AIM To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy(POEM) to prevent endoscopic progre...AIM To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy(POEM) to prevent endoscopic progression of achalasia.METHODS We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients(197 women, 162 men) with a mean age of 42.1 years(range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type Ⅰ(n = 119), Ⅱa(n = 106), Ⅱb(n = 60), Ⅱc(n = 60), or Ⅲ(n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared.RESULTS Symptom duration increased significantly with increasing Ling classification(from Ⅰ to Ⅲ)(P < 0.05), whereas lower esophageal sphincter pressure decreased with increasing Ling type(from Ⅰ to Ⅲ)(P < 0.05). There was no difference in sex ratio or onset age among the Ling types, although the age at time of diagnosis washigher in Ling types Ⅱc and Ⅲ than in Ling types Ⅰ, Ⅱa, and Ⅱb. Of the 21 patients, 19 underwent highresolution manometry both before and after treatment. The mean preoperative and postoperative lower esophageal sphincter pressure were 34.6 mmH g(range, 15.3-59.4 mm Hg) and 15.0 mm Hg(range, 2.1-21.6 mmH g), respectively, indicating a statistically significant decrease after POEM. All of the 21 patients were treated successfully by POEM(postoperative Eckardt score ≤ 3) and still had the same Ling type during a mean followup period of 37.8 mo(range, 24-51 mo).CONCLUSION The Ling classification represents the endoscopic progressive process of achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM(Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.展开更多
The recognition of headache by human being has gone through a long period of time.Headache was sorted into three kinds early in first century A.D. by Aretaeus(81-138),who named mild repeated headache as"cephalalg...The recognition of headache by human being has gone through a long period of time.Headache was sorted into three kinds early in first century A.D. by Aretaeus(81-138),who named mild repeated headache as"cephalalgia",frequently attacking chronic headache as"cephalaea",and unilateral severe headache"heterocrania".Christian Ludwig展开更多
A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertak...A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertaken to further explore TQ’s chemopreventive efficacy against 1, 2-dimethylhydrazine (DMH)-induced colon carcinogenesis in the rat model through a two-phase study (initiation and post-initiation) and to evaluate its potential impact on tumor progression and invasion in vivo. TQ treatment in the initiation phase significantly reduced tumor incidence, multiplicity and mean tumor volume. However, although mean tumor volume and multiplicity were decreased upon TQ treatment in the post-initiation phase, TQ did not reduce incidence significantly. Cellular proliferation, as assessed by expression of colonic PCNA, was shown to be inhibited in consequence to TQ treatment in both phases, with a more pronounced reduction in the initiation phase. In addition, our results demonstrated an appreciable negative impact of TQ on vascular endothelial growth factor (VEGF) production in tumor-bearing rats. Furthermore, we provided evidence that TQ-treatment, in both phases, tended to considerably suppress tumor progression and invasion. Taken together, the present study demonstrated that TQ, at an orally daily dose of 10 mg/kg, has a chemopreventive effect in the initiation phase, and has the potential to attenuate tumor burden, suppress progression of pre-neoplastic lesions and to inhibit tumor growth in the post-initiation phase of DMH-induced colon carcinogenesis, We surmise that such effects of TQ may be due to suppression of cellular proliferation and inhibition of VEGF production. The results could provide an effective chemopreventive approach in the primary prevention of colon cancer in humans in the next future, and illuminate a promising horizon to combat progression of benign colonic pre-neoplastic lesions into malignant metastatic tumors and to manage colon cancer.展开更多
文摘AIM To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy(POEM) to prevent endoscopic progression of achalasia.METHODS We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients(197 women, 162 men) with a mean age of 42.1 years(range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type Ⅰ(n = 119), Ⅱa(n = 106), Ⅱb(n = 60), Ⅱc(n = 60), or Ⅲ(n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared.RESULTS Symptom duration increased significantly with increasing Ling classification(from Ⅰ to Ⅲ)(P < 0.05), whereas lower esophageal sphincter pressure decreased with increasing Ling type(from Ⅰ to Ⅲ)(P < 0.05). There was no difference in sex ratio or onset age among the Ling types, although the age at time of diagnosis washigher in Ling types Ⅱc and Ⅲ than in Ling types Ⅰ, Ⅱa, and Ⅱb. Of the 21 patients, 19 underwent highresolution manometry both before and after treatment. The mean preoperative and postoperative lower esophageal sphincter pressure were 34.6 mmH g(range, 15.3-59.4 mm Hg) and 15.0 mm Hg(range, 2.1-21.6 mmH g), respectively, indicating a statistically significant decrease after POEM. All of the 21 patients were treated successfully by POEM(postoperative Eckardt score ≤ 3) and still had the same Ling type during a mean followup period of 37.8 mo(range, 24-51 mo).CONCLUSION The Ling classification represents the endoscopic progressive process of achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM(Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.
文摘The recognition of headache by human being has gone through a long period of time.Headache was sorted into three kinds early in first century A.D. by Aretaeus(81-138),who named mild repeated headache as"cephalalgia",frequently attacking chronic headache as"cephalaea",and unilateral severe headache"heterocrania".Christian Ludwig
文摘A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertaken to further explore TQ’s chemopreventive efficacy against 1, 2-dimethylhydrazine (DMH)-induced colon carcinogenesis in the rat model through a two-phase study (initiation and post-initiation) and to evaluate its potential impact on tumor progression and invasion in vivo. TQ treatment in the initiation phase significantly reduced tumor incidence, multiplicity and mean tumor volume. However, although mean tumor volume and multiplicity were decreased upon TQ treatment in the post-initiation phase, TQ did not reduce incidence significantly. Cellular proliferation, as assessed by expression of colonic PCNA, was shown to be inhibited in consequence to TQ treatment in both phases, with a more pronounced reduction in the initiation phase. In addition, our results demonstrated an appreciable negative impact of TQ on vascular endothelial growth factor (VEGF) production in tumor-bearing rats. Furthermore, we provided evidence that TQ-treatment, in both phases, tended to considerably suppress tumor progression and invasion. Taken together, the present study demonstrated that TQ, at an orally daily dose of 10 mg/kg, has a chemopreventive effect in the initiation phase, and has the potential to attenuate tumor burden, suppress progression of pre-neoplastic lesions and to inhibit tumor growth in the post-initiation phase of DMH-induced colon carcinogenesis, We surmise that such effects of TQ may be due to suppression of cellular proliferation and inhibition of VEGF production. The results could provide an effective chemopreventive approach in the primary prevention of colon cancer in humans in the next future, and illuminate a promising horizon to combat progression of benign colonic pre-neoplastic lesions into malignant metastatic tumors and to manage colon cancer.
