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1.
Z Gastroenterol ; 2024 Apr 24.
Article in English | MEDLINE | ID: mdl-38657616

ABSTRACT

RATIONALE: The COVID-19 pandemic caused by the SARS-CoV-2 virus has led to health complications beyond respiratory symptoms, revealing multi-organ involvement, including potential gastrointestinal implications. PATIENT CONCERNS: We present a case of a 40-year-old female without any history of achalasia who developed symptoms of the condition following a confirmed SARS-CoV-2 infection. Unusually, multiple esophageal ulcers were identified, which are not typically associated with achalasia. DIAGNOSIS: Achalasia and esophageal ulcers were confirmed through a series of examinations, including barium swallow, CT scan, and upper endoscopy. Furthermore, immunohistochemical staining of esophageal biopsy specimens revealed the presence of the SARS-CoV-2 spike protein, suggesting direct viral involvement. INTERVENTIONS: The patient was treated with calcium channel blockers and proton pump inhibitors and later underwent a peroral endoscopic myotomy (POEM) procedure following the resolution of her COVID-19 infection. OUTCOME: After the POEM procedure, the patient made a good recovery. LESSONS: This case underscores the potential for SARS-CoV-2 to trigger gastrointestinal complications and emphasizes the need for ongoing patient management and further research into the long-term implications of COVID-19. Despite the single-case nature of this report, it contributes to the expanding understanding of the diverse and multi-systemic impact of COVID-19.

2.
Clin Transl Oncol ; 26(6): 1438-1445, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38194018

ABSTRACT

BACKGROUND: Lung adenocarcinoma is a common cause of cancer-related deaths worldwide, and accurate EGFR genotyping is crucial for optimal treatment outcomes. Conventional methods for identifying the EGFR genotype have several limitations. Therefore, we proposed a deep learning model using non-invasive CT images to predict EGFR mutation status with robustness and generalizability. METHODS: A total of 525 patients were enrolled at the local hospital to serve as the internal data set for model training and validation. In addition, a cohort of 30 patients from the publicly available Cancer Imaging Archive Data Set was selected for external testing. All patients underwent plain chest CT, and their EGFR mutation status labels were categorized as either mutant or wild type. The CT images were analyzed using a self-attention-based ViT-B/16 model to predict the EGFR mutation status, and the model's performance was evaluated. To produce an attention map indicating the suspicious locations of EGFR mutations, Grad-CAM was utilized. RESULTS: The ViT deep learning model achieved impressive results, with an accuracy of 0.848, an AUC of 0.868, a sensitivity of 0.924, and a specificity of 0.718 on the validation cohort. Furthermore, in the external test cohort, the model achieved comparable performances, with an accuracy of 0.833, an AUC of 0.885, a sensitivity of 0.900, and a specificity of 0.800. CONCLUSIONS: The ViT model demonstrates a high level of accuracy in predicting the EGFR mutation status of lung adenocarcinoma patients. Moreover, with the aid of attention maps, the model can assist clinicians in making informed clinical decisions.


Subject(s)
Adenocarcinoma of Lung , Deep Learning , ErbB Receptors , Lung Neoplasms , Mutation , Tomography, X-Ray Computed , Humans , ErbB Receptors/genetics , Adenocarcinoma of Lung/genetics , Adenocarcinoma of Lung/pathology , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Female , Male , Middle Aged , Aged , Adult
3.
BMC Med Inform Decis Mak ; 24(1): 3, 2024 01 02.
Article in English | MEDLINE | ID: mdl-38167058

ABSTRACT

BACKGROUND: Precise prediction of esophageal squamous cell carcinoma (ESCC) invasion depth is crucial not only for optimizing treatment plans but also for reducing the need for invasive procedures, consequently lowering complications and costs. Despite this, current techniques, which can be invasive and costly, struggle with achieving the necessary precision, highlighting a pressing need for more effective, non-invasive alternatives. METHOD: We developed ResoLSTM-Depth, a deep learning model to distinguish ESCC stages T1-T2 from T3-T4. It integrates ResNet-18 and Long Short-Term Memory (LSTM) networks, leveraging their strengths in spatial and sequential data processing. This method uses arterial phase CT scans from ESCC patients. The dataset was meticulously segmented by an experienced radiologist for effective training and validation. RESULTS: Upon performing five-fold cross-validation, the ResoLSTM-Depth model exhibited commendable performance with an accuracy of 0.857, an AUC of 0.901, a sensitivity of 0.884, and a specificity of 0.828. These results were superior to the ResNet-18 model alone, where the average accuracy is 0.824 and the AUC is 0.879. Attention maps further highlighted influential features for depth prediction, enhancing model interpretability. CONCLUSION: ResoLSTM-Depth is a promising tool for ESCC invasion depth prediction. It offers potential for improvement in the staging and therapeutic planning of ESCC.


Subject(s)
Carcinoma, Squamous Cell , Deep Learning , Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Humans , Esophageal Squamous Cell Carcinoma/diagnostic imaging , Esophageal Squamous Cell Carcinoma/pathology , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Tomography, X-Ray Computed
4.
Z Gastroenterol ; 2023 Oct 05.
Article in English | MEDLINE | ID: mdl-37798922

ABSTRACT

RATIONALE: Non-islet cell tumor hypoglycemia (NICTH) is a paraneoplastic syndrome caused by tumors other than insulinoma that is primarily due to excessive production of insulin-like growth factor-II (IGF-II). The prevalence of NICTH is likely underestimated because of a lack of clinical recognition. PATIENT CONCERNS: A 41-year-old male with massive malignant liver tumors presented with recurrent severe hypoglycemia, weight loss, and liver cirrhosis. DIAGNOSIS: NICTH related to IGF-II produced by hepatocellular carcinoma was diagnosed based on clinical symptoms, biochemical tests, and elevated IGF-II/IGF-I ratio. INTERVENTION: Initial treatment with intravenous glucose and parenteral nutrition showed limited efficacy. Glucocorticoids and recombinant human growth hormone led to progressive improvement in blood glucose levels. OUTCOME: Due to extensive tumor burden and liver failure, surgical resection was not feasible, and the patient ultimately succumbed to refractory hypoglycemia and passed away in two weeks. LESSONS: Early recognition and diagnosis of NICTH are crucial in patients with recurrent hypoglycemia and large tumors. Surgical resection is the preferred treatment option, but supportive care and pharmacological interventions, such as glucocorticoids and growth hormone, can help manage refractory hypoglycemia. Further research is needed to explore novel treatment options, including anti-IGF-I and -IGF-II neutralizing antibodies.

5.
HPB (Oxford) ; 25(5): 533-542, 2023 05.
Article in English | MEDLINE | ID: mdl-36801198

ABSTRACT

BACKGROUND: Microvascular invasion (MVI) is a risk factor for early recurrence and poor prognosis of hepatocellular carcinoma (HCC). Preoperative assessment of MVI status is beneficial for clinical therapy and prognosis evaluation. METHODS: A total of 305 surgically resected patients were included retrospectively. All recruited patients underwent plain and contrast-enhanced abdominal CT. They were then randomly divided into training and validation sets in a ratio of 8:2. Self-attention-based ViT-B/16 and ResNet-50 analyzed CT images to predict MVI status preoperatively. Then, Grad-CAM was used to generate an attention map showing the high-risk MVI patches. Using five-fold cross validation, the performance of each model was evaluated. RESULTS: Among 305 HCC patients, 99 patients were pathologically MVI-positive and 206 were MVI-negative. ViT-B/16 with fusion phase predicted the MVI status with an AUC of 0.882 and an accuracy of 86.8% in the validation set, which is similar to ResNet-50 with an AUC of 0.875 and an accuracy of 87.2%. The fusion phase improved performance a bit as compared to the single phase used for MVI prediction. The influence of peritumoral tissue on predictive ability was limited. A color visualization of the suspicious patches where microvascular has invaded was presented by attention maps. CONCLUSION: ViT-B/16 model can predict preoperative MVI status in CT images of HCC patients. Assisted by attention maps, it can assist patients in making tailored treatment decisions.


Subject(s)
Carcinoma, Hepatocellular , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/surgery , Carcinoma, Hepatocellular/pathology , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/surgery , Liver Neoplasms/pathology , Retrospective Studies , Neoplasm Invasiveness , Prognosis
6.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-1008830

ABSTRACT

Diabetic peripheral neuropathy(DPN) is a chronic complication resulted from peripheral nerve injury in the late stage of diabetes. It involves a variety of pathological changes such as oxidative stress, endoplasmic reticulum stress, neuroinflammation, and apoptosis of Schwann cells(SCs). DPN is the main factor leading to lower limb disability or amputation in diabetic patients, with high incidence, long disease course, and poor prognosis. The modern medicine treatment of DPN mainly focuses on controlling blood glucose and improving microcirculation and nerve nutrition, which can only mitigate the clinical symptoms and not fundamentally reverse the pathological changes of peripheral nerves. Autophagy is a self-clearing mechanism that maintains cellular homeostasis by removing excess metabolites. Traditional Chinese medicine(TCM), featuring the holistic concept and syndrome differentiation, can treat chronic diseases in a multi-target, multi-pathway, and wide-range manner. Modern studies have shown that the occurrence and development of DPN are related to a variety of pathological changes, and autophagy is a key mechanism associated with DPN. The environment with persistent high glucose can lead to the inhibition or over-activation of peripheral nerve cells, which causes irreversible damage of nerve cells and the occurrence and development of DPN. Therefore, restoring autophagy balance and reducing nerve damage is one of the key ways to treat DPN. The recent studies have confirmed that some active ingredients in traditional Chinese medicines and TCM compound prescriptions can inhibit the oxidative stress, endoplasmic reticulum stress, mitochondrial damage, inflammation, and apoptosis of SCs in DPN by regulating the autophagy pathway, thus playing a role in the prevention and treatment of DPN. However, the systematic induction in this field remains to be carried out. This paper reviewed the relevant literature, explained the mechanism of TCM in the prevention and treatment of DPN by regulating autophagy, and summarized the potential targets of TCM in the treatment of DPN, with a view to providing new ideas for clinical research and drug development.


Subject(s)
Humans , Autophagy , Diabetes Mellitus , Diabetic Neuropathies/complications , Medicine, Chinese Traditional , Oxidative Stress , Schwann Cells/pathology
7.
Acta Pharmaceutica Sinica ; (12): 285-297, 2023.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-965698

ABSTRACT

Polysaccharides is one of the main bioactive components of Cordyceps species, because of the potential clinical value with stronger anti-tumor, such as anti-neuroblastoma, anti-melanoma, anti-lung cancer, anti-colon cancer and so on, its have received widespread attention in biomedical field and increasing research in last decades. According to structural elucidation, this review gives a systematic literature overview on antitumor mechanism of Cordyceps species-derived polysaccharides from three aspects, including inhibition of tumor cell growth, enhancement of immunomodulatory activity and reduction of tumor metastasis. Finally, it also puts forward some scientific problems for follow up research.

8.
Scand J Gastroenterol ; 57(7): 862-871, 2022 07.
Article in English | MEDLINE | ID: mdl-35170370

ABSTRACT

BACKGROUND: Several studies have revealed that serum vitamin D is an important factor for metabolic associated fatty liver disease (MAFLD), but there had been no consistent conclusion. METHODS: Of 427,507 subjects who underwent health examination, 83,625 who met the inclusion criteria were included in a cross-sectional analysis. Clinical and laboratory data were collected for analysis. MAFLD was diagnosed by abdominal imaging. RESULTS: Multivariate linear regression models discovered a negative association between serum vitamin D and MAFLD (OR: 0.92, 95% CI: 0.90 to 0.94, p = .001), after adjusting for other well-identified risk factors. The same result was found when serum vitamin D was handled as a categorical variable (quartile, Q1-Q4) (Q4 vs. Q1, OR: 0.82, 95% CI: 0.77 to 0.87, p < .001), and a significant linear trend was observed (p for trend <.001). After analysis, a nonlinear relationship was detected between serum vitamin D and MAFLD, with an inflection point of 2.23 (44.6 nmol/L or 17.84 ng/mL). The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.16 (1.06 to 1.28) and 0.89 (0.86 to 0.91), respectively. All interactions with MAFLD were not significant for age, sex, diabetes, hypertension, smoking and body mass index (p for interaction = .110, .558, .335, .195, .616 and .401, respectively). CONCLUSIONS: There was a nonlinear relationship between serum vitamin D and MAFLD. When the serum vitamin D level was ≥44.6 nmol/L (17.84 ng/mL), a negative correlation between serum vitamin D and MAFLD was detected. Below this level, serum vitamin D might promote the progression of MAFLD.


Subject(s)
Liver Diseases , Non-alcoholic Fatty Liver Disease , Vitamin D Deficiency , Cross-Sectional Studies , Humans , Vitamin D , Vitamin D Deficiency/complications , Vitamins
9.
Saudi J Gastroenterol ; 28(4): 304-311, 2022.
Article in English | MEDLINE | ID: mdl-35170435

ABSTRACT

Background: Nonalcoholic fatty liver disease (NAFLD) is a common component of chronic liver disease. Total bile acid (TBA) may influence the NAFLD progression through its signaling pathways. We attempted to find out if there is a correlation between TBA and NAFLD. Methods: 427,507 subjects were enrolled in health examinations conducted by The First Affiliated Hospital of Wenzhou Medical University. Among them, only 67616 met the inclusion criteria. Demographic, clinical, and laboratory data were gathered from all subjects. We used multivariate logistic regression model to find the correlation between serum TBA and NAFLD after adjusting for acknowledged risk factors for NAFLD. Results: A negative correlation was found between the TBA and NAFLD after adjusting for confounders in the multivariate logistic regression model (OR: 0.80; 95% CI: 0.72, 0.88, P < 0.001). After subgroup analysis, we found the interaction between NAFLD and diabetes was significant (P = 0.043). In patients with NAFLD without diabetes, TBA showed a protective effect in NAFLD (OR: 0.75; 95% CI: 0.67, 0.85). Conclusion: TBA is protective for NAFLD, but not in patients with NAFLD and diabetes. Further studies are urgently required to completely explore the underlying mechanisms of TBA in the pathogenesis of NAFLD.


Subject(s)
Non-alcoholic Fatty Liver Disease , Bile Acids and Salts , Cross-Sectional Studies , Humans , Logistic Models , Non-alcoholic Fatty Liver Disease/epidemiology , Non-alcoholic Fatty Liver Disease/pathology , Risk Factors
10.
Scand J Gastroenterol ; 57(5): 574-580, 2022 05.
Article in English | MEDLINE | ID: mdl-34994675

ABSTRACT

BACKGROUND AND AIM: It is important to predict the risk of gastric cancer (GC) for endoscopists because early detection of GC determines the selection of the best treatment strategy and the prognosis of patients. The study aimed to evaluate the utility of a predictive nomogram based on the Kyoto classification of gastritis for GC. METHODS: It was a retrospective study that included 2639 patients who received esophagogastroduodenoscopy and serum pepsinogen (PG) assay from January 2019 to November 2019 at the Endoscopy Center of the Department of Gastroenterology, Wenzhou Central Hospital. Routine biopsy was conducted to determine the benign and malignant lesions pathologically. All cases were randomly divided into the training set (70%) and the validation set (30%) by using the bootstrap method. A nomogram was formulated according to multivariate analysis of the training set. The predictive accuracy and discriminative ability of the nomogram were assessed by concordance index (C-index), area under the curve (AUC) of receiver operating characteristic curve (ROC) as well as calibration curve and were validated by the validation set. RESULTS: Among all patients enrolled, 102 of 2636 cases showed LGIN, HGIN and gastric cancer pathology results, whereas the rest cases showed benign pathological results. Multivariate analysis indicated that age, sex, PG I/II ratio and Kyoto classification scores were independent predictive variables for GC. The C-index of the nomogram of the training set was 0.79 (95% CI: 0.74 to 0.84) and the AUC of ROC is 0.79. The calibration curve of the nomogram demonstrated an optimal agreement between predicted probability and observed probability of the risk of GC. The C-index was 0.86 (95% CI: 0.79 to 0.94) with a calibration curve of better concurrence in the validation set. CONCLUSION: The nomogram formulated was proven to be of high predictive value for GC.


Subject(s)
Gastritis , Stomach Neoplasms , Gastritis/diagnosis , Humans , Nomograms , Prognosis , Retrospective Studies , Stomach Neoplasms/pathology
11.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-953538

ABSTRACT

@#Objective     To investigate the influence of prior percutaneous coronary intervention (PCI) on the outcome of coronary artery bypass grafting (CABG). Methods     Clinical data of 5 216 patients from Jiangsu Province CABG registry who underwent primary isolated CABG from 2016 to 2019 were retrospectively analyzed. Patients were divided into a PCI group (n=673) and a non-PCI group (n=4 543) according to whether they had received PCI treatment. The PCI group included 491 males and 182 females, aged 62.6±8.2 years, and the non-PCI group included 3 335 males and 1 208 females, aged 63.7±8.7 years. Multivariable logistic regression and propensity score matching (PSM) were used to compare 30-day mortality, incidence of major complications and 1-year follow-up outcomes between the two groups. Results     Both in original cohort and matched cohort, there was no statistical difference in the 30-day mortality [14 (2.1%) vs. 77 (1.7%), P=0.579; 14 (2.1%) vs. 11 (1.6%), P=0.686], or the incidence of major complications (myocardial infarction, stroke, mechanical ventilation≥24 h, dialysis for new-onset renal failure, deep sternal wound infection and atrial fibrillation) (all P>0.05). The rate of reoperation for bleeding in the PCI group was higher than that in the non-PCI group [19 (2.8%) vs. 67 (1.5%), P=0.016; 19 (2.8%) vs. 7 (1.0%), P=0.029]. Both in original cohort and matched cohort, there was no statistical difference in 1-year survival rate between the two groups [613 (93.1%) vs. 4 225 (94.6%), P=0.119; 613 (93.1%) vs. 630 (95.2%), P=0.124], while the re-admission rate in the PCI group was significantly higher than that in the non-PCI group [32 (4.9%) vs. 113 (2.5%), P=0.001; 32 (4.9%) vs. 17 (2.6%), P=0.040]. Conclusion     This study shows that a history of PCI treatment does not significantly increase the perioperative mortality and major complications of CABG, but increases the rate of cardiogenic re-admission 1 year postoperatively.

12.
Pharmacol Res Perspect ; 9(2): e00732, 2021 04.
Article in English | MEDLINE | ID: mdl-33715287

ABSTRACT

Everolimus, which inhibits mTOR kinase activity and is clinically used in graft rejection treatment, may have a two-sided influence on metabolic syndrome; its role in obesity and hyperglycemic in animals and humans, however, has been explored insufficiently. This study further determined how continual everolimus treatment affects glucose homeostasis and body weight control in C57BL6/J mice with obesity. An obesity mouse model was developed by administering a high-fat diet (HFD) to C57BL6/J mice over 12 weeks. The experimental group, while continuing their HFD consumption, were administered everolimus daily for 8 weeks. Metabolic parameters, glucose tolerance, fatty liver score, endocrine profile, insulin sensitivity index (ISI), insulin resistance (IR) index, and Akt phosphorylation, GLUT4, TNF-α, and IL-1 levels were measured in vivo. Compared with the control group, the everolimus group gained less body weight and had smaller adipocytes and lower fat pad weight; triglyceride (serum and hepatic), patatin-like phospholipase domain-containing 3, and fatty acid synthase levels; fatty liver scores; and glucose tolerance test values-all despite consuming more food. However, the everolimus group exhibited decreased ISI and muscle Akt phosphorylation and GLUT4 expression as well as impaired glucose tolerance and serum TNF-α and IL-1ß levels-even when insulin levels were high. In conclusion, continual everolimus treatment may lead to diabetes with glucose intolerance and IR.


Subject(s)
Diabetes Mellitus/chemically induced , Everolimus/adverse effects , Glucose Intolerance/chemically induced , Insulin Resistance , Obesity/drug therapy , Animals , Blood Glucose/analysis , Body Weight/drug effects , Diabetes Mellitus/blood , Diabetes Mellitus/diagnosis , Diabetes Mellitus/metabolism , Diet, High-Fat/adverse effects , Disease Models, Animal , Everolimus/administration & dosage , Glucose Intolerance/blood , Glucose Intolerance/diagnosis , Glucose Intolerance/metabolism , Glucose Tolerance Test , Humans , Male , Mice , Obesity/blood , Obesity/etiology , Obesity/metabolism
13.
Environ Pollut ; 278: 116760, 2021 Jun 01.
Article in English | MEDLINE | ID: mdl-33725532

ABSTRACT

A paradoxical impact of high rates of production and consumption of antibiotics is their widespread release in the environment. Consequently, low concentrations of antibiotics and their byproducts have been routinely identified from various environmental settings especially from aquatic environments. However, the impact of such low concentrations of antibiotics on the exposed host especially in early life remains poorly understood. We exposed zebrafish to two different environmental concentrations of oxytetracycline and sulfamethoxazole, from larval stage to adulthood (∼120 days) and characterized their impact on the taxonomic diversity, antibiotic resistance genes, and metabolic pathways of the gut microbiome using metagenomic shotgun sequencing and analysis. Long term exposure of environmental concentrations of oxytetracycline and sulfamethoxazole significantly impacted the taxonomic composition and metabolic pathways of zebrafish gut microbiome. The antibiotic exposed samples exhibited significant enrichment of multiple flavobacterial species, including Flavobacterium sp. F52, Flavobacterium johnsoniae and Flavobacterium sp. Fl, which are well known pathogenic bacteria. The relative abundance of antibiotic resistance genes, especially several tetratcycline and sulfonamide resistance genes were significantly higher in the exposed samples and showed a linear correlation with the antibiotic concentrations. Furthermore, several metabolic pathways, including folate biosynthesis, oxidative phosphorylation, and biotin metabolism pathways, showed significant enrichment in the antibiotic exposed samples. Collectively, our results suggest that early life exposure of the environmental concentrations of antibiotics can increase the abundance of unfavorable bacteria, antibiotic resistance genes and associated pathways in the gut microbiome of zebrafish.


Subject(s)
Gastrointestinal Microbiome , Animals , Anti-Bacterial Agents/toxicity , Flavobacterium , Zebrafish
14.
Int J Impot Res ; 33(3): 296-302, 2021 Apr.
Article in English | MEDLINE | ID: mdl-32203432

ABSTRACT

Defining the risks associated with diabetes mellitus in patients undergoing penile prosthesis implantation remains controversial. Our study aims to assess whether preoperative hemoglobin a1c and preoperative blood glucose levels are associated with an increased risk for postoperative infection in diabetic men. We performed a retrospective review of 932 diabetic patients undergoing primary penile prosthesis implantation from 18 high-volume penile prosthesis implantation surgeons throughout the United States, Germany, Belgium, and South Korea. Preoperative hemoglobin a1c and blood glucose levels within 6 h of surgery were collected and assessed in univariate and multivariate models for correlation with postoperative infection, revision, and explantation rates. The primary outcome is postoperative infection and the secondary outcomes are postoperative revision and explantation. In all, 875 patients were included in the final analysis. There were no associations between preoperative blood glucose levels or hemoglobin a1c levels and postoperative infection rates; p = 0.220 and p = 0.598, respectively. On multivariate analysis, a history of diabetes-related complications was a significant predictor of higher revision rates (p = 0.034), but was nonsignificant for infection or explantation rates. We conclude preoperative blood glucose levels and hemoglobin a1c levels are not associated with an increased risk for postoperative infection, revision, or explantation in diabetic men undergoing penile prosthesis implantation.


Subject(s)
Diabetes Mellitus , Penile Implantation , Penile Prosthesis , Belgium , Blood Glucose , Diabetes Mellitus/epidemiology , Germany , Glycated Hemoglobin/analysis , Humans , Male , Penile Implantation/adverse effects , Penile Prosthesis/adverse effects , Postoperative Complications , Republic of Korea , Retrospective Studies , United States
15.
Urol Oncol ; 39(1): 72.e15-72.e20, 2021 01.
Article in English | MEDLINE | ID: mdl-32843292

ABSTRACT

BACKGROUND: Securing reliable data on functional outcomes following radical prostatectomy (RP) is paramount to patient follow-up and management. OBJECTIVE: To validate an email-based patient-reported outcomes tracking system in assessing pad-free continence rates and time-to continence recovery following RP. PATIENTS AND METHODS: 483 men undergoing RP by a single surgeon from November 2013 to March 2019 were prospectively assigned to 1 of 3 tracking systems: 1) a preaddressed paper packet containing a pad-free card and daily urinary pad log, (N = 249); 2) an automated email questionnaire, (N = 234) or 3) both (N = 51). Patients tracked electronically received electronic Research Electronic Data Capture surveys 30 days after catheter removal, with up to 3 reminders sent automatically if no response was received within 2 days. Response rates and continence rates were compared in group 1 vs. group 2 via student t-tests; time-to pad-free status was assessed for concordance among men in group 3 via linear regression. RESULTS: Thirty-day response rates in group 1 (paper) vs. group 2 (electronic) were 80.7% (201/249) and 94.0% (220/234), (P < 0.0001); pad-free rates were 64.2% (129/201) and 64.1% (141/220), (P = 0.9847), respectively. Similarly, 1-year response rates in group 1 and 2 were 87.6% (218/249) vs. 94.0% (220/234), (P = 0.0146); pad-free rates were 91.7% (200/218) vs. 96.4% (212/220), (P = 0.0411), respectively. In group 3, time to pad-free continence recovery assessed via Patient Reported Outcomes via Online Questionnaire (PROVOQ) was highly concordant in 89.6% (43/48) of patients ± 5 days (Figure 1, R2 = 0.9893). No significant bias was found for subsequent reporting in either group. CONCLUSION: The use of automated email survey questionnaires via PROVOQ for the assessment of patient-reported post-RP continence recovery facilitates increased response rates, timeliness of response, and accuracy. PROVOQ significantly reduce the labor of tracking continence outcomes, improve quality improvement efforts, and enables surgeons to more clearly differentiates risk of long-term incontinence.


Subject(s)
Patient Reported Outcome Measures , Postoperative Complications/diagnosis , Prostatectomy , Prostatic Neoplasms/surgery , Quality Improvement , Self Report , Urinary Incontinence/diagnosis , Aged , Electronic Mail , Humans , Male , Middle Aged , Prospective Studies , Prostatectomy/methods
16.
Article in English | WPRIM (Western Pacific) | ID: wpr-888480

ABSTRACT

OBJECTIVES@#To study the association between cesarean section and sensory integration dysfunction (SID) in preschool children through a prospective cohort study.@*METHODS@#Based on the multicenter mother-infant cohort established by the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the International Peace Maternity and Child Health Hospital Affiliated to Shanghai Jiao Tong University School of Medicine in 2012, the sensory integration functions (three dimensions: vestibular balance, tactile defensiveness, and proprioception) of 392 preschool children were evaluated by the Chinese Children Sensory Integration Capacity Development Rating Scale in 2017. Births by cesarean section were the exposure factors, and the children born by vaginal delivery were enrolled as controls. A multivariable logistic regression analysis was used to evaluate the association of cesarean section with each dimension of SID.@*RESULTS@#The prevalence rate of SID was 21.9% (86/392) among the preschool children, and the prevalence rates of vestibular balance disorder, tactile over-responsivity, and proprioceptive disorder were 5.9% (23/392), 5.4% (21/392), and 15.1% (59/392) respectively. After adjustment for the confounding factors including maternal age at delivery and maternal educational level and child birth situation, the cesarean section group had a significant increase in the risk of proprioceptive disorder (@*CONCLUSIONS@#Cesarean section can significantly increase the risk of proprioceptive disorder in preschool children, especially in boys.


Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Pregnancy , Cesarean Section , China/epidemiology , Cohort Studies , Delivery, Obstetric , Prospective Studies
17.
Rice (N Y) ; 13(1): 82, 2020 Dec 14.
Article in English | MEDLINE | ID: mdl-33315140

ABSTRACT

BACKGROUND: Rice, the most important crop in Asia, has been cultivated in Taiwan for more than 5000 years. The landraces preserved by indigenous peoples and brought by immigrants from China hundreds of years ago exhibit large variation in morphology, implying that they comprise rich genetic resources. Breeding goals according to the preferences of farmers, consumers and government policies also alter gene pools and genetic diversity of improved varieties. To unveil how genetic diversity is affected by natural, farmers', and breeders' selections is crucial for germplasm conservation and crop improvement. RESULTS: A diversity panel of 148 rice accessions, including 47 cultivars and 59 landraces from Taiwan and 42 accessions from other countries, were genotyped by using 75 molecular markers that revealed an average of 12.7 alleles per locus with mean polymorphism information content of 0.72. These accessions could be grouped into five subpopulations corresponding to wild rice, japonica landraces, indica landraces, indica cultivars, and japonica cultivars. The genetic diversity within subpopulations was: wild rices > landraces > cultivars; and indica rice > japonica rice. Despite having less variation among cultivars, japonica landraces had greater genetic variation than indica landraces because the majority of Taiwanese japonica landraces preserved by indigenous peoples were classified as tropical japonica. Two major clusters of indica landraces were formed by phylogenetic analysis, in accordance with immigration from two origins. Genetic erosion had occurred in later japonica varieties due to a narrow selection of germplasm being incorporated into breeding programs for premium grain quality. Genetic differentiation between early and late cultivars was significant in japonica (FST = 0.3751) but not in indica (FST = 0.0045), indicating effects of different breeding goals on modern germplasm. Indigenous landraces with unique intermediate and admixed genetic backgrounds were untapped, representing valuable resources for rice breeding. CONCLUSIONS: The genetic diversity of improved rice varieties has been substantially shaped by breeding goals, leading to differentiation between indica and japonica cultivars. Taiwanese landraces with different origins possess various and unique genetic backgrounds. Taiwanese rice germplasm provides diverse genetic variation for association mapping to unveil useful genes and is a precious genetic reservoir for rice improvement.

18.
J Orthop Surg (Hong Kong) ; 28(2): 2309499020921755, 2020.
Article in English | MEDLINE | ID: mdl-32406306

ABSTRACT

Pediatric humeral medial condyle fracture (HMCF) is a rare condition and is difficult to detect, especially in young children. The management of late presentation of HMCF is challenging and lacks consensus. Herein, we reported four cases of HMCF nonunion received open reduction and internal fixation (ORIF) or supracondyle osteotomy from our institution. In addition, 12 cases of ORIF and 4 cases of osteotomy reported in the previous studies were also reviewed. The HMCF nonunion can heal after ORIF, but the indication and the optimal techniques need to be clarified. Supracondylar osteotomy alone is an effective and safe treatment option to improve the functional and cosmetic outcomes of HMCF nonunion.


Subject(s)
Fracture Fixation, Internal/methods , Fractures, Ununited/surgery , Humeral Fractures/surgery , Open Fracture Reduction/methods , Adolescent , Child, Preschool , Elbow Joint/diagnostic imaging , Elbow Joint/surgery , Female , Fractures, Ununited/diagnosis , Humans , Humeral Fractures/diagnosis , Male , Osteotomy/methods , Radiography , Treatment Outcome , Young Adult
19.
Neuropharmacology ; 146: 109-116, 2019 03 01.
Article in English | MEDLINE | ID: mdl-30472272

ABSTRACT

Neuroimaging endophenotypes in animal models provide an objective and translationally-relevant alternative to cognitive/behavioral traits in human psychopathologies. Metabolic alterations, such as those involved in the glutamate-cycle, have been proposed to play a preponderant role in both depression and schizophrenia. Chronic Mild Unpredictable Stress (CMUS) and sub-chronic administration of NMDA receptor antagonist generate animal models of depression and schizophrenia, respectively. The models are based on etiologically-relevant factors related to the induction and support of these psychopathologies. To test metabolic alterations within the glutamate-cycle and in other major neurochemicals, single-voxel Magnetic Resonance Spectroscopy was recorded within the hippocampus in both rat models and control animals. Surprisingly, altered glutamate-related metabolites were observed in the CMUS model, but not NMDA-based model, as indicated by decreased glutamine and increased GABA levels. However, both models presented elevated total visible choline and inositol levels relative to controls. These results indicate the presence cell membrane metabolic alterations and inflammatory processes shared in both models, comparable to evidence presented in schizophrenia and depression and other comparable animal models. These translationally-relevant biomarkers may thus form the basis for drug-development targets in both psychopathologies.


Subject(s)
Depression/metabolism , Disease Models, Animal , Glutamic Acid/metabolism , Hippocampus/metabolism , Schizophrenia/metabolism , Anhedonia , Animals , Choline/metabolism , Depression/diagnostic imaging , Excitatory Amino Acid Antagonists/pharmacology , Glutamine/metabolism , Inositol/metabolism , Magnetic Resonance Spectroscopy , Male , Memantine/pharmacology , Motor Activity , Rats , Rats, Wistar , Schizophrenia/diagnostic imaging , Stress, Psychological/metabolism , Sucrose , Taurine/metabolism
20.
J Cell Physiol ; 234(5): 7257-7265, 2019 05.
Article in English | MEDLINE | ID: mdl-30367453

ABSTRACT

Recently, long noncoding RNA have been identified as new gene regulators and prognostic biomarkers in various cancers, including renal cell carcinoma (RCC). The expression and biological roles of LINC00961 have been reported in many human cancers. However, up to date, no study of LINC00961 has been shown in RCC. Currently, we aimed to investigate the function of LINC00961 in RCC progression. Interestingly, we observed that LINC00961 could act as a novel biomarker in predicting the diagnosis of RCC. Then, we found that LINC00961 was greatly downregulated in RCC cell lines (Caki-1, Caki-2, 786-O, A498, and ACHN cells) compared with normal renal cell lines (HK-2 cells). Then, 786-O cells and ACHN cells were infected with LV-LINC00961. As displayed in our current study, LINC00961 overexpression could obviously suppress the proliferation and survival of RCC cells in vitro. In addition, RCC cell apoptosis was greatly induced and cell cycle progression was blocked in G1 phase by upregulation of LINC00961 in 786-O cells and ACHN cells. Subsequently, we found that LV-LINC00961 was able to restrain RCC cell migration and cell invasion capacity. Meanwhile, the messenger RNA and protein expression levels of epithelial-mesenchymal transition (EMT)-associated markers Slug and N-cadherin in RCC cell lines were dramatically inhibited by overexpressing LINC00961. Finally, the in vivo experiment was carried out and we observed that LINC00961 could inhibit RCC development through modulating EMT process. Taken these together, it was indicated in our study that LINC00961 was involved in RCC progression through targeting EMT pathway.


Subject(s)
Carcinoma, Renal Cell/metabolism , Epithelial-Mesenchymal Transition , Kidney Neoplasms/metabolism , Peptides/metabolism , Animals , Antigens, CD/genetics , Antigens, CD/metabolism , Apoptosis , Cadherins/genetics , Cadherins/metabolism , Carcinoma, Renal Cell/genetics , Carcinoma, Renal Cell/pathology , Cell Cycle , Cell Line, Tumor , Cell Movement , Cell Proliferation , Disease Progression , Female , Gene Expression Regulation, Neoplastic , Humans , Kidney Neoplasms/genetics , Kidney Neoplasms/pathology , Mice, Inbred BALB C , Mice, Nude , Neoplasm Invasiveness , Peptides/genetics , Signal Transduction , Snail Family Transcription Factors/genetics , Snail Family Transcription Factors/metabolism
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