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Predictive value of symptoms and demographics in diagnosing malignancy or peptic stricture

World Journal of Gastroenterology 2012年第32期18卷 4357-4362页

作者： Iain A Murray Joanne Palmer Carolyn Waters harry r dalton Department of Gastroenterology Royal Cornwall HospitalTruroCornwall TR1 3LJUnited Kingdom research and Development Knowledge SpaRoyal Cornwall HospitalTruroCornwall TR1 3LJUnited Kingdom

AIM:To determine which features of history and demographics predict a diagnosis of malignancy or peptic stricture in patients presenting with dysphagia.METHODS:A prospective case-control study of 2000 consecutive referrals(1031 female,age range:17-103 years) to a rapid access service for dysphagia,based in a teaching hospital within the United Kingdom,over 7 years.The service consists of a nurse-led telephone triage followed by investigation(barium swallow or gastroscopy),if appropriate,within 2 wk.Logistic regression analysis of demographic and clinical variables was performed.This includes age,sex,duration of dysphagia,whether to liquids or solids,and whether there are associated features(reflux,odynophagia,weight loss,regurgitation).We determined odds ratio(Or) for these variables for the diagnoses of malignancy and peptic stricture.We determined the value of the Edinburgh Dysphagia Score(EDS) in predicting cancer in our cohort.Multivariate logistic regression was performed and P red significant.The local ethics committee confirmed ethics approval was not required(audit).rESULTS:The commonest diagnosis is gastro-esophageal reflux disease(41.3%).Malignancy(11.0%) and peptic stricture(10.0%) were also relatively common.Malignancies were diagnosed by histology(97%) or on radiological criteria,either sequential barium swallows showing progression of disease or unequivocal evidence of malignancy on computed tomography.The majority of malignancies were esophago-gastric in origin but ear,nose and throat tumors,pancreatic cancer and extrinsic compression from lung or mediastinal metastatic cancer were also found.Malignancy was statistically more frequent in older patients(aged >73 years,Or 1.1-3.3,age rs 6.5%,60-73 years 11.2%,> 73 years 11.8%,P r 2.2-4.8,males 14.5%,females 5.6%,P rt duration of dysphagia(≤ 8 wk,Or 4.5-20.7,16.6%,8-26 wk 14.5%,> 26 wk 2.5%,P rogressive symptoms(Or 1.3-2.6:progressive 14.8%,intermittent 9.3%,P < 0.001),with weight loss of ≥

关键词：人口统计学恶性肿瘤统计预测消化道 Logistic回归分析狭窄诊断症状

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Bile acids,gut microbiota,and therapeutic insights in hepatocellular carcinoma

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Cancer Biology & Medicine 2024年第2期21卷 144-162页

作者： Yang Song harry CH Lau Xiang Zhang Jun Yu Institute of Digestive Disease and Department of Medicine and Therapeutics State Key Laboratory of Digestive DiseaseLi Ka Shing Institute of Health SciencesCUHK Shenzhen Research InstituteThe Chinese University of Hong KongHong KongChina Department of Gastroenterology Zhongshan Hospital Xiamen UniversityXiamen 361004China

Hepatocellular carcinoma(HCC)is a prevalent and aggressive liver malignancy.The interplay between bile acids(BAs)and the gut microbiota has emerged as a critical factor in HCC development and progression.Under normal conditions,BA metabolism is tightly regulated through a bidirectional interplay between gut microorganisms and BAs.The gut microbiota plays a critical role in BA metabolism,and BAs are endogenous signaling molecules that help maintain liver and intestinal homeostasis.Of note,dysbiotic changes in the gut microbiota during pathogenesis and cancer development can disrupt BA homeostasis,thereby leading to liver inflammation and fibrosis,and ultimately contributing to HCC development.Therefore,understanding the intricate interplay between BAs and the gut microbiota is crucial for elucidating the mechanisms underlying hepatocarcinogenesis.In this review,we comprehensively explore the roles and functions of BA metabolism,with a focus on the interactions between BAs and gut microorganisms in HCC.Additionally,therapeutic strategies targeting BA metabolism and the gut microbiota are discussed,including the use of BA agonists/antagonists,probiotic/prebiotic and dietary interventions,fecal microbiota transplantation,and engineered bacteria.In summary,understanding the complex BA-microbiota crosstalk can provide valuable insights into HCC development and facilitate the development of innovative therapeutic approaches for liver malignancy.

关键词： Bile acid gut microbiota hepatocellular carcinoma therapeutics microbiota modulation

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Hepatitis E virus: Western Cape, South Africa

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World Journal of Gastroenterology 2016年第44期22卷 9853-9859页

作者： richie G Madden Sebastian Wallace Mark Sonderup Stephen Korsman Tawanda Chivese Bronwyn Gavine Aniefiok Edem roxy Govender Nathan English Christy Kaiyamo Odelia Lutchman Annemiek A van der Eijk Suzan D Pas Glynn W Webb Joanne Palmer Elizabeth Goddard Sean Wasserman harry r dalton C Wendy Spearman royal Cornwall Hospital Trust and European Centre for Environment and Human Health University of Exeter Division of Hepatology Department of Medicine Faculty of Health Sciences University of Cape Town and Groote Schuur Hospital National Health Laboratory Service Groote Schuur Hospital Cape Town and Division of Medical Virology University of Cape Town Faculty of Health Sciences Department of Viroscience Erasmus Medical Centre Medical Center Rotterdam Department of Paediatrics Faculty of Health Sciences University of Cape Town and Red Cross Children’s Hospital Division of Infectious Diseases and HIV Medicine Department of Medicine Faculty of Health Sciences University of Cape Town and Groote Schuur Hospital

AIM To conduct a prospective assessment of anti-hepatitis E virus(HEV) Ig G seroprevalence in the Western Cape Province of South Africa in conjunction with evaluating risk factors for exposure.METHODS Consenting participants attending clinics and wards of Groote Schuur, red Cross Children's Hospital and their affiliated teaching hospitals in Cape Town, South Africa, were sampled. Healthy adults attending blood donor clinics were also recruited. Patients with known liver disease were excluded and all major ethnic/race groups were included to broadly represent local demographics. relevant demographic data was captured at the time of sampling using an interviewer-administered confidential questionnaire. Human immunodeficiency virus(HIV) status was self-disclosed. HEV Ig G testing was performed using the Wantai? assay.rESULTS HEV is endemic in the region with a seroprevalence of 27.9%(n = 324/1161) 95%CI: 25.3%-30.5%(21.9% when age-adjusted) with no significant differences between ethnic groups or HIV status. Seroprevalence in children is low but rapidly increases in early adulthood. With univariate analysis, age ≥ 30 years old, pork and bacon/ham consumption suggested risk. In the multivariate analysis, the highest risk factor for HEV Ig G seropositivity(Or = 7.679, 95%CI: 5.38-10.96, P rs or older followed by pork consumption(Or = 2.052, 95%CI: 1.39-3.03, P recent clinical case demonstrates that HEV genotype 3 may be currently circulating in the Western Cape.CONCLUSION Hepatitis E seroprevalence was considerably higher than previously thought suggesting that hepatitis E warrants consideration in any patient presenting with an unexplained hepatitis in the Western Cape, irrespective of travel history, age or ethnicity.

关键词： Hepatitis E Seroprevalence South Africa Pork consumption Genotype

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Amelioration of habitat since the early Holocene contributed to the origin of agriculture in the farming-pastoral zone of northern China

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Science China Earth Sciences 2024年第8期67卷 2535-2546页

作者： Xin JIA Zhiping ZHANG Yonggang SUN runqi JIANG Shuangwen YI Wei CHEN Jue SUN Guoqiang LI Shuzhi WANG Enrui LI Xiaonong HU Qingchun BAO harry F.LEE Huayu LU Ulanqab Museum The Institute of Cultural relics and Archaeology Department of Geography and resource Management The Chinese University of Hong Kong Jiangsu Center for Collaborative Innovation in Geographical Information resource Development and Application School of Geography and Ocean Science Nanjing University Key Laboratory of Virtual Geographic Environment (Ministry of Education of PrC) Nanjing Normal University School of Geography Nanjing Normal University Institute of Environmental Archaeology Nanjing Normal University Schlool of History and Culture Chifeng University State Key Laboratory of Palaeobiology and Stratigraphy Nanjing Institute of Geology and Palaeontology Chinese Academy of Sciences Key Laboratory of Western China's Environmental Systems (Ministry of Education) College of Earth and Environmental SciencesLanzhou University Institute of Archaeology Chinese Academy of Social Sciences

The origin of agriculture in the farming-pastoral zone of northern China remains in dispute. The central region of the Inner Mongolia Plateau is located in the core area of the farming-pastoral zone; thus, it is a critical region for exploring the origin of the dryland farming system in northern China. This study selected the Yumin Site and Banan Site, which belong to the Yumin Culture-the beginning of Neolithic culture in Inner Mongolia-as the research objects. Based on the quartz optically stimulated luminescence(OSL) dating on the sedimentary sections from the Yumin site(YM) and Banan site(BN1 and BN2), the Holocene chronology framework of each section was established. After that, by identifying carbonized grains in the Yumin site and the multi-proxy analysis of each section, we investigated the relationship between the origin of agriculture and climate change in this region. The results revealed that the timing of the origin of agriculture recorded in the Yumin site lagged behind the timing of a significant increase of precipitation during the early Holocene but coincided with the timing of a significant increase of vegetation around 8.4 ka. This phenomenon was further confirmed by the published high-resolution paleoenvironmental records from the surrounding area of the Yumin Culture. We propose that with the gradual amelioration of hydrothermal conditions since the beginning of the Holocene, the regional ecosystem had been improved, resulting in the gradual conversion of the land surface from infertile sand to organic-rich soil, providing an appropriate environmental foundation for the origin of dryland farming in northern China around 8.4 ka. This study highlighted that the “accumulative environmental effects” during the early Holocene played a vital role in the origin of agriculture in northern China and provided a reference for agricultural management in the context of future climate change.

关键词： Origin of agriculture Accumulative environmental effects Yumin Culture Northern China Holocene

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Hepatitis E virus in patients with acute severe liver injury

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World Journal of Hepatology 2014年第6期6卷 426-434页

作者： Claire Louise Crossan Kenneth J Simpson Darren G Craig Christopher Bellamy Janice Davidson harry r dalton Linda Scobie Department of Life Sciences Glasgow Caledonian UniversityGlasgowG4 0BAUnited Kingdom Scottish Liver Transplant Unit Royal Infirmary of EdinburghEdinburghEH16 4SAUnited Kingdom Department of Pathology University of EdinburghEdinburghEH16 4SBUnited Kingdom Gastrointestinal Unit Royal Cornwall Hospitaland European Centre for the Environment and Human HealthUniversity of Exeter Medical SchoolTruroTR1 3HDUnited Kingdom Department of Life Sciences School of Health and Life SciencesGlasgow Caledonian UniversityGlasgowG40BAUnited Kingdom

AIM: To examine the incidence of hepatitis E(HepE) in individuals with acute liver injury severe enough to warrant treatment at a transplant unit.METHODS: Hepatitis E virus(HEV) is an emerging pathogen in developed countries causing severe illness, particularly in immunocompromised patients or those with underlying chronic liver disease. HepE infection isoften under diagnosed, as clinicians can be reluctant to test patients who have not travelled to regions traditionally considered hyperendemic for HepE. There are few data regarding the significance of HEV in patients with very severe acute liver injury in developed countries. Eighty patients with acute severe liver injury attending the Scottish Liver Transplant unit were tested for HEV and anti-HEV IgG and IgM. Severe acute liver injury was defined as a sudden deterioration in liver function confirmed by abnormal liver function tests and coagulopathy or presence of hepatic encephalopathy. Eighty percent of these patients were diagnosed with paracetomol overdose. No patients had a history of chronic or decompensated chronic liver disease at time of sampling. IgG positive samples were quantified against the World Health Organization anti-HEV IgG standard. Samples were screened for HEV viral rNA by quantitative reverse transcription polymerase chain reaction.rESULTS: Four cases of hepatitis E were identified. Three of the four cases were only diagnosed on retrospective testing and were initially erroneously ascribed to drug-induced liver injury and decompensated chronic liver disease, with the cause of the decompensation uncertain. One case was caused by HEV genotype 1 in a traveller returning from Asia, the other three were autochthonous and diagnosed on retrospective testing. In two of these cases(where rNA was detected) HEV was found to be genotype 3, the most prevalent genotype in developed countries. Three patients survived, two of whom had been misdiagnosed as having drug induced liver injury. The fourth patient died from sepsis and liver failure precipitated

关键词：病毒学感染尖锐的肝损害肝炎 E 病毒

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上海安亭新镇经验:规划结构中的文化和空间适应与转化

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China City Planning review 2024年第1期33卷 22-33页

作者：哈利·邓·哈托格鲍莉珂梁毅方 TU Delft the Netherlands Tongji University ShanghaiP.R.China 不详 Amsterdam University of Applied Sciences Amsterdamthe Netherlands

this paper we study planned and unplanned adjustment processes in master-planned communities and new towns by a first wave of residents,in which changes in lifestyles play a central role.How can unplanned transitions be stimulated and play a role in making a new town more attractive,sustainable,adjustable,and fexible in use?We apply this to the case of Anting New Town in Shanghai.We focus on both personal and collective adjustments and appropriation in housing,commercial,as well as public space.We explore methods of doing visual research by observation,in line with methods by Venturi and Boudon.By adding economic and socio-cultural drivers and institutional frameworks,which allow these alterations to happen,conclusions are made about the possible sustainability,adjustability,and flexibility of these planned structures.We analyze adjustments from different perspectives on the themes of urbanity and identity:architectural-morphological,②functional-economical,and socio-cultural.Following different approaches to studying the planned and unplanned city,we explain how the urbanity and identity of Anting have changed in various ways.Appropriation of building structures and urban spaces is a key element in this process of change.It is the outcome of a wider process of economicand socio-culturalchange.

关键词： adaptability appropriation identity master-planned communities new towns open city personalization public space

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Can patients determine the level of their dysphagia?

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World Journal of Gastroenterology 2017年第6期23卷 1038-1043页

作者： Hafiz Hamad Ashraf Joanne Palmer harry richard dalton Carolyn Waters Thomas Luff Madeline Strugnell Iain Alexander Murray Departments of Gastroenterology Royal Cornwall Hospital NHS Trust research and Development Royal Cornwall Hospital NHS Trust Clinical Imaging Royal Cornwall Hospital NHS Trust

AIM To determine if patients can localise dysphagia level determined endoscopically or radiologically and association of gender, age, level and pathology.METHODS retrospective review of consecutive patients presenting to dysphagia hotline between March 2004 and March 2015 was carried out. Demographics, clinical history and investigation findings were recorded including patient perception of obstruction level (pharyngeal, mid sternal or low sternal) was documented and the actual level of obstruction found on endoscopic or radiological examination (if any) was noted. All patients with evidence of obstruction including oesophagealcarcinoma, peptic stricture, Schatzki ring, oesophageal pouch and cricopharyngeal hypertrophy were included in the study who had given a perceived level of dysphagia. The upper GI endoscopy reports (barium study where upper GI endoscopy was not performed) were reviewed to confirm the distance of obstructing lesion from central incisors. A previously described anatomical classification of oesophagus was used to define the level of obstruction to be upper, middle or lower oesophagus and this was compared with patient perceived level.rESULTS Three thousand six hundred and sixty-eight patients were included, 42.0% of who were female, mean age 70.7 ± 12.8 years old. Of those with obstructing lesions, 726 gave a perceived level of dysphagia: 37.2% had oesophageal cancer, 36.0% peptic stricture, 13.1% pharyngeal pouches, 10.3% Schatzki rings and 3.3% achalasia. Twenty-seven point five percent of patients reported pharyngeal level (upper) dysphagia, 36.9% mid sternal dysphagia and 25.9% lower sternal dysphagia (9.5% reported multiple levels). The level of obstructing lesion seen on diagnostic testing was upper (17.2%), mid (19.4%) or lower (62.9%) or combined (0.3%). When patients localised their level of dysphagia to a single level, the kappa statistic was 0.245 (P r agreement. 48% of patients reporting a single level of dysphagia were accurate in localising the obstructing

关键词：吞咽混乱食道的狭窄食道的瘤 Gastroscopy 荧光检查耐心的感觉咽头的小袋

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Trends in global semen parameter values

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Asian Journal of Andrology 2013年第2期15卷 169-173,I0004页

作者： harry Fisch Stephen r Braun Departments of Urology and reproductive Medicine Weill Cornell Medical College New York PresbyterianHospital New York NY 10028 USA

Allegations for a worldwide decline in semen par.ameter values have not withstood scientific scrutiny. Methodological flaws in an influential 1992 paper are summarized here, and studies that have been published since 1992 are reviewed. Of the 35 major studies of time trends in semen quality reviewed here, eight （a total of 18 109 men） suggest a decline in semen quality; 21 （112 386 men） show either no change or an increase in semen quality;, and six （26 007 men） show ambiguous or conflicting results. The cause （or causes） of the geographical and temporal variations in semen parameter values reported by these diverse studies deserve further investigation.

关键词： PAST 20 YEArS SPErM COUNTS FErTILE MEN GENErAL-POPULATION UNITED-STATES LAST DECADE NO EVIDENCE DANISH MEN YOUNG MEN QUALITY

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Synthesis, Mechanism of Formation and Insecticidal Activity of Novel Fluorinated Organophosphorus Compounds

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Chinese Journal of Chemistry 2002年第12期20卷 1598-1601,1464页

作者：吴军 HUDSON harry r. Department of Chemistry Zhejiang University Hangzhou Zhejiang 310027 China Division of Chemistry School of Biological and Applied Sciences University of North London London N7 8DB UK

The major products of the interaction between triethyl phosphite and 3-fluoropropanoyl chloride at room temperature are diethyl (E)-1-(3-fluoropropanoyloxy)-3-fluoroprop-1-enylphosphonate (3) and diethyl l-(diethoxyphosphoryl)-3-fluoropropyl phosphate (4). The compounds 3 and 4 were separated by chromatography, and structurally characterized by elemental analysis, NMr spectroscopy (1H, 13C, 19F and 31P) and mass spectrometry. Possible reaction mechanisms are proposed. The major products 3 and 4 were tested for insecticidal activity. 3 gave 100% control of Musca domestica L. and Phaedon cochledriae Fab. at a dose of 20 μg/per insect.

关键词： synthesis reaction mechanism insecticidal activity fluorinated organophosphonate

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Numerical modelling of resonance mechanisms in jointed rocks using transfer functions

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Journal of rock Mechanics and Geotechnical Engineering 2023年第5期15卷 1076-1089页

作者： harry Holmes Chrysothemis Paraskevopoulou Mark Hildyard Krishna Neaupane David P.Connolly School of Earth and Environment University of LeedsLeedsLS29JTUK AECOM Ltd. ChesterfieldS417SLUK

resonance effects in parallel jointed rocks subject to stress waves are investigated using transfer functions,derived from signals generated through numerical modelling.resonance is important for a range of engineering situations as it identifies the frequency of waves which will be favourably transmitted.Two different numerical methods are used for this study,adopting the finite difference method and the combined discrete element-finite difference method.The numerical models are validated by replicating results from previous studies.The two methods are found to behave similarly and show the same resonance effects;one operating at low frequency and the other operating at relatively high frequency.These resonance effects are interpreted in terms of simple physical systems and analytical equations are derived to predict the resonant frequencies of complex rock masses.Low frequency resonance is shown to be generated by a system synonymous with masses between springs,described as spring resonance,with an equal number of resonant frequencies as the number of blocks.High frequency resonance is generated through superposition of multiple reflected waves developing standing waves within intact blocks,described as superposition resonance.While resonance through superposition has previously been identified,resonance based on masses between springs has not been previously identified in jointed rocks.The findings of this study have implications for future analysis of multiple jointed rock masses,showing that a wave travelling through such materials can induce other modes of propagation of waves,i.***.spring resonance.

关键词： resonance Jointed rocks Finite difference method Discrete element Transfer functions Wave propagation

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