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Comparison of postoperative complications rates of endoscopic submucosal dissection in patients of different age groups with lesions at different locations 不同年龄组不同部位病变的内镜下粘膜下剥离术后并发症发生率比较
Pub Date : 2019-07-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.07.007
Weiqing Chen, Ming Hu, F. Ji
Objective To retrospectively analyze the characteristics of postoperative complications of endoscopic submucosal dissection (ESD) in patients of different age groups with lesions at different locations. Methods From January 2011 to October 2017, at The First Affiliated Hospital of Zhejiang University, clinical data of 1 688 patients who received ESD treatment (1 799 ESD operations) were collected. The lesions were located in the esophagus (n=232), stomach (n=1 225), duodenum (n=9), colon (n=152) and rectum (n=181). There were 500 patients (508 ESD operations) with underlying diseases, and 1 188 patients without underlying diseases. Most patients with lesions at stomach, esophagus and colon rectum, and these patients were divided into four age groups <45 years (n=202), 4559 years (n=643), 6074 years (n=744), and ≥75 years (n=99). The postoperative complications rates of ESD in different lesions among four age groups were compared. Chi-square test was performed for statistical analysis. Results From 2011 to 2017, the complication rates after ESD were 20.0% (8/40), 18.3% (21/115), 15.9% (35/220), 10.7% (31/291), 11.3% (40/355), 10.7% (41/384) and 10.7% (42/394), respectively, and the difference was not statistically significant (χ2=10.432, P=0.064). Further analysis revealed that the complication rates after ESD between 2011 and 2013 was significantly higher than that between 2014 and 2017 (17.1%, 64/375 vs. 10.8%, 154/1 424); and the difference was statistically significant (χ2=10.895, P<0.01). The complication rates of patients with lesions in the esophagus of<45 years group, 4559 years group, 6074 years group and ≥75 years group were 4.5% (1/22), 23.6% (17/72), 24.4% (31/127) and five cases (totally 11 cases). The complication rates of patients with lesions in the stomach of<45 years group, 4559 years group, 6074 years group and ≥75 years group were 19.2% (28/146), 14.2% (68/479), 15.8% (85/539) and 16.4% (10/61). The complication rates of lesions in the colon of<45 years group, 4559 years group, 6074 years group and ≥75 years group were one case (totally 12 cases), 3.4% (2/58), 10.9% (7/64) and five cases (totally 18 cases), respectively.The complication rates of lesions in the rectum of <45 years group, 4559 years group, 6074 years group and ≥75 years group were 3.3% (1/30), 10.4% (7/67), 19.4% (14/72) and two cases (totally 12 cases), respectively. There were significant differences in complication rates between different age groups with lesions in the esophagus (χ2=10.894, P=0.012) and the colon (χ2=13.540, P=0.004). In addition, the complication rates of patients with underlying diseases and without underlying diseases were 14.6% (74/508) and 12.5% (149/1 188), respectively, and there was no statistically significant difference (χ2=1.278, P=0.258). Conclusions The postoperative complications of ESD is closely associated with lesion location and age. For elderly patients, especially those with lesions in the esophagus and c
目的回顾性分析不同年龄组不同部位病变的内镜下粘膜下剥离(ESD)术后并发症的特点。方法收集2011年1月至2017年10月浙江大学附属第一医院1 688例接受ESD治疗的患者(其中1 799例手术)的临床资料。病变位于食道(n=232)、胃(n=1 225)、十二指肠(n=9)、结肠(n=152)和直肠(n=181)。有基础疾病患者500例(508例),无基础疾病患者1 188例。以胃、食道、结肠直肠病变为主,年龄分为<45岁(n=202)、4559岁(n=643)、6074岁(n=744)、≥75岁(n=99) 4组。比较4个年龄组不同病变的ESD术后并发症发生率。采用卡方检验进行统计学分析。结果2011 ~ 2017年,ESD术后并发症发生率分别为20.0%(8/40)、18.3%(21/115)、15.9%(35/220)、10.7%(31/291)、11.3%(40/355)、10.7%(41/384)、10.7%(42/394),差异无统计学意义(χ2=10.432, P=0.064)。进一步分析发现,2011 - 2013年ESD术后并发症发生率显著高于2014 - 2017年(17.1%,64/375 vs. 10.8%, 154/1 424);差异有统计学意义(χ2=10.895, P<0.01)。食管病变发生率<45岁组、4559岁组、6074岁组和≥75岁组分别为4.5%(1/22)、23.6%(17/72)、24.4%(31/127)和5例(共11例)。<45岁组、4559岁组、6074岁组和≥75岁组胃病变并发症发生率分别为19.2%(28/146)、14.2%(68/479)、15.8%(85/539)和16.4%(10/61)。<45岁组、4559岁组、6074岁组和≥75岁组结肠病变并发症发生率分别为1例(共12例)、3.4%(2/58)、10.9%(7/64)和5例(共18例)。<45岁组、4559岁组、6074岁组和≥75岁组直肠病变并发症发生率分别为3.3%(1/30)、10.4%(7/67)、19.4%(14/72)和2例(共12例)。不同年龄组间食管、结肠病变并发症发生率差异有统计学意义(χ2=10.894, P=0.012);有基础疾病与无基础疾病患者的并发症发生率分别为14.6%(74/508)和12.5%(149/1 188),差异无统计学意义(χ2=1.278, P=0.258)。结论ESD术后并发症与病变部位、年龄密切相关。对于老年患者,特别是有食道、结肠病变的患者,更加重视并加强临床实践,可有效减少并发症的发生。关键词:术后并发症;出血;内镜下粘膜下剥离;穿孔
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引用次数: 0
Mechanism of microRNA-182 targeting and regulating forkhead box transcription factor 2 to promote the invasion, metastasis and angiogenesis of hepatocellular carcinoma microRNA-182靶向调控叉头盒转录因子2促进肝细胞癌侵袭转移及血管生成的机制
Pub Date : 2019-07-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.07.006
Yun-jian Wang, Min Zhang, Guohua You, Luyang Zhang
Objective To investigate the expression of miRNA-182 in hepatocellular carcinoma (HCC) cell lines and tissues, to verify the targeted regulation relationship between miRNA-182 and forkhead box transcription factor 2 (FOXF2) and to explore whether miRNA-182 can promote the invasion, metastasis and angiogenesis of HCC by targeting FOXF2. Methods From January to October 2017, a total of 41 patients with primary HCC admitting to Cancer Hospital Affiliated to Zhengzhou University and receiving operation were enrolled. The expression of miRNA-182 in tumor tissues and normal paracancerous tissues was detected by quantitative real-time fluorescence polymerase chain reaction (qRT-PCR). The effects of overexpression of miRNR-182 and FOXF2 on invasion and metastasis of HCC were detected by Transwell transfer experiment and the Boyden invasion experiment. The effects of miRNA-182 and FOXF2 on angiogenesis of HCC were determinded by in vitro angiogenesis experiments. The targeted regulation relationship between miRNA-182 and FOXF2 was investigated by dual luciferase reporter gene. The expression of FOXF2 at mRNA and protein level after miRNA-182 and miRNA-182 scramble transfection was detected by qRT-PCR and Western blotting method. T test was performed for statistical analysis. Results The expression in miRNA-182 in HCC tissue was higher than that in normal tissues adjacent to cancer (5.41±1.72 vs. 1.80±0.76), and the difference was statistically significant (t=-5.764, P<0.01). The results of Transwell transfer experiment and the Boyden invasion experiment showed that the number of cells passing through the membrane of the small chamber of miRNA-182 over-expression group was higher than that of miRNA-182 scramble group (85.65±4.86 vs. 31.43±2.41, 55.34±5.66 vs. 19.13±2.12), the number of cells passing through the membrane of the small chamber of miRNA-182+ FOXF2 over expression group was less than that of simple miRNA-182 over expression group (11.21±3.16 vs. 31.43±2.41, 8.67±2.83 vs. 19.13±2.12), and the differences were statistically significant (t=15.110, 9.220, 5.443 and 4.410; all P<0.05). The activity of luciferase of wild FOXF2 and miRNA-182 cotransfection group was lower than that of miRNA-182 scramble group (0.43±0.10 vs. 0.97±0.05), and the difference was statistically significant (t=8.042, P=0.012). However the activity of luciferase of mutated FOXF2 and miRNA-182 cotransfection group was higher than that of miRNA-182 scramble group (0.97±0.47 vs. 1.06±0.52), and the difference was not statistically significant (t=0.934, P=0.402). The results of in vitro angiogenesis experiments demonstrated that the number of constituent vessels in miRNA-182 over expression group was higher than that in miRNA-182 scramble group (14.27±1.77 vs. 5.91±1.42), and after FOXF2 over-expressing plasmids cotransfected, the angiogenesis ability restored (1.78±0.71 vs. 14.27±1.77), and the differences were statistically significant (t=6.530 and 4.570, both P<0.
目的研究miRNA-182在肝细胞癌(HCC)细胞系和组织中的表达,验证miRNA-182与叉头盒转录因子2 (FOXF2)的靶向调控关系,探讨miRNA-182是否能通过靶向FOXF2促进HCC的侵袭、转移和血管生成。方法选取2017年1 - 10月在郑州大学附属肿瘤医院接受手术治疗的原发性肝癌患者41例。采用实时荧光聚合酶链式反应(qRT-PCR)检测miRNA-182在肿瘤组织和正常癌旁组织中的表达。通过Transwell转移实验和Boyden侵袭实验检测miRNR-182和FOXF2过表达对HCC侵袭转移的影响。通过体外血管生成实验检测miRNA-182和FOXF2对HCC血管生成的影响。通过双荧光素酶报告基因研究miRNA-182与FOXF2的靶向调控关系。采用qRT-PCR和Western blotting方法检测转染miRNA-182和miRNA-182后FOXF2在mRNA和蛋白水平上的表达。采用T检验进行统计学分析。结果miRNA-182在HCC组织中的表达高于癌旁正常组织(5.41±1.72∶1.80±0.76),差异有统计学意义(t=-5.764, P<0.01)。Transwell转移实验和Boyden侵袭实验结果显示,miRNA-182过表达组通过小室膜的细胞数量高于miRNA-182 scramble组(85.65±4.86 vs. 31.43±2.41,55.34±5.66 vs. 19.13±2.12);miRNA-182+ FOXF2过表达组通过小室膜的细胞数少于单纯miRNA-182过表达组(11.21±3.16 vs. 31.43±2.41,8.67±2.83 vs. 19.13±2.12),差异有统计学意义(t=15.110、9.220、5.443、4.410;所有P < 0.05)。野生FOXF2与miRNA-182共转染组荧光素酶活性低于miRNA-182炒炒组(0.43±0.10∶0.97±0.05),差异有统计学意义(t=8.042, P=0.012)。突变FOXF2和miRNA-182共转染组荧光素酶活性高于miRNA-182 scramble组(0.97±0.47比1.06±0.52),差异无统计学意义(t=0.934, P=0.402)。体外血管生成实验结果显示,miRNA-182过表达组血管组成数高于miRNA-182 scramble组(14.27±1.77比5.91±1.42),FOXF2过表达质粒共转染后血管生成能力恢复(1.78±0.71比14.27±1.77),差异有统计学意义(t=6.530、4.570,P均<0.05)。Western blotting结果显示,转染miRNA-182组FOXF2表达水平低于转染miRNA-182组(1.01±0.13∶4.32±0.46),差异有统计学意义(t=7.420, P=0.012)。qRT-PCR结果显示,miRNA-182转染组FOXF2 mRNA表达量低于miRNA-182炒置组(0.591±0.284∶1.534±0.345),差异有统计学意义(t=3.465, P=0.014)。结论miRNA-182可通过调控FOXF2促进肝癌细胞的侵袭转移。关键词:肝癌;肝细胞癌;microrna - 182;FOXF2;侵袭转移;血管生成
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引用次数: 0
Role and mechanism of circular RNA-vimentin in the proliferation and apoptosis of colorectal cancer cells 环状RNA-vimentin在结直肠癌细胞增殖和凋亡中的作用及机制
Pub Date : 2019-07-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.07.005
Jianning Yao, Xuexiu Zhang, Yan-zhen Zhang, Yanle Li, Chunfeng Wang
Objective To investigate the role and mechanism of circular RNA-vimentin (circ-VIM) in the proliferation and apoptosis of colorectal cancer cells. Methods From December 2016 to December 2017, at Department of General Surgery of The First Affiliated Hospital of Zhengzhou University, the clinical data of 100 patients who underwent radical resection of colorectal cancer and were confirmed by pathological examination after operation were collected. The tumor tissues and corresponding paracancerous tissues (negative control) were also collected. The expression of circ-VIM in the colorectal cancer tissues was determined by quantitative real-time polymerase chain reaction (qRT-PCR). The proliferation of HCT-116 and HT29 colorectal cancer cells was detected by cell counting kit-8 assay. The ratio of apoptosis of HCT-116 and HT29 cells was measured by annexin Ⅴ/propidium iodide double staining assay. The mitochondrial membrane potential of HCT-116 and HT29 cells was examined by 5, 5′, 6, 6′-tetrachloro-1, 1′, 3, 3′-tetraethyl-imidacarbocyanine iodide (JC-1) assay. The expression changes of protein kinase B and mammalian target of rapamycin were tested by Western blotting. The target miRNA of circ-VIM was predicted by miRDB software. T-test and chi-square test were performed for statistical analysis. Results The expression of circ-VIM in colorectal cancer tissues was 2.387±0.536, which was higher than that in corresponding paracancerous tissues (1.110±0.134), and the difference was statistically significant (t=23.096, P<0.01). And the expression levels of circ-VIM were significantly different in patients with different tumor size, TNM stage and lymph node metastasis (all P<0.05). The proliferation of HCT-116 cells and HT29 cells in lenti-circ-VIM group was 0.737±0.023 and 0.835±0.025, respectively, which were both higher than those in control group (0.449±0.020 and 0.531±0.019), and the differences were statistically significant (t=20.706 and -15.374, both P<0.01). The proliferation of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was 0.236±0.027 and 0.243±0.019, which were lower than those in control group, and the differences were statistically significant (t=24.557 and -23.197, both P<0.01). The ratio of apoptosis of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was (18.00±1.82)% and (20.80±0.61)%, which was higher than those in control group ((6.64±2.01)% and (7.35±1.36)%), and the differences were statistically significant (t=8.826 and 17.454, both P<0.01). The fluorescence intensity ratio of JC-1 aggregate and JC-1 monomer of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was 2.21±0.12 and 1.40±0.11, which was lower than those in control group (14.54±1.00 and 9.24±1.18), and the differences were statistically significant (t=-19.558 and -15.685, both P<0.01), which indicated mitochondrial membrane potential decreased. After treated with lenti-circ-VIM-shRNA, the expression of phosphorylated protein ki
目的探讨环状RNA-vimentin (circ-VIM)在结直肠癌细胞增殖和凋亡中的作用及机制。方法收集2016年12月至2017年12月郑州大学第一附属医院普外科行大肠癌根治术并术后病理证实的100例患者的临床资料。同时收集肿瘤组织及相应的癌旁组织(阴性对照)。采用实时荧光定量聚合酶链反应(qRT-PCR)检测circ-VIM在结直肠癌组织中的表达。采用细胞计数试剂盒-8检测HCT-116和HT29结直肠癌细胞的增殖情况。膜联蛋白Ⅴ/碘化丙啶双染色法检测HCT-116和HT29细胞的凋亡率。采用5,5 ',6,6 ' -四氯- 1,1 ',3,3 ' -四乙基-碘化咪碳菁(JC-1)法检测HCT-116和HT29细胞的线粒体膜电位。Western blotting检测蛋白激酶B和哺乳动物雷帕霉素靶蛋白的表达变化。通过miRDB软件预测circ-VIM的靶miRNA。采用t检验和卡方检验进行统计学分析。结果circ-VIM在结直肠癌组织中的表达量为2.387±0.536,高于相应癌旁组织的表达量(1.110±0.134),差异有统计学意义(t=23.096, P<0.01)。circ-VIM在不同肿瘤大小、TNM分期及淋巴结转移的患者中表达水平差异有统计学意义(均P<0.05)。lentic -circ- vim组HCT-116细胞和HT29细胞的增殖分别为0.737±0.023和0.835±0.025,均高于对照组(0.449±0.020和0.531±0.019),差异有统计学意义(t=20.706和-15.374,P均<0.01)。lentic -circ- vim - shrna组HCT-116细胞和HT29细胞的增殖分别为0.236±0.027、0.243±0.019,均低于对照组,差异均有统计学意义(t=24.557、-23.197,P均<0.01)。lentic -circ- vim - shrna组HCT-116细胞和HT29细胞的凋亡率分别为(18.00±1.82)%和(20.80±0.61)%,高于对照组(6.64±2.01)%和(7.35±1.36)%,差异有统计学意义(t=8.826、17.454,P均<0.01)。lentic -circ- vim - shrna组HCT-116细胞和HT29细胞JC-1聚集体和JC-1单体荧光强度比分别为2.21±0.12和1.40±0.11,均低于对照组(14.54±1.00和9.24±1.18),差异有统计学意义(t=-19.558和-15.685,P均<0.01),表明线粒体膜电位下降。经lentic -circ- vim - shrna处理后,磷酸化蛋白激酶B、磷酸化哺乳动物雷帕霉素靶蛋白、B细胞淋巴瘤-2和线粒体细胞色素C在蛋白水平上的表达均下调,而细胞质细胞色素C、B细胞淋巴瘤-2相关X蛋白和cleaved caspase-3在蛋白水平上的表达均上调。当circ-VIM表达上调时,miRNA-147b、miRNA-4447和miRNA-3656的表达下调。当circ-VIM表达下调时,miRNA-147b、miRNA-4447和miRNA-3656表达上调。结论circ-VIM在结直肠癌中表达异常增高,参与结直肠癌细胞的增殖和凋亡。关键词:结直肠肿瘤;细胞增殖;细胞凋亡;circ-VIM
{"title":"Role and mechanism of circular RNA-vimentin in the proliferation and apoptosis of colorectal cancer cells","authors":"Jianning Yao, Xuexiu Zhang, Yan-zhen Zhang, Yanle Li, Chunfeng Wang","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.07.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.07.005","url":null,"abstract":"Objective \u0000To investigate the role and mechanism of circular RNA-vimentin (circ-VIM) in the proliferation and apoptosis of colorectal cancer cells. \u0000 \u0000 \u0000Methods \u0000From December 2016 to December 2017, at Department of General Surgery of The First Affiliated Hospital of Zhengzhou University, the clinical data of 100 patients who underwent radical resection of colorectal cancer and were confirmed by pathological examination after operation were collected. The tumor tissues and corresponding paracancerous tissues (negative control) were also collected. The expression of circ-VIM in the colorectal cancer tissues was determined by quantitative real-time polymerase chain reaction (qRT-PCR). The proliferation of HCT-116 and HT29 colorectal cancer cells was detected by cell counting kit-8 assay. The ratio of apoptosis of HCT-116 and HT29 cells was measured by annexin Ⅴ/propidium iodide double staining assay. The mitochondrial membrane potential of HCT-116 and HT29 cells was examined by 5, 5′, 6, 6′-tetrachloro-1, 1′, 3, 3′-tetraethyl-imidacarbocyanine iodide (JC-1) assay. The expression changes of protein kinase B and mammalian target of rapamycin were tested by Western blotting. The target miRNA of circ-VIM was predicted by miRDB software. T-test and chi-square test were performed for statistical analysis. \u0000 \u0000 \u0000Results \u0000The expression of circ-VIM in colorectal cancer tissues was 2.387±0.536, which was higher than that in corresponding paracancerous tissues (1.110±0.134), and the difference was statistically significant (t=23.096, P<0.01). And the expression levels of circ-VIM were significantly different in patients with different tumor size, TNM stage and lymph node metastasis (all P<0.05). The proliferation of HCT-116 cells and HT29 cells in lenti-circ-VIM group was 0.737±0.023 and 0.835±0.025, respectively, which were both higher than those in control group (0.449±0.020 and 0.531±0.019), and the differences were statistically significant (t=20.706 and -15.374, both P<0.01). The proliferation of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was 0.236±0.027 and 0.243±0.019, which were lower than those in control group, and the differences were statistically significant (t=24.557 and -23.197, both P<0.01). The ratio of apoptosis of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was (18.00±1.82)% and (20.80±0.61)%, which was higher than those in control group ((6.64±2.01)% and (7.35±1.36)%), and the differences were statistically significant (t=8.826 and 17.454, both P<0.01). The fluorescence intensity ratio of JC-1 aggregate and JC-1 monomer of HCT-116 cells and HT29 cells in lenti-circ-VIM-shRNA group was 2.21±0.12 and 1.40±0.11, which was lower than those in control group (14.54±1.00 and 9.24±1.18), and the differences were statistically significant (t=-19.558 and -15.685, both P<0.01), which indicated mitochondrial membrane potential decreased. After treated with lenti-circ-VIM-shRNA, the expression of phosphorylated protein ki","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"2016 1","pages":"458-465"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86650322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Distribution of food specific antibodies in patients with inflammatory bowel disease 炎症性肠病患者食物特异性抗体的分布
Pub Date : 2019-07-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.07.003
Yulin Yang, Chang Liu, Zhaoqing Yang, Hui Tao
Objective To investigate the incidence of food intolerance in patients with inflammatory bowel disease (IBD) and to analyze the differential diagnostic value of intolerant food in Crohn′s disease (CD) and ulcerative colitis (UC) and its effects on the diseases. Methods From January 2017 to June 2018, at Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University/General Hospital of Eastern Theater Command, PLA, a total of 252 IBD (154 CD and 98 UC) patients were enrolled. In the same period 46 non-IBD patients were recruited. Allergic diseases were excluded. The food-specific IgG antibodies were detected by enzyme linked immunosorbent assay (ELISA) in all enrolled patients. The chi-square test, Kruskal-Wallis test and Spearman correlation analysis were performed for statistical analysis. Regression analysis was used to screen the risk factors. Results The total positive rates of serum IgG antibody of corn, rice, soybean, tomato and wheat in CD patients were 60.4% (93/154), 57.8% (89/154), 42.9% (66/154), 68.2% (105/154) and 19.5% (30/154), respectively, which were higher than those in patients with UC (7.1%, 7/98; 5.1%, 5/98; 5.1%, 5/98; 16.3%, 16/98 and 3.1%, 3/98, respectively) and those of non-IBD patients (2.2%, 1/46; 2.2%, 1/46; 0, 0/46; 0, 0/46 and 0, 0/46, respectively), and the differences were statistically significant (χ2=70.940, 71.092, 42.185, 64.517, 14.187; 48.190, 44.270, 29.424, 66.029, 10.542; all P 0.05) and there was a negative correlation between the total number of IgG positive food and age in UC patients (rs=-0.376, P<0.01). The median number of total IgG positive food of patients with lesions involving the terminal ileum (L1) and ileocolon (L3) was two and four, respectively, and the difference was statistically significant(the statistic was 11.717, P=0.002). The median number of total IgG positive food of UC patients with rectal lesions (E1) and extensive colon lesions (E3) was zero and one, respectively, and the difference was statistically significant (the statistic was 7.191, P=0.022). In addition, positive IgG shrimp and soybean were risk factors of CD patients combined with extra-intestinal manifestations and low body mass index (odd ratio (OR)=24.558, 95%CI 2.243 to 268.936; OR=2.253, 95%CI 1.048 to 4.841; both P<0.05, respectively). Conclusions CD patients are more susceptible to food intolerance. The number of intolerant foods have differential diagnostic value in CD, UC and non-IBD. The larger the lesion of IBD patients, the more common the food intolerance. IgG antibody positive food positive, may affect extra-intestinal manifestations and nutritional status of CD patients. Key words: Inflammatory bowel diseases; Crohn disease; Colitis, ulcerative; Food antibodies
目的调查炎症性肠病(IBD)患者食物不耐受的发生率,分析食物不耐受在克罗恩病(CD)和溃疡性结肠炎(UC)中的鉴别诊断价值及其对这两种疾病的影响。方法2017年1月至2018年6月,在南京大学医学院金陵医院消化内科/解放军东部战区总医院,共收集IBD患者252例(CD 154例,UC 98例)。在同一时期,46名非ibd患者被招募。排除过敏性疾病。采用酶联免疫吸附试验(ELISA)检测食物特异性IgG抗体。采用卡方检验、Kruskal-Wallis检验和Spearman相关分析进行统计学分析。采用回归分析筛选危险因素。结果CD患者血清IgG抗体总阳性率分别为60.4%(93/154)、57.8%(89/154)、42.9%(66/154)、68.2%(105/154)和19.5%(30/154),高于UC患者(7.1%,7/98;5.1%, 5/98;5.1%, 5/98;分别为16.3%,16/98和3.1%,3/98)和非ibd患者(2.2%,1/46;2.2%, 1/46;0, 0/46;差异均有统计学意义(χ2=70.940、71.092、42.185、64.517、14.187;48.190, 44.270, 29.424, 66.029, 10.542;UC患者IgG阳性食物总数与年龄呈负相关(rs=-0.376, P<0.01)。累及回肠末端(L1)和回肠结肠(L3)的患者总IgG阳性食物中位数分别为2个和4个,差异有统计学意义(统计值为11.717,P=0.002)。UC伴直肠病变(E1)和广泛结肠病变(E3)患者总IgG阳性食物中位数分别为0和1,差异有统计学意义(统计值为7.191,P=0.022)。此外,IgG阳性的虾和大豆是合并肠外表现和低体重指数的CD患者的危险因素(奇比(OR)=24.558, 95%CI 2.243 ~ 268.936;OR=2.253, 95%CI 1.048 ~ 4.841;P<0.05)。结论乳糜泻患者更易发生食物不耐受。不耐受食物的数量对CD、UC和非ibd具有鉴别诊断价值。IBD患者病变越大,食物不耐受越常见。IgG抗体阳性食物呈阳性,可能影响乳糜泻患者的肠外表现和营养状况。关键词:炎症性肠病;克罗恩病;溃疡性结肠炎;食物的抗体
{"title":"Distribution of food specific antibodies in patients with inflammatory bowel disease","authors":"Yulin Yang, Chang Liu, Zhaoqing Yang, Hui Tao","doi":"10.3760/CMA.J.ISSN.0254-1432.2019.07.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.0254-1432.2019.07.003","url":null,"abstract":"Objective \u0000To investigate the incidence of food intolerance in patients with inflammatory bowel disease (IBD) and to analyze the differential diagnostic value of intolerant food in Crohn′s disease (CD) and ulcerative colitis (UC) and its effects on the diseases. \u0000 \u0000 \u0000Methods \u0000From January 2017 to June 2018, at Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University/General Hospital of Eastern Theater Command, PLA, a total of 252 IBD (154 CD and 98 UC) patients were enrolled. In the same period 46 non-IBD patients were recruited. Allergic diseases were excluded. The food-specific IgG antibodies were detected by enzyme linked immunosorbent assay (ELISA) in all enrolled patients. The chi-square test, Kruskal-Wallis test and Spearman correlation analysis were performed for statistical analysis. Regression analysis was used to screen the risk factors. \u0000 \u0000 \u0000Results \u0000The total positive rates of serum IgG antibody of corn, rice, soybean, tomato and wheat in CD patients were 60.4% (93/154), 57.8% (89/154), 42.9% (66/154), 68.2% (105/154) and 19.5% (30/154), respectively, which were higher than those in patients with UC (7.1%, 7/98; 5.1%, 5/98; 5.1%, 5/98; 16.3%, 16/98 and 3.1%, 3/98, respectively) and those of non-IBD patients (2.2%, 1/46; 2.2%, 1/46; 0, 0/46; 0, 0/46 and 0, 0/46, respectively), and the differences were statistically significant (χ2=70.940, 71.092, 42.185, 64.517, 14.187; 48.190, 44.270, 29.424, 66.029, 10.542; all P 0.05) and there was a negative correlation between the total number of IgG positive food and age in UC patients (rs=-0.376, P<0.01). The median number of total IgG positive food of patients with lesions involving the terminal ileum (L1) and ileocolon (L3) was two and four, respectively, and the difference was statistically significant(the statistic was 11.717, P=0.002). The median number of total IgG positive food of UC patients with rectal lesions (E1) and extensive colon lesions (E3) was zero and one, respectively, and the difference was statistically significant (the statistic was 7.191, P=0.022). In addition, positive IgG shrimp and soybean were risk factors of CD patients combined with extra-intestinal manifestations and low body mass index (odd ratio (OR)=24.558, 95%CI 2.243 to 268.936; OR=2.253, 95%CI 1.048 to 4.841; both P<0.05, respectively). \u0000 \u0000 \u0000Conclusions \u0000CD patients are more susceptible to food intolerance. The number of intolerant foods have differential diagnostic value in CD, UC and non-IBD. The larger the lesion of IBD patients, the more common the food intolerance. IgG antibody positive food positive, may affect extra-intestinal manifestations and nutritional status of CD patients. \u0000 \u0000 \u0000Key words: \u0000Inflammatory bowel diseases; Crohn disease; Colitis, ulcerative; Food antibodies","PeriodicalId":10009,"journal":{"name":"中华消化杂志","volume":"41 1","pages":"444-451"},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85237359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Magnetically controlled capsule gastroscopy: a new era of gastrointestinal endoscopy 磁控胶囊胃镜:胃肠内镜的新时代
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.002
Z. Liao
磁控胶囊胃镜诊断准确性高,与电子胃镜高度一致,已在国内外千余家单位应用50余万例,成为被广泛接受的舒适化胃镜检查新方法。与此同时,针对胶囊胃镜的循证医学研究也得到了全面开展。从应用的安全有效性到对胃癌的诊断效能评价,从检查技术的优化到胃肠道准备方案,不断的探索研究必将促使磁控胶囊胃镜的革新与突破,从而更好地为人类服务。
磁控胶囊胃镜诊断准确性高,与电子胃镜高度一致,已在国内外千余家单位应用50余万例,成为被广泛接受的舒适化胃镜检查新方法。与此同时,针对胶囊胃镜的循证医学研究也得到了全面开展。从应用的安全有效性到对胃癌的诊断效能评价,从检查技术的优化到胃肠道准备方案,不断的探索研究必将促使磁控胶囊胃镜的革新与突破,从而更好地为人类服务。
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引用次数: 1
Analysis of risk factors for non-curative resection after endoscopic submucosal dissection in early esophageal cancer and high-grade intraepithelial neoplasia 早期食管癌及高级别上皮内瘤变内镜下粘膜下夹层非治性切除的危险因素分析
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.007
Jiajia Yang, Yini Dang, Lei Peng, Duochen Jin, Huaiming Sang, Meihong Chen
Objective To investigate the risk factors for non-curative resection after endoscopic submucosal dissection (ESD) for early esophageal cancer and high-grade intraepithelial neoplasia. Methods The clinicopathological data of 427 cases of early esophageal cancer and high-grade intraepithelial neoplasia who underwent ESD was performed from January 2013 to December 2016 in the Department of Gastroenterology, First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. According to the results of postoperative pathology and immunohistochemistry, 339 patients were defined as curative resection group and 88 patients were defined as non-curative resection group. Chi-square test, univariate analysis and multivariate logistic regression analysis were used for statistical analysis. Results A total of 427 patients were enrolled in this study, with an average age of (63.2±7.7) years, including 96 cases of early esophageal cancer and 331 cases of high-grade intraepithelial neoplasia. The enbloc resection rate of ESD was 94.8%(405/427), 88 of them were non-curative resected, and the non-curative resection rate was 20.6%. Univariate analysis showed that early esophageal cancer (odds ratio (OR)=3.682, 95% confidence interval (CI) 2.216 to 6.118, P<0.01), submucosal infiltration (OR=10.220, 95%CI4.861 to 21.481, P<0.01), ESD indications (OR=6.005, 95%CI3.545 to 10.172, P<0.01) and lifting sign after injecting at the base of lesions (OR=2.508, 95%CI1.005 to 6.255, P=0.042) were statistically significant between non-curative resection group and curative resection group. Multivariate unconditional logistic regression analysis revealed that submucosal infiltration (OR=4.329, 95%CI1.758 to 10.661, P=0.001), not absolute indications of ESD (OR=6.484, 95%CI2.205 to 19.068, P=0.001) and negative lifting sign (OR=3.182, 95%CI1.171 to 8.651, P=0.023) were independent risk factors for non-curative resection. Conclusions Patients with early esophageal cancer, submucosal infiltration, not absolute indications for ESD and negative lifting signs are prone to non-curative resection. Moreover, submucosal infiltration, not absolute indications for ESD, and negative lifting signs are the independent risk factors for non-curative resection. Key words: Endoscopic submucosal dissection; Early esophageal cancer; Precancerous lesions; Non-curative resection
目的探讨内镜下粘膜下剥离术(ESD)治疗早期食管癌及高级别上皮内瘤变的危险因素。方法回顾性分析2013年1月至2016年12月南京医科大学第一附属医院消化内科行ESD手术的427例早期食管癌伴高级别上皮内瘤变患者的临床病理资料。根据术后病理及免疫组化结果,339例患者定义为治愈切除组,88例患者定义为非治愈切除组。采用卡方检验、单因素分析和多因素logistic回归分析进行统计分析。结果共纳入427例患者,平均年龄(63.2±7.7)岁,其中早期食管癌96例,高级别上皮内瘤变331例。ESD的整体切除率为94.8%(405/427),其中88例为不可治愈性切除,不可治愈性切除率为20.6%。单因素分析显示,早期食管癌(优势比(OR)=3.682, 95%可信区间(CI) 2.216 ~ 6.118, P<0.01)、粘膜下浸润(OR=10.220, 95% ci4.861 ~ 21.481, P<0.01)、ESD指征(OR=6.005, 95% ci3.545 ~ 10.172, P<0.01)、病灶底部注射后提升征候(OR=2.508, 95% ci1.005 ~ 6.255, P=0.042)在非治愈性切除组与治愈性切除组之间差异均有统计学意义。多因素无条件logistic回归分析显示,粘膜下浸润(OR=4.329, 95%CI1.758 ~ 10.661, P=0.001)、非绝对指征ESD (OR=6.484, 95%CI2.205 ~ 19.068, P=0.001)和阴性举征(OR=3.182, 95%CI1.171 ~ 8.651, P=0.023)是非根治性切除的独立危险因素。结论早期食管癌、黏膜下浸润、非绝对指征ESD及阴性举征患者易行非治性切除。此外,粘膜下浸润,非ESD的绝对指征,以及负举征是非根治性切除的独立危险因素。关键词:内镜下粘膜下剥离;早期食管癌;癌前病变;Non-curative切除
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引用次数: 0
Influencing factors of different bowel preparation regimens on the quality of colonoscopy 不同肠准备方案对结肠镜检查质量的影响因素
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.008
Xiaohong Jiang, Weiqun Ding, Zhongguang Luo, Xinhua Huang
Objective To explore the influencing factors of different bowel preparation before colonoscopy on the intestinal cleanliness and polyp detection rate. Methods From March to August in 2018, at the Center of Endoscopy of Huashan Hospital Affiliated to Fudan University, the patients who underwent colonoscopy were selected and their general data of bowel preparation regimens were collected. Self-factors of the patients, different bowel preparation regimens, bowel preparation quality and polyp detection rate were observed. The quality of bowel preparation was evaluated by Boston bowel preparation scale (BBPS). T test, and analysis of variance and chi-square test were used for statistical analysis. Results Among 1 008 patients who underwent colonoscopy, there were 506 males and 502 females, and average age was (57.3±13.7) years. There were statistically significant differences in BBPS score of patients with different body mass index (BMI), Parkinson disease and history of abdominal surgery (F=3.319, t=-2.060 and -2.544; all P<0.05). The BBPS score of patients with three-day low residue diet before examination was higher than that of those without preparation before examination (6.04±2.50 vs. 5.54±2.73), and the difference was statistically significant (t=2.514, P=0.010). The BBPS scores of 2 000 mL polyethylene glycol electrolyte lavage solution (PEG) taken once, 2 000 mL PEG taken separately, 3 000 mL PEG taken once and 3 000 mL PEG taken separately were 5.06±2.88, 6.11±2.44, 5.94±2.32 and 6.10±2.47, respectively, and the difference was statistically significant (F=7.242, P<0.01). There were significant differences in polyp detection rates among the patients with different age, gender, BMI, and with history of constipation, hypertension and diabetes mellitus (χ2=33.170, 8.489, 12.024, 4.034, 26.790, 10.381; all P<0.05). The polyp detection rate of patients with oral methyl silicone oil was higher than that of patients without oral methyl silicone oil (52.6%, 30/57 vs. 29.7%, 221/744), and the difference was statistically significant (χ2=12.934, P<0.01). Age (odds ratio (OR)=1.328, 95% confidence interval (CI) 1.162 to 1.517) and BMI (OR=1.412, 95%CI1.115 to 1.787) were independent risk factors for polyp detection rate. Conclusions Parkinson disease, history of abdominal surgery and BMI are the related factors affecting the quality of bowel preparation before colonoscopy. Age and BMI are independent risk factors for polyp detection rate. Key words: Colonoscopes; Polyethylene glycols; Bowel preparation; Simethicone
目的探讨结肠镜检查前不同肠道准备对肠道清洁度及息肉检出率的影响因素。方法选择2018年3 - 8月在复旦大学附属华山医院内镜中心行结肠镜检查的患者,收集其肠道准备方案的一般资料。观察患者自身因素、不同肠准备方案、肠准备质量及息肉检出率。采用波士顿肠准备量表(Boston bowel preparation scale, BBPS)评价肠准备质量。采用T检验、方差分析和卡方检验进行统计分析。结果1 008例患者行结肠镜检查,男性506例,女性502例,平均年龄(57.3±13.7)岁。不同体重指数(BMI)、帕金森病、腹部手术史患者的BBPS评分差异有统计学意义(F=3.319, t=-2.060、-2.544;所有P < 0.05)。检查前3天低渣饮食组患者BBPS评分高于检查前未准备组(6.04±2.50∶5.54±2.73),差异有统计学意义(t=2.514, P=0.010)。2 000 mL聚乙二醇电解质灌洗液(PEG)一次取、2 000 mL单独取、3 000 mL一次取、3 000 mL单独取的BBPS评分分别为5.06±2.88、6.11±2.44、5.94±2.32、6.10±2.47,差异有统计学意义(F=7.242, P<0.01)。不同年龄、性别、BMI、有无便秘、高血压、糖尿病病史的患者息肉检出率差异有统计学意义(χ2=33.170、8.489、12.024、4.034、26.790、10.381;所有P < 0.05)。口服甲基硅油组息肉检出率高于未口服甲基硅油组(52.6%,30/57比29.7%,221/744),差异有统计学意义(χ2=12.934, P<0.01)。年龄(优势比(OR)=1.328, 95%可信区间(CI) 1.162 ~ 1.517)和BMI (OR=1.412, 95%可信区间(CI) 1.115 ~ 1.787)是影响息肉检出率的独立危险因素。结论帕金森病、腹部手术史和BMI是影响结肠镜检查前肠道准备质量的相关因素。年龄和BMI是影响息肉检出率的独立危险因素。关键词:结肠镜;聚乙二醇;肠道准备;二甲基硅油
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引用次数: 0
Role and mechanism of microRNA-92b-3p in esophageal squamous cell carcinoma analyzed by weighted gene co-expression network analysis 加权基因共表达网络分析microRNA-92b-3p在食管鳞状细胞癌中的作用及机制
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.009
Wanpeng Wang, C. Fu, Qidi Zhang, Chengshi Wang, Zhongxiang He, Yun Gu, Yanyan Zhang, Weijun Deng, J. Pu
Objective To screen the critical genes related to the development of esophageal squamous cell carcinoma (ESCC) by weighted gene co-expression network analysis (WGCNA) and to verify by experiments. Methods Gene expression data of ESCC were downloaded from gene expression omnibus (GEO) database based on gene chip platform (GPL) 570, GPL571, GPL96/97 or GPL14613 platform, respectively. Meanwhile, the obtained differentially expressed genes together with gene expression data of 81 ESCC patients from the cancer genome atlas (TCGA) and clinical data were analyzed by WGCNA to set up co-expression networks including mRNA and microRNA (miRNA). The expression of miRNA in ESCC tissues and paracancerous tissues was examined by quantitative real-time polymerase chain reaction (RT-PCR). And the expression of target protein Kruppel like factor 4 (KLF4) and desmocollin 2 (DSC2) were detected by immunohistochemistry. After ESCC cell line ECA-109 cells were transfected with miRNA-92b-3p mimic, cell cycle was tested by flow cytometry, the cell invasion and migration ability was measured by Transwell chamber assay and scratch-wound assay. The expression of KLF4 and DSC2 was observed by confocal laser scanning microscopy and Western blotting.The target genes were verified by luciferase assay. T-test, rank sum test, chi-square test and Pearson correlation analysis were performed for statistical analysis. Results A total of 4 023 differential expression gene (DEG) and 328 differential expression miRNA (DEM) were screened and 11 gene modules were set up by WGCNA. Among them, the brown modules were negatively associated with tumor grade and T stage (r=-0.340 and -0.268, P=0.002 and 0.016). Meanwhile, has-miR-92b and the potential target genes KLF4 and DSC2 were all in the brown module. Furthermore, the results of RT-PCR showed the expression of miRNA-92b-3p in ESCC tissues was higher than that in paracancerous tissues (3.052(1.652, 5.371) vs. 0.985(0.558, 2.032)), and the difference was statistically significant (Z=-4.021, P<0.01). The results of immunohistochemistry demonstrated that the positive rates of KLF4 and DSC2 in ESCC tissues were 43.3%(13/30) and 20.0%(6/30), respectively, which were lower than those of paracancerous tissues (70.0%(21/30) and 63.3%(19/30)), and the differences were statistically significant (χ2=4.344 and 1.589, both P<0.05). After ECA-109 cells were transfected with miRNA-92b-3p mimics, the percentage of cells at G0/G1 phase decreased ((63.71±2.83)% vs. (54.62±4.00)%) and the percentage of cells at the S phase and G2/M phase increased ((31.81±2.88)% vs. (41.20%±2.87)%, and (3.87±1.75)% vs. (8.10±1.71)%, respectively), and the differences were statistically significant (t=3.215, 4.000 and 2.998; P=0.032, 0.016 and 0.040). The invasion and migration ability of the cells were significantly improved (79.67±27.54 vs. 280.33±46.18, (69.72±3.91)% vs.(84.90±5.25)%), and the differences were statistically significant (t=6.465 and 4.019, P=
目的应用加权基因共表达网络分析(WGCNA)筛选与食管鳞状细胞癌(ESCC)发生发展相关的关键基因,并进行实验验证。方法分别从基于基因芯片平台(GPL) 570、GPL571、GPL96/97和GPL14613平台的基因表达综合数据库(GEO)下载ESCC基因表达数据。同时,将获得的差异表达基因与来自肿瘤基因组图谱(TCGA)的81例ESCC患者的基因表达数据及临床资料进行WGCNA分析,建立包括mRNA和microRNA (miRNA)在内的共表达网络。实时荧光定量聚合酶链反应(RT-PCR)检测ESCC组织和癌旁组织中miRNA的表达。免疫组化检测靶蛋白Kruppel like factor 4 (KLF4)和desmocollin 2 (DSC2)的表达。用miRNA-92b-3p模拟物转染ESCC细胞系ECA-109细胞后,流式细胞术检测细胞周期,Transwell室法和划痕法检测细胞侵袭和迁移能力。用激光共聚焦扫描显微镜和Western blotting观察KLF4和DSC2的表达。目的基因经荧光素酶测定验证。采用t检验、秩和检验、卡方检验和Pearson相关分析进行统计学分析。结果WGCNA共筛选到4 023个差异表达基因(DEG)和328个差异表达miRNA (DEM),构建了11个基因模块。其中棕色模块与肿瘤分级、T分期呈负相关(r=-0.340、-0.268,P=0.002、0.016)。同时,has-miR-92b和潜在靶基因KLF4、DSC2均位于棕色模块。RT-PCR结果显示,miRNA-92b-3p在ESCC组织中的表达高于癌旁组织(3.052(1.652,5.371)比0.985(0.558,2.032)),差异有统计学意义(Z=-4.021, P<0.01)。免疫组化结果显示,ESCC组织中KLF4和DSC2的阳性率分别为43.3%(13/30)和20.0%(6/30),低于癌旁组织(70.0%(21/30)和63.3%(19/30)),差异有统计学意义(χ2=4.344、1.589,P均<0.05)。miRNA-92b-3p模拟物转染cea -109细胞后,G0/G1期细胞比例降低(63.71±2.83)% vs(54.62±4.00)%),S期和G2/M期细胞比例增加(分别为(31.81±2.88)% vs(41.20%±2.87)%、(3.87±1.75)% vs(8.10±1.71)%),差异均有统计学意义(t=3.215、4.000、2.998;P=0.032, 0.016, 0.040)。细胞侵袭和迁移能力显著提高(79.67±27.54 vs. 280.33±46.18,69.72±3.91)% vs. 84.90±5.25)%),差异有统计学意义(t=6.465和4.019,P=0.003和0.016)。Western blotting结果显示,与对照模拟物组相比,转染miRNA-92b-3p模拟物后,KLF4和DSC2的表达均显著下调(1.00±0.23比0.42±0.03,1.00±0.20比0.55±0.21),差异有统计学意义(t=4.470和5.493,P=0.042和0.032)。荧光素酶分析结果表明,miRNA-92b-3p可以直接结合KLF4和DSC2。结论WGCNA是一种有效的系统生物学途径,miRNA-92b-3p是一种新的促癌基因。关键词:计算生物学;加权基因共表达网络分析;食管鳞状细胞癌;微rna - 92 b;Kruppel like factor 4;Desmocollin 2
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引用次数: 0
Progress in diagnosis and treatment of enteroscopy 肠镜检查诊断与治疗进展
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.006
Fachao Zhi
目前临床应用的小肠镜主要是气囊辅助小肠镜,包括双气囊小肠镜和单气囊小肠镜。其对于小肠疾病的诊断与随访已经比较普及,如小肠出血、不明原因腹泻和腹痛、反复发作的不全肠梗阻、不明原因贫血等;对某些小肠疾病的治疗也正逐渐开展,如小肠异物取出术、小肠息肉内镜下切除术、小肠出血内镜下止血术、小肠狭窄内镜下扩张术及支架置入术、特殊解剖状态下的内镜逆行胰胆管造影术等。诊治兼具将是小肠镜的应用常规。
目前临床应用的小肠镜主要是气囊辅助小肠镜,包括双气囊小肠镜和单气囊小肠镜。其对于小肠疾病的诊断与随访已经比较普及,如小肠出血、不明原因腹泻和腹痛、反复发作的不全肠梗阻、不明原因贫血等;对某些小肠疾病的治疗也正逐渐开展,如小肠异物取出术、小肠息肉内镜下切除术、小肠出血内镜下止血术、小肠狭窄内镜下扩张术及支架置入术、特殊解剖状态下的内镜逆行胰胆管造影术等。诊治兼具将是小肠镜的应用常规。
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引用次数: 0
Serum metabolomics analysis and establishment of diagnostic model of pancreatic cancer associated diabetes 胰腺癌相关性糖尿病血清代谢组学分析及诊断模型的建立
Pub Date : 2019-06-15 DOI: 10.3760/CMA.J.ISSN.0254-1432.2019.06.010
Xiangyi He, Yuan Fang, Baiyong Shen, Yao-zong Yuan
Objective To establish the diagnostic model based on detection of serum biomarkers in pancreatic cancer (PC) associated diabetes. Methods From June 2013 to July 2014, at Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, 30 patients diagnosed with PC companied with new onset diabetic mellitus and 30 patients with new onset type 2 diabetic mellitus, were enrolled. Serum samples were examined by liquid chromatography-mass spectrometry (LC-MS) for metabolomics analysis. Orthogonal partial least square (OPLS) was performed for raw data analysis to obtain the differentially expressed metabolites between two groups. The first 15 cases of each group were taken as training samples and the left as validation samples. The model was established using logistic regression via stepwise differentially expressed metabolites and clinical data input in training samples. The diagnostic efficiency of the model was verified in validating samples. Results Ten differentially expressed metabolites were identified in PC companied with new onset diabetic mellitus group and new onset type 2 diabetic mellitus group. The differentially expressed metabolites identified in positive ion mode were 3-ketosphingosine, arachidonoyl dopamine, phosphatidylethanolamine (18∶2), ubiquinone-1 and valine. The differentially expressed metabolites identified in negative ion mode were C16 sphingosine-1-phosphate, keto palmitic acid, isoleucine, N-succinyl-L-diaminopimelic acid and uridine. The diagnostic model was established in training samples: p=e(Xβ)/(1+ e(Xβ)), (Xβ)=-158.975-1.891 (age)+ 0.309 (phosphatidylethanolamine 18∶2)+ 1.035 (C16 sphingosine-1-phosphate)+ 0.084 (isoleucine)+ 1.114 5 (N-succinyl-L-diaminopimelic acid). The area under curve (AUC) of receiver operating characteristic (ROC) of this model was 0.982 in validation samples, the sensitivity and specificity were both 93.3%. Conclusion Serum metabolomics-based diagnostic approach is a promising method for screening PC from new onset diabetic mellitus. Key words: Pancreatic neoplasms; Diabetes mellitus; Serum metabolomics
目的建立基于血清生物标志物检测的胰腺癌相关性糖尿病诊断模型。方法选取2013年6月至2014年7月上海交通大学医学院瑞金医院诊断为PC合并新发糖尿病患者30例和新发2型糖尿病患者30例。血清样品采用液相色谱-质谱法(LC-MS)进行代谢组学分析。采用正交偏最小二乘法(OPLS)对原始数据进行分析,以获得两组之间代谢物的差异表达。每组取前15例作为训练样本,其余为验证样本。通过逐步差异表达代谢物和临床数据输入训练样本,采用logistic回归建立模型。通过实例验证了该模型的诊断效率。结果PC伴发新发糖尿病组和新发2型糖尿病组共鉴定出10种差异表达代谢物。在正离子模式下鉴定的差异表达代谢物有3-酮鞘氨酸、花生四烯酰基多巴胺、磷脂酰乙醇胺(18∶2)、泛素-1和缬氨酸。在负离子模式下鉴定的差异表达代谢物有C16鞘氨醇-1-磷酸、酮棕榈酸、异亮氨酸、n -琥珀酰- l-二氨基亚苯甲酸和尿苷。在训练样本中建立诊断模型:p=e(Xβ)/(1+ e(Xβ)), (Xβ)=-158.975 ~ 1.891(年龄)+ 0.309(磷脂酰乙醇胺18∶2)+ 1.035 (C16鞘氨醇-1-磷酸)+ 0.084(异亮氨酸)+ 1.114 5 (n -琥珀酰- l-二氨基苯甲酸)。在验证样本中,该模型的受试者工作特征(ROC)曲线下面积(AUC)为0.982,灵敏度和特异性均为93.3%。结论基于血清代谢组学的诊断方法是一种很有前途的筛查新发糖尿病PC的方法。关键词:胰腺肿瘤;糖尿病;血清代谢组学
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引用次数: 0
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中华消化杂志
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