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Objective:To explore whether the regular feedback system in opportunistic screening of colorectal cancer can improve the adenoma detection rate (ADR) of endoscopists.Methods:This study was an observational study, divided into three stages: the baseline stage before intervention (the pre-intervention period), the regular feedback stage (the intervention period) and the post-intervention stage (the post-intervention period). In the pre-intervention period, all patients who underwent opportunistic screening of colorectal cancer in Department of Gastroenterology in Beijing Shijitan Hospital Affiliated to Capital Medical University from June 2017 to May 2018 were reviewed, and the ADR of each endoscopist was calculated. In the intervention period from June 2018 to November 2018, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist during the previous month was calculated at the beginning of each month and feedback was provided in the form of a report. In the post-intervention period from December 2018 to January 2019, colonoscopies were performed on patients for opportunistic screening of colorectal cancer by endoscopists who participated in the feedback. The ADR of each endoscopist was calculated after the feedback stopped. ADR and polyp detection rate (PDR) of three stages were compared.Results:A total of 1 768, 1 308 and 344 patients were enrolled for opportunistic screening of colorectal cancer during the pre-intervention, the intervention and the post-intervention period respectively. Eight endoscopists participated in the whole process of this study. The total ADR increased from 23.70% (419/1 768) in the pre-intervention period to 33.72% (441/1 308) in the intervention period ( χ2=37.449, P<0.05). Two months after intervention, ADR decreased slightly to 33.14% (114/344), but was still higher compared with before ( χ2=13.602, P<0.05). The total PDR increased from 47.17% (834/1 768) in the pre-intervention period to 52.68% (689/1 308) in the intervention period ( χ2=9.111, P<0.05). Two months after the intervention, PDR increased slightly to 53.78% (185/344), and still higher compared with before ( χ2=5.035, P<0.05). Conclusion:Regular feedback to endoscopists can improve ADR in opportunistic screening of colorectal cancer.
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Endothelial progenitor cells (EPCs) play an important role in diabetic vascular complications. A large number of studies have revealed that some clinical antihyperglycemics can improve the complications of diabetes by regulating the function of EPCs. Metformin can improve EPCs function in diabetic patients by regulating oxidative stress level or downstream signaling pathway of adenosine monophosphate activated protein kinase; Pioglitazone can delay the aging of EPCs by regulating telomerase activity; acarbose, sitagliptin and insulin can promote the proliferation, migration and adhesion of EPCs. In addition to lowering blood glucose, the effects of antihyperglycemics on EPCs may also be one of the mechanisms to improve the complications of diabetes. This article reviews the research progress on the regulation of EPC proliferation and function by antihyperglycemics.
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Humans , Cell Movement/drug effects , Cells, Cultured , Endothelial Progenitor Cells/drug effects , Hypoglycemic Agents/pharmacology , Signal Transduction/drug effectsABSTRACT
OBJECTIVE@#To investigate the effect of SRC kinase inhibitor PP2 on the invasion and metastasis of lung cancer A549 cells and explore its molecular mechanism.@*METHODS@#MTT assay was used to evaluate the inhibitory effect of PP2 on the proliferation of A549 cells. Cell scratch and Transwell assays were performed to assess the invasion and metastatic capacity of A549 cells after treatment with 1, 2, 4, 8, and 16 μmol/L PP2 for 24 h. Western blotting was used to detect the expressions of connexin43 (Cx43) and MMP-2 in the cells after small interfering RNA (siRNA)-mediated silencing or overexpression of Cx43; the changes in the cell invasion and metastasis in response to PP2 treatment after Cx43 silencing or overexpression were investigated.@*RESULTS@#MTT assay showed that treatment with PP2 at 2, 4, 8, 16, and 32 μmol/L significantly inhibited the proliferation of A549 cells in a concentration-dependent manner. Treatments with PP2 at 1, 2, 4, 8, and 16 μmol/L for 24 h also concentration-dependently lowered the invasion and metastatic abilities of the cells ( < 0.05). At 4 and 8 μmol/L, PP2 significantly increased the expression level of Cx43 protein and decreased the expression level of MMP-2 protein. Overexpression of Cx43 significantly enhanced the inhibitory effect of PP2 on the cell invasion and metastasis, and Cx43 silencing significantly attenuated the inhibitory effect of PP2 ( < 0.05).@*CONCLUSIONS@#PP2 treatment can suppress the invasion and metastasis of A549 cells possibly by modulating the expression of Cx43.
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Humans , A549 Cells , Cell Line, Tumor , Cell Movement , Cell Proliferation , Connexin 43 , Lung Neoplasms , Neoplasm Invasiveness , Protein Kinase Inhibitors , src-Family KinasesABSTRACT
Objective To investigate the effect of comprehensive internal medical treatment including gastric endoscopy on patients with bezoar. Methods From 2010 to 2016,a retrospective study was conducted on fifty?two patients admitted to Beijing Shijitan Hospital, Capital Medical University. Results The main accompanying diseases were hypertension,coronary heart disease,diabetes mellitus and so on. Food that are easy to induce bezoar : banana, persimmon, hawthorn, chestnut, etc. The treatment included endoscopic treatment, intravenous proton pump suppression, and oral Coca?Cola and bicarbonate solution. The bezoar in two patients after 3 weeks of medical treatment were still not dissolved,finally surgery were performed. One patient's pathology showed early cardiac adenocarcinoma. Five patients had incomplete intestinal obstruction, after fasting and gastrointestinal decompression, and the bezoars were excreted through feces. All patients were cured without death. Conclusion Gastroscopy is a timely treatment that can help diagnose and treat gastric bezoar. The main predisposing factors include hypertension, coronary heart disease, diabetes mellitus and so on. Endoscopic treatment,intravenous proton pump inhibitor,sodium bicarbonate and Coca?Cola could dissolve most bezoar. We should be alert to the possibility of early cancer.
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Objective To investigate the value of NICE classification on real-time diagnosis for neoplastic and non-neoplastic colorectal polyps. Methods The histological type of 107 polypoid lesions from 50 patients detected by colonoscopy was predicted by 4 endoscopic physicians using NICE classification, including 1 chief physician, 2 associate chief physician, and 1 attending physician. Taking pathological result as gold standard, the real-time diagnostic accuracy of NICE classification for neoplastic colorectal polyps was evaluated, and the differences of diagnostic accuracy between the 4 endoscopic physicians were compared. Results Among the 107 polypoid lesions, 49 were neoplastic polyps and 58 were non-neoplastic polyps. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification on determination of the histological type of polyps were 81. 6% (40/49), 70. 0% (40/58), 74. 8% ( 80/107) , 70. 0%( 40/58) , and 81. 6%( 40/49) , respectively. There was no statistical difference on the prediction ability between the 4 physicians using NICE classification. Conclusion NICE classification is a feasible method for real-time prediction of histology type of colorectal polyps, and it is undemanding to the qualifications of physicians.
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Objective To investigate the value of NICE classification on real-time diagnosis for neoplastic and non-neoplastic colorectal polyps. Methods The histological type of 107 polypoid lesions from 50 patients detected by colonoscopy was predicted by 4 endoscopic physicians using NICE classification, including 1 chief physician, 2 associate chief physician, and 1 attending physician. Taking pathological result as gold standard, the real-time diagnostic accuracy of NICE classification for neoplastic colorectal polyps was evaluated, and the differences of diagnostic accuracy between the 4 endoscopic physicians were compared. Results Among the 107 polypoid lesions, 49 were neoplastic polyps and 58 were non-neoplastic polyps. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NICE classification on determination of the histological type of polyps were 81. 6% (40/49), 70. 0% (40/58), 74. 8% ( 80/107) , 70. 0%( 40/58) , and 81. 6%( 40/49) , respectively. There was no statistical difference on the prediction ability between the 4 physicians using NICE classification. Conclusion NICE classification is a feasible method for real-time prediction of histology type of colorectal polyps, and it is undemanding to the qualifications of physicians.
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Objective To analyze the clinical and endoscopic characteristics of fundic gland polyps (FGPs).Methods A case-control study was carried out at the Afifliated Beijing Shijitan Hospital of Capital Medical University from 2008 to 2015. The patients who accepted an upper endoscopy and found the gastric polyps for the ifrst time (diagnosed by pathology) were included in the study. Then, we analyzed the clinic and pathological characteristics of FGPs and non-FGPs.Results During the study period, 867 patients were enrolled, and 319 (36.8%) patients had FGPs. Compared the cases with the controls, the size of FGPs was smaller, an average is (0.40 ± 0.15) cm, single accounted for 67.7%, and 88.1% of FGPs were located at fundus and body. Helicobacter pylori infection of the cases detected was found in 6.1%, less than non-FGPs. There were statistically signiifcant differences observed in these aspects. From 2008 to 2015, the proportion of FGPs in gastric polyps and the detection rate of FGPs are both gradually elevated.Conclusions FGPs are the common gastric polyps, and its detection rate is gradually elevated. Most of the FGPs are mainly located at fundus and body, and single. Helicobacter pylori infection detected in the patients who have FGPs is rare.
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Objectives To investigate the clinical, pathological and endoscopic characteristics of colorectal polyps treated by endoscopic mucosal resection (EMR), then evaluate its therapeutic effect and security, and analyze its significance in diagnosis and treatment. Methods Clinical and pathological data of 437 patients (687 lesions), who underwent EMR from August, 2014 to August, 2015 were collected. A retrospective analysis was made, and lesions were statistically analyzed by variables such as age, sex, endoscopic features and clinical and pathological characteristics, and so on, according to the group procedure of adenoma cancerization and 'high risk adenomas - low risk adenomas - non-adenoma polyps' to observe the curative effect and safety on EMR. Results 48.28% of the patients who received colonoscopy examines were detected with polyps, and 34.90% of them were operated EMR, including advanced adenomas, which were 17.08% of the total quantity. From non-adenoma to advanced adenoma, with a increasing possibility of carcinogenesis, the location of polyps are transferred from proximal colon to distal colon and lesions are readily to be pedunculated ones with a higher level of mucosal lobulation and other kinds of mucosal changing. The degeneration of the colorectum is associated with pedunculated polyps, distal colorectal polyps, the size (>1.0 cm), adenomas containing villous structures and mucosal lobulation. As for EMR treatment, the en bloc resection rate can reach as high as 99.70%, with a complication rate of 1.14%. Conclusions Some special characteristics can be found in the site and the endoscopic feature of advanced adenomas and degenerated adenomas. To polyps sizing in 0.5 ~ 3.0 cm, EMR with endoclips has a remarkable effect and a low complication incidence. It can reduce the process of colorectal adenoma degenerates to multiple colorectal adenocarcinoma, which can be regarded as an effective method to prevent and cure the colorectal carcinoma.
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Aim To study the inhibitory effect of isoquercitrin on Raf/MEK/ERK signaling pathway in HepG2 cells.Methods MTT was used to detect the proliferation of human liver cancer HepG2 cells after the treatment of isoquercitrin.The morphology and growth of cells were observed under inverted microscope after the different concentrations of isoquercitrin(0, 40, 80, 160, 320 μmol·L-1) to treat HepG2 cells for 24 and 48 h.Cell cycle was assessed by flow cytometry.Ras, Raf, MEK, ERK expression was assayed by Western blot, and mRNA expression was detected by quantitative fluorescence PCR.Results Isoquercitrin could inhibit the growth of HepG2 cells in a concentration-and time-dependent manner.Typical morphological changes of apoptosis were observed by inverted microscopy after HepG2 cells were treated with different concentrations of of isoquercitrin for 24 h or 48 h.The cell cycle assay showed that with the increasing concentration of isoquerditrin, the number of cells that was arrested in G1 phase gradually increased.Compared with the blank group, the expressions of Ras, Raf, MEK, ERK mRNA were down-regulated, and related proteins expression were also down-regulated(P<0.05), and these results had statistical significance.Conclusion Isoquercitrin can induce the apoptosis of HepG2 cells, which may be related to the Raf/MEK/ERK signaling pathway.
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Objective To investigate the influence of isoquercitrin on the inflammatory factors in LPS-induced RAW264.7 cells.Methods MTT method was used to detect inhibition ratio of RAW264.7 cells induced by isoquercitrin.The level of TNF-α in culture medium was measured by ELISA.Nitric oxide (NO) was detected by Nitrate Assay Kit.Western blotting was used to investigate the influence on the productions of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2).Results The half inhibitory concentration (IC50) of isoquercitrin was 65.73 μmol·L-1.LPS had no inhibitory effect on the cells.Compared with LPS group,the level of TNF-α was decreased to 74.80% and 60.57% in isoquercitrin (20,10 μmol·L-1) groups in a dose-dependent manner.The results measured by Nitrate Assay Kit revealed that isoquercitrin (20,10 μmol·L-1) could suppress production of NO,the level of NO decreased to 79.34% and 68.81%(P<0.05).The Western blotting results showed that isoquercitrin (20,15,10 μmol·L-1) inhibited the productions of iNOS and COX-2 (P<0.05).Conclusion Isoquercitrin has anti-inflammatory effects by inhibiting the productions of TNF-α,NO,iNOS and COX-2,and the most effective dose for the inhibition is 10 μmol·L-1.
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Objective To investigate whetherthe extract of HUANGPI inhibitthe secretion of TNF-αvia TLR4/MyD88/TRAF6 signaling pathway. Methods ELISA assay was performed to determine TNF-α level in cell culture medium. MTT assay was used to detect the effects of the extract of HUANGPI and LPS on the viabilities of RAW 264.7 cells. Proteinexpressions of TLR4 and TRAF6 were detected by Western blotting assay. Results The extract of HUANGPI inhibited the secretion of TNF-αin a dose-dependent manner. Compared to LPS group , were TNF-αwas significantly suppressed in the cells in LPS+MyD88 inhibitor group , LPS+extract group and LPS+extract+MyD88 inhibitor group,with the corresponding reductions of TLR4 and TRAF6 protein expression at74% and21%,70% and27%,44% and8.5%, respectively. Conclusion MYD88-dependent signaling pathway might be involved in the mechanism underlying the effect of the extract of HUANGPI on suppressing LPS-induced inflammation.
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<p><b>OBJECTIVE</b>To investigate the effect of valproate acid sodium (VPA) on gap junction intercellular communication in breast cancer Hs578T cells and explore the mechanism.</p><p><b>METHODS</b>MTT assay was used to detect the cytotoxicity of VPA on Hs578T cells, and parachute assay was used to detect the effect of VPA on dye spread of the cells. Western blotting was employed to detect the expression changes of Cx43 total protein in VPA-treated Hs578T cells. The effect of VPA on the expression of Cx43 on the surface of Hs578T cells was examined with immunofluorescence assay.</p><p><b>RESULTS</b>MTT assay showed no obvious cytotoxicity of VPA on Hs578T cells at the concentrations below 10 mmol/L. VPA below 5 mmol/L obviously increased the gap junction function in Hs578T cells (P<0.01), and significantly enhanced the expression of Cx43 total protein (P<0.01) and Cx43 expression on the surface of Hs578T cells (P<0.01).</p><p><b>CONCLUSION</b>VPA can obviously increase the gap junction function in Hs578T cells possibly by enhancing Cx43 total protein expression and Cx43 protein expression on the surface of Hs578T cells.</p>
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Female , Humans , Breast Neoplasms , Metabolism , Cell Communication , Cell Line, Tumor , Connexin 43 , Metabolism , Gap Junctions , Valproic Acid , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To determine the expression of connexin 43 (Cx43) protein and explore the functional modulation of gap junction intercellular communication in astrocytes.</p><p><b>METHODS</b>Cultured neonatal SD rat astrocytes were divided into normal control group, all-trans retinoic acid (ATRA) group (treated with 10 µmol/L ATRA for 24 h) and oleamide group (treated with 25 µmol/L oleamide for 2 h). Western blotting and immunofluorescence assay were used to detect total cellular Cx43 protein expression and Cx43 expression on the surface of the astrocytes, respectively. Parachute assay was used to evaluate the functional changes of gap junction intercellular communication of the astrocytes.</p><p><b>RESULTS</b>Compared with the normal control cells, ATRA treatment resulted in a significantly increased expression of total Cx43 protein in the astrocytes (P<0.01), and oleamide significantly suppressed its expression (P<0.01). Similarly, ATRA obviously enhanced while oleamide suppressed Cx43 protein expression on the surface of the astrocytes. The gap junction intercellular communication of the astrocytes was enhanced by ATRA (P<0.01) and inhibited by oleamide (P<0.01).</p><p><b>CONCLUSION</b>ATRA and oleamide can modulate gap junction intercellular communication of the astrocytes possibly by regulating the expression of Cx43 protein.</p>
Subject(s)
Animals , Rats , Astrocytes , Metabolism , Cell Communication , Cells, Cultured , Connexin 43 , Metabolism , Gap Junctions , Metabolism , Oleic Acids , Pharmacology , Rats, Sprague-Dawley , Tretinoin , PharmacologyABSTRACT
Objective To analyze the differences of morphological and microvascular characteristics between hyperplastic polyps and colorectal adenoma (CA) under narrow band imaging (NBI) without magnification endoscopy,and to evaluate the value of NBI in differential diagnosis.Methods Patients with rectal polyps diagnosed by common endoscopy and pathologically confirmed CA and hyperplastic polyps were recruited in this study and under NBI examination.The pit pattern was divided into type A and B according to modified Kudo pit pattern classification.And the vascular pattern was classified into three types,type Ⅰ with invisible microvascular,type Ⅱ with even microvascular arranged along pit and type Ⅲ with uneven microvascular and irregular arranged.The differences of morphological and microvascular characteristics between hyperplastic polyps and CA were compared and the inter-observer consistency of NBI without magnification endoscopy was evaluated.Results Overall,87 patients with 107 polyps (73 CAs,34 hyperplastic polyps) underwent NBI without magnification endoscopy examination.The maximum diameter and the proportion of polyps with sublobe was higher in CA group than that of hyperplastic polyps group (P =0.0023 and 0.0047).In CA group,most pit shapes were type B (86.3％,63/73),and most vascular pattern types were Ⅱ/Ⅲ (82.2％,60/73).The sensitivity,specificity and accuracy of CA diagnosed with features of type B pit shape or Ⅱ/Ⅲ vascular pattern type was 97.3％,82.4％ and 92.5％.The sensitivity,specificity and accuracy of CA diagnosed with combined features of type B pit shape and Ⅱ/Ⅲ vascular pattern type was 71.2％,91.2％ and 77.6％.The mean kappa value of inter-observer consistency was 0.761.Conclusions There are differences in pit shapes and vascular pattern characteristics between CA and hyperplastic polyps.According to these two facts,CA and hyperplastic polyps can be initially differential diagnosed by NBI without magnification endoscopy.
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Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.
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Objective To investigate significance of interferon-γ/interleukin-4(IFN-γ/IL-4) and macrophages in uterus in early embryo loss (or resorption), and to elucidate the anti-abortive effect and the immunological modulation at maternal-fetal interface with quercetin and bornvl acetate. Methods Lipopolysaccharide (LPS)(0.10μg/mouse)was injected via tail vein in order to induce abortion in 7-day-gestation mice which received quercetin and bornvl acetate at days 4-7 of gestation. Levels of IFN-γ and IL-4 in uterus lysate supernatant were measured using enzyme-linked immuno-absorbent assay (ELISA), and uterine macrophages of each group ( n =10) were detected by immunohistochemistry. Results The amount of macrophages was much higher in the uteri of LPS-induced abortion mice than that in control mice. The abortion rate of mouse declined to certain level. The therapy of quercetin combined with bornyl acetate reversed LPS-induced abortion. Conclusion The increase of IFN-γ/IL-4 and the amount of macrophages in the LPS-treated mouse uterus is associated with the embryo loss, and quercetin and bornyl acetate have the anti-abortive effect through modulation of maternal-fetal interface immunity balance.
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Objective To study the hemostnsis effects of compression cords oppressing after femoral artery puncture and encheiresis. Methods Self-made compression cords were used to stop bleeding of femoral artery puncture sites in 2164 patients underwent 3046 cases of arteriopuncture encheiresis. The total eases were divided into group A (1482 eases) and group B (1564 cases) according to different treatment of oppression and breaking duration which were 8-10 hours for group A and 5-6 hours for group B, the hemostasis effects, discomfortableness and related complications within two groups were evaluated. Results The proportion of patients who got good hemostasis effects were 99.2% in group A, 99.0% in group B. There was no difference in hemostasis effects between two groups (P> 0.05). While the rate of discomfortableness in group A (63.8%) was higher than that in group B(42.9%) (P<0.05). The related serious complications were 2 patients in group A, but no occurred in group B. Conclusion Self-made compression cords op- pressing and 5-6 hours breaking time course can achieve both finer hemostasis effect and lower frequency of complications after femoral artery puncture and encheiresis.