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Appropriateness of indication and diagnostic yield of colonoscopy: First report based on the 2000 guidelines of the American Society for Gastrointestinal Endoscopy

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World Journal of Gastroenterology 2005年第44期11卷 7007-7013页

作者： Iqbal Siddique Krishna Mohan Fuad Hasan Anjum Memon Istvan Patty Basil Al-Nakib department of Medicine Thunayan Al-Ghanim Gastroenterology Center department of Public Health and primary care

AIM: To assess the appropriateness of referrals and to determine the diagnostic yield of colonoscopy according to the 2000 guidelines of the American Society for Gastrointestinal Endoscopy (ASGE).METHODS: A total of 736 consecutive patients (415males, 321 females; mean age 43.6±16.6 years)undergoing colonoscopy during October 2001-March2002 Were prospectively enrolled in the study. The 2000ASGE guidelines were used to assess the appropriateness of the indications for the procedure. Diagnostic yield was defined as the ratio between significant findings detected on colonoscopy and the total number of procedures performed for that ***: The large majority (64%) of patients had colonoscopy for an indication that was considered'generally indicated'; it was 'generally not indicated' for20%, and it was 'not listed' for 16% in the *** diagnostic yield of colonoscopy was highest for the 'generally indicated' (38%) followed by 'not listed'(13%) and 'generally not indicated' (5%) *** the multivariable analysis, the diagnostic yield was independently associated with the appropriateness of indication that was 'generally indicated' (odds ratio=12.3) and referrals by gastroenterologist (odds ratio = 1.9).CONCLUSION: There is a high likelihood of inappropriate referrals for colonoscopy in an open-access endoscopy system. The diagnostic yield of the procedure is dependent on the appropriateness of indication and referring physician's specialty. Certain indications 'not listed' in the guidelines have an intermediate diagnostic yield and further studies are required to evaluate whether they should be included in future revisions of the ASGE guidelines.

关键词： Colonoscopy Indications Diagnostic yield Guidelines Appropriateness

Sleep as a window to understand and regulate Alzheimer's disease:emerging roles of thalamic reticular nucleus

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Neural Regeneration Research 2025年第6期20卷 1711-1712页

作者： Haoqi Sun Shiqian Shen Robert J.Thomas M.Brandon Westover Can Zhang department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Center for Translational Pain Research Department of AnesthesiaCritical Care and Pain MedicineMassachusetis General HospitalHarvard Medical SchoolBostonMAUSA Division of Pulmonary Critical Care and Sleep MedicineDepartment of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Genetics and Aging Research Unit McCance Center for Brain HealthMass General Institute for Neurodegenerative DiseaseDepartment of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA

Introduction:Alzheimer 's disease(AD) is a common neurodegenerative disorder and the primary cause of dementia. Considerable evidence supports the “amyloid hypothesis,” stating that the pathogenesis of AD is primarily caused by the deposition of amyloid-β(Aβ), which drives tau phosphorylation, neuroinflammation, and neurodegeneration in the brain. The amyloid hypothesis is strengthened by the significant and moderate benefit of lecanemab, a humanized antibody through an anti-amyloid mechanism,showing slowed clinical decline(van Dyck et al.,2023). The recent positive results of anti-amyloid trials have brought back focus on the amyloid hypothesis through biochemical, genetic, and pharmacological approaches(Zhang, 2023).

关键词： Alzheimer inflammation hypothesis

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Projective Hilbert modules and sequential approximations

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Science China Mathematics 2025年第1期 137-168页

作者： Lawrence G.Brown Huaxin Lin department of Mathematics Purdue University department of Mathematics East China Normal University department of Mathematics University of Oregon Shanghai Institute for Mathematics and interdisciplinary Sciences

We show that when A is a separable C*-algebra,every countably generated Hilbert A-module is projective（with bounded module maps as morphisms）.We also study the approximate extensions of bounded module *** the case where A is a σ-unital simple C*-algebra with strict comparison,and every strictly positive lower semicontinuous affine function on quasitraces can be realized as the rank of an element in the Cuntz semigroup,we show that the Cuntz semigroup is equivalent to unitarily equivalent classes of countably generated Hilbert A-modules if and only if A has stable rank one.

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Expression of macrophage migration inhibitory factor is associated with enhanced angiogenesis and advanced stage in gastric carcinomas

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World Journal of Gastroenterology 2005年第24期11卷 3767-3771页

作者： Chia-Tung Shun Jaw-Town Lin Shih-Pei Huang Min-Tsan Lin Ming-Shiang Wu department of Forensic Medicine and Pathology department of Internal Medicine and primary care Medicine department of Surgery

AIM: Macrophage migration inhibitory factor (MIF) was reported to inactivate p53 and play an essential role in the growth and angiogenesis of tumors that arise at sites of chronic inflammation. Gastric inflammation is a prerequisite for the development of gastric carcinoma (GC), which has recently been linked to Helicobacter pylori (H pylori) infection. This study aimed to investigate dinicopathological significance of MIF expression in GCs. METHODS: We selected 90 consecutive patients with GCs for investigation of the relation among MIF status, clinicopathological parameters, p53 expression and angiogenesis. MIF and p53 expression was assessed by immunohistochemistry as positive and negative groups. Tumor vascularity was evaluated by counting microvessel density on anti-CD34 stained sections. Expression status of MIF was correlated with determined dinicopathological data, p53 immunoreactivity and microvessel counts. RESULTS: Strong immunostainings of MIF were observed in the cytoplasm of cancerous cells in 40% (36/90) of cases but not in normal or metaplastic epithelia. There was no statistically significant correlation between MIF expression and age, gender, H pylori infection, tumor location, histological subtypes, lymph node metastasis or p53 expression. Early GC less frequently overexpressed MIF as compared to advanced GCs (4/20 vs 32/70, P= 0.04). A remarkably increased microvessel count was noted in GCs with MIF expression than those without MIF expression (55.1±30.1 vs 31.3±28.8, P= 0.0001). CONCLUSION: Our results suggest that expression of MIF may contribute to the progression and enhanced angiogenesis in a substantial portion of GCs.

关键词： Gastric cancer H pylori Angiogenesis

Prognostic value of alcohol consumptionand some other dietary habits for survival in a cohort of Chinese men with lung cancer

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Chinese Journal of Cancer 2017年第7期36卷 298-305页

作者： Wentao Li Lap Ah Tse Joseph S.K.Au Kai Shing Yu Feng Wang Ignatius Tak-sun Yu JC School of Public Health and primary care The Chinese University of Hong Kong4F School of Public Health and Primary CarePrince of Wales Hospital department of Clinical Oncology Hong Kong Adventist Hospital

Background:Alcohol consumption and some other dietary habits are thought to be associated with lung cancer ***,the effects of these habits on lung cancer prognosis have been studied *** purpose of this study was to address these gaps in ***:We studied a cohort of 1052 Chinese men in Hong Kong who were diagnosed with primary lung *** proportional hazards models were used to determine the prognostic values of consumption of alcohol,fresh fruits or vegetables,meat,and fried or preserved ***:Compared with never drinkers,men who drank alcohol 1-3 days per week had a more favorable lung cancer prognosis(hazard ratio[HR]:0.82,95%confidence interval[CI]0.68-0.97);however,this survival advantage was not significant in men who drank alcohol more frequently(HR:0.91,95%CI 0.73-1.14).Compared with men who consumed preserved or fried food only occasionally,men who consumed these foods frequently had a higher risk of lung cancer mortality(HR:1.20,95%CI 1.00-1.42).Conclusions:Occasional consumption of alcohol was a favorable survival factor for Chinese men with lung ***,this survival benefit did not exist for frequent drinkers of *** men with lung cancer who were frequent consumers of fried or preserved food had a worse prognosis than those who consumed these foods only occasionally.

关键词： Dietary habits Alcohol Lung cancer Prognosis Epidemiology

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Vector meson's spin alignments in high energy reactions

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Science China(Physics,Mechanics & Astronomy) 2025年第1期Mechanics & Astronomy) .卷 5-20页

作者： Jin-Hui Chen Zuo-Tang Liang Yu-Gang Ma Xin-Li Sheng Qun Wang Key Laboratory of Nuclear Physics and Ion-beam Application (MoE) Institute of Modern PhysicsFudan University Institute of Frontier and interdisciplinary Science Key Laboratory of Particle Physics and Particle Irradiation (MOE)Shandong University INFN-Firenze department of Modern Physics University of Science and Technology of China School of Mechanics and Physics Anhui University of Science and Technology

The global spin alignment of vector mesons has been observed by the STAR collaboration at the Relativistic Heavy Ion Collider （RHIC） at Brookhaven National Laboratory （BNL）.It provides a unique opportunity to probe the correlation between the polarized quark and antiquark in the strongly coupled quark-gluon plasma （sQGP） produced in relativistic heavy ion collisions,opening a new window to explore the properties of s *** addition,spin alignments of vector mesons have also been observed in other high-energy particle collisions such as e+e-annihilations at high energies where hadron production is dominated by quark fragmentation *** results obtained are quite different from those obtained in heavy ion collisions where quark coalescence/combination mechanism dominates suggesting strong dependence on hadronization *** comprehensive studies in different hadronization processes are *** this article,we present a brief review of theoretical and experimental advances in the study of vector meson’s spin alignments in a variety of high-energy particle collisions,with emphasis on hadronization mechanisms.

关键词： vector meson spin alignment global polarization relativistic heavy ion collisions fragmentation

Deprescribing antihypertensive treatment in nursing home patients and the effect on blood pressure

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Journal of Geriatric Cardiology 2018年第4期15卷 275-283页

作者： Christine Gulla Elisabeth Flo Reidun LS Kjome Bettina S Husebo Centre for Elderly and Nursing Home Medicine Department of Global Public Health and Primary Care University of Bergen Norway department of Clinical Psychology University of Bergen Norway Centre for Pharmacy/department of Global Public Health and primary care University of Bergen Norway Municipality of Bergen Bergen Norway

Background It is debatable whether treating multimorbid nursing home patients with antihypertensive drugs produces beneficial effects. Most cardiovascular guidelines promote treatment; few have advice on how to deprescribe when treatment may no longer be necessary. We investigated the effect of medication review on antihypertensive drug use and the association between cognition, blood pressure, and prescribing. Methods From August 2014 to December 2015, 765 patients from 72 units （clusters） in 32 Norwegian nursing homes were included in a 4-month, multicentre, cluster-randomized, controlled trial, with 9-month follow-up. Patients ≥ 65 years old with antihypertensive treatment （n = 295, 39%） were randomized to systematic medication review where the physician received support from peers （collegial mentoring） or were given care as usual （control condition）. Outcome measures were the number of antihypertensive drugs, systolic blood pressure, and pulse. We used hospitalizations and deaths as criteria to assess harm. Results At baseline, each patient used 9.2 ± 3.5 regular drugs, and 1.6 ± 0.7 antihypertensives. Mean blood pressure was 128/71 mmHg and 9% had a systolic pressure ≥ 160 mmHg. Between baseline and month four, antihypertensives were deprescribed to a significantly higher extent in the intervention group （n = 43, 32%） compared to control （n = 11, 10%）; Incidence Rate Ratio = 0.8, 95% CI = 0.7？0.9. In the intervention group, there was an immediate increase in systolic blood pressure when antihypertensives were reduced, from baseline 128 ± 19.5 mmHg to 143 ± 25.5 mmHg at month four. However, at month nine, the blood pressure had reverted to baseline values （mean 134 mmHg）. Deprescription did not affect pulse and systolic pressure. The number of hospitalizations was higher in control patients at month four （P = 0.031） and nine （P = 0.041）. Conclusion A systematic medication review supported by collegial mentoring significantly decreased the use of antihypertensive

关键词： Antihypertensive drugs Deprescribing Hypertension Long-term care Medication review

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Antibiotic use in early childhood and risk of obesity: longitudinal analysis of a national cohort

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World Journal of Pediatrics 2019年第4期15卷 390-397页

作者： Dervla Kelly Alan Kelly Tom O'Dowd Catherine B.Hayes department of Public Health and primary care Trinity College DublinRussell CenterTallaght CrossDublin 24Ireland

Background Taking oral antibiotics during childhood has been linked with an increased risk of childhood *** study assessed any potential association in number of courses of antibiotics taken between 2-3 and 4-5 years of age and body mass trajectory up to age *** The study was a secondary analysis of 8186 children and their parents from the infant cohort of the Irish National Longitudinal Study of *** use was measured by parental recall between ages 2-3 and *** models described the relationship between antibiotic exposure and body mass index (BMI) standard deviation scores andbinary outcomes,and examined interactions between covariates,which included socioeconomic status,diet assessed by food frequency questionnaires and maternal *** Any antibiotic usage between 2 and 3 years did not predict risk of overweight or obesity at age *** or more courses of antibiotics between 2 and 3 years were independently associated with obesity at age 5 (odds ratio 1.6,95% confidence interval 1.11-2.31).Effect size was modest (coefficient + 0.09 body mass SD units,standard error 0.04,P =0.037).Maternal BMI modified the relationship:≥ 4 courses of antibiotics between 2 and 3 years were associated with a + 0.12 body mass SD units increase in weight at age 5 among children of normal-weight mothers (P=0.035),but not in children of overweight *** Number of antibiotic courses,rather than antibiotic use,may be an important factor in any link between early antibiotic exposure and subsequent childhood *** is needed to confirm differential effects on babies of normal versus overweight/obese mothers independent of socioeconomic factors.

关键词： Antibiotics Body mass index Early childhood Infants Obesity

Haplotype of prostaglandin synthase 2/cyclooxygenase 2 is involved in the susceptibility to inflammatory bowel disease

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World Journal of Gastroenterology 2005年第38期11卷 6003-6008页

作者： David G Cox J Bart A Crusius Petra HM Peeters H Bas Bueno-de-Mesquita A Salvador Pe(n|~)a Federico Canzian International Agency for Research on Cancer Laboratory of Immunogenetics Julius Center for Health Sciences and primary care department of Epidemiology Laboratory of Immunogenetics and department of Gastroenterology

AIM： Prostaglandin G/H synthase 2 （PTGS2 or COX2） is one of the key factors in the cellular response to inflammation. PTGS2 is expressed in the affected intestinal segments of patients with inflammatory bowel diseases （IBD）. In IBD patients, non-steroidal anti-inflammatory drugs, which have been shown to reduce both the production and activity of PTGS2, may activate IBD and aggravate the symptoms. We aimed at examining genetic variants of PTGS2 that may be risk factors for IBD. METHODS： We genotyped 291 individuals diagnosed with IBD and 367 controls from the Dutch population for the five most frequent polymorphisms of the PTG52 gene. Clinical data were collected on all patients. DNA was extracted via normal laboratory methods. Genotyping was carried out using multiplex PCR followed by the Invader Assay and the 5＇ exonuclease assay （TaqMan）. New polymorphism screening was performed by pre-screening with denaturing high-performance liquid chromatography, followed by fluorescent sequencing. RESULTS： Allele 5209G was weakly associated with Crohn＇s disease （odds ratio [OR] 1.63, 95% confidence interval [CI] 1.03-2.57）, and allele 8473T with ulcerativecolitis （OR 1.50, 95%CI 1.00-2.27）. The haplotype including both alleles showed a strong association with IBD （OR 13.15, 95%CI 3.17-116.15）. This haplotype, while rare （-0.3%） in the general population, is found more frequently in patients （3.5%）. CONCLUSION： Our data suggest that this haplotype of PTGS2 contributes to the susceptibility of IBD.

关键词： Inflammatory bowel disease Prostaglandin G/H synthase Cyclooxygenase SNP Haplotype