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Characteristics and prognosis of small bowel tumors:A retrospective study

World Journal of Clinical Cases 2024年第34期12卷 6696-6704页

作者： Fang-Chen Liu Ching-Hsiang Wang Peng-Jen Chen Yu-Lueng Shih Hsuan-Hwai lin jung-chun lin Wei-Kuo Chang Tsai-Yuan Hsieh Gen-Min lin Tien-Yu Huang Division of Gastroenterology Department of Internal MedicineTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Department of Internal Medicine Taoyuan Armed Forces General HospitalTaoyuan 325208Taiwan Department of Medicine Tri-Service General Hospital and National Defense Medical CenterTaipei 114Taiwan Department of Medicine Hualien Armed Forces General HospitalHualien 970Taiwan Taiwan Association for the Study of Small Intestinal Diseases Taoyuan 33305Taiwan

BACKGROUND Small bowel tumors(SBTs)are a heterogeneous group of difficult-to-diagnose tumors that account for 2%-5%of all gastrointestinal ***-balloon enteroscopy greatly enhances the diagnosis and treatment of ***,few epidemiological studies have been conducted in Taiwan to determine the clinical profile of *** To investigate the clinical characteristics,managements and prognosis of SBTs in a medical center in *** The study enrolled 51 patients aged 58.9±8.8 years(range,22-93)diagnosed with SBTs from November 2009 to July *** retrospectively recorded clinical characteristics,indications,endoscopic findings,pathological results,management,and outcomes for further *** A male preponderance was observed(56.8%).The most common indications were suspected small intestinal tumors(52.9%)and obscure gastrointestinal bleeding(39.2%).The most common tumor location was the ileum(41.2%).The performance of imaging studies(P=0.004)and the types of findings(P=0.005)differed significantly between malignant and benign *** most frequent imaging finding was a small intestinal mass(43.1%).The top three malignant tumor types were gastrointestinal stromal tumors(GISTs),adenocarcinomas,and ***,the proportions of benign and malignant tumors were 27.5%and 72.5%,*** survival rates of patients with malignant tumors in the GIST and non-GIST groups differed significantly(P=0.015).Kaplan–Meier survival analysis showed a significant difference in survival between patients in the malignant and benign groups(P=0.04).All patients with lymphoma underwent chemotherapy(n=7/8,87.5%),whereas most patients with GISTs underwent surgery(n=13/14,92.8%).CONCLUSION Patients with GISTs have a significantly higher survival rate than those with other malignant ***,a large-scale nationwide study is warranted to evaluate the population-based epidemiology of SBTs.

关键词： Gastrointestinal bleeding Intestinal neoplasms Single-balloon enteroscopy,survival rate

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The regulatory pathways leading to stem-like cells underlie prostate cancer progression

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Asian Journal of Andrology 2019年第3期21卷 233-240页

作者： chun-jung lin U-Ging Lo Jer-Tsong Hsieh Department of Urology UT Southwestern Medical Center Dallas TX 75390 USA

Prostate cancer (PCa) is the most common cause of malignancy in males and the third leading cause of cancer mortality in the United States. The standard care for primary PCa with local invasive disease mainly is surgery and radiation. For patients with distant metastases, androgen deprivation therapy (ADT) is a gold standard. Regardless of a favorable outcome of ADT, patients inevitably relapse to an end-stage castration-resistant prostate cancer (CRPC) leading to mortality. Therefore, revealing the mechanism and identifying cellular components driving aggressive PCa is critical for prognosis and therapeutic intervention. Cancer stem cell (CSC) phenotypes characterized as poor differentiation, cancer initiation with self-renewal capabilities, and therapeutic resistance are proposed to contribute to the onset of CRPC. In this review, we discuss the role of CSC in CRPC with the evidence of CSC phenotypes and the possible underlying mechanisms.

关键词： cancer stem cell castration-resistant prostate cancer neuroendocrine differentiation transdifferentiation

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MELD score can predict early mortality in patients with rebleeding after band ligation for variceal bleeding

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World Journal of Gastroenterology 2011年第16期17卷 2120-2125页

作者： chun-Yen lin I-Shyan Sheen Tsung-Nan lin chun-jung lin Wen-Juei Jeng Chien-Hao Huang Yu-Pin Ho Cheng-Tang Chiu Department of Hepato-Gastroenterology Linkou Medical CenterChang Gung Memorial Hospital and Chang Gung University College of Medicine

AIM:To investigate the outcomes,as well as risk factors for 6-wk mortality,in patients with early rebleeding after endoscopic variceal band ligation (EVL) for esophageal variceal hemorrhage (EVH).METHODS:Among 817 EVL procedures performed for EVH between January 2007 and December 2008,128 patients with early rebleeding,defined as rebleeding within 6 wk after EVL,were enrolled for ***:The rate of early rebleeding after EVL for acute EVH was 15.6% (128/817).The 5-d,6-wk,3-mo,and 6-mo mortality rates were 7.8%,38.3%,55.5%,and 58.6%,respectively,in these early rebleeding *** use of beta-blockers,occurrence of hypovolemic shock,and higher model for end-stage liver disease (MELD) score at the time of rebleeding were independent predictors for 6-wk mortality.A cut-off value of 21.5 for the MELD score was found with an area under ROC curve of 0.862 (P < 0.001).The sensitivity,specificity,positive predictive value,and negative predictive value were 77.6%,81%,71.7%,and 85.3%,*** for the 6-mo survival rate,patients with a MELD score ≥ 21.5 had a significantly lower survival rate than patients with a MELD score < 21.5 (P < 0.001).CONCLUSION:This study demonstrated that the MELD score is an easy and powerful predictor for 6-wk mortality and outcomes of patients with early rebleeding after EVL for EVH.

关键词： Model for end-stage liver disease score Esophageal variceal hemorrhage Rebleeding Cirrhosis Mortality

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Isolated varices over hepatic flexure colon indicating superior mesenteric venous thrombosis caused by uncinate pancreatic head cancer - a case report

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World Journal of Gastroenterology 2005年第12期11卷 1886-1889页

作者： Yu-Pin Ho chun-jung lin Jeng-Hwei Tseng Cheng-Tang Chiu Department of Gastroenterology

Very rare cases of varices involving right side colon were reported. Most of them were due to cirrhotic portal hypertension or other primary causes. No report case contributed to pancreatic cancer. Here, we reported a case of uncinate pancreatic cancer with the initial finding of isolated hepatic flexure colon varices. Following studies confirmed isolated varices involving hepatic flexure colon due to pancreatic cancer with occlusion of superior mesenteric vein. From this report, superior mesenteric vein occlusion caused by uncinate pancreatic head cancer should be considered as a differential diagnosis of colon varices.

关键词： Colon varices Pancreatic cancer Superior mesenteric vein occlusion

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Treatment of Helicobacter pylori infection:Current status and future concepts

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World Journal of Gastroenterology 2014年第18期20卷 5283-5293页

作者： Jyh-Chin Yang Chien-Wei Lu chun-jung lin Department of Internal Medicine Hospital and College of MedicineNational Taiwan University School of Pharmacy National Taiwan University

Helicobacter pylori(***)infection is highly associated with the occurrence of gastrointestinal diseases,including gastric inflammation,peptic ulcer,gastric cancer,and gastric mucosa-associated lymphoid-tissue *** alternative therapies,including phytomedicines and probiotics,have been used to improve eradication,current treatment still relies on a combination of antimicrobial agents,such as amoxicillin,clarithromycin,metronidazole,and levofloxacin,and antisecretory agents,such as proton pump inhibitors(PPIs).A standard triple therapy consisting of a PPI and two antibiotics(clarithromycin and amoxicillin/metronidazole)is widely used as the first-line regimen for treatment of infection,but the increased resistance of *** to clarithromycin and metronidazole has significantly reduced the eradication rate using this therapy and bismuth-containing therapy or 10-d sequential therapy has therefore been proposed to replace standard triple ***,levofloxacin-based triple therapy can be used as rescue therapy for *** infection after failure of first-line *** increase in resistance to antibiotics,including levofloxacin,may limit the applicability of such ***,since resistance of *** to amoxicillin is generally low,an optimized high dose dual therapy consisting of a PPI and amoxicillin can be an effective first-line or rescue *** addition,the concomitant use of alternative medicine has the potential to provide additive or synergistic effects against *** infection,though its efficacy needs to be verified in clinical studies.

关键词： Helicobacter pylori Antimicrobial agents Proton pump inhibitor Campylobacter pyloridis

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Aberrant activation of nuclear factor of activated T cell 2 in lamina propria mononuclear cells in ulcerative colitis

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World Journal of Gastroenterology 2008年第11期14卷 1759-1767页

作者： Tsung-Chieh Shih Sen-Yung Hsieh Yi-Yueh Hsieh Tse-Chin Chen Chien-Yu Yeh chun-jung lin Deng-Yn lin Cheng-Tang Chiu Clinical Proteomics Center Chang Gung Memorial HospitalTaoyuan 333Taiwan Clinical Proteomics Center Chang Gung Memorial HospitalTaoyuan 333Taiwan Department of Hepato-GastroenterologyChang Gung Memorial HospitalChang Gung University School of Medicine Taoyuan 333Taiwan Department of Anatomic Pathology Chang Gung Memorial HospitalTaoyuan 333Taiwan Department of Colorecto-Surgery Chang Gung Memorial HospitalTaoyuan 333Taiwan Department of Hepato-Gastroenterology Chang Gung Memorial HospitalChang Gung University School of Medicine Taoyuan 333Taiwan

AIM:To investigate the role of nuclear factor of activated T cell 2(NFAT2),the major NFAT protein in peripheral T cells,in sustained T cell activation and intractable inflammation in human ulcerative colitis(UC). METHODS:We used two-dimensional gel-electrophoresis, immunohistochemistry,double immunohistochemical staining,and confocal microscopy to inspect the expression of NFAT2 in 107,15,48 and 5 cases of UC, Crohn's disease(CD),non-specific colitis,and 5 healthy individuals,respectively. RESULTS:Up-regulation with profound nucleo- translocation/activation of NFAT2 of lamina propria mononuclear cells(LPMC)of colonic mucosa was found specifically in the affected colonic mucosa from patients with UC,as compared to CD or NC(Pling pathways,our results not only provide new insights into the mechanism for sustained intractable inflammation,but also suggest the calcium-calcineurin/NFAT pathway as a new therapeutic target for ulcerative colitis.

关键词： Nuclear factor of activated T cells Ulcerative colitis Inflammatory bowel disease Nuclear factor of activated T cells cl Nuclear factor of activated T cells 2

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Predictive factors for lymph node metastasis in early gastric cancer

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World Journal of Gastroenterology 2010年第41期16卷 5252-5256页

作者： Chang-Mu Sung Chen-Ming Hsu Jun-Te Hsu Ta-Sen Yeh chun-jung lin Tse-Ching Chen Cheng-Tang Chiu Department of Gastroenterologyand Hepatology Chang Gung Memorial Hospital College of Medicine Chang Gung University Department of Surgery Chang Gung Memorial Hospital Chang Gung University Department of Pathology Chang Gung Me-morial Hospital Chang Gung University

AIM: To analyze the predictive factors for lymph node metastasis (LNM) in early gastric cancer (EGC). METHODS: Data from patients surgically treated for gastric cancers between January 1994 and December 2007 were retrospectively collected. Clinicopathological factors were analyzed to identify predictive factors for LNM. RESULTS: Of the 2936 patients who underwent gas-trectomy and lymph node dissection, 556 were diag-nosed with EGC and included in this study. Among these, 4.1% of patients had mucosal tumors (T1a) with LNM while 24.3% of patients had submucosal tumorswith LNM. Univariate analysis found that female gen-der, tumors ≥ 2 cm, tumor invasion to the submucosa, vascular and lymphatic involvement were significantly associated with a higher rate of LNM. On multivariate analysis, tumor size, lymphatic involvement, and tumor with submucosal invasion were associated with LNM. CONCLUSION: Tumor with submucosal invasion, size ≥ 2 cm, and presence of lymphatic involvement are predictive factors for LNM in EGC.

关键词： Early gastric cancer Lymph node metasta-sis Endoscopic treatment Endoscopic submucosa dis-section Depth of tumor invasion

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IDS-INT:Intrusion detection system using transformer-based transfer learning for imbalanced network traffic

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Digital Communications and Networks 2024年第1期10卷 190-204页

作者： Farhan Ullah Shamsher Ullah Gautam Srivastava Jerry chun-Wei lin School of Software Northwestern Polytechnical UniversityXian710072ShaanxiChina Knowledge Unit of Systems and Technology University of Management and TechnologySialkot 51040Pakistan Department of Math and Computer Science Brandon UniversityBrandonMB R7A 6A9Canada Department of Computer Science and Math Lebanese American UniversityBeirut1102Lebanon Western Norway University of Applied Sciences BergenNorway Research Centre for Interneural Computing China Medical UniversityTaichungTaiwanChina

A network intrusion detection system is critical for cyber security against llegitimate *** terms of feature perspectives,network traffic may include a variety of elements such as attack reference,attack type,a subcategory of attack,host information,malicious scripts,*** terms of network perspectives,network traffic may contain an imbalanced number of harmful attacks when compared to normal *** is challenging to identify a specific attack due to complex features and data imbalance *** address these issues,this paper proposes an Intrusion Detection System using transformer-based transfer learning for Imbalanced Network Traffic(IDS-INT).IDS-INT uses transformer-based transfer learning to learn feature interactions in both network feature representation and imbalanced ***,detailed information about each type of attack is gathered from network interaction descriptions,which include network nodes,attack type,reference,host information,***,the transformer-based transfer learning approach is developed to learn detailed feature representation using their semantic ***,the Synthetic Minority Oversampling Technique(SMOTE)is implemented to balance abnormal traffic and detect minority ***,the Convolution Neural Network(CNN)model is designed to extract deep features from the balanced network ***,the hybrid approach of the CNN-Long Short-Term Memory(CNN-LSTM)model is developed to detect different types of attacks from the deep *** experiments are conducted to test the proposed approach using three standard datasets,i.e.,UNsWNB15,CIC-IDS2017,and *** explainable AI approach is implemented to interpret the proposed method and develop a trustable model.

关键词： Network intrusion detection Transfer learning Features extraction Imbalance data Explainable AI Cybersecurity

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Coupling Analysis of Multiple Machine Learning Models for Human Activity Recognition

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Computers, Materials & Continua 2024年第6期79卷 3783-3803页

作者： Yi-chun Lai Shu-Yin Chiang Yao-Chiang Kan Hsueh-chun lin Department of Public Health China Medical UniversityTaichung406040Taiwan Department of Information and Telecommunications Engineering Ming Chuan UniversityGui-ShanTaoyuan333Taiwan Department of Electrical Engineering Yuan Ze UniversityChung-Li32003Taiwan Department and Institute of Health Service Administrations China Medical UniversityTaichung406040Taiwan

Artificial intelligence(AI)technology has become integral in the realm of medicine and healthcare,particularly in human activity recognition(HAR)applications such as fitness and rehabilitation *** study introduces a robust coupling analysis framework that integrates four AI-enabled models,combining both machine learning(ML)and deep learning(DL)approaches to evaluate their effectiveness in *** analytical dataset comprises 561 features sourced from the UCI-HAR database,forming the foundation for training the ***,the MHEALTH database is employed to replicate the modeling process for comparative purposes,while inclusion of the WISDM database,renowned for its challenging features,supports the framework’s resilience and *** ML-based models employ the methodologies including adaptive neuro-fuzzy inference system(ANFIS),support vector machine(SVM),and random forest(RF),for data *** contrast,a DL-based model utilizes one-dimensional convolution neural network(1dCNN)to automate feature ***,the recursive feature elimination(RFE)algorithm,which drives an ML-based estimator to eliminate low-participation features,helps identify the optimal features for enhancing model *** best accuracies of the ANFIS,SVM,RF,and 1dCNN models with meticulous featuring process achieve around 90%,96%,91%,and 93%,*** analysis using the MHEALTH dataset showcases the 1dCNN model’s remarkable perfect accuracy(100%),while the RF,SVM,and ANFIS models equipped with selected features achieve accuracies of 99.8%,99.7%,and 96.5%,***,when applied to the WISDM dataset,the DL-based and ML-based models attain accuracies of 91.4%and 87.3%,respectively,aligning with prior research *** conclusion,the proposed framework yields HAR models with commendable performance metrics,exhibiting its suitability for integration into the healthcare services system through AI-driven applications.

关键词： Human activity recognition artificial intelligence support vector machine random forest adaptive neuro-fuzzy inference system convolution neural network recursive feature elimination

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Psychological intervention based on social cognitive theory: Treating pain, anxiety, and depression in perioperative patients

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World Journal of Psychiatry 2024年第8期14卷 1199-1207页

作者： Hai-Jian Mao lin-Fei Wang chun lin Department of Surgical Anesthesiology The First People’s Hospital of Lin’an DistrictHangzhouHangzhou 311300Zhejiang ProvinceChina Department of Gastrointestinal Surgery Hangzhou First People’s HospitalHangzhou 310006Zhejiang ProvinceChina Department of Comprehensive Intervention The First People’s Hospital of Lin’an DistrictHangzhouHangzhou 311300Zhejiang ProvinceChina

BACKGROUND Surgery is an effective method for treating certain *** such as disease,preoperative fear and tension,surgical stress,postoperative pain,and related complications directly affect the smooth progression and outcome of *** may experience a series of psychological and physiological changes during the perioperative period,resulting in anxiety and depression,which may reduce the pain threshold and worsen their *** We enrolled 200 patients who underwent surgical care at The First People’s Hospital of lin’an District,Hangzhou between January and December *** were categorized into a routine intervention group(n=103)and a psychological intervention group(n=97),based on the intervention strategies *** assessment tools,including the self-rating anxiety scale(SAS),the self-rating depression scale(SDS),and the Connor–Davidson Resilience scale,were used to measure patients’negative states and *** pre-and post-intervention scores for these metrics in the two groups were then *** In the psychological intervention group,the SAS and SDS scores(31.56±5.18 and 31.46±4.57,respectively)were significantly reduced compared to the routine intervention group(P<0.05).The visual analog scale pain scores at 12 and 24 hours after intervention(6.85±1.21,4.24±0.72)were notably higher than those in the routine intervention group(P<0.05).The psychological intervention group also demonstrated superior scores in perseverance(36.08±3.29),self-reliance(22.63±2.91),optimism(11.42±1.98),and resilience(70.13±5.37),compared to the routine intervention group(P<0.05).Additionally,the psychological intervention group’s confrontation score(23.16±4.29)was higher(P<0.05).This group also reported lower scores in avoidance(9.28±1.94)and yielding(6.19±1.92)(P<0.05).Lastly,the Short Form 36 Health Survey scores were significantly higher in the psychological intervention group,indicating a better quality of life(P<0.05).CONCLUSION

关键词： Perioperative period Social cognitive theory Psychological intervention Pain Anxiety and depression

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