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Acute pancreatitis: pathogenesis and emerging therapies

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胰腺病学杂志(英文) 2024年第1期7卷 10-20页

作者： Zaman Saif Gorelick Fred department of internal medicine Yale School of Medicine New Haven CT veteran’s Administration Healthcare System West Haven CT department of Cell Biology Yale School of Medicine New Haven CT

Acute pancreatitis is a severe inflammatory disorder with limited treatment options. Improved understanding of disease mechanisms has led to new and potential therapies. Here we summarize what we view as some of the most promising new therapies for treating acute pancreatitis, emphasizing the rationale of specific treatments based on disease mechanisms. Targeted pharmacologic interventions are highlighted. We explore potential treatment benefits and risks concerning reducing acute injury, minimizing complications, and improving long-term outcomes. Mechanisms associated with acute pancreatitis initiation, perpetuation, and reconstitution are highlighted, along with potential therapeutic targets and how these relate to new treatments.

关键词： Acinar cell Acute pancreatitis Calcium signaling Transporters Treatment

Managing end-stage carcinoid heart disease:A case report and literature review

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World Journal of Gastrointestinal Oncology 2024年第3期16卷 1076-1083页

作者： Nikola Bulj vedran Tomasic Maja Cigrovski Berkovic department of Cardiology University Hospital Centre“Sestre Milosrdnice“Zagreb 10000Croatia Division of Gastroenterology Department of Internal MedicineUniversity Hospital Centre“Sestre Milosrdnice”Zagreb 10000Croatia department for Sport and Exercise medicine University of Zagreb Faculty of KinesiologyZagreb 10000Croatia

BACKGROUND Gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)are rare tumors,often diagnosed in an advanced stage when curative treatment is impossible and grueling symptoms related to vasoactive substance release by tumor cells affect patients’quality of *** complications of GEP-NENs,primarily tricuspid and pulmonary valve disease,and right-sided heart failure,are the leading cause of death,even compared to metastatic *** SUMMARY We present a case of a 35-year-old patient with progressive dyspnea,back pain,polyneuropathic leg pain,and nocturnal diarrhea lasting for a decade before the diagnosis of neuroendocrine carcinoma of unknown primary with extensive liver *** the initial presentation,serum biomarkers were not evaluated,and the patient received five cycles of doxorubicin,which he did not tolerate well,so he refused further therapy and was lost to *** 10 years,he presented to the emergency room with signs and symptoms of right-sided heart *** markers,serum chromogranin A,and urinary 5-hydroxyindoleacetic acid were extremely elevated(900 ng/mL and 2178µmol/L),and transabdominal ultrasound confirmed hepatic *** tomo-graphy(CT)showed liver metastases up to 6 cm in diameter and metastases in mesenteric lymph nodes and ***,an Octreoscan showed lesions in the heart,thoracic spine,duodenum,and ascendent colon.A standard trans-thoracic echocardiogram confirmed findings of carcinoid heart *** patient was not a candidate for valve *** started octreotide acetate treatment,and the dose escalated to 80 mg IM *** biochemical CONCLUSION Carcinoid heart disease occurs with carcinoid syndrome related to advanced neuroendocrine tumors,usually with liver metastases,which manifests as right-sided heart valve dysfunction leading to right-sided heart *** heart disease and tumor burden are major prognostic factors of poor surviva

关键词： Gastroenteropancreatic neuroendocrine neoplasms Carcinoid syndrome Carcinoid heart disease Diagnosis Treatment Case report

New insights into ATR inhibition in muscle invasive bladder cancer:The role of apolipoprotein B mRNA editing catalytic subunit 3B

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Oncology Research 2024年第6期32卷 1021-1030页

作者： HYUNHO KIM UIJU CHO SOOK HEE HONG HYUNG SOON PARK IN-HO KIM HO JUNG AN BYOUNG YONG SHIM JIN HYOUNG KANG Division of Medical Oncology Department of Internal MedicineSt.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea department of Pathology St.Vincent’s HospitalCollege of MedicineThe Catholic University of KoreaSuwonKorea Division of Medical Oncology Department of Internal MedicineSeoul St.Mary’s HospitalCollege of MedicineThe Catholic University of KoreaSeoulKorea

Background:Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC),an endogenous mutator,induces DNA damage and activates the ataxia telangiectasia and Rad3-related(ATR)-checkpoint kinase 1(Chk1)*** cisplatin-based therapy is the mainstay for muscle-invasive bladder cancer(MIBC),it has a poor survival ***,this study aimed to evaluate the efficacy of an ATR inhibitor combined with cisplatin in the treatment of APOBEC catalytic subunit 3B(APOBEC3B)expressing ***:Immunohistochemical staining was performed to analyze an association between APOBEC3B and ATR in patients with *** APOBEC3B expression in MIBC cell lines was assessed using real-time polymerase chain reaction and western blot *** blot analysis was performed to confirm differences in phosphorylated Chk1(pChk1)expression according to the APOBEC3B *** viability and apoptosis analyses were performed to examine the anti-tumor activity of ATR inhibitors combined with ***:There was a significant association between APOBEC3B and ATR expression in the tumor tissues obtained from patients with *** with higher APOBEC3B expression showed higher pChk1 expression than cells expressing low APOBEC3B *** treatment of ATR inhibitor and cisplatin inhibited cell growth in MIBC cells with a higher APOBEC3B *** to cisplatin single treatment,combination treatment induced more apoptotic cell death in the cells with higher APOBEC3B ***:Our study shows that APOBEC3B’s higher expression status can enhance the sensitivity of MIBC to cisplatin upon ATR *** result provides new insight into appropriate patient selection for the effective application of ATR inhibitors in MIBC.

关键词： Apolipoprotein B mRNA editing catalytic polypeptide(APOBEC) Ataxia telangiectasia and Rad3-related(ATR) Bladder cancer DNA damage response DNA replication stress

Nomograms and prognosis for superficial esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2024年第10期30卷 1291-1294页

作者： Hong Tao Lin Ahmed Abdelbaki Somashekar G Krishna department of internal medicine Division of GastroenterologyHepatology and NutritionThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

In recent years,endoscopic resection,particularly endoscopic submucosal dis-section,has become increasingly popular in treating non-metastatic superficial esophageal squamous cell carcinoma(ESCC).In this evolving paradigm,it is crucial to identify factors that predict higher rates of lymphatic invasion and poorer *** tumor size,deeper invasion,poorer differentiation,more infiltrative growth patterns(INF-c),higher-grade tumor budding,positive lymphovascular invasion,and certain biomarkers have been associated with lymph node metastasis and increased morbidity through retrospective reviews,leading to the construction of comprehensive nomograms for outcome *** validated by future prospective studies,these nomograms would prove highly applicable in guiding the selection of treatment for superficial ESCC.

关键词： Esophageal cancer Esophageal squamous cell carcinoma Esophageal resection Endoscopic mucosal resection Endoscopic submucosal dissection Lymph node metastasis

Health behavior outcomes in stroke survivors prescribed wearables for atrial fibrillation detection stratified by age

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Journal of Geriatric Cardiology 2024年第3期21卷 323-330页

作者： Joanne Mathew Jordy Mehawej Ziyue Wang Taylor Orwig Eric Ding Andreas Filippaios Syed Naeem Edith Mensah Otabil Alex Hamel Kamran Noorishirazi IrinaRadu Jane Saczynski David D.McManus Khanh-van Tran Division of Cardiovascular medicine Department of MedicineUniversity of Massachusetts Chan Medical SchoolLake Avenue NorthWorcesterUSA department of internal medicine Central Michigan UniversityMount PleasantUSA department of Pharmacy and Health Systems Sciences School of PharmacyNortheastern UniversityBostonUSA department of Population and Quantitative Health Sciences University of Massachusetts Chan Medical SchoolLake Avenue NorthWorcesterUSA

BACKGROUND Smartwatches have become readily accessible tools for detecting atrial fibrillation(AF).There remains limited data on how they affect psychosocial outcomes and engagement in older *** examine the health behavior outcomes of stroke survivors prescribed smartwatches for AF detection stratified by *** We analyzed data from the Pulsewatch study,a randomized controlled trial that enrolled patients(≥50 years)with a history of stroke or transient ischemic attack and CHA2DS2-vASc≥*** participants were equipped with a cardiac patch monitor and a smartwatch-app dyad,while control participants wore the cardiac patch monitor for up to 44 *** evaluated health behavior parameters using standardized tools,including the Consumer Health Activation Index,the Generalized Anxiety Disorder questionnaire,the 12-Item Short Form Health Survey,and wear time of participants categorized into three age groups:Group 1(ages 50-60),Group 2(ages 61-69),and Group 3(ages 70-87).We performed statistical analysis using a mixedeffects repeated measures linear regression model to examine differences amongst age *** Comparative analysis between Groups 1,2 and 3 revealed no significant differences in anxiety,patient activation,perception of physical health and wear *** use of smartwatch technology was associated with a decrease in perception of mental health for Group 2 compared to Group 1(β=-3.29,P=0.046).CONCLUSION Stroke survivors demonstrated a willingness to use smartwatches for AF ***,among these study participants,the majority did not experience negative health behavior outcomes or decreased engagement as age increased.

关键词： prescribed stratified wear

Experience of primary intestinal lymphangiectasia in adults: Twelve case series from a tertiary referral hospital

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World Journal of Clinical Cases 2024年第4期12卷 746-757页

作者： Ji Eun Na Ji Eun Kim Sujin Park Eun Ran Kim Sung Noh Hong Young-Ho Kim Dong Kyung Chang department of internal medicine Inje University Haeundae Paik HospitalBusan 48108South Korea department of medicine Samsung Medical CenterSeoul 06351South Korea department of Pathology Samsung Medical CenterSeoul 06351South Korea

BACKGROUND While primary intestinal lymphangiectasia(PIL)is considered a rare condition,there have been several reported cases in ***,the absence of clear guidance from diagnosis to treatment and prognosis poses challenges for both physicians and *** To enhance understanding by investigating clinical presentation,diagnosis,treatment,complications,and prognoses in adult PIL *** We enrolled adult patients diagnosed with PIL between March 2016 and September *** primary outcome involved examining the diagnosis and treatment process of these *** secondary outcomes included identifying complications(infections,thromboembolism)and assessing prognoses(frequency of hospitalization and mortality)during the follow-up *** Among the 12 included patients,peripheral edema(100%)and diarrhea(75%)were the main presenting *** tests showed that all the pati-ents exhibited symptoms of hypoalbuminemia and ***,the predominant findings were edema of the small intestine(67%)and ascites(58%).The typical endoscopic finding with a snowflake appearance was observed in 75%of *** the 12 patients,two responded positive-ly to octreotide and sirolimus,and eight who could undergo maintenance therapy discontinued *** due to PIL led to infection in half of the patients,thromboembolism in three patients,and one *** PIL can be diagnosed in adults across various age groups,with different severity and treatment responses among patients,leading to diverse complications and ***,tailored treatments will be *** anticipate that our findings will contribute to the management of PIL,an etiology of protein-losing enteropathy.

关键词： Primary intestinal lymphangiectasia in adults Protein-losing enteropathy Diagnosis Treatment Prognosis

value of glucose transport protein 1 expression in detecting lymph node metastasis in patients with colorectal cancer

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World Journal of Clinical Cases 2024年第5期12卷 931-941页

作者： Hongsik Kim Song-Yi Choi Tae-Young Heo Kyeong-Rok Kim Jisun Lee Min Young Yoo Taek-Gu Lee Joung-Ho Han department of internal medicine Chungbuk National University HospitalCheongju 28644South Korea department of Pathology Chungnam National University College of MedicineDaejeon 35015South Korea Information and Statistics Chungbuk National UniversityCheongju 28644South Korea department of Radiology College of MedicineChungbuk National UniversityChungbuk National University HospitalCheongju-si 28644South Korea department of Nuclear medicine School of MedicineInha UniversityIncheon 22332South Korea department of Surgery Chungbuk National UniversityCollege of MedicineCheongju-si 28644South Korea department of internal Medicen Chungbuk National UniversityCollege of medicineCheongju-si 28644South Korea

BACKGROUND There are limited data on the use of glucose transport protein 1(GLUT-1)expre-ssion as a biomarker for predicting lymph node metastasis in patients with colorectal ***-1 and GLUT-3,hexokinase(HK)-II,and hypoxia-induced factor(HIF)-1 expressions may be useful biomarkers for detecting primary tumors and lymph node metastasis when combined with fluorodeoxyglucose(FDG)uptake on positron emission tomography/computed tomography(PET/CT).AIM To evaluate GLUT-1,GLUT-3,HK-II,and HIF-1 expressions as biomarkers for detecting primary tumors and lymph node metastasis with 18F-FDG-PET/*** This retrospective study included 169 patients with colorectal cancer who underwent colectomy and preoperative 18F-FDG-PET/CT at Chungbuk National University Hospital between January 2009 and May *** tissue cores from the central and peripheral areas of the tumors were obtained and were examined by a dedicated pathologist,and the expressions of GLUT-1,GLUT-3,HK-II,and HIF-1 were determined using immunohisto-chemical *** analyzed the correlations among their expressions,various clinicopathological factors,and the maximum standardized uptake value(SUvmax)of PET/*** GLUT-1 was found at the center or periphery of the tumors in 109(64.5%)of the 169 ***-1 positivity was significantly correlated with the SUvmax of the primary tumor and lymph nodes,regardless of the biopsy site(tumor center,Pvely).GLUT-1 positivity and negativity were associated with higher and lower sensitivities of PET/CT,respectively,for the detection of lymph node metastasis,regardless of the biopsy ***3,HK-II,and HIF-1 expressions were not significantly correlated with the SUvmax of the primary tumor and lymph *** GLUT-1 expression was significantly correlated with the SUvmax of 18F-FDG-PET/CT for primary tumors and lymph *** should consider GLUT-1 expression in preoperative endoscop

关键词： 18F-FDG-PET-CT Biomarker Colorectal neoplasms Glucose transporter type 1 Lymph node

Mechanism of Qili Qiangxin Capsule for Heart Failure Based on miR133a-Endoplasmic Reticulum Stress

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Chinese Journal of Integrative medicine 2024年第5期30卷 398-407页

作者： JI Xiao-di YANG Ding CUI Xi-yuan LOU Li-xia NIE Bo ZHAO Jiu-li ZHAO Ming-jing WU Ai-ming Dongzhimen Hospital Affiliated to Beijing University of Chinese medicine Key Laboratory of Chinese Internal Medicine of Ministry of Education and BeijingBeijing 100700China department of Traditional Chinese medicine Fuwai HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Objective:To investigate the pharmacological mechanism of Qili Qiangxin Capsule(QLQX)improvement of heart failure(HF)based on miR133a-endoplasmic reticulum stress(ERS)***:A left coronary artery ligation-induced HF after myocardial infarction model was used in this *** were randomly assigned to the sham group,the model group,the QLQX group[0.32 g/(kg·d)],and the captopril group[2.25 mg/(kg·d)],15 rats per group,followed by 4 weeks of *** function such as left ventricular ejection fraction(EF),fractional shortening(FS),left ventricular systolic pressure(LvSP),left ventricular end diastolic pressure(LvEDP),the maximal rate of increase of left ventricular pressure(+dp/dt max),and the maximal rate of decrease of left ventricular pressure(–dp/dt max)were monitored by echocardiography and *** and eosin(HE)and Masson stainings were used to visualize pathological changes in myocardial *** m RNA expression of mi R133a,glucose-regulated protein78(GRP78),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6),X-box binding protein1(XBP1),C/EBP homologous protein(CHOP)and Caspase 12 were detected by *** protein expression of GRP78,p-IRE1/IRE1ratio,cleaved-ATF6,XBP1-s(the spliced form of XBP1),CHOP and Caspase 12 were detected by Western *** T-mediated d UTP nick-end labeling(TUNEL)staining was used to detect the rate of ***:QLQX significantly improved cardiac function as evidenced by increased EF,FS,LvSP,+dp/dt max,-dp/dt max,and decreased LvEDP(Pvolume fraction in myocardial tissue(Pve

关键词： heart failure Qili Qiangxin Capsule miR133a endoplasmic reticulum stress apoptosis

Congestive ischemic colitis successfully treated with antiinflammatory therapy: A case report

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World Journal of Clinical Cases 2024年第1期12卷 142-147页

作者： Geon Woo Lee Su Bum Park department of internal medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan HospitalYangsan 50612South Korea

BACKGROUND Congestive ischemic colitis is a rare subtype of ischemic colitis with an unknown *** conservative management,such as fasting,no established treatment exists;therefore,surgical intervention should be considered in some cases if symptoms *** literature suggests that anti-inflam-matory agents may effectively treat congestive ischemic *** SUMMARY We present the case of a 68-year-old female patient who underwent laparoscopic left hemicolectomy for transverse colon cancer 3 years ***,follow-up included an annual colonoscopy and abdominal computed tomography(CT)at a local ***,progressive erythema and edema of the sigmoid colon were observed 1 year *** admission to our hospital,she complained of abdominal pain and *** CT showed thickening of the sigmoid colon walls,and colonoscopy revealed erythema,edema,and multiple ulcers with exudate in the sigmoid *** angiography showed engorgement of the sigmoid vasa recta without any vascular *** diagnosis was congestive ischemic colitis,and we treated the patient with anti-inflammatory *** 2 mo of glucocorticoid therapy(20 mg once daily)and 7 mo of 5-aminosalicylate therapy(1 g twice daily),the ulcers completely *** has not experienced any recurrence for 2 *** Anti-inflammatory therapy,specifically glucocorticoids and 5-aminosalicylate,has demonstrated promising efficacy and introduces potential novel treatment options for congestive ischemic colitis.

关键词： Ischemic colitis Glucocorticoids 5-aminosalicylate Colon cancer