Objective:Abdominal aortic aneurysm(AAA)is a significant medical problem with a high mortality rate.Nevertheless,the underlying mechanism for the progression and regression of AAA is unknown.Methods:Experimental model...Objective:Abdominal aortic aneurysm(AAA)is a significant medical problem with a high mortality rate.Nevertheless,the underlying mechanism for the progression and regression of AAA is unknown.Methods:Experimental model of AAA was first created by porcine pancreatic elastase incubation around the infrarenal aorta of C57BL/6 mice.Then,AAA progression and regression were evaluated based on the diameter and volume of AAA.The aortas were harvested for hematoxylin-eosin staining(HE),orcein staining,sirius red staining,immunofluorescence analysis and peris’prussian blue staining at the indicated time point.Finally,P-aminopropionitrile monofumarate(BAPN)was used to explore the underlying mechanism of the regression of AAA.Results:When we extended the observation period to 100 days,we not only observed an increase in the AAA diameter and volume in the early stage,but also a decrease in the late stage.Consistent with AAA diameter and volume,the aortic thickness showed the same tendency based on HE staining.The elastin and collagen content first degraded and then regenerated,which corresponds to the early deterioration and late regression of AAA.Then,endogenous up-regulation of lysyl oxidase(LOX)was detected,accompanying the regression of AAA,as detected by an immunofluorescent assay.BAPN and LOX inhibitor considerably inhibited the regression of AAA,paralleling the degradation of elastin lamella and collagen.Conclusion:Taken together,we tentatively conclude that endogenous re-generation of LOX played an influential role in the regression of AAA.Therefore,regulatory factors on the generation of LOX exhibit promising therapeutic potential against AAA.展开更多
BACKGROUND Histological changes after direct-acting antivirals(DAAs)therapy in hepatitis C virus(HCV)patients has not been elucidated.Whether the predominantly progressive,indeterminate and predominately regressive(P-...BACKGROUND Histological changes after direct-acting antivirals(DAAs)therapy in hepatitis C virus(HCV)patients has not been elucidated.Whether the predominantly progressive,indeterminate and predominately regressive(P-I-R)score,evaluating fibrosis activity in hepatitis B virus patients has predictive value in HCV patients has not been investigated.AIM To identify histological changes after DAAs therapy and to evaluate the predictive value of the P-I-R score in HCV patients.METHODS Chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.Sustained virologic response(SVR)was defined as an undetectable serum HCV RNA level at 24 wk after treatment cessation.The Ishak system and P-I-R score were assessed.Inflammation improvement and fibrosis regression were defined as a≥2-points decrease in the histology activity index(HAI)score and a≥1-point decrease in the Ishak fibrosis score,respectively.Fibrosis progression was defined as a≥1-point increase in the Ishak fibrosis score.Histologic improvement was defined as a≥2-points decrease in the HAI score without worsening of the Ishak fibrosis score after DAAs therapy.The P-I-R score was also assessed.“absolutely reversing or advancing”was defined as the same directionality implied by both change in the Ishak score and posttreatment P-I-R score;and“probably reversing or advancing”was defined as only one parameter showing directionality.RESULTS Thirty-eight chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.The mean age of these patients was 40.9±14.6 years and there were 53%(20/38)males.Thirty-four percent(13/38)of patients were cirrhotic.Eighty-two percent(31/38)of patients achieved inflammation improvement.The median HAI score decreased significantly after SVR(pretreatment 7.0 vs posttreatment 2.0,Z=-5.146,P=0.000).Thirty-seven percent(14/38)of patients achieved fibrosis improvement.The median Ishak score decreased significantly after SVR(pretreatment 4.0 vs posttreatment 3.0,Z=-2.354,P=0.019).Eighty-two percent(31/38)of patients showed histological improvement.The P-I-R score was evaluated in 61%(23/38)of patients.The progressive group showed lower platelet(P=0.024)and higher HAI scores(P=0.070)before treatment.In patients with stable Ishak stage after treatment:Progressive injury was seen in 22%(4/18)of patients,33%(6/18)were classified as indeterminate and regressive changes were seen in 44%(8/18)of patients who were judged as probably reversing by the Ishak and P-I-R systems.CONCLUSION Significant improvement of necroinflammation and partial remission of fibrosis in HCV patients occurred shortly after DAAs therapy.The P-I-R score has potential in predicting fibrosis in HCV patients.展开更多
Liver fibrosis is a wound-healing response of liver cells to chronic injuries caused by viral infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), toxins, and alcohol abuse. The ability to stage dis...Liver fibrosis is a wound-healing response of liver cells to chronic injuries caused by viral infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), toxins, and alcohol abuse. The ability to stage diseases for treatment na?ve patients to initiate proper medical procedures and predict the clinical causes of the disease or the treatment response is important given the increased prevalence of liver fibrosis caused by HBV, HCV and fatty liver diseases. CHI3L1 (chitinase-3-like protein 1, also known as YKL-40), which belongs to the chitinase family but lacks chitinolytic activity and is highly expressed in the liver, seems to fulfill this role. CHI3L1 is a non-invasive staging marker for liver fibrosis caused by HBV, HCV and non-alcoholic fatty liver disease as well as a predictor of the clinical causes and fibrotic changes after treatments. CHI3L1 predicts histological progression of liver fibrosis and fibrosis progression rate (fibrosis unit/year), rapid fibrosis progression after liver transplantation and response to interferon and recent direct acting antiviral therapy in chronic HCV patients. CHI3L1 also predicts response to antiviral therapy in chronic HBV patients.展开更多
AIM To elucidate longitudinal changes of an endoscopic Barrett esophagus(BE), especially of short segment endoscopic BE(SSBE). METHODS This study comprised 779 patients who underwent two or more endoscopies between Ja...AIM To elucidate longitudinal changes of an endoscopic Barrett esophagus(BE), especially of short segment endoscopic BE(SSBE). METHODS This study comprised 779 patients who underwent two or more endoscopies between January 2009 and December 2015. The intervals between the first and the last endoscopy were at least 6 mo. The diagnosis of endoscopic BE was based on the criteria proposed by the Japan Esophageal Society and was classified as long segment(LSBE) and SSBE, the latter being further divided into partial and circumferential types. The potential background factors that were deemed to affect BE change included age, gender, antacid therapy use, gastroesophageal reflux disease-suggested symptoms, esophagitis, and hiatus hernia. Time trends of a new appearance and complete regression were investigated by Kaplan-Meier curves. The factors that may affect appearance and complete regression were investigated by χ~2 and Student-t tests, and multivariable Cox regression analysis. RESULTS Incidences of SSBE and LSBE were respectively 21.7% and 0%, with a mean age of 68 years. Complete regression of SSBE was observed in 61.5% of initial SSBE patients, while 12.1% of initially disease free patients experienced an appearance of SSBE. Complete regressions and appearances of BE occurred constantly over time, accounting for 80% and 17% of 5-year cumulative rates. No LSBE development from SSBE was observed. A hiatus hernia was the only significant factor that facilitated BE development(P = 0.03) or hampered(P = 0.007) BE regression. CONCLUSION Both appearances and complete regressions of SSBE occurred over time. A hiatus hernia was the only significant factor affecting the BE story.展开更多
目的通过分析早产儿视网膜病变(retinopathy of prematurity,ROP)自然退行和进展的影响因素,了解ROP的发展规律,以期对ROP病儿的临床及筛查工作有一定指导作用。方法收集2018年9月至2021年4月在徐州医科大学附属医院就诊并进行眼底筛查...目的通过分析早产儿视网膜病变(retinopathy of prematurity,ROP)自然退行和进展的影响因素,了解ROP的发展规律,以期对ROP病儿的临床及筛查工作有一定指导作用。方法收集2018年9月至2021年4月在徐州医科大学附属医院就诊并进行眼底筛查的病儿472例。收集确定有眼底病变的141例病儿的临床资料,退行组107例,需干预治疗的进展组34例,分析早产儿视网膜病变自然退行与进展的影响因素。结果退行组和进展组平均胎龄分别为(31.61±2.29)周、(29.76±1.82)周,经独立样本的t检验,差异有统计学意义(P<0.05),两组出生体质量的中位数分别为1.58(1.25,1.82)kg、1.26(1.03,1.48)kg,无创通气时间为8.50(6.00,18.75)d、20.00(10.75,32.25)d,两组合并支气管肺发育不良(bronchopulmonary dysplasia,BPD)的占比分别为40.2%(43/107),79.4%(27/34),败血症59.8%(64/107)、82.4%(28/34)、贫血59.8%(64/107),82.4%(28/34)、输血34.6%(37/107)、61.8%(21/34),经非参数两独立样本检验,差异有统计学意义(均P<0.01);多因素logistics回归分析显示,胎龄(β=-0.32,P=0.004,OR<1)是ROP进展的独立危险因素。结论低出生体质量、胎龄小、无创通气时间长,合并支气管肺发育不良、败血症、贫血、输血的病儿ROP进展至需干预治疗的风险较高,提示对于胎龄小、低出生体质量的早产儿加强筛查管理,对于ROP病儿应防治BPD、贫血、严格把控输血指征用氧指征;胎龄是ROP进展的独立危险因素,应加强母孕期的检查与护理,延长孕周。展开更多
Conceptual models are suitable for describing internal relationships of complex systems, including soil. We used conceptual models, the Jenny＇s and Johnson and Watson-Stegner＇s models to understand the formation and...Conceptual models are suitable for describing internal relationships of complex systems, including soil. We used conceptual models, the Jenny＇s and Johnson and Watson-Stegner＇s models to understand the formation and evolution of soil. We studied 20 pedons in granitic hilly lands, loessial piedmont, and piedmont plain in southern Mashhad, northeast Iran. These soils were characterized by high levels of gypsum, especially in the granitic saprolites, which suggested the importance of the wind in shaping the soil structure. Jenny＇s model is a developmental and equilibrium model, which only describes the state of the soil formation factors and considers that each bioclimatie zone has a specific climax soil. It focuses on the genesis of the surface soil and is not suitable for buried soils and paleosols. Johnson and Watson-Stegner＇s model describes soil as a product of progressive and regressive processes due to horizonation or haploidization. Progressive processes during the last interglacial cycle created a well-developed paleosol with an argillic horizon in all landforms, except the piedmont plain. Developmental soil up-building by aeolian addition led to gypsum enrichment of the granitic saprolite. Erosion decreased soil thickness and exposed the argillic horizon. The Last Glacial Maximum led to greater deposition of loess, covering the paleosol. Humidity was higher during the early Holocene than today, leading to the development of a Bk horizon. This horizon was preserved in the stable surfaces of granitic hilly land and in the loessial piedmont, but buried on the piedmont plain via the deposition of alluvial sediments. Jenny＇s model could be used for current soil formation factors, whereas Johnson and Watson-Stegner＇s model required morphological characteristics of pedons for interpretation.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81770478 and No.81970395)the Shanghai Science and Technology Development Foundation(No.21S21901900)+1 种基金Inter-governmental Science and Technology Innovation Cooperation Program,Ministry of Science and Technology of China(No.2021YFE0111300)the Biological Resources Programme,Chinese Academy of Sciences(No.KFJ-BRP-008).
文摘Objective:Abdominal aortic aneurysm(AAA)is a significant medical problem with a high mortality rate.Nevertheless,the underlying mechanism for the progression and regression of AAA is unknown.Methods:Experimental model of AAA was first created by porcine pancreatic elastase incubation around the infrarenal aorta of C57BL/6 mice.Then,AAA progression and regression were evaluated based on the diameter and volume of AAA.The aortas were harvested for hematoxylin-eosin staining(HE),orcein staining,sirius red staining,immunofluorescence analysis and peris’prussian blue staining at the indicated time point.Finally,P-aminopropionitrile monofumarate(BAPN)was used to explore the underlying mechanism of the regression of AAA.Results:When we extended the observation period to 100 days,we not only observed an increase in the AAA diameter and volume in the early stage,but also a decrease in the late stage.Consistent with AAA diameter and volume,the aortic thickness showed the same tendency based on HE staining.The elastin and collagen content first degraded and then regenerated,which corresponds to the early deterioration and late regression of AAA.Then,endogenous up-regulation of lysyl oxidase(LOX)was detected,accompanying the regression of AAA,as detected by an immunofluorescent assay.BAPN and LOX inhibitor considerably inhibited the regression of AAA,paralleling the degradation of elastin lamella and collagen.Conclusion:Taken together,we tentatively conclude that endogenous re-generation of LOX played an influential role in the regression of AAA.Therefore,regulatory factors on the generation of LOX exhibit promising therapeutic potential against AAA.
基金The National Natural Science Foundation of China,No.81870406the Beijing Natural Science Foundation,No.7182174and the China National Science and Technology Major Project for Infectious Diseases Control during the 13th Five-Year Plan Period,No.2017ZX10202202.
文摘BACKGROUND Histological changes after direct-acting antivirals(DAAs)therapy in hepatitis C virus(HCV)patients has not been elucidated.Whether the predominantly progressive,indeterminate and predominately regressive(P-I-R)score,evaluating fibrosis activity in hepatitis B virus patients has predictive value in HCV patients has not been investigated.AIM To identify histological changes after DAAs therapy and to evaluate the predictive value of the P-I-R score in HCV patients.METHODS Chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.Sustained virologic response(SVR)was defined as an undetectable serum HCV RNA level at 24 wk after treatment cessation.The Ishak system and P-I-R score were assessed.Inflammation improvement and fibrosis regression were defined as a≥2-points decrease in the histology activity index(HAI)score and a≥1-point decrease in the Ishak fibrosis score,respectively.Fibrosis progression was defined as a≥1-point increase in the Ishak fibrosis score.Histologic improvement was defined as a≥2-points decrease in the HAI score without worsening of the Ishak fibrosis score after DAAs therapy.The P-I-R score was also assessed.“absolutely reversing or advancing”was defined as the same directionality implied by both change in the Ishak score and posttreatment P-I-R score;and“probably reversing or advancing”was defined as only one parameter showing directionality.RESULTS Thirty-eight chronic HCV patients with paired liver biopsy specimens before and after DAAs treatment were included.The mean age of these patients was 40.9±14.6 years and there were 53%(20/38)males.Thirty-four percent(13/38)of patients were cirrhotic.Eighty-two percent(31/38)of patients achieved inflammation improvement.The median HAI score decreased significantly after SVR(pretreatment 7.0 vs posttreatment 2.0,Z=-5.146,P=0.000).Thirty-seven percent(14/38)of patients achieved fibrosis improvement.The median Ishak score decreased significantly after SVR(pretreatment 4.0 vs posttreatment 3.0,Z=-2.354,P=0.019).Eighty-two percent(31/38)of patients showed histological improvement.The P-I-R score was evaluated in 61%(23/38)of patients.The progressive group showed lower platelet(P=0.024)and higher HAI scores(P=0.070)before treatment.In patients with stable Ishak stage after treatment:Progressive injury was seen in 22%(4/18)of patients,33%(6/18)were classified as indeterminate and regressive changes were seen in 44%(8/18)of patients who were judged as probably reversing by the Ishak and P-I-R systems.CONCLUSION Significant improvement of necroinflammation and partial remission of fibrosis in HCV patients occurred shortly after DAAs therapy.The P-I-R score has potential in predicting fibrosis in HCV patients.
文摘Liver fibrosis is a wound-healing response of liver cells to chronic injuries caused by viral infections, including hepatitis B virus (HBV), hepatitis C virus (HCV), toxins, and alcohol abuse. The ability to stage diseases for treatment na?ve patients to initiate proper medical procedures and predict the clinical causes of the disease or the treatment response is important given the increased prevalence of liver fibrosis caused by HBV, HCV and fatty liver diseases. CHI3L1 (chitinase-3-like protein 1, also known as YKL-40), which belongs to the chitinase family but lacks chitinolytic activity and is highly expressed in the liver, seems to fulfill this role. CHI3L1 is a non-invasive staging marker for liver fibrosis caused by HBV, HCV and non-alcoholic fatty liver disease as well as a predictor of the clinical causes and fibrotic changes after treatments. CHI3L1 predicts histological progression of liver fibrosis and fibrosis progression rate (fibrosis unit/year), rapid fibrosis progression after liver transplantation and response to interferon and recent direct acting antiviral therapy in chronic HCV patients. CHI3L1 also predicts response to antiviral therapy in chronic HBV patients.
文摘AIM To elucidate longitudinal changes of an endoscopic Barrett esophagus(BE), especially of short segment endoscopic BE(SSBE). METHODS This study comprised 779 patients who underwent two or more endoscopies between January 2009 and December 2015. The intervals between the first and the last endoscopy were at least 6 mo. The diagnosis of endoscopic BE was based on the criteria proposed by the Japan Esophageal Society and was classified as long segment(LSBE) and SSBE, the latter being further divided into partial and circumferential types. The potential background factors that were deemed to affect BE change included age, gender, antacid therapy use, gastroesophageal reflux disease-suggested symptoms, esophagitis, and hiatus hernia. Time trends of a new appearance and complete regression were investigated by Kaplan-Meier curves. The factors that may affect appearance and complete regression were investigated by χ~2 and Student-t tests, and multivariable Cox regression analysis. RESULTS Incidences of SSBE and LSBE were respectively 21.7% and 0%, with a mean age of 68 years. Complete regression of SSBE was observed in 61.5% of initial SSBE patients, while 12.1% of initially disease free patients experienced an appearance of SSBE. Complete regressions and appearances of BE occurred constantly over time, accounting for 80% and 17% of 5-year cumulative rates. No LSBE development from SSBE was observed. A hiatus hernia was the only significant factor that facilitated BE development(P = 0.03) or hampered(P = 0.007) BE regression. CONCLUSION Both appearances and complete regressions of SSBE occurred over time. A hiatus hernia was the only significant factor affecting the BE story.
文摘目的通过分析早产儿视网膜病变(retinopathy of prematurity,ROP)自然退行和进展的影响因素,了解ROP的发展规律,以期对ROP病儿的临床及筛查工作有一定指导作用。方法收集2018年9月至2021年4月在徐州医科大学附属医院就诊并进行眼底筛查的病儿472例。收集确定有眼底病变的141例病儿的临床资料,退行组107例,需干预治疗的进展组34例,分析早产儿视网膜病变自然退行与进展的影响因素。结果退行组和进展组平均胎龄分别为(31.61±2.29)周、(29.76±1.82)周,经独立样本的t检验,差异有统计学意义(P<0.05),两组出生体质量的中位数分别为1.58(1.25,1.82)kg、1.26(1.03,1.48)kg,无创通气时间为8.50(6.00,18.75)d、20.00(10.75,32.25)d,两组合并支气管肺发育不良(bronchopulmonary dysplasia,BPD)的占比分别为40.2%(43/107),79.4%(27/34),败血症59.8%(64/107)、82.4%(28/34)、贫血59.8%(64/107),82.4%(28/34)、输血34.6%(37/107)、61.8%(21/34),经非参数两独立样本检验,差异有统计学意义(均P<0.01);多因素logistics回归分析显示,胎龄(β=-0.32,P=0.004,OR<1)是ROP进展的独立危险因素。结论低出生体质量、胎龄小、无创通气时间长,合并支气管肺发育不良、败血症、贫血、输血的病儿ROP进展至需干预治疗的风险较高,提示对于胎龄小、低出生体质量的早产儿加强筛查管理,对于ROP病儿应防治BPD、贫血、严格把控输血指征用氧指征;胎龄是ROP进展的独立危险因素,应加强母孕期的检查与护理,延长孕周。
文摘Conceptual models are suitable for describing internal relationships of complex systems, including soil. We used conceptual models, the Jenny＇s and Johnson and Watson-Stegner＇s models to understand the formation and evolution of soil. We studied 20 pedons in granitic hilly lands, loessial piedmont, and piedmont plain in southern Mashhad, northeast Iran. These soils were characterized by high levels of gypsum, especially in the granitic saprolites, which suggested the importance of the wind in shaping the soil structure. Jenny＇s model is a developmental and equilibrium model, which only describes the state of the soil formation factors and considers that each bioclimatie zone has a specific climax soil. It focuses on the genesis of the surface soil and is not suitable for buried soils and paleosols. Johnson and Watson-Stegner＇s model describes soil as a product of progressive and regressive processes due to horizonation or haploidization. Progressive processes during the last interglacial cycle created a well-developed paleosol with an argillic horizon in all landforms, except the piedmont plain. Developmental soil up-building by aeolian addition led to gypsum enrichment of the granitic saprolite. Erosion decreased soil thickness and exposed the argillic horizon. The Last Glacial Maximum led to greater deposition of loess, covering the paleosol. Humidity was higher during the early Holocene than today, leading to the development of a Bk horizon. This horizon was preserved in the stable surfaces of granitic hilly land and in the loessial piedmont, but buried on the piedmont plain via the deposition of alluvial sediments. Jenny＇s model could be used for current soil formation factors, whereas Johnson and Watson-Stegner＇s model required morphological characteristics of pedons for interpretation.
