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World Journal of Clinical Cases 2022年第15期10卷 4971-4984页

作者： chun-yan weng Cheng Ye Yi-Hong Fan Bin Lv chun-Li Zhang Meng Li Department of Gastroenterology The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina Department of Pathology The First Affiliated Hospital of Zhejiang Chinese Medicine UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract(ITLPDGI),a primary tumor forming in the gastrointestinal(GI)tract,represents a rarely diagnosed clonal T-cell disease with a protracted clinical course.CASE SUMMARY This report presented a 45-year-old male patient with a 6-year history of anal fistula and a more than 10-year history of recurrent diarrhea who was not correctly diagnosed until the occurrence of complications such as intestinal perforation.Postsurgical histopathological analysis,combined with hematoxylineosin staining,immunohistochemistry and TCRβ/γ clonal gene rearrangement test,confirmed the diagnosis of CD8+ITLPD-GI.CONCLUSION Individuals with this scarce lymphoma frequently show non-specific symptoms that are hard to recognize.So far,indolent CD8+ITLPD-GI has not been comprehensively examined.The current mini-review focused on evaluating indolent CD8+ITLPD-GI cases based on existing literature and discussing future directions for improved differential diagnosis,detection of genetic and epigenetic alterations,and therapeutic target identification.

关键词： Indolent T-cell lymphoproliferative disease Gastrointestinal tract Inflammatory bowel disease Immunohistochemistry Case report

Endoscopic submucosal dissection for early signet ring cell gastric cancer:A systematic review and meta-analysis

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World Journal of Clinical Cases 2022年第20期10卷 6915-6926页

作者： chun-yan weng Shao-Peng Sun Chang Cai Jing-Li Xu Bin Lv Department of Gastroenterology The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310000Zhejiang ProvinceChina Department of Gastrointestinal Surgery The First Clinical Medical University of Zhejiang Chinese Medical UniversityHangzhou 310000Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medical UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND The use of endoscopic submucosal dissection(ESD)for treating early signet ring cell carcinoma(SRC)is controversial due to the risk of lymph node metastasis.AIM To carry out a meta-analysis to evaluate ESD for therapeutic efficacy and safety in early signet ring cell gastric cancer.METHODS The PubMed,Web of Science,Cochrane Library,and EMBASE databases were used to search for relevant studies evaluating the therapeutic efficacy and safety of ESD in SRC.The rates of recurrence,complete resection,incomplete resection,curative resection,en bloc resection,and adverse events were extracted and analyzed.The methodological quality of the enrolled studies was assessed using the Newcastle-Ottawa Scale.Publication bias was evaluated by the Egger’s test.Institutional review board approval and written consent were not needed for this report.RESULTS This meta-analysis enrolled seven studies with 653 participants undergoing ESD treatment for early SRC.The overall recurrence rate was 0.010[95%confidence interval(CI):0.000-0.040,Z=1.422,P=0.155].The total lymph-ovascular invasion rate was 0.038(95%CI:0.007-0.088,Z=3.026,P=0.002).The total en bloc resection rate was estimated at 0.984(95%CI:0.925-1.000,Z=19.463,P=0.000).The total complete and incomplete resection rates were estimated at 0.785(95%CI:0.596-0.928,Z=9.789,P=0.000)and 0.188(95%CI:0.016-0.468,Z=2.531,P=0.011),respectively.The total procedureassociated gastric hemorrhage and perforation rates were estimated at 0.026(95%CI:0.005-0.061,Z=3.006 P=0.003)and 0.004(95%CI:0.000-0.028,Z=0.938,P=0.348),respectively.The curative resection,vertical margin invasion,and lateral margin invasion rates were 72.1%(145/341),2.3%(8/348),and 34.45%(41/119),respectively.CONCLUSION ESD constitutes a promising therapeutic approach for early undifferentiated SRC gastric cancer.However,further improvements are required for increasing its treatment efficacy and reducing adverse outcomes.

关键词： Endoscopic submucosal dissection Endoscopy Early gastric cancer Signet ring cell Metaanalysis

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1377-1384页

作者： chun-yan Bai Wei Tian Qian Zhang Department of Rehabilitation Medicine Beijing Aerospace General HospitalBeijing 100076China Department of Rehabilitation Medicine People’s Hospital of HengshuiHengshui 053000Hebei ProvinceChina Department of Internal Medicine Hebei Academy of Chinese Medicine SciencesShijiazhuang 050000Hebei ProvinceChina

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

关键词： Chronic gastritis Liver-stomach disharmony Microcosmic syndrome differentiation Chinese herbal medicine Randomized controlled trial Microcosmic syndrome scores

Artemsieverolactones A—H,Eight Guaiane-Type Sesquiterpenoid Trimers from Artemisia sieversiana

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Chinese Journal of Chemistry 2024年第10期42卷 1084-1092页

作者： Wei Dong Xiao-yan Huang Tian-Ze Li yan-Mei weng Chang-An Geng Ji-Jun Chen State Key Laboratory of Phytochemistry and Plant Resources in West China Kunming Institute of BotanyChinese Academy of SciencesKunmingYunnan 650201China University of Chinese Academyof Sciences Beijing 100049China

Eight new guaiane-type sesquiterpenoid trimers,artemsieverolactones A—H,possessing unprecedented scaffolds via biocatalyzed[4+2]Diels−Alder cycloaddition reactions were identified from Artemisia sieversiana.Their structures were determined by comprehensive spectroscopic data,single-crystal X-ray diffraction analyses,and ECD calculations.In terms of structure,artemsieverolactones A—H are first examples of sesquiterpenoid trimers from guaiane-type sesquiterpenoid through four different[4+2]Diels−Alder cycloaddition models.Antihepatic fibrosis assay suggested that five compounds exhibited activity against HSC-LX2 with IC_(50)values ranging from 37.8 to 117.1μmol/L.The most active artemsieverolactone B(2)displayed significant inhibitory activity against HSC-LX2 with IC_(50)value of 37.8μmol/L,which was 3 times more active than the positive drug silybin(IC_(50),139.7μmol/L).Preliminary mechanism study revealed that artemsieverolactone B could inhibit the deposition of human collagen typeⅠ(ColⅠ),human hyaluronic acid(HA),and human laminin(HL)with IC_(50)values of 40.4μmol/L(Col I),55.1μmol/L(HL),47.3μmol/L(HA),which was 2 to 3-fold more potent than silybin.

关键词： Artemisia sieversiana Artemsieverolactones A-H Guaiane-type sesquiterpenoid trimers Antihepatic fibrosis Extracellular matrix Cancer NMR spectroscopy X-ray diffraction

Genetic mechanism of body size variation in groupers:Insights from phylotranscriptomics

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Zoological Research 2024年第2期45卷 314-328页

作者： Wei-Wei Zhang Zhuo-Ying weng Xi Wang yang yang Duo Li Le Wang Xiao-chun Liu Zi-Ning Meng State Key Laboratory of Biocontrol Institute of Aquatic Economic Animals and Guangdong Province Key Laboratory of Aquatic Economic AnimalsSchool of Life SciencesSun Yat-sen UniversityGuangzhouGuangdong 510275China Southern Laboratory of Ocean Science and Engineering(Zhuhai) ZhuhaiGuangdong 519000China Area of Ecology and Biodiversity School of Biological SciencesUniversity of Hong KongHong Kong SAR 999077China Molecular Population Genetics Group Temasek Life Sciences LaboratorySingapore City 117604Singapore

Animal body size variation is of particular interest in evolutionary biology,but the genetic basis remains largely unknown.Previous studies have shown the presence of two parallel evolutionary genetic clusters within the fish genus Epinephelus with evident divergence in body size,providing an excellent opportunity to investigate the genetic basis of body size variation in vertebrates.Herein,we performed phylotranscriptomic analysis and reconstructed the phylogeny of 13 epinephelids originating from the South China Sea.Two genetic clades with an estimated divergence time of approximately 15.4 million years ago were correlated with large and small body size,respectively.A total of 180 rapidly evolving genes and two positively selected genes were identified between the two groups.Functional enrichment analyses of these candidate genes revealed distinct enrichment categories between the two groups.These pathways and genes may play important roles in body size variation in groupers through complex regulatory networks.Based on our results,we speculate that the ancestors of the two divergent groups of groupers may have adapted to different environments through habitat selection,leading to genetic variations in metabolic patterns,organ development,and lifespan,resulting in body size divergence between the two locally adapted populations.These findings provide important insights into the genetic mechanisms underlying body size variation in groupers and species differentiation.

关键词： Phylotranscriptomics Grouper Body size Rapidly evolving genes(REGs) Positively selected genes(PSGs)

Recent advances in age-related metabolic dysfunction-associated steatotic liver disease

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World Journal of Gastroenterology 2024年第7期30卷 652-662页

作者： Qian-Jun He Yi-Fei Li Ling-Tong Zhao chun-Tong Lin chun-yan Yu Dan Wang College of Basic Medicine Beihua UniversityJilin 132013Jilin ProvinceChina Department of Traumatic Surgery Jilin Central HospitalJilin 132001Jilin ProvinceChina

Metabolic dysfunction-associated steatotic liver disease(MASLD)affects approximately 25%of the world's population and has become a leading cause of chronic liver disease.In recent years,an increasing amount of data suggests that MASLD is associated with aging.As the population ages,age-related MASLD will become a major global health problem.Targeting an aging will become a new approach to the treatment of MASLD.This paper reviews the current studies on the role of aging-related factors and therapeutic targets in MASLD,including:Oxidative stress,autophagy,mitochondrial homeostasis,bile acid metabolism homeostasis,and dysbiosis.The aim is to identify effective therapeutic targets for age-related MASLD and its progression.

关键词： Metabolic dysfunction-associated steatotic liver disease Aging Mitochondrial homeostasis Bile acid homeostasis Dysbiosis

Multi-exit self-distillation with appropriate teachers

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Frontiers of Information Technology & Electronic Engineering 2024年第4期25卷 585-599页

作者： Wujie SUN Defang CHEN Can WANG Deshi YE yan FENG chun CHEN College of Computer Science and Technology Zhejiang UniversityHangzhou 310000China

Multi-exit architecture allows early-stop inference to reduce computational cost,which can be used in resource-constrained circumstances.Recent works combine the multi-exit architecture with self-distillation to simultaneously achieve high efficiency and decent performance at different network depths.However,existing methods mainly transfer knowledge from deep exits or a single ensemble to guide all exits,without considering that inappropriate learning gaps between students and teachers may degrade the model performance,especially in shallow exits.To address this issue,we propose Multi-exit self-distillation with Appropriate TEachers(MATE)to provide diverse and appropriate teacher knowledge for each exit.In MATE,multiple ensemble teachers are obtained from all exits with different trainable weights.Each exit subsequently receives knowledge from all teachers,while focusing mainly on its primary teacher to keep an appropriate gap for efficient knowledge transfer.In this way,MATE achieves diversity in knowledge distillation while ensuring learning efficiency.Experimental results on CIFAR-100,TinyImageNet,and three fine-grained datasets demonstrate that MATE consistently outperforms state-of-the-art multi-exit self-distillation methods with various network architectures.

关键词： Multi-exit architecture Knowledge distillation Learning gap

Peroral endoscopic longer vs shorter esophageal myotomy for achalasia treatment:A systematic review and meta-analysis

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World Journal of Gastrointestinal Surgery 2022年第3期14卷 247-259页

作者： chun-yan weng Cheng-Hai He Ming-yang Zhuang Jing-Li Xu Bin Lyu Department of Gastroenterology The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Gastroenterology The Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310006Zhejiang ProvinceChina Internal Medicine of Chinese Medicine The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Surgery The First Clinical Medical College of Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Zhejiang Chinese Medicine UniversityHangzhou 310006Zhejiang ProvinceChina

BACKGROUND Peroral endoscopic myotomy(POEM)has been demonstrated to be safe and effective in the treatment of achalasia.Longer myotomy is the standard POEM procedure for achalasia but when compared with shorter myotomy,its effectiveness is not as well known.AIM To compare the clinical effectiveness of longer and shorter myotomy.METHODS PubMed,EmBase,Cochrane Library,web of science and clinicaltrials.gov were queried for studies comparing shorter and longer POEM for achalasia treatment.The primary outcome was clinical success rate.Secondary outcomes comprised of operative time,adverse events(AEs)rate,gastroesophageal reflux disease(GERD)and procedure-related parameters.The Mantel-Haenszel fixed-effects model was primarily used for the analysis.Publication bias was assessed.RESULTS Six studies were included in this analysis with a total of 514 participants.During the follow-up period of 1-28.7 mo,longer and shorter myotomy in treating achalasia showed similar excellent effectiveness[overall clinical success(OR=1,95%CI:0.46-2.17,P=1,I2:0%;subgroup of abstract(OR=1.19,95%CI:0.38 to 3.73;P=0.76;I2:0%);subgroup of full text(OR=0.8695%CI:0.30 to 2.49;P=0.78;I2:0%)].Shorter myotomy had significantly reduced mean operative time compared with the longer procedure.There were no statistically significant differences in AEs rates,including GERD(overall OR=1.21,95%CI:0.76-1.91;P=0.42;I2:9%;subgroup of abstract OR=0.77,95%CI:0.40-1.47;P=0.43;I2:0%;subgroup of full text OR=1.91,95%CI:0.98-3.75;P=0.06;I2:0%),hospital stay(overall MD=-0.07,95%CI:-0.30 to 0.16;P=0.55;I2:24%;subgroup of abstract MD=0.20,95%CI:-0.25 to 0.65;P=0.39;I2:0;subgroup of full text MD=-0.16,95%CI:-0.42 to 0.10;P=0.23;I2:42%),and major bleeding(overall OR=1.25,95%CI:0.58-2.71;P=0.56;I2:0%)between the two procedures.These differences remained statistically non-significant in all sensitivity analyses.CONCLUSION POEM was effective in treating achalasia.Shorter and longer myotomy procedures provided similar therapeutic effects in terms of long-term effectiveness.

关键词： Endoscopy Meta-analysis Myotomy Peroral endoscopic myotomy Gastroesophageal reflux disease

Sequence structure controllable polymerization-induced self-assembly

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Science China Chemistry 2024年第1期67卷 390-397页

作者： Zi-Xuan Chang Ren-Man Zhu chun-yan Hong Wen-Jian Zhang Department of Polymer Science and Engineering University of Science and Technology of ChinaHefei 230026China Institute of Physical Science and Information Technology Anhui UniversityHefei 230601China Key Laboratory of Environment-Friendly Polymeric Materials of Anhui Province Anhui UniversityHefei 230601China

Polymerization-induced self-assembly(PISA)combines synthesis and self-assembly of artificial polymers in one-pot,which brings us one step closer to emulating biosynthesis.However,the reported PISA formulations primarily focus on developing nano-objects with new chemical compositions and rarely on structural regulation of polymers with specific components.Herein,sequence structure controllable polymerization-induced self-assembly(SCPISA)is reported by using 7-(2-methacryloyloxyethoxy)-4-methylcoumarin(CMA)as a monomer.During the copolymerization of 2-hydroxyethyl methacrylate(HEMA)and CMA,controlled incorporation of CMA units into the polymer chains can be realized by programmable light/heat changes.SCPISA-based P(HEMA-co-CMA)copolymers with the same composition but different sequence structures generate a range of assemblies.Moreover,the morphologies of the resultant nano-objects can also be controlled by regulating the feed molar ratio of CMA and HEMA,which is similar to the conventional PISA,but the synthesis procedure is obviously simplified in SCPISA.The versatility of the methodology is further demonstrated by the fabrication of different functional nano-objects with sequence structure-dependent morphologies in SCPISA systems with different functional monomers.

关键词： polymerization-induced self-assembly sequence-controlled polymers PET-RAFT polymerization

Present situation of minimally invasive surgical treatment for early gastric cancer

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1154-1165页

作者： chun-yan Li Yi-Feng Wang Li-Kang Luo Xiao-Jun yang The First Clinical Medical School Lanzhou UniversityLanzhou 730000Gansu ProvinceChina The First Clinical Medicine College Gansu University of Chinese MedicineLanzhou 730000Gansu ProvinceChina General Surgery Clinical Centre Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina The Second Department of General Surgery Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Lanzhou University People's Clinical Hospital Lanzhou 730000Gansu ProvinceChina Gansu Research Center of Prevention and Control Project for Digestive Oncology Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology Gansu Provincial HospitalLanzhou 730000Gansu ProvinceChina

Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.

关键词： Minimally invasive surgery Early gastric cancer Endoscopic mucosal resection Endoscopic full-thickness resection Laparoscopic and endoscopic cooperative surgery