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1Mesenchymal stem cell-derived exosomes promote neurogenesis and cognitive function recovery in a mouse model of Alzheimer’s disease显示文摘Studies have shown that mesenchymal stem cell-derived exosomes can enhance neural plasticity and improve cognitive impairment.The purpose of this study was to investigate the effects of mesenchymal stem cell-derived exosomes on neurogenesis and cognitive capacity in a mouse model of Alzheimer’s disease.Alzheimer’s disease mouse models were established by injection of beta amyloid 1?42 aggregates into dentate gyrus bilaterally.Morris water maze and novel object recognition tests were performed to evaluate mouse cognitive deficits at 14 and 28 days after administration.Afterwards,neurogenesis in the subventricular zone was determined by immunofluorescence using doublecortin and PSA-NCAM antibodies.Results showed that mesenchymal stem cells-derived exosomes stimulated neurogenesis in the subventricular zone and alleviated beta amyloid 1?42-induced cognitive impairment,and these effects are similar to those shown in the mesenchymal stem cells.These findings provide evidence to validate the possibility of developing cell-free therapeutic strategies for Alzheimer’s disease.All procedures and experiments were approved by Institutional Animal Care and Use Committee(CICUAL)(approval No.CICUAL 2016-011)on April 25,2016.Edwin E. Reza-Zaldivar Mercedes A. Hernández-Sapiéns Yanet K. Gutiérrez-Mercado Sergio Sandoval-ávila Ulises Gomez-Pinedo Ana L. Márquez-Aguirre Estefanía Vázquez-Méndez Eduardo Padilla-Camberos Alejandro A. Canales-Aguirre 2019Neural Regeneration Research2019,14,9:19
2Prognostic value of increased carbohydrate antigen in patients with heart failure显示文摘AIM:To study the prognostic value of carbohydrateantigen 125(CA125) and whether it adds prognostic information to N-terminal pro-brain natriuretic peptide(NT-proBNP) in stable heart failure(HF) patients.METHODS:The predictive value of CA125 was retrospectively assessed in 156 patients with stable HF remitted to the outpatient HF unit for monitoring from 2009 to 2011.Patients were included in the study if they had a previous documented episode of HF and received HF treatment.CA125 and NT-proBNP concentrations were measured.The independent association between NT-proBNP or CA125 and mortality was assessed with Cox regression analysis,and their combined predictive ability was tested by the integrated discrimination improvement(IDI) index.RESULTS:The mean age of the 156 patients was 72 ± 12 years.During follow-up(17 ± 8 mo),27 patients died,1 received an urgent heart transplantation and 106 required hospitalization for HF.Higher CA125 values were correlated with outcomes:58 ± 85 KU/L if hospitalized vs 34 ± 61 KU/L if not(P < 0.05),and 94 ± 121 KU/L in those who died or needed urgent heart transplantation vs 45 ± 78 KU/L in survivors(P < 0.01).After adjusting for propensity scores,the highest risk was observed when both biomarkers were elevated vs not elevated(HR = 8.95,95%CI:3.11-25.73; P < 0.001) and intermediate when only NT-proBNP was elevated vs not elevated(HR = 4.15,95%CI:1.41-12.24; P < 0.01).Moreover,when CA125 was added to the clinical model with NT-proBNP,a 4%(P < 0.05) improvement in the IDI was found.CONCLUSION:CA125 > 60 KU/L identified patients in stable HF with poor survival.Circulating CA125 level adds prognostic value to NT-proBNP level in predicting HF outcomes.Ana B Méndez Jordi Ordonez-Llanos Andreu Ferrero Mariana Noguero Teresa Mir Josefina Mora Antoni Bayes-Genis Sònia Mirabet Juan Cinca Eulàlia Roig 2014World Journal of Cardiology2014,6,4:13
3Helicobacter pylori infection- recent developments in diagnosis显示文摘Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.Ana Isabel Lopes Filipa F Vale Mónica Oleastro 2014World Journal of Gastroenterology2014,20,28:12
4Polymorphisms of DNA repair genes XRCC1 and XRCC3, interaction with environmental exposure and risk of chronic gastritis and gastric cancer显示文摘AIM: To evaluate the association between polymorphisms XRCC1 Arg194Trp and Arg399Gln and XRCC3Thr241Met and the risk for chronic gastritis and gastric cancer, in a Southeastern Brazilian population.METHODS: Genotyping by PCR-RFLP was carried out on 202 patients with chronic gastritis (CG) and 160 patients with gastric cancer (GC), matched to 202 (C1) and 150(C2) controls, respectively.RESULTS: No differences were observed among the studied grou ps with regard to the genotype distribution of XRCC1 codons 194 and 399 and of XRCC3 codon 241. However, the combined analyses of the three variant alleles (194Trp, 399Gln and 241Met) showed an increased risk for chronic gastritis when compared to the GC group. Moreover, an interaction between the polymorphic alleles and demographic and environmental factors was observed in the CG and GC groups. XRCC1 194Trp was associated with smoking in the CG group,while the variant alleles XRCC1 399Gln and XRCC3241Met were related with gender, smoking, drinking and H pylori infection in the CG and GC groups.CONCLUSION: Our results showed no evidence of a rela-tionship between the polymorphisms XRCC1Arg194Trp and Arg399Gln and XRCC3 Thr241Met and the risk of chronic gastritis and gastric cancer in the Brazilian population, but the combined effect of these variants may interact to increase the risk for chronic gastritis,considered a premalignant lesion. Our data also indicate a gene-environment interaction in the susceptibility to chronic gastritis and gastric cancer.Márcia Cristina Duarte Jucimara Colombo Andrea Regina Baptista Rossit Alaor Caetano Aldenis Albaneze Borim Durval Wornrath Ana Elizabete Silva 2005World Journal of Gastroenterology2005,11,42:11
5Etiopathogenesis of primary biliary cirrhosis显示文摘Primary biliary cirrhosis(PBC) is an autoimmune disease of the liver characterized by progressive bile duct destruction eventually leading to cirrhosis and liver failure.The serological hallmark of the disease is the presence of circulating antimitochondrial antibodies(AMA).These reflect the presence of autoreactive T and B cells to the culprit antigens,the E2 subunits of mitochondrial 2-oxo-acid dehydrogenase enzymes,chiefly pyruvate dehydrogenase(PDC-E2).The disease results from a combination of genetic and environmental risk factors.Genetic predisposition is indicated by the higher familial incidence of the disease particularly among siblings and the high concordance rate among monozygotic twins.Environmental triggering events appear crucial to disrupt a pre-existing unstable immune tolerance of genetic origin allowing,after a long latency,the emergence of clinical disease.Initiating mimetopes of the vulnerable epitope of the PDC-E2 autoantigen can be derived from microbes that utilize the PDC enzyme or,alternatively,environmental xenobiotics/chemical compounds that modify the structure of native proteins to make them immunogenic.A further alternative as a source of antigen is PDC-E2 derived from apoptotic cells.In the effector phase the biliary ductular cell,by reason of itsproclivity to express the antigen PDC-E2 in the course of apoptosis,undergoes a multilineage immune attack comprised of CD4+ and CD8+ T cells and antibody.In this article,we critically review the available evidence on etiopathogenesis of PBC and present interpretations of complex data,new developments and theories,and nominate directions for future research.Ana Lleo Pietro Invernizzi Ian R Mackay Harry Prince Ren-Qian Zhong M Eric Gershwin 2008World Journal of Gastroenterology2008,14,21:9
6大气二氧化氮与每日总死亡率、心血管和呼吸系统疾病死亡率的短期关联:398个城市的多中心分析显示文摘目的:采用统一的分析方案,评估全球多个国家/地区的二氧化氮(NO_(2))与总死亡率、心血管和呼吸系统疾病死亡率之间的短期关联。研究设计:采用两阶段的时间序列分析方法、过度离散的广义线性模型和多水平meta分析。研究地点:22个低到高收入国家/地区的398个城市。主要结局指标:1973—2018年逐日总死亡人数(6280万人)、心血管疾病死亡人数(1970万人)和呼吸系统疾病死亡人数(550万人)。结果:平均而言,NO_(2)浓度在滞后1天(前1天)每增加10μg/m^(3),会导致总死亡率、心血管和呼吸系统疾病死亡率分别增加0.46%(95%可信区间0.36%~0.57%)、0.37%(0.22%~0.51%)、0.47%(0.21%~0.72%)。在对共污染物(PM_(10)、PM_(2.5)、臭氧、二氧化硫和一氧化碳)进行调整后,这些关联仍然很稳定。所有3种死因的暴露-反应曲线几乎是线性的,没有明显的阈值。在398个城市中,可归因于高过假定零水平的NO_(2)浓度造成的死亡比例为1.23%(95%可信区间0.96%~1.51%)。结论:这项多中心研究提供了关于NO_(2)短期暴露与总死亡率、心血管和呼吸系统死亡风险之间的独立和线性关联的关键证据,说明通过加强NO_(2)的控制和监管限制标准,可获得人群水平的健康收益。孟夏 刘聪(校) 陈仁杰 郑湃(译) 阚海东(校) Francesco Sera Ana Vicedo-Cabrera Ai Milojevic Maria Guo Yuming Tong Shilu Micheline de Sousa Zanotti Stagliorio Coelh Paulo Hilario Nascimento Saldiva Eric Lavigne Patricia Matus Correa Nicolas Valdes Ortega Samuel Osorio Garcia Jan Kysely Ales Urban Hans Orru Marek Maasikmets Jouni J K Jaakkola Niilo Ryti Veronika Huber Alexandra Schneider Klea Katsouyanni Antonis Analitis Masahiro Hashizume Yasushi Honda Chris Fook Sheng Ng Baltazar Nunes João Paulo Teixeira Iulian Horia Holobaca Simona Fratianni Ho Kim Aurelio Tobias Carmeníniguez Bertil Forsberg ChristoferÅström Martina S Ragettli Yue-Liang Leon Guo Shih-Chun Pan Shanshan Li Michelle L Bell Antonella Zanobetti Joel Schwartz Tangchun Wu Antonio Gasparrini 2021英国医学杂志中文版2021,24,8:7
7Stem cell therapy in inflammatory bowel disease: A promising therapeutic strategy?显示文摘Inflammatory bowel diseases are inflammatory, chronic and progressive diseases of the intestinal tract for which no curative treatment is available. Research in other fields with stem cells of different sources and with immunoregulatory cells(regulatory T-lymphocytes and dendritic T-cells) opens up new expectations for their use in these diseases. The goal for stem cell-based therapy is to provide a permanent cure. To achieve this, it will be necessary to obtain a cellular product, original or genetically modified, that has a high migration capacity and homes into the intestine, has high survival after transplantation, regulates the immune reaction while not being visible to the patient's immune system, and repairs the injured tissue.Ana I Flores Gonzalo J Gómez-Gómez ángeles Masedo-González M Pilar Martínez-Montiel 2015World Journal of Stem Cells2015,7,2:7
8Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup显示文摘AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732).Peter D Siersema Amit Rastogi Anke M Leufkens Paul A Akerman Kassem Azzouzi Richard I Rothstein Frank P Vleggaar Alessandro Repici Giacomo Rando Patrick I Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East Pierre H Deprez Brian P Saunders Anthony N Kalloo Bradley Creel Vikas Singh Anne Marie Lennon Daniel C DeMarco 2012World Journal of Gastroenterology2012,18,26:6
9Gastric cancer in a Caucasian population: Role of pepsinogen C genetic variants显示文摘瞄准:在胃蛋白酶原 C (PGC ) 基因学习插入 / 删除多型性的角色,为胃粘膜的终端区别的一个有效标记,在到胃的损害的开发的危险性。方法:没有肿瘤的疾病的证据,学习与已知的胃的损害的 99 件样品和 127 件样品被执行。PCR 被采用, 6 多态的等位基因被放大:等位基因 1 (510 bp ) ,等位基因 2 (480 bp ) ,等位基因 3/4 (450/460 bp ) ,等位基因 5 (400 bp ) 并且等位基因 6 (310 bp ) 。结果:我们的结果表明等位基因 6 搬运人似乎对任何胃的损害的发展有保护(或 = 0.34;P<0.001 ) ,与象萎缩或肠的组织变形那样的胃的腺癌联系的 non-dysplastic 损害(或 = 0.28;P<0.001 ) 或侵略 GC (或 = 0.39;P = 0.004 ) 。结论:我们的学习表明等位基因 6 搬运人地位在胃的损害的发展有一个保护的角色,可能由于它有 PGC 的更高的表示的协会。而且,在控制组的等位基因 6 搬运人的频率比在亚洲人口获得了高是远的,它可能代表在白种人和亚洲人口之间的基因差距。Ana L Pinto-Correia Hugo Sousa Maria Fragoso Luís Moreira-Dias Carlos Lopes Rui Medeiros Mário Dinis-Ribeiro 2006World Journal of Gastroenterology2006,12,31:6
10Therapeutic and prophylactic thalidomide in TNBS-induced colitis: Synergistic effects on TNF-α, IL-12 and VEGF production显示文摘AIM: To evaluated the therapeutic and prophylactic effect of thalidomide on 2, 4, 6-trinitrobenzene sulfonic acid (TNBS)-induced colitis. Thalidomide has been reported to downregulate the expression of tumor necrosis factor a (TNF-α), IL-12, and vascular endothelial growth factor (VEGF), hallmarks of intestinal inflammation in Crohn's disease (CD). METHODS: Male Wistar rats were divided in five groups of ten animals each. Four groups received a rectal infusion of TNBS in ethanol. The first group was sacrificed 7 d after colitis induction. The second and third groups received either thalidomide or placebo by gavage and were sacrificed at 14 d. The fourth group received thalidomide 6 h before TNBS administration, and was sacrificed 7 d after induction. The fifth group acted as the control group and colitis was not induced. Histological inflammatory scores of the colon were performed and lamina propria CD4+ T cells, macrophages, and VEGF+ cells were detected by immunohistochemistry. TNF-a and IL-12 were quantified in the supernatant of organ cultures by ELISA. RESULTS: Significant reduction in the inflammatory score and in the percentage of VEGF+ cells was observed in the group treated with thalidomide compared with animals not treated with thalidomide. Both TNF-αand IL-12 levels were significantly reduced among TNBS induced colitis animals treated with thalidomide compared with animals that did not receive thalidomide. TNF-αlevels were also significantly reduced among the animals receiving thalidomide prophylaxis compared with untreated animals with TNBS-induced colitis. Intestinal levels of TNF-αand IL-12 were significantly correlated with the inflammatory score and the number of VEGF+ cells. CONCLUSION: Thalidomide significantly attenuates TNBS-induced colitis by inhibiting the intestinal production of TNF-α, IL-12, and VEGF. This effect may support the use of thalidomide as an alternate approach in selected patients with CD.Ana Teresa Carvalho Heitor Souza Antonio Jose Carneiro Morgana Castelo-Branco Kalil Madi Alberto Schanaider Flavia Silva Fernando Antonio Pereira Júnior Márcia G Pereira Cláudio Tortori Ilana Dines Jane Carvalho Eduardo Rocha Celeste Elia 2007World Journal of Gastroenterology2007,13,15:6
11Oxidative stress modulation in hepatitis C virus infected cells显示文摘Hepatitis C virus(HCV) replication is associated with the endoplasmic reticulum, where the virus can induce cellular stress. Oxidative cell damage plays an important role in HCV physiopathology. Oxidative stress is triggered when the concentration of oxygen species in the extracellular or intracellular environment exceeds antioxidant defenses. Cells are protected and modulate oxidative stress through the interplay of intracellular antioxidant agents, mainly glutathione system(GSH) and thioredoxin; and antioxidant enzyme systems such as superoxide dismutase, catalase, GSH peroxidase, and heme oxygenase-1. Also, the use of natural and synthetic antioxidants(vitamin C and E, N-acetylcysteine, glycyrrhizin, polyenylphosphatidyl choline, mitoquinone, quercetin, S-adenosylmethionine and silymarin) has already shown promising results as co-adjuvants in HCV therapy. Despite all the available information, it is not known how different agents with antiviral activity can interfere with the modulation of the cell redox state induced by HCV and decrease viral replication. This review describes an evidence-based consensus on molecular mechanisms involved in HCV replication and their relationship with cell damage induced by oxidative stress generated by the virus itself and cell antiviral machinery. It also describes some molecules that modify the levels of oxidative stress in HCV-infected cells.Sonia A Lozano-Sepulveda Owen L Bryan-Marrugo Carlos Cordova-Fletes Maria C Gutierrez-Ruiz Ana M Rivas-Estilla 2015World Journal of Hepatology2015,7,29:6
12Subcurative radiation significantly increases cell proliferation, invasion, and migration of primary glioblastoma multiforme in vivo显示文摘Tumor cell proliferation, infiltration, migration, and neovascularization are known causes of treatment resistance in glioblastoma multiforme(GBM). The purpose of this study was to determine the effect of radiation on the growth characteristics of primary human GBM developed in a nude rat. Primary GBM cells grown from explanted GBM tissues were implanted orthotopically in nude rats. Tumor growth was confirmed by magnetic resonance imaging on day 77(baseline) after implantation. The rats underwent irradiation to a dose of 50 Gy delivered subcuratively on day 84 postimplantation(n = 8), or underwent no radiation(n = 8). Brain tissues were obtained on day 112(nonirradiated) or day 133(irradiated). Immunohistochemistry was performed to determine tumor cell proliferation(Ki-67) and to assess the expression of infiltration marker(matrix metalloproteinase-2, MMP-2) and cell migration marker(CD44). Tumor neovascularization was assessed by microvessel density using von-Willebrand factor(vWF) staining. Magnetic resonance imaging showed well-developed, infiltrative tumors in 11 weeks postimplantation. The proportion of Ki-67-positive cells in tumors undergoing radiation was(71 ± 15)% compared with(25 ± 12)% in the nonirradiated group(P = 0.02). The number of MMP-2-positive areas and proportion of CD44-positive cells were also high in tumors receiving radiation, indicating great invasion and infiltration. Microvessel density analysis did not show a significant difference between nonirradiated and irradiated tumors. Taken together, we found that subcurative radiation significantly increased proliferation, invasion, and migration of primary GBM. Our study provides insights into possible mechanisms of treatment resistance following radiation therapy for GBM.Adarsh Shankar Sanath Kumar Asm Iskander Nadimpalli RS Varma Branislava Janic Ana deCarvalho Tom Mikkelsen Joseph A Frank Meser M Ali Robert A Knight Stephen Brown Ali S Arbab 2014Chinese Journal of Cancer2014,33,3:5
13Validation of a new scoring system: Rapid assessment faecal incontinence score显示文摘AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between 'state' and 'leaks' was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of 'state' and 'leaks' yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of 'r ' for the different subscales of the questionnaire were: 'lifestyle' r =-0.87, 'coping/behaviour' r =-0.91, 'depression' r =-0.36 and 'embarrassment' r =-0.90,(P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high.CONCLUSION: RAFIS is a valid and reliable tool to assess Faecal Incontinence.Fernando de la Portilla Arantxa Calero-Lillo Rosa M Jiménez-Rodríguez Maria L Reyes Manuela Segovia-González María Victoria Maestre Ana M García-Cabrera 2015World Journal of Gastrointestinal Surgery2015,7,9:5
14National natural capital accounting with the ecological footprint concept显示文摘Mathis Wackernagel Larry Onisto Patricia Bello Alejandro Callejas Linares Ina Susana López Falfán Jesus Méndez Garc??a Ana Isabel Suárez Guerrero Ma Guadalupe Suárez Guerrero 1999Ecological Economics1999,,3:5
15Current role and future perspectives of cardiac rehabilitation in coronary heart disease显示文摘Ischaemic heart disease(IHD)is a major cause of morbidity and mortality worldwide.While there have been major advances in this field,these patients are still a higher risk subgroup.As such,strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance.Cardiac rehabilitation(CR),encompassing several domains including exercise training,cardiovascular risk factor optimization,nutritional and psychological assessments,as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD.Indeed,CR is associated with several benefits in this population,ranging from functional capacity to improvements in outcomes.Whilst this,there are still several issues concerning the optimal application of CR which are still not fully ascertained,such as lack of referral and completion,as well as questions related to programme design(particularly among patients with multiple comorbidities).In this review,we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD,while also discussing some of the caveats in the current data,as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention.Eduardo M Vilela Ricardo Ladeiras-Lopes Ana Joao Joana Braga Susana Torres Sofia Viamonte José Ribeiro Madalena Teixeira José P Nunes Ricardo Fontes-Carvalho 2021World Journal of Cardiology2021,13,12:5
16Understanding plant drought resistance in a Mediterranean coastal sand dune ecosystem:differences between native and exotic invasive species显示文摘Aims Mediterranean coastal dunes are habitats of great conservation interest,with a distinctive and rich flora.In the last century,Acacia spp.,native from Australia,have been introduced in Portugal,with the objective of stabilizing sand dunes,and since have become dominant in numerous sand dune habitats.This invasion process led to the reduction of native plant species richness,changed soil characteristics and modified habitat’s microclimatic char-acteristics.The aim of this research was to typify and compare,in Mediterranean sand dune ecosystems,the ecophysiological responses to drought of Helichrysum italicum and Corema album,two native species,and Acacia longifolia,an exotic invasive spe-cies.We addressed the following specific objectives:(i)to com-pare water relations and water use efficiencies,(ii)to evaluate water stress,(iii)to assess water use strategies and water sources used by plants and(iv)to evaluate the morphological adaptations at leaf and phyllode level.Methods In order to obtain an integrative view of ecophysiological patterns,water relations and performance measuring methods have been applied:predawn(ψPD)and midday(ψMD)water potential,chloro-phyll a fluorescence,oxygen isotopic composition of xylem,rain and groundwater(δ18O)and leaf carbon isotopic discrimination(Δ13C).The leaf characteristics of the three species,as well as the histochemistry of non-glandular trichome cell walls,were also studied to identify morpho-traits related to drought resistance.Important Findings The results support our initial hypothesis:although A.longifolia clearly possesses a degree of resistance to water stress,such ability is provided by a different water strategy,when compared to native species.Natives relied on morphological adaptations to restrict water loss,whereas the invasive species adjusted the water uptake as a way to balance their limited ability of restricting water loss.We corroborate that woody native species(i)have a conservative water-saving strategy and minor seasonal variations relative to invasive species,(ii)use enriched water sources during drought periods,indicating different water sources and root systems com-paring with invasive species and(iii)present drought leaf morpho-functional adaptations related with limiting water loss.Comparing the physiological performance of invasive and native species can offer causal explanations for the relative success of alien plant invasions on sand dunes ecosystems.Cristina Antunes Ana Júlia Pereira Patrícia Fernandes Margarida Ramos Lia Ascensão Otília Correia Cristina Máguas 2018Journal of Plant Ecology2018,11,1:4
17Outcome in obscure gastrointestinal bleeding after capsule endoscopy显示文摘AIM: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. METHODS: Patients who were referred to Hospital del Mar(Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid antiinflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings(significant or non-significant), work-up and patient out-comes were analyzed from electronic charts. Variables were compared by χ 2 analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-Meier curves and Cox regression model. RESULTS: There were 105 patients [45.7% women, median age of 72 years old(interquartile range 56-79)] and a median follow-up of 326 d(interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1%(55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients(69.5%), OGIB was resolved. Multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios(HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above(HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE(HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding. CONCLUSION: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions.Alex Caas-Ventura Lucia Márque Xavier Bessa Josep Maria DedeuDepartment of Gastroenterology Hospital del Mar Research Institute Pompeu Fabra University Marc Puigvehí Sílvia Delgado-Aros Ines Ana Ibáez Agustin Seoane Luis Barranco Felipe Bory Montserrat Andreu Begoa González-Suárez 2013World Journal of Gastrointestinal Endoscopy2013,5,11:4
18达比加群酯、利伐沙班或阿哌沙班与依诺肝素用于全髋关节或膝关节置换术后的血栓预防:系统综述、荟萃分析和间接治疗比较显示文摘目的 分析新型口服抗凝药预防全髋或全膝关节置换术后静脉血栓栓塞的临床转归.设计系统综述、荟萃分析以及间接治疗比较.数据来源 Medline和CENTRAL(至2011年4月为止)、临床试验注册中心、会议论文集以及药品监管机构的网站.研究选择利伐沙班、达比加群酯或阿哌沙班与依诺肝素相比,预防全髋或全膝关节置换术后静脉血栓栓塞症的随机对照试验.由两名研究者独立提取数据.采用随机效应荟萃分析估计症状性静脉血栓栓塞、临床相关出血、死亡和净临床终点(症状性静脉血栓栓塞、严重出血和死亡的复合转归)的相对危险度.分别使用RevMan和ITC软件进行直接和间接比较.结果 共纳入16项试验,共计38 747例患者.与依诺肝素组相比,利伐沙班组(RR:0.48;95%CI:0.31~0.75)和阿哌沙班组(RR:0.82;95%CI:0.41~1.64)的症状性静脉血栓栓塞发生风险较低,达比加群酯组(RR:0.71;95%CI:0.23~2.12).与依诺肝素组相比,利伐沙班组的临床相关出血相对危险度较高(RR:1.25;95%CI:1.05~1.49),达比加群酯组与依诺肝素组相似(RR:1.12;95%CI:0.94~1.35),而阿哌沙班组的相对危险度则较低(RR:0.82;95%CI:0.69~0.98).直接和间接比较的结果显示,各种治疗的净临床终点均无差异.结论新型口服抗凝药的有效性较高,同时普遍有较高的出血倾向.新型口服抗凝药之间的有效性和安全性无显著差异.Antonio Gómez-Outes Ana Isabel Terleira-Fernández M Luisa Suárez-Gea Emilio Vargas-Castrillón 2013中华关节外科杂志(电子版)2013,7,6:4
19Effects of the nitrification inhibitor nitrapyrin and tillage practices on yield-scaled nitrous oxide emission from a maize field in Iran显示文摘Nitrification inhibitors can effectively decrease nitrification rates and nitrous oxide(N_(2)O)emission while increasing crop yield under certain conditions.However,there is no information available on the effects of nitrification inhibitors and tillage practices on N_(2)O emissions from maize cropping in Iran.To study how tillage practices and nitrapyrin(a nitrification inhibitor)affect N_(2)O emission,a split factorial experiment using a completely randomized block design with three replications was carried out in Northeast Iran,which has a cold semiarid climate.Two main plots were created with conventional tillage and minimum tillage levels,and two nitrogen(N)fertilizer(urea)management systems(with and without nitrapyrin application)were created as subplots.Tillage level did not have any significant effect on soil ammonium(NH_(4)^(+))and nitrate(NO_(3)^(-))concentrations,cumulative amount and yield-scaled N_(2)O emission,and aboveground biomass of maize,whereas nitrapyrin application showed significant effect.Nitrapyrin application significantly reduced the cumulative amount of N_(2)O emission by 41%and 32%in conventional tillage and minimum tillage practices,respectively.A reduction in soil NO_(3)^(-)concentration by nitrapyrin was also observed.The average yield-scaled N_(2)O emission was 13.6 g N_(2)O-N kg^(-1)N uptake in both tillage systems without nitrapyrin application and was significantly reduced to 7.9 and 8.2 g N_(2)O-N kg^(-1)N uptake upon the application of nitrapyrin in minimum tillage and conventional tillage practices,respectively.Additionally,nitrapyrin application increased maize biomass yield by 4%and 13%in the minimum tillage and conventional tillage systems,respectively.Our results indicate that nitrapyrin has a potential role in reducing N_(2)O emission from agricultural systems where urea fertilizers are broadcasted,which is common in Iran due to the practice of traditional farming.Azam BORZOUEI Ulo MANDER Alar TEEMUSK Alberto SANZ-COBENA Mohammad ZAMAN Dong-Gill KIM Christoph MÜLLER Ali Askary KELESTANIE Parvaneh SAYYAD AMIN Ebrahim MOGHISEH Khadim DAWAR Ana Gabriela PÉREZ-CASTILLO 2021Pedosphere2021,31,2:4
20Aplastic anemia and severe pancytopenia during treatment with peg-interferon,ribavirin and telaprevir for chronic hepatitis C显示文摘Telaprevir and Boceprevir are the first direct acting antivirals approved for chronic hepatitis C in combination with peg-interferon alfa and ribavirin.Pancytopenia due to myelotoxicity caused by these drugs may occur,but severe hematological abnormalities or aplastic anemia(AA) have not been described.We collected all cases of severe pancytopenia observed during triple therapy with telaprevir in four Spanish centers since approval of the drug in 2011.Among 142 cirrhotic patients receiving treatment,7 cases of severe pancytopenia(5%) were identified and three were consistent with the diagnosis of AA.Mean age was 59 years,five patients had compensated cirrhosis and two patients had severe hepatitis C recurrence after liver transplantation.Severe pancytopenia was diagnosed a median of 10 wk after the initiation of therapy.Three patients had pre-treatment hematological abnormalities related to splenomegaly.In six patients,antiviral treatment was interrupted at the onset of hematological abnormalities.Two patients died due to septic complications and one patient due to acute alveolar hemorrhage.The remaining patients recovered.Severe pancytopenia and especially AA,are not rare during triple therapy with telaprevir in patients with advanced liver disease.Close monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications.Sabela Lens Jose L Calleja Ana Campillo Jose A Carrion Teresa Broquetas Christie Perello Juan de la Revilla Zoe Marino Maria-Carlota Londono Jose M Sanchez-Tapias Alvaro Urbano-Ispizua Xavier Forns 2015World Journal of Gastroenterology2015,21,17:4
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