BACKGROUND Massive intragastric clotting(MIC) makes endoscopic therapy difficult in patients with acute upper gastrointestinal bleeding. Literature data on how to address this problem are limited. Here, we report on a...BACKGROUND Massive intragastric clotting(MIC) makes endoscopic therapy difficult in patients with acute upper gastrointestinal bleeding. Literature data on how to address this problem are limited. Here, we report on a case of massive stomach bleeding with MIC that was successfully treated endoscopically using an overtube of singleballoon enteroscopy.CASE SUMMARY A 62-year-old gentleman with metastatic lung cancer was admitted to the intensive care unit due to tarry stools and hematemesis of 1500 mL of blood during hospitalization. Emergent esophagogastroduodenoscopy revealed massive blood clots and fresh blood in the stomach with evidence of active bleeding.Bleeding sites could not be observed even by changing the patient’s position and aggressive endoscope suction. The MIC was successfully removed using an overtube connected with a suction pipe, which was inserted into the stomach with an overtube of a single-balloon enteroscope. An ultrathin gastroscope was also introduced through the nose into the stomach to guide the suction. A massive blood clot was successfully removed, and an ulcer with oozing bleeding at the inferior lesser curvature of the upper gastric body was revealed, facilitating endoscopic hemostatic therapy.CONCLUSION This technique appears to be a previously unreported method to suction MIC out of the stomach in patients with acute upper gastrointestinal bleeding. This technique could be considered when other methods are not available or if they fail to remove massive blood clots in the stomach.展开更多
Two patients with liver cirrhosis and portal hyper-tension related to hepatitis infection were admitted to Shanghai Ruijin Hospital due to recurrent melena and hematemesis. Isolated gastric varices were observed in th...Two patients with liver cirrhosis and portal hyper-tension related to hepatitis infection were admitted to Shanghai Ruijin Hospital due to recurrent melena and hematemesis. Isolated gastric varices were observed in the gastric fundus during the retroflexion of gastroscope. We carried out endoscopic sclerotherapy successfully for bleeding gastric varices with combined cyanoacrylate and aethoxysklerol, which disappeared dramatically several months after two courses of sclerotherapy for each patient. No complication and clinical signs of gastrointestinal re-bleeding were observed during the 6-mo endoscopic follow-up. CT portal angiography (CTPA) has been widely used in the assessment of variceal treatment and improves the results of endoscopic injection therapy.展开更多
Neural stem cells,which are capable of multi-potential differentiation and self-renewal,have recently been shown to have clinical potential for repairing central nervous system tissue damage.However,the theme trends a...Neural stem cells,which are capable of multi-potential differentiation and self-renewal,have recently been shown to have clinical potential for repairing central nervous system tissue damage.However,the theme trends and knowledge structures for human neural stem cells have not yet been studied bibliometrically.In this study,we retrieved 2742 articles from the PubMed database from 2013 to 2018 using "Neural Stem Cells" as the retrieval word.Co-word analysis was conducted to statistically quantify the characteristics and popular themes of human neural stem cell-related studies.Bibliographic data matrices were generated with the Bibliographic Item Co-Occurrence Matrix Builder.We identified 78 high-frequency Medical Subject Heading(MeSH)terms.A visual matrix was built with the repeated bisection method in gCLUTO software.A social network analysis network was generated with Ucinet 6.0 software and GraphPad Prism 5 software.The analyses demonstrated that in the 6-year period,hot topics were clustered into five categories.As suggested by the constructed strategic diagram,studies related to cytology and physiology were well-developed,whereas those related to neural stem cell applications,tissue engineering,metabolism and cell signaling,and neural stem cell pathology and virology remained immature.Neural stem cell therapy for stroke and Parkinson’s disease,the genetics of microRNAs and brain neoplasms,as well as neuroprotective agents,Zika virus,Notch receptor,neural crest and embryonic stem cells were identified as emerging hot spots.These undeveloped themes and popular topics are potential points of focus for new studies on human neural stem cells.展开更多
Previous studies have shown that nicorandil has a protective effect on cardiomyocytes.However,there is no study to investigate whether perioperative intravenous nicorandil can further reduce the myocardial infarct siz...Previous studies have shown that nicorandil has a protective effect on cardiomyocytes.However,there is no study to investigate whether perioperative intravenous nicorandil can further reduce the myocardial infarct size in patients with ST-segment elevation myocardial infarction(STEMI)compared to the current standard of percutaneous coronary intervention(PCI)regimen.The CHANGE(China-Administration of Nicorandil Group)study is a multicenter,prospective,randomized,double-blind and parallel-controlled clinical study of STEMI patients undergoing primary PCI in China,aiming to evaluate the efficacy and safety of intravenous nicorandil in ameliorating the myocardial infarct size in STEMI patients undergoing primary PCI and provide evidence-based support for myocardial protection strategies of STEMI patients.展开更多
Hypoxia,characterized by reduced oxygen concentration,is a significant stressor that affects the survival of aerobic species and plays a prominent role in cardiovascular diseases.From the research history and mileston...Hypoxia,characterized by reduced oxygen concentration,is a significant stressor that affects the survival of aerobic species and plays a prominent role in cardiovascular diseases.From the research history and milestone events related to hypoxia in cardiovascular development and diseases,The"hypoxia-inducible factors(HIFs)switch"can be observed from both temporal and spatial perspectives,encompassing the occurrence and progression of hypoxia(gradual decline in oxygen concentration),the acute and chronic manifestations of hypoxia,and the geographical characteristics of hypoxia(natural selection at high altitudes).Furthermore,hypoxia signaling pathways are associated with natural rhythms,such as diurnal and hibernation processes.In addition to innate factors and natural selection,it has been found that epigenetics,as a postnatal factor,profoundly influences the hypoxic response and progression within the cardiovascular system.Within this intricate process,interactions between different tissues and organs within the cardiovascular system and other systems in the context of hypoxia signaling pathways have been established.Thus,it is the time to summarize and to construct a multi-level regulatory framework of hypoxia signaling and mechanisms in cardiovascular diseases for developing more therapeutic targets and make reasonable advancements in clinical research,including FDA-approved drugs and ongoing clinical trials,to guide future clinical practice in the field of hypoxia signaling in cardiovascular diseases.展开更多
Summary What is already known about this topic?Acute myocardial infarction(AMI)is the most serious form of cardiovascular diseases.The case fatality rate(CFR)of AMI patients is an important index to reflect the progno...Summary What is already known about this topic?Acute myocardial infarction(AMI)is the most serious form of cardiovascular diseases.The case fatality rate(CFR)of AMI patients is an important index to reflect the prognosis of AMI.What is added by this report?During the study period,the overall 30-day,60-day,and 90-day CFR of AMI was 5.9%,6.9%,and 7.6%,respectively.The CFRs in gradeⅢhospitals were lower than in gradeⅡhospitals,and the in-hospital CFR was significantly lower than that in post-discharge out-of-hospital.展开更多
Semiconductor lasers directly grown on silicon offer great potential as critical components in high-volume,lowcost integrated silicon photonics circuits.Although InAs/InP quantum dash(QDash)lasers on native InP substr...Semiconductor lasers directly grown on silicon offer great potential as critical components in high-volume,lowcost integrated silicon photonics circuits.Although InAs/InP quantum dash(QDash)lasers on native InP substrate emitting at 1.5μm(C-band)have demonstrated notable performance,the growth of InAs/InP QDash lasers on silicon remains undeveloped because of the 8%lattice mismatch between InP and silicon.Here we report advances of growth techniques leading to the first C-band room-temperature continuous-wave electrically pumped QDash lasers on CMOS standard(001)silicon substrates by metalorganic chemical vapor deposition.A correlation between various material characterizations and device performance is analyzed for different QDash laser structures grown on planar nominal(001)silicon.With the optimized QDash growth and improved fabrication process,the lowest threshold current density of 1.5 kA∕cm^(2) was determined on an 8μm×1.5 mmdevice on planar silicon with a single facet output power exceeding 14 mW.The device results illustrate the good material quality of the QDash lasers grown on silicon,suggesting potential applications for other active components of photonic integrated circuits,such as semiconductor optical amplifiers,modulators,and photodetectors.展开更多
基金Supported by Natural Youth Science Foundation of China,No.82104743Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Innovation Project,No KY2056.
文摘BACKGROUND Massive intragastric clotting(MIC) makes endoscopic therapy difficult in patients with acute upper gastrointestinal bleeding. Literature data on how to address this problem are limited. Here, we report on a case of massive stomach bleeding with MIC that was successfully treated endoscopically using an overtube of singleballoon enteroscopy.CASE SUMMARY A 62-year-old gentleman with metastatic lung cancer was admitted to the intensive care unit due to tarry stools and hematemesis of 1500 mL of blood during hospitalization. Emergent esophagogastroduodenoscopy revealed massive blood clots and fresh blood in the stomach with evidence of active bleeding.Bleeding sites could not be observed even by changing the patient’s position and aggressive endoscope suction. The MIC was successfully removed using an overtube connected with a suction pipe, which was inserted into the stomach with an overtube of a single-balloon enteroscope. An ultrathin gastroscope was also introduced through the nose into the stomach to guide the suction. A massive blood clot was successfully removed, and an ulcer with oozing bleeding at the inferior lesser curvature of the upper gastric body was revealed, facilitating endoscopic hemostatic therapy.CONCLUSION This technique appears to be a previously unreported method to suction MIC out of the stomach in patients with acute upper gastrointestinal bleeding. This technique could be considered when other methods are not available or if they fail to remove massive blood clots in the stomach.
文摘Two patients with liver cirrhosis and portal hyper-tension related to hepatitis infection were admitted to Shanghai Ruijin Hospital due to recurrent melena and hematemesis. Isolated gastric varices were observed in the gastric fundus during the retroflexion of gastroscope. We carried out endoscopic sclerotherapy successfully for bleeding gastric varices with combined cyanoacrylate and aethoxysklerol, which disappeared dramatically several months after two courses of sclerotherapy for each patient. No complication and clinical signs of gastrointestinal re-bleeding were observed during the 6-mo endoscopic follow-up. CT portal angiography (CTPA) has been widely used in the assessment of variceal treatment and improves the results of endoscopic injection therapy.
基金supported by the National Natural Science Foundation of China,No.81471308(to JL)the Stem Cell Clinical Research Project in China,No.CMR-20161129-1003(to JL)the Innovation Technology Funding of Dalian in China,No.2018J11CY025(to JL)
文摘Neural stem cells,which are capable of multi-potential differentiation and self-renewal,have recently been shown to have clinical potential for repairing central nervous system tissue damage.However,the theme trends and knowledge structures for human neural stem cells have not yet been studied bibliometrically.In this study,we retrieved 2742 articles from the PubMed database from 2013 to 2018 using "Neural Stem Cells" as the retrieval word.Co-word analysis was conducted to statistically quantify the characteristics and popular themes of human neural stem cell-related studies.Bibliographic data matrices were generated with the Bibliographic Item Co-Occurrence Matrix Builder.We identified 78 high-frequency Medical Subject Heading(MeSH)terms.A visual matrix was built with the repeated bisection method in gCLUTO software.A social network analysis network was generated with Ucinet 6.0 software and GraphPad Prism 5 software.The analyses demonstrated that in the 6-year period,hot topics were clustered into five categories.As suggested by the constructed strategic diagram,studies related to cytology and physiology were well-developed,whereas those related to neural stem cell applications,tissue engineering,metabolism and cell signaling,and neural stem cell pathology and virology remained immature.Neural stem cell therapy for stroke and Parkinson’s disease,the genetics of microRNAs and brain neoplasms,as well as neuroprotective agents,Zika virus,Notch receptor,neural crest and embryonic stem cells were identified as emerging hot spots.These undeveloped themes and popular topics are potential points of focus for new studies on human neural stem cells.
基金supported by the National Key Research and Development program of China(2018ZX09201013)Xinxin Merck Cardiovascular Research Fund(2017-CCA-xinxin merck fund-003)。
文摘Previous studies have shown that nicorandil has a protective effect on cardiomyocytes.However,there is no study to investigate whether perioperative intravenous nicorandil can further reduce the myocardial infarct size in patients with ST-segment elevation myocardial infarction(STEMI)compared to the current standard of percutaneous coronary intervention(PCI)regimen.The CHANGE(China-Administration of Nicorandil Group)study is a multicenter,prospective,randomized,double-blind and parallel-controlled clinical study of STEMI patients undergoing primary PCI in China,aiming to evaluate the efficacy and safety of intravenous nicorandil in ameliorating the myocardial infarct size in STEMI patients undergoing primary PCI and provide evidence-based support for myocardial protection strategies of STEMI patients.
文摘Hypoxia,characterized by reduced oxygen concentration,is a significant stressor that affects the survival of aerobic species and plays a prominent role in cardiovascular diseases.From the research history and milestone events related to hypoxia in cardiovascular development and diseases,The"hypoxia-inducible factors(HIFs)switch"can be observed from both temporal and spatial perspectives,encompassing the occurrence and progression of hypoxia(gradual decline in oxygen concentration),the acute and chronic manifestations of hypoxia,and the geographical characteristics of hypoxia(natural selection at high altitudes).Furthermore,hypoxia signaling pathways are associated with natural rhythms,such as diurnal and hibernation processes.In addition to innate factors and natural selection,it has been found that epigenetics,as a postnatal factor,profoundly influences the hypoxic response and progression within the cardiovascular system.Within this intricate process,interactions between different tissues and organs within the cardiovascular system and other systems in the context of hypoxia signaling pathways have been established.Thus,it is the time to summarize and to construct a multi-level regulatory framework of hypoxia signaling and mechanisms in cardiovascular diseases for developing more therapeutic targets and make reasonable advancements in clinical research,including FDA-approved drugs and ongoing clinical trials,to guide future clinical practice in the field of hypoxia signaling in cardiovascular diseases.
基金National Natural Science Foundation of China:92046020.
文摘Summary What is already known about this topic?Acute myocardial infarction(AMI)is the most serious form of cardiovascular diseases.The case fatality rate(CFR)of AMI patients is an important index to reflect the prognosis of AMI.What is added by this report?During the study period,the overall 30-day,60-day,and 90-day CFR of AMI was 5.9%,6.9%,and 7.6%,respectively.The CFRs in gradeⅢhospitals were lower than in gradeⅡhospitals,and the in-hospital CFR was significantly lower than that in post-discharge out-of-hospital.
基金Research Grants Council,University Grants Committee(614813,16212115)Innovation and Technology Fund(ITS/273/16FP).
文摘Semiconductor lasers directly grown on silicon offer great potential as critical components in high-volume,lowcost integrated silicon photonics circuits.Although InAs/InP quantum dash(QDash)lasers on native InP substrate emitting at 1.5μm(C-band)have demonstrated notable performance,the growth of InAs/InP QDash lasers on silicon remains undeveloped because of the 8%lattice mismatch between InP and silicon.Here we report advances of growth techniques leading to the first C-band room-temperature continuous-wave electrically pumped QDash lasers on CMOS standard(001)silicon substrates by metalorganic chemical vapor deposition.A correlation between various material characterizations and device performance is analyzed for different QDash laser structures grown on planar nominal(001)silicon.With the optimized QDash growth and improved fabrication process,the lowest threshold current density of 1.5 kA∕cm^(2) was determined on an 8μm×1.5 mmdevice on planar silicon with a single facet output power exceeding 14 mW.The device results illustrate the good material quality of the QDash lasers grown on silicon,suggesting potential applications for other active components of photonic integrated circuits,such as semiconductor optical amplifiers,modulators,and photodetectors.
