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Triple tube drainage for “difficult” gastroduodenal perforations:A prospective study

World Journal of Gastrointestinal Surgery 2017年第1期9卷 19-24页

作者： Nitin Agarwal Nishant Kumar Malviya Nikhil gupta Iqbal Singh Sanjay Gupta Department of Surgery and Renal Transplant Postgraduate Institute of Medical Education and Research (PG-IMER) and Dr. Ram Manohar Lohia Hospital Depart-ment of Surgery University College of Medical Sciences and Guru Tegh Bahadur Hospital Department of Surgery Post Graduate Institute of Medical Education and Research (PGIMER) and Dr RML Hospital

AIM To prospectively study the outcome of difficult gastroduodenal perforations(GDPs) treated by triple tube drainage(TTD) in order to standardize the procedure.METHODS Patients presenting to a single surgical unit of a tertiary hospital with difficult GDPs(large, unfavourable local and systemic factors) were treated with TTD(gastrostomy, duodenostomy and feeding jejunostomy). Postoperative parameters were observed like time to return of bowel sounds, time to start enteral feeds, time to start oral feeds, daily output of all drains, time to clamping/removal of all drains, time for skin to heal, complications, hospital stay, and, mortality. Descriptive statistics were used. RESULTS Between December 2013 and April 2015, 20 patients undergoing TTD for GDP were included, with mean age of 44.6 ± 19.8 years and male:female ratio of 17:3. Mean pre-operative APACHE Ⅱ scores were 10.85 ± 3.55; most GDPs were prepyloric(9/20; 45%) or proximal duodenal(8/20; 40%) and mean size was 1.83 ± 0.59 cm(largest 2.5 cm). Median times of resumption of enteral feeding, removal of gastrostomy, removal of duodenostomy,removal of feeding jejunostomy and oral feeding were 4 d(4-5 IQR), 13(12-16.5 IQR), 16(16.25-22.25 IQR), 18(16.5-24 IQR) and 12 d(10.75-18.5 IQR) respectively. Median hospital stay was 22 d(19-26 IQR) while mortality was 4/20(20%). CONCLUSION TTD for difficult GDP is feasible, easy in the emergency, and patients recover in two-three weeks. It obviates the need for technically demanding and riskier procedures.

关键词：消化剂溃疡穿孔腹膜炎 APACHE 使试管排水增加两倍十二指肠造口术

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Audiovestibular functioning of post-menopausal females with osteoporosis and osteopenia

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Journal of Otology 2021年第1期16卷 27-33页

作者： Manisha K.Juneja sanjay Munjal Anuradha Sharma Ashok K.gupta sanjay Bhadada Speech and Hearing Unit ENT DepartmentGMCHSec-32ChandigarhIndia Speech&Hearing Unit Dept.of OtolaryngologyPGIMERChandigarhIndia Dept.of Otolaryngology PGIMERChandigarhIndia Dept.of Endocrinology PGIMERChandigarhIndia

Introduction:Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass,especially in postmenopausal women.These can be associated with body pain,fractures,hearing loss and balance disorders.The present study aims to evaluate audio-vestibular function in postmenopausal patients with osteopenia or osteoporosis.Methods:The study included 48 postmenopausal women(new subjects)diagnosed with osteoporosis(n=23)or osteopenia(n=25)in the age range of 50e66 years,as well as 28 normal women as controls.Audiological testing included pure tone audiometry(conventional and extended high-frequency audiometry),speech audiometry,impedance audiometry and otoacoustic emissions,including both transient evoked otoacoustic emissions(TEOAEs)and distortion product otoacoustic emissions(DPOAEs).All subjects also underwent vestibular evoked myogenic potentials testing(both ocular and cervical VEMPs).Results:In the present study,hearing was worse at all frequencies in the osteoporosis group in comparison with the osteopenia and control groups,with worse speech recognition and discrimination scores and OAEs.Vestibular function was affected in 95.65%of women with osteoporosis and 76%of those with osteopenia.Conclusion:Osteoporosis and osteopenia are risk factors for vestibular dysfunction and hearing deficits in postmenopausal women.Thus,hearing and vestibular function should be monitored by audiological and vestibular testing periodically in these individuals.

关键词： Hearing loss Audio-vestibular testing Pure tone audiometry(PTA) OAE’S Speech audiometry VEMP Sensorineural hearing

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Hepatocellular carcinoma: Understanding molecular mechanisms for defining potential clinical modalities

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World Journal of Hepatology 2021年第11期13卷 1568-1583页

作者： Abhiram Natu Anjali Singh Sanjay Gupta Epigenetics and Chromatin Biology Group Gupta LaboratoryCancer Research InstituteAdvanced Centre for TreatmentResearch and Education in CancerTata Memorial CentreKhargharNavi Mumbai 410210MaharashtraIndia Homi Bhabha National Institute Training School ComplexAnushakti NagarMumbai 400085MaharashtraIndia

Liver cancer is the sixth most commonly occurring cancer and costs millions of lives per year.The diagnosis of hepatocellular carcinoma(HCC)has relied on scanning techniques and serum-based markers such asα-fetoprotein.These measures have limitations due to their detection limits and asymptomatic conditions during the early stages,resulting in late-stage cancer diagnosis where targeted chemotherapy or systemic treatment with sorafenib is offered.However,the aid of conventional therapy for patients in the advanced stage of HCC has limited outcomes.Thus,it is essential to seek a new treatment strategy and improve the diagnostic techniques to manage the disease.Researchers have used the omics profile of HCC patients for sub-classification of tissues into different groups,which has helped us with prognosis.Despite these efforts,a promising target for treatment has not been identified.The hurdle in this situation is genetic and epigenetic variations in the tumor,leading to disparities in response to treatment.Understanding reversible epigenetic changes along with clinical traits help to define new markers for patient categorization and design personalized therapy.Many clinical trials of inhibitors of epigenetic modifiers(also known as epi-drugs)are in progress.Epi-drugs like azacytidine or belinostat are already approved for other cancer treatments.Furthermore,epigenetic changes have also been observed in drug-resistant HCC tumors.In such cases,combinatorial treatment of epi-drugs with systemic therapy or trans-arterial chemoembolization might re-sensitize resistant cells.

关键词： Hepatocellular carcinoma Diagnosis Treatment Epigenetics Epi-drugs Drug resistance

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Role of prostate cancer stem-like cells in the development of antiandrogen resistance

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Cancer Drug Resistance 2022年第2期5卷 459-471页

作者： Prem Prakash Kushwaha Shiv Verma Shashank Kumar Sanjay Gupta Department of Urology Case Western Reserve UniversityClevelandOH 44106USA. The Urology Institute University Hospitals Cleveland Medical CenterClevelandOH 44106USA. Molecular Signaling and Drug Discovery Laboratory Department of BiochemistryCentral University of PunjabBathinda 151401India. Department of Pathology Case Western Reserve UniversityClevelandOH 44106USA. Department of Pharmacology Case Western Reserve UniversityClevelandOH 44106USA. Department of Nutrition Case Western Reserve UniversityClevelandOH 44106USA. Divison of General Medical Sciences Case Comprehensive Cancer CenterClevelandOH 44106USA.

Androgen deprivation therapy(ADT)is the standard of care treatment for advance stage prostate cancer.Treatment with ADT develops resistance in multiple ways leading to the development of castration-resistant prostate cancer(CRPC).Present research establishes that prostate cancer stem-like cells(CSCs)play a central role in the development of treatment resistance followed by disease progression.Prostate CSCs are capable of self-renewal,differentiation,and regenerating tumor heterogeneity.The stemness properties in prostate CSCs arise due to various factors such as androgen receptor mutation and variants,epigenetic and genetic modifications leading to alteration in the tumor microenvironment,changes in ATP-binding cassette(ABC)transporters,and adaptations in molecular signaling pathways.ADT reprograms prostate tumor cellular machinery leading to the expression of various stem cell markers such as Aldehyde Dehydrogenase 1 Family Member A1(ALDH1A1),Prominin 1(PROM1/CD133),Indian blood group(CD44),SRY-Box Transcription Factor 2(Sox2),POU Class 5 Homeobox 1(POU5F1/Oct4),Nanog and ABC transporters.These markers indicate enhanced self-renewal and stemness stimulating CRPC evolution,metastatic colonization,and resistance to antiandrogens.In this review,we discuss the role of ADT in prostate CSCs differentiation and acquisition of CRPC,their isolation,identification and characterization,as well as the factors and pathways contributing to CSCs expansion and therapeutic opportunities.

关键词： Prostate cancer second-generation antiandrogens cancer stem cells castration resistance prostate cancer androgen deprivation therapy

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Real-world clinical effectiveness of sorafenib among patients with unresectable hepatocellular carcinoma at two centers in the United States

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World Journal of Gastrointestinal Oncology 2023年第10期15卷 1796-1806页

作者： Daneng Li Stephen B Gruber Shrividya Iyer Sanjay Gupta Mohamedtaki Tejani Department of Medical Oncology and Therapeutics Research City of Hope Comprehensive Cancer CenterDuarteCA 91010United States Center for Precision Medicine City of Hope Comprehensive Cancer CenterDuarteCA 91010United States Department of Oncology Worldwide Real-World EvidenceEisai Inc.NutleyNJ 07110United States Department of Oncology and Hematology Advent Health Cancer InstituteOrlandoFL 32804United States

BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 1

关键词： Retrospective observational study Sorafenib Hepatocellular carcinoma Clinical effectiveness

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A multiplicative Gauss-Newton minimization algorithm:Theory and application to exponential functions

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Applied Mathematics(A Journal of Chinese Universities) 2021年第3期36卷 370-389页

作者： Anmol gupta sanjay Kumar Department of Electronics and Communication Engineering Thapar Institute of Engineering and TechnologyPatiala 147004India

Multiplicative calculus(MUC)measures the rate of change of function in terms of ratios,which makes the exponential functions significantly linear in the framework of MUC.Therefore,a generally non-linear optimization problem containing exponential functions becomes a linear problem in MUC.Taking this as motivation,this paper lays mathematical foundation of well-known classical Gauss-Newton minimization(CGNM)algorithm in the framework of MUC.This paper formulates the mathematical derivation of proposed method named as multiplicative Gauss-Newton minimization(MGNM)method along with its convergence properties.The proposed method is generalized for n number of variables,and all its theoretical concepts are authenticated by simulation results.Two case studies have been conducted incorporating multiplicatively-linear and non-linear exponential functions.From simulation results,it has been observed that proposed MGNM method converges for 12972 points,out of 19600 points considered while optimizing multiplicatively-linear exponential function,whereas CGNM and multiplicative Newton minimization methods converge for only 2111 and 9922 points,respectively.Furthermore,for a given set of initial value,the proposed MGNM converges only after 2 iterations as compared to 5 iterations taken by other methods.A similar pattern is observed for multiplicatively-non-linear exponential function.Therefore,it can be said that proposed method converges faster and for large range of initial values as compared to conventional methods.

关键词： multiplicative calculus multiplicative least square method multiplicative Newton minimization multiplicative Gauss-Newton minimization non-linear exponential functions

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Emerging targets in cancer drug resistance

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Cancer Drug Resistance 2019年第2期2卷 161-177页

作者： Shashank Kumar Prem Prakash Kushwaha Sanjay Gupta School of Basic and Applied Sciences Department of Biochemistry and Microbial SciencesCentral University of PunjabBathinda 151001India Department of Urology Case Western Reserve UniversityClevelandOhio 44106USA The Urology Institute University Hospitals Cleveland Medical CenterClevelandOhio 44106USA Department of Nutrition Case Western Reserve UniversityClevelandOhio 44106USA Divison of General Medical Sciences Case Comprehensive Cancer CenterClevelandOhio 44106USA Department of Urology Louis Stokes Cleveland Veterans Affairs Medical CenterClevelandOhio 44106USA.

Drug resistance is a complex phenomenon that frequently develops as a failure to chemotherapy during cancer treatment.Malignant cells increasingly generate resistance to various chemotherapeutic drugs through distinct mechanisms and pathways.Understanding the molecular mechanisms involved in drug resistance remains an important area of research for identification of precise targets and drug discovery to improve therapeutic outcomes.This review highlights the role of some recent emerging targets and pathways which play critical role in driving drug resistance.

关键词： Drug resistance transforming growth factor-β Keap1-Nrf2 PI3K-Akt FOXO transcription factors focal adhesion kinases annexins MIEN1 gene splicing sphingolipids microRNA

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Dietary phytochemicals and their role in cancer chemoprevention

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 709-712页

作者： Shashank Kumar Sanjay Gupta Molecular Signaling and Drug Discovery Laboratory Department of BiochemistrySchool of Basic and Applied SciencesCentral University of PunjabBathinda 151401India Department of Urology Case Western Reserve UniversityClevelandOH 44106USA Department of Urology The Urology InstituteUniversity Hospitals Cleveland Medical CenterClevelandOH 44106USA Department of Nutrition Case Western Reserve UniversityClevelandOH 44106USA Divison of General Medical Sciences Case Comprehensive Cancer CenterClevelandOH 44106USA Department of Urology Louis Stokes Cleveland Veterans Affairs Medical CenterClevelandOH 44106USA.

Epidemiological studies suggest a close association between diet and cancer initiation,which provides evidence that the dietary components may be effectively developed as chemopreventive agents[1].These pieces of evidence are further supported by several case-control and cohort studies,which overwhelmingly support a converse association between the intake of phytochemicals and cancer risk[2,3].A number of clinical studies have been conducted demonstrating that dietary phytochemicals have the ability to inhibit tumorigenesis[4].Components presenting in fruit and vegetables termed“bioactive”phytochemicals belong to several classes of micronutrients,including flavonoids,polyphenols,and dietary fiber.These components have the ability to reduce the cancer risk alone or by interactions between them.

关键词： prevention cancer dietary

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Genome-Wide Comparative in silico Analysis of Calcium Transporters of Rice and Sorghum

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Genomics, Proteomics & Bioinformatics 2011年第4期9卷 138-150页

作者： Anshita Goel Gohar Taj Dinesh Pandey Sanjay Gupta Anil Kumar Department of Molecular Biology and Genetic Engineering College of Basic Sciences and Humanities G.B. Pant University of Agriculture and Technology Department of Biotechnology Uttrakhand Technical University Department of Biotechnology SBS Biomedical P.G. Institute of Biomedical Science and Research

The mechanism of calcium uptake, translocation and accumulation in Poaceae has not yet been fully understood. To address this issue, we conducted genome-wide comparative in silico analysis of the calcium （Ca2＋） transporter gene family of two crop species, rice and sorghum. Gene annotation, identification of upstream cis-acting ele- ments, phylogenetic tree construction and syntenic mapping of the gene family were performed using several bio- informatics tools. A total of 31 Ca2＋ transporters, distributed on 9 out of 12 chromosomes, were predicted from rice genome, while 28 Ca2＋ transporters predicted from sorghum are distributed on all the chromosomes except chromosome 10 （Chr 10）. Interestingly, most of the genes on Chr 1 and Chr 3 show an inverse syntenic relation- ship between rice and sorghum. Multiple sequence alignment and motif analysis of these transporter proteins re- vealed high conservation between the two species. Phylogenetic tree could very well identify the subclasses of channels, ATPases and exchangers among the gene family. The in silico c/s-regulatory element analysis suggested diverse functions associated with light, stress and hormone responsiveness as well as endosperm- and meris- tem-specific gene expression. Further experiments are warranted to validate the in silico analysis of the predicted transporter gene family and elucidate the functions of Ca2＋ transporters in various biological processes.

关键词： in silico comparison calcium transporter rice sorghum genomic annotation synteny

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Microalgal bioremediation of food-processing industrial wastewater under mixotrophic conditions： Kinetics and scaleup approach

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Frontiers of Chemical Science and Engineering 2016年第4期10卷 499-508页

作者： Suvidha gupta R. A. Pandey sanjay B. Pawar Environmental Biotechnology Division CSIR-Nafional Environmental Engineering Research Institute (NEERI) Nagpur 440020 India

The Chlorella microalgae were mixotrophically cultivated in an unsterilized and unfikered raw foodprocessing industrial wastewater. Both inorganic carbon （CO2-air） and organic carbon （wastewater） were provided simultaneously for microalgae growth. The aim of the study is to find out the utilization rates of total organic carbon （TOC） and chemical oxygen demand （COD） under mixotrophic conditions for a given waste water. About 90% reduction in TOC and COD were obtained for all dilutions of wastewater. Over 60% of nitrate and 40% of phosphate were consumed by microalgae from concentrated raw wastewater. This study shows that microalgae can use both organic and inorganic sources of carbon in more or less quantity under mixotrophic conditions. The growth of microalgae in food-processing industrial wastewater with all studied dilution factors, viz. zero （raw）, 1.6 （dilution A）, and 5 （dilution B） suggests that the freshwater requirement could be reduced substantially （20%-60%）. The degradation kinetics also suggests that the microalgae cultivation on a high COD wastewater is feasible and scalable.

关键词： total organic carbon wastewater bioremedia-tion kinetics mixotrophic cultivation

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