak serum levels of CK-MB as well as post-procedural CK-MB elevation within 48 hours after PCI were not significantly different between the two groups （ 15 vs 18 and 38% vs 43% ; respectively; P 〉 0. 05 ）. ECG changes and the inhibition of platelet aggregation between two groups were similar （ P 〉 0.05 ）. Although the inci- dences of MACE at 90-day and 180-day after PCI were not statistically different, they were consistently lower with upstream tirofiban （3 % vs 6% and 6% vs 16% ; P 〉 0.05 ）. The incidences of bleeding complications and thrombocyto- penia were similar in the two groups （ 11% vs 9% ; P 〉 0.05 ）. Conclusions Among patients with NSTE-ACS at high-risk undergoing PCI, upstream tirofiban is associated with attenuated myocardial damage without increasing complications. （ S Chin J Cardiol 2009; 10（4） ： 179 -185）展开更多
文摘A randomized double-blind intervention trial was carried determine whether oral calcium supplementation could lower the proliferation of epithelial cells of the esophagus. 41 subjects identified with precancerous lesions by histopathology were randomized to receive oral supplementation of their conventional diets with 0.6 g of calcium as calcium carbonate or placebo. Both at the entry to the study and at the end of the treatment, seven months later, the subjects were examined, with an emphasis on the frequency and distribution of proliferating epithelial cells of the esophagus. Patterns of cell proliferation was defined by dividing the esophageal epithelium into cell columns oriented perpendicularly to the basal cell layer and by comparing the numbers and fractions of tritiated thymidine-labeled epithelial cells in the various cell columns and cell compartments.Before dietary supplementation with calcium, the profile of proliferating epithelial cells in the esophageal compartments in calcium group is similar to that in the placebo group, which is comparable to that previously observed in subjects with high risk for esophageal cancer. Seven months after supplementation having been started, in calcium group, proliferation was significantly reduced and the profile of the esophageal columns approached to that previously observed in subjects at low risk for esophageal cancer, however, in the placebo group, the proliferation and profile maintain at the same level as that before supplementation. Our findings indicate that oral calcium supplementation induces a more quiescent equilibrium in epithelial-cell proliferation in the esophageal mucosa of the subjects at high-risk for esophageal cancer, similar to that observed in subjects at low risk.
文摘Objectives To compare the efficacy and safety of upstream tirofiban with downstream tirofiban in patients with non- ST-segment elevation acute coronary syndromes （NSTE-ACS） at high-risk undergoing percutaneous coronary intervention （PCI）. Methods Two hundred and four patients with NSTE-ACS at high-risk undergoing PCI were randomized to upstream （4 -6 hours before coronary angiography） tirofiban or downstream （with the guidewire crossing the lesion） tirofiban. We evaluated myocardial damage after PCI by qualitatively analyzing cardiac troponin I （cTnI） and MB isoenzyme of creatine kinase （CK-MB）. Platelet aggregation inhibition and thrombolysis in myocardial infarction （TIMI） flow grade were assessed. The incidences of major adverse cardiac events （MACE） at 24-hour, 90-day and 180-day after PCI were followed up. The incidences of bleeding complications and thrombocytopenia during tirofiban administration were recorded. Results There were 102 patients with NSTE-ACS randomly assigned to upstream group and downstream group respectively. The peak serum levels of cTnI within 48 hours after PCI were significantly lower with upstream tirofiban than downstream tirofiban （0.34 vs 0. 61 ; P 〈 0.05 ）. Post-procedural cTnI elevation within 48 hours was significantly less frequent among patients who received upstream tirofiban than downstream tirofiban （63 % vs 82%, P 〈 0. 05 ）. The peak serum levels of CK-MB as well as post-procedural CK-MB elevation within 48 hours after PCI were not significantly different between the two groups （ 15 vs 18 and 38% vs 43% ; respectively; P 〉 0. 05 ）. ECG changes and the inhibition of platelet aggregation between two groups were similar （ P 〉 0.05 ）. Although the inci- dences of MACE at 90-day and 180-day after PCI were not statistically different, they were consistently lower with upstream tirofiban （3 % vs 6% and 6% vs 16% ; P 〉 0.05 ）. The incidences of bleeding complications and thrombocyto- penia were similar in the two groups （ 11% vs 9% ; P 〉 0.05 ）. Conclusions Among patients with NSTE-ACS at high-risk undergoing PCI, upstream tirofiban is associated with attenuated myocardial damage without increasing complications. （ S Chin J Cardiol 2009; 10（4） ： 179 -185）
