BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a n...BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a new imaging technology,has shown potential application prospects in oncology surgery.The meta-analysis to study the application value of ICG-FI in the diagnosis of gastric cancer sentinel lymph node biopsy is helpful to comprehensively evaluate the clinical effect of this technology and provide more reliable guidance for clinical practice.AIM To assess the diagnostic efficacy of optical imaging in conjunction with indocya-nine green(ICG)-guided sentinel lymph node(SLN)biopsy for gastric cancer.METHODS Electronic databases such as PubMed,Embase,Medline,Web of Science,and the Cochrane Library were searched for prospective diagnostic tests of optical imaging combined with ICG-guided SLN biopsy.Stata 12.0 software was used for analysis by combining the"bivariable mixed effect model"with the"midas"command.The true positive value,false positive value,false negative value,true negative value,and other information from the included literature were extracted.A literature quality assessment map was drawn to describe the overall quality of the included literature.A forest plot was used for heterogeneity analysis,and P<0.01 was considered to indicate statistical significance.A funnel plot was used to assess publication bias,and P<0.1 was considered to indicate statistical significance.The summary receiver operating characteristic(SROC)curve was used to calculate the area under the curve(AUC)to determine the diagnostic accuracy.If there was interstudy heterogeneity(I2>50%),meta-regression analysis and subgroup analysis were performed.analysis were performed.RESULTS Optical imaging involves two methods:Near-infrared(NIR)imaging and fluorescence imaging.A combination of optical imaging and ICG-guided SLN biopsy was useful for diagnosis.The positive likelihood ratio was 30.39(95%CI:0.92-1.00),the sensitivity was 0.95(95%CI:0.82-0.99),and the specificity was 1.00(95%CI:0.92-1.00).The negative likelihood ratio was 0.05(95%CI:0.01-0.20),the diagnostic odds ratio was 225.54(95%CI:88.81-572.77),and the SROC AUC was 1.00(95%CI:The crucial values were sensitivity=0.95(95%CI:0.82-0.99)and specificity=1.00(95%CI:0.92-1.00).The Deeks method revealed that the"diagnostic odds ratio"funnel plot of SLN biopsy for gastric cancer was significantly asymmetrical(P=0.01),suggesting significant publication bias.Further meta-subgroup analysis revealed that,compared with fluorescence imaging,NIR imaging had greater sensitivity(0.98 vs 0.73).Compared with optical imaging immediately after ICG injection,optical imaging after 20 minutes obtained greater sensitivity(0.98 vs 0.70).Compared with that of patients with an average SLN detection number<4,the sensitivity of patients with a SLN detection number≥4 was greater(0.96 vs 0.68).Compared with hematoxylin-eosin(HE)staining,immunohistochemical(+HE)staining showed greater sensitivity(0.99 vs 0.84).Compared with subserous injection of ICG,submucosal injection achieved greater sensitivity(0.98 vs 0.40).Compared with 5 g/L ICG,0.5 and 0.05 g/L ICG had greater sensitivity(0.98 vs 0.83),and cT1 stage had greater sensitivity(0.96 vs 0.72)than cT2 to cT3 clinical stage.Compared with that of patients≤26,the sensitivity of patients>26 was greater(0.96 vs 0.65).Compared with the literature published before 2010,the sensitivity of the literature published after 2010 was greater(0.97 vs 0.81),and the differences were statistically significant(all P<0.05).CONCLUSION For the diagnosis of stomach cancer,optical imaging in conjunction with ICG-guided SLN biopsy is a therapeut-ically viable approach,especially for early gastric cancer.The concentration of ICG used in the SLN biopsy of gastric cancer may be too high.Moreover,NIR imaging is better than fluorescence imaging and may obtain higher sensitivity.展开更多
Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses t...Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses to climate change.Here we attempted to explore how three sympatrically distributed raptor species(the Upland Buzzard Buteo hemilasius,UB;the Common Kestrel,also called Eurasian Kestrel Falco tinnunculus,EK;and the Saker Falcon Falco cherrug,SF)would respond to climate change over time,and whether their responses would bias by different morphology.We tested the alternative hypotheses for Allen’s rule for UB,EK,and SF in Qinghai Province,China,by modeling their current and future habitat suitability and confirming whether a consistent pattern exists between climate-induced range shifts and morphological differences among species.The extent of the projected distribution range within protected areas was also calculated for each species.We identified the future downward elevation shift for all the species,but with the notable northeastward shifting of the suitable climate space for UB and SF.Climate change would induce range contraction in the future,and the most acute influence is always the result of the pessimistic SSP585 scenario.No obvious pattern in climate-induced range shift was found for EK,for whom the morphological traits were significantly smaller all the time.More seriously,the ratios of highly suitable habitats being protected for our three raptor species were almost at a deficient level(below 1%).This study firstly tested the alternative hypothesis of Allen’s rule among raptors in Qinghai Province unprecedently,confirmed the morphological basis for different responses to changing climate across species,and demonstrated the protection deficiency under the current protected area design.We advocate more related studies in the future to verify our findings across more taxa.展开更多
Purpose:To determine the effect of unanticipated mid-flight medial-lateral external perturbation of the upper or lower trunk on anterior cruciate ligament(ACL)loading variable s during jump-landings.Methods:Thirty-two...Purpose:To determine the effect of unanticipated mid-flight medial-lateral external perturbation of the upper or lower trunk on anterior cruciate ligament(ACL)loading variable s during jump-landings.Methods:Thirty-two participants performed double-leg vertical jump-landings while bilateral kinematics and kinetics were collected under 6conditions(upper or lower trunk perturbation locations;no,left,or right perturbation directions).Two customized catapult apparatuses were created to apply pushing perturbation to participants near the maximal jump height.Results:The ball contacted participants near the center of mass for the lower-trunk conditions and approximately 23 cm above the center of mass for the upper-trunk conditions.Under upper-trunk perturbation,the contralateral leg demonstrated significantly smaller knee flexion angles at initial contact and greater peak knee abduction angles,peak vertical ground reaction forces,peak knee extension moments,and peak knee adduction moments compared to other legs among all conditions.Under lower-trunk perturbation,the contralateral leg showed significantly smaller knee flexion angles at initial contact and increased peak vertical ground reaction forces and peak knee extension moments compared to legs in the no-perturbation conditions.Conclusion:Mid-flight external trunk pushing perturbation increased ACL loading variables for the leg contralateral to the perturbation.The uppertrunk perturbation resulted in greater changes in ACL loading variables compared to the lower-trunk perturbation,likely due to trunk and ipsilateral leg rotation and more laterally located center of mass relative to the contralateral leg.These findings may help us understand the mechanisms of indirect-contact ACL injuries and develop jump-landing training strategies under mid-flight trunk perturbation to better prevent ACL injury.展开更多
BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholi...BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholic fatty liver disease.The diagnostic value of transient elastography for autoimmune liver diseases(AILDs)is worth studying.AIM To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in AILD.METHODS The PubMed,Cochrane Library and EMBASE databases were searched.Studies evaluating the efficacy of noninvasive methods in the diagnosis of AILDs[autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)and primary sclerosing cholangitis(PSC)]were included.The summary area under the receiver operating characteristic curve(AUROC),diagnostic odds ratio,sensitivity and specificity were used to assess the accuracy of these noninvasive methods for staging fibrosis.RESULTS A total of 60 articles were included in this study,and the number of patients with AIH,PBC and PSC was 1594,3126 and 501,respectively.The summary AUROC of transient elastography in the diagnosis of significant fibrosis,advanced fibrosis and cirrhosis in patients with AIH were 0.84,0.88 and 0.90,respectively,while those in patients with PBC were 0.93,0.93 and 0.91,respectively.The AUROC of cirrhosis for patients with PSC was 0.95.However,other noninvasive indices(aspartate aminotransferase to platelet ratio index,aspartate aminotransferase/alanine aminotransferase ratio,fibrosis-4 index)had corresponding AUROCs less than 0.80.CONCLUSION Transient elastography exerts better diagnostic accuracy in AILD patients,especially in PBC patients.The appropriate cutoff values for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 and 14.4 to 16.9 KPa for PBC patients.展开更多
·AIM:To evaluate the effect of 0.05%atropine on the control of myopia for 2y(phase I)and on spherical equivalent refraction(SER)progression for 1y(phase II)after its withdrawal in Chinese myopic children.·ME...·AIM:To evaluate the effect of 0.05%atropine on the control of myopia for 2y(phase I)and on spherical equivalent refraction(SER)progression for 1y(phase II)after its withdrawal in Chinese myopic children.·METHODS:Totally 142 children with myopia were randomly assigned to the 0.05%atropine group or to the placebo group.In phase I,children received 1 treatment for each eye daily.In phase II,the patients received no treatment.Axial length(AL),SER,intraocular pressure(IOP)and atropine-related side effects were assessed at 6 months’intervals.·RESULTS:During phase I,the mean change of SER was-0.46±0.30 D in the atropine group,compared to-1.72±1.12 D in the placebo group(P<0.001).The mean change of AL in the atropine group(0.26±0.30 mm)was significantly shorter than that in the placebo group(0.76±0.62 mm,P=0.002).In addition,in phase II(12mo after the withdrawal of atropine),there was no significant difference in AL change from the atropine group,when compared with that from the placebo group(0.31±0.25 mm vs 0.28±0.26 mm,P>0.05).Furthermore,the change in SER from the atropine group was 0.50±0.41 D,which was significantly lower than 0.72±0.60 D from placebo group,(P<0.05).Finally,there were no statistically significant differences in IOP between the treatment and control groups at any stages(all P>0.05).·CONCLUSION:The use of 0.05%atropine for two consecutive years may effectively control elongation of AL and thus progression of myopia,without significant SER progression 1y after atropine withdrawal.Therefore,treatment with 0.05%atropine daily for 2y is effective and safe.展开更多
AIM: To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy (HE), and the effect of H pylori eradication in cirrhotic patients. METHODS: From July 2003 to Ja...AIM: To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy (HE), and the effect of H pylori eradication in cirrhotic patients. METHODS: From July 2003 to January 2005, 457 cirrhotic patients in five regions of Zhejiang Province were enrolled. Patients were evaluated for demographics, number connection test, H pylori infection, liver impairment, blood ammonia concentration and HE. Patients with H pylori infection were given 1 wk therapy with omeprazole plus clarithromycin and tinidazole. 14C urea breath test was performed and mental symptoms and blood ammonia level were reassessed after bacterium eradication. RESULTS: Overall H pylori infection rate was 60.6%, and HE occurred in 47.5% of cirrhotic patients. Subclinical HE (SHE) was detected in 55 of 117 cirrhotic patients. Blood ammonia concentration in H pylori negative (n = 180) and positive (n = 277) cirrhotic patients was 53.8 ± 51.4 and 78.4 ± 63.6 μmol/L, respectively (P < 0.01), which was significantly reduced to 53.5 ± 37.7 μmol/L after bacterium eradication (n = 126) (P < 0.01). Blood ammonia was 97.5 ± 81.0 μmol/L in H pylori -positive cirrhotic patients, and this did not significantly change in those with persistent infection after H pylori eradication (n = 11). HE was more frequently observed in patients with H pylori infection than in those without (58.5% vs 30.6%, P < 0.01). HE rate significantly dropped to 34.1% after H pylori eradiation (P < 0.01). H pylori prevalence significantly differed among cirrhotic patients with HE (74.4%), SHE(69.1%), and those without HE (53.2%) (P < 0.05). Blood ammonia level was significantly different among cirrhotic patients with HE (94.5 ± 75.6 μmol/L), SHE (59.9 ± 49.2 μmol/L), and without HE (47.3 ± 33.5 μmol/L) (P < 0.05). Logistic regression analysis showed that blood ammonia concentration, Child-Pugh stage, upper gastrointestinal bleeding, electrolyte disturbance, and urea nitrogen were risk factors for HE. CONCLUSION: H pylori infection is an important factor for inducing high blood ammonia concentration and HE in cirrhotic patients. H pylori eradication may be helpful for treatment and prevention of HE.展开更多
AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospit...AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University from June 2000 to December 2007.Data regarding demographic,clinical characteristics and immunosuppressants usage were analyzed. RESULTS:A total of 227 eligible patients were evaluated in this study,including 104 patients with Crohn’s disease and 123 with ulcerative colitis.Among the patients,61 had indications for immunosuppressive agents use.However,only 21 (34.4%)received immunosuppressive agents.Among the 21 patients,6(37.5%)received a subtherapeutic dose of azathioprine with no attempt to increase the dosage.Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo,15 patients went into remission,four patients were not affected and one relapsed.Among these 20 patients,four patients suffered from myelotoxicity and one suffered from hepatotoxicity.CONCLUSION:Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries.Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.展开更多
Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitig...Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitigate CI.Ethylene is known to promote senescence and CI,while 1-methylcyclopropene(1-MCP)is an antagonist that inhibits the effects of ethylene.However,how1-MCP and ethylene affect proline,PA,and NO levels under chilling stress remains unclear.To address these questions,1-MCP(1μL·L^(−1))and ethylene(1μL·L^(−1))treatments were applied to peach fruit.Fruit were stored at 4°C for 28 d,then moved to 25°C for 3 d immediately after cold storage.Peach fruit exhibited CI symptoms after 7 d of cold storage with enhanced electrolyte leakage and malondialdehyde contents.The 1-MCP treatment significantly(P<0.05)restrained peach CI,and fruit did not exhibit CI symptoms until 14 d of cold storage.Proline and PAs in peach under chilling stress weremostly synthesized from glutamate and arginine,which were catalyzed by1-pyrroline-5-carboxylate synthetase and arginine decarboxylase,respectively.1-MCPtreated fruit exhibited higher proline and PA contents and enhanced chilling tolerance compared to the control,while ethylene-treated fruit had lower proline and PA contents and reduced chilling tolerance.Ethylene-treated fruit,which exhibited more severe CI symptoms compared to the control,had significantly(P<0.05)lower NO contents and NO synthase activities.However,NOmay not be a direct acting factor in 1-MCPinduced chilling tolerance,as 1-MCP-treated fruit had lower NO contents and NO synthase activities compared to the control.In conclusion,proline and PA clearly played direct and important roles in 1-MCP-induced peach chilling tolerance,while NO may not be actively involved.展开更多
文摘BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a new imaging technology,has shown potential application prospects in oncology surgery.The meta-analysis to study the application value of ICG-FI in the diagnosis of gastric cancer sentinel lymph node biopsy is helpful to comprehensively evaluate the clinical effect of this technology and provide more reliable guidance for clinical practice.AIM To assess the diagnostic efficacy of optical imaging in conjunction with indocya-nine green(ICG)-guided sentinel lymph node(SLN)biopsy for gastric cancer.METHODS Electronic databases such as PubMed,Embase,Medline,Web of Science,and the Cochrane Library were searched for prospective diagnostic tests of optical imaging combined with ICG-guided SLN biopsy.Stata 12.0 software was used for analysis by combining the"bivariable mixed effect model"with the"midas"command.The true positive value,false positive value,false negative value,true negative value,and other information from the included literature were extracted.A literature quality assessment map was drawn to describe the overall quality of the included literature.A forest plot was used for heterogeneity analysis,and P<0.01 was considered to indicate statistical significance.A funnel plot was used to assess publication bias,and P<0.1 was considered to indicate statistical significance.The summary receiver operating characteristic(SROC)curve was used to calculate the area under the curve(AUC)to determine the diagnostic accuracy.If there was interstudy heterogeneity(I2>50%),meta-regression analysis and subgroup analysis were performed.analysis were performed.RESULTS Optical imaging involves two methods:Near-infrared(NIR)imaging and fluorescence imaging.A combination of optical imaging and ICG-guided SLN biopsy was useful for diagnosis.The positive likelihood ratio was 30.39(95%CI:0.92-1.00),the sensitivity was 0.95(95%CI:0.82-0.99),and the specificity was 1.00(95%CI:0.92-1.00).The negative likelihood ratio was 0.05(95%CI:0.01-0.20),the diagnostic odds ratio was 225.54(95%CI:88.81-572.77),and the SROC AUC was 1.00(95%CI:The crucial values were sensitivity=0.95(95%CI:0.82-0.99)and specificity=1.00(95%CI:0.92-1.00).The Deeks method revealed that the"diagnostic odds ratio"funnel plot of SLN biopsy for gastric cancer was significantly asymmetrical(P=0.01),suggesting significant publication bias.Further meta-subgroup analysis revealed that,compared with fluorescence imaging,NIR imaging had greater sensitivity(0.98 vs 0.73).Compared with optical imaging immediately after ICG injection,optical imaging after 20 minutes obtained greater sensitivity(0.98 vs 0.70).Compared with that of patients with an average SLN detection number<4,the sensitivity of patients with a SLN detection number≥4 was greater(0.96 vs 0.68).Compared with hematoxylin-eosin(HE)staining,immunohistochemical(+HE)staining showed greater sensitivity(0.99 vs 0.84).Compared with subserous injection of ICG,submucosal injection achieved greater sensitivity(0.98 vs 0.40).Compared with 5 g/L ICG,0.5 and 0.05 g/L ICG had greater sensitivity(0.98 vs 0.83),and cT1 stage had greater sensitivity(0.96 vs 0.72)than cT2 to cT3 clinical stage.Compared with that of patients≤26,the sensitivity of patients>26 was greater(0.96 vs 0.65).Compared with the literature published before 2010,the sensitivity of the literature published after 2010 was greater(0.97 vs 0.81),and the differences were statistically significant(all P<0.05).CONCLUSION For the diagnosis of stomach cancer,optical imaging in conjunction with ICG-guided SLN biopsy is a therapeut-ically viable approach,especially for early gastric cancer.The concentration of ICG used in the SLN biopsy of gastric cancer may be too high.Moreover,NIR imaging is better than fluorescence imaging and may obtain higher sensitivity.
基金financial support and the invaluable field assistance from the Forestry and Grassland Bureau of local counties in Qinghai ProvinceNational Natural Science Foundation of China(Grant No.32101237 and Grant No.41871294)Tibet Major Science and Technology Project(Grant No.XZ201901-GA-06)supported this work。
文摘Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses to climate change.Here we attempted to explore how three sympatrically distributed raptor species(the Upland Buzzard Buteo hemilasius,UB;the Common Kestrel,also called Eurasian Kestrel Falco tinnunculus,EK;and the Saker Falcon Falco cherrug,SF)would respond to climate change over time,and whether their responses would bias by different morphology.We tested the alternative hypotheses for Allen’s rule for UB,EK,and SF in Qinghai Province,China,by modeling their current and future habitat suitability and confirming whether a consistent pattern exists between climate-induced range shifts and morphological differences among species.The extent of the projected distribution range within protected areas was also calculated for each species.We identified the future downward elevation shift for all the species,but with the notable northeastward shifting of the suitable climate space for UB and SF.Climate change would induce range contraction in the future,and the most acute influence is always the result of the pessimistic SSP585 scenario.No obvious pattern in climate-induced range shift was found for EK,for whom the morphological traits were significantly smaller all the time.More seriously,the ratios of highly suitable habitats being protected for our three raptor species were almost at a deficient level(below 1%).This study firstly tested the alternative hypothesis of Allen’s rule among raptors in Qinghai Province unprecedently,confirmed the morphological basis for different responses to changing climate across species,and demonstrated the protection deficiency under the current protected area design.We advocate more related studies in the future to verify our findings across more taxa.
基金supported by the National Science Foundation(1933409)the China Scholarship Council+1 种基金a student research grant from the International Society of Biomechanics in Sportsthe Wyoming IDeA Networks for Biomedical Research Excellence,supported by the National Institutes of Health(P20GM103432)。
文摘Purpose:To determine the effect of unanticipated mid-flight medial-lateral external perturbation of the upper or lower trunk on anterior cruciate ligament(ACL)loading variable s during jump-landings.Methods:Thirty-two participants performed double-leg vertical jump-landings while bilateral kinematics and kinetics were collected under 6conditions(upper or lower trunk perturbation locations;no,left,or right perturbation directions).Two customized catapult apparatuses were created to apply pushing perturbation to participants near the maximal jump height.Results:The ball contacted participants near the center of mass for the lower-trunk conditions and approximately 23 cm above the center of mass for the upper-trunk conditions.Under upper-trunk perturbation,the contralateral leg demonstrated significantly smaller knee flexion angles at initial contact and greater peak knee abduction angles,peak vertical ground reaction forces,peak knee extension moments,and peak knee adduction moments compared to other legs among all conditions.Under lower-trunk perturbation,the contralateral leg showed significantly smaller knee flexion angles at initial contact and increased peak vertical ground reaction forces and peak knee extension moments compared to legs in the no-perturbation conditions.Conclusion:Mid-flight external trunk pushing perturbation increased ACL loading variables for the leg contralateral to the perturbation.The uppertrunk perturbation resulted in greater changes in ACL loading variables compared to the lower-trunk perturbation,likely due to trunk and ipsilateral leg rotation and more laterally located center of mass relative to the contralateral leg.These findings may help us understand the mechanisms of indirect-contact ACL injuries and develop jump-landing training strategies under mid-flight trunk perturbation to better prevent ACL injury.
基金Natural Science and Technology Major Project of Fujian Province,No.2021D033Natural Science Foundation of Shanghai,No.20ZR1410900+1 种基金Medical Innovation Project of Fujian Province,No.2022CXB020National Science and Technology Major Project,No.2017ZX 10203202-003-002.
文摘BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholic fatty liver disease.The diagnostic value of transient elastography for autoimmune liver diseases(AILDs)is worth studying.AIM To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in AILD.METHODS The PubMed,Cochrane Library and EMBASE databases were searched.Studies evaluating the efficacy of noninvasive methods in the diagnosis of AILDs[autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)and primary sclerosing cholangitis(PSC)]were included.The summary area under the receiver operating characteristic curve(AUROC),diagnostic odds ratio,sensitivity and specificity were used to assess the accuracy of these noninvasive methods for staging fibrosis.RESULTS A total of 60 articles were included in this study,and the number of patients with AIH,PBC and PSC was 1594,3126 and 501,respectively.The summary AUROC of transient elastography in the diagnosis of significant fibrosis,advanced fibrosis and cirrhosis in patients with AIH were 0.84,0.88 and 0.90,respectively,while those in patients with PBC were 0.93,0.93 and 0.91,respectively.The AUROC of cirrhosis for patients with PSC was 0.95.However,other noninvasive indices(aspartate aminotransferase to platelet ratio index,aspartate aminotransferase/alanine aminotransferase ratio,fibrosis-4 index)had corresponding AUROCs less than 0.80.CONCLUSION Transient elastography exerts better diagnostic accuracy in AILD patients,especially in PBC patients.The appropriate cutoff values for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 and 14.4 to 16.9 KPa for PBC patients.
基金Supported by the Special Fund for Young and Middle-aged Academic Technology Leaders and Reserve Talents of Yunnan Province (No.202005AC160021)the Famous Doctor of Yun Ling (No.YNWR-MY-2020-088)。
文摘·AIM:To evaluate the effect of 0.05%atropine on the control of myopia for 2y(phase I)and on spherical equivalent refraction(SER)progression for 1y(phase II)after its withdrawal in Chinese myopic children.·METHODS:Totally 142 children with myopia were randomly assigned to the 0.05%atropine group or to the placebo group.In phase I,children received 1 treatment for each eye daily.In phase II,the patients received no treatment.Axial length(AL),SER,intraocular pressure(IOP)and atropine-related side effects were assessed at 6 months’intervals.·RESULTS:During phase I,the mean change of SER was-0.46±0.30 D in the atropine group,compared to-1.72±1.12 D in the placebo group(P<0.001).The mean change of AL in the atropine group(0.26±0.30 mm)was significantly shorter than that in the placebo group(0.76±0.62 mm,P=0.002).In addition,in phase II(12mo after the withdrawal of atropine),there was no significant difference in AL change from the atropine group,when compared with that from the placebo group(0.31±0.25 mm vs 0.28±0.26 mm,P>0.05).Furthermore,the change in SER from the atropine group was 0.50±0.41 D,which was significantly lower than 0.72±0.60 D from placebo group,(P<0.05).Finally,there were no statistically significant differences in IOP between the treatment and control groups at any stages(all P>0.05).·CONCLUSION:The use of 0.05%atropine for two consecutive years may effectively control elongation of AL and thus progression of myopia,without significant SER progression 1y after atropine withdrawal.Therefore,treatment with 0.05%atropine daily for 2y is effective and safe.
文摘AIM: To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy (HE), and the effect of H pylori eradication in cirrhotic patients. METHODS: From July 2003 to January 2005, 457 cirrhotic patients in five regions of Zhejiang Province were enrolled. Patients were evaluated for demographics, number connection test, H pylori infection, liver impairment, blood ammonia concentration and HE. Patients with H pylori infection were given 1 wk therapy with omeprazole plus clarithromycin and tinidazole. 14C urea breath test was performed and mental symptoms and blood ammonia level were reassessed after bacterium eradication. RESULTS: Overall H pylori infection rate was 60.6%, and HE occurred in 47.5% of cirrhotic patients. Subclinical HE (SHE) was detected in 55 of 117 cirrhotic patients. Blood ammonia concentration in H pylori negative (n = 180) and positive (n = 277) cirrhotic patients was 53.8 ± 51.4 and 78.4 ± 63.6 μmol/L, respectively (P < 0.01), which was significantly reduced to 53.5 ± 37.7 μmol/L after bacterium eradication (n = 126) (P < 0.01). Blood ammonia was 97.5 ± 81.0 μmol/L in H pylori -positive cirrhotic patients, and this did not significantly change in those with persistent infection after H pylori eradication (n = 11). HE was more frequently observed in patients with H pylori infection than in those without (58.5% vs 30.6%, P < 0.01). HE rate significantly dropped to 34.1% after H pylori eradiation (P < 0.01). H pylori prevalence significantly differed among cirrhotic patients with HE (74.4%), SHE(69.1%), and those without HE (53.2%) (P < 0.05). Blood ammonia level was significantly different among cirrhotic patients with HE (94.5 ± 75.6 μmol/L), SHE (59.9 ± 49.2 μmol/L), and without HE (47.3 ± 33.5 μmol/L) (P < 0.05). Logistic regression analysis showed that blood ammonia concentration, Child-Pugh stage, upper gastrointestinal bleeding, electrolyte disturbance, and urea nitrogen were risk factors for HE. CONCLUSION: H pylori infection is an important factor for inducing high blood ammonia concentration and HE in cirrhotic patients. H pylori eradication may be helpful for treatment and prevention of HE.
基金Supported by Zhejiang Province Natural Science Foundationof China,R2080029 Caoqian Research Group
文摘AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University from June 2000 to December 2007.Data regarding demographic,clinical characteristics and immunosuppressants usage were analyzed. RESULTS:A total of 227 eligible patients were evaluated in this study,including 104 patients with Crohn’s disease and 123 with ulcerative colitis.Among the patients,61 had indications for immunosuppressive agents use.However,only 21 (34.4%)received immunosuppressive agents.Among the 21 patients,6(37.5%)received a subtherapeutic dose of azathioprine with no attempt to increase the dosage.Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo,15 patients went into remission,four patients were not affected and one relapsed.Among these 20 patients,four patients suffered from myelotoxicity and one suffered from hepatotoxicity.CONCLUSION:Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries.Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.
基金This work was supported by the Natural Science Foundation of Jiangsu Province of China(Grant No.BK20140483)China Postdoctoral Science Foundation(Grant No.2014M560451).
文摘Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitigate CI.Ethylene is known to promote senescence and CI,while 1-methylcyclopropene(1-MCP)is an antagonist that inhibits the effects of ethylene.However,how1-MCP and ethylene affect proline,PA,and NO levels under chilling stress remains unclear.To address these questions,1-MCP(1μL·L^(−1))and ethylene(1μL·L^(−1))treatments were applied to peach fruit.Fruit were stored at 4°C for 28 d,then moved to 25°C for 3 d immediately after cold storage.Peach fruit exhibited CI symptoms after 7 d of cold storage with enhanced electrolyte leakage and malondialdehyde contents.The 1-MCP treatment significantly(P<0.05)restrained peach CI,and fruit did not exhibit CI symptoms until 14 d of cold storage.Proline and PAs in peach under chilling stress weremostly synthesized from glutamate and arginine,which were catalyzed by1-pyrroline-5-carboxylate synthetase and arginine decarboxylase,respectively.1-MCPtreated fruit exhibited higher proline and PA contents and enhanced chilling tolerance compared to the control,while ethylene-treated fruit had lower proline and PA contents and reduced chilling tolerance.Ethylene-treated fruit,which exhibited more severe CI symptoms compared to the control,had significantly(P<0.05)lower NO contents and NO synthase activities.However,NOmay not be a direct acting factor in 1-MCPinduced chilling tolerance,as 1-MCP-treated fruit had lower NO contents and NO synthase activities compared to the control.In conclusion,proline and PA clearly played direct and important roles in 1-MCP-induced peach chilling tolerance,while NO may not be actively involved.