RESUMO
Objective To assess the diagnostic accuracy of bowel sound analysis for irritable bowel syndrome (IBS) with a systematic review and meta-analysis. Methods We searched MEDLINE, Embase, the Cochrane Library, Web of Science, and IEEE Xplore databases until September 2023. Cross-sectional and case-control studies on diagnostic accuracy of bowel sound analysis for IBS were identified. We estimated the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio with a 95% confidence interval (CI), and plotted a summary receiver operating characteristic curve and evaluated the area under the curve. Results Four studies were included. The pooled diagnostic sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were 0.94 (95% CI, 0.87-0.97), 0.89 (95% CI, 0.81-0.94), 8.43 (95% CI, 4.81-14.78), 0.07 (95% CI, 0.03-0.15), and 118.86 (95% CI, 44.18-319.75), respectively, with an area under the curve of 0.97 (95% CI, 0.95-0.98). Conclusions Computerized bowel sound analysis is a promising tool for IBS. However, limited high-quality data make the results' validity and applicability questionable. There is a need for more diagnostic test accuracy studies and better wearable devices for monitoring and analysis of IBS.
Assuntos
Síndrome do Intestino Irritável , Síndrome do Intestino Irritável/diagnóstico , Humanos , Curva ROC , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Liver ischemia/reperfusion (I/R) injury is usually caused by hepatic inflow occlusion during liver surgery, and is frequently observed during war wounds and trauma. Hepatocyte ferroptosis plays a critical role in liver I/R injury, however, it remains unclear whether this process is controlled or regulated by members of the DEAD/DExH-box helicase (DDX/DHX) family. METHODS: The expression of DDX/DHX family members during liver I/R injury was screened using transcriptome analysis. Hepatocyte-specific Dhx58 knockout mice were constructed, and a partial liver I/R operation was performed. Single-cell RNA sequencing (scRNA-seq) in the liver post I/R suggested enhanced ferroptosis by Dhx58hep-/-. The mRNAs and proteins associated with DExH-box helicase 58 (DHX58) were screened using RNA immunoprecipitation-sequencing (RIP-seq) and IP-mass spectrometry (IP-MS). RESULTS: Excessive production of reactive oxygen species (ROS) decreased the expression of the IFN-stimulated gene Dhx58 in hepatocytes and promoted hepatic ferroptosis, while treatment using IFN-α increased DHX58 expression and prevented ferroptosis during liver I/R injury. Mechanistically, DHX58 with RNA-binding activity constitutively associates with the mRNA of glutathione peroxidase 4 (GPX4), a central ferroptosis suppressor, and recruits the m6A reader YT521-B homology domain containing 2 (YTHDC2) to promote the translation of Gpx4 mRNA in an m6A-dependent manner, thus enhancing GPX4 protein levels and preventing hepatic ferroptosis. CONCLUSIONS: This study provides mechanistic evidence that IFN-α stimulates DHX58 to promote the translation of m6A-modified Gpx4 mRNA, suggesting the potential clinical application of IFN-α in the prevention of hepatic ferroptosis during liver I/R injury.
Assuntos
Ferroptose , Traumatismo por Reperfusão , Animais , Camundongos , Diclorodifenil Dicloroetileno , Hepatócitos , Interferon-alfa , RNA , RNA MensageiroRESUMO
BACKGROUND: Although chronic erosive gastritis (CEG) is common, its clinical characteristics have not been fully elucidated. The lack of consensus regarding its treatment has resulted in varied treatment regimens. AIM: To explore the clinical characteristics, treatment patterns, and short-term outcomes in CEG patients in China. METHODS: We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology. Patients and treating physicians completed a questionnaire regarding history, endoscopic findings, and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment. RESULTS: Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included. Epigastric pain (68.0%), abdominal distension (62.6%), and postprandial fullness (47.5%) were the most common presenting symptoms. Gastritis was classified as chronic non-atrophic in 69.9% of patients. Among those with erosive lesions, 72.1% of patients had lesions in the antrum, 51.0% had multiple lesions, and 67.3% had superficial flat lesions. In patients with epigastric pain, the combination of a mucosal protective agent (MPA) and proton pump inhibitor was more effective. For those with postprandial fullness, acid regurgitation, early satiety, or nausea, a MPA appeared more promising. CONCLUSION: CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms. Gastroscopy may play a major role in its detection and diagnosis. Treatment should be individualized based on symptom profile.
Assuntos
Gastrite Atrófica , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Úlcera Gástrica , Humanos , Mucosa Gástrica/patologia , Gastrite/diagnóstico , Gastrite/tratamento farmacológico , Gastrite/epidemiologia , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/epidemiologia , Gastrite Atrófica/patologia , Gastroscopia , Infecções por Helicobacter/patologia , Estilo de Vida , Dor , Úlcera Gástrica/patologiaRESUMO
OBJECTIVE: To evaluate subtraction images acquired with 3D true steady-state free-precession(SSFP)sequence combined with time-spatial labeling inversion pulse(T-SLIP)for selective and non-contrast-enhanced(non-CE)visualization of the portal venous system,and explore the optimization of this protocol. METHODS: Totally 13 healthy volunteers were recruited.Respiratory-triggered 3D true SSFP sequences on a 1.5T MRI system combined with T-SLIP placed on the spleen and mesenteric area were performed.The portographic images were generated from the subtraction between the pulse on and off images.According to the difference in inversion time(TI)of T-SLIP,four image groups group A(TI of 1300 ms),group B(TI of 1100 ms),group C(TI of 900 ms)and group D(TI of 700 ms),were assigned and compared to detect the optimal TI for portography.For quantitative analysis,the signal intensity(SI)of left and right liver lobe,the large vessels as main,right and left portal vein(MPV,RPV and LPV,respectively)and small vessels as branches of segments four(P4),six(P6)and eight(P8)were measured.The relative SI of MPV,RPV and LPV,as well as P4,P6 and P8 were also compared.For qualitative evaluation,the quality score of visualization was also evaluated using a 4-point scale.One-Way ANOVA and LSD test were used for comparison of quantitative data,and Friedman signed rank test was used for comparison of qualitative scores. RESULTS: In 52 sequences of 13 volunteers,the selective visualization of the portal vein was all successfully conducted.Quantitative evaluation showed significant increased SI at the left lobe between C and D groups and A and B groups(comparison of group C to group A and BP=0.004,0.011;comparison of group D to group A and BP=0.001,0.004),while relative SI of LPV of groups C and D were lower than groups A and B(comparison of group C to group A and BP=0.015,0.015;comparison of group D to group A and BP=0.000,0.000).The relative SI of MPV in group D were decreased than groups A(P=0.000),B(P=0.000),and C(P=0.019).There was no significant difference in relative SI of small vessels among four groups(P>0.05).The image score of portal vessels in four groups also showed no differences(P>0.05). CONCLUSIONS: 3D true SSFP scan with T-SLIP enabled selective non-CE visualization of the portal vein with digital subtraction method.A fixed TI of both 1300 and 1100 ms can be preferable.