BACKGROUND Acute pancreatitis(AP)encompasses a spectrum of pancreatic inflammatory conditions,ranging from mild inflammation to severe pancreatic necrosis and multisystem organ failure.Given the challenges associated ...BACKGROUND Acute pancreatitis(AP)encompasses a spectrum of pancreatic inflammatory conditions,ranging from mild inflammation to severe pancreatic necrosis and multisystem organ failure.Given the challenges associated with obtaining human pancreatic samples,research on AP predominantly relies on animal models.In this study,we aimed to elucidate the fundamental molecular mechanisms underlying AP using various AP models.AIM To investigate the shared molecular changes underlying the development of AP across varying severity levels.METHODS AP was induced in animal models through treatment with caerulein alone or in combination with lipopolysaccharide(LPS).Additionally,using Ptf1αto drive the specific expression of the hM3 promoter in pancreatic acinar cells transgenic C57BL/6J-hM3/Ptf1α(cre)mice were administered Clozapine N-oxide to induce AP.Subsequently,we conducted RNA sequencing of pancreatic tissues and validated the expression of significantly different genes using the Gene Expression Omnibus(GEO)database.RESULTS Caerulein-induced AP showed severe inflammation and edema,which were exacerbated when combined with LPS and accompanied by partial pancreatic tissue necrosis.Compared with the control group,RNA sequencing analysis revealed 880 significantly differentially expressed genes in the caerulein model and 885 in the caerulein combined with the LPS model.Kyoto Encyclopedia of Genes and Genomes enrichment analysis and Gene Set Enrichment Analysis indicated substantial enrichment of the TLR and NOD-like receptor signaling pathway,TLR signaling pathway,and NF-κB signaling pathway,alongside elevated levels of apoptosis-related pathways,such as apoptosis,P53 pathway,and phagosome pathway.The significantly elevated genes in the TLR and NOD-like receptor signaling pathways,as well as in the apoptosis pathway,were validated through quantitative real-time PCR experiments in animal models.Validation from the GEO database revealed that only MYD88 concurred in both mouse pancreatic tissue and human AP peripheral blood,while TLR1,TLR7,RIPK3,and OAS2 genes exhibited marked elevation in human AP.The genes TUBA1A and GADD45A played significant roles in apoptosis within human AP.The transgenic mouse model hM3/Ptf1α(cre)successfully validated significant differential genes in the TLR and NOD-like receptor signaling pathways as well as the apoptosis pathway,indicating that these pathways represent shared pathological processes in AP across different models.CONCLUSION The TLR and NOD receptor signaling pathways play crucial roles in the inflammatory progression of AP,notably the MYD88 gene.Apoptosis holds a central position in the necrotic processes of AP,with TUBA1A and GADD45A genes exhibiting prominence in human AP.展开更多
Optical neural networks have significant advantages in terms of power consumption,parallelism,and high computing speed,which has intrigued extensive attention in both academic and engineering communities.It has been c...Optical neural networks have significant advantages in terms of power consumption,parallelism,and high computing speed,which has intrigued extensive attention in both academic and engineering communities.It has been considered as one of the powerful tools in promoting the fields of imaging processing and object recognition.However,the existing optical system architecture cannot be reconstructed to the realization of multi-functional artificial intelligence systems simultaneously.To push the development of this issue,we propose the pluggable diffractive neural networks(P-DNN),a general paradigm resorting to the cascaded metasurfaces,which can be applied to recognize various tasks by switching internal plug-ins.As the proof-of-principle,the recognition functions of six types of handwritten digits and six types of fashions are numerical simulated and experimental demonstrated at near-infrared regimes.Encouragingly,the proposed paradigm not only improves the flexibility of the optical neural networks but paves the new route for achieving high-speed,low-power and versatile artificial intelligence systems.展开更多
AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal ala...AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.展开更多
AIM: To assess the effect of Helicobacter pylori(H. pylori) infection on metabolic parameters in Mongolian gerbils.METHODS: A total of 40 male, 5- to 8-wk-old, specific-pathogen-free Mongolian gerbils(30-50 g) were ra...AIM: To assess the effect of Helicobacter pylori(H. pylori) infection on metabolic parameters in Mongolian gerbils.METHODS: A total of 40 male, 5- to 8-wk-old, specific-pathogen-free Mongolian gerbils(30-50 g) were randomly allocated into two groups: a control group(n = 20) and an H. pylori group(n = 20). After a two-week acclimation period, the control group was administered Brucella broth and the H. pylori group was challenged intra-gastrically five times every other day with approximately 109/CFU H. pylori ATCC43504(Cag A+, Vac A+). Each group was then divided into two subgroups, which were sacrificed at either 6 or 12 mo. The control and H. pylori subgroups each contained 10 Mongolian gerbils. Body weight, abdominal circumference, and body length were measured, and body mass index(BMI) and Lee's index were calculated. Biochemical assays were used to detect serum indexes, including glucose, glycated hemoglobin(GHb), glycated hemoglobin A1c(Hb A1c), triacylglycerol, and total cholesterol, using an automatic biochemistry analyzer. Inflammatory cytokines, including interleukin(IL)-1β, IL-2, IL-4,IL-10, IL-12, tumor necrosis factor-α(TNF-α) and interferon(IFN)-g, were assayed using ELISA. The expression of insulin and insulin-like growth factor 1(IGF-1) was detected by immunohistochemistry, and islet apoptosis was measured using the terminal deoxynucleotidyl transferase-mediated d UTP nick end labeling(TUNEL) assay.RESULTS: At each time point, body weight, abdominal circumference, BMI, and Lee's index were increased after H. pylori infection. However, these differences were not significant. H. pylori infection significantly increased the GHb(5.45 ± 0.53 vs 4.98 ± 0.22, P < 0.05) and Hb A1c(4.91 ± 0.61 vs 4.61 ± 0.15, P < 0.05) levels at 12 mo. We observed no significant differences in serum biochemical indexes, including fasting blood glucose, triacylglycerol and total cholesterol, at 6 or 12 mo after infection. H. pylori infection significantly increased the expression of IGF-1(P < 0.05). Insulin levels from the pancreas and the apoptotic rate of islet β-cells remained unchanged. Also, we observed no significant differences among cytokines levels, including IL-1β, IL-2, IL-4, IL-10, IL-12, TNF-α and IFN-g. IL-4 was the only exception, which increased at 6(44.36 ± 25.17 vs 17.38 ± 3.47, P < 0.05) and 12 mo(33.41 ± 10.00 vs 18.91 ± 5.31, P < 0.05) after H. pylori infection.CONCLUSION: Long-term H. pylori infection is significantly associated with high levels of Hb A1 c in Mongolian gerbils, indicating a potential role of H. pylori infection in glucose dysregulation.展开更多
AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross...AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.展开更多
AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patie...AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patients diagnosed with chronic hepatitis B infection between May 2005 and July2010,204 were eligible for analysis.The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups.The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.RESULTS:The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41%(162/204) and 43.82%(71/162),respectively.Multivariate analysis revealed that only post treatment hepatitis B surface antigen(HBsAg)level was associated with virological relapse {P= 0.011).The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥1500 IU/L than in those with HBsAg levels < 1500 IU/L(P= 0.0013).The area under the curve was 0.603(P= 0.033).The cutoff HBsAg value for predicting virological relapse was 1443IU/L CONCLUSION:We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.展开更多
BACKGROUND Moderately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality.Severe Clostridium difficile infection (sCDI) is a serious and rare nos...BACKGROUND Moderately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality.Severe Clostridium difficile infection (sCDI) is a serious and rare nosocomial diarrheal complication,especially in MSAP patients.Fecal microbiota transplantation (FMT) is a highly effective treatment for refractory and recurrent CDI (rCDI).However,knowledge regarding the initial use of FMT in patients suffering from sCDI is limited.CASE SUMMARY Here,we report an MSAP patient complicated with sCDI who was treated by FMT as a first-line therapy.The patient was a 51-year-old man who suffered from diarrhea in his course of acute pancreatitis.An enzyme immunoassay was performed to detect toxins,and the result was positive for toxin-producing C.difficile and toxin B and negative for C.difficile ribotype 027.The colonoscopy revealed pseudomembranous colitis.Due to these findings,sCDI was our primary consideration.Because the patient provided informed consent for FMT treatment,we initially treated the patient by FMT rather than metronidazole.Diarrhea resolved within 5 d after FMT.The patient remained asymptomatic,and the follow-up colonoscopy performed 40 d after discharge showed a complete recovery.Our case is the first reported in China.CONCLUSION This case explores the possibilities of initially using FMT to treat severe CDI.Moreover,FMT may become a critical component of the treatment for severe CDI in MSAP patients.展开更多
This study demonstrates the yield asymmetry in Mg-3Al-1Zn alloy containing both ND-texture(c-axis//ND(Normal direction))and TD-texture(c-axis//TD(Transverse direction))in a quantitative view.The results showed that th...This study demonstrates the yield asymmetry in Mg-3Al-1Zn alloy containing both ND-texture(c-axis//ND(Normal direction))and TD-texture(c-axis//TD(Transverse direction))in a quantitative view.The results showed that the yield asymmetry is strongly dependent on the distribution of bimodal texture components,on the basis of the successful establishment of the quantified relationship between pre-deformation parameters and texture components distribution.It’s meaningful for providing key reference to texture design.Mechanical behavior of bimodal textured Mg alloy under tension and compression was tested.CYS/TYS(compressive yield stress/tensile yield stress)equal to 1 is obtained,implying that the yield asymmetry is eliminated when two textures distribute at specific fractions.The corresponding mechanism for the texture-dependence of tension-compression yield asymmetry is revealed by the analysis of slip/twinning activities and a compound use of the activation stress difference of slip/twinning(ΔStress)and geometrical compatibility factor(m′)between neighboring grains.Balanced activity of{10■2}twinning and a quite similar boundary obstacle effect against slip/twinning transfer under tension and compression accounts for such good symmetry performance.展开更多
Acute pancreatitis(AP)is a common gastrointestinal disorder.Approximately15%-20%of patients develop severe AP.Systemic inflammatory response syndrome and multiple organ dysfunction syndrome may be caused by the massiv...Acute pancreatitis(AP)is a common gastrointestinal disorder.Approximately15%-20%of patients develop severe AP.Systemic inflammatory response syndrome and multiple organ dysfunction syndrome may be caused by the massive release of inflammatory cytokines in the early stage of severe AP,followed by intestinal dysfunction and pancreatic necrosis in the later stage.A study showed that 59%of AP patients had associated intestinal barrier injury,with increased intestinal mucosal permeability,leading to intestinal bacterial translocation,pancreatic tissue necrosis and infection,and the occurrence of multiple organ dysfunction syndrome.However,the real effect of the gut microbiota and its metabolites on intestinal barrier function in AP remains unclear.This review summarizes the alterations in the intestinal flora and its metabolites during AP development and progression to unveil the mechanism of gut failure in AP.展开更多
BACKGROUND The dysbiosis of the gut microbiome is evident in Crohn's disease(CD) compared with healthy controls(HC), although the alterations from active CD to remission after treatment are unclear.AIM To characte...BACKGROUND The dysbiosis of the gut microbiome is evident in Crohn's disease(CD) compared with healthy controls(HC), although the alterations from active CD to remission after treatment are unclear.AIM To characterize the mucosa-associated gut microbiota in patients with CD before and after the induction therapy.METHODS The basic information was collected from the subjects and the CD activity index(CDAI) was calculated in patients. A 16S rRNA sequencing approach was applied to determine the structures of microbial communities in mucosal samples including the terminal ileal, ascending colon, descending colon and rectum. The composition and function of mucosa-associated gut microbiota were compared between samples from the same cohort of patients before and after treatment.Differential taxa were identified to calculate the microbial dysbiosis index(MDI)and the correlation between MDI and CDAI was analyzed using Pearson correlation test. Predictive functional profiling of microbial communities was obtained with PICRUSt.RESULTS There were no significant differences in microbial richness among the four anatomical sites in individuals. Compared to active disease, the alpha diversity of CD in remission was increased towards the level of HC compared to the active stage. The principal coordinate analysis revealed that samples of active CD were clearly separated from those in remission, which clustered close to HC. Sixty-five genera were identified as differentially abundant between active and quiescent CD, with a loss of Fusobacterium and a gain of potential beneficial bacteria including Lactobacillus, Akkermansia, Roseburia, Ruminococcus and Lachnospira after the induction of remission. The combination of these taxa into a MDI showed a positive correlation with clinical disease severity and a negative correlation with species richness. The increased capacity for the inferred pathways including Lipopolysaccharide biosynthesis and Lipopolysaccharide biosynthesis proteins in patients before treatment negatively correlated with the abundance of Roseburia,Ruminococcus and Lachnospira.CONCLUSION The dysbiosis of mucosa-associated microbiota was associated with the disease phenotype and may become a potential diagnostic tool for the recurrence of disease.展开更多
天然气水合物大多赋存于海底沉积层或永久冻土带的沉积层孔隙中。用0.5~1 mm和2~4 mm 2种粒径的二氧化硅(SiO2)颗粒模拟真实环境,并量取不同体积SiO2分别与300 mg/L的十二烷基硫酸钠(SDS)进行复配,考察了不同体积的二氧化硅颗粒与SDS的...天然气水合物大多赋存于海底沉积层或永久冻土带的沉积层孔隙中。用0.5~1 mm和2~4 mm 2种粒径的二氧化硅(SiO2)颗粒模拟真实环境,并量取不同体积SiO2分别与300 mg/L的十二烷基硫酸钠(SDS)进行复配,考察了不同体积的二氧化硅颗粒与SDS的复配体系对水合物生成过程的影响;探究不同初始压力对该体系的影响。结果表明,加入二氧化硅颗粒后能够缩短水合物的诱导时间;同体积2~4 mm二氧化硅颗粒生成水合物的剩余压力均要低于0.5~1 mm粒径;2种粒径中都是50 m L的颗粒中剩余压力最低、储气效果更好;此外,水合物在较高的初始压力下生成效果最好。展开更多
BACKGROUND Pancreatic endocrine insufficiency after acute pancreatitis(AP) has drawn increasing attention in recent years.AIM To assess the impact of risk factors on the development of pancreatic endocrine insufficien...BACKGROUND Pancreatic endocrine insufficiency after acute pancreatitis(AP) has drawn increasing attention in recent years.AIM To assess the impact of risk factors on the development of pancreatic endocrine insufficiency after AP.METHODS This retrospective observational long-term follow-up study was conducted in a tertiary hospital. Endocrine function was evaluated by the oral glucose tolerance test. The data, including age, sex, body mass index, APACHE II score, history of smoking and drinking, organ failure, pancreatic necrosis, debridement of necrosis(minimally invasive and/or open surgery), and time interval, were collected from the record database.RESULTS A total of 361 patients were included in the study from January 1, 2012 to December 30, 2018. A total of 150(41.6%) patients were diagnosed with dysglycemia(including diabetes mellitus and impaired glucose tolerance), while211(58.4%) patients had normal endocrine function. The time intervals(mo) of the above two groups were 18.73 ± 19.10 mo and 31.53 ± 27.27 mo, respectively(P= 0.001). The morbidity rates of pancreatic endocrine insufficiency were 46.7%,28.0%, and 25.3%, respectively, in the groups with different follow-up times. The risk factors for pancreatic endocrine insufficiency after AP were severity(odds ratio [OR] = 3.489;95% confidence interval [CI]: 1.501-8.111;P = 0.004) and pancreatic necrosis(OR = 4.152;95%CI: 2.580-6.684;P = 0.001).CONCLUSION Pancreatic necrosis and severity are independent risk factors for pancreatic endocrine insufficiency after AP. The area of pancreatic necrosis can affect pancreatic endocrine function.展开更多
基金Supported by National Natural Science Foundation of China,No.82260133 and No.82370661the Academic and Technical Leader of major disciplines in Jiangxi Province,No.20225BCJ23021+2 种基金the Jiangxi Medicine Academy of Nutrition and Health Management,No.2022-PYXM-01the Natural Science Foundation of Jiangxi Province,No.20224ACB216004the Technological Innovation Team Cultivation Project of the First Affiliated Hospital of Nanchang University,No.YFYKCTDPY202202.
文摘BACKGROUND Acute pancreatitis(AP)encompasses a spectrum of pancreatic inflammatory conditions,ranging from mild inflammation to severe pancreatic necrosis and multisystem organ failure.Given the challenges associated with obtaining human pancreatic samples,research on AP predominantly relies on animal models.In this study,we aimed to elucidate the fundamental molecular mechanisms underlying AP using various AP models.AIM To investigate the shared molecular changes underlying the development of AP across varying severity levels.METHODS AP was induced in animal models through treatment with caerulein alone or in combination with lipopolysaccharide(LPS).Additionally,using Ptf1αto drive the specific expression of the hM3 promoter in pancreatic acinar cells transgenic C57BL/6J-hM3/Ptf1α(cre)mice were administered Clozapine N-oxide to induce AP.Subsequently,we conducted RNA sequencing of pancreatic tissues and validated the expression of significantly different genes using the Gene Expression Omnibus(GEO)database.RESULTS Caerulein-induced AP showed severe inflammation and edema,which were exacerbated when combined with LPS and accompanied by partial pancreatic tissue necrosis.Compared with the control group,RNA sequencing analysis revealed 880 significantly differentially expressed genes in the caerulein model and 885 in the caerulein combined with the LPS model.Kyoto Encyclopedia of Genes and Genomes enrichment analysis and Gene Set Enrichment Analysis indicated substantial enrichment of the TLR and NOD-like receptor signaling pathway,TLR signaling pathway,and NF-κB signaling pathway,alongside elevated levels of apoptosis-related pathways,such as apoptosis,P53 pathway,and phagosome pathway.The significantly elevated genes in the TLR and NOD-like receptor signaling pathways,as well as in the apoptosis pathway,were validated through quantitative real-time PCR experiments in animal models.Validation from the GEO database revealed that only MYD88 concurred in both mouse pancreatic tissue and human AP peripheral blood,while TLR1,TLR7,RIPK3,and OAS2 genes exhibited marked elevation in human AP.The genes TUBA1A and GADD45A played significant roles in apoptosis within human AP.The transgenic mouse model hM3/Ptf1α(cre)successfully validated significant differential genes in the TLR and NOD-like receptor signaling pathways as well as the apoptosis pathway,indicating that these pathways represent shared pathological processes in AP across different models.CONCLUSION The TLR and NOD receptor signaling pathways play crucial roles in the inflammatory progression of AP,notably the MYD88 gene.Apoptosis holds a central position in the necrotic processes of AP,with TUBA1A and GADD45A genes exhibiting prominence in human AP.
基金The authors acknowledge the funding provided by the National Key R&D Program of China(2021YFA1401200)Beijing Outstanding Young Scientist Program(BJJWZYJH01201910007022)+2 种基金National Natural Science Foundation of China(No.U21A20140,No.92050117,No.62005017)programBeijing Municipal Science&Technology Commission,Administrative Commission of Zhongguancun Science Park(No.Z211100004821009)This work was supported by the Synergetic Extreme Condition User Facility(SECUF).
文摘Optical neural networks have significant advantages in terms of power consumption,parallelism,and high computing speed,which has intrigued extensive attention in both academic and engineering communities.It has been considered as one of the powerful tools in promoting the fields of imaging processing and object recognition.However,the existing optical system architecture cannot be reconstructed to the realization of multi-functional artificial intelligence systems simultaneously.To push the development of this issue,we propose the pluggable diffractive neural networks(P-DNN),a general paradigm resorting to the cascaded metasurfaces,which can be applied to recognize various tasks by switching internal plug-ins.As the proof-of-principle,the recognition functions of six types of handwritten digits and six types of fashions are numerical simulated and experimental demonstrated at near-infrared regimes.Encouragingly,the proposed paradigm not only improves the flexibility of the optical neural networks but paves the new route for achieving high-speed,low-power and versatile artificial intelligence systems.
文摘AIM To assess the diagnostic value of FIB-4, aspartate aminotransferase-to-platelet ratio index(APRI), and liver stiffness measurement(LSM) in patients with hepatitis B virus infection who have persistently normal alanine transaminase(PNALT).METHODS We enrolled 245 patients with chronic hepatitis B: 95 in PNALT group, 86 in intermittently elevated alanine transaminase(PIALT1) group [alanine transaminase(ALT) within 1-2 × upper limit of normal value(ULN)], and 64 in PIALT2 group(ALT > 2 × ULN). All the patients received a percutaneous liver biopsy guided by ultrasonography. LSM, biochemical tests, and complete blood cell counts were performed.RESULTS The pathological examination revealed moderate inflammatory necrosis ratios of 16.81%(16/95), 32.56%(28/86), and 45.31%(28/64), and moderate liverfibrosis of 24.2%(23/95), 33.72%(29/86), and 43.75%(28/64) in the PNALT, PIALT1, and PIALT2 groups, respectively. The degrees of inflammation and liver fibrosis were significantly higher in the PIALT groups than in the PNALT group(P < 0.05). No significant difference was found in the areas under the curve(AUCs) between APRI and FIB-4 in the PNALT group; however, significant differences were found between APRI and LSM, and between FIB-4 and LSM in the PNALT group(P < 0.05 for both). In the PIALT1 and PIALT2 groups, no significant difference(P > 0.05) was found in AUCs for all comparisons(P > 0.05 for all). In the overall patients, a significant difference in the AUCs was found only between LSM and APRI(P < 0.05).CONCLUSION APRI and FIB-4 are not the ideal noninvasive hepatic fibrosis markers for PNALT patients. LSM is superior to APRI and FIB-4 in PNALT patients because of the influence of liver inflammation and necrosis.
基金Supported by(in part)grants from the National Natural Science Foundation of China,No.81060038,No.81270479,and No.81470832the National Science and Technology Major Projects for"Major New Drugs Innovation and Development"of China,No.2011ZX09302-007-03+1 种基金the"Talent 555 Project"of Jiangxi Province,Chinaand the Graduate Innovation Fund of Jiangxi Province,No.YC2014-B021
文摘AIM: To assess the effect of Helicobacter pylori(H. pylori) infection on metabolic parameters in Mongolian gerbils.METHODS: A total of 40 male, 5- to 8-wk-old, specific-pathogen-free Mongolian gerbils(30-50 g) were randomly allocated into two groups: a control group(n = 20) and an H. pylori group(n = 20). After a two-week acclimation period, the control group was administered Brucella broth and the H. pylori group was challenged intra-gastrically five times every other day with approximately 109/CFU H. pylori ATCC43504(Cag A+, Vac A+). Each group was then divided into two subgroups, which were sacrificed at either 6 or 12 mo. The control and H. pylori subgroups each contained 10 Mongolian gerbils. Body weight, abdominal circumference, and body length were measured, and body mass index(BMI) and Lee's index were calculated. Biochemical assays were used to detect serum indexes, including glucose, glycated hemoglobin(GHb), glycated hemoglobin A1c(Hb A1c), triacylglycerol, and total cholesterol, using an automatic biochemistry analyzer. Inflammatory cytokines, including interleukin(IL)-1β, IL-2, IL-4,IL-10, IL-12, tumor necrosis factor-α(TNF-α) and interferon(IFN)-g, were assayed using ELISA. The expression of insulin and insulin-like growth factor 1(IGF-1) was detected by immunohistochemistry, and islet apoptosis was measured using the terminal deoxynucleotidyl transferase-mediated d UTP nick end labeling(TUNEL) assay.RESULTS: At each time point, body weight, abdominal circumference, BMI, and Lee's index were increased after H. pylori infection. However, these differences were not significant. H. pylori infection significantly increased the GHb(5.45 ± 0.53 vs 4.98 ± 0.22, P < 0.05) and Hb A1c(4.91 ± 0.61 vs 4.61 ± 0.15, P < 0.05) levels at 12 mo. We observed no significant differences in serum biochemical indexes, including fasting blood glucose, triacylglycerol and total cholesterol, at 6 or 12 mo after infection. H. pylori infection significantly increased the expression of IGF-1(P < 0.05). Insulin levels from the pancreas and the apoptotic rate of islet β-cells remained unchanged. Also, we observed no significant differences among cytokines levels, including IL-1β, IL-2, IL-4, IL-10, IL-12, TNF-α and IFN-g. IL-4 was the only exception, which increased at 6(44.36 ± 25.17 vs 17.38 ± 3.47, P < 0.05) and 12 mo(33.41 ± 10.00 vs 18.91 ± 5.31, P < 0.05) after H. pylori infection.CONCLUSION: Long-term H. pylori infection is significantly associated with high levels of Hb A1 c in Mongolian gerbils, indicating a potential role of H. pylori infection in glucose dysregulation.
基金Supported by the Preventive Medicine research projects of Jiangsu Province,No.Y2012016the Social Development Project of Zhenjiang City,No.SH2014060
文摘AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.
基金Supported by Natural Science Foundation of Jiangsu Province,China,No.BK2011515Medical Project of Health Department Jiangsu Province,No.H201248+1 种基金Preventive Medicine research projects of Jiangsu Province,No.Y2012016the Social Development Project of Zhenjiang City,No.SH2013056
文摘AIM:To investigate the virological relapse rate in hepatitis B e antigen(HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.METHODS:Among patients diagnosed with chronic hepatitis B infection between May 2005 and July2010,204 were eligible for analysis.The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups.The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.RESULTS:The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41%(162/204) and 43.82%(71/162),respectively.Multivariate analysis revealed that only post treatment hepatitis B surface antigen(HBsAg)level was associated with virological relapse {P= 0.011).The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥1500 IU/L than in those with HBsAg levels < 1500 IU/L(P= 0.0013).The area under the curve was 0.603(P= 0.033).The cutoff HBsAg value for predicting virological relapse was 1443IU/L CONCLUSION:We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.
基金Supported by Project of Postgraduate Teaching Case Base Construction of Nanchang University,No.9202-0210210802Project of Health Commission of Jiangxi Province,No.20175071Postgraduate Innovation Fund Project of Nanchang University,No.2017262
文摘BACKGROUND Moderately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality.Severe Clostridium difficile infection (sCDI) is a serious and rare nosocomial diarrheal complication,especially in MSAP patients.Fecal microbiota transplantation (FMT) is a highly effective treatment for refractory and recurrent CDI (rCDI).However,knowledge regarding the initial use of FMT in patients suffering from sCDI is limited.CASE SUMMARY Here,we report an MSAP patient complicated with sCDI who was treated by FMT as a first-line therapy.The patient was a 51-year-old man who suffered from diarrhea in his course of acute pancreatitis.An enzyme immunoassay was performed to detect toxins,and the result was positive for toxin-producing C.difficile and toxin B and negative for C.difficile ribotype 027.The colonoscopy revealed pseudomembranous colitis.Due to these findings,sCDI was our primary consideration.Because the patient provided informed consent for FMT treatment,we initially treated the patient by FMT rather than metronidazole.Diarrhea resolved within 5 d after FMT.The patient remained asymptomatic,and the follow-up colonoscopy performed 40 d after discharge showed a complete recovery.Our case is the first reported in China.CONCLUSION This case explores the possibilities of initially using FMT to treat severe CDI.Moreover,FMT may become a critical component of the treatment for severe CDI in MSAP patients.
基金co-supported by National Natural Science Foundation of China(51901202,52101132)Natural Science Foundation of Jiangsu Province(No.BK 20191442)。
文摘This study demonstrates the yield asymmetry in Mg-3Al-1Zn alloy containing both ND-texture(c-axis//ND(Normal direction))and TD-texture(c-axis//TD(Transverse direction))in a quantitative view.The results showed that the yield asymmetry is strongly dependent on the distribution of bimodal texture components,on the basis of the successful establishment of the quantified relationship between pre-deformation parameters and texture components distribution.It’s meaningful for providing key reference to texture design.Mechanical behavior of bimodal textured Mg alloy under tension and compression was tested.CYS/TYS(compressive yield stress/tensile yield stress)equal to 1 is obtained,implying that the yield asymmetry is eliminated when two textures distribute at specific fractions.The corresponding mechanism for the texture-dependence of tension-compression yield asymmetry is revealed by the analysis of slip/twinning activities and a compound use of the activation stress difference of slip/twinning(ΔStress)and geometrical compatibility factor(m′)between neighboring grains.Balanced activity of{10■2}twinning and a quite similar boundary obstacle effect against slip/twinning transfer under tension and compression accounts for such good symmetry performance.
基金Supported by the National Natural Science Foundation of China,No.81760120 and No.81960128the Key Program of Science and Technology Department of Jiangxi Province,No.20171BBG70084 and No.20192ACBL20037.
文摘Acute pancreatitis(AP)is a common gastrointestinal disorder.Approximately15%-20%of patients develop severe AP.Systemic inflammatory response syndrome and multiple organ dysfunction syndrome may be caused by the massive release of inflammatory cytokines in the early stage of severe AP,followed by intestinal dysfunction and pancreatic necrosis in the later stage.A study showed that 59%of AP patients had associated intestinal barrier injury,with increased intestinal mucosal permeability,leading to intestinal bacterial translocation,pancreatic tissue necrosis and infection,and the occurrence of multiple organ dysfunction syndrome.However,the real effect of the gut microbiota and its metabolites on intestinal barrier function in AP remains unclear.This review summarizes the alterations in the intestinal flora and its metabolites during AP development and progression to unveil the mechanism of gut failure in AP.
基金the National Natural Science Foundation of China,No.81660101 and No.81860106the Special Scientific Research Fund of Public Welfare Profession of National Health and Family Planning Commission,No.201502026the Graduate Innovation Fund of Nanchang University,No.CX2017251
文摘BACKGROUND The dysbiosis of the gut microbiome is evident in Crohn's disease(CD) compared with healthy controls(HC), although the alterations from active CD to remission after treatment are unclear.AIM To characterize the mucosa-associated gut microbiota in patients with CD before and after the induction therapy.METHODS The basic information was collected from the subjects and the CD activity index(CDAI) was calculated in patients. A 16S rRNA sequencing approach was applied to determine the structures of microbial communities in mucosal samples including the terminal ileal, ascending colon, descending colon and rectum. The composition and function of mucosa-associated gut microbiota were compared between samples from the same cohort of patients before and after treatment.Differential taxa were identified to calculate the microbial dysbiosis index(MDI)and the correlation between MDI and CDAI was analyzed using Pearson correlation test. Predictive functional profiling of microbial communities was obtained with PICRUSt.RESULTS There were no significant differences in microbial richness among the four anatomical sites in individuals. Compared to active disease, the alpha diversity of CD in remission was increased towards the level of HC compared to the active stage. The principal coordinate analysis revealed that samples of active CD were clearly separated from those in remission, which clustered close to HC. Sixty-five genera were identified as differentially abundant between active and quiescent CD, with a loss of Fusobacterium and a gain of potential beneficial bacteria including Lactobacillus, Akkermansia, Roseburia, Ruminococcus and Lachnospira after the induction of remission. The combination of these taxa into a MDI showed a positive correlation with clinical disease severity and a negative correlation with species richness. The increased capacity for the inferred pathways including Lipopolysaccharide biosynthesis and Lipopolysaccharide biosynthesis proteins in patients before treatment negatively correlated with the abundance of Roseburia,Ruminococcus and Lachnospira.CONCLUSION The dysbiosis of mucosa-associated microbiota was associated with the disease phenotype and may become a potential diagnostic tool for the recurrence of disease.
文摘天然气水合物大多赋存于海底沉积层或永久冻土带的沉积层孔隙中。用0.5~1 mm和2~4 mm 2种粒径的二氧化硅(SiO2)颗粒模拟真实环境,并量取不同体积SiO2分别与300 mg/L的十二烷基硫酸钠(SDS)进行复配,考察了不同体积的二氧化硅颗粒与SDS的复配体系对水合物生成过程的影响;探究不同初始压力对该体系的影响。结果表明,加入二氧化硅颗粒后能够缩短水合物的诱导时间;同体积2~4 mm二氧化硅颗粒生成水合物的剩余压力均要低于0.5~1 mm粒径;2种粒径中都是50 m L的颗粒中剩余压力最低、储气效果更好;此外,水合物在较高的初始压力下生成效果最好。
基金Supported by National Natural Science Foundation of China,No.81860122。
文摘BACKGROUND Pancreatic endocrine insufficiency after acute pancreatitis(AP) has drawn increasing attention in recent years.AIM To assess the impact of risk factors on the development of pancreatic endocrine insufficiency after AP.METHODS This retrospective observational long-term follow-up study was conducted in a tertiary hospital. Endocrine function was evaluated by the oral glucose tolerance test. The data, including age, sex, body mass index, APACHE II score, history of smoking and drinking, organ failure, pancreatic necrosis, debridement of necrosis(minimally invasive and/or open surgery), and time interval, were collected from the record database.RESULTS A total of 361 patients were included in the study from January 1, 2012 to December 30, 2018. A total of 150(41.6%) patients were diagnosed with dysglycemia(including diabetes mellitus and impaired glucose tolerance), while211(58.4%) patients had normal endocrine function. The time intervals(mo) of the above two groups were 18.73 ± 19.10 mo and 31.53 ± 27.27 mo, respectively(P= 0.001). The morbidity rates of pancreatic endocrine insufficiency were 46.7%,28.0%, and 25.3%, respectively, in the groups with different follow-up times. The risk factors for pancreatic endocrine insufficiency after AP were severity(odds ratio [OR] = 3.489;95% confidence interval [CI]: 1.501-8.111;P = 0.004) and pancreatic necrosis(OR = 4.152;95%CI: 2.580-6.684;P = 0.001).CONCLUSION Pancreatic necrosis and severity are independent risk factors for pancreatic endocrine insufficiency after AP. The area of pancreatic necrosis can affect pancreatic endocrine function.
