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Objective To investigate the value of SpyGlass single-operator choledochoscopy system in the diagnosis and treatment of patients with unexplained biliary stricture, complex bile duct stones, or other biliary tract diseases. Methods A retrospective analysis was performed for the clinical data of the patients with biliary tract diseases who were diagnosed and treated with SpyGlass in The Second Affiliated Hospital of Nanjing Medical University from December 2017 to June 2020. For the patients with biliary stricture, the biliary lesions were fully visualized under the guidance of SpyGlass, and SpyBite biopsy was performed if necessary; the patients with bile duct stones were treated with SpyGlass-guided direct-view laser lithotripsy; for the patients with gallbladder disease, the cystic duct was superselected with the assistance of SpyGlass. The SpyGlass system was analyzed in terms of its sensitivity, specificity, and accuracy rate in diagnosis and treatment, lithotripsy success rate, stone clearance rate, procedure success rate, and incidence rate of complications. Results A total of 58 patients underwent SpyGlass procedure. SpyGlass was used to evaluate biliary stricture of unknown nature in 44 (76%) patients; SpyGlass visual impression had a diagnostic sensitivity of 92% (24/26), a specificity of 94% (17/18), and an accuracy of 93% (41/44), and SpyBite biopsy had a diagnostic sensitivity of 71% (15/21), a specificity of 92% (11/12), and an accuracy of 79% (26/33). SpyGlass was used for the treatment of bile duct stones in 8 patients (14%), with a lithotripsy success rate of 83% (5/6) and a stone clearance rate of 88% (7/8). A guide wire under the SpyGlass system was to superselect the cystic duct in 5 patients (9%), with a procedure success rate of 80% (4/5). In one patient (1%), SpyGlass was used to assist the removal of common bile duct stones after liver transplantation and the treatment of bile duct anastomotic stricture. A total of 5 patients (9%) experienced complications after surgery. Conclusion The SpyGlass choledochoscopy system is accurate, safe, and effective in the diagnosis and treatment of unexplained biliary stricture, complex bile duct stones, and other biliary tract diseases.
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Objective To investigate the value of SpyGlass single-operator choledochoscopy system in the diagnosis and treatment of patients with unexplained biliary stricture, complex bile duct stones, or other biliary tract diseases. Methods A retrospective analysis was performed for the clinical data of the patients with biliary tract diseases who were diagnosed and treated with SpyGlass in The Second Affiliated Hospital of Nanjing Medical University from December 2017 to June 2020. For the patients with biliary stricture, the biliary lesions were fully visualized under the guidance of SpyGlass, and SpyBite biopsy was performed if necessary; the patients with bile duct stones were treated with SpyGlass-guided direct-view laser lithotripsy; for the patients with gallbladder disease, the cystic duct was superselected with the assistance of SpyGlass. The SpyGlass system was analyzed in terms of its sensitivity, specificity, and accuracy rate in diagnosis and treatment, lithotripsy success rate, stone clearance rate, procedure success rate, and incidence rate of complications. Results A total of 58 patients underwent SpyGlass procedure. SpyGlass was used to evaluate biliary stricture of unknown nature in 44 (76%) patients; SpyGlass visual impression had a diagnostic sensitivity of 92% (24/26), a specificity of 94% (17/18), and an accuracy of 93% (41/44), and SpyBite biopsy had a diagnostic sensitivity of 71% (15/21), a specificity of 92% (11/12), and an accuracy of 79% (26/33). SpyGlass was used for the treatment of bile duct stones in 8 patients (14%), with a lithotripsy success rate of 83% (5/6) and a stone clearance rate of 88% (7/8). A guide wire under the SpyGlass system was to superselect the cystic duct in 5 patients (9%), with a procedure success rate of 80% (4/5). In one patient (1%), SpyGlass was used to assist the removal of common bile duct stones after liver transplantation and the treatment of bile duct anastomotic stricture. A total of 5 patients (9%) experienced complications after surgery. Conclusion The SpyGlass choledochoscopy system is accurate, safe, and effective in the diagnosis and treatment of unexplained biliary stricture, complex bile duct stones, and other biliary tract diseases.
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Objective: To investigate the relationship between serum level of Apelin-13 and bone mineral density [BMD] as well as other parameters, and determine the influence of Apelin-13 on osteoporosis in patients with Type-2 diabetes mellitus
Methods: Seventy-six patients with Type-2 diabetes mellitus were recruited from Department of Endocrinology of our hospital between January 2013 and July 2017. The clinical data, including age, gender, height, weight, body mass index [BMI] and disease duration were recorded for all patients. Blood sample was collected for measurement of Apelin-13, Procollagen type-I N propeptide [PINP] and Cross-linked carboxy terminal telopeptide of type-I collagen [ICTP], and BMD was tested with a dual-energy X-ray absorptiometry scanner
Results: The patients were divided into three groups, in which 19 patients were assigned in osteoporosis group, 25 in osteopenia group and 32 in normal group. The level of Apelin-13 in osteoporosis group was significantly lower than that in osteopenia and normal groups [p<0.05], and the value in osteopenia group was significant lower than that in normal group [p<0.05]. Correlation analysis showed in the included patients the level of Apelin-13 was positively correlated to the value of BMD and PINP [p<0.05], but negatively correlated to age and ICTP [p<0.05]
Conclusion: In conclusion, this study demonstrated that there was a close relationship among Apelin-13, BMD, ICTP and PINP, and Apelin-13 plays an important role in the occurrence of osteoporosis in patients with Type-2 diabetes mellitus
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Humans , Male , Female , Adult , Middle Aged , Diabetes Mellitus, Type 2 , Osteoporosis , Bone Density , Intercellular Signaling Peptides and ProteinsABSTRACT
Multiple sclerosis ( MS) is an autoimmune disease of the central nervous system ( CNS) characterized by demyelination and inflammation lesions.MS predominantly affects young adults with a high incidence of disability. However, the exact pathogenesis of MS is still not clear.Studies found that microglia polarization tending to pro-inflammatory M1-like state during the onset of MS, causing the M1/M2 ratio imbalance, forming pro-inflammatory microenvironment state, and which further leading to nervous tissue damage ultimately.Microglia polarization may be considered as the initiator of pathologic alterations by releasing pro-inflammatory cytokines and secondarily trigger the initial microglia response.Given the pivotal role of imbalanced microglia polarization in MS initiation, a critical review of microglia polarization is presented here, in order to elucidate the pathogenesis of MS and highlight the noteworthy candidate therapeutic targets for clinic treatment.
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Generally,the pathological changes of multiple sclerosis(MS) is mostly on lesion of the central white matter (WM). However,the clinical symptoms such as cognitive impairment cannot be fully explained just by the WM damage. Therefore, central gray matter(GM)damage has attracted more attention. The development of magnetic resonance imaging(MRI)makes in vivo detection of GM while showing the clinical symptoms possible. Yet,the correlation between the patient clinical symptoms and GM dam?age particularly in cortex still need to be elucidated. Hence,we summarize the historical background and give an overview of the corre?lation between GM damage and MS clinical symptoms in terms of cognitive impairment and epilepsy.
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The pathogenesis of multiple sclerosis ( MS) involves alterations to multiple pathways and processes, which represent a significant challenge for developing more-effective therapies.In MS, abnormalities have been identified in several cytokine-signaling pathways, as well as those of other immune receptors.Among the downstream molecules implicated are Jak/Stat, NF-κb, ERK1/2, p38 or Jun/Fos, current MS drugs target some of these pathways.This article will with the aid of the latest research results of systems biology approaches that study pathway dysregulation in the process of MS development, targeting these relevant MS-signaling pathways, offers the opportunity to accelerate the development of novel individual or combination therapies for the future of new drug research.
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Objective To discuss the feasibility of establishing the model of combining myocardial ischemic coronary disease with syndrome of kidney deficiency and blood stasis by surgical method.Methods Non-disease of kidney deficiency and blood stasis syndrome model was built by taking the methods of fright, being placed in a cold environment and injection of hydrocortisone. The model of combining the myocardial ischemic coronary disease with the syndrome of kidney deficiency and blood stasis was established through ligating the left anterior descending branch of artery and injecting hydrocortisone. The rats were divided into kidney deficiency and blood stasis group, combination of disease and syndrome group, and normal group, 5 rats in each group. The temperature, weight, heart rate, breathing rate and whole blood viscosity, casson viscosity of the rats in the two groups before and after modeling were observed. According to TCM clinical diagnosis criteria of kidney deficiency and blood stasis syndrome, TCM syndrome characteristics of the two groups were compared.ResultsCompared with normal groups and before modeling, rat temperature dropped and breathing rate increased in kidney deficiency and blood stasis group, combination of disease and syndrome group (P<0.05). Compared with normal group, rat weight decreased or grew slowly, and whole blood viscosity and casson viscosity increased (P<0.05, P<0.01). There were statistical significant differences in whole blood viscosity and electrocardiogram between the two groups (P<0.05).Conclusion There is no obvious difference between TCM syndrome characteristics of the two groups. They all meet the TCM clinical diagnosis criteria of kidney deficiency and blood stasis syndrome.
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Microglia are the inherent macrophages and immune surveillance cells in the central nervous system (CNS) and compose the first guard of immune defense in CNS .The activation of microglia is one of the pathological features of many CNS diseases and acts as an important role during the multiple sclerosis (MS) process.MS is a CNS disease characterized by neuroinflammatory infiltration , demyelination and axonal damage.Accumulation of activated microglia at the injury site has been observed in brains of MS patients and experimental animals with complicated mechanisms.Microglia have both detrimental and beneficial roles .For instance, microglia have been shown to recruit and reactivate T cells in the CNS and release many detrimental molecules such as proteases , inflammatory cytokines, and free radicals.Conversely, they have also been observed to aid in axonal regeneration and remyelination as well as assist in the clearance of inhibitory myelin debris .In addition, microglia have been shown to release a variety of neurotrophic factors . Cuprizone [oxalic acid bis (cyclohexylidene hydrazide )] is a well-known copper-chelating agent.Cuprizone ingestion in mice induces a highly reproducible demyelination of distinct brain regions .Discussion on the detrimental and beneficial aspects of microglia in cuprizone animal models will serve to better understand the development of MS and find out new therapeutic targets.This review will further our understanding of the dichotomous roles of microglia in cuprizone -induced demyelination in animal models of multiple sclerosis .
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<p><b>OBJECTIVE</b>To explore the suitable level and action time of 17-beta estradiol and fluid shear stress (FSS) and their combined effect on the proliferation of rat osteoblasts in vitro.</p><p><b>METHODS</b>MC3T3-E1 osteoblasts were adopted after subcultured and different concentrations of 17-beta estradiol and FSS values were applied respectively on MC3T3-E1, the suitable level of 17-beta estradiol and FSS were selected through MTT and alkaline phosphatase (ALP). Then the two factors at the suitable level were applied simultaneously to MC3T3-E1 to detect the proliferation activity.</p><p><b>RESULTS</b>Seventeen-beta estradiol(10(-8) mol x L(-1) for 5 d and 12 x 10(-5) N FSS for 60 min exhibited better effects on the proliferation activity than the other groups respectively, and the combined effect of both factors was better than any single-factor treated group.</p><p><b>CONCLUSION</b>Both 17-beta estradiol and FSS have a suitable threshold in promoting proliferation of osteoblasts, and two-factor treated group exhibits better effect than any other single-factor treated groups. Therefore 17-beta estradiol and FSS have a synergetic action on differentiation and proliferation of osteoblasts.</p>
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Animals , Rats , Alkaline Phosphatase , Cell Differentiation , Estradiol , Osteoblasts , Stress, MechanicalABSTRACT
Statins not only can help lower cholesterol,but also has certain effect for the treatment of malignant tumor.Its possible antitumor mechanisms include inducing apoptosis and differentiation,inhibiting tumor cell proliferation,reducing the invasion and metastasis of tumor cells,combined sensitization and chemical prevention effect.
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The genesis of malignant tumor is proved to be mainly caused by regulatory disturbance of cell cycle,in which p27 protein and cyclin D1 protein are major regulators.Cyclin D1 and p27 are positive andnegative regulator respeetively.Recently,redueed expression of p27 protein and overexpression of cyclinD1 pro-tein are found in various eaacers.It has been demonstrated that p27and cyelinD1 are closely associated with the genesis and development of many cancers.Cell cycle and its regulatory has become the focus in tumor research.
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Objective To investigate the effect of chemotherapy drugs on the expression of carci-noembryonic antigen (CEA) in the gastric tissue with precancerous lesions in ectopie cancer. Methods There were 45 cases of cancer patients (precancerous lesions group), the pathological biopsy showed that there were atypical hyperplasia or intestinal metaplasia by gastroscope before chemotherapy. Gastruscope was done before chemotherapy and after six cycles of chemotherapy. Gastric tissue was taken respectively in the same site. The expression of CEA was measured in the gastric tissue. Normal gastric tissue taken from 10 cases of cancer patients was served as control. Compared respectively the expression of CEA in the gastric tissue in control group and precancerous lesions group, in precancerous lesions group between before and after treatment. Results CEA expression in the gastric tissue was (27.76±9.67), (3.32±0.60)μg/L in precancerous lesions group and control group respectively, there was significant difference between two groups(P<0.05). CEA expression in the gastric tissue was (27.76±9.67), (26.60±10.80)μg/L before and after treatment in precancerous lesions group respectively, P<0.05. CEA expression in the gastric tissue before treatment was (23.11±4.11), (17.10±1.66)μg/L, after treatment was (21.11±5.66), (15.10±3.31)μg/L in the mild to moderate atypical hyperplasia, mild to moderate intestinal metaplasia respectively, there was significant difference between before and after treatment in the mild to moderate precancerous lesions. There was no significant difference between before and after treatment in the severe precancerous lesions. Conclusions Chemotherapy drugs can significantly reduce the expression of CEA in the gastric tis-sue in the mild to moderate precancerous lesions. The results suggests that mild to moderate precancerous lesions can be reversed.
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G-protein-coupled receptors (GPCRs) are major targets for drug discovery. The regulator of G-protein signaling (RGS) proteins is a recently identified protein family,which strongly modulates the activity of G proteins. RGS proteins accelerate the deactivation of G proteins to reduce GPCR signaling; however, some also have an effector function and transmit signals. Combining GPCR agonists with RGS inhibitors should potentiate responses and markedly increase the regional specificity of agonist. In the central nervous system, RGS proteins have unique tissue distributions and are strongly regulated by signal transduction events. Thus the diversity of RGS makes them attractive targets for pharmacotherapy of neurological disorders.