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Increase in Acute Cholecystitis and Laparoscopic Resection after COVID-19 Pandemic: A Japanese Single Center Experience. COVID-19 大流行后急性胆囊炎和腹腔镜切除术的增加:日本单中心经验。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-26 Epub Date: 2024-06-27 DOI: 10.1620/tjem.2024.J054
Mineto Ohta, Rikiya Kanba, Masataka Kudo, Hiroyasu Nishimaki, Akane Mineyuki, Kenji Namiki

Coronavirus disease 2019 (COVID-19) emerged as viral pandemic in the year 2019 and surgical intervention was forced to be restricted during the pandemic. This study aims to compare the perioperative outcomes of surgeries for acute cholecystitis in the period following the COVID-19 pandemic. A retrospective analysis was conducted on the demographic and perioperative data of 246 cholecystectomy cases performed between June 2017 and November 2022. This analysis focused on comparing patient background and perioperative outcomes before and after the COVID-19 pandemic. As a result, prior to the pandemic, 72 emergency surgeries for acute cholecystitis were performed, compared with 174 cases following the COVID-19 pandemic onset. This increase, particularly in mild and moderate acute cholecystitis cases, led to a significant rise in the proportion of laparoscopic resections and a concurrent decrease in postoperative hospital stays. Our findings suggest a potential increase in acute cholecystitis cases at our hospital coinciding with the COVID-19 pandemic. Early laparoscopic cholecystectomy, when feasible within the medical system's capacity, can be an effective treatment strategy during the pandemic.

2019年,冠状病毒病(COVID-19)成为病毒性大流行,在疫情期间,外科手术被迫受到限制。本研究旨在比较COVID-19大流行后急性胆囊炎手术围手术期结局。回顾性分析2017年6月至2022年11月246例胆囊切除术患者的人口学及围手术期资料。该分析的重点是比较COVID-19大流行前后的患者背景和围手术期结果。因此,在大流行之前,进行了72例急性胆囊炎急诊手术,而在COVID-19大流行发作后,进行了174例手术。这种增加,特别是在轻度和中度急性胆囊炎病例中,导致腹腔镜切除术比例显著上升,同时术后住院时间减少。我们的研究结果表明,与COVID-19大流行同时,我们医院的急性胆囊炎病例可能增加。在医疗系统能力范围内可行的情况下,早期腹腔镜胆囊切除术可成为大流行期间的有效治疗策略。
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引用次数: 0
Metformin Mitigates Bevacizumab-Evoked Endothelial Dysfunction through Activating MEK/ERK and PI3K/AKT Pathways. 二甲双胍通过激活MEK/ERK和PI3K/AKT通路减轻贝伐单抗诱发的内皮功能障碍
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-26 DOI: 10.1620/tjem.2024.J147
Bing Liu, Ruoyu Deng, Zhenzhen Yang, Dong Zhou
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引用次数: 0
Mechanism of Hippo/YAP axis mediating high glucose-induced ferroptosis in HK-2 cells. Hippo/YAP轴介导高糖诱导HK-2细胞铁下垂的机制。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-26 DOI: 10.1620/tjem.2024.J148
Yifan Zhang, Zhaoyu Lin, Zhoutao Xie, Yingxue He
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引用次数: 0
The Prognostic Significance of Transient Receptor Potential Canonical 1 and Its Association with Vascular Endothelial Growth Factor Receptor 2 in Papillary Thyroid Carcinoma Patients. 甲状腺乳头状癌患者瞬时受体电位Canonical 1的预后意义及其与血管内皮生长因子受体2的联系
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-25 Epub Date: 2024-06-27 DOI: 10.1620/tjem.2024.J050
Mengshi Chen, Bo Liu, Zhaoming Ding, Ruinan Sheng, Jiewu Zhang

Transient receptor potential canonical 1 (TRPC1) facilitates the proliferation, invasion, and metastasis of thyroid cancer cells through up-regulating vascular endothelial growth factor receptor 2 (VEGFR2), while its clinical role in papillary thyroid carcinoma (PTC) is unknown. This study intended to evaluate the prognostic value of TRPC1 and its correlation with VEGFR2 in PTC patients. In this retrospective study, tumor TRPC1 immunohistochemistry (IHC) score was evaluated in 287 PTC patients who underwent surgical resection and 30 thyroid benign lesion (TBL) patients. Moreover, 50 tumor tissue samples from PTC patients were randomly selected for VEGFR2 IHC score evaluation. Our study showed that tumor TRPC1 IHC score was increased in PTC patients versus TBL patients (P = 0.006). Meanwhile, tumor TRPC1 IHC score was related to extrathyroidal invasion (P = 0.028) and pathological node stage 1 (P = 0.011) in PTC patients. Tumor TRPC1 IHC score > 0 was not related to disease-free survival (DFS) or overall survival (OS) (both P > 0.05); however, tumor TRPC1 IHC score > 3 was linked with shortened DFS (P = 0.005) and OS (P = 0.020) in PTC patients. By time-dependent area under curve (AUC) analyses, tumor TRPC1 IHC score showed good values in estimating relapse and death risks over 7 years with all AUCs above 0.7. Furthermore, tumor TRPC1 IHC score > 3 independently predicted shorter DFS (hazard ratio = 2.948, P = 0.045), but not OS (P > 0.05) in PTC patients. Tumor TRPC1 IHC score was positively associated with tumor VEGFR2 IHC score in PTC patients (P = 0.010). Collectively, TRPC1 links with extrathyroidal and lymph node invasion, elevated disease relapse risk, and increased VEGFR2 in PTC patients.

瞬时受体电位规范1 (Transient receptor potential canonical 1, TRPC1)通过上调血管内皮生长因子受体2 (VEGFR2)促进甲状腺癌细胞的增殖、侵袭和转移,但其在甲状腺乳头状癌(PTC)中的临床作用尚不清楚。本研究旨在评估TRPC1在PTC患者中的预后价值及其与VEGFR2的相关性。在这项回顾性研究中,对287例手术切除的PTC患者和30例甲状腺良性病变(TBL)患者的肿瘤TRPC1免疫组化(IHC)评分进行了评估。随机选取50例PTC患者肿瘤组织样本进行VEGFR2 IHC评分评估。我们的研究显示,PTC患者的肿瘤TRPC1 IHC评分高于TBL患者(P = 0.006)。肿瘤TRPC1 IHC评分与PTC患者甲状腺外浸润(P = 0.028)和病理淋巴结1期(P = 0.011)相关。肿瘤TRPC1 IHC评分>与无病生存期(DFS)或总生存期(OS)无关(P均为> 0.05);然而,肿瘤TRPC1 IHC评分>.3与PTC患者缩短的DFS (P = 0.005)和OS (P = 0.020)相关。通过随时间变化的曲线下面积(AUC)分析,肿瘤TRPC1 IHC评分在估计7年内复发和死亡风险方面具有良好的价值,所有AUC均大于0.7。此外,肿瘤TRPC1 IHC评分bbbb3独立预测PTC患者较短的DFS(风险比= 2.948,P = 0.045),但不能预测OS (P b> 0.05)。PTC患者肿瘤TRPC1 IHC评分与肿瘤VEGFR2 IHC评分呈正相关(P = 0.010)。总的来说,TRPC1与PTC患者甲状腺外和淋巴结侵袭、疾病复发风险升高和VEGFR2升高有关。
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引用次数: 0
Reminiscence Therapy-Engaged Care Exhibits a Pleasing Effect on Attenuating Psychological Burden and Bolstering Quality of Life in Elderly Postoperative Cervical Cancer Patients with Anxiety or Depression. 回忆疗法-参与式护理对减轻焦虑或抑郁的老年宫颈癌术后患者的心理负担和提高其生活质量有良好效果
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-25 Epub Date: 2024-07-04 DOI: 10.1620/tjem.2024.J060
Wei Wei, Ping Fu, Lei Ju, Li Chen, Hongyu Hui

Reminiscence therapy (RT) is an effective psychological intervention to address mental disorders in the elderly; however, it is insufficiently appraised in elderly postoperative cervical cancer patients complicated with anxiety or depression. Hence, this study aimed to explore the effect of RT-engaged care (RTEC) on this population. Totally, 112 elderly postoperative cervical cancer patients with anxiety or depression were enrolled in this single-center, randomized, controlled study, and randomized into RTEC group (N = 56) or usual care group (N = 56) for a 12-week intervention. Evaluations were performed at baseline and the 4 th week (W4), 8th week (W8), and 12th week (W12) after intervention initiation.Hospital anxiety and depression scale (HADS)-anxiety score at W12 (P = 0.028) as well as HADS-depression score at W8 (P = 0.028) and W12 (P = 0.017) were reduced in RTEC group compared to usual care group. However, the mini-mental state examination score at W4, W8, and W12 was not different between the two groups (all P > 0.050). Concerning quality of life (QoL), EuroQol 5-dimensions score at W12 was reduced in RTEC group than in usual care group (P = 0.010). Both quality of life questionnaire Core 30 (QLQ-C30) global-health-status score and QLQ-C30 function score at W8 and W12 were elevated in RTEC group compared to usual care group (all P < 0.050). Whereas no difference was seen in QLQ-C30 symptom score at these timepoints between the two groups (all P > 0.050). In conclusion, RTEC alleviates psychological burden and improves QoL in elderly postoperative cervical cancer patients with anxiety or depression, while the effect in enhancing cognitive function is not obvious.

回忆疗法是治疗老年人精神障碍的有效心理干预手段。然而,对老年宫颈癌术后并发焦虑或抑郁的患者评价不足。因此,本研究旨在探讨RT-engaged care (RTEC)对这一人群的影响。本研究共纳入112例老年宫颈癌术后焦虑或抑郁患者,采用单中心随机对照研究,随机分为RTEC组(N = 56)和常规护理组(N = 56),进行为期12周的干预。在基线和干预开始后第4周(W4)、第8周(W8)和第12周(W12)进行评估。与常规护理组相比,RTEC组医院焦虑抑郁量表(HADS)-焦虑评分W12 (P = 0.028)、HADS-抑郁评分W8 (P = 0.028)和W12 (P = 0.017)均降低。而两组在W4、W8、W12的精神状态测试得分差异无统计学意义(P均为0.050)。在生活质量(QoL)方面,RTEC组在W12时EuroQol 5维度得分低于常规护理组(P = 0.010)。与常规护理组相比,RTEC组生活质量问卷Core 30 (QLQ-C30)整体健康状态评分和W8、W12时QLQ-C30功能评分均显著升高(P均< 0.050)。而两组在这些时间点的QLQ-C30症状评分无差异(P均为0.050)。综上所述,RTEC减轻了老年宫颈癌术后焦虑或抑郁患者的心理负担,改善了患者的生活质量,而对认知功能的增强作用不明显。
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引用次数: 0
Expression Levels of miR-181 Family Members in Oral Biofluids as Biomarkers for Periodontitis Severity. 作为牙周炎严重程度生物标志物的口腔生物流体中 miR-181 家族成员的表达水平
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-20 Epub Date: 2024-07-04 DOI: 10.1620/tjem.2024.J058
Qun Li, Jin-Juan Zhu

This study aimed to assess the diagnostic potential of microRNA-181 (miR-181) family members in oral biofluids, namely saliva and gingival crevicular fluid (GCF), as biomarkers for periodontitis severity. A cohort of 150 patients with periodontitis, including 82 with mild to moderate and 68 with advanced periodontitis, along with 90 healthy controls, were recruited. Analysis of miR-181 family expression using quantitative real-time polymerase chain reaction (qRT-PCR) revealed differential expression levels in oral biofluids among the study groups. Salivary miRNAs, particularly miR-181a, displayed significant discriminatory ability in distinguishing periodontitis patients from healthy controls and between different stages of periodontitis severity, with high sensitivity and moderate to high specificity. In GCF samples, miR-181a and miR-181b exhibited robust discriminatory ability, while miR-181c showed moderate discriminatory ability. Conversely, miR-181d demonstrated lower discriminatory power in both saliva and GCF. Additionally, combination diagnosis using miR-181 family showed superior performance compared to individual miRNAs. Furthermore, enzyme-linked immunosorbent assay (ELISA) analysis of inflammatory biomarkers (TNF-α, IL-6, and IL-1β) in GCF revealed elevated levels in periodontitis patients compared to healthy controls, with a further increase observed in advanced periodontitis. Spearman correlation analysis demonstrated a significant negative correlation between miR-181 family expression in GCF and inflammatory biomarker levels, indicating their potential role in modulating periodontal inflammation. Overall, these findings suggest that miR-181 family members in oral biofluids, particularly saliva, hold promise as diagnostic biomarkers for periodontitis severity. Additionally, their negative correlation with inflammatory biomarkers highlights their potential as modulators of periodontal inflammation, providing valuable insights into the pathogenesis of periodontitis.

本研究旨在评估口腔生物液体(即唾液和龈沟液(GCF))中microRNA-181 (miR-181)家族成员作为牙周炎严重程度生物标志物的诊断潜力。研究招募了150名牙周炎患者,包括82名轻度至中度牙周炎患者和68名晚期牙周炎患者,以及90名健康对照者。使用定量实时聚合酶链反应(qRT-PCR)分析miR-181家族表达,揭示了研究组间口服生物体液中miR-181家族表达水平的差异。唾液mirna,特别是miR-181a,在区分牙周炎患者和健康对照以及牙周炎严重程度的不同阶段方面显示出显著的区别能力,具有高敏感性和中高特异性。在GCF样本中,miR-181a和miR-181b表现出强大的区分能力,而miR-181c表现出中等的区分能力。相反,miR-181d在唾液和GCF中表现出较低的区分能力。此外,与单个mirna相比,使用miR-181家族的联合诊断表现出更好的性能。此外,酶联免疫吸附试验(ELISA)分析GCF中炎症生物标志物(TNF-α、IL-6和IL-1β)显示,与健康对照组相比,牙周炎患者GCF中的炎症生物标志物(TNF-α、IL-6和IL-1β)水平升高,晚期牙周炎患者进一步升高。Spearman相关分析显示,GCF中miR-181家族表达与炎症生物标志物水平呈显著负相关,表明其在调节牙周炎症中的潜在作用。总的来说,这些发现表明,口腔生物液体,特别是唾液中的miR-181家族成员有望作为牙周炎严重程度的诊断生物标志物。此外,它们与炎症生物标志物的负相关突出了它们作为牙周炎症调节剂的潜力,为牙周炎的发病机制提供了有价值的见解。
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引用次数: 0
Differences in Clinical Practice and Disease Course Between Elderly-Onset and Long-Standing Elderly Ulcerative Colitis: A Single-Center Study in Japan. 老年性溃疡性结肠炎和久治不愈的老年性溃疡性结肠炎在临床实践和病程上的差异:日本单中心研究
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-20 Epub Date: 2024-07-11 DOI: 10.1620/tjem.2024.J063
Motoi Sawahashi, Rintaro Moroi, Yoichi Kakuta, Hiroshi Nagai, Yusuke Shimoyama, Takeo Naito, Hisashi Shiga, Atsushi Masamune

The optimal immunosuppressive therapy for elderly patients with ulcerative colitis (UC) remains unclear. We aimed to evaluate clinical practice and prognosis in elderly patients with UC through comparing between those with elderly-onset UC (EOUC) and those with long-standing elderly UC (LEUC). In this retrospective single-center cohort study, we evaluated elderly patients with UC aged ≥ 60 in August 2022 through collecting medical record data from the time of diagnosis of UC until August 2022. The patients were divided into two groups based on age at disease onset: EOUC (age at onset, ≥ 60 years) and LEUC (age at onset, < 60 years). We assessed the cumulative rates of systemic steroid and molecular targeted drug (MTD) initiation, and colectomy. We enrolled 97 eligible patients (EOUC group, n = 30; LEUC group, n = 67). The cumulative rates of initiating systemic steroid (46% vs. 22% at 1 year, respectively; P = 0.002) and MTD (17% vs. 5% at 1 year, respectively; P = 0.002) were higher in the EOUC group than in the LEUC group. In multivariate analysis, elderly onset was significantly associated with systemic steroid (hazard ratio [HR] 2.74, 95% confidence interval [CI] 1.43-5.29; P = 0.003) and MTD (HR 2.76, 95% CI 1.30-5.87; P = 0.008) initiation. Cumulative colectomy rates did not differ significantly between the two groups. Patients with EOUC were initiated on systemic steroids and MTDs sooner following disease onset than patients with LEUC. Our findings suggest rapid progression and refractoriness in patients with EOUC.

老年溃疡性结肠炎(UC)患者的最佳免疫抑制治疗尚不清楚。我们的目的是通过比较老年发性UC (EOUC)和长期老年UC (LEUC)患者的临床实践和预后。在这项回顾性单中心队列研究中,我们通过收集从诊断为UC到2022年8月的病历数据,对2022年8月年龄≥60岁的老年UC患者进行评估。根据发病年龄将患者分为EOUC(发病年龄≥60岁)和LEUC(发病年龄< 60岁)两组。我们评估了系统性类固醇和分子靶向药物(MTD)启动和结肠切除术的累积率。我们纳入97例符合条件的患者(EOUC组,n = 30;LEUC组,n = 67)。在1年内,开始使用全身性类固醇的累积率分别为46%和22%;P = 0.002)和MTD(1年时分别为17%和5%;P = 0.002), EOUC组高于LEUC组。在多变量分析中,老年发病与全身性类固醇显著相关(风险比[HR] 2.74, 95%可信区间[CI] 1.43-5.29;P = 0.003)和MTD (HR 2.76, 95% CI 1.30-5.87;P = 0.008)。两组累积结肠切除术率无显著差异。EOUC患者在发病后比LEUC患者更早开始全身性类固醇和MTDs治疗。我们的研究结果表明EOUC患者的快速进展和难治性。
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引用次数: 0
Pulmonary Alveolar Proteinosis-Like Pathological Changes Mimicking Lung Adenocarcinoma in Situ. 模仿原位肺腺癌的肺泡蛋白病病理变化
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-20 Epub Date: 2024-07-18 DOI: 10.1620/tjem.2024.J064
Kazuki Hayasaka, Tomohiro Fujita, Shunsuke Eba, Nobuyuki Sato, Hidekachi Kurotaki, Chihiro Inoue

An enlarging ground-glass nodule (GGN) in the lungs closely resembles the characteristic appearance of a well differentiated lung adenocarcinoma or adenocarcinoma in situ (AIS). Herein, we present an unusual case characterized by clinical features suggestive of AIS but pathologically confirmed as exhibiting pulmonary alveolar proteinosis (PAP)-like changes. Patients with enlarging pure GGNs warrant consideration for diagnostic and curative surgery. While a considerable proportion of such cases receives a pathological diagnosis of lung malignancy, it is imperative to consider alternative benign conditions in the differential diagnosis, such as PAP-like changes.

肺内增大的磨玻璃结节(GGN)与高分化肺腺癌或原位腺癌(AIS)的特征非常相似。在此,我们报告一个不寻常的病例,其临床特征提示AIS,但病理证实表现为肺泡蛋白沉积症(PAP)样变化。单纯ggn增大的患者需要考虑进行诊断和治疗性手术。虽然这类病例中有相当大比例的病理诊断为肺恶性肿瘤,但在鉴别诊断中必须考虑其他良性情况,如pap样改变。
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引用次数: 0
Successful Total Callosotomy in a Patient with Lennox-Gastaut Syndrome and Cardio-Facio-Cutaneous Syndrome. 全胼胝体切开术成功治疗lenox -胃综合征和心-面-皮综合征1例。
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-19 DOI: 10.1620/tjem.2024.J146
Aritomo Kawashima, Haruhiko Nakamura, Kaori Kodama, Yukimune Okubo, Wakaba Endo, Takehiko Inui, Noriko Togashi, Saki Uneoka, Moriei Shibuya, Yoshitsugu Oikawa, Yu Katata, Yurika Numata-Uematsu, Mitsugu Uematsu, Hiroshi Kawame, Shin-Ichiro Osawa, Daiju Oba, Tetsuya Niihori, Yoko Aoki, Kazuhiro Haginoya
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引用次数: 0
Expression of Vascular and Tissue Repair Factors in Laryngeal Granulomas. 喉肉芽肿中血管和组织修复因子的表达
IF 1.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-12-13 Epub Date: 2024-06-27 DOI: 10.1620/tjem.2024.J056
Yutaka Tateda, Ryoukichi Ikeda, Risako Kakuta, Kenji Izuhara, Takenori Ogawa, Kazue Ise, Hiroki Shimada, Keigo Murakami, Kazuhiro Murakami, Yasuhiro Nakamura, Yukio Katori, Nobuo Ohta

Voice abuse, chronic cough, laryngeal surgery, and tracheal intubation may lead to injury and subsequent repair/remodeling in the vocal fold mucosa. Periostin is known to be involved in airway remodeling and is also associated with various otolaryngological diseases. D-β-aspartic acid is the major isomer of D-aspartic acid found in tissues of elderly individuals. In ischemic heart disease, increased CD31 expression has been observed around cardiomyocytes during remodeling, and endothelial proliferation has been reported at these sites. In this study, we investigated the expression and role of CD31, CD34, D-β-aspartic acid, and periostin in the formation of laryngeal granulation tissue. This retrospective study involved five patients who underwent surgical treatment for laryngeal granulation tissue. The expressions of CD31, CD34, D-β-aspartic acid, and periostin in surgical samples were investigated by immunohistochemistry. Histologically, the specimens showed inflammatory cell infiltration, fibrin exudation, fibrosis, and neovascularization, but no tumor cells. No stratified squamous epithelial covering was observed. The expression of periostin and D-β-aspartic acid was also observed in the specimens. CD31-positive cells (endothelial cells) and CD34-positive cells (progenitors of endothelial cells) were observed in the specimens. Our results indicate that the overexpression of CD31, CD34, D-β-aspartic acid, and periostin may play a role in the pathogenesis of laryngeal granulation tissue, and we speculate that D-β-aspartic acid and periostin could serve as novel biomarkers and therapeutic targets for laryngeal granulation tissue.

声音滥用,慢性咳嗽,喉部手术和气管插管可能导致声带粘膜损伤和随后的修复/重塑。众所周知,骨膜蛋白参与气道重塑,也与各种耳鼻喉科疾病有关。D-β-天冬氨酸是D-天冬氨酸在老年人组织中发现的主要异构体。在缺血性心脏病中,在重塑过程中,在心肌细胞周围观察到CD31表达增加,并且在这些部位有内皮细胞增殖的报道。在本研究中,我们研究了CD31、CD34、D-β-天冬氨酸和骨膜蛋白在喉部肉芽组织形成中的表达及其作用。本回顾性研究涉及5例接受喉肉芽组织手术治疗的患者。采用免疫组织化学方法检测手术标本中CD31、CD34、D-β-天冬氨酸和骨膜蛋白的表达。组织学上可见炎性细胞浸润、纤维蛋白渗出、纤维化和新生血管,未见肿瘤细胞。未见分层鳞状上皮覆盖。在标本中还观察到骨膜蛋白和D-β-天冬氨酸的表达。在标本中观察到cd31阳性细胞(内皮细胞)和cd34阳性细胞(内皮细胞祖细胞)。本研究结果提示CD31、CD34、D-β-天冬氨酸和骨膜蛋白的过表达可能参与喉部肉芽组织的发病机制,推测D-β-天冬氨酸和骨膜蛋白可作为喉部肉芽组织新的生物标志物和治疗靶点。
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引用次数: 0
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Tohoku Journal of Experimental Medicine
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