AIM： To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation （OLT） biliary complications and to study their profile before and after endoscopic therapy.METHODS：...AIM： To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation （OLT） biliary complications and to study their profile before and after endoscopic therapy.METHODS： Patients who developed biliary complications were analysed in detail for the clinical information, laboratory tests, treatment offered, response to it, follow up and outcomes. The profile of liver enzymes was determined. The safety, efficacy and outcomes of endoscopic retrograde cholangiography （ERC） were also analysed. RESULTS： 40 patients required ERC for 70 biliary complications. GGT was found to be 〉 3 times （388.1 ± 70.9 U/mL vs 168.5 4± 34.2 U/L, P = 0.007） and SAP 〉 2 times （345.1 ± 59.1 U/L vs 152.7 ± 21.4 U/L, P = 0.003） the immediate post OLT values. Most frequent complication was isolated anastomotic res in 28 （40%）. Sustained success was achieved in 26 （81%） patients. CONCLUSION： Biliary complications still remain an important problem post OLT. SAP and GGT can be used as early, non-invasive markers for diagnosis and also to assess the adequacy of therapy. Endoscopic management is usually effective in treating the majority of these biliary complications.展开更多
Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mech...Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can be achieved through stand-ardized experimental human pain models. Experimental pain models in healthy volunteers are advantageous for evaluation of analgesic action, as this is often diff icult to assess in the clinic because of confounding factors such as sedation, nausea and general malaise. These pain models facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic stud- ies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical treatment of visceral pain. To improve treatment of visceral pain, it is important to study the underlying mechanisms of pain and the action of analgesics used for its treatment. An experimental pain model activates different modalities and can be used to investigate the mechanism of action of different analgesics in detail. In combination with pharmacokinetic studies and objective assessment such as electroencephalography, new information re-garding a given drug substance and its effects can be obtained. Results from experimental human visceral pain research can bridge the gap in knowledge between animal studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.展开更多
Acute esophageal necrosis (AEN) or 'black esophagus' is a clinical condition found at endoscopy. It is a rare entity the exact etiology of which remains unknown. We describe a case of 'black esophagus'...Acute esophageal necrosis (AEN) or 'black esophagus' is a clinical condition found at endoscopy. It is a rare entity the exact etiology of which remains unknown. We describe a case of 'black esophagus', first of its kind, in the setting of liver cirrhosis and hepatic encephalopathy.展开更多
AIM： To investigate and review the contrast-enhanced multiple-phase computed tomography （CEMP CT） and magnetic resonance imaging （MRI） findings in patients with pathologically confirmed hepatic epithelioid hemang...AIM： To investigate and review the contrast-enhanced multiple-phase computed tomography （CEMP CT） and magnetic resonance imaging （MRI） findings in patients with pathologically confirmed hepatic epithelioid hemangioendothelioma （HEHE）. METHODS： Findings from imaging examinations in 8 patients （5 women and 3 men） with pathologically confirmed HEHE were retrospectively reviewed （CT images obtained from 7 patients and MR images obtained from 6 patients）. The age of presentation varied from 27 years to 60 years （average age 39.8 years）. RESULTS： There were two types of HEHE： multifocal type （n = 7） and diffuse type （n = 1）. Tn the multifocal-type cases, there were 74 lesions on CT and 28 lesions on MRI with 7 lesions found with diffusion weighted imaging; 18 （24.3%） of 74 lesions on plain CT and 26 （92.9%） of 28 lesions on pre-contrast MRI showed the target sign. On CEMP CT, 28 （37.8%） of 74 lesions appeared with the target sign and a progressive-enhancement rim and 9 （12.2%） of 74 lesions displayed progressive enhancement, maintaining a state of persistent enhancement. On CEMP MRI, 27 （96.4%） of 28 lesions appeared with the target sign with a progressive-enhancement rim and 28 （100%） of 28 lesions displayed progressive-enhancement, maintaining a state of persistent enhancement. In the diffuse-type cases, an enlarged liver was observed with a large nodule appearing with persistent enhancement on CEMP CT and MRI. CONCLUSION： The most important imaging features of HEHE are the target sign and/or progressive en- hancement with persistent enhancement on CEMP CT and MRI. MRI is advantageous over CT in displaying these imaging features.展开更多
Irritable bowel syndrome （IBS） is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS （IBS-D） is a ...Irritable bowel syndrome （IBS） is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS （IBS-D） is a major subtype of IBS, the predominant manifestations of which are abdominal pain and diarrhea. The pathogenesis of IBS-D remained unknown until recently. The effects of psychosocial stress, central hypervigilance, neuroendocrine abnor- mality, disturbed gastrointestinal motility, mucosal immune activation, intestinal barrier dysfunction, visceral hyper- sensitivity （VH）, altered gut flora, and genetic susceptibility may be involved in its development. Recently, increased attention has been placed on the neural-immune-endocrine network mechanism in IBS-D, especially the role of var- ious neuroendocrine mediators. As a member of the neurotrophin family, nerve growth factor （NGF） has diverse bio- logical effects, and participates in the pathogenesis of many diseases. Basic studies have demonstrated that NGF is associated with inflammatory- and stress-related VH, as well as stress-related intestinal barrier dysfunction. The aim of this study is to summarize recent literature and discuss the role of NGF in the pathophysiology of IBS-D, especially in VH and intestinal barrier dysfunction, as well as its potential as a therapeutic target in IBS-D.展开更多
Gut microbiota of four economically important Asian carp species(silver carp, Hypophthalmichthys molitrix; bighead carp,Hypophthalmichthys nobilis; grass carp, Ctenopharyngodon idella; common carp, Cyprinus carpio) we...Gut microbiota of four economically important Asian carp species(silver carp, Hypophthalmichthys molitrix; bighead carp,Hypophthalmichthys nobilis; grass carp, Ctenopharyngodon idella; common carp, Cyprinus carpio) were compared using 16 S rRNA gene pyrosequencing. Analysis of more than 590,000 quality-filtered sequences obtained from the foregut, midgut and hindgut of these four carp species revealed high microbial diversity among the samples. The foregut samples of grass carp exhibited more than 1,600 operational taxonomy units(OTUs) and the highest alpha-diversity index, followed by the silver carp foregut and midgut. Proteobacteria, Firmicutes, Bacteroidetes and Fusobacteria were the predominant phyla regardless of fish species or gut type. Pairwise(weighted) UniFrac distance-based permutational multivariate analysis of variance with fish species as a factor produced significant association(P<0.01). The gut microbiotas of all four carp species harbored saccharolytic or proteolytic microbes, likely in response to the differences in their feeding habits. In addition, extensive variations were also observed even within the same fish species. Our results indicate that the gut microbiotas of Asian carp depend on the exact species, even when the different species were cohabiting in the same environment. This study provides some new insights into developing commercial fish feeds and improving existing aquaculture strategies.展开更多
OBJECTIVE:To study the Chinese ancient five-element theory,one of the philosophical foundations of Traditional Chinese Medicine(TCM)theory construction,from the perspective of comtemporary cognitive science,and to rev...OBJECTIVE:To study the Chinese ancient five-element theory,one of the philosophical foundations of Traditional Chinese Medicine(TCM)theory construction,from the perspective of comtemporary cognitive science,and to reveal the important functions of five-element theory in the construction of TCM theory.METHODS:The basic effects of five-element theory in the construction of TCM theory are intensively expounded and proved from the following aspects:embodiment of five-element theory in cognizing the world,quasi axiom of five-element theory in essence,classification thery of family resemblance and deductive inference pattern of five-element theory,and the openness and expansibility of five-element theory.RESULTS:If five-element theory is considered acognitive pattern or cognitive system related to culture,then there should be features of cognitive embodiment in the cognitive system.If five-element theory is regarded as a symbolic system,however,then there should be a quasi-axiom for the system,and inferential deduction.If,however,five-element theory is taken as a theoretical constructive metaphor,then there should be features of opening and expansibility for the metaphor.CONCLUSION:Based on five-element theory,this study provides a cognitive frame for the construction of TCM(a medicine that originated in China,and is characterized by holism and treatment based on pattern identification differentiation)theory with the function of constructing a concept base,thereby implying further research strategies.Useful information may be produced from the creative inferences obtained from the incorporation of five-element theory.展开更多
文摘AIM： To correlate the significance of liver biochemical tests in diagnosing post orthotopic liver transplantation （OLT） biliary complications and to study their profile before and after endoscopic therapy.METHODS： Patients who developed biliary complications were analysed in detail for the clinical information, laboratory tests, treatment offered, response to it, follow up and outcomes. The profile of liver enzymes was determined. The safety, efficacy and outcomes of endoscopic retrograde cholangiography （ERC） were also analysed. RESULTS： 40 patients required ERC for 70 biliary complications. GGT was found to be 〉 3 times （388.1 ± 70.9 U/mL vs 168.5 4± 34.2 U/L, P = 0.007） and SAP 〉 2 times （345.1 ± 59.1 U/L vs 152.7 ± 21.4 U/L, P = 0.003） the immediate post OLT values. Most frequent complication was isolated anastomotic res in 28 （40%）. Sustained success was achieved in 26 （81%） patients. CONCLUSION： Biliary complications still remain an important problem post OLT. SAP and GGT can be used as early, non-invasive markers for diagnosis and also to assess the adequacy of therapy. Endoscopic management is usually effective in treating the majority of these biliary complications.
文摘Deep visceral pain is frequent and presents major challenges in pain management, since its pathophysiology is still poorly understood. One way to optimize treatment of visceral pain is to improve knowledge of the mechanisms behind the pain and the mode of action of analgesic substances. This can be achieved through stand-ardized experimental human pain models. Experimental pain models in healthy volunteers are advantageous for evaluation of analgesic action, as this is often diff icult to assess in the clinic because of confounding factors such as sedation, nausea and general malaise. These pain models facilitate minimizing the gap between knowledge gained in animal and human clinical studies. Combining experimental pain studies and pharmacokinetic stud- ies can improve understanding of the pharmacokinetic-pharmacodynamic relationship of analgesics and, thus, provide valuable insight into optimal clinical treatment of visceral pain. To improve treatment of visceral pain, it is important to study the underlying mechanisms of pain and the action of analgesics used for its treatment. An experimental pain model activates different modalities and can be used to investigate the mechanism of action of different analgesics in detail. In combination with pharmacokinetic studies and objective assessment such as electroencephalography, new information re-garding a given drug substance and its effects can be obtained. Results from experimental human visceral pain research can bridge the gap in knowledge between animal studies and clinical condition in patients suffering from visceral pain, and thus constitute the missing link in translational pain research.
文摘Acute esophageal necrosis (AEN) or 'black esophagus' is a clinical condition found at endoscopy. It is a rare entity the exact etiology of which remains unknown. We describe a case of 'black esophagus', first of its kind, in the setting of liver cirrhosis and hepatic encephalopathy.
文摘AIM： To investigate and review the contrast-enhanced multiple-phase computed tomography （CEMP CT） and magnetic resonance imaging （MRI） findings in patients with pathologically confirmed hepatic epithelioid hemangioendothelioma （HEHE）. METHODS： Findings from imaging examinations in 8 patients （5 women and 3 men） with pathologically confirmed HEHE were retrospectively reviewed （CT images obtained from 7 patients and MR images obtained from 6 patients）. The age of presentation varied from 27 years to 60 years （average age 39.8 years）. RESULTS： There were two types of HEHE： multifocal type （n = 7） and diffuse type （n = 1）. Tn the multifocal-type cases, there were 74 lesions on CT and 28 lesions on MRI with 7 lesions found with diffusion weighted imaging; 18 （24.3%） of 74 lesions on plain CT and 26 （92.9%） of 28 lesions on pre-contrast MRI showed the target sign. On CEMP CT, 28 （37.8%） of 74 lesions appeared with the target sign and a progressive-enhancement rim and 9 （12.2%） of 74 lesions displayed progressive enhancement, maintaining a state of persistent enhancement. On CEMP MRI, 27 （96.4%） of 28 lesions appeared with the target sign with a progressive-enhancement rim and 28 （100%） of 28 lesions displayed progressive-enhancement, maintaining a state of persistent enhancement. In the diffuse-type cases, an enlarged liver was observed with a large nodule appearing with persistent enhancement on CEMP CT and MRI. CONCLUSION： The most important imaging features of HEHE are the target sign and/or progressive en- hancement with persistent enhancement on CEMP CT and MRI. MRI is advantageous over CT in displaying these imaging features.
基金Project supported by the National Ministry of Science and Technology“Twelfth Five-Year”Supporting Project(No.2014BAI08B02),China
文摘Irritable bowel syndrome （IBS） is a common functional gastrointestinal disorder characterized by recurrent abdominal pain or discomfort associated with abnormal bowel habits. Diarrhea-predominant IBS （IBS-D） is a major subtype of IBS, the predominant manifestations of which are abdominal pain and diarrhea. The pathogenesis of IBS-D remained unknown until recently. The effects of psychosocial stress, central hypervigilance, neuroendocrine abnor- mality, disturbed gastrointestinal motility, mucosal immune activation, intestinal barrier dysfunction, visceral hyper- sensitivity （VH）, altered gut flora, and genetic susceptibility may be involved in its development. Recently, increased attention has been placed on the neural-immune-endocrine network mechanism in IBS-D, especially the role of var- ious neuroendocrine mediators. As a member of the neurotrophin family, nerve growth factor （NGF） has diverse bio- logical effects, and participates in the pathogenesis of many diseases. Basic studies have demonstrated that NGF is associated with inflammatory- and stress-related VH, as well as stress-related intestinal barrier dysfunction. The aim of this study is to summarize recent literature and discuss the role of NGF in the pathophysiology of IBS-D, especially in VH and intestinal barrier dysfunction, as well as its potential as a therapeutic target in IBS-D.
基金supported by the National Natural Science Foundation of China(31400109,31372202)the Youth Innovation Promotion Association,Chinese Academy of Sciences(Y22Z07)
文摘Gut microbiota of four economically important Asian carp species(silver carp, Hypophthalmichthys molitrix; bighead carp,Hypophthalmichthys nobilis; grass carp, Ctenopharyngodon idella; common carp, Cyprinus carpio) were compared using 16 S rRNA gene pyrosequencing. Analysis of more than 590,000 quality-filtered sequences obtained from the foregut, midgut and hindgut of these four carp species revealed high microbial diversity among the samples. The foregut samples of grass carp exhibited more than 1,600 operational taxonomy units(OTUs) and the highest alpha-diversity index, followed by the silver carp foregut and midgut. Proteobacteria, Firmicutes, Bacteroidetes and Fusobacteria were the predominant phyla regardless of fish species or gut type. Pairwise(weighted) UniFrac distance-based permutational multivariate analysis of variance with fish species as a factor produced significant association(P<0.01). The gut microbiotas of all four carp species harbored saccharolytic or proteolytic microbes, likely in response to the differences in their feeding habits. In addition, extensive variations were also observed even within the same fish species. Our results indicate that the gut microbiotas of Asian carp depend on the exact species, even when the different species were cohabiting in the same environment. This study provides some new insights into developing commercial fish feeds and improving existing aquaculture strategies.
基金Supported by the Natural Science Foundation of China(No.30973971,No.81173464)Doctoral Fund of the Ministry of Education of China(No.20090013110012)
文摘OBJECTIVE:To study the Chinese ancient five-element theory,one of the philosophical foundations of Traditional Chinese Medicine(TCM)theory construction,from the perspective of comtemporary cognitive science,and to reveal the important functions of five-element theory in the construction of TCM theory.METHODS:The basic effects of five-element theory in the construction of TCM theory are intensively expounded and proved from the following aspects:embodiment of five-element theory in cognizing the world,quasi axiom of five-element theory in essence,classification thery of family resemblance and deductive inference pattern of five-element theory,and the openness and expansibility of five-element theory.RESULTS:If five-element theory is considered acognitive pattern or cognitive system related to culture,then there should be features of cognitive embodiment in the cognitive system.If five-element theory is regarded as a symbolic system,however,then there should be a quasi-axiom for the system,and inferential deduction.If,however,five-element theory is taken as a theoretical constructive metaphor,then there should be features of opening and expansibility for the metaphor.CONCLUSION:Based on five-element theory,this study provides a cognitive frame for the construction of TCM(a medicine that originated in China,and is characterized by holism and treatment based on pattern identification differentiation)theory with the function of constructing a concept base,thereby implying further research strategies.Useful information may be produced from the creative inferences obtained from the incorporation of five-element theory.
