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Platycodon grandiflorum extract represses up-regulated adipocyte fatty acid binding protein triggered by a high fat feeding in obese rats

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World Journal of Gastroenterology 2007年第25期13卷 3493-3499页

作者： Yoon Shin Park Yoosik Yoon Hong Seok Ahn division of intractable diseases Center for Biomedical Sciences National Institute of Health 194 Tongillo Eunpyeong-gu Seoul 122-701 South Korea College of Medicine Chung Ang University 221 Heukseok-dong Dongjak-gu Seoul 156-756 South Korea Sungshin Women's University Department Food and Nutrition 5 Dongsun-Dong Sungbuk-Gu Seoul 136-742 South Korea

AIM: To investigate the effect of Platycodon grandi- florum extract (PGE) on lipid metabolism and FABP mRNA expression in subcutaneous adipose tissue of high fat diet-induced obese rats. METHODS: PGE was treated to investigate the inhibitory effect on the pre-adipocyte 3T3-L1 differentiation and pancreatic lipase activity. Male Sprague-Dawley rats with an average weight of 439.03 ± 7.61 g were divided into four groups: the control groups that fed an experimental diet alone (C and H group) and PGE treatment groups that administered PGE along with a control diet or HFD at a concentration of 150 mg/kg body weight (C + PGE and H + PGE group, respectively) for 7 wk. Plasma total cholesterol (TC) and triglycerol (TG) concentrations were measured from the tail vein of rats. Adipocyte cell area was measured from subcutaneous adipose tissue and the fatty acid binding protein (FABP) mRNA expression was analyzed by northern blot analysis. RESULTS: PGE treatment inhibited 3T3-L1 pre-adipocyte differentiation and fat accumulation, and also decreased pancreatic lipase activity. In this experiment, PGE signifi cantly reduced plasma TC and TG concentrations as well as body weight and subcutaneous adipose tissue weight. PGE also significantly decreased the size of subcutaneous adipocytes. Furthermore, it significantly repressed the up-regulation of FABP mRNA expression induced by a high-fat feeding in subcutaneous adipose tissue. CONCLUSION: PGE has a plasma lipid lowering-effect and anti-obesity effect in obese rats fed a high fat *** these results, we can suggest the possibility that PGE can be used as a food ingredient or drug component to therapeutically control obesity.

关键词： Obesity High fat diet Platycodon grandiflorum extract Fatty acid binding protein Subcutaneousadipose tissue

Vagus nerve stimulation for refractory epilepsy:long term efficacy and side-effects

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Chinese Medical Journal 2004年第1期117卷 58-61页

作者：許志輝蓝明權黄家星祈理治潘偉生 division of Neurology Department of MedicineDivision of NeurosurgeryDepartment of SurgeryPrince of Wales Hospital the Chinese University of Hong KongHong Kong Special Administrative Region

Background In general vagus nerve stimulation (VNS) can serve as an adjunctive treatment for patients with refractory partial -onset seizures. And we evaluated the long-term efficacy and safety of VNS in a group of Chinese patients with refratory epilepsy. Methods Of 127 patients with refractory epilepsy,13 patients who were not eligible for surgical intervention were implanted with the Cyberonics VNS system. Seizure frequency,physical examination and side effects profile were recorded at follow-up visits for a minimum of 18 months. Results Mean duration of treatment was 47.4 months,and the longest follow-up period was 71 months. Mean baseline seizure frequency was 26.6 seizures per month. The mean percentage reductions in convulsions were 33.2%,47.1% and 40.0% at 6,12 and 18 months,respectively. One patient became seizure free,and six (46%) had 50% or more reduction in seizure frequency. Response was poor (intractable convulsions.

关键词： refractory epilepsy·vagus nerve stimulation·epilepsy surgery·Chinese population

Management of acute pancreatitis in Japan: analysis of nationwide epidemiological survey

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World Journal of Gastroenterology 2016年第28期22卷 6335-6344页

作者： Shin Hamada Atsushi Masamune Tooru Shimosegawa division of Gastroenterology Tohoku University Graduate School of Medicine

Acute pancreatitis(AP) is an acute inflammatory disease of the exocrine pancreas. In Japan, nationwide epidemiological surveys have been conducted every 4 to 5 years by the Research Committee of intractable Pancreatic diseases, under the support of the Ministry of Health, Labour, and Welfare of Japan. We reviewed the results of the nationwide surveys focusing on the severity assessment and changes in the therapeutic strategy for walled-off necrosis. The severity assessment system currently used in Japan consists of 9 prognostic factors and the imaging grade on contrastenhanced computed tomography. By univariate analysis, all of the 9 prognostic factors were associated with AP-related death. A multivariate analysis identified 4 out of the 9 prognostic factors(base excess or shock, renal failure, systemic inflammatory response syndrome criteria, and age) that were associated with AP-related death. Receiver-operating characteristics curve analysis showed that the area under the curve was 0.82 for these 4 prognostic factors and 0.84 for the 9 prognostic factors, suggesting the comparable utility of these 4 factors in the severity assessment. We also examined the temporal changes in treatment strategy for walled-off necrosis in Japan according to the 2003, 2007, and 2011 surveys. Step-up approaches and lessinvasive endoscopic therapies were uncommon in 2003 and 2007, but became popular in 2011. Mortality has been decreasing in patients who require intervention for walled-off necrosis. In conclusion, the nationwide survey revealed the comparable utility of 4 prognostic factors in the severity assessment and the increased use of less-invasive, step-up approaches with improved clinical outcomes in the management of walled-off necrosis.

关键词： Endoscopic necrosectomy Diagnostic criteria Epidemiology Pancreatic pseudocyst Systemic inflammatory response syndrome Step-up approach Walled-off necrosis

Helicobacter pylori-associated immune thrombocytopenia:Clinical features and pathogenic mechanisms

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World Journal of Gastroenterology 2014年第3期20卷 714-723页

作者： Masataka Kuwana division of Rheumatology Department of Internal MedicineKeio University School of Medicine

Immune thrombocytopenia (ITP) is an autoimmune disease mediated by anti-platelet autoantibodies. There is growing evidence that the eradication of Helicobacter pylori (H. pylori) effectively increases platelet count in a considerable proportion of ITP patients infected with this bacterium. In the majority of ITP patients responding to H. pylori eradication therapy, the anti-platelet autoantibody response is completely resolved with no relapse for more than 7 years, indicating that the disease is cured. Therefore, adult patients with suspected ITP should be examined for H. pylori infection, and eradication therapy is recommended if the infection is present. Notably, however, the efficacy of H. pylori eradication therapy in ITP patients varies widely among countries, with a higher response rate in Japan compared with the United States and European countries other than Italy. The pathogenesis of H. pylori-associated ITP is still uncertain, although the mechanisms are known to involve multiple factors. H. pylori may modulate the Fcγ-receptor balance of monocytes/macrophages in favor of activating Fcγ receptors, and H. pylori components may mimic the molecular makeup of platelet antigens. Further studies of the pathogenic process of H. pylori-associated ITP may be useful for the development of new therapeutic strategies for ITP.

关键词： Autoantibody, Childhood, Helicobacter pylori, Fcγ receptor, Immune thrombocytopenia, Idiopathic thrombocytopenic purpura, Systemic lupus erythematosus

Pancreatic duct drainage using EUS-guided rendezvous technique for stenotic pancreaticojejunostomy

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World Journal of Gastroenterology 2013年第31期19卷 5182-5186页

作者： Tetsuya Takikawa Atsushi Kanno Atsushi Masamune Shin Hamada Eriko Nakano Shin Miura Hiroyuki Ariga Jun Unno Kiyoshi Kume Kazuhiro Kikuta Morihisa Hirota Hiroshi Yoshida Yu Katayose Michiaki Unno Tooru Shimosegawa division of Gastroenterology Tohoku University Graduate School of Medicine Miyagi 980-8574 Japan division of Hepato-biliary-Pancreatic Surgery Tohoku University Graduate School of Medicine Miyagi 980-8574 Japan

The patient was a 30-year-old female who had undergone excision of the extrahepatic bile duct and Rouxen-Y hepaticojejunostomy for congenital biliary dilatation at the age of ***,she suffered from recurrent acute pancreatitis due to pancreaticobiliary maljunction and received subtotal stomach-preserving *** developed a pancreatic fistula and an intra-abdominal abscess after the *** complications were improved by percutaneous abscess drainage and antibiotic *** ever,upper abdominal discomfort and the elevation of serum pancreatic enzymes persisted due to stenosis from the *** we could not accomplish dilation of the stenosis by endoscopic retrograde cholangiopancreatography,we tried an endoscopic ultrasonography(EUS) guided rendezvous technique for pancreatic duct *** transgastric puncture of the pancreatic duct using an EUS-fine needle aspiration needle,the guidewire was inserted into the pancreatic duct and finally reached to the jejunum through the stenotic *** changed the echoendoscope to an oblique-viewing endoscope,then grasped the guidewire and withdrew it through the *** stenosis of the pancreaticojejunostomy was dilated up to 4 mm,and a pancreatic stent was put in *** the pancreatic stent was removed after three months,the patient remained *** duct drainage using an EUS-guided rendezvous technique was useful for the treatment of a stenotic pancreaticojejunostomy after pancreaticoduodenectomy.

关键词： Balloon dilatation Endoscopic ultrasoundguided fine needle aspiration Pancreaticobiliary maljunction Pancreaticoduodenectomy Pancreatitis Postoperative complication

Total pancreatectomy with islet cell transplantation vs intrathecal narcotic pump infusion for pain control in chronic pancreatitis

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World Journal of Gastroenterology 2016年第16期22卷 4160-4167页

作者： Mohamad Mokadem Lama Noureddine Thomas Howard Lee Mc Henry Stuart Sherman Evan L Fogel James L Watkins Glen A Lehman division of Gastroenterology and Hepatology Roy J. and Lucille A. Carver College of Medicine University of Iowa Iowa IA 52242 United States division of Nephrology and Hypertension Roy J. and Lucille A. Carver College of Medicine University of Iowa Iowa IA 52242 United States Community Health Network Indianapolis IN 46219 United States division of Gastroenterology and Hepatology Indiana University Medical Center Indianapolis IN 46202 United States

AIM: To evaluate pain control in chronic pancreatitis patients who underwent total pancreatectomy with islet cell transplantation or intrathecal narcotic pump ***: We recognized 13 patients who underwent intrathecal narcotic pump(ITNP) infusion and 57 patients who underwent total pancreatectomy with autologous islet cell transplantation(TP + ICT) for chronic pancreatitis(CP) pain control between 1998 and 2008 at Indiana University Hospital. All patients had already failed multiple other modalities for pain control and the decision to proceed with either intervention was made at the discretion of the patients and their treating physicians. All patients were evaluated retrospectively using a questionnaire inquiring about their pain control(using a 0-10 pain scale), daily narcotic dose usage, and hospital admission days for pain control before each intervention and during their last follow-up. RESULTS: All 13 ITNP patients and 30 available TP + ICT patients were evaluated. The mean age was approximately 40 years in both groups. The median duration of pain before intervention was 6 years and 7 years in the ITNP and TP + ICT groups, respectively. The median pain score dropped from 8 to 2.5(on a scale of 0-10) in both groups on their last follow up. The median daily dose of narcotics also decreased from 393 mg equivalent of morphine sulfate to 8 mg in the ITNP group and from 300 mg to 40 mg in the TP + ICT group. No patient had diabetes mellitus(DM) before either procedure whereas 85% of those who underwent pancreatectomy were insulin dependent on their last evaluation despite ICT. CONCLUSION: ITNP and TP + ICT are comparable for pain control in patients with CP however with high incidence of DM among those who underwent TP + ICT. Prospective comparative studies and longer follow up are needed to better define treatment outcomes.

关键词： Chronic pancreatitis intractable pain Total pancreatectomy Islet cell transplantation Intrathecal narcotic pump infusion

Predictors of pain response after endoscopic ultrasound-guided celiac plexus neurolysis for abdominal pain caused by pancreatic malignancy

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World Journal of Gastroenterology 2021年第1期27卷 69-79页

作者： Chao-Qun Han Xue-Lian Tang Qin Zhang Chi Nie Jun Liu Zhen Ding division of Gastroenterology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022Hubei ProvinceChina

BACKGROUND Endoscopic ultrasound-guided celiac plexus neurolysis(EUS-CPN)has gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated ***,response to treatment is *** To identify the efficacy of EUS-CPN and explore determinants of pain response in EUS-CPN for pancreatic cancer-associated *** A retrospective study of 58 patients with abdominal pain due to inoperable pancreatic cancer who underwent EUS-CPN were *** efficacy for palliation of pain was evaluated based on the visual analog scale pain score at 1 wk and 4 wk after *** and multivariable logistic regression analyses were performed to explore predictors of pain *** A good pain response was obtained in 74.1%and 67.2%of patients at 1 wk and 4 wk,*** located in the body/tail of the pancreas and patients receiving bilateral treatment were weakly associated with a good *** analysis revealed patients with invisible ganglia and metastatic disease were significant factors for a negative response to EUS-CPN at 1 wk and 4 wk,respectively,particularly for invasion of the celiac plexus(odds ratio(OR)=13.20,P=0.003 for 1 wk and OR=15.11,P=0.001 for 4 wk).No severe adverse events were *** EUS-CPN is a safe and effective form of treatment for intractable pancreatic cancer-associated *** ganglia,distant metastasis,and invasion of the celiac plexus were predictors of less effective response in EUS-CPN for pancreatic cancer-related *** these patients,efficacy warrants attention.

关键词： Endoscopic ultrasound Celiac plexus neurolysis Pancreatic cancer Pain Predictor

Advances in surgical applications of growth factors for wound healing

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Burns & Trauma 2019年第1期7卷 85-97页

作者： Sho Yamakawa Kenji Hayashida division of Plastic and Reconstructive Surgery Shimane University Faculty of Medicine89-1 Enya-choIzumoShimane 693-8501Japan

Growth factors have recently gained clinical importance for wound *** of recombinant growth factors has been shown to mimic cellmigration,proliferation,and differentiation in vivo,allowing for external modulation of the healing *** drug delivery systems can enhance the biological activity of these growth factors,which have a very short in vivo half-life after topical *** the basic mechanisms of these growth factors are well understood,most have yet to demonstrate a significant impact in animal studies or small-sized clinical *** this review,we emphasized currently approved growth factor therapies,including a sustained release system for growth factors,emerging therapies,and future research possibilities combined with surgical *** seeking to understand wound healing at a systemic level are currently ***,further research and consideration in surgery will be needed to provide definitive confirmation of the efficacy of growth factor therapies for intractable wounds.

关键词： Wound healing Growth factor Surgical application

The effectiveness and safety of the RESTORE R drug-eluting balloon versus a drug-eluting stent for small coronary vessel disease： study protocol for a multi-center, randomized, controlled trial

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Journal of Geriatric Cardiology 2018年第7期15卷 469-475页

作者： Yi-Da TANG Shu-Bin QIAO Xi SU Yun-Dai CHEN Ze-Ning JIN Hui CHEN Biao XU Xiang-Qing KONG Wen-Yue PANG Yong LIU Zai-Xin YU Xue LI Hui LI Yan-Yan ZHAO Wei LI Jian TIAN Chang-Dong GUAN Bo XU Run-Lin GAO Department of Cardiology Fu Wai Hospital National Centerfor Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China Department of Cardiology Wuhan Asia Heart Hospital Wuhan Hubei China Department of Cardiology Chinese PLA General Hospital Beijing China Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing China Department of Cardiology Beijing Friendship Hospital Capital Medical University Beijing China Department of Cardiology Affiliated Nanjing Drum Tower Hospital of Nanjing University School of Medicine Nanjing Jiangsu China Department of Cardiology Jiangsu Province Hospital the First Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu China Department of Cardiology Shengjing Hospital of China Medical University Shenyang Liaoning China Department of Cardiology The Fourth Central Hospital of Tianjin Tianjin China Department of Cardiology Xiangya Hospital of Central South University Changsha Hunan China Department of Cardiology Tangdu Hospital of the Fourth Military Medical University Xi 'an Shannxi China Department of Cardiology Daqing Oilfield General Hospital Daqing Heilongjiang China division of Biometrics National Center for Cardiovascular Diseases of China Beijing China Catheterization Laboratories Fu Wai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences Beijing China

bjective Small coronary vessel disease （disease affecting coronary vessels with main branch diameters of 〈 2.75 mm） is a common and intractable problem in percutaneous coronary intervention （PCI）. This study was designed to test the theory that the effectiveness and safety of drug-eluting balloons for the treatment of de novo lesions in small coronary vessels are non-inferior to those of drug-eluting stents. Methods We designed a prospective, multicenter, randomized, controlled clinical trial aiming to assess the effectiveness and safety of the RESTORE R （Cardionovum, Bonn, Germany） drug-eluting balloon （DEB） versus the RESOLUTE R （Medtronic, USA） drug-eluting stent （DES） in the treatment of small coronary vessel disease. This trial started in August 2016. A total of 230 patients with a reference vessel diameter （RVD）〉 2.25 mm and 〈 2.75 mm were randomly assigned to treatment with a DEB or a DES at a 1：1 ratio. The study was also designed to enroll 30 patients with an RVD 〉 2.00 mm and 〈 2.25 mm in the tiny vessel cohort. Results The key baseline data include demographic characteristics, relative medical history, baseline angiographic values and baseline procedural characteristics. The primary endpoint is in-segment diameter stenosis at nine months after the index procedure. Secondary endpoints include acute success, all-cause death, myocardial infarction, target vessel revascularization, target lesion revascularization and stent thrombosis. Conclusions The study will evaluate the clinical efficacy, angiographic outcomes, and safety of DEBs compared to DESs in the treatment of de novo coronary artery lesions in small vessels.

关键词： Drag eluting balloon Percutaneous coronary intervention Small vessel disease