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Pancreatic stent improves the success rate of needle-knife papillotomy in patients with difficult biliary cannulation

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World Journal of Gastroenterology 2025年第1期31卷 58-67页

作者： Mu-Hsien Lee Cheng-Hui Lin chi-Huan Wu Yung-Kuan Tsou Kai-Feng Sung Sheng-Fu wang Nai-Jen Liu Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital and Chang Gung University College of MedicineTaoyuan 33305Taiwan School of Medicine Chang Gung UniversityTaoyuan 33305Taiwan

BACKGROUND Needle-knife precut papillotomy(NKP)is typically performed ***,it remains unclear whether pancreatic stent(PS)placement can improve the outcomes of *** To explore whether PS placement improves the success rate of NKP in patients with difficult biliary *** This single-center retrospective study included 190 patients who underwent NKP between January 2017 and December 2021 after failed conventional biliary *** cases with incidental pancreatic duct cannulation during conventional biliary cannulation,the decision for pre-NKP PS placement was made at the endoscopist's *** primary outcome was the difference in the NKP success rate between patients with and without PS placement;the secondary outcome was the adverse event *** Among the 190 participants,82 received pre-NKP PS(PS-NKP group)whereas 108 did not[freehand or freehand NKP(FH-NKP)group].Post-NKP selective biliary cannulation was successful in 167(87.9%)patients,and the PS-NKP had a significantly higher success rate than the FH-NKP group(93.9%vs 83.3%,P=0.027).The overall adverse event rates were 7.3%and 11.1%in the PS-NKP and FH-NKP groups,respectively(P=0.493).A periampullary diverticulum(PAD)and significant intraoperative bleeding during NKP were independently associated with NKP failure;however,a pre-NKP PS was the only predictor of NKP *** the 44 participants with PADs,the PS-NKP group had a non-significantly higher NKP success rate than the FH-NKP group(87.5%and 65%,respectively;P=0.076).CONCLUSION PS significantly improved the success rate of NKP in patients with difficult biliary cannulation.

关键词： Difficult biliary cannulation Endoscopic retrograde cholangiopancreatography Needle-knife papillotomy Pancreatic stent Selective biliary cannulation

Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A chinese multicenter study

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World Journal of Gastroenterology 2025年第2期31卷 85-101页

作者： Jun-Yi Zhan Jie Chen Jin-zhong Yu Fei-Peng Xu Fei-Fei Xing De-Xin wang Ming-Yan Yang Feng Xing Jian wang Yong-Ping Mu Cell Biology Laboratory Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Institute of Liver Diseases Shanghai Academy of Chinese MedicineShanghai 201203China Clinical Key Laboratory of Traditional chinese Medicine of Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Key Laboratory of Liver and Kidney Disease of the Ministry of Education Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Gastroenterology and Hepatology Zhongshan Hospital Affiliated to Fudan UniversityShanghai 200032China Shanghai Institute of Liver Disease Fudan UniversityShanghai 200032China Evidence-Based Medicine Center Fudan UniversityShanghai 200032China Department of Gastrointestinal Endoscopy Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China Department of Hepatology Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese MedicineShanghai 201203China

BACKGROUND Rebleeding after recovery from esophagogastric variceal bleeding(EGVB)is a severe complication that is associated with high rates of both incidence and *** its clinical importance,recognized prognostic models that can effectively predict esophagogastric variceal rebleeding in patients with liver cirrhosis are *** To construct and externally validate a reliable prognostic model for predicting the occurrence of esophagogastric variceal *** This study included 477 EGVB patients across 2 cohorts:The derivation cohort(n=322)and the validation cohort(n=155).The primary outcome was rebleeding events within 1 *** least absolute shrinkage and selection operator was applied for predictor selection,and multivariate Cox regression analysis was used to construct the prognostic *** validation was performed with bootstrap *** assessed the discrimination,calibration and accuracy of the model,and performed patient risk *** Six predictors,including albumin and aspartate aminotransferase concentrations,white blood cell count,and the presence of ascites,portal vein thrombosis,and bleeding signs,were selected for the rebleeding event prediction following endoscopic treatment(REPET)*** predicting rebleeding within 1 year,the REPET model ex-hibited a concordance index of 0.775 and a Brier score of 0.143 in the derivation cohort,alongside 0.862 and 0.127 in the validation ***,the REPET model revealed a significant difference in rebleeding rates(P<0.01)between low-risk patients and intermediate-to high-risk patients in both *** We constructed and validated a new prognostic model for variceal rebleeding with excellent predictive per-formance,which will improve the clinical management of rebleeding in EGVB patients.

关键词： Esophagogastric variceal bleeding Variceal rebleeding Liver cirrhosis Prognostic model Risk stratification Secondary prophylaxis

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冠状动脉阻抗系统的建立及其稳定性

复旦学报（医学版） 2004年第4期31卷 331-335页

作者：张良惠葛均波罗忠池汪源源钱菊英蔡迺绳王威琪复旦大学附属中山医院心内科-上海市心血管病研究所上海200032 复旦大学电子工程系上海200433

目的　利用计算机和图像、信号采集设备建立冠状动脉阻抗系统 ,并研究冠状动脉阻抗参数的稳定性。方法　与心电信号同步通过腔内超声导管、多普勒导丝和压力导丝 ,获取随心动周期变化的冠状动脉腔内超声图像、流速和压力信号 ;通过自制... 详细信息

目的　利用计算机和图像、信号采集设备建立冠状动脉阻抗系统 ,并研究冠状动脉阻抗参数的稳定性。方法　与心电信号同步通过腔内超声导管、多普勒导丝和压力导丝 ,获取随心动周期变化的冠状动脉腔内超声图像、流速和压力信号 ;通过自制软件得到随心动周期变化的腔内面积曲线、平均流速曲线、压力曲线和流量 /压力曲线 ;按机电类比方法通过傅立叶变换得到冠脉阻抗参数。采集不同情况下 1 0头小型猪以及 2 1例病人左前降支的基础状态和最大充血状态重复性测量信号分别为 80对。结果　相关分析发现重复性冠脉阻抗参数间有很好的相关性 (P <0 .0 1 ) ;基础状态和充血状态的平均冠脉阻抗和一次谐波冠脉阻抗的决定系数 (r2 )均大于0 .97(P <0 .0 0 1 )。结论　本实验成功建立反映冠脉脉动流阻力的冠脉阻抗系统。

关键词：冠状动脉阻抗系统建立稳定性多普勒压力血管内超声

Triboelectric nanogenerators as wearable power sources and self-powered sensors

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National Science Review 2023年第1期10卷 28-48页

作者： Xiong Pu chi Zhang zhong Lin wang CAS Center for Excellence in Nanoscience Beijing Key Laboratory of Micro-Nano Energy and Sensor Beijing Institute of Nanoenergy and NanosystemsChinese Academy of Sciences School of Nanoscience and Technology University of Chinese Academy of Sciences School of Materials Science and Engineering College of EngineeringGeorgia Institute of Technology

Smart we arable technologies are augmenting human bodies beyond our biological capabilities in communication,healthcare and *** supply and information acquisition are essential for wearable electronics,whereas the increasing demands in multifunction are raising the requirements for energy and sensor *** triboelectric nanogenerator(TENG),proven to be able to convert various mechanical energies into electricity,can fulfill either of these two functions and therefore has drawn extensive attention and research efforts *** everyday life of a human body produces considerable mechanical energies and,in the meantime,the human body communicates mainly through mechanical signals,such as sound,body gestures and muscle ***,the TENG has been intensively studied to serve as either wearable sources or wearable self-powered ***,the recent finding on the fundamental understanding of TENGs is revisited briefly,followed by a summary of recent advancements in TENG-based wearable power sources and self-powered *** challenges and prospects of this area are given as well.

关键词： triboelectric nanogenerators power sources self-powered sensors wearable electronics

BIBR1532 inhibits proliferation and metastasis of esophageal squamous cancer cells by inducing telomere dysregulation

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 214-225页

作者： Qin wang Qing-Rong Li Lei Xu Zi-Chun Yuan Xiao Liu Mao-Ju Tang Man Luo Xiao-Wu zhong Qiang Ma Xiao-Lan Guo Department of Clinical Laboratory Affiliated Hospital of North Sichuan Medical CollegeNanchong 637000Sichuan ProvinceChina School of Laboratory Medicine&Translational Medicine Research Center North Sichuan Medical CollegeNanchong 637000Sichuan ProvinceChina

BACKGROUND Esophageal squamous cell carcinoma(ESCC)is a malignant tumor with high morbidity and mortality,and easy to develop resistance to chemotherapeutic *** are DNA-protein complexes located at the termini of chro-mosomes in eukaryotic cells,which are unreplaceable in maintaining the stability and integrity of ***,an RNA-dependent DNA polymerase,play vital role in telomere length maintain,targeting telomerase is a promising therapeutic strategy for ***150 and KYSE410 cells were cultured and exposed to various concentrations of *** viability was assessed at 48 hours and 72 hours to determine the IC50 *** effects of BIBR1532 on ESCC cell proliferation,migration,and cellular senescence were evaluated using the cell counting kit-8 assay,plate colony formation assay,scratch assay,transwell assay,andβ-galactosidase staining,*** blotting was performed to detect the expression of RESULTS The IC50 values for KYSE150 and KYSE410 cells after 48 hours of BIBR1532 exposure were 48.53μM and 39.59μM,*** values decreased to 37.22μM and 22.71μM,respectively,following a longer exposure of 72 ***1532 exhibited dose-dependent effects on KYSE150 and KYSE410 cells,including decreased hTERT expression,inhibition of proliferation and metastasis,and induction of cellular ***,BIBR1532 upregulated the expression of the DDR protein,γ-H2AX,and activated the ataxia telangiectasia and Rad3-related protein(ATR)/check point kinase 1(CHK-1)and ataxia-telangiectasia mutated gene(ATM)/CHK2 ***1532 downregulated the expression of telomere-binding proteins,including telomeric-repeat binding factor 1(TRF1),TRF2,protection of telomeres 1,and TIN2-interacting protein *** a nude mouse xenograft model,BIBR1532 significantly suppressed tumor growth,reduced hTERT expression,and increasedγ-H2AX protein *** and eosin staining of various organs,including the heart,liver,s

关键词： Esophageal squamous cell carcinoma BIBR1532 Human telomerase reverse transcriptase DNA damage response Telomere-binding proteins

Human-induced pluripotent stem cell-derived neural stem cell exosomes improve blood-brain barrier function after intracerebral hemorrhage by activating astrocytes via PI3K/AKT/MCP-1 axis

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Neural Regeneration Research 2025年第2期20卷 518-532页

作者： Conglin wang Fangyuan Cheng Zhaoli Han Bo Yan Pan Liao Zhenyu Yin Xintong Ge Dai Li Rongrong zhong Qiang Liu Fanglian Chen Ping Lei Department of Geriatrics Tianjin Medical University General HospitalTianjinChina School of Medicine Nankai UniversityTianjinChina Tianjin Neurological Institute TianjinChina

Cerebral edema caused by blood-brain barrier injury after intracerebral hemorrhage is an important factor leading to poor ***-induced pluripotent stem cell-derived neural stem cell exosomes(hiPSC-NSC-Exos)have shown potential for brain injury repair in central nervous system *** this study,we explored the impact of hiPSC-NSC-Exos on blood-brain barrier preservation and the underlying *** results indicated that intranasal delivery of hiPSC-NSC-Exos mitigated neurological deficits,enhanced blood-brain barrier integrity,and reduced leukocyte infiltration in a mouse model of intracerebral ***,hiPSC-NSC-Exos decreased immune cell infiltration,activated astrocytes,and decreased the secretion of inflammatory cytokines like monocyte chemoattractant protein-1,macrophage inflammatory protein-1α,and tumor necrosis factor-αpost-intracerebral hemorrhage,thereby improving the inflammatory *** sequencing indicated that hiPSC-NSC-Exo activated the PI3K/AKT signaling pathway in astrocytes and decreased monocyte chemoattractant protein-1 secretion,thereby improving blood-brain barrier *** with the PI3K/AKT inhibitor LY294002 or the monocyte chemoattractant protein-1 neutralizing agent C1142 abolished these *** summary,our findings suggest that hiPSC-NSC-Exos maintains blood-brain barrier integrity,in part by downregulating monocyte chemoattractant protein-1 secretion through activation of the PI3K/AKT signaling pathway in astrocytes.

关键词： AKT astrocyte blood-brain barrier cerebral edema exosomes human-induced pluripotent stem cells intracerebral hemorrhage neural stem cells neuroinflammation PI3K

“大、小、重、慢”疾病定义与全科医生“4善”定位的探讨

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中国全科医学 2025年第1期28卷 125-128页

作者：李敏王仲清华大学附属北京清华长庚医院临床医学院全科医学系北京市102218 北京清华长庚医院全科与健康医学部北京市102218

随着我国医药卫生体制的深度改革,特别是分级诊疗制度的推进,全科医生在基层医疗保健体系中的角色日益重要。全科医生不仅是居民健康的第一道防线,更是常见疾病预防、诊断、治疗及健康教育的关键执行者。国家对全科医生提出了“小病善... 详细信息

随着我国医药卫生体制的深度改革,特别是分级诊疗制度的推进,全科医生在基层医疗保健体系中的角色日益重要。全科医生不仅是居民健康的第一道防线,更是常见疾病预防、诊断、治疗及健康教育的关键执行者。国家对全科医生提出了“小病善治、大病善识、重病善转、慢病善管”的临床定位。本文通过问答形式,分析“小、大、重、慢”疾病的分类与全科医生的“4善”定位,探讨全科医生在新医改时代下的重要职能及挑战。访谈者认为虽然分级诊疗制度旨在优化医疗资源配置,但在实践中仍面临“大、小、重、慢”疾病分类的模糊性和基层医疗资源的不均衡分配等问题。全科医生在这个体系中扮演着至关重要的角色,其需要具备综合的临床诊疗能力,并与专科医生共同制定临床判断标准和诊疗标准。为了应对这些挑战并充分发挥全科医生在现代医疗体系中的作用,迫切需要对全科医学教育和实践进行进一步改革与优化,同时强化全科医生的角色定位,以确保在提升医疗服务质量和效率的同时,实现公平和可持续的健康保障体系。

关键词：全科医学全科医生分级诊疗医疗体系改革疾病分类医疗资源优化

Constraints on holographic QCD phase transitions from PTA observations

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Science china(Physics,Mechanics & Astronomy) 2025年第1期Mechanics & Astronomy) .卷 71-78页

作者： Song He Li Li Sai wang Shao-Jiang wang Center for Theoretical Physics and College of Physics Jilin University School of Physical Science and Technology Ningbo University Max Planck Institute for Gravitational Physics (Albert Einstein Institute) CAS Key Laboratory of Theoretical Physics Institute of Theoretical Physics Chinese Academy of Sciences School of Fundamental Physics and Mathematical Sciences Hangzhou Institute for Advanced StudyUniversity of Chinese Academy of Sciences (UCAS) School of Physical Sciences University of Chinese Academy of Sciences (UCAS) Theoretical Physics Division Institute of High Energy Physics Chinese Academy of Sciences

The underlying physics of QCD phase transition in the early Universe remains largely unknown due to its strong-coupling nature during the quark-gluon plasma/hadron gas transition, yet a holographic model has been proposed to quantitatively fit the lattice QCD data while with its duration of the first-order phase transition(FoPT) left undetermined. At specific baryon chemical potential, the first-order QCD phase transition agrees with the observational constraint of baryon asymmetry. It, therefore, provides a scenario for phase transition gravitational waves(GWs) within the standard model of particle physics. If these background GWs could contribute dominantly to the recently claimed common-spectrum red noise from pulsar timing array(PTA) observations, the duration of this FoPT can be well constrained, and the associated primordial black holes are still allowed by current observations.

关键词： pulsar timing array QCD phase transition gravitational waves primordial black holes

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急性脑梗死患者氯吡格雷抵抗的相关因素研究

卒中与神经疾病 2016年第6期23卷 395-398页

作者：吴金龙钟池王磊李文王绍博山东省潍坊市潍坊医学院神经病学教研室 261053 潍坊医学院附属潍坊市人民医院神经内科

目的探讨急性脑梗死患者氯吡格雷抵抗(clopidogrel resisitance,CR)的相关因素。方法收集急性脑梗死患者100例,入院后连续口服氯吡格雷7 d后空腹抽取肘静脉血,用血栓弹力图(thromboelastograms,TEG)测得二磷酸腺苷(adenosine diphosphat... 详细信息

目的探讨急性脑梗死患者氯吡格雷抵抗(clopidogrel resisitance,CR)的相关因素。方法收集急性脑梗死患者100例,入院后连续口服氯吡格雷7 d后空腹抽取肘静脉血,用血栓弹力图(thromboelastograms,TEG)测得二磷酸腺苷(adenosine diphosphate,ADP)受体途径诱导的血小板抑制率,将患者分为氯吡格雷抵抗组(CR)和氯吡格雷敏感组(clopidogrel sensitivity,CS);根据2组患者的临床检测水平和Logistic回归分析引起CR的因素。结果 31例患者出现氯吡格雷抵抗,发生率为31%。单因素分析发现并发2型糖尿病、LDL-C水平、空腹血糖水平(FPG)差异明显(P<0.05)。多因素Logistic回归分析发现,2型糖尿病(OR=13.198,P<0.05)、LDL-C水平(OR=0.349,P<0.05)是引起CR的独立危险因素。结论部分急性脑梗死患者会出现氯吡格雷抵抗,2型糖尿病、LDL-C水平是其独立危险因素。

关键词：急性脑梗死氯吡格雷抵抗血栓弹力图(TEG)