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Comprehensive lifestyle intervention vs soy protein-based meal regimen in non-alcoholic steatohepatitis

World Journal of Gastroenterology 2019年第9期25卷 1116-1131页

作者： Peter Deibert Adhara Lazaro Denise Schaffner Aloys Berg Daniel Koenig Wolfgang Kreisel Manfred W Baumstark Daniel Steinmann martin Buechert Thomas Lange faculty of medicine Department of MedicineInstitute of Exercise and Occupational MedicineMedical CenterUniversity of Freiburg Department of Nutrition Institute for Sports and Sports ScienceUniversity of Freiburg faculty of medicine Department of MedicineDivision of GastroenterologyHepatologyEndocrinology and Infectious DiseasesMedical CenterUniversity of Freiburg University Hospital of Freiburg Occupational Medicine faculty of medicine Department of Radiology-Medical PhysicsMedical CenterUniversity of Freiburg

BACKGROUND Non-alcoholic steatohepatitis(NASH) has become one of the leading causes of liver disease in the western world. In obese patients weight reduction is recommended. Up to now there are no specific guidelines for weight loss in order to reduce hepatic fat *** To investigate the effects of a 24-wk guided lifestyle intervention program compared to a meal replacement regimen based on soy *** Twenty-six subjects with NASH participated in a randomized single-center study. They were randomly assigned to either meal replacement group(MR-G)with soy-yogurt-honey preparation or to guided lifestyle change group(LC-G)with endurance activity and nutrition counselling. Serum alanine transaminase(ALT), aspartate transaminase(AST), lipid parameters, and adipokines were measured. Liver fat content and lipid composition were determined by magnetic resonance imaging and magnetic resonance spectroscopy. Body fat mass and lean body mass were assessed using Bod Pod? device. Pre-and post-intervention monitoring of parameters was performed. Statistical analyses were conducted with SPSS software, results were expressed as median(interquartile range).RESULTS Twenty-two subjects(MR-G, n = 11 and LC-G, n = 11) completed the study(9 women, 13 men; age 52.1(15.0) years, body mass index(BMI) 32.3(3.3) kg/m^2).In both groups a significant weight loss was achieved(MR-G:-6.4(3.6) kg, P <0.01; LC-G:-9.1(10.4) kg, P < 0.01). BMI dropped in both groups(MR-G:-2.3(1.5)kg/m^2, P = 0.003; LC-G:-3.0(3.4) kg/m^2, P = 0.006). Internal fat and hepatic lipid content were markedly reduced in both groups in comparable amount. There was a strong correlation between reduction in liver fat and decrease in ***, both groups showed an improvement in glycemic control and lipid profile. Changes in adipokines, particularly in adiponectin and leptin were closely related to intrahepatic lipid *** Comprehensive lifestyle intervention and meal replacement regimen have compar

关键词： Non-alcoholic steatohepatitis Meal replacement therapy Soy protein Lifestyle change Weight reduction Obesity

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Journal of Geriatric Cardiology 2017年第10期14卷 632-638页

作者： Aydin Huseynov Ibrahim El-battrawy Uzair Ansari Katja Schramm Xiaobo Zhou Siegfried Lang martin Borggrefe Ibrahim Akin The First Department of medicine Faculty of Medicine Mannheim University Medical Centre Mannheim (UMM) University of Heidelberg Mannheim Germany

Background Takotsubo syndrome （TS） is an important cardiac disease that affects predominantly postmenopausal women. This study was conducted to determine the impact of age on the short- and long-term outcome of TS patients. Methods ＆ Results The data from a collective of 114 TS patients with a mean follow-up of 1591 ：E 1079 days was retrospectively analysed. The study population was divided into two groups （≤ 65 and 〉 65 years） so as to evaluate the impact of age on the short- and long-term mortality of TS patients. In-hospital eventslike life-threatening arrhythmias （14.58% vs. 9.09%; P = 0.036）, need for mechanical respiratory support （41.66% vs. 28.78%; P = 0.15） as well as inotropic agent use （22.91% vs. 15.15%; P = 0.29）, although not reaching the statistical cut-of, tended to occur more often in the younger group. Heart failure was more common in the elderly age group （P = 0.03）. The use of multivariate analysis ruled out age as a significant marker of long term mortality （HR： 1.0; 95% CI： 0.9-1.0; P = 0.60）. Conclusions Age does not influence the clinical course of TS in terms of the short- as well as long-term outcome. The study revealed a higher incidence of life threatening arrhythmias in the younger patient age-group and a higher incidence of heart failure among the older group of patients.

关键词： Age Cardiovascular risk Mortality Takotsubo syndrome

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Association of late-life changes in blood pressure and cognitive status

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Journal of Geriatric Cardiology 2016年第1期13卷 37-43页

作者： Maria E Lacruz Daniel Tiller Alexander Kluttig Karin H Greiser Sebastian Nuding Karl Werdan Johannes Haerting Institute of Medical Epidemiology Biostatistics and Informatics Martin-Luther-University Halle-Wittenberg Halle/Saale Germany German Cancer Research Centre Division of Cancer Epidemiology Heidelberg Germany Department of medicine III Martin-Luther-University Halle-Wittenberg Halle/Saale Germany

BackgroundDisagreement exists on the association between changes in blood pressure and cognitive impairment. We aimed to ex-amine whether 4-year changes in systolic and diastolic blood pressure （SBP and DBP） are associated with cognitive status in a representative sample of older men and *** of longitudinal data from 854 participants of a population-based German sample （aged 60-87 years） was performed with standard cognitive screening and blood pressure measurements. Effects of changes in SBP and DBP （10 mmHg and 5 mmHg respectively as unit of regression effect measure） on cognitive status were evaluated using non-parametric and lin-ear regression *** clear associations were seen between changes in SBP or in DBP and cognitive scores. Small effects were found after stratification for sex and hypertension awareness. Specifically, larger decreases in SBP were associated with higher cogni-tive scores in those men aware of their hypertension （10 mmHg decrease in SBP,b =-0.26, 95% CI：-0.51 to-0.02） and men with con-trolled hypertension （10 mmHg decrease in SBP,b =-0.44, 95% CI：-0.92 to-0.03）. Additionally larger increases in DBP were associated with higher cognitive scores in men with controlled hypertension （5 mmHg increase in DBP,b = 0.67, 95% CI： 0.19-1.15）. For women aware of their hypertension, larger decreases in DBP were associated with higher cognitive scores （5 mmHg decrease in DBP,b =-0.26; 95%CI：-0.51 to-0.01）.ConclusionsChanges in blood pressure were only weakly associated with cognitive status. Specifically, decreases in SBP were associated with higher cognitive scores in men aware of their hypertension and especially those that were medically controlled.

关键词： Blood pressure Cognitive status The elderly

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Predictors of graft function and survival in second kidney transplantation: A single center experience

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World Journal of Transplantation 2023年第6期13卷 331-343页

作者： Mahmoud Khalil Rabea Ahmed Gadelkareem Medhat Ahmed Abdallah Mohamed Abdel-Basir Sayed FathyGaber Elanany Paolo Fornara Nasreldin Mohammed Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515AssiutEgypt Department of Urology and Kidney Transplantation Martin Luther UniversityHalle(Saale)71515Germany

BACKGROUND The increasing kidney retransplantation rate has created a parallel field of research,including the risk factors and outcomes of this advanced form of renal replacement *** presentation of experiences from different kidney transplantation centers may help enrich the literature on kidney retransplantation,as a specific topic in the field of kidney *** To identify the risk factors affecting primary graft function and graft survival rates after second kidney transplantation(SKT).METHODS The records of SKT cases performed between January 1977 and December 2014 at a European tertiary-level kidney transplantation center were retrospectively reviewed and *** the descriptive characteristics,the survivals of patients and both the first and second grafts were described using Kaplan-Meier *** addition,Kaplan-Meier analyses were also used to estimate the survival probabilities at 1,3,5,and 10 post-operative years,as well as at the longest followup duration ***,bivariate associations between various predictors and the categorical outcomes were assessed,using the suitable biostatistical tests,according to the predictor *** Out of 1861 cases of kidney transplantation,only 48 cases with SKT were eligible for studying,including 33 men and 15 women with a mean age of 42.1±13 *** primary non-function(PNF)graft occurred in five patients(10.4%).In bivariate analyses,a high body mass index(P=0.009)and first graft loss due to acute rejection(P=0.025)were the only significant predictors of PNF *** second graft survival was reduced by delayed graft function in the first(P=0.008)and second(P<0.001)***,the effect of acute rejection within the first year after the first transplant did not reach the threshold of significance(P=0.053).The mean follow-up period was 59.8±48.6 *** graft/patient survival rates at 1,3,5 and 10 years were 90.5%/97.9%,79.9%/95.6%,73.7%/91.9%,and 51.6%/83.0%,respe

关键词： Graft failure Graft function Kidney Kidney retransplantation Primary non-function graft Second kidney transplantation

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Altered PIWI-LIKE 1 and PIWI-LIKE 2 mRNA expression in ejaculated spermatozoa of men with impaired sperm characteristics

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Asian Journal of Andrology 2018年第3期20卷 260-264页

作者： Maria Giebler Thomas Greither Lisa Muller Carina Mosinger Hermann M Behre Center for Reproductive medicine and Andrology Martin Luther University Halle-Wittenberg Halle (Saale) 06120 Germany.

In about half the cases of involuntary childlessness, a male infertility factor is involved. The PIWI-LIKE genes, a subclade of the Argonaute protein family, are involved in RNA silencing and transposon control in the germline. Knockout of murine Piwi-like 1 and 2 homologs results in complete infertility in males. The aim of this study was to analyze whether the mRNA expression of human PIWI-LIKE I-4 genes is altered in ejaculated spermatozoa of men with impaired sperm characteristics. Ninety male participants were included in the study, among which 47 were with normozoospermia, 36 with impaired semen characteristics according to the World Health Organization （WHO） manual, 5th edition, and 7 with azoospermia serving as negative control for the PIWI-LIKE 1-4 mRNA expression in somatic cells in the ejaculate. PIWI-LIKE 1-4 mRNA expression in the ejaculated spermatozoa of the participants was measured by quantitative real-time PCR. In nonazoospermic men, PIWIoLIKE 1-4 mRNA was measurable in ejaculated spermatozoa in different proportions. PIWI-LIKE 1 （100.0%） and PIWI-LIKE 2 （49.4%） were more frequently expressed than PIWI-LIKE3 （9.6%） and PIWI-LIKE 4 （15.7%）. Furthermore, a decreased PIWI-LIKE2 mRNA expression showed a significant correlation with a decreased sperm count （P = 0.022） and an increased PIWI-LIKE 1 mRNA expression with a decreased progressive motility （P = 0.048）. PIWI-LIKE 1 and PIWI-LIKE 2 mRNA expression exhibited a significant association with impaired sperm characteristics and may be a useful candidate for the evaluation of the impact of PIWI-LIKE 1-4 mRNA expression on male infertility.

关键词： male infertility Piwi PIWI-LIKEgenes sperm quality parameters

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Inflammatory bowel disease incidence in Czech children:A regional prospective study,2000-2015

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World Journal of Gastroenterology 2017年第22期23卷 4090-4101页

作者： Jan Schwarz Josef Sykora Dominika Cvalínová Renáta Pomahacová Jana Klecková martin Kryl Petr Vcelák Department of Paediatrics Charles UniversityFaculty of Medicine in PilsenFaculty Hospital Department of Computer Science and NTIS-Research Centre Faculty of Applied SciencesUniversity of West Bohemia

AIM To examine the incidence and trends in pediatric inflammatory bowel diseases(IBDs) over 2000-2015 and project the incidence to 2018. METHODS A 16-year prospective study of IBD patients < 19 years of age was conducted in the Czech Republic(the Pilsen region). All incident IBD cases within a well-defined geographical area were retrieved from a prospectively collected computerized clinical database. Historical Czech data were used for comparison(1990-2001). Our catchment population was determined from the census data. We calculated the incidence by relating the number of newly diagnosed cases to the size of thepediatric population-at-risk in each calendar year. Age/sex, disease type, place of residence, and race/ethnicity were identified. RESULTS In total, 170 new IBD cases [105 Crohn's disease(CD), 48 ulcerative colitis(UC), and 17 IBD-unclassified(IBD-U)] were identified. The median age at IBD diagnosis was 14.2 years, 59.4% were males, and 97.1% were Caucasians. A male preponderance of IBD(P = 0.026) and CD(P = 0.016) was observed. With 109209 person-years in the catchment area, the average incidence of IBD per 100000 person-years was 10.0(6.2 for CD, 2.8 for UC, and 1.0 for IBD-U) for children aged 0 to 19 years; for those aged 0 to 15 years, the incidence rate was 7.3(4.6 for CD, 2.0 for UC, and 0.7 for IBD-U). An increase in incidence with age was observed(P = 0.0003). Over the 16-year period, the incidence increased for IBD patients(P = 0.01) and CD in particular(P < 0.0001), whereas the incidence for UC(P = 0.09) and IBD-U(P = 0.339) remained unchanged. IBD-projected data from 2016 to 2018 were 12.1, 12.3 and 12.6 per 100000 personyears, *** Pediatric-onset IBD incidence is around its highest point. The increase, which is particularly pronounced for CD, may be challenging to relate to causes of pediatric disease.

关键词： Inflammatory bowel disease Incidence Children Czech Republic Pilsen region Projections Crohn’s disease Ulcerative colitis

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High-throughput base editing:a promising technology for precision medicine and drug discovery

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Signal Transduction and Targeted Therapy 2021年第7期6卷 1937-1938页

作者： Agapios Sachinidis faculty of medicine Institute of NeurophysiologyUniversity of CologneCologneGermany Center for Molecular medicine Cologne(CMMC) University of CologneCologneGermany

Recently,two resource papers(Hanna et al.1 and Cuella-martin et al.2)were published describing high-throughput large-scale functional assessment of tens of thousands of human singlenucleotide variants(SNVs)across mult... 详细信息

关键词： base editing

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Complement:a global immunometabolic regulator in amyotrophic lateral sclerosis

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Neural Regeneration Research 2021年第6期16卷 1210-1211页

作者： martin W.Lo John D.Lee School of Biomedical Sciences Faculty of MedicineThe University of QueenslandSt LuciaQueenslandAustralia

Recently,McDonald et al.(2020)proposed that complement causes a metabolic switch to lipid consumption in amyotrophic lateral sclerosis(ALS),which raises the possibility of complement as a global immunometabolic *** ALS,neuromuscular degeneration occurs concurrently with complement-mediated inflammation,glucose intolerance,and elevated lipid ***,complement is being increasingly recognized as a metabolic regulator that can induce insulin resistance and alter fuel source ***,the authors propose that chronic complement activation may be driving metabolic reprogramming in ALS,which has broad implications for the field of immunometabolism and would be the first mechanistic explanation of the“lipid switch”in ***,it suggests that complement can drive a global shift in resources during inflammation,in which glucose is redirected from peripheral tissues to immune cells to support their inflammatory actions.

关键词： inflammation metabolism elevated

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The transjugular intrahepatic portosystemic shunt: Smaller stent diameters are required to optimize pressure response

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iLIVER 2023年第2期2卷 89-96页

作者： martin Rossle Dominik Bettinger Robert Thimme Michael Schultheiss Department of medicine II Medical Center University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburgGermany Berta-Ottenstein-Programme Faculty of MedicineUniversity of FreiburgGerman

Background and aims:The present treatment goal of the transjugular intrahepatic portosystemic shunt(TIPS)is a portosystemic pressure gradient of12 mmHg or its reduction by>50%.This study relates the stent diameter to the reduction of the pressure gradient and attempts to predict the appropriate stent diameter necessary to reach the treatment ***:Pressure response,super response,and poor response were investigated in 208 de-novo TIPS patients and defined as post-TIPS gradients between>6 and 12 mmHg,6 mmHg,or not reaching the goal(>12 mmHg,reduction<50%),*** were related to the smallest stent diameters measured by planimetry of the radiographic ***:Responders(65%),super responders(26%),or poor responders(9%)had comparable stent diameters of 7.21.0 mm,but different post-TIPS gradients(9.71.9 mmHg,4.51.5 mmHg,and 14.21.4 mmHg,p<0.001),relative reduction of pre-TIPS gradients(51.711.4%,73.611.1%,and 34.09.1%,p<0.001),and specific reduction per mm of stent diameter(7.52.0%/mm,10.12.0%/mm,and 4.81.4%/mm,p<0.001).Prediction of the stent diameter required to reach response was not *** two super responders had a stent diameter of<6 *** and poor responders differed by the increase in the right atrial pressure(+5.0 mmHg vs.+3.1 mmHg,p=0.026)and reduction in the portal vein pressure(-8.6 mmHg vs.-4.6 mmHg,p<0.001).Conclusion:Most patients reached the treatment goal with stent diameters of<8 ***(super response,gradient ≤6 mmHg)can be prevented by stent diameters as small as 6 *** individual response was not related to the stent diameter and not *** dysfunction may play an important role by its effect on the right atrial(preload)and portal pressure(afterload).

关键词： Portal hypertension Transjugular intrahepatic portosystemic stentshunt TIPS Portosystemic pressure gradient Stent diameter Hepatic encephalopathy Cardiac function

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Sclerosing angiomatoid nodular transformation of the spleen, a rare cause for splenectomy: Two case reports

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World Journal of Clinical Cases 2020年第1期8卷 103-109页

作者： Sophia Chikhladze Ann-Kathrin Lederer Stefan Fichtner-Feigl Uwe A Wittel martin Werner Konrad Aumann Department of General and Visceral Surgery Medical Center-University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburg 79106Germany Center for Complementary medicine Department of Infection Prevention and Hospital EpidemiologyMedical Center-University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburg 79106Germany Institute of Surgical Pathology Medical Center-University of FreiburgFaculty of MedicineUniversity of FreiburgFreiburg 79106Germany

BACKGROUND Sclerosing angiomatoid nodular transformation(SANT)is a rare benign disease of the spleen with unknown *** symptoms are inhomogeneous,and suspicious splenic lesion often found incidentally,leading to splenectomy,as malignancy cannot securely be ruled *** is made histologically after *** SUMMARY Two cases of German,white,non-smoking,and non-drinking patients of normal weight are *** first one is a 26-year-old man without medical history who was exhibiting an undesired weight loss of 10 kg and recurring vomiting for about 18 *** second one is a 65-year-old woman with hypertension who had previously undergone gynecological surgery,suffering from a lasting feeling of abdominal *** showed radiologically an inhomogeneous splenic lesion leading to splenectomy approximately 6 and 9 wk after surgical *** diagnoses of SANT were made ***-up went well,and both were treated according to the recommendation for asplenic *** SANT is a rare cause of splenectomy and an incidental histological *** research should focus on clinical and radiological diagnosis of SANT as well as on treatment of patients with asymptomatic and small findings.

关键词： Splenectomy Sclerosing angiomatoid nodular transformation Spleen Abdominal discomfort Gastrointestinal dysfunction Case report

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