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Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery 被引量:1
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作者 Zhen-Zhen Wang Xian-Bin Zhou +8 位作者 Yi Wang Xin-Li Mao Li-Ping Ye Ling-Ling Yan ya-hong chen Ya-Qi Song Yue Cai Shi-Wen Xu Shao-Wei Li 《World Journal of Gastroenterology》 SCIE CAS 2021年第35期5958-5966,共9页
BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still ... BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.AIM To evaluate the effectiveness and safety of an over-the-scope clip(OTSC)in the treatment of perforation post-endoscopic resection of duodenal SELs.METHODS From May 2015 to November 2019,18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs.Data comprising the rate of complete resection,closure of intraprocedural perforation,delayed bleeding,delayed perforation,and postoperative infection were extracted.RESULTS The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%.The median perforation size was 1 cm in diameter.Seventeen patients had minor intraoperative bleeding,while the remaining 1 patient had considerable amount of bleeding during the procedure.Seven patients had postoperative abdominal infections,of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock.All 18 patients recovered and were discharged.No delayed bleeding or perforation was reported.The mean time taken to resume normal diet after the procedure was 6.5 d.The mean postoperative hospital stay was 9.5 d.No residual or recurrent lesions were detected during the follow-up period(15-66 mo).CONCLUSION Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method. 展开更多
关键词 Over-the-scope clip Duodenal subepithelial lesion Endoscopic resection Perforation EFFECTIVENESS SAFETY
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Calcitonin gene-related peptide inhibits neuronal apoptosis in heatstroke rats via PKA/p-CREB pathway 被引量:1
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作者 Jie Zhu ya-hong chen +2 位作者 Jing-Jing Ji cheng-Xiang Lu Zhi-Feng Liu 《Chinese Journal of Traumatology》 CAS CSCD 2024年第1期18-26,共9页
Purpose:The incidence of heatstroke(HS)is not particularly high;however,once it occurs,the consequences are serious.It is reported that calcitonin gene-related peptide(CGRP)is protective against brain injury in HS rat... Purpose:The incidence of heatstroke(HS)is not particularly high;however,once it occurs,the consequences are serious.It is reported that calcitonin gene-related peptide(CGRP)is protective against brain injury in HS rats,but detailed molecular mechanisms need to be further investigated.In this study,we further explored whether CGRP inhibited neuronal apoptosis in HS rats via protein kinase A(PKA)/p-cAMP response element-binding protein(p-CREB)pathway.Methods:We established a HS rat model in a pre-warmed artificial climate chamber with a temperature of(35.5±0.5)℃and a relative humidity of 60%±5%.Heatstress was stopped once core body temperature reaches above 41℃.A total of 25 rats were randomly divided into 5 groups with 5 animals each:control group,HS group,HS+CGRP group,HS+CGRP antagonist(CGRP8-37)group,and HS+CGRP+PKA/p-CREB pathway blocker(H89)group.A bolus injection of CGRP was administered to each rat in HS+CGRP group,CGRP8-37(antagonist of CGRP)in HS+CGRP8-37 group,and CGRP with H89 in HS+CGRP+H89 group.Electroencephalograms were recorded and the serum concentration of S100B,neuron-specific enolase(NSE),neuron apoptosis,activated caspase-3 and CGRP expression,as well as pathological morphology of brain tissue were detected at 2 h,6 h,and 24 h after HSin vivo.The expression of PKA,p-CREB,and Bcl-2 in rat neurons were also detected at 2 h after HSin vitro.Exogenous CGRP,CGRP8-37,or H89 were used to determine whether CGRP plays a protective role in brain injury via PKA/p-CREB pathway.The unpairedt-test was used between the 2 samples,and the mean±SD was used for multiple samples.Double-tailedp<0.05 was considered statistically significant.Results:Electroencephalogram showed significant alteration ofθ(54.50±11.51vs.31.30±8.71,F=6.790,p=0.005)andαwave(16.60±3.21vs.35.40±11.28,F=4.549,p=0.020)in HS group compared to the control group 2 h after HS.The results of triphosphate gap terminal labeling(TUNEL)showed that the neuronal apoptosis of HS rats was increased in the cortex(9.67±3.16vs.1.80±1.10,F=11.002,p=0.001)and hippocampus(15.73±8.92vs.2.00±1.00,F=4.089,p=0.028),the expression of activated caspase-3 was increased in the cortex(61.76±25.13vs.19.57±17.88,F=5.695,p=0.009)and hippocampus(58.60±23.30vs.17.80±17.62,F=4.628,p=0.019);meanwhile the expression of serum NSE(5.77±1.78vs.2.35±0.56,F=5.174,p=0.013)and S100B(2.86±0.69vs.1.35±0.34,F=10.982,p=0.001)were increased significantly under HS.Exogenous CGRP decreased the concentrations of NSE and S100B,and activated the expression of caspase-3(0.41±0.09vs.0.23±0.04,F=32.387,p<0.001)under HS;while CGRP8-37 increased NSE(3.99±0.47vs.2.40±0.50,F=11.991,p=0.000)and S100B(2.19±0.43vs.1.42±0.30,F=4.078,p=0.025),and activated the expression caspase-3(0.79±0.10vs.0.23±0.04,F=32.387,p<0.001).For the cell experiment,CGRP increased Bcl-2(2.01±0.73vs.2.15±0.74,F=8.993,p<0.001),PKA(0.88±0.08vs.0.37±0.14,F=20.370,p<0.001),and p-CREB(0.87±0.13vs.0.29±0.10,F=16.759,p<0.001)levels;while H89,a blocker of the PKA/p-CREB pathway reversed the expression.Conclusions:CGRP can protect against HS-induced neuron apoptosis via PKA/p-CREB pathway and reduce activation of caspase-3 by regulating Bcl-2.Thus CGRP may be a new target for the treatment of brain injury in HS. 展开更多
关键词 HEATSTROKE Calcitonin gene-related peptide Brain injury APOPTOSIS
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Impact of obstructive sleep apnea on pulmonary hypertension in patients with chronic obstructive pulmonary disease 被引量:15
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作者 Wan-Lu Sun Jian-Li Wang +6 位作者 Guo-Hua Jia Wen-Jun Mi Yi-Xuan Liao Yong-Wei Huang Zheng Hu Li-Qiang Zhang ya-hong chen 《Chinese Medical Journal》 SCIE CAS CSCD 2019年第11期1272-1282,共11页
Background:Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) syndrome are highly prevalent respiratory conditions. Their coexistence is referred to as the overlap syndrome. They are both r... Background:Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) syndrome are highly prevalent respiratory conditions. Their coexistence is referred to as the overlap syndrome. They are both related to pulmonary hypertension (PH) development. This study investigated the effects of OSA on PH in patients with COPD and the associated factors. Methods: Consecutive patients with stable COPD were recruited for an observational cross-sectional study from September 2016 to May 2018 at Peking University Third Hospital. In total, 106 patients with COPD were enrolled and performed home portable monitoring and echocardiography. OSA was defined by an apnea hypopnea index (AHI)>10 events/h. Based on OSA absence or presence, patients were divided into the COPD with OSA and COPD without OSA groups. Factors affecting pulmonary artery pressure (PAP) and PH were identified using univariate analysis and logistic regression models. Results: In the 106 patients with COPD, the mean age was 69.52 years, 91.5% were men, and the mean forced expiratory volume in 1 s (FEV!) percentage of predicted was 56.15%. Fifty-six (52.8%) patients with COPD were diagnosed with OSA, and 24 (22.6%) patients with COPD were diagnosed as PH. Compared with COPD without OSA group, the median PAP in COPD with severe OSA group increased by 5 mmHg (36.00 [26.00-50.00] mmHg vs. 31.00 [24.00-34.00] mmHg, P = 0.036). COPD with percent of night-time spent with oxygen saturation below 90%(T90)> 10% group had higher PAP than COPD with T90 < 1 % group (36.00 [29.00-50.00)] mmHg vs. 29.00 [25.50-34.00] mmHg, F = 7.889, P = 0.007). Univariate analysis revealed age, FEVi% predicted, T90, and Charlson index had statistically significant effects on PH. Multiple regression analysis showed a significant and independent effect of both FEVj% predicted (odds ratio [OR]= 3.46;95% confidence interval [Cl]: 1.15-10.46;P = 0.028) and AHI (OR = 3.20;95% Cl: 1.09-19.35;P = 0.034) on PH. Conclusions: Patients with COPD with OSA are more susceptible to PH, which is associated with declining lung function and increased severity of OSA. Thus, nocturnal hypoxemia and OSA in elderly patients with COPD should be identified and treated. 展开更多
关键词 Chronic OBSTRUCTIVE PULMONARY disease ECHOCARDIOGRAPHY OBSTRUCTIVE SLEEP APNEA PULMONARY hypertension
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Twenty years of changes in the disease assessment method of the Global Initiative for Chronic Obstructive Lung Disease 被引量:7
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作者 Yi-Xuan Liao ya-hong chen 《Chinese Medical Journal》 SCIE CAS CSCD 2020年第17期2098-2103,共6页
The Global Initiative for Chronic Obstructive Lung Disease(GOLD)has been changing for nearly 20 years.GOLD has moved from single assessment using spirometry to a more comprehensive assessment of chronic obstructive pu... The Global Initiative for Chronic Obstructive Lung Disease(GOLD)has been changing for nearly 20 years.GOLD has moved from single assessment using spirometry to a more comprehensive assessment of chronic obstructive pulmonary disease using spirometry,symptoms and exacerbation history.And subsequently,a new assessment system for chronic obstructive pulmonary disease separated spirometric grades from the old assessment system,and classified patients only according to their symptoms and history of exacerbation.The distribution,clinical characteristics,treatment,and prognosis of the new subgroups were different from the old ones.In this review,we will present a brief profile of changes made to the disease assessment method of GOLD,based on the relevant existing literature. 展开更多
关键词 Chronic obstructive pulmonary disease Global Initiative for Chronic Obstructive Lung Disease Disease assessment method
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Hydrogen Sulfide Inhibits Transforming Growth Factor Beta-1 Induced Bronchial Epithelial-mesenchymal Transition 被引量:2
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作者 cheng-cheng Liao ya-hong chen +1 位作者 Fan Lin Yong-Fen Qi 《Chinese Medical Journal》 SCIE CAS CSCD 2015年第23期3247-3250,共4页
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the developed world and associated with a high individual and socioeconomic burden. It is characterized by persisten... INTRODUCTION Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the developed world and associated with a high individual and socioeconomic burden. It is characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious panicles or gases. Peri-bronchiolar fibrosis was occurred in small airways in the early state of COPD, and then followed by structure changes, and finally became persistent airflow limitation?21 Recent researches have shown that epithelial-mesenchymal transition (EMT) is one of the leading causes of fibrosis in various diseases. 展开更多
关键词 Chronic Obstructive Pulmonary Disease Epithelia-mesenchymal Transition Hydrogen Sulfide Small Airway Fibrosis
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Comparative effectiveness and safety of 32 pharmacological interventions recommended by guidelines for coronavirus disease 2019:a systematic review and network meta-analysis combining 66 trials 被引量:1
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作者 Shan-Shan Wu Qing-Xin Zhou +7 位作者 Xue-Yang Zeng Jing-Xue Zhang Zhi-Rong Yang Qing-Qing Yang Zi-Lu Zhang ya-hong chen Feng Sun Si-Yan Zhan 《Chinese Medical Journal》 SCIE CAS CSCD 2021年第16期1920-1929,共10页
Background:The global pandemic coronavirus disease 2019(COVID-19)has become a major public health problem and presents an unprecedented challenge.However,no specific drugs were currently proven.This study aimed to eva... Background:The global pandemic coronavirus disease 2019(COVID-19)has become a major public health problem and presents an unprecedented challenge.However,no specific drugs were currently proven.This study aimed to evaluate the comparative efficacy and safety of pharmacological interventions in patients with COVID-19.Methods:Medline,Embase,the Cochrane Library,and clinicaltrials.gov were searched for randomized controlled trials(RCTs)in patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)/SARS-CoV.Random-effects network metaanalysis within the Bayesian framework was performed,followed by the Grading of Recommendations Assessment,Development,and Evaluation system assessing the quality of evidence.The primary outcome of interest includes mortality,cure,viral negative conversion,and overall adverse events(OAEs).Odds ratio(OR)with 95%confidence interval(CI)was calculated as the measure of effect size.Results:Sixty-six RCTs with 19,095 patients were included,involving standard of care(SOC),eight different antiviral agents,six different antibiotics,high and low dose chloroquine(CQ_HD,CQ_LD),traditional Chinese medicine(TCM),corticosteroids(COR),and other treatments.Compared with SOC,a significant reduction of mortality was observed for TCM(OR=0.34,95%CI:0.20–0.56,moderate quality)and COR(OR=0.84,95%CI:0.75–0.96,low quality)with improved cure rate(OR=2.16,95%CI:1.60–2.91,low quality for TCM;OR=1.17,95%CI:1.05–1.30,low quality for COR).However,an increased risk of mortality was found for CQ_HD vs.SOC(OR=3.20,95%CI:1.18–8.73,low quality).TCM was associated with decreased risk of OAE(OR=0.52,95%CI:0.38–0.70,very low quality)but CQ_HD(OR=2.51,95%CI:1.20–5.24)and interferons(IFN)(OR=2.69,95%CI:1.02–7.08)vs.SOC with very low quality were associated with an increased risk.Conclusions:COR and TCM may reduce mortality and increase cure rate with no increased risk of OAEs compared with standard care.CQ_HD might increase the risk of mortality.CQ,IFN,and other antiviral agents could increase the risk of OAEs.The current evidence is generally uncertain with low-quality and further high-quality trials are needed. 展开更多
关键词 SARS-CoV-2 COVID-19 Pharmacological intervention Network meta-analysis EFFECTIVENESS SAFETY
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Generalized high-order twisted partially coherent beams and their propagation characteristics
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作者 Hai-Yun Wang Zhao-Hui Yang +4 位作者 Kun Liu ya-hong chen Lin Liu Fei Wang Yang-Jian Cai 《Frontiers of physics》 SCIE CSCD 2022年第5期167-174,共8页
Twist phase is a nontrivial statistical phase that only exists in partially coherent fields,which makes the beam carry orbital angular momentum(OAM).In this paper,we introduce a new kind of partially coherent beams ca... Twist phase is a nontrivial statistical phase that only exists in partially coherent fields,which makes the beam carry orbital angular momentum(OAM).In this paper,we introduce a new kind of partially coherent beams carrying high-order twist phase,named generalized high-order twisted partially coherent beams(GHTPCBs).The propagation dynamics such as the spectral density and OAM flux density propagating in free space are investigated numerically with the help of mode superposition and fast Fourier transform(FFT)algorithm.Our results show that the GHTPCBs are capable of self-focusing,and the beam spot during propagation exhibits teardrop-like or the diamond-like shape in some certain cases.Moreover,the influences of the twist order and the twist factor on the OAM flux density during propagation are also illustrated in detail.Finally,we experimentally synthesize the GHTPCBs with controllable twist phase by means of pseudo-mode superposition and measure their spectral density during propagation.The experimental results agree well with the theoretical predictions.Our studies may find applications in nonlinear optics and particle trapping. 展开更多
关键词 light manipulation statistical optics twist phase coherence structure orbital angular momentum
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