Underwater vs conventional endoscopic mucosal resection in treatment of colorectal polyps: A meta-analysis.

BACKGROUND: Underwater endoscopic mucosal resection (UEMR) of colorectal lesions is emerging as an alternative method to conventional endoscopic mucosal resection (EMR); however, it is still controversial whether there is a difference in the effectiveness between UEMR and EMR. AIM: To evaluate the effectiveness and safety of UEMR in the treatment of colorectal polyps. METHODS: Clinical studies comparing the effectiveness or safety of UEMR in the treatment of colorectal polyps were searched in medical databases, including PubMed, Embase, Cochrane Library, CNKI, and Wanfang Data, monographs, theses, and papers presented at conferences. Statistical analyses were performed using Revman 5.3 software. RESULTS: Seven non-randomized controlled trials and one randomized controlled trial met the inclusion criteria. In total, 1382 patients (1511 polyps) were included in the study, including 722 who received UEMR and 789 who received EMR. In the UEMR and EMR groups, the en bloc resection rates were 85.87% and 73.89%, respectively, with a relative risk (RR) value of 1.14 (95% confidence interval [CI]: 1.01-1.30; P < 0.05). In the sub-group analysis, the en bloc resection rate showed no statistically significant difference between the EMR and UEMR groups for polyps less than 20 mm in diameter. However, a statistically significant difference was found between the EMR and UEMR groups for polyps equal to or greater than 20 mm in diameter. The post-endoscopic resection recurrence rates at 3-6 mo of the UEMR and EMR groups were 3.26% and 15.17%, respectively, with an RR value of 0.27 (95%CI: 0.09-0.83; P < 0.05). The post-endoscopic resection recurrence rates of UEMR and EMR at 12 mo were 6.25% and 14.40%, respectively, with an RR value of 0.43 (95%CI: 0.20-0.92; P < 0.05). Additionally, the incidence of adverse events was 8.17% and 6.21%, respectively, with an RR value of 1.07 (95%CI: 0.50-2.30; P > 0.05). CONCLUSION: UEMR is an effective technique for colorectal polyps and appears to have some advantages over EMR, particularly with regard to some treatment outcomes.

Prevalence of High Non-high-density Lipoprotein Cholesterol and Associated Risk Factors in Patients with Diabetes Mellitus in Jilin Province, China: A Cross-sectional Study.

Dyslipidemia is a risk factor for cardiovascular diseases (CVDs) in patients with diabetes, and non-high-density lipoprotein cholesterol (non-HDL-C) is a better predictor of CVDs than low-density lipoprotein cholesterol (LDL-C) in patients with diabetes. Therefore, we aimed to investigate the distribution of non-HDL-C and the prevalence of high non-HDL-C level in Chinese patients with diabetes mellitus and identify the associated risk factors. Non-HDL-C concentration positively correlated with total cholesterol, triglycerides, and LDL-C concentrations. Although both non-HDL-C and LDL-C concentration both related positively with TC concentration, the magnitude of correlation was relatively higher for non-HDL-C. The prevalence of high non-HDL-C (⋝4.14 mmol/L) was higher in two age groups (55-64 years: 46.7%; 65-79 years: 47.3%) than other age groups (18-24 years: 4.2%; 25-34 years: 43.6%; 35-44 years: 38.1%; 45-54 years: 41.0%). It was also higher among overweight (45.1%), generally obese (50.9%), or abdominally obese (47.3%) subjects, compared with normal weight subjects (34.5%). The risk of high non-HDL-C increased with advancing age. Both general obesity [odds ratio (OR)=1.488, 95% confidence interval (CI): 1.003-2.209] and abdominal obesity (OR=1.561, 95% CI: 1.101-2.214) were significantly associated with high non-HDL-C levels.

[Effects of Changjishu soft elastic capsule in treatment of diarrhea-predominant irritable bowel patients with liver-qi stagnation and spleen deficiency syndrome: a randomized double-blinded controlled trial].

OBJECTIVE: To evaluate the efficacy and safety of Changjishu soft elastic capsule, a new Chinese herbal medicine for smoothing liver, invigorating spleen and regulating qi activity, on diarrhea-predominant irritable bowel syndrome (D-IBS) patients with liver-qi stagnation and spleen deficiency syndrome. METHODS: A randomized, double-blinded, and positive control method was adopted. One hundred and four cases of D-IBS conforming to the inclusive criteria were randomly divided into treatment group (78 cases) and control group (26 cases). Patients in the treatment group were treated with Changjishu soft elastic capsule, four capsules once daily and three times a day. Patients in the control group were treated with glutamine compound enteric capsule, three capsules once daily and three times a day. After 21-day treatment, the efficacy of Changjishu soft elastic capsule was evaluated by the changes of single symptom such as abdominal pain or discomfort, defecation frequency, and stool characteristics. The safety of Changjishu elastic capsule was assessed by laboratory data and adverse events. RESULTS: Abdominal pain or discomfort scores at days 7, 14, 21 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Defecation frequency score at day 14 and the declined score at day 21 in the treatment group significantly decreased as compared with the control group (P < 0.05). Stool characteristics score and the declined score at day 21 in the treatment group significantly decreased as compared with those of the control group (P < 0.05). Rugitus scores and the declined scores at days 14 and 21 significantly decreased as compared with the control group (P < 0.05). The total response rates in the treatment and control groups were 71.62% and 40.91%, and the recovery rates were 20.27% and 13.64%, respectively. There existed significant differences between the two groups in therapeutic effect (P < 0.01). The therapeutic effect of Changjishu elastic capsule was better than that of glutamine compound enteric capsule. Side effects and adverse events were not found in the two groups. CONCLUSION: Changjishu soft elastic capsule is effective and safe for treatment of D-IBS patients with liver-qi stagnation and spleen deficiency syndrome.

Insights into corn genes derived from large-scale cDNA sequencing.

We present a large portion of the transcriptome of Zea mays, including ESTs representing 484,032 cDNA clones from 53 libraries and 36,565 fully sequenced cDNA clones, out of which 31,552 clones are non-redundant. These and other previously sequenced transcripts have been aligned with available genome sequences and have provided new insights into the characteristics of gene structures and promoters within this major crop species. We found that although the average number of introns per gene is about the same in corn and Arabidopsis, corn genes have more alternatively spliced isoforms. Examination of the nucleotide composition of coding regions reveals that corn genes, as well as genes of other Poaceae (Grass family), can be divided into two classes according to the GC content at the third position in the amino acid encoding codons. Many of the transcripts that have lower GC content at the third position have dicot homologs but the high GC content transcripts tend to be more specific to the grasses. The high GC content class is also enriched with intronless genes. Together this suggests that an identifiable class of genes in plants is associated with the Poaceae divergence. Furthermore, because many of these genes appear to be derived from ancestral genes that do not contain introns, this evolutionary divergence may be the result of horizontal gene transfer from species not only with different codon usage but possibly that did not have introns, perhaps outside of the plant kingdom. By comparing the cDNAs described herein with the non-redundant set of corn mRNAs in GenBank, we estimate that there are about 50,000 different protein coding genes in Zea. All of the sequence data from this study have been submitted to DDBJ/GenBank/EMBL under accession numbers EU940701-EU977132 (FLI cDNA) and FK944382-FL482108 (EST).

Enhancement of alkaloid production in opium and California poppy by transactivation using heterologous regulatory factors.

Genes encoding regulatory factors isolated from Arabidopsis, soybean and corn have been screened to identify those that modulate the expression of genes encoding for enzymes involved in the biosynthesis of morphinan alkaloids in opium poppy (Papaver somniferum) and benzophenanthridine alkaloids in California poppy (Eschscholzia californica). In opium poppy, the over-expression of selected regulatory factors increased the levels of PsCOR (codeinone reductase), Ps4'OMT (S-adenosyl-l-methionine:3'-hydroxy-N-methylcoclaurine 4'-O-methyltransferase) and Ps6OMT [(R,S)-norcoclaurine 6-O-methyltransferase] transcripts by 10- to more than 100-fold. These transcriptional activations translated into an enhancement of alkaloid production in opium poppy of up to at least 10-fold. In California poppy, the transactivation effect of regulatory factor WRKY1 resulted in an increase of up to 60-fold in the level of EcCYP80B1 [(S)-N-methylcoclaurine 3'-hydroxylase] and EcBBE (berberine bridge enzyme) transcripts. As a result, the accumulations of selected alkaloid intermediates were enhanced up to 30-fold. The transactivation effects of other regulatory factors led to the accumulation of the same intermediates. These regulatory factors also led to the production of new alkaloids in California poppy callus culture.

FROM VACUOLAR GS-X PUMPS TO MULTISPECIFIC ABC TRANSPORTERS.

While the concept of H+-coupling has dominated studies of energy-dependent organic solute transport in plants for over two decades, recent studies have demonstrated the existence of a group of organic solute transporters, belonging to the ATP-binding cassette (ABC) superfamily, that are directly energized by MgATP rather than by a transmembrane H+-electrochemical potential difference. Originally identified in microbial and animal cells, the ABC superfamily is one of the largest and most widespread protein families known. Competent in the transport of a broad range of substances including sugars, peptides, alkaloids, inorganic anions, and lipids, all ABC transporters are constituted of one or two copies each of an integral membrane sector and cytosolically oriented ATP-binding domain. To date, two major subclasses, the multidrug resistance-associated proteins (MRPs) and multidrug resistance proteins (MDRs) (so named because of the phenotypes conferred by their animal prototypes), have been identified molecularly in plants. However, only the MRPs have been defined functionally. This review therefore focuses on the functional capabilities, energetics, organization, and regulation of the plant MRPs. Otherwise known as GS-X pumps, or glutathione-conjugate or multispecific organic anion Mg2+-ATPases, the MRPs are considered to participate in the transport of exogenous and endogenous amphipathic anions and glutathionated compounds from the cytosol into the vacuole. Encoded by a multigene family and possessing a unique domain organization, the types of processes that likely converge and depend on plant MRPs include herbicide detoxification, cell pigmentation, the alleviation of oxidative damage, and the storage of antimicrobial compounds. Additional functional capabilities might include channel regulation or activity, and/or the transport of heavy metal chelates. The identification of the MRPs, in particular, and the demonstration of a central role for ABC transporters, in general, in plant function not only provide fresh insights into the molecular basis of energy-dependent solute transport but also offer the prospect for manipulating and investigating many fundamental processes that have hitherto evaded analysis at the transport level.