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Pancreatic exocrine insufficiency, diabetes mellitus and serum nutritional markers after acute pancreatitis

World Journal of Gastroenterology 2014年第48期20卷 18432-18438页

作者： Miroslav Vujasinovic Bojan Tepes Jana Makuc Sasa Rudolf Jelka Zaletel Tjasa Vidmar Maja Seruga Bostjan Birsa Miroslav Vujasinovic Jana Makuc Tjasa Vidmar Department of Internal Medicine Slovenj Gradec General Hospital Slovenj Gradec 2380 Slovenia Abakus Medico Diagnostic Centre Rogaska Slatina 3250 Slovenia Department of Radiology University Medical Centre Maribor Maribor 2000 Slovenia Department of Endocrinology Diabetes and Metabolic Diseases University Medical Centre Ljubljana Ljubljana 1000 Slovenia Department of Internal Medicine Murska Sobota General Hospital Murska Sobota 9001 Slovenia Department of Internal Medicine Celje General Hospital Celje 3000 Slovenia

AIM:To investigate impairment and clinical significance of exocrine and endocrine pancreatic function in patients after acute pancreatitis(AP).METHODS:Patients with AP were invited to participate in the study.Severity of AP was determined by the Atlanta classification and definitions revised in2012.Pancreatic exocrine insufficiency(PEI)was diagnosed by the concentration of fecal elastase-1.An additional work-up,including laboratory testing of serum nutritional markers for determination ofmalnutrition,was offered to all patients with low levels of fecal elastase-1 FE.Hemoglobin A1c or oral glucose tolerance tests were also performed in patients without prior diabetes mellitus,and type 3c diabetes mellitus(T3c DM)was diagnosed according to American Diabetes Association criteria.RESULTS:One hundred patients were included in the study:75%(75/100)of patients had one attack of AP and 25%(25/100)had two or more attacks.The most common etiology was alcohol.Mild,moderately severe and severe AP were present in 67,15 and 18%of patients,respectively.The mean time from attack of AP to inclusion in the study was 2.7 years.PEI was diagnosed in 21%(21/100)of patients and T3c DM in14%(14/100)of patients.In all patients with PEI,at least one serologic nutritional marker was below the lower limit of normal.T3c DM was more frequently present in patients with severe AP(P=0.031),but was also present in some patients with mild and moderately severe AP.PEI was present in all degrees of severity of AP.There were no statistically significantly differences according to gender,etiology and number of AP attacks.CONCLUSION:As exocrine and endocrine pancreatic insufficiency can develop after AP,routine follow-up of patients is necessary,for which serum nutritional panel measurements can be useful.

关键词： Acute pancreatitis Diabetes mellitus Pancreatic ex

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Radiofrequency ablation during continuous saline infusion can extend ablation margins

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World Journal of Gastroenterology 2013年第8期19卷 1278-1282页

作者： Toru Ishikawa Tomoyuki Kubota Ryoko Horigome Naruhiro Kimura Hiroki Honda Akito Iwanaga Keiichi Seki Terasu Honma Toshiaki Yoshida Department of Gastroenterology and Hepatology Saiseikai Niigata Daini HospitalNiigata 950-1104Japan

AIM:To determine whether fluid injection during radiofrequency ablation(RFA) can increase the coagulation area.METHODS:Bovine liver(1-2 kg) was placed on an aluminum tray with a return electrode affixed to the base,and the liver was punctured by an expandable electrode.During RFA,5% glucose;50% glucose;or saline fluid was infused continuously at a rate of 1.0 mL/min through the infusion line connected to the infusion port.The area and volume of the thermocoagulated region of bovine liver were determined after RFA.The Joule heat generated was determined from the temporal change in output during the RFA experiment.RESULTS:No liquid infusion was 17.3 ± 1.6 mL,similar to the volume of a 3-cm diameter sphere(14.1 mL).Mean thermocoagulated volume was significantly larger with continuous infusion of saline(29.3 ± 3.3 mL) than with 5% glucose(21.4 ± 2.2 mL),50%glucose(16.5 ± 0.9 mL) or no liquid infusion(17.3 ± 1.6 mL).The ablated volume for RFA with saline was approximately 1.7-times greater than for RFA with no liquid infusion,representing a significant difference between these two conditions.Total Joule heat generated during RFA was highest with saline,and lowest with 50% glucose.CONCLUSION:RFA with continuous saline infusion achieves a large ablation zone,and may help inhibit local recurrence by obtaining sufficient ablation margins.RFA during continuous saline infusion can extend ablation margins,and may be prevent local recurrence.

关键词： Radiofrequency ablation ex vivo bovine liver Large ablation zone Saline Glucose Joule heat

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有机化学基本理论问题新的研究方法、新的观念和新的思维模式

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有机化学 2001年第11期21卷 949-953页

作者：虞忠衡中国科学院化学研究所分子动态和稳态国家重点实验室北京100080

有机化学基本理论研究的总结和回顾.15年来,在国家自然科学基金委员会的支持下,为了认识电子离域的本质,在量子化学领域,我们建立和发展了新的作用能分解方法和大型计算程序,发展和完善了轨道定域化程序.我们的方法可以为任何一个共轭分... 详细信息

有机化学基本理论研究的总结和回顾.15年来,在国家自然科学基金委员会的支持下,为了认识电子离域的本质,在量子化学领域,我们建立和发展了新的作用能分解方法和大型计算程序,发展和完善了轨道定域化程序.我们的方法可以为任何一个共轭分子(无论是平面的还是非平面的,是含共轭双键的还是含累积双键的),提供一个π与σ体系彻底分离的片断分子轨道基组.这个轨道基组不仅满足分子特殊的对称性,而且还具有确切的电子占据数.与Huckel理论完全不同,我们强调:π电子的离域除了对它原先的定域π体系有强烈的失稳定作用外,它还可通过π-σ空间作用,对σ构架产生强烈的稳定作用.据此,我们提出了芳环化合物新的分类准则,揭示了芳香环流起因的必要条件,定义环的刚度为芳香性的一个新判据.发现,分子内基团间的局部作用(CT和ex)同它们对分子整体性能的影响是完全相反的.就构象而言,稳定的cT作用是相斥的,失稳定的ex作用是相吸的;就电子转移而言,大的ex作用是电荷转移的助动力.其助动性在于,它能降低因CT作用而产生的给体自身对电荷转移的阻力.论证了,在二苯乙烯类分子中,π-π共轭,π-σ超共轭和σ-σ非键轨道作用都是失稳定的.与σ-σ和π-σ作用相比,π-π作用对于分子构像的影响是非常微弱的.与经典的思维模式相反,有机分子总是倾向于较小的失稳定,而不是较大的稳定.为了维持尽可能最稳定的电子总能量,在σ-σ作用的驱动下,共轭基团应该尽量地偏离共平面.阻止分子扭曲的(非电子作用力)是核排斥力.因此,一个空间拥挤的构象可以是能量有利的构象.在我们的研究中,经典有机结构理论的整体因果关系已经全面地被颠倒.

关键词：电子离域结构理论新能量分解法 CT ex 电荷转移芳香性分子构象有机化学基本理论共轭效应电子交换作用分子构象

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GEOLOGICAL EVOLUTION AND OROGENY OF EAST KUNLUN TERRAIN ON THE NORTHERN QINGHAI—TIBET PLATEAU

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地学前缘 2000年第S1期7卷 234-235页

作者： Xu Zhiqin, Yang Jingsui, Li Haibing(Institute of Geology, Chinese Academy of Geological Sciences, Beijing 100037,China)

The East Kunlun terrain is located on the northern Qinghai—Tibet plateau, composed of the East Kunlun Mountain and the Qaidam Basin and bounded by the Qilian terrain on the north and Bayanhar—Songpan Ganze terrain on the south. It is regarded as a composite orogenic belt characterized by having developed superimposed ductile tectonic regimes reflecting the collision orogeny during Early Paleozoic and Triassic periods. It has also experienced transformation from ductile to brittle deformation caused by the post orogeny, since Jurassic after the formation of the East Kunlun Mountain and the Qaidam Basin. A Paleozoic subduction complex zone was recently recognized along the north border of the East Kunlun terrain from Da Qaidam to Dulan (Xu,et al, 1 999). It is composed of ophiolite (of Early Paleozoic age?), tectonic melange and very high\|pressure metamorphic rocks with eclogite (\%p\%=2 2GPa, \%t\%=720℃) (Yang,et al.,1998) and garnet\|peridotite (\%p\%=2 5GPa, t =837℃). The Anyemaqin Triassic subduction complex zone trending in NWW\|SEE was developed along the eastern segment of the south border of the East Kunlun terrain. It is mainly composed of ultramafic and mafic rocks, pillow basalt, radiolaria\|bearing clastic rocks, tectonic melange and mylonite. The subduction complex zone contains a series of the southward overthrusting imbricated slices. Instead of this subduction complex zone, a 2 km\|wide sinistral strike\|slip ductile shear zone trending in E\|W was developed along the western segment. On the basis of macroscopic and microscopic studies on a series of structural sections, we divide the East Kunlun Mountain into four tectonic units as follows: (1) North Proterozoic Metamorphic Basement Zone; (2) South Early Paleozoic—Triassic Superimposed Fold Zone; (3) South Triassic Transpression Zone; (4) Anyemaqin Back\|Arc Decollement\|Thrust Zone.

关键词： East Kunlun terrain composite orogenic belt subduction compl ex zone transpression shear zone

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Pulmonary manifestations of Crohn's disease

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World Journal of Gastroenterology 2014年第1期20卷 133-141页

作者： De-Gan Lu Xiao-Qing Ji Xun Liu Hong-Jia Li Cai-Qing Zhang Department of Respiratory Medicine Shandong Provincial Qianfoshan Hospital Department of ENT Central Hospital of Taian City

Crohn’s disease(CD)is a systemic illness with a constellation of extraintestinal manifestations affecting various organs.Of these extraintestinal manifestations of CD,those involving the lung are relatively rare.However,there is a wide array of lung manifestations,ranging from subclinical alterations,airway diseases and lung parenchymal diseases to pleural diseases and drug-related diseases.The most frequent manifestation is bronchial inflammation and suppuration with or without bronchiectasis.Bronchoalveolar lavage findings show an increased percentage of neutrophils.Drug-related pulmonary abnormalities include disorders which are directly induced by sulfasalazine,mesalamine and methotrexate,and opportunistic lung infections due to immunosuppressive treatment.In most patients,the development of pulmonary disease parallels that of intestinal disease activity.Although infrequent,clinicians dealing with CD must be aware of these,sometimes life-threatening,conditions to avoid further impairment of health status and to alleviate patient symptoms by prompt recognition and treatment.The treatment of CD-related respiratory disorders depends on the specific pattern of involvement,and in most patients,steroids are required in the initial management.

关键词： Crohn’s disease Inflammatory bowel disease Lung ex

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ex vivo expansion of hematopoietic stem and progenitor cells: Recent advances

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World Journal of Hematology 2014年第2期3卷 18-28页

作者： Katsuhiro Kita Fangming Xiu Marc G Jeschke Department of Biochemistry and Molecular Biology The University of Texas Medical Branch Sunnybrook Research Institute University of Toronto Ross Tilley Burn Centre Sunny brook Health Science Centre and Sunnybrook Research Institute and Division of Plastic Surgery Department of Surgery University of Toronto

Hematopoietic stem cells(HSCs) have become the most extensively studied stem cells and HSC-based cellular therapy is promising for hematopoietic cancers and hereditary blood disorders. Successful treatment of patients with HSC cells depends on sufficient number of highly purified HSCs and progenitor cells. However, stem cells are a very rare population no matter where they come from. Thus, ex vivo amplification of these HSCs is essential. The heavy demands from more and more patients for HSCs also require industrial-scale expansion of HSCs with lower production cost and higher efficiency. Two main ways to reach that goal:(1) to find clinically applicable, simple and efficient methods(or reagents) to enrich HSCs;(2) to find new developmental regulators and chemical compounds in order to replace the currently used cytokine cocktails for HSCsamplification. In this Editorial review, we would like to introduce the current status of ex vivo expansion of HSCs, particularly focusing on enrichment and culture supplements.

关键词： Hematopoietic stem cell ex vivo expansion Serum-free culture Cell surface markers Enrichment Stem cell isolation

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History,ethics,advantages and limitations of experimental models for hepatic ablation

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World Journal of Gastroenterology 2013年第2期19卷 147-154页

作者： Seok Ling Ong Gianpiero Gravante Matthew S Metcalfe Ashley R Dennison Department of Hepatobiliary and Pancreatic Surgery Leicester General HospitalLeicester LE5 4PWUnited Kingdom

Numerous techniques developed in medicine require careful evaluation to determine their indications,limitations and potential side effects prior to their clinical use.At present this generally involves the use of animal models which is undesirable from an ethical standpoint,requires complex and time-consuming authorization,and is very expensive.This process is exemplified in the development of hepatic ablation techniques,starting experiments on explanted livers and progressing to safety and efficacy studies in living animals prior to clinical studies.The two main approaches used are ex vivo isolated non-perfused liver models and in vivo animal models.ex vivo non perfused models are less expensive,easier to obtain but not suitable to study the heat sink effect or experiments requiring several hours.In vivo animal models closely resemble clinical subjects but often are expensive and have small sample sizes due to ethical guidelines.Isolated perfused ex vivo liver models have been used to study drug toxicity,liver failure,organ transplantation and hepatic ablation and combine advantages of both previous models.

关键词： Liver Ablation experiment ex vivo In vivo Perfusion

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<i>ex Utero</i>intrapartum treatment (exIT)

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Open Journal of Obstetrics and Gynecology 2013年第9期3卷 51-60页

作者： Srinivas Pentyala Aleef Rahman Pooja Mysore Sahana Pentyala Kyle Urbanczyk Thomas Tumillo John Muller Yimei Miao Sardar Khan Department of Anesthesiology Stony Brook Medical Center Stony Brook USA Department of Urology Stony Brook Medical Center Stony Brook USA

The anesthesia ex utero intrapartum treatment (exIT) procedure is a specialized surgical procedure used to deliver babies who have airway compression due to cystic adenomatoid malformation, bronchopulmonary sequestration, cervical teratomas, or other congenital conditions. exIT is erroneously known as a routine cesarean section (CS), but is rather an extension of CS with discernible differences. The procedure creates an opening in the anesthetized abdomen of the mother and uterus. Once exIT is complete, the remainder of the CS proceeds. exIT is much more complex than a routine CS, as it requires coordination between the mother and a multidisciplinary team of surgical and neonatal personnel. This review highlights current anesthetic concepts during the exIT procedure.

关键词： Caesarean Section Airway Vaginal Birth Anesthesia ex Utero Intrapartum Treatment exIT

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Hematopoietic stem cells from peripheral blood the perspective of non-mobilized peripheral blood

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Health 2010年第6期2卷 519-527页

作者： Vassilios Katsares Zissis Paparidis Eleni Nikolaidou Anastasia Petsa Iliana Karvounidou Karina-Alina Ardelean Nikolaos Peroulis Nikolaos Grigoriadis John Grigoriadis 不详

The peripheral blood is a major source of hematopoietic stem cells. Almost for two decades the peripheral blood has been mobilized, in order to enhance the CD34+ concentration. The isolated stem cells from the mobilized peripheral blood are used as an alternative, or in addition to bone marrow derived stem cells. In this paper, a new perspective is being discussed;the use of non-mobilized peripheral blood as an alternative source for hematopoietic progenitor cells. The number of isolated hematopoietic stem cells is evaluated using flow cytometry. The viability can be evaluated using the trypan blue exclusion test, the flow cytometry or automated assays. The isolated hematopoietic stem cells could be used for ex vivo expansion either in static systems or in proper bioreactor systems, prior to cryopreservation and/or transplantation.

关键词： Non-Mobilized Peripheral Blood Hematopoietic Stem Cells ex Vivo expansion

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The use of remifentanil in ex utero intrapartum treatment procedures

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Open Journal of Pediatrics 2013年第4期3卷 366-369页

作者： Chad Whited Eileen Raynor Duke University Hospital Durham USA

Purpose: We propose that using remifentanil in ex utero intrapartum treatment (exIT) procedures reduces the need for maternal exposure to general anesthesia. Using remifentanil along with spinal anesthesia eliminates the fetal and maternal risks associated with inhalational general anesthesia, allows the mother to be awake, and obviates the need for and costs associated with general anesthesia and a second anesthesia team. Materials and Methods: We performed a retrospective review of all sequential patients undergoing ex utero intrapartum treatment procedure at our hospital from 1/1/2009 to 11/1/2010. All procedures were performed under regional neuraxial analgesia, using nitroglycerine as a tocolytic agent and remifentanil for analgesia. Variables included indication, time to secured fetal airway, complications, estimated blood loss, need for additional anesthetics, participating personnel, and survival. Results: All five of our ex utero intrapartum treatment procedures were successfully completed with combined spinal epidural remifentanil anesthetic. No patient was required additional alternative anesthetic. There were no complications with mother or fetus. Indications for procedure were arthyrogryposis (n = 3), fetal goiter, and micrognathia. Average time to secured airway was 10.25 minutes. Average estimated blood loss was 1010 ml. All five mothers were conscious during their procedure. Conclusions: We report the largest series of ex utero intrapartum treatment procedures performed with remifentanil regional anesthesia. We found that the combined use of nitroglycerin and regional remifentanil anesthesia is a safe alternative to the pediatric otolaryngologist for performing ex utero intrapartum treatment procedures without the risks of general anesthesia, allowing the mother to be awake for the delivery, and reducing the cost of providing care.

关键词： exIT ex Utero Intrapartum Treatment Procedure Remifentanil Airway

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