Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized...Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized search of the PubMed,Embase,the Cochrane Library,and Web of Science databases was performed.The studies included in the final analyses encompassed 7 high-quality RCTs,involving 432 tumor patients.The intervention group received immunonutritional supplements enriched with omega-3 fatty acids,arginine,glutamine,and other nutrients.The control group received a standard diet or a placebo.Primary outcome indicators included muscle mass,body weight,body mass index(BMI),inflammatory markers[e.g.,C-reactive protein(CRP),interleukin(IL)-6],and patient prognosis.The study followed the PRISMA 2020 guidelines.Results:Meta-analyses showed that immunonutritional interventions reduced IL-6 levels compared with the control group(mean=-5.85,95%CI:-10.88 to -0.82,P=0.02).No significant differences were observed in the body weight(mean=-1.50,95%CI:-6.24 to 3.24,I^(2)=0,P=0.54),BMI(mean=-0.38,95%CI:-1.84 to 1.09,I^(2)=0,P=0.61),handgrip strength(mean=1.97,95%CI:-2.94 to 6.88,I^(2)=0,P=0.43),or fat tissue index(mean=0.70,95%CI:-0.56 to 1.97,I^(2)=0,P=0.27).CRP levels showed a nonsignificant downward trend in the intervention group(mean=-4.13,95%CI:-13.63 to 5.38,I^(2)=66%,P=0.39),with high heterogeneity potentially attributable to differences in trial design,patients’baseline status,and intervention methods.Risk of bias assessment confirmed the high quality of the included studies.Conclusions:Immunonutritional interventions may modulate inflammatory responses in oncology patients,particularly those at higher nutritional risk,but their effect on enhancing muscle mass was not statistically confirmed.Impacts on body weight and BMI remain ambiguous,potentially influenced by factors such as the specific intervention administered,its duration,the concentrations of the different components,and the patients’baseline status.This study provides preliminary support for immunonutrition in managing sarcopenia in oncology patients;however,additional high-quality RCTs with larger sample sizes and standardized protocols are needed to further substantiate the efficacy and safety of the interventions,thereby providing a more robust evidence-based foundation for clinical practice.展开更多
Increasing evidence suggests that fine roots are particularly sensitive to environmental changes,making them essential in responding and adapting forest ecosystems to climate change.However,we still lack a fundamental...Increasing evidence suggests that fine roots are particularly sensitive to environmental changes,making them essential in responding and adapting forest ecosystems to climate change.However,we still lack a fundamental understanding of the underlying mechanisms that control fine root plasticity.The objective of this study was to determine the influence of soil moisture changes on fine root dynamics and morphology of European beech(Fagus sylvatica L.).We conducted a 30-month study of fine root traits,i.e.,fine root biomass(FRB),productivity,mortality,turnover,specific root length(SRL),specific root area(SRA),and root tip frequency(RTF),along a soil moisture gradient from dry,intermediate,and wet conditions in a near-natural mature beech forest.Sequential root coring with accompanying soil measurements was carried out at three study sites reflecting the gradient in soil water availability.For most fine root traits,we found significant differences between the upper 10 cm and lower soil depths.FRB showed significant differences between study sites,with the lowest FRB at the dry site.However,productivity,turnover,SRL,SRA,and RTF showed no significant differences between sites,but a high variability between seasons,suggesting an adaptation to short-term fluctuations but not to long-term gradients in soil water content(SWC).Linear mixed models revealed that decreasing SWC led to a significant increase in SRL,SRA,and RTF(standardized coefficients:-1.0±0.46,-1.1±0.46,and-1.1±0.43,respectively).Our observations indicate an adaptation strategy of beech to low availability of soil water and drought by forming thin absorptive roots and by maintaining a high seasonal plasticity to tolerate fluctuations in soil moisture.By highlighting the belowground morphological adaptations of mature forests to low soil water availability,our results provide novel insights into the structure and dynamics of forest ecosystem adaptations to climate change.展开更多
The reaction of 4-nitro-N'-(pyridin-2-ylmethylene)benzohydrazide(HL) with Ln(OAc)_(3)·4H_(2)O in MeOH makes it possible to synthesize mononuclear complexes [Ln(L)_(2)(OAc)(MeOH)]·2H_(2)O(Ln=Tb^(Ⅲ)(1),E...The reaction of 4-nitro-N'-(pyridin-2-ylmethylene)benzohydrazide(HL) with Ln(OAc)_(3)·4H_(2)O in MeOH makes it possible to synthesize mononuclear complexes [Ln(L)_(2)(OAc)(MeOH)]·2H_(2)O(Ln=Tb^(Ⅲ)(1),Eu^(Ⅲ)(2) and Gd^(Ⅲ)(3)) with chelate acetate and L^(-)anions.Compound 1 can be crystallized in reaction with molar ratio HL:Ln=1:1,2:1,3:1,and we successfully synthesized complex with three chelate L anions[Tb(L)_(3)]_(2)·2MeOH·H_(2)O(4) by interaction of TbCl_(3)·6H_(2)O with deprotonated HL(HL:Ln=3:1).Terbium(Ⅲ) compound 1 starts to decompose at~323 K and becomes stable up to 552 K according to the STA.Compound 1 shows slow magnetic relaxation with parameters Δ_(eff)/k_B=(6.75±0.02) K,τ_(0)=(1.71 × 10^(-6)±1 × 10^(-8)) s.Complexes 1 and 2 exhibit only fluorescence and phosphorescence of the L^(-).Ion-centered luminescence of the Tb^(3+)or Eu^(3+)ion is not observed.Using the tangent method at the high-energy edge of the phospho rescence spectrum of Gd^(3+),complex 3 T_(1) energy level of L^(-)is estimated to be 19700 cm^(-1).Reasons of luminescence quenching are discussed.Structures of 1 and 4 were determined by single crystal X-ray diffraction,and compounds 1-3 were characterized by powder X-ray diffraction(PXRD).展开更多
Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of...Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.展开更多
Neutrophil extracellular traps(NET)have emerged as critical players in the pathogenesis of atherosclerosis and other cardiovascular diseases(CVD).These web-like structures,composed of DNA,histones,and granule proteins...Neutrophil extracellular traps(NET)have emerged as critical players in the pathogenesis of atherosclerosis and other cardiovascular diseases(CVD).These web-like structures,composed of DNA,histones,and granule proteins released by neutrophils,contribute significantly to both inflammation and thrombosis.This manuscript offers a comprehensive review of the recent literature on the involvement of NET in atherosclerosis,highlighting their interactions with various pathophysiological processes and their potential as biomarkers for CVD.Notably,the impact of radiation on NET formation is explored,emphasising how oxidative stress and inflammatory responses drive NET release,contributing to plaque instability.The role of histones,particularly citrullinated histones,in endothelial dysfunction and plaque progression is discussed,highlighting their significance in the pathophysiology of atherosclerosis.Furthermore,the complex relationship between lipoproteins and NET formation is examined,with a focus on how elevated low-density lipoprotein(LDL)and decreased high-density lipoprotein(HDL)levels facilitate NET release,thus promoting vascular inflammation and plaque instability.The influence of cholesterol on NET formation is also explored,underscoring its contribution to plaque development and stability.The role of Peptidylarginine deiminase 4(PAD4)in the regulation of NETosis is reviewed,with attention given to how PAD4-driven citrullination of histones affects atherosclerosis progression.Moreover,the manuscript examines the potential of NET components—such as double-stranded DNA,myeloperoxidase–DNA complexes,and citrullinated histone H3—as biomarkers for assessing disease severity and predicting adverse cardiovascular events,including ST-elevation myocardial infarction(STEMI)and stroke.Elevated levels of these biomarkers correlate with worse clinical outcomes,suggesting their utility in guiding therapeutic interventions.In contrast to the existing body of work,this review highlights the novelty of integrating recent findings on NET interactions with lipid metabolism,histone modifications,and PAD4 activity in the context of atherosclerosis.Overall,NET plays an integral role in the inflammatory and thrombotic processes underpinning atherosclerosis,and their components hold promise as both diagnostic markers and therapeutic targets in cardiovascular disease management.展开更多
Gallstone disease(GD) is a chronic recurrent hepatobiliary disease,the basis for which is the impaired metabolism of cholesterol,bilirubin and bile acids,which is characterized by the formation of gallstones in the he...Gallstone disease(GD) is a chronic recurrent hepatobiliary disease,the basis for which is the impaired metabolism of cholesterol,bilirubin and bile acids,which is characterized by the formation of gallstones in the hepatic bile duct,common bile duct,or gallbladder.GD is one of the most prevalent gastrointestinal diseases with a substantial burden to health care systems.GD can result in serious outcomes,such as acute gallstone pancreatitis and gallbladder cancer.The epidemiology,pathogenesis and treatment of GD are discussed in this review.The prevalence of GD varies widely by region.The prevalence of gallstone disease has increased in recent years.This is connected with a change in lifestyle:reduction of motor activity,reduction of the physical load and changes to diets.One of the important benefits of early screening for gallstone disease is that ultrasonography can detect asymptomatic cases,which results in early treatment and the prevention of serious outcomes.The pathogenesis of GD is suggested to be multifactorial and probably develops from complex interactions between many genetic and environmental factors.It suggests that corticosteroids and oral contraceptives,which contain hormones related to steroid hormones,may be regarded as a model system of cholelithiasis development in man.The achievement in the study of the physiology of bile formation and the pathogenesis of GD has allowed expanding indications for therapeutic treatment of GD.展开更多
Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ul...Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ulcer disease in a certain state of the macroorganism. It is well established that H. pylori infection is the main cause of chronic gastritis and peptic ulcer disease(PUD). Decontamination of the gastric mucosa with various antibiotics leads to H. pylori elimination and longer remission in this disease. However,the reasons for repeated detection of H. pylori in recurrent PUD after its successful eradication remain unclear. The reason for the redetection of H. pylori in recurrent PUD can be either reinfection or ineffective anti-Helicobacter therapy. The administration of antibacterial drugs can lead not only to the emergence of resistant strains of microorganisms,but also contribute to the conversion of H. pylori into the resting(dormant) state. The dormant forms of H. pylori have been shown to play a potential role in the development of relapses of PUD. The paper discusses morphological H. pylori forms,such as S-shaped,C-shaped,U-shaped,and coccoid ones. The authors proposes the classification of H. pylori according to its morphological forms and viability.展开更多
AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm survival.METHODS One hundred and seventy-six patients ...AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm survival.METHODS One hundred and seventy-six patients with gastric cancer undergoing NAc T and a planned gastrectomy at the chinese p LA General hospital were selected from January 2011 to January 2017. Univariate and multivariable analyses were used to investigate the impact of NAc T-surgery interval time(< 4 wk, 4-6 wk, and > 6 wk) on pc R rate and overall survival(OS).RESULTS The NAc T-surgery interval time and clinician T stage were independent predictors of pc R. The interval time > 6 wk was associated with a 74% higher odds of pc R as compared with an interval time of 4-6 wk(p = 0.044), while the odds ratio(OR) of clinical T3 vs clinical T4 stage for pc R was 2.90(95%c I: 1.04-8.01, p = 0.041). In cox regression analysis of long-term survival, postneoadjuvant therapy pathological N(yp N) stage significantly impacted OS(N0 vs N3: h R = 0.16, 95%c I: 0.37-0.70, p = 0.015; N1 vs N3: h R = 0.14, 95%c I: 0.02-0.81, p = 0.029) and disease-free survival(DFS)(N0 vs N3: h R = 0.11, 95%c I: 0.24-0.52, p = 0.005; N1 vs N3: h R = 0.17, 95%c I: 0.02-0.71, p = 0.020). The surgical procedure also had a positive impact on OS and DFS. The hazard ratio of distal gastrectomy vs total gastrectomy was 0.12(95%c I: 0.33-0.42, p = 0.001) for OS, and 0.13(95%c I: 0.36-0.44, p = 0.001) for DFS.CONCLUSION The NAc T-surgery interval time is associated with pc R but has no impact on survival, and an interval time > 6 wk has a relatively high odds of pc R.展开更多
The incidence and prevalence of metabolic syndrome(MS) and colorectal cancer(CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence ...The incidence and prevalence of metabolic syndrome(MS) and colorectal cancer(CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions(adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same- obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian(Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.展开更多
AIM To investigate the hepatitis C virus(HCV)infection in the tissues of carcinoma ofextrahepatic bile duct and study theircorrelation.METHODS HCV NS5 protein and HCV RNA weredetected by labeled streptavidin biotin(LS...AIM To investigate the hepatitis C virus(HCV)infection in the tissues of carcinoma ofextrahepatic bile duct and study theircorrelation.METHODS HCV NS5 protein and HCV RNA weredetected by labeled streptavidin biotin(LSAB)method and in situ reverse transcriptionpolymerase chain reaction(IS-RT-PCR)insections of 51 cases of carcinoma ofextrahepatic bile duct and 34 cases of controlgroup(without malignant biliary disease).RESULTS In 51 cases of carcinoma ofextrahepatic bile duct,HCV NS5 protein wasdetected in 14(27.5%),which was clearlystained in the cytoplasm of cancer cell but not inthe nucleus or cell membrane.HCV RNA wasdetected in 18(35.4%),which was located inthe nucleus of cancer cell in 12 cases and in thecytoplasm in 6 cases.HCV NS5 protein and RNAcoexistence was found in 2 cases.In 34 cases ofcontrol group,HCV RNA was detected in 2(5.9%).HCV NS5 protein and RNA positive cellswere found either scattered or in clusters.CONCLUSION The prevalence of hepatitis C viral infection in the tissues of carcinoma ofextrahepatic bile duct was significantly higherthan in control group(X^2=9.808,P=0.002).The findings suggest a correlation between HCVinfection and carcinoma of extrahepatic bileduct,which is different from the traditionalviewpoint.HCV infection might be involved inthe development of carcinoma of extrahepaticbile duct.展开更多
In deep mineral exploration, the acquisition of audio magnetotelluric （AMT） data is severely affected by ambient noise near the observation sites; This near-field noise restricts investigation depths. Mathematical m...In deep mineral exploration, the acquisition of audio magnetotelluric （AMT） data is severely affected by ambient noise near the observation sites; This near-field noise restricts investigation depths. Mathematical morphological filtering （MMF） proved effective in suppressing large-scale strong and variably shaped noise, typically low-frequency noise, but can not deal with pulse noise of AMT data. We combine compressive sensing and MMF. First we use MMF to suppress the large-scale strong ambient noise; second, we use the improved orthogonal match pursuit （IOMP） algorithm to remove the residual pulse noise. To remove the noise and protect the useful AMT signal, a redundant dictionary that matches with spikes and is insensitive to the useful signal is designed. Synthetic and field data from the Luzong field suggest that the proposed method suppresses the near-source noise and preserves the signal well; thus, better results are obtained that improve the output of either MMF or IOMP.展开更多
BACKGROUND:Laparoscopic cholecystectomy(LC)has become the'gold standard'in treating benign gallbladder diseases.Increasing laparoscopic experience and techniques have made laparoscopic subtotal cholecystectomy...BACKGROUND:Laparoscopic cholecystectomy(LC)has become the'gold standard'in treating benign gallbladder diseases.Increasing laparoscopic experience and techniques have made laparoscopic subtotal cholecystectomy(LSC)a feasible option in more complex procedures.In recent years,few studies with a few cases of LSC have reported good results in patients with various types of cholecystitis.This study was designed to evaluate the feasibility,indications,characteristics and benefits of LSC in patients with complicated cholecystitis.METHODS:Altogether,3485 patients were scheduled to receive LC during the past 4 years at our institute.Among them,168 patients with various complicated forms of cholecystitis were treated by LSC.Meanwhile,the other 3317 patients who received standard LC were enrolled as the control group.Perioperative data from the two groups were collected and retrospectively analyzed.RESULTS:In the LSC group,135 patients suffered from acute calculic cholecystitis,18 from chronic calculic cholecystitis with cirrhotic portal hypertention,and 15 from chronic calculic atrophy cholecystitis with severe fibrosis.These patients constituted 4.8%of the total patients who underwent LC(168/3485)in the same period at our institute.In 122 patients,the cystic duct and artery were clipped before division.In another 46 patients,the gallbladder was initially incised at Hartmann's pouch.Five patients(3.0%)were converted to open subtotal cholecystectomy.The median operation time for LSC was 65.5±15.2 minutes,estimated operative blood loss was 71.5±15.5 ml,and the time to resume diet was 20.4±6.3 hours.Thirteen patients(7.7%)had local complications.The mean postoperative hospital stay was 4.2±2.6 days.In the LC group,2887 had chronic calculic cholecystitis,312had acute calculic cholecystitis,47 had chronic calculic atrophy cholecystitis,and 71 had polypus.Seventeen patients(0.5%)were converted to open cholecystectomy.The median operation time was 32.6±10.2 minutes,the estimated operative blood loss was 24.5±8.5 ml,and the time to resume diet was 18.3±4.5 hours.Thirty-nine patients(1.2%)had local complications.Mean postoperative hospital stay was 3.8±1.4 days.There was no bile duct injury or mortality in either group.CONCLUSIONS:LSC for patients with complicated cholecystitis is difficult,with a longer operation time,more operative blood loss and higher conversion and complication rates than LC.However,it is feasible and relatively safe.LSC is advantageous over open surgery,but it remains a non-routine choice.It is important to know the technical characteristics of LSC,and pay attention to perioperative bleeding and bile leak.展开更多
This review considers the physiological and molecular biochemical mechanisms of bile formation.The composition of bile and structure of a bile canaliculus,biosynthesis and conjugation of bile acids,bile phospholipids,...This review considers the physiological and molecular biochemical mechanisms of bile formation.The composition of bile and structure of a bile canaliculus,biosynthesis and conjugation of bile acids,bile phospholipids,formation of bile micellar structures,and enterohepatic circulation of bile acids are described.In general,the review focuses on the molecular physiology of the transporting systems of the hepatocyte sinusoidal and apical membranes.Knowledge of physiological and biochemical basis of bile formation has implications for understanding the mechanisms of development of pathological processes,associated with diseases of the liver and biliary tract.展开更多
AIM. To investigate IL-1β＋3 594 in the 5^th intron, IL-10-1 082 and CD14-159 polymorphisms in patients with acute pancreatitis （AP） and septic shock.METHODS： The study induded 215 patients （109 with acute severe...AIM. To investigate IL-1β＋3 594 in the 5^th intron, IL-10-1 082 and CD14-159 polymorphisms in patients with acute pancreatitis （AP） and septic shock.METHODS： The study induded 215 patients （109 with acute severe pancreatitis （SAP）, 106 with acute mild pancreatitis （MAP）） and 116 healthy volunteers. Genomic DNA was prepared from peripheral blood leukocytes. Genotypes and allele frequencies were determined in patients and healthy controls using restriction fragment length polymorphism analysis of PCR products.RESULTS： The frequencies of IL-β＋3 594T, IL-10-1082G and CD14-159T allele were similar in patients with mild or severe pancreatitis and in controls. Within SAP patients, no significant differences were found in the allele distribution examined when etiology was studied again. Patients with septic shock showed a significantly higher prevalence of IL-10-1082G allele than those without shock （X^2 = 5.921,P= 0.015）.CONCLUSION： IL-10-1082G plays an important role in the susceptibility of SAP patients to septic shock. Genetic factors are not important in determination of disease severity or susceptibility to AP.展开更多
Primary biliary cirrhosis (PBC) is an organ-specific autoimmune disease that predominantly affects women and is characterized by chronic, progressive destruction of small intrahepatic bile ducts with portal inflammati...Primary biliary cirrhosis (PBC) is an organ-specific autoimmune disease that predominantly affects women and is characterized by chronic, progressive destruction of small intrahepatic bile ducts with portal inflammation and ultimately fibrosis, leading to liver failure in the absence of treatment. Little is known about the etiology of PBC. PBC is characterized by anti-mitochondrial antibodies and destruction of intrahepatic bile ducts. The serologic hallmark of PBC is the presence of auto-antibodies to mitochondria, especially to the E2 component of the pyruvate dehydrogenase complex (PDC). Current theories on the pathogenesis of PBC favor the hypothesis that the disease develops as a result of an inappropriate immune response following stimulation by an environmental or infectious agent. Some reports suggest that xenobiotics and viral infections may induce PBC. The pathogenetic mechanism is believed to be caused by a defect in immunologic tolerance, resulting in the activation and expansion of self-antigen specific T and B lymphocyte clones and the production of circulating autoantibodies in addition to a myriad of cytokines and other inflammatory mediators. This leads to ductulopenia and persistent cholestasis, by developing end-stage hepatic-cell failure. In this review are given our own and literary data about mechanisms of development of intrahepatic cholestasis and possible ways of its correction.展开更多
BACKGROUND Open abdomen(OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the me...BACKGROUND Open abdomen(OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula(EAF), which is one of the most common complications of OA therapy, remains a thorny challenge.CASE SUMMARY Our team applied thermoplastic polyurethane as a befitting material for producing a 3 D-printed "fistula stent" in the management of an EAF patient,who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction. After a series of operations and OA therapy, the patient developed an EAF.CONCLUSION Application of this novel "fistula stent" resulted in a drastic reduction in the amount of lost enteric effluent and greatly accelerated rehabilitation processes.展开更多
Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily increasing.This trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screen...Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily increasing.This trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screening programs across Europe have experienced considerable improvements(fecal occult blood testing;transition from opportunistic to population based program settings).The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality rates.Each year,approximately 8000 people are diagnosed with CRC and some 4000 die from this malignancy.Twenty years ago,the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal Cancer Screening Program in 2000.Originally,this program was based on the guaiac fecal occult blood test(FOBT)offered by general practitioners,followed by colonoscopy in cases of FOBT positivity.The program has continuously evolved,namely with the implementation of immunochemical FOBTs and screening colonoscopy,as well as the involvement of gynecologists.Since the establishment of the Czech CRC Screening Registry in 2006,2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening program.The overall program expanded to cover 25.0%of the target population by 2011.However,stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation,which is currently being prepared.展开更多
AIM： To explore the effects of recombinant human growth hormone （rhGH） on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS： Eight patients w...AIM： To explore the effects of recombinant human growth hormone （rhGH） on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS： Eight patients with enterocutaneous fistulas received recombinant human growth hormone （10 ug/d） for 7 d. Image analysis and immunohistochemical techniques were used to analyse the expression of proliferating cell nuclear antigen （PCNA） in intestinal mucosal epithelial cells in biopsy samples from the patients who had undergone an endoscopic biopsy through the fistula at day 0, 4 and 7. Body weights, nitrogen excretion, serum levels of total proteins, albumin, prealbumin, transferrin and fibronectin were measured at day 0, 4 and 7. RESULTS： Significant improvements occurred in the expression of PCNA in the intestinal mucosal epithelial cells at day 4 and 7 compared to day 0 （24.93 ± 3.41%, 30.46 ± 5.24% vs 12.92 ± 4.20%, p 〈 0.01）. These changes were accompanied by the significant improvement of villus height （500.54 ± 53.79 um, 459.03 ± 88.98um vs 210.94 ± 49.16 um, P 〈 0.01）, serum levels of total proteins （70.52 ± 5.13 g/L, 74.89 ± 5.16 g/L vs 63.51 ± 2.47 g/L, P 〈 0.01）, albumin （39.44 ± 1.18 g/L, 42.39 ± 1.68 g/L vs 35.74 ± 1.75 g/L, P 〈 0.01） and fibronectin （236.3 4- 16.5 mg/L, 275.8± 16.9 mg/L vs 172.5 ± 21.4 mg/L, P 〈 0.01） at day 4 and 7, and prealbumin （286.38 ± 65.61 mg/L vs 180.88 ± 48.28 mg/L, P 〈 0.05）, transferrin （2.61 ± 0.12 g/L vs 2.41 ±0.14 g/L, P 〈 0.05） at day 7. Nitrogen excretion was significantly decreased at day 7 （3.40 ± 1.65 g/d vs 7.25 ± 3.92 g/d, P 〈 0.05）. No change was observed in the body weight. CONCLUSION： Recombinant human growth hormone could promote intestinal mucosal epithelial cell proliferation and protein synthesis in patients with enterocutaneous fistula.展开更多
The effect of the addition of small amounts of rare earths （Ln=La, Ce, Nd and Gd） to alumina supported copper-cobalt spinel oxide on the catalysts efficiency in CO and CH4 oxidation and in NO decomposition was inves...The effect of the addition of small amounts of rare earths （Ln=La, Ce, Nd and Gd） to alumina supported copper-cobalt spinel oxide on the catalysts efficiency in CO and CH4 oxidation and in NO decomposition was investigated. Samples of Ln/CuCo/AI catalyst were prepared and characterized by X-ray diffraction （XRD）, X-ray photoelectron spectroscopy （XPS）, atomic absorption spectroscopy （AAS）, scanning electron mieroscopy-energy dispersive spectroscopy （SEM-EDS）, H2-temperature-programmed reduc- tion （H2-TPR）, electron paramagnetic resonanee （EPR） spectroscopy and low temperature nitrogen adsorption, The results showed that the addition of rare earths changed the surface state of the alumina supported copper-cobalt spinel catalyst. As a result, partial re- duction of copper species was observed as well as migration of these species between the surface and the bulk. The Ln/CuCo/A1 catalysts behaved differently in oxidation and reduction processes. In oxidation processes where oxide structure was important, Ce/CuCo/A1 and Nd/CuCo/A1 were the most active catalysts. The catalyst Ce/CuCo/AI was the most active in the oxidation reactions because of the availability and favorable surface distribution of the redox couples Cu＋/Cu2＋ and Ce3＋/Ce4＋. In NO decompostion, Ln-modified catalysts significantly improved the selectivity of the process to N2.展开更多
BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs a...BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs and the mechanism is still unclear.AIM To evaluate the clinical outcomes of and to identify predictive factors for irreversible intestinal ischemia requiring surgical resection in AMVT patients treated by TT.METHODS The records of consecutive patients with AMVT treated by TT from January 2010 to October 2017 were retrospectively analyzed.We compared patients who required resection of irreversible intestinal ischemia to patients who did not require.RESULTS Among 58 patients,prompt TT was carried out 28.5 h after admission.A total of 42(72.4%)patients underwent arteriovenous combined thrombolysis,and 16(27.6%)underwent arterial thrombolysis alone.The overall 30-d mortality rate was 8.6%.Irreversible intestinal ischemia was indicated in 32(55.2%)patients,who had a higher 30-d mortality and a longer in-hospital stay than patients without resection.The significant independent predictors of irreversible intestinal ischemia were Acute Physiology and Chronic Health Evaluation(APACHE)II score(odds ratio=2.368,95% confidence interval:1.047-5.357,P=0.038)and leukocytosis(odds ratio=2.058,95% confidence interval:1.085-3.903,P=0.027).Using the receiver operating characteristic curve,the cutoff values of the APACHE II score and leukocytosis for predicting the onset of irreversible intestinal ischemia were calculated to be 8.5 and 12×10^9/L,respectively.CONCLUSION Prompt TT could achieve a favorable outcome in AMVT patients.High APACHE II score and leukocytosis can significantly predict the occurrence of irreversible intestinal ischemia.Therefore,close monitoring of these factors may help with the early identification of patients with irreversible intestinal ischemia,in whom ultimately surgical resection is required,before the initiation of TT.展开更多
基金supported by the Jiangsu Provincial Department of Science and Technology,China(No.BE2022773).
文摘Background:A systematic evaluation and meta-analysis of randomized controlled trials(RCTs)was conducted to assess the impact of immunonutritional interventions on sarcopenia in oncology patients.Methods:A computerized search of the PubMed,Embase,the Cochrane Library,and Web of Science databases was performed.The studies included in the final analyses encompassed 7 high-quality RCTs,involving 432 tumor patients.The intervention group received immunonutritional supplements enriched with omega-3 fatty acids,arginine,glutamine,and other nutrients.The control group received a standard diet or a placebo.Primary outcome indicators included muscle mass,body weight,body mass index(BMI),inflammatory markers[e.g.,C-reactive protein(CRP),interleukin(IL)-6],and patient prognosis.The study followed the PRISMA 2020 guidelines.Results:Meta-analyses showed that immunonutritional interventions reduced IL-6 levels compared with the control group(mean=-5.85,95%CI:-10.88 to -0.82,P=0.02).No significant differences were observed in the body weight(mean=-1.50,95%CI:-6.24 to 3.24,I^(2)=0,P=0.54),BMI(mean=-0.38,95%CI:-1.84 to 1.09,I^(2)=0,P=0.61),handgrip strength(mean=1.97,95%CI:-2.94 to 6.88,I^(2)=0,P=0.43),or fat tissue index(mean=0.70,95%CI:-0.56 to 1.97,I^(2)=0,P=0.27).CRP levels showed a nonsignificant downward trend in the intervention group(mean=-4.13,95%CI:-13.63 to 5.38,I^(2)=66%,P=0.39),with high heterogeneity potentially attributable to differences in trial design,patients’baseline status,and intervention methods.Risk of bias assessment confirmed the high quality of the included studies.Conclusions:Immunonutritional interventions may modulate inflammatory responses in oncology patients,particularly those at higher nutritional risk,but their effect on enhancing muscle mass was not statistically confirmed.Impacts on body weight and BMI remain ambiguous,potentially influenced by factors such as the specific intervention administered,its duration,the concentrations of the different components,and the patients’baseline status.This study provides preliminary support for immunonutrition in managing sarcopenia in oncology patients;however,additional high-quality RCTs with larger sample sizes and standardized protocols are needed to further substantiate the efficacy and safety of the interventions,thereby providing a more robust evidence-based foundation for clinical practice.
基金supported by the Federal Ministry of Food and Agriculture (BMEL)the Federal Ministry for the Environment,Nature Conservation,Nuclear Safety and Consumer Protection (BMUV) through the Fachagentur Nachwachsende Rohstoffe e. V.(FNR)(grant no. 2218 WK53X4)
文摘Increasing evidence suggests that fine roots are particularly sensitive to environmental changes,making them essential in responding and adapting forest ecosystems to climate change.However,we still lack a fundamental understanding of the underlying mechanisms that control fine root plasticity.The objective of this study was to determine the influence of soil moisture changes on fine root dynamics and morphology of European beech(Fagus sylvatica L.).We conducted a 30-month study of fine root traits,i.e.,fine root biomass(FRB),productivity,mortality,turnover,specific root length(SRL),specific root area(SRA),and root tip frequency(RTF),along a soil moisture gradient from dry,intermediate,and wet conditions in a near-natural mature beech forest.Sequential root coring with accompanying soil measurements was carried out at three study sites reflecting the gradient in soil water availability.For most fine root traits,we found significant differences between the upper 10 cm and lower soil depths.FRB showed significant differences between study sites,with the lowest FRB at the dry site.However,productivity,turnover,SRL,SRA,and RTF showed no significant differences between sites,but a high variability between seasons,suggesting an adaptation to short-term fluctuations but not to long-term gradients in soil water content(SWC).Linear mixed models revealed that decreasing SWC led to a significant increase in SRL,SRA,and RTF(standardized coefficients:-1.0±0.46,-1.1±0.46,and-1.1±0.43,respectively).Our observations indicate an adaptation strategy of beech to low availability of soil water and drought by forming thin absorptive roots and by maintaining a high seasonal plasticity to tolerate fluctuations in soil moisture.By highlighting the belowground morphological adaptations of mature forests to low soil water availability,our results provide novel insights into the structure and dynamics of forest ecosystem adaptations to climate change.
基金supported by the Russian Science Foundation (2273-10199)。
文摘The reaction of 4-nitro-N'-(pyridin-2-ylmethylene)benzohydrazide(HL) with Ln(OAc)_(3)·4H_(2)O in MeOH makes it possible to synthesize mononuclear complexes [Ln(L)_(2)(OAc)(MeOH)]·2H_(2)O(Ln=Tb^(Ⅲ)(1),Eu^(Ⅲ)(2) and Gd^(Ⅲ)(3)) with chelate acetate and L^(-)anions.Compound 1 can be crystallized in reaction with molar ratio HL:Ln=1:1,2:1,3:1,and we successfully synthesized complex with three chelate L anions[Tb(L)_(3)]_(2)·2MeOH·H_(2)O(4) by interaction of TbCl_(3)·6H_(2)O with deprotonated HL(HL:Ln=3:1).Terbium(Ⅲ) compound 1 starts to decompose at~323 K and becomes stable up to 552 K according to the STA.Compound 1 shows slow magnetic relaxation with parameters Δ_(eff)/k_B=(6.75±0.02) K,τ_(0)=(1.71 × 10^(-6)±1 × 10^(-8)) s.Complexes 1 and 2 exhibit only fluorescence and phosphorescence of the L^(-).Ion-centered luminescence of the Tb^(3+)or Eu^(3+)ion is not observed.Using the tangent method at the high-energy edge of the phospho rescence spectrum of Gd^(3+),complex 3 T_(1) energy level of L^(-)is estimated to be 19700 cm^(-1).Reasons of luminescence quenching are discussed.Structures of 1 and 4 were determined by single crystal X-ray diffraction,and compounds 1-3 were characterized by powder X-ray diffraction(PXRD).
基金supported by NIH grants to M Bukrinsky P30 AI117970by the“Creation of Experimental Laboratories in the Natural Sciences Program”and Basic Research Program at the Higher School of Economics University.
文摘Eosinophils are multifunctional granulocytes that contribute to the initiation and modulation of inflammation.Accumulating evidence suggests that eosinophils are adaptable leukocytes that orchestrate the resolution of inflammatory responses.The most prevalent chronic inflammatory illness,rheumatoid arthritis(RA),is typified by persistent synovitis thatmakes it hard for the disease to go away on its own.Interestingly,a unique subset of eosinophils known as regulatory eosinophils has been found in RA patients’synovium,especially while the disease is in remission.Pro-resolving signatures of regulatory eosinophils in the synovium are distinct from those of their lung counterparts.The most recent research on eosinophils and their function in this disease pathogenesis is compiled in this review.Based on the role of regulatory eosinophils,a new pathological model of inflammation resolution in RA is proposed,and potential therapeutic strategies aimed at enhancing the action of regulatory eosinophils in RA are proposed.
基金supported by NIH grants to MI Bukrinsky(R01NS124477 and P30AI117970)by the“Creation of Experimental Laboratories in the Natural Sciences Program”and Basic Research Programat Higher School of Economics University.
文摘Neutrophil extracellular traps(NET)have emerged as critical players in the pathogenesis of atherosclerosis and other cardiovascular diseases(CVD).These web-like structures,composed of DNA,histones,and granule proteins released by neutrophils,contribute significantly to both inflammation and thrombosis.This manuscript offers a comprehensive review of the recent literature on the involvement of NET in atherosclerosis,highlighting their interactions with various pathophysiological processes and their potential as biomarkers for CVD.Notably,the impact of radiation on NET formation is explored,emphasising how oxidative stress and inflammatory responses drive NET release,contributing to plaque instability.The role of histones,particularly citrullinated histones,in endothelial dysfunction and plaque progression is discussed,highlighting their significance in the pathophysiology of atherosclerosis.Furthermore,the complex relationship between lipoproteins and NET formation is examined,with a focus on how elevated low-density lipoprotein(LDL)and decreased high-density lipoprotein(HDL)levels facilitate NET release,thus promoting vascular inflammation and plaque instability.The influence of cholesterol on NET formation is also explored,underscoring its contribution to plaque development and stability.The role of Peptidylarginine deiminase 4(PAD4)in the regulation of NETosis is reviewed,with attention given to how PAD4-driven citrullination of histones affects atherosclerosis progression.Moreover,the manuscript examines the potential of NET components—such as double-stranded DNA,myeloperoxidase–DNA complexes,and citrullinated histone H3—as biomarkers for assessing disease severity and predicting adverse cardiovascular events,including ST-elevation myocardial infarction(STEMI)and stroke.Elevated levels of these biomarkers correlate with worse clinical outcomes,suggesting their utility in guiding therapeutic interventions.In contrast to the existing body of work,this review highlights the novelty of integrating recent findings on NET interactions with lipid metabolism,histone modifications,and PAD4 activity in the context of atherosclerosis.Overall,NET plays an integral role in the inflammatory and thrombotic processes underpinning atherosclerosis,and their components hold promise as both diagnostic markers and therapeutic targets in cardiovascular disease management.
文摘Gallstone disease(GD) is a chronic recurrent hepatobiliary disease,the basis for which is the impaired metabolism of cholesterol,bilirubin and bile acids,which is characterized by the formation of gallstones in the hepatic bile duct,common bile duct,or gallbladder.GD is one of the most prevalent gastrointestinal diseases with a substantial burden to health care systems.GD can result in serious outcomes,such as acute gallstone pancreatitis and gallbladder cancer.The epidemiology,pathogenesis and treatment of GD are discussed in this review.The prevalence of GD varies widely by region.The prevalence of gallstone disease has increased in recent years.This is connected with a change in lifestyle:reduction of motor activity,reduction of the physical load and changes to diets.One of the important benefits of early screening for gallstone disease is that ultrasonography can detect asymptomatic cases,which results in early treatment and the prevention of serious outcomes.The pathogenesis of GD is suggested to be multifactorial and probably develops from complex interactions between many genetic and environmental factors.It suggests that corticosteroids and oral contraceptives,which contain hormones related to steroid hormones,may be regarded as a model system of cholelithiasis development in man.The achievement in the study of the physiology of bile formation and the pathogenesis of GD has allowed expanding indications for therapeutic treatment of GD.
文摘Nearly half of the global population are carriers of Helicobacter pylori(H. pylori),a Gram-negative bacterium that persists in the healthy human stomach. H. pylori can be a pathogen and causes development of peptic ulcer disease in a certain state of the macroorganism. It is well established that H. pylori infection is the main cause of chronic gastritis and peptic ulcer disease(PUD). Decontamination of the gastric mucosa with various antibiotics leads to H. pylori elimination and longer remission in this disease. However,the reasons for repeated detection of H. pylori in recurrent PUD after its successful eradication remain unclear. The reason for the redetection of H. pylori in recurrent PUD can be either reinfection or ineffective anti-Helicobacter therapy. The administration of antibacterial drugs can lead not only to the emergence of resistant strains of microorganisms,but also contribute to the conversion of H. pylori into the resting(dormant) state. The dormant forms of H. pylori have been shown to play a potential role in the development of relapses of PUD. The paper discusses morphological H. pylori forms,such as S-shaped,C-shaped,U-shaped,and coccoid ones. The authors proposes the classification of H. pylori according to its morphological forms and viability.
基金Supported by the Beijing Municipal Science and Technology Plan,No.D141100000414002the National Natural Science Foundation of China,No.81272698,No.81672319,and No.81602507
文摘AIM To evaluate whether the neoadjuvant chemotherapy(NAc T)-surgery interval time significantly impacts the pathological complete response(pc R) rate and longterm survival.METHODS One hundred and seventy-six patients with gastric cancer undergoing NAc T and a planned gastrectomy at the chinese p LA General hospital were selected from January 2011 to January 2017. Univariate and multivariable analyses were used to investigate the impact of NAc T-surgery interval time(< 4 wk, 4-6 wk, and > 6 wk) on pc R rate and overall survival(OS).RESULTS The NAc T-surgery interval time and clinician T stage were independent predictors of pc R. The interval time > 6 wk was associated with a 74% higher odds of pc R as compared with an interval time of 4-6 wk(p = 0.044), while the odds ratio(OR) of clinical T3 vs clinical T4 stage for pc R was 2.90(95%c I: 1.04-8.01, p = 0.041). In cox regression analysis of long-term survival, postneoadjuvant therapy pathological N(yp N) stage significantly impacted OS(N0 vs N3: h R = 0.16, 95%c I: 0.37-0.70, p = 0.015; N1 vs N3: h R = 0.14, 95%c I: 0.02-0.81, p = 0.029) and disease-free survival(DFS)(N0 vs N3: h R = 0.11, 95%c I: 0.24-0.52, p = 0.005; N1 vs N3: h R = 0.17, 95%c I: 0.02-0.71, p = 0.020). The surgical procedure also had a positive impact on OS and DFS. The hazard ratio of distal gastrectomy vs total gastrectomy was 0.12(95%c I: 0.33-0.42, p = 0.001) for OS, and 0.13(95%c I: 0.36-0.44, p = 0.001) for DFS.CONCLUSION The NAc T-surgery interval time is associated with pc R but has no impact on survival, and an interval time > 6 wk has a relatively high odds of pc R.
基金Supported by Intern Grant Agency of the Czech Ministry of Health(IGA)No.NT 13673-4
文摘The incidence and prevalence of metabolic syndrome(MS) and colorectal cancer(CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions(adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same- obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian(Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.
文摘AIM To investigate the hepatitis C virus(HCV)infection in the tissues of carcinoma ofextrahepatic bile duct and study theircorrelation.METHODS HCV NS5 protein and HCV RNA weredetected by labeled streptavidin biotin(LSAB)method and in situ reverse transcriptionpolymerase chain reaction(IS-RT-PCR)insections of 51 cases of carcinoma ofextrahepatic bile duct and 34 cases of controlgroup(without malignant biliary disease).RESULTS In 51 cases of carcinoma ofextrahepatic bile duct,HCV NS5 protein wasdetected in 14(27.5%),which was clearlystained in the cytoplasm of cancer cell but not inthe nucleus or cell membrane.HCV RNA wasdetected in 18(35.4%),which was located inthe nucleus of cancer cell in 12 cases and in thecytoplasm in 6 cases.HCV NS5 protein and RNAcoexistence was found in 2 cases.In 34 cases ofcontrol group,HCV RNA was detected in 2(5.9%).HCV NS5 protein and RNA positive cellswere found either scattered or in clusters.CONCLUSION The prevalence of hepatitis C viral infection in the tissues of carcinoma ofextrahepatic bile duct was significantly higherthan in control group(X^2=9.808,P=0.002).The findings suggest a correlation between HCVinfection and carcinoma of extrahepatic bileduct,which is different from the traditionalviewpoint.HCV infection might be involved inthe development of carcinoma of extrahepaticbile duct.
基金supported by the National High Technology Research and Development Program of China(No.2014AA06A602)National Natural Science Foundation of China(No.41404111)Natural Science Foundation of Hunan Province(No.2015JJ3088)
文摘In deep mineral exploration, the acquisition of audio magnetotelluric （AMT） data is severely affected by ambient noise near the observation sites; This near-field noise restricts investigation depths. Mathematical morphological filtering （MMF） proved effective in suppressing large-scale strong and variably shaped noise, typically low-frequency noise, but can not deal with pulse noise of AMT data. We combine compressive sensing and MMF. First we use MMF to suppress the large-scale strong ambient noise; second, we use the improved orthogonal match pursuit （IOMP） algorithm to remove the residual pulse noise. To remove the noise and protect the useful AMT signal, a redundant dictionary that matches with spikes and is insensitive to the useful signal is designed. Synthetic and field data from the Luzong field suggest that the proposed method suppresses the near-source noise and preserves the signal well; thus, better results are obtained that improve the output of either MMF or IOMP.
文摘BACKGROUND:Laparoscopic cholecystectomy(LC)has become the'gold standard'in treating benign gallbladder diseases.Increasing laparoscopic experience and techniques have made laparoscopic subtotal cholecystectomy(LSC)a feasible option in more complex procedures.In recent years,few studies with a few cases of LSC have reported good results in patients with various types of cholecystitis.This study was designed to evaluate the feasibility,indications,characteristics and benefits of LSC in patients with complicated cholecystitis.METHODS:Altogether,3485 patients were scheduled to receive LC during the past 4 years at our institute.Among them,168 patients with various complicated forms of cholecystitis were treated by LSC.Meanwhile,the other 3317 patients who received standard LC were enrolled as the control group.Perioperative data from the two groups were collected and retrospectively analyzed.RESULTS:In the LSC group,135 patients suffered from acute calculic cholecystitis,18 from chronic calculic cholecystitis with cirrhotic portal hypertention,and 15 from chronic calculic atrophy cholecystitis with severe fibrosis.These patients constituted 4.8%of the total patients who underwent LC(168/3485)in the same period at our institute.In 122 patients,the cystic duct and artery were clipped before division.In another 46 patients,the gallbladder was initially incised at Hartmann's pouch.Five patients(3.0%)were converted to open subtotal cholecystectomy.The median operation time for LSC was 65.5±15.2 minutes,estimated operative blood loss was 71.5±15.5 ml,and the time to resume diet was 20.4±6.3 hours.Thirteen patients(7.7%)had local complications.The mean postoperative hospital stay was 4.2±2.6 days.In the LC group,2887 had chronic calculic cholecystitis,312had acute calculic cholecystitis,47 had chronic calculic atrophy cholecystitis,and 71 had polypus.Seventeen patients(0.5%)were converted to open cholecystectomy.The median operation time was 32.6±10.2 minutes,the estimated operative blood loss was 24.5±8.5 ml,and the time to resume diet was 18.3±4.5 hours.Thirty-nine patients(1.2%)had local complications.Mean postoperative hospital stay was 3.8±1.4 days.There was no bile duct injury or mortality in either group.CONCLUSIONS:LSC for patients with complicated cholecystitis is difficult,with a longer operation time,more operative blood loss and higher conversion and complication rates than LC.However,it is feasible and relatively safe.LSC is advantageous over open surgery,but it remains a non-routine choice.It is important to know the technical characteristics of LSC,and pay attention to perioperative bleeding and bile leak.
文摘This review considers the physiological and molecular biochemical mechanisms of bile formation.The composition of bile and structure of a bile canaliculus,biosynthesis and conjugation of bile acids,bile phospholipids,formation of bile micellar structures,and enterohepatic circulation of bile acids are described.In general,the review focuses on the molecular physiology of the transporting systems of the hepatocyte sinusoidal and apical membranes.Knowledge of physiological and biochemical basis of bile formation has implications for understanding the mechanisms of development of pathological processes,associated with diseases of the liver and biliary tract.
基金Supported Dy the Affiliated Hospital of Qindao University Medial College Doctoral Foundation, No. 2003-6
文摘AIM. To investigate IL-1β＋3 594 in the 5^th intron, IL-10-1 082 and CD14-159 polymorphisms in patients with acute pancreatitis （AP） and septic shock.METHODS： The study induded 215 patients （109 with acute severe pancreatitis （SAP）, 106 with acute mild pancreatitis （MAP）） and 116 healthy volunteers. Genomic DNA was prepared from peripheral blood leukocytes. Genotypes and allele frequencies were determined in patients and healthy controls using restriction fragment length polymorphism analysis of PCR products.RESULTS： The frequencies of IL-β＋3 594T, IL-10-1082G and CD14-159T allele were similar in patients with mild or severe pancreatitis and in controls. Within SAP patients, no significant differences were found in the allele distribution examined when etiology was studied again. Patients with septic shock showed a significantly higher prevalence of IL-10-1082G allele than those without shock （X^2 = 5.921,P= 0.015）.CONCLUSION： IL-10-1082G plays an important role in the susceptibility of SAP patients to septic shock. Genetic factors are not important in determination of disease severity or susceptibility to AP.
文摘Primary biliary cirrhosis (PBC) is an organ-specific autoimmune disease that predominantly affects women and is characterized by chronic, progressive destruction of small intrahepatic bile ducts with portal inflammation and ultimately fibrosis, leading to liver failure in the absence of treatment. Little is known about the etiology of PBC. PBC is characterized by anti-mitochondrial antibodies and destruction of intrahepatic bile ducts. The serologic hallmark of PBC is the presence of auto-antibodies to mitochondria, especially to the E2 component of the pyruvate dehydrogenase complex (PDC). Current theories on the pathogenesis of PBC favor the hypothesis that the disease develops as a result of an inappropriate immune response following stimulation by an environmental or infectious agent. Some reports suggest that xenobiotics and viral infections may induce PBC. The pathogenetic mechanism is believed to be caused by a defect in immunologic tolerance, resulting in the activation and expansion of self-antigen specific T and B lymphocyte clones and the production of circulating autoantibodies in addition to a myriad of cytokines and other inflammatory mediators. This leads to ductulopenia and persistent cholestasis, by developing end-stage hepatic-cell failure. In this review are given our own and literary data about mechanisms of development of intrahepatic cholestasis and possible ways of its correction.
文摘BACKGROUND Open abdomen(OA) has been generally accepted for its magnificent superiority and effectiveness in patients with severe trauma, severe intra-abdominal infection, and abdominal compartment syndrome. In the meantime, OA calls for a mass of nursing and the subsequent enteroatomospheric fistula(EAF), which is one of the most common complications of OA therapy, remains a thorny challenge.CASE SUMMARY Our team applied thermoplastic polyurethane as a befitting material for producing a 3 D-printed "fistula stent" in the management of an EAF patient,who was initially admitted to local hospital because of abdominal pain and distension and diagnosed with bowel obstruction. After a series of operations and OA therapy, the patient developed an EAF.CONCLUSION Application of this novel "fistula stent" resulted in a drastic reduction in the amount of lost enteric effluent and greatly accelerated rehabilitation processes.
基金Supported by The Intern Grant Agency of the Czech Ministry of Health(IGA),No.NT 13673-4
文摘Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily increasing.This trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screening programs across Europe have experienced considerable improvements(fecal occult blood testing;transition from opportunistic to population based program settings).The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality rates.Each year,approximately 8000 people are diagnosed with CRC and some 4000 die from this malignancy.Twenty years ago,the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal Cancer Screening Program in 2000.Originally,this program was based on the guaiac fecal occult blood test(FOBT)offered by general practitioners,followed by colonoscopy in cases of FOBT positivity.The program has continuously evolved,namely with the implementation of immunochemical FOBTs and screening colonoscopy,as well as the involvement of gynecologists.Since the establishment of the Czech CRC Screening Registry in 2006,2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening program.The overall program expanded to cover 25.0%of the target population by 2011.However,stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation,which is currently being prepared.
基金Supported by National Natural Science Foundation of China, No. 30571797National Natural Science Foundation of Jiangsu Province, No. BK2006719
文摘AIM： To explore the effects of recombinant human growth hormone （rhGH） on intestinal mucosal epithelial cell proliferation and nutritional status in patients with enterocutaneous fistula. METHODS： Eight patients with enterocutaneous fistulas received recombinant human growth hormone （10 ug/d） for 7 d. Image analysis and immunohistochemical techniques were used to analyse the expression of proliferating cell nuclear antigen （PCNA） in intestinal mucosal epithelial cells in biopsy samples from the patients who had undergone an endoscopic biopsy through the fistula at day 0, 4 and 7. Body weights, nitrogen excretion, serum levels of total proteins, albumin, prealbumin, transferrin and fibronectin were measured at day 0, 4 and 7. RESULTS： Significant improvements occurred in the expression of PCNA in the intestinal mucosal epithelial cells at day 4 and 7 compared to day 0 （24.93 ± 3.41%, 30.46 ± 5.24% vs 12.92 ± 4.20%, p 〈 0.01）. These changes were accompanied by the significant improvement of villus height （500.54 ± 53.79 um, 459.03 ± 88.98um vs 210.94 ± 49.16 um, P 〈 0.01）, serum levels of total proteins （70.52 ± 5.13 g/L, 74.89 ± 5.16 g/L vs 63.51 ± 2.47 g/L, P 〈 0.01）, albumin （39.44 ± 1.18 g/L, 42.39 ± 1.68 g/L vs 35.74 ± 1.75 g/L, P 〈 0.01） and fibronectin （236.3 4- 16.5 mg/L, 275.8± 16.9 mg/L vs 172.5 ± 21.4 mg/L, P 〈 0.01） at day 4 and 7, and prealbumin （286.38 ± 65.61 mg/L vs 180.88 ± 48.28 mg/L, P 〈 0.05）, transferrin （2.61 ± 0.12 g/L vs 2.41 ±0.14 g/L, P 〈 0.05） at day 7. Nitrogen excretion was significantly decreased at day 7 （3.40 ± 1.65 g/d vs 7.25 ± 3.92 g/d, P 〈 0.05）. No change was observed in the body weight. CONCLUSION： Recombinant human growth hormone could promote intestinal mucosal epithelial cell proliferation and protein synthesis in patients with enterocutaneous fistula.
基金Project supported by the European Social Fund(ESF)(BG051PO001-3.3.06-0050)
文摘The effect of the addition of small amounts of rare earths （Ln=La, Ce, Nd and Gd） to alumina supported copper-cobalt spinel oxide on the catalysts efficiency in CO and CH4 oxidation and in NO decomposition was investigated. Samples of Ln/CuCo/AI catalyst were prepared and characterized by X-ray diffraction （XRD）, X-ray photoelectron spectroscopy （XPS）, atomic absorption spectroscopy （AAS）, scanning electron mieroscopy-energy dispersive spectroscopy （SEM-EDS）, H2-temperature-programmed reduc- tion （H2-TPR）, electron paramagnetic resonanee （EPR） spectroscopy and low temperature nitrogen adsorption, The results showed that the addition of rare earths changed the surface state of the alumina supported copper-cobalt spinel catalyst. As a result, partial re- duction of copper species was observed as well as migration of these species between the surface and the bulk. The Ln/CuCo/A1 catalysts behaved differently in oxidation and reduction processes. In oxidation processes where oxide structure was important, Ce/CuCo/A1 and Nd/CuCo/A1 were the most active catalysts. The catalyst Ce/CuCo/AI was the most active in the oxidation reactions because of the availability and favorable surface distribution of the redox couples Cu＋/Cu2＋ and Ce3＋/Ce4＋. In NO decompostion, Ln-modified catalysts significantly improved the selectivity of the process to N2.
基金Supported by National Natural Science Foundation of China,No.81770532Jiangsu Province Medical Foundation for Youth Talents,China,No.QNRC2016901.
文摘BACKGROUND Acute mesenteric venous thrombosis(AMVT)can cause a poor prognosis.Prompt transcatheter thrombolysis(TT)can achieve early mesenteric revascularization.However,irreversible intestinal ischemia still occurs and the mechanism is still unclear.AIM To evaluate the clinical outcomes of and to identify predictive factors for irreversible intestinal ischemia requiring surgical resection in AMVT patients treated by TT.METHODS The records of consecutive patients with AMVT treated by TT from January 2010 to October 2017 were retrospectively analyzed.We compared patients who required resection of irreversible intestinal ischemia to patients who did not require.RESULTS Among 58 patients,prompt TT was carried out 28.5 h after admission.A total of 42(72.4%)patients underwent arteriovenous combined thrombolysis,and 16(27.6%)underwent arterial thrombolysis alone.The overall 30-d mortality rate was 8.6%.Irreversible intestinal ischemia was indicated in 32(55.2%)patients,who had a higher 30-d mortality and a longer in-hospital stay than patients without resection.The significant independent predictors of irreversible intestinal ischemia were Acute Physiology and Chronic Health Evaluation(APACHE)II score(odds ratio=2.368,95% confidence interval:1.047-5.357,P=0.038)and leukocytosis(odds ratio=2.058,95% confidence interval:1.085-3.903,P=0.027).Using the receiver operating characteristic curve,the cutoff values of the APACHE II score and leukocytosis for predicting the onset of irreversible intestinal ischemia were calculated to be 8.5 and 12×10^9/L,respectively.CONCLUSION Prompt TT could achieve a favorable outcome in AMVT patients.High APACHE II score and leukocytosis can significantly predict the occurrence of irreversible intestinal ischemia.Therefore,close monitoring of these factors may help with the early identification of patients with irreversible intestinal ischemia,in whom ultimately surgical resection is required,before the initiation of TT.
