AIM To compare the features ofgastroesophageal reflux disease between elderlyand younger patients.METHODS Twenty-four hour pH-monitoring andendoscopy were P6rformed for the 66 elderlypatients with typical gastroesopha...AIM To compare the features ofgastroesophageal reflux disease between elderlyand younger patients.METHODS Twenty-four hour pH-monitoring andendoscopy were P6rformed for the 66 elderlypatients with typical gastroesophageaI refluxsymptoms, and the results were compared with112 symptomatic younger patients.RESULTS The results of 24-h pH-monitoringand endoscopy showed that the elderly patientshad pathological reflux and reflux esophagitismore frequently than the younger patients.P6rcentage time with pH< 4 in elderly patientswith reflux esophagitis was 32.5% in 24 hours,as compared with 12.9% in the younger patientswith reflux esophagitis (P < 0 .05 ). The elderlypatients with reflux esophagitis have longerP6riOds of acid reflux in both upright and Supinepositions than the younger patients. Endoscopyshowed that 20 .8% of elderIy patients had grade Ⅲ / Ⅳ esophagitis, whereas only 3.4% ofyounger patients had grade Ⅲ/ Ⅳ esophagitis(P < 0.002 ). Percentages of grades Ⅰ /Ⅱesophagitis in the two groups were 12.5% and26. 5%, respectiveIy (P< 0. 002 ).CONCLUSION Elderly patients, as comparedwith younger patients, have more severegastroesophageal reflux and esophageal lesions.The incompetence of lower esophageal sphincter and the presence of hiataI hernia may beimportant factors leading to the difference in incidence and severity of reflux esophagitisbetween elderly and younger patients.展开更多
BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the character...BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the characterization of FLLs in comparison with final diagnosis based on gold standard assessment. METHODS: The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue (R), Bracco, Italy). Sensitivity, specificity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS: When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue (R) enhanced US examination. Sensitivity and specificity improved from 49% and 25% at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION: SonoVue (R) enhanced US improves the characterization of FLLs and may limit the need for further investigations.展开更多
Dear Editor, In February and March 2013, a novel influenza A （H7N9） virus emerged in China, causing an acute respiratory distress syndrome and occasionally multiple organ failure with high fatality rates in humans ...Dear Editor, In February and March 2013, a novel influenza A （H7N9） virus emerged in China, causing an acute respiratory distress syndrome and occasionally multiple organ failure with high fatality rates in humans （Li et al., 2014）. A total of 681 laboratory-confirmed cases and 275 deaths have been reported as of November 13th,展开更多
Background Treatments to regenerate different tissue involving the transplantation of bone marrow derived mesenchymal precursor cells are anticipated. Using an alternative methods, in vitro organotypic slice culture m...Background Treatments to regenerate different tissue involving the transplantation of bone marrow derived mesenchymal precursor cells are anticipated. Using an alternative methods, in vitro organotypic slice culture method, would be useful to transplant cells and assessing the effects. This study was to determine the possibility of differentiating human bone marrow precursor cells into cells of the neuronal lineage by transplanting into canine spinal cord organotypic slice cultures. Methods Bone marrow aspirates were obtained from posterior superior iliac spine （PSIS） of patients that had undergone spinal fusion due to a degenerative spinal disorder. For cell imaging, mesenchymal precursor cells （MPCs） were pre-stained with PKH-26 just before transplantation to canine spinal cord slices. Canine spinal cord tissues were obtained from three adult beagle dogs. Spinal cords were cut into transverse slices of 1 mm using tissue chopper. Two slices were transferred into 6-well plate containing 3 ml DMEM with antibiotics. Prepared MPCs （lx104） were transplanted into spinal cord slices. On days 0, 3, 7, 14, MPCs were observed for morphological changes and expression of neuronal markers through immunofluorescence and reverse transcription-polymerase chain reaction （RT-PCR）. Results The morphological study showed： spherical cells in the control and experiment groups on day 0; and on day 3, cells in the control group had one or two thick, short processes and ones in the experiment group had three or four thin, long processes. On day 7, these variously-sized processes contacted each other in the experiment group, but showed typical spindle-shaped cells in the control group. Immunofluorescence showed that PKH-26（＋） MPCs stained positive for NeuN （＋） and GFAP（＋） in experimental group only. Also RT-PCR showed weak expression of β-tubulin III and GFAP. Conclusions Human bone marrow mesenchymal precursor cells （hMPCs） have the potential to differentiate into the neuronal like cells in this canine spinal cord organotypic slice culture model. Furthermore, these findings suggested the possibility that these cells can be utilized to treat patients with spinal cord injuries.展开更多
文摘AIM To compare the features ofgastroesophageal reflux disease between elderlyand younger patients.METHODS Twenty-four hour pH-monitoring andendoscopy were P6rformed for the 66 elderlypatients with typical gastroesophageaI refluxsymptoms, and the results were compared with112 symptomatic younger patients.RESULTS The results of 24-h pH-monitoringand endoscopy showed that the elderly patientshad pathological reflux and reflux esophagitismore frequently than the younger patients.P6rcentage time with pH< 4 in elderly patientswith reflux esophagitis was 32.5% in 24 hours,as compared with 12.9% in the younger patientswith reflux esophagitis (P < 0 .05 ). The elderlypatients with reflux esophagitis have longerP6riOds of acid reflux in both upright and Supinepositions than the younger patients. Endoscopyshowed that 20 .8% of elderIy patients had grade Ⅲ / Ⅳ esophagitis, whereas only 3.4% ofyounger patients had grade Ⅲ/ Ⅳ esophagitis(P < 0.002 ). Percentages of grades Ⅰ /Ⅱesophagitis in the two groups were 12.5% and26. 5%, respectiveIy (P< 0. 002 ).CONCLUSION Elderly patients, as comparedwith younger patients, have more severegastroesophageal reflux and esophageal lesions.The incompetence of lower esophageal sphincter and the presence of hiataI hernia may beimportant factors leading to the difference in incidence and severity of reflux esophagitisbetween elderly and younger patients.
文摘BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the characterization of FLLs in comparison with final diagnosis based on gold standard assessment. METHODS: The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue (R), Bracco, Italy). Sensitivity, specificity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS: When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue (R) enhanced US examination. Sensitivity and specificity improved from 49% and 25% at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION: SonoVue (R) enhanced US improves the characterization of FLLs and may limit the need for further investigations.
文摘Dear Editor, In February and March 2013, a novel influenza A （H7N9） virus emerged in China, causing an acute respiratory distress syndrome and occasionally multiple organ failure with high fatality rates in humans （Li et al., 2014）. A total of 681 laboratory-confirmed cases and 275 deaths have been reported as of November 13th,
文摘Background Treatments to regenerate different tissue involving the transplantation of bone marrow derived mesenchymal precursor cells are anticipated. Using an alternative methods, in vitro organotypic slice culture method, would be useful to transplant cells and assessing the effects. This study was to determine the possibility of differentiating human bone marrow precursor cells into cells of the neuronal lineage by transplanting into canine spinal cord organotypic slice cultures. Methods Bone marrow aspirates were obtained from posterior superior iliac spine （PSIS） of patients that had undergone spinal fusion due to a degenerative spinal disorder. For cell imaging, mesenchymal precursor cells （MPCs） were pre-stained with PKH-26 just before transplantation to canine spinal cord slices. Canine spinal cord tissues were obtained from three adult beagle dogs. Spinal cords were cut into transverse slices of 1 mm using tissue chopper. Two slices were transferred into 6-well plate containing 3 ml DMEM with antibiotics. Prepared MPCs （lx104） were transplanted into spinal cord slices. On days 0, 3, 7, 14, MPCs were observed for morphological changes and expression of neuronal markers through immunofluorescence and reverse transcription-polymerase chain reaction （RT-PCR）. Results The morphological study showed： spherical cells in the control and experiment groups on day 0; and on day 3, cells in the control group had one or two thick, short processes and ones in the experiment group had three or four thin, long processes. On day 7, these variously-sized processes contacted each other in the experiment group, but showed typical spindle-shaped cells in the control group. Immunofluorescence showed that PKH-26（＋） MPCs stained positive for NeuN （＋） and GFAP（＋） in experimental group only. Also RT-PCR showed weak expression of β-tubulin III and GFAP. Conclusions Human bone marrow mesenchymal precursor cells （hMPCs） have the potential to differentiate into the neuronal like cells in this canine spinal cord organotypic slice culture model. Furthermore, these findings suggested the possibility that these cells can be utilized to treat patients with spinal cord injuries.
