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Open Journal of Nursing 2015年第5期5卷 482-489页

作者： Agneta Bergsten Brucefors Jacek Hochwalder Jessica Sjovall Lena Hjelte Stockholm CF Centre Karolinska University Hospital HuddingeKarolinska InstitutetStockholmSweden Department of Psychology Malardalen UniversityEskilstunaSweden

The aim was to examine depression and anxiety among parents of children with Cystic Fibrosis and the association between the parents’ symptoms and the child’s quality of life as rated by the parents. Parents completed HADS (Hospital Anxiety and Depression Scale), and CES-D (Center of Epidemiologic Studies Depression Scale), and assessed the children’s quality of life with CFQ-R (Cystic Fibrosis Questionnaire-Revised). Anxiety amongst the parents was higher than the general population (m = 6.55, SD = 3.54, p < 0.001). The level of depression does not differ from that of the general population. Mothers showed more anxiety symptoms than fathers (p < 0.001). Gender differences were not significant for depression symptoms. There is a strong association between the fathers’ self-rated depression and their rating of their child’s health. Both children and parents should be paid attention to in order to identify mental ill-health and take measures in good time.

关键词： Cystic Fibrosis Depression Anxiety Quality of Life Parents Children

Liver fibrosis in non-alcoholic fatty liver disease-diagnostic challenge with prognostic significance

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World Journal of Gastroenterology 2015年第39期21卷 11077-11087页

作者： Per Stal Division of Gastroenterology and Hepatology Karolinska InstitutetDepartment of Digestive DiseasesHuddinge K63Karolinska University Hospital

Non-alcoholic fatty liver disease(NAFLD) is the mostcommon liver disease in the Western world, with a prevalence of 20%. In a subgroup of patients, inflammation, ballooning degeneration of hepatocytes and a varying degree of fibrosis may develop, a condition named non-alcoholic steatohepatitis. Advanced liver fibrosis(stage F3) and cirrhosis(stage F4) are histologic features that most accurately predict increased mortality in both liver-related and cardiovascular diseases. Patients with advanced fibrosis or cirrhosis are at risk for complications such as hepatocellular carcinoma and esophageal varices and should therefore be included in surveillance programs. However, liver disease and fibrosis are often unrecognized in patients with NAFLD, possibly leading to a delayed diagnosis of complications. The early diagnosis of advanced fibrosis in NAFLD is therefore crucial, and it can be accomplished using serum biomarkers(e.g., the NAFLD Fibrosis Score, Fib-4 Index or BARD) or non-invasive imaging techniques(transient elastography or acoustic radiation force impulse imaging). The screening of risk groups, such as patients with obesity and/or type 2 diabetes mellitus, for NAFLD development with these non-invasive methods may detect advanced fibrosis at an early stage. Additionally, patients with a low risk for advanced fibrosis can be identified, and the need for liver biopsies can be minimized. This review focuses on the diagnostic challenge and prognostic impact of advanced liver fibrosis in NAFLD.

关键词： Non-alcoholic fatty liver disease Fibrosis Mortality Biomarkers Elastography

Recent advances in estrogen-signaling and new sites for pharmacological interventions

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Recent advances in estrogen-signaling and new sites for phar...

Physical activity, obesity and gastroesophageal reflux disease in the general population

第十五届国际药理学大会

作者： Jan-Ake Gustafsson Department of Biosciences and Nutrition NOVUM karolinska institutet Stockholm

＜正＞ Both in vitro and in vivo. ERβ acts as an antiproliferative principle in several tissues, e g the prostate where ERβ is antiproliferative. proapoptotic and prodifferentiative. An ERβ agonist developed by Eli Lilly shows all of the anticipated biological effects on the prostate, namely reduced cellular proliferation and increased apoptosis, leading to a diminished size of both mouse and rat prostate. This opens up hitherto unthought-of pharmaceutical possibilities in treating prostate disorders in humans, including both benign prostatic hyperplasia and prostate carcinoma. It now appears quite clear that ERβ also exerts an antiproliferative effect on human breast cancer cells both in vitro and in vivo;there seems to be sufficient indications for a pharmaceutical potential of ERβ agonists in treatment of breast cancer. A similar case can be made for use of ERβ agonists in treatment of colon cancer. Furthermore. ERβ is of major importance in estrogenic regulation of the immune system. Wyeth-Ayerst has reported extremely encouraging results of ERβ agonists in treatment of rodent models of inflammatory bowel disease （IBD）. rheumatoid arthritis and endometriosis.

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World Journal of Gastroenterology 2012年第28期18卷 3710-3714页

作者： Therese Djrv Anna Wikman Helena Nordenstedt Asif Johar Jesper Lagergren Pernilla Lagergren Unit of Upper Gastrointestinal Research Department of Molecular Medicine and Surgery Karolinska Institutet SE-17176 Stockholm Sweden Jesper Lagergren Division of Cancer Studies King's College London London WC2R 2LS United Kingdom

AIM: To clarify the association between physical activity and gastroesophageal reflux disease (GERD) in nonobese and obese people. METHODS: A Swedish population-based cross-sectional survey was conducted. Participants aged 40-79 years were randomly selected from the Swedish Registry of the Total Population. Data on physical activity, GERD, body mass index (BMI) and the covariates age, gender, comorbidity, education, sleeping problems, and tobacco smoking were obtained using validated questionnaires. GERD was self-reported and defined as heartburn or regurgitation at least once weekly, and having at least moderate problems from such symptoms. Frequency of physical activity was categorized into three groups: (1) "high" (several times/week); (2) "intermediate" (approximately once weekly); and (3) "low" (1-3 times/mo or less). Analyses were stratified for participants with "normal weight" (BMI 30 kg/m 2 ). Multivariate logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for potential confounding by covariates. RESULTS: Of 6969 eligible and randomly selected individuals, 4910 (70.5%) participated. High frequency of physical activity was reported by 2463 (50%) participants, GERD was identified in 472 (10%) participants, and obesity was found in 680 (14%). There were 226 (5%) individuals with missing information about BMI. Normal weight, overweight and obese participants were similar regarding distribution of gender and tobacco smoking status, while obese participants were on average slightly older, had fewer years of education, more comorbidity, slightly more sleeping problems, lower frequency of physical activity, and higher occurrence of GERD. Among the 2146 normal-weight participants, crude point estimates indicated a decreased risk of GERD among individuals with high frequency of physical activity (OR: 0.59, 95% CI: 0.39-0.89), compared to low

关键词： Physical exercise Gastroesophageal reflux disease Population-based study Risk factor Body mass index Obesity

Data Do Not Support Effectiveness of Acupuncture for Improving Live Birth Rate in Women with Polycystic Ovary Syndrome

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Chinese Journal of Integrative Medicine 2018年第5期24卷 399-400页

作者： KUANG Hong-ying1 LI Yan1 ZHANG He-ping2 Richard S.Legro3 Elisabet Stener-Victorin4 Department of Obstetrics and Gynecology the First Affiliated Hospital of Heilongjiang University of Chinese Medicine Department of Biostatistics Yale School of Public Health Department of Obstetrics and Gynecology Penn State University College of Medicine Department of Physiology and Pharmacology Karolinska Institutet

Recently, the arguments raised by Gang and Jing have been published in Chinese Journal of Integrative Medicine, concerning the randomized controlled trial （RCT） of our team published in JAMA. The conclusions of Gang and Jingo） result not only from misunderstanding of the aims of our study,） but also a lack of basic knowledge for the design of RCT and the limitations on the content, and hence the length, of the primary outcome article in high-impact journals （i.e. 2,500 words and a total of 5 figures/tables in JAMA）. We will address their main critiques point by point below.

关键词： Polycystic Ovary Syndrome

Adherence to medication: A nation-wide study from the Children's Cancer Hospital, Egypt

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World Journal of Psychiatry 2013年第2期3卷 25-33页

作者： Hanan El Malla Nathalie Ylitalo Helm Ulrica Wilder?ng Yasser El Sayed Elborai Gunnar Steineck Ulrika Kreicbergs Division of Clinical Cancer Epidemiology Department of OncologySahlgrenska University Hospital Department of Medical Epidemiology and Biostatistics Karolinska Institutet Children’s Cancer Hospital (CCHE 57357) National Cancer Institute Division of Clinical Cancer Epidemiology Department of Oncology and PathologyKarolinska Institutet Department of Women’s and Children’s Health Karolinska Institutet Sophiahemmet University College

AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt. METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read thequestions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo(February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows(SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one(90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment(181/281, 64%). Sixty-eight percent(123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance(111/123, 90%) and inadequate information(100/123, 81%). In the adherent group, 20% of the parents(n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123(7%) for both their child's doctor and other health-care professionals. Almost all of

关键词： Cancer Adherence to medical regimen Non-compliance Patient-physician communication Paediatric oncology Psycho-oncology Psychosocial

Changes in the gut microbiota mediate the differential regulatory effects of two glucose oxidases produced by Aspergillus niger and Penicillium amagasakiense on the meat quality and growth performance of broilers

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Journal of Animal Science and Biotechnology 2020年第4期11卷 1232-1244页

作者： Shengru Wu Xiaodong Chen Taohuan Li Hao Ren Lixin Zheng Xiaojun Yang College of Animal Science and Technology Northwest A&F UniversityYanglingShaanxiChina Center for Translational Microbiome Research Department of MolecularTumor and Cell BiologyKarolinska InstitutetStockholmSweden Jiangxi Zhengbang Technology Co. Ltd.NanchangJiangxiChina.

Background: Glucose oxidase(GOD), an aerobic dehydrogenase, has been used as an antibiotic substitute in feed.A study was conducted to evaluate the differential effects of 2 different GODs fermented by Aspergillus niger or Penicillium amagasakiense on caecal microbiota and to further illuminate the potential roles of changes in the gut microbiota in regulating the growth performance and meat quality of broiler ***: A total of 420 one-day-old healthy Arbor Acres broilers were randomly assigned to 4 treatments: the control group,the antibiotic growth promoter(AGP) supplementation group, and the GOD-A and GOD-P(GODs produced by A. niger and P. amagasakiense, respectively) groups. As a result, supplementation with GOD produced by P. amagasakiense could significantly improve the average daily weight gain and average daily feed intake of broilers before 21 days of age by significantly increasing the enzymatic activities of jejunal amylase and those of ileal amylase, chymotrypsin, and lipase in21-day-old broilers and could increase the enzymatic activities of duodenal amylase, jejunal amylase and lipase, and ileal chymotrypsin and lipase in 42-day-old broilers. Meanwhile, compared with AGP treatment, supplementation with GOD produced by P. amagasakiense significantly decreased the L value of 21-day-old broilers and the Δp H and L* value of 42-day-old broilers, while supplementation with GOD produced by A. niger significantly increased the p H24 hvalue of 21-day-old and 42-day-old broilers by reducing plasma malondialdehyde content. By using 16 S r RNA sequencing, we found that the beneficial bacteria and microbiota in broilers were not disturbed but were improved by GOD supplementation compared with ADP treatment, including the genera Eubacterium and Christensenel a and the species uncultured_Eubacterium_sp,Clostridium_asparagiforme, and uncultured_Christensenel a_sp, which were positively related to the improved intestinal digestive enzymatic activities, grow

关键词： Broiler Glucose oxidase Growth performance Gut function Gut microbiota

COVID-19 associated liver injury:An updated review on the mechanisms and management of risk groups

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Liver Research 2023年第3期7卷 207-215页

作者： Yue Shi Mina Wang Liqun Wu Xuexin Li Zehuan Liao Second Clinical Medical College Beijing University of Chinese MedicineBeijingChina Graduate School Beijing University of Chinese MedicineBeijingChina Department of Acupuncture and Moxibustion Beijing Hospital of Traditional Chinese MedicineCapital Medical UniversityBeijing Key Laboratory of Acupuncture NeuromodulationBeijingChina Department of Medical Biochemistry and Biophysics Karolinska InstitutetSolnaSweden School of Biological Sciences Nanyang Technological UniversitySingaporeSingapore Department of Microbiology Tumor and Cell Biology(MTC)Karolinska InstitutetStockholmSweden

Coronavirus disease 2019(COVID-19)has been associated with various liver injury cases *** date,the prevalence,mechanism,clinical manifestations,diagnosis,and outcomes of COVID-19-induced liver injury in various at-risk groups are not well *** injury may arise in the prevention and treatment of COVID-19 from direct causes such as viral infection and indirect causes such as systemic inflammation,hypoxic changes,and drugs that exacerbate any pre-existing liver *** have found that patients with underlying liver disease are at higher risk of COVID-19-induced liver *** condition of cardiopulmonary and metabolic diseases and vulnerable stages in lifespan may also involve in the development of COVID-19-induced liver *** review summarized studies of COVID-19-induced liver injury in different at-risk groups regarding their clinical characteristics,parameters,and correlations of the severity with these indicators and signs as well as potential treatment suggestions,to increase attention to physiological and pathological conditions and continue liver function monitoring as they can help in strengthening early supportive treatment and reducing the incidence of adverse outcomes.

关键词： Coronavirus disease 2019(COVID-19) Liver injury Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Risk groups Treatments Management

瑞典斯德哥尔摩市社区人群老年痴呆和阿尔茨海默病的危险因素队列研究

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中华流行病学杂志 2005年第11期26卷 882-887页

作者：仇成轩 Bengt Winblad Laura Fratiglioni Aging Research Center Division of Geriatric Epidemiology NeurotecKarolinska Institutet and the Stockholm Gerontology Research CenterStockholmSweden

目的探讨老年痴呆和阿尔茨海默病(AD)的危险因素。方法在6年间(1991—1996 年)对斯德哥尔摩市一个社区非痴呆老年人群(n=1301,年龄≥75岁)进行两次随访检查,并按照美国老年精神病协会制订的DSM-Ⅲ-R标准诊断随访期间痴呆和AD新发病例。... 详细信息

目的探讨老年痴呆和阿尔茨海默病(AD)的危险因素。方法在6年间(1991—1996 年)对斯德哥尔摩市一个社区非痴呆老年人群(n=1301,年龄≥75岁)进行两次随访检查,并按照美国老年精神病协会制订的DSM-Ⅲ-R标准诊断随访期间痴呆和AD新发病例。研究对象在基线调查时对有关因素暴露情况系经问卷调查、临床检查和查阅住院病例登记资料库等方法确定。采用Cox 比例风险模型对资料进行统计分析。结果随访期间共有350例被诊断为痴呆,包括260例AD患者。多因素分析结果显示,痴呆和AD发病的危险因素有年龄大、文化程度低、认知功能损害、体力活动障碍、低舒张压、糖尿病、缺血性心脏病和携带APOEε4基因。脑卒中和心房纤维颤动亦能增加痴呆的危险性,而服用抗高血压药物则可降低痴呆和AD发病的危险性。结论某些人口统计学因素、认知和体力功能障碍、血管性疾病及遗传易感性是老年痴呆和AD的重要危险因素;使用抗高血压药物及控制高血压相关的血管性疾病可能会降低痴呆发病的危险性。

关键词：老年痴呆阿尔茨海默病危险因素队列研究

Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 720-727页

作者： Joana Marques Francisco Baldaque-Silva Pedro Pereira Urban Arnelo Naohisa Yahagi Guilherme Macedo Faculty of Medicine University of Porto Gastrocentrum karolinska University Hospital Karolinska Institutet Gastroenterology Department Hospital Sao Joao Department of Clinical Science Intervention and Technology (CLINTEC) Karolinska Institutet and Centre for Digestive Diseases Karolinska University Hospital Division of Research and Development for Minimally Invasive Treatment Cancer Center School of Medicine Keio University

Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal)(endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk(delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.

关键词： Polyps Duodenum Adenoma Resection Endoscopy