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Dynamic glial response and crosstalk in demyelination-remyelination and neurodegeneration processes

Neural Regeneration Research 2021年第7期16卷 1359-1368页

作者： Tianci Chu Lisa B.E.Shields Wenxin Zeng Yi Ping Zhang Yuanyi Wang gregory N.Barnes Christopher B.Shields Jun Cai Pediatric Research Institute Department of PediatricsUniversity of Louisville School of MedicineLouisvilleKYUSA Norton Neuroscience Institute Norton HealthcareLouisvilleKYUSA Department of Spine Surgery The First Hospital of Jilin UniversityChangchunJilin ProvinceChina Department of Neurology University of Louisville School of MedicineLouisvilleKYUSA Department of Pharmacology and Toxicology University of LouisvilleLouisvilleKYUSA Department of Neurological Surgery University of Louisville School of MedicineLouisvilleKYUSA

Multiple sclerosis is an autoimmune disease in which the immune system attacks the myelin sheath in the central nervous *** is characterized by blood-brain barrier dysfunction throughout the course of multiple sclerosis, followed by the entry of immune cells and activation of local microglia and *** cells(microglia, astrocytes, and oligodendrocyte lineage cells) are known as the important mediators of neuroinflammation, all of which play major roles in the pathogenesis of multiple *** communications between glial cells affect the activities of oligodendrocyte lineage cells and influence the demyelination-remyelination process.A finely balanced glial response may create a favorable lesion environment for efficient remyelination and *** review focuses on glial response and neurodegeneration based on the findings from multiple sclerosis and major rodent demyelination *** particular, glial interaction and molecular crosstalk are discussed to provide insights into the potential cell-and molecule-specific therapeutic targets to improve remyelination and neuroregeneration.

关键词： astrocyte crosstalk demyelination glial response microglia/macrophage multiple sclerosis neurodegeneration neuroinflammation oligodendrocyte lineage cells remyelination

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Direct cost variance analysis of peroral endoscopic myotomy vs heller myotomy for management of achalasia:A tertiary referral center experience

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World Journal of gastrointestinal Endoscopy 2023年第10期15卷 593-601页

作者： Syedreza Ali Haider gregory S Bills C Prakash gyawali Passisd Laoveeravat Jordan Miller Samir Softic Mihir S Wagh Moamen gabr Department of Internal Medicine Washington University School of Medicine St.LouisSt.LouisMO 63018United States Department of Digestive Disease and Nutrition University of Kentucky College of MedicineLexingtonKY 40508United States Department of Internal Medicine Washington University School of Medicine St.Louis and Barnes Jewish HospitalSt.LouisMO 63108United States Department of Cardiothoracic Surgery University of Kentucky College of MedicineLexingtonKY 40508United States Department of Pediatrics University of Kentucky College of Medicine and Kentucky Children’s HospitalLexingtonKY 40508United States Interventional Endoscopy Division of GastroenterologyUniversity of Colorado School of MedicineAuroraCO 80045United States Department of Advanced Endoscopy Beth Israel Deaconess Medical CenterBostonMA 02215United States

BACKgROUND Laparoscopic Heller myotomy(LHM)has been the traditional surgical treatment for ***,peroral endoscopic myotomy(POEM)has demonstrated similar clinical outcomes with shorter procedure *** comparing the direct cost-effectiveness of POEM vs LHM are *** To compare costs of POEM vs *** Haider SA et *** costs:POEM vs Heller myotomy WJgE https://*** 594 October 16,2023 Volume 15 Issue 10 This retrospective chart review aimed to compare the outcomes and cost of clinical care between patients who underwent POEM and LHM procedures for *** study was conducted at a tertiary academic center from January 2019 to December *** outcomes,including post-operative Eckardt scores and adverse events,were assessed and compared between the two *** cost variance analysis was utilized to evaluate the cost of clinical care incurred by patients undergoing POEM in the year preceding the procedure,during the index admission,and one year post-procedure,in comparison to patients undergoing *** Of 30 patients were included(15 POEM and 15 LHM)in the *** in the POEM group had a mean Eckardt score of 0.5±0.5 post-procedure,which was no different from patients in the LHM group(0.7±0.6,P=0.17)indicating comparative ***,the total costs of the admission for the procedure in the LHM group were on average$1827 more expensive than in the POEM group(Pgher in the LHM group,but not statistically different(P=0.34).The patients in the LHM group one year after the index procedure had accrued$19730.24 larger total cost,although this was not statistically different from POEM group(P=0.68).CONCLUSION Despite similar clinical outcomes,the cost of the index procedure admission for POEM was significantly lower than for *** difference was primarily related to shorter time increments utilized in the operating roo

关键词： Peroral endoscopic myotomy Cost analysis Laparoscopic Heller myotomy Achalasia

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颅内出血患者抗栓药逆转指南美国神经重症监护学会和美国重症医学会对医疗卫生专业人员的声明

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国际脑血管病杂志 2016年第11期24卷 961-985页

作者： Jennifer A. Frontera John J. Lewin Ⅲ Alejandro A. Rabinstein Imo P. Aisiku Anne W. Alexandrov Aaron M. Cook gregory J. del Zoppo Monisha A. Kumar Ellinor I. B. Peerschke Michael F. Stiefel Jeanne S Teitelbaum Katja E. Wartenberg Cindy L. Zerfoss 杨一萍谢丽丽宁小金季宇腾柯开富 From the Cerebrovascular Center Neurological Institute Cleveland Clinic and Case Western Reserve University 9500 Euclid Ave. S80 Cleveland OH44195 USA The Departments of Pharmacy and Anesthesiology & Critical Care Medicine The Johns Hopkins Hospital and Johns Hopkins University School of Medicine Baltimore MD USA The Department of Neurology Mayo Clinic Rochester MN USA Harvard Medical School Brigham and Women's Hospital Boston MA USA The University of Tennessee Health Science Center Memphis TN USA Department of Pharmacy Practice & Science (UK College of Pharmacy) University of Kentucky Lexington KY USA The Departments of Medicine (Hematology) and Neurology University of Washington School of Medicine Seattle WA USA The Departments of Neurology Neurosurgery Anesthesiology & Critical Care Perelman School of Medicine Hospital of the University of Pennsylvania Philadelphia PA USA The Department of Laboratory Medicine and Pathology Memorial Sloan Kettering Cancer Center and Weill Comell Medical School New York NY USA The Department of Neurosurgery Westchester Medical Center New York Medical College Valhalla NY USA Hepital du Sacre-Coeur and University of Montreal and Montreal Neurological Institute and Mcgill University Montreal Quebec Canada Klinik fur Neurologie Martin-Luther-Universitat Halle-Wittenberg Halle Germany The Neuroscience and Neurosurgery Departments Centra Lynchburg General Hospital Lvnchburg VA. USA 南通大学附属医院神经内科 226001

背景抗栓药的使用，包括抗凝药、抗血小板药和溶栓药，在过去10年中日益增多并且预计将继续上升。虽然抗栓药相关性颅内出血可能是灾难性的，但快速逆转凝血功能障碍可能有助于限制血肿增大和改善转归。方法美国神经重症监护学会联合美... 详细信息

背景抗栓药的使用，包括抗凝药、抗血小板药和溶栓药，在过去10年中日益增多并且预计将继续上升。虽然抗栓药相关性颅内出血可能是灾难性的，但快速逆转凝血功能障碍可能有助于限制血肿增大和改善转归。方法美国神经重症监护学会联合美国重症医学会组建了一个国际性多机构委员会，涉及的专业领域包括神经重症监护、神经内科、神经外科、卒中、血液学、血液病理学、急诊医学、药学、护理和指南制定，目的是进行文献评价并制定一份循证实践指南。该委员会进行了正式的文献检索，并对符合标准的研究进行了评价。结果利用gRADE方法学，委员会提出了在颅内出血情况下逆转维生素K拮抗药、直接Xa因子拮抗药、直接凝血酶抑制药、普通肝素、低分子肝素、类肝素、戊多糖、溶栓药和抗血小板药的推荐意见。结论该指南提供了及时和循证的抗栓药逆转策略以协助临床医生治疗抗栓药相关性颅内出血。

关键词：抗凝药抗血小板药抗栓药颅内出血脑出血脑实质出血蛛网膜下腔出血硬膜下出血逆转解药维生素K拮抗药华法林香豆素直接凝血酶抑制药达比加群 Xa因子抑制药阿哌沙班利伐沙班依杜沙班低分子肝素肝素类肝素戊多糖磺达肝素 TPA rtPA 阿替普酶溶栓药纤溶酶原激活物阿司匹林氯吡格雷凝血酶原复合物新鲜冰冻血浆重组因子Ⅶa 鱼精蛋白血小板去氨加压素冷沉淀指南 gRADE标准

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