Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbati...Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent illnesses.UC is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any age.The incidence of UC has increased worldwide over recent decades,especially in developing nations.In contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over time.It is important to emphasize that there is considerable variability in the phenotypic presentation of UC.Within this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor prognosis.In this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the disease.The aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis.展开更多
Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infecti...Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infection may also influence the development and severity of various extragastric diseases.According to the current evidence,whereas this bacterium is a risk factor for some of these manifestations,it might play a protective role in other pathological conditions.In that context,when considered the gastrointestinal tract,H.pylori positivity have been related to Inflammatory Bowel Disease,Gastroesophageal Reflux Disease,Non-Alcoholic Fatty Liver Disease,Hepatic Carcinoma,Cholelithiasis,and Cholecystitis.Moreover,lower serum levels of iron and vitamin B12 have been found in patients with H.pylori infection,leading to the emergence of anemias in a portion of them.With regards to neurological manifestations,a growing number of studies have associated that bacterium with multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,and Guillain-Barrésyndrome.Interestingly,the risk of developing cardiovascular disorders,such as atherosclerosis,is also influenced by the infection.Besides that,the H.pylori-associated inflammation may also lead to increased insulin resistance,leading to a higher risk of diabetes mellitus among infected individuals.Finally,the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism.In this sense,this minireview aims to gather the main studies associating H.pylori infection with extragastric conditions,and also to explore the main mechanisms that may explain the role of H.pylori in those diseases.展开更多
Lignin is a polymer of phenylpropanoid compounds formed through a complex biosynthesis route, represented by a metabolic grid for which most of the genes involved have been sequenced in several plants, mainly in the m...Lignin is a polymer of phenylpropanoid compounds formed through a complex biosynthesis route, represented by a metabolic grid for which most of the genes involved have been sequenced in several plants, mainly in the model-plants Arabidopsis thaliana and Populus. Plants are exposed to different stresses, which may change lignin content and composition. In many cases, particularly for plant-microbe interactions, this has been suggested as defence responses of plants to the stress. Thus, understanding how a stressor modulates expression of the genes related with lignin biosynthesis may allow us to develop study-models to increase our knowledge on the metabolic control of lignin deposition in the cell wall. This review focuses on recent literature reporting on the main types of abiotic and biotic stresses that alter the biosynthesis of lignin in plants.展开更多
AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental pla...AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental plaque specimens and gastric biopsies were submitted to histological exami-nation, rapid urease test and polymerase chain reac-tion (PCR) assays to detect the presence of cagA and vacA polymorphisms.RESULTS: Detection of H. pylori from dental plaque and gastric biopsy samples was greater by PCR com-pared to histological examination and the rapid ure-ase test. DNA from H. pylori was detected in 96% of gastric mucosa samples and in 72% of dental plaque samples. Sixty-three (89%) of 71 dental plaque sam-ples that were H. pylori-positive also exhibited identical vacA and cagA genotypes in gastric mucosa. The most common genotype was vacAs1bm1 and cagA positive, either in dental plaque or gastric mucosa. These viru-lent H. pylori isolates were involved in the severity of clinical outcome.CONCLUSION: These pathogenic strains were found simultaneously in dental plaque and gastric mucosa, which suggests that gastric infection is correlated with the presence of H. pylori in the mouth.展开更多
AIM： To evaluate and compare the expression profiles of CXCL12 （SDF-1）, CCL19 （MIP-3β）, CCL20 （MIP-3a） and CCL21 （6Ckine, Exodus2） and their receptors on RNA and protein levels in hepatocellular carcinoma （...AIM： To evaluate and compare the expression profiles of CXCL12 （SDF-1）, CCL19 （MIP-3β）, CCL20 （MIP-3a） and CCL21 （6Ckine, Exodus2） and their receptors on RNA and protein levels in hepatocellular carcinoma （HCC） versus colorectal liver metastases （CRLM） and to elucidate their impact on the carcinogenesis and progression of malignant liver diseases. METHODS： Chemokine expression was analyzed by RT-PCR and ELISA in 11 cases of HCC specimens and in 23 cases of CRLM and corresponding adjacent nontumorous liver tissues, respectively. Expressions of their receptors CXCR4, CCR6 and CCR7 were analyzed by RT- PCR and Western blot analysis in the same cases of HCC and CRLM. RESULTS： Significant up-regulation for CCL20/CCR6 was detected in both cancer types. Moreover, CCL20 demonstrated significant overexpression in CRLM in relation to the HCC tissues. Being significantly up-regulated only in CRLM, CXCR4 displayed an aberrant expression pattern with respect to the HCC tissues. CONCLUSION： Correlation of CXCR4 expression with CRLM suggests CXCR4 as a potential predictive factor for CRLM. High level expression of CCL20 and its receptor CCR6 in HCC and CRLM with marked up-regulation of CCL20 in CRLM in relation to HCC tissues indicates involvement of the CCL20/CCR6 ligand-receptor pair in the carcinogenesis and progression of hepatic malignancies.展开更多
The gut microbiota is a complex community of microorganisms that inhabit the digestive tracts of humans,living in symbiosis with the host.Dysbiosis,characterized by an imbalance between the beneficial and opportunisti...The gut microbiota is a complex community of microorganisms that inhabit the digestive tracts of humans,living in symbiosis with the host.Dysbiosis,characterized by an imbalance between the beneficial and opportunistic gut microbiota,is associated with several gastrointestinal disorders,such as irritable bowel syndrome(IBS);inflammatory bowel disease(IBD),represented by ulcerative colitis and Crohn’s disease;and colorectal cancer(CRC).Dysbiosis can disrupt the mucosal barrier,resulting in perpetuation of inflammation and carcinogenesis.The increase in some specific groups of harmful bacteria,such as Escherichia coli(E.coli)and enterotoxigenic Bacteroides fragilis(ETBF),has been associated with chronic tissue inflammation and the release of pro-inflammatory and carcinogenic mediators,increasing the chance of developing CRC,following the inflammationdysplasia-cancer sequence in IBD patients.Therefore,the aim of the present review was to analyze the correlation between changes in the gut microbiota and the development and maintenance of IBD,CRC,and IBD-associated CRC.Patients with IBD and CRC have shown reduced bacterial diversity and abundance compared to healthy individuals,with enrichment of Firmicute sand Bacteroidetes.Specific bacteria are also associated with the onset and progression of CRC,such as Fusobacterium nucleatum,E.coli,Enterococcus faecalis,Streptococcus gallolyticus,and ETBF.Future research can evaluate the advantages of modulating the gut microbiota as preventive measures in CRC high-risk patients,directly affecting the prognosis of the disease and the quality of life of patients.展开更多
AIM：To evaluate the methylation status of CDH1, FHIT, MTAP and PLAGL1 promoters and the association of these findings with clinico-pathological characteristics.METHODS： Methylation-specific PCR （MSP） assay was per...AIM：To evaluate the methylation status of CDH1, FHIT, MTAP and PLAGL1 promoters and the association of these findings with clinico-pathological characteristics.METHODS： Methylation-specific PCR （MSP） assay was performed in 13 nonneoplastic gastric adenocarcinorna, 30 intestinal-type gastric adenocarcinorna and 35 diffuse-type gastric adenocarcinorna samples from individuals in Northern Brazil. Statistical analyses were performed using the chi-square or Fisher＇s exact test to assess associations between rnethylation status and clinico-pathological characteristics.RESULTS： Hypermethylation frequencies of CDH1, FHIT, MTAPand PLAGL1 promoter were 98.7%, 53.9%, 23.1% and 29.5%, respectively. Hyperrnethylation of three or four genes revealed a significant association with diffuse-type gastric cancer compared with nonneoplastic cancer. A higher hyperrnethylation frequency was significantly associated with H pylori infection in gastric cancers, especially with diffuse-type. Cancer samples without lymph node metastasis showed a higher FHIT hypermethylation frequency. MTAP hypermethylation was associated with H pylori in gastric cancer samples, as well as with diffuse-type compared with intestinal-type. In diffuse-type, MTAP hypermethylation was associated with female gender.CONCLUSION： Our findings show differential gene methylation in tumoral tissue, which allows us to conclude that hypermethylation is associated with gastric carcinogenesis. MTAP promoter hypermethylation can be characterized as a marker of diffuse-type gastric cancer, especially in women and may help in diagnosis, prognosis and therapies. The H pylori infectious agent was present in 44.9% of the samples. This infection may be correlated with the carcinogenic process through the gene promoter hypermethylation, especially the MTAP promoter in diffuse-type. A higher H pylori infection in diffuse-type may be due to greater genetic predisposition.展开更多
The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse mome...The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse momentum, PT, and rapidity, y. The kinematic region of the measurements is pT〈20 GeV/c and 2.0 〈g〈4.5.The measurements use a data sample corresponding to an integrated luminosity of 3fb-1 collected by the LHCb detector in pp collisions at centre-of-mass energies √s=7 TeV in 2011 and √s=8 TeV in 2012. Based on previous LHCb results of the fragmentation fraction ratio,f∧0/b/fd,the branching fraction of the decay ∧0/b→ J/ψ pK-is measured to be B（∧0/b→ J/ψ pK-）=（3.17±0.04±0.07±0.34＋0.45/-0.28）×10-4,where the first uncertainty is statistical, the second is systematic, the third is due to the uncertainty on the branching fraction of the decay -B/0 →J/ψ-K＊（892）0,and the fourth is due to the knowledge of f∧0/b/fd.The sum of the asymmetries in the production and decay between ∧0/b and ∧0/bis also measured as a function of PT and y.The previously published branching fraction of ∧0/b→ J/ψ pπ-,relative to that of ∧0/b→ J/ψ pK-,is updated. The branching fractions of ∧0/b→P＋c（→ J/ψp）K-are determined.展开更多
AIM： To evaluate the safety and feasibility of bone marrow cell （BMC） transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS： Ten patients （eight males） wit...AIM： To evaluate the safety and feasibility of bone marrow cell （BMC） transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS： Ten patients （eight males） with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 mL of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS： The median age of the patients was 52 years （range 24-70 years）. All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 （2.19 ± 0.9） and 4 mo （2.10 ± 1.0） after cell transplantation that baseline levels （238 ± 1.2）. Albumin levels 4 mo after BMC infusion （3.73 ± 0.5） were higher than baseline levels （3.47 ± 0.5）. International normalized ratio （INR） decreased from 1.48 （SD = 0.23） to 1.43 （SD = 0.23） one month after cell transplantation. CONCLUSION： BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease.展开更多
AIM:To compare band ligation(BL) with endoscopic sclerotherapy(SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS:A prospective,randomized,single-center study without crossover was...AIM:To compare band ligation(BL) with endoscopic sclerotherapy(SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS:A prospective,randomized,single-center study without crossover was conducted.After endoscopic diagnosis of esophageal variceal rupture,patients were randomized into groups for SCL or BL treatment.Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point,with a maximum volume of 20 mL.For BL patients,banding at the rupture point was attempted,followed by ligation of all variceal tissue of the distal esophagus.Primary outcomes for both groups were initial failure of bleeding control(5 d) ,early re-bleeding(5 d to 6 wk),and complications,including mortality.From May 2005 to May 2007,100 patients with variceal bleeding were enrolled in thestudy:50 SCL and 50 BL patients.No differences between groups were observed across gender,age,ChildPugh status,presence of shock at admission,mean hemoglobin levels,and variceal size. RESULTS:No differences were found between groups for bleeding control,early re-bleeding rates,complications,or mortality.After 6 wk,36(80%) SCL and 33(77 %) EBL patients were alive and free of bleeding.A statistically significant association between Child-Pugh status and mortality was found,with 16%mortality in Child A and B patients and 84%mortality in Child C patients(P<0.001) . CONCLUSION:Despite the limited number of patients included,our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.展开更多
AIM： TO investigate toll-like receptor 2 （TLR2） -196 to -274 del, and TLR4 （＋896A/G rs4986790 and ＋1196C/ T rs4986791） polymorphisms at risk of chronic gastritis and gastric cancer in a Brazilian population and...AIM： TO investigate toll-like receptor 2 （TLR2） -196 to -274 del, and TLR4 （＋896A/G rs4986790 and ＋1196C/ T rs4986791） polymorphisms at risk of chronic gastritis and gastric cancer in a Brazilian population and associ-ation of gastric lesions with risk factors such as smoking, alcohol intake and Helicobacter pylori infection.METHODS： In this casecontrol study, polymorphism at TLR2 -96 to -174 del was investigated by using the allele-specific polymerase chain reaction （PCR） method, while the PCR-restriction fragment length polymorphism technique was carried out to identify the TLR4 （rs4986790 and rs4986791） genotypes in 607 Brazilian individuals （208 with chronic gastritis-CG, 174 with gastric cancer-GC and 225 controls -C）.RESULTS： The single nucleotide polymorphisms TLR4＋1196ClT was not associated with risk of chronic gastritis or gastric cancer and the homozygous genotypes TLR4＋896GG and TLR4＋1196TF were absent in the studied population. However, the frequency of TLR2 -196 to -174 ins/del ＋ del/del and TLR4＋896AGgenotypes was significantly higher （P 〈 0.01 and P = 0.01, respectively） in the cancer group （33.4% and 11.5%, respectively） than in the control group （16.9% and 4.5%, respectively）. It was also observed that the G-C haplotype of the TLR4＋896A/G＋1196C/T （P = 0.02） and the combination of variant alleles of the TLR21TLR4＋896G （P = 0.02） are associated with susceptibility to gastric cancer. In addition, the multiple logistic regression showed that male gender [odds ratio （OR） = 2.70; 95% CI： 1.66-4.41; P 〈 0.01], alcohol intake （OR = 2.93; 95% CI： 1.76-4.87, P 〈 0.01）, TLR2 -196 to -174 del （OR = 2.64; 95% CI： 1.56-4.44; P 〈 0.01） and TLR4＋896G （OR = 3.19; 95% CI： 1.34- 7.61; P 〈 0.01） polymorphisms were associated with a higher susceptibility to developing this neoplasm.CONCLUSION： Our data indicate that T/R2 -196 to -174 del and TLR4＋896G may increase the risk of gastric cancer in a Brazilian populat展开更多
AIM： To study the association between Interleukin-1 （IL-1） and tumor necrosis factor （TNF）-α polymorphisms, infection by Helicobacter pylori （H pylori） and the development of gastrointestinal diseases.METHODS...AIM： To study the association between Interleukin-1 （IL-1） and tumor necrosis factor （TNF）-α polymorphisms, infection by Helicobacter pylori （H pylori） and the development of gastrointestinal diseases.METHODS： Genomic DNA was extracted from the peripheral blood of 177 patients with various gastrointestinal diseases and from 100 healthy volunteers. The polymorphisms in IL-1β and TNF-α genes were analyzed using the polymerase chain reactionrestriction fragment length polymorphism method （PCRRFLP） and those from IL-1RN with PCR. The presence of infection due to H pylori and the presence of the CagA toxin were detected by serology. The histopathological parameters in the gastric biopsies of the patients were according to the Sydney classification.RESULTS： A comparison of the frequencies of the different polymorphisms studied among the patients and the control group demonstrated that the allele IL- 1RN＊2 was more frequent among patients with gastric ulcers and adenocarcinoma. Carriers of the allele IL- RN＊2 and those with reactive serology for anti-CagA IgG had a greater risk of developing peptic ulcer and gastric adenocarcinoma, as well as a higher degree of inflammation and neutrophilic activity in the gastricCONCLUSION： Our results indicate a positive association between IL-1RN gene polymorphism and infection by positive H pylori CagA strains and the development of gastric ulcers and adenocarcinoma.展开更多
AIM： To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions.METHODS： From January/1997 to D...AIM： To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions.METHODS： From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUSFNA. The final diagnosis was obtained either by surgery （356 cases） or after a mean clinical follow-up of 11.8 mo in the remaining patients.RESULTS： There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 （97.4%） cases. There were 352 （57.6%） malignancies and 259 （42.4%） benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67% of the lesions. Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4%, 99.2%, 99.3%, 77.2% and 87.2%. Specifically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8% ys 82.4%, 100% ys 98.4%, 100% vs 99%, 54.8% vs 74.1% and 83.1% vs 87.8%. For cystic lesions, the values were, respectively, 72.2%, 99.3%, 97.5%, 91% and 92.2%.CONCLUSION： EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions can reveal the best negative predictive value and diagnostic accuracy, both higher than 90%.展开更多
Background: Early allograft dysfunction (EAD) is a severe complication after liver transplantation. The associated risk factors and complications have re-gained recent interest. This study investigated risk factors, s...Background: Early allograft dysfunction (EAD) is a severe complication after liver transplantation. The associated risk factors and complications have re-gained recent interest. This study investigated risk factors, survival and complications associated with EAD in a large liver transplant center in Latin America. Methods: Retrospective, unicenter, cohort, based on data from adult patients undergoing first deceaseddonor liver transplant from January 2009 to December 2013. EAD was defined by one or more of the following:(i) bilirubin ≥10 mg/dL on postoperative day 7;(ii) international normalized ratio ≥1.6 on postoperative day 7, and (iii) alanine aminotransferase or aspartate aminotransferase > 2000 IU/L within the first seven days after transplant. Results: A total of 602 patients were included;of these 34.2% developed EAD. Donor risk factors were male ( P = 0.007), age between 50 and 59 years ( P = 0.034), overweight ( P = 0.028) or grade I obesity ( P = 0.012), sodium > 157 mmol/L ( P = 0.002) and grade IV ischemia/reperfusion injury ( P = 0.002). Cold ischemia time ≥10 h ( P = 0.008) and warm ischemia time ≥40 min ( P = 0.013) were the surgical factors. Male ( P < 0.001) was the only recipient protective factor. Compared with the non-EAD group, patients with EAD were submitted to more reoperations (24.3% vs. 13.4%, P = 0.001) and had higher graft loss rates (37.9% vs. 21.2%, P < 0.001), with similar patient survival rates ( P = 0.238). Conclusions: EAD risk factors are related to donor, surgical procedure and recipient. Donor risk factors for EAD were male, age between 50 and 59 years, donor overweight or grade Ⅰ obesity, sodium > 157 mmol/L and grade Ⅳ ischemia/reperfusion injury. Cold ischemia time ≥10 h and warm ischemia time ≥40 min were the surgical risk factors. Male was the only recipient protective factor. Patients with EAD had higher reoperations and graft loss rates.展开更多
AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 20...AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.展开更多
Mesoporous nanocrystal clusters of anatase TiO2 with large surface area and enhanced photocatalytic activity have been successfully synthesized. The synthesis involves the self-assembly of hydrophobic TiO2 nanocrystal...Mesoporous nanocrystal clusters of anatase TiO2 with large surface area and enhanced photocatalytic activity have been successfully synthesized. The synthesis involves the self-assembly of hydrophobic TiO2 nanocrystals into submicron clusters, coating of these clusters with a silica layer, thermal treatment to remove organic ligands and improve the crystallinity of the clusters, and finally removing silica to expose the mesoporous catalysts. With the help of the silica coating, the clusters not only maintain their small grain size but also keep their mesoporous structure after calcination at high temperatures （with BET surface area as high as 277 m2/g）. The etching of SiO2 also results in the clusters having high dispersity in water. We have been able to identify the optimal calcination temperature to produce TiO2 nanocrystal clusters that possess both high crystallinity and large surface area, and therefore show excellent catalytic efficiency in the decomposition of organic molecules under illumination by UV light. Convenient doping with nitrogen converts these nanocrystal clusters into active photocatalysts in both visible light and natural sunlight. The strategy of forming well-defined mesoporous clusters using nanocrystals promises a versatile and useful method for designing photocatalysts with enhanced activity and stability.展开更多
Epigenetic alterations contribute significantly to the development and progression of gastric cancer,one of the leading causes of cancer death worldwide.Epigenetics refers to the number of modifications of the chromat...Epigenetic alterations contribute significantly to the development and progression of gastric cancer,one of the leading causes of cancer death worldwide.Epigenetics refers to the number of modifications of the chromatin structure that affect gene expression without altering the primary sequence of DNA,and these changes lead to transcriptional activation or silencing of the gene.Over the years,the study of epigenetic processes has increased,and novel therapeutic approaches that target DNA methylation and histone modifications have emerged.A greater understanding of epigenetics and the therapeutic potential of manipulating these processes is necessary for gastric cancer treatment.Here,we review recent research on the effects of aberrant DNA and histone methylation on the onset and progression of gastric tumors and the development of compounds that target enzymes that regulate the epigenome.展开更多
Inflammatory bowel disease(IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density(BMD), which leads to osteopenia and osteoporo...Inflammatory bowel disease(IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density(BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn's disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored.展开更多
The aim of this work was to isolate and identify the yeasts prevalent in fresh grapes cultivated in the “São Francisco Valley” region (Brazil), as well as evaluating the cell growth of these indigenous ye...The aim of this work was to isolate and identify the yeasts prevalent in fresh grapes cultivated in the “São Francisco Valley” region (Brazil), as well as evaluating the cell growth of these indigenous yeasts during the fermentation of grape musts and their contribution to the improvement of wine aroma. The Chenin Blanc grape must fermented by H. opuntiae presented higher acceptance means at the three points analyzed (6.74, 6.78 and 7.30) and in the fermentation carried out by the yeasts H. opuntiae and S. cerevisiae, the highest mean acceptance (7.22) was observed after 120 hours, with no statistical difference from the sample fermented by H. opuntiae alone. Since these samples that showed higher acceptance means also receiving higher scores for purchasing intention, corresponding to the concepts of “definitely would buy” and “probably would buy”. The present study suggests that the fermentations of grape musts carried out by the yeast H. opuntiae and mixed cultures of H. opuntiae and Saccharomyces cerevisiae, positively influenced the sensory qualities of the wines and showed greater potential to increase the aroma of the musts and to develop specific wine styles.展开更多
文摘Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent illnesses.UC is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any age.The incidence of UC has increased worldwide over recent decades,especially in developing nations.In contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over time.It is important to emphasize that there is considerable variability in the phenotypic presentation of UC.Within this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor prognosis.In this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the disease.The aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis.
文摘Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infection may also influence the development and severity of various extragastric diseases.According to the current evidence,whereas this bacterium is a risk factor for some of these manifestations,it might play a protective role in other pathological conditions.In that context,when considered the gastrointestinal tract,H.pylori positivity have been related to Inflammatory Bowel Disease,Gastroesophageal Reflux Disease,Non-Alcoholic Fatty Liver Disease,Hepatic Carcinoma,Cholelithiasis,and Cholecystitis.Moreover,lower serum levels of iron and vitamin B12 have been found in patients with H.pylori infection,leading to the emergence of anemias in a portion of them.With regards to neurological manifestations,a growing number of studies have associated that bacterium with multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,and Guillain-Barrésyndrome.Interestingly,the risk of developing cardiovascular disorders,such as atherosclerosis,is also influenced by the infection.Besides that,the H.pylori-associated inflammation may also lead to increased insulin resistance,leading to a higher risk of diabetes mellitus among infected individuals.Finally,the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism.In this sense,this minireview aims to gather the main studies associating H.pylori infection with extragastric conditions,and also to explore the main mechanisms that may explain the role of H.pylori in those diseases.
文摘Lignin is a polymer of phenylpropanoid compounds formed through a complex biosynthesis route, represented by a metabolic grid for which most of the genes involved have been sequenced in several plants, mainly in the model-plants Arabidopsis thaliana and Populus. Plants are exposed to different stresses, which may change lignin content and composition. In many cases, particularly for plant-microbe interactions, this has been suggested as defence responses of plants to the stress. Thus, understanding how a stressor modulates expression of the genes related with lignin biosynthesis may allow us to develop study-models to increase our knowledge on the metabolic control of lignin deposition in the cell wall. This review focuses on recent literature reporting on the main types of abiotic and biotic stresses that alter the biosynthesis of lignin in plants.
基金Supported by Coordenao de Aperfeioamento de Pessoal de Nível Superior and Federal University of Pará
文摘AIM: To establish whether virulence factor genes vacA and cagA are present in Helicobacter pylori (H. pylori) retrieved from gastric mucosa and dental plaque in pa-tients with dyspepsia. METHODS: Cumulative dental plaque specimens and gastric biopsies were submitted to histological exami-nation, rapid urease test and polymerase chain reac-tion (PCR) assays to detect the presence of cagA and vacA polymorphisms.RESULTS: Detection of H. pylori from dental plaque and gastric biopsy samples was greater by PCR com-pared to histological examination and the rapid ure-ase test. DNA from H. pylori was detected in 96% of gastric mucosa samples and in 72% of dental plaque samples. Sixty-three (89%) of 71 dental plaque sam-ples that were H. pylori-positive also exhibited identical vacA and cagA genotypes in gastric mucosa. The most common genotype was vacAs1bm1 and cagA positive, either in dental plaque or gastric mucosa. These viru-lent H. pylori isolates were involved in the severity of clinical outcome.CONCLUSION: These pathogenic strains were found simultaneously in dental plaque and gastric mucosa, which suggests that gastric infection is correlated with the presence of H. pylori in the mouth.
文摘AIM： To evaluate and compare the expression profiles of CXCL12 （SDF-1）, CCL19 （MIP-3β）, CCL20 （MIP-3a） and CCL21 （6Ckine, Exodus2） and their receptors on RNA and protein levels in hepatocellular carcinoma （HCC） versus colorectal liver metastases （CRLM） and to elucidate their impact on the carcinogenesis and progression of malignant liver diseases. METHODS： Chemokine expression was analyzed by RT-PCR and ELISA in 11 cases of HCC specimens and in 23 cases of CRLM and corresponding adjacent nontumorous liver tissues, respectively. Expressions of their receptors CXCR4, CCR6 and CCR7 were analyzed by RT- PCR and Western blot analysis in the same cases of HCC and CRLM. RESULTS： Significant up-regulation for CCL20/CCR6 was detected in both cancer types. Moreover, CCL20 demonstrated significant overexpression in CRLM in relation to the HCC tissues. Being significantly up-regulated only in CRLM, CXCR4 displayed an aberrant expression pattern with respect to the HCC tissues. CONCLUSION： Correlation of CXCR4 expression with CRLM suggests CXCR4 as a potential predictive factor for CRLM. High level expression of CCL20 and its receptor CCR6 in HCC and CRLM with marked up-regulation of CCL20 in CRLM in relation to HCC tissues indicates involvement of the CCL20/CCR6 ligand-receptor pair in the carcinogenesis and progression of hepatic malignancies.
文摘The gut microbiota is a complex community of microorganisms that inhabit the digestive tracts of humans,living in symbiosis with the host.Dysbiosis,characterized by an imbalance between the beneficial and opportunistic gut microbiota,is associated with several gastrointestinal disorders,such as irritable bowel syndrome(IBS);inflammatory bowel disease(IBD),represented by ulcerative colitis and Crohn’s disease;and colorectal cancer(CRC).Dysbiosis can disrupt the mucosal barrier,resulting in perpetuation of inflammation and carcinogenesis.The increase in some specific groups of harmful bacteria,such as Escherichia coli(E.coli)and enterotoxigenic Bacteroides fragilis(ETBF),has been associated with chronic tissue inflammation and the release of pro-inflammatory and carcinogenic mediators,increasing the chance of developing CRC,following the inflammationdysplasia-cancer sequence in IBD patients.Therefore,the aim of the present review was to analyze the correlation between changes in the gut microbiota and the development and maintenance of IBD,CRC,and IBD-associated CRC.Patients with IBD and CRC have shown reduced bacterial diversity and abundance compared to healthy individuals,with enrichment of Firmicute sand Bacteroidetes.Specific bacteria are also associated with the onset and progression of CRC,such as Fusobacterium nucleatum,E.coli,Enterococcus faecalis,Streptococcus gallolyticus,and ETBF.Future research can evaluate the advantages of modulating the gut microbiota as preventive measures in CRC high-risk patients,directly affecting the prognosis of the disease and the quality of life of patients.
基金Supported by Fundao de Amparo à Pesquisa do Estado de So Paulo, Coordenao de Aperfeioamento de Pessoal de Nível Superior and Conselho Nacional de Desenvolvimento Científico e Tecnológico
文摘AIM：To evaluate the methylation status of CDH1, FHIT, MTAP and PLAGL1 promoters and the association of these findings with clinico-pathological characteristics.METHODS： Methylation-specific PCR （MSP） assay was performed in 13 nonneoplastic gastric adenocarcinorna, 30 intestinal-type gastric adenocarcinorna and 35 diffuse-type gastric adenocarcinorna samples from individuals in Northern Brazil. Statistical analyses were performed using the chi-square or Fisher＇s exact test to assess associations between rnethylation status and clinico-pathological characteristics.RESULTS： Hypermethylation frequencies of CDH1, FHIT, MTAPand PLAGL1 promoter were 98.7%, 53.9%, 23.1% and 29.5%, respectively. Hyperrnethylation of three or four genes revealed a significant association with diffuse-type gastric cancer compared with nonneoplastic cancer. A higher hyperrnethylation frequency was significantly associated with H pylori infection in gastric cancers, especially with diffuse-type. Cancer samples without lymph node metastasis showed a higher FHIT hypermethylation frequency. MTAP hypermethylation was associated with H pylori in gastric cancer samples, as well as with diffuse-type compared with intestinal-type. In diffuse-type, MTAP hypermethylation was associated with female gender.CONCLUSION： Our findings show differential gene methylation in tumoral tissue, which allows us to conclude that hypermethylation is associated with gastric carcinogenesis. MTAP promoter hypermethylation can be characterized as a marker of diffuse-type gastric cancer, especially in women and may help in diagnosis, prognosis and therapies. The H pylori infectious agent was present in 44.9% of the samples. This infection may be correlated with the carcinogenic process through the gene promoter hypermethylation, especially the MTAP promoter in diffuse-type. A higher H pylori infection in diffuse-type may be due to greater genetic predisposition.
基金Supported by CERN and national agencies:CAPES,CNPq,FAPERJ and FINEP(Brazil)NSFC(China)+17 种基金CNRS/IN2P3(France)BMBF,DFG,HGF and MPG(Germany)INFN(Italy)FOM and NWO(The Netherlands)MNi SW and NCN(Poland)MEN/IFA(Romania)Min ES and FANO(Russia)Min ECo(Spain)SNSF and SER(Switzerland)NASU(Ukraine)STFC(United Kingdom)NSF(USA)supported by IN2P3(France),KIT and BMBF(Germany),INFN(Italy),NWOSURF(The Netherlands),PIC(Spain),Grid PP(United Kingdom)support from EPLANET,Marie Sk lodowska-Curie ActionsERC(European Union),Conseil général de Haute-Savoie,Labex ENIGMASS and OCEVU,RégionAuvergne(France),RFBR(Russia),Xunta GalGENCAT(Spain),Royal Society and Royal Commission for the Exhibition of 1851(United Kingdom)
文摘The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse momentum, PT, and rapidity, y. The kinematic region of the measurements is pT〈20 GeV/c and 2.0 〈g〈4.5.The measurements use a data sample corresponding to an integrated luminosity of 3fb-1 collected by the LHCb detector in pp collisions at centre-of-mass energies √s=7 TeV in 2011 and √s=8 TeV in 2012. Based on previous LHCb results of the fragmentation fraction ratio,f∧0/b/fd,the branching fraction of the decay ∧0/b→ J/ψ pK-is measured to be B（∧0/b→ J/ψ pK-）=（3.17±0.04±0.07±0.34＋0.45/-0.28）×10-4,where the first uncertainty is statistical, the second is systematic, the third is due to the uncertainty on the branching fraction of the decay -B/0 →J/ψ-K＊（892）0,and the fourth is due to the knowledge of f∧0/b/fd.The sum of the asymmetries in the production and decay between ∧0/b and ∧0/bis also measured as a function of PT and y.The previously published branching fraction of ∧0/b→ J/ψ pπ-,relative to that of ∧0/b→ J/ψ pK-,is updated. The branching fractions of ∧0/b→P＋c（→ J/ψp）K-are determined.
基金Supported by IMBTMCT/CNPq and Monte Tabor/Hospital Sao Rafael
文摘AIM： To evaluate the safety and feasibility of bone marrow cell （BMC） transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS： Ten patients （eight males） with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 mL of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS： The median age of the patients was 52 years （range 24-70 years）. All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 （2.19 ± 0.9） and 4 mo （2.10 ± 1.0） after cell transplantation that baseline levels （238 ± 1.2）. Albumin levels 4 mo after BMC infusion （3.73 ± 0.5） were higher than baseline levels （3.47 ± 0.5）. International normalized ratio （INR） decreased from 1.48 （SD = 0.23） to 1.43 （SD = 0.23） one month after cell transplantation. CONCLUSION： BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease.
基金Supported by department of Gastroenterology-Gastrointestinal Endoscopy Unit,So Paulo University School of Medicine
文摘AIM:To compare band ligation(BL) with endoscopic sclerotherapy(SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS:A prospective,randomized,single-center study without crossover was conducted.After endoscopic diagnosis of esophageal variceal rupture,patients were randomized into groups for SCL or BL treatment.Sclerotherapy was performed by ethanolamine oleate intravascular injection both above and below the rupture point,with a maximum volume of 20 mL.For BL patients,banding at the rupture point was attempted,followed by ligation of all variceal tissue of the distal esophagus.Primary outcomes for both groups were initial failure of bleeding control(5 d) ,early re-bleeding(5 d to 6 wk),and complications,including mortality.From May 2005 to May 2007,100 patients with variceal bleeding were enrolled in thestudy:50 SCL and 50 BL patients.No differences between groups were observed across gender,age,ChildPugh status,presence of shock at admission,mean hemoglobin levels,and variceal size. RESULTS:No differences were found between groups for bleeding control,early re-bleeding rates,complications,or mortality.After 6 wk,36(80%) SCL and 33(77 %) EBL patients were alive and free of bleeding.A statistically significant association between Child-Pugh status and mortality was found,with 16%mortality in Child A and B patients and 84%mortality in Child C patients(P<0.001) . CONCLUSION:Despite the limited number of patients included,our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.
基金Supported by The So Paulo State Research Foundation,No.2010/00507-0CNPq,No.471908/2010-0
文摘AIM： TO investigate toll-like receptor 2 （TLR2） -196 to -274 del, and TLR4 （＋896A/G rs4986790 and ＋1196C/ T rs4986791） polymorphisms at risk of chronic gastritis and gastric cancer in a Brazilian population and associ-ation of gastric lesions with risk factors such as smoking, alcohol intake and Helicobacter pylori infection.METHODS： In this casecontrol study, polymorphism at TLR2 -96 to -174 del was investigated by using the allele-specific polymerase chain reaction （PCR） method, while the PCR-restriction fragment length polymorphism technique was carried out to identify the TLR4 （rs4986790 and rs4986791） genotypes in 607 Brazilian individuals （208 with chronic gastritis-CG, 174 with gastric cancer-GC and 225 controls -C）.RESULTS： The single nucleotide polymorphisms TLR4＋1196ClT was not associated with risk of chronic gastritis or gastric cancer and the homozygous genotypes TLR4＋896GG and TLR4＋1196TF were absent in the studied population. However, the frequency of TLR2 -196 to -174 ins/del ＋ del/del and TLR4＋896AGgenotypes was significantly higher （P 〈 0.01 and P = 0.01, respectively） in the cancer group （33.4% and 11.5%, respectively） than in the control group （16.9% and 4.5%, respectively）. It was also observed that the G-C haplotype of the TLR4＋896A/G＋1196C/T （P = 0.02） and the combination of variant alleles of the TLR21TLR4＋896G （P = 0.02） are associated with susceptibility to gastric cancer. In addition, the multiple logistic regression showed that male gender [odds ratio （OR） = 2.70; 95% CI： 1.66-4.41; P 〈 0.01], alcohol intake （OR = 2.93; 95% CI： 1.76-4.87, P 〈 0.01）, TLR2 -196 to -174 del （OR = 2.64; 95% CI： 1.56-4.44; P 〈 0.01） and TLR4＋896G （OR = 3.19; 95% CI： 1.34- 7.61; P 〈 0.01） polymorphisms were associated with a higher susceptibility to developing this neoplasm.CONCLUSION： Our data indicate that T/R2 -196 to -174 del and TLR4＋896G may increase the risk of gastric cancer in a Brazilian populat
基金Supported by Secretaria Executiva de Ciência,Tecnologiae Meio Ambiente-SECTAM and Coordenao de Aperfeioamento de Pessoal de Nível Superior-CAPES
文摘AIM： To study the association between Interleukin-1 （IL-1） and tumor necrosis factor （TNF）-α polymorphisms, infection by Helicobacter pylori （H pylori） and the development of gastrointestinal diseases.METHODS： Genomic DNA was extracted from the peripheral blood of 177 patients with various gastrointestinal diseases and from 100 healthy volunteers. The polymorphisms in IL-1β and TNF-α genes were analyzed using the polymerase chain reactionrestriction fragment length polymorphism method （PCRRFLP） and those from IL-1RN with PCR. The presence of infection due to H pylori and the presence of the CagA toxin were detected by serology. The histopathological parameters in the gastric biopsies of the patients were according to the Sydney classification.RESULTS： A comparison of the frequencies of the different polymorphisms studied among the patients and the control group demonstrated that the allele IL- 1RN＊2 was more frequent among patients with gastric ulcers and adenocarcinoma. Carriers of the allele IL- RN＊2 and those with reactive serology for anti-CagA IgG had a greater risk of developing peptic ulcer and gastric adenocarcinoma, as well as a higher degree of inflammation and neutrophilic activity in the gastricCONCLUSION： Our results indicate a positive association between IL-1RN gene polymorphism and infection by positive H pylori CagA strains and the development of gastric ulcers and adenocarcinoma.
文摘AIM： To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions.METHODS： From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUSFNA. The final diagnosis was obtained either by surgery （356 cases） or after a mean clinical follow-up of 11.8 mo in the remaining patients.RESULTS： There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 （97.4%） cases. There were 352 （57.6%） malignancies and 259 （42.4%） benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67% of the lesions. Overall, the sensitivity, specificity, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4%, 99.2%, 99.3%, 77.2% and 87.2%. Specifically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8% ys 82.4%, 100% ys 98.4%, 100% vs 99%, 54.8% vs 74.1% and 83.1% vs 87.8%. For cystic lesions, the values were, respectively, 72.2%, 99.3%, 97.5%, 91% and 92.2%.CONCLUSION： EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions can reveal the best negative predictive value and diagnostic accuracy, both higher than 90%.
文摘Background: Early allograft dysfunction (EAD) is a severe complication after liver transplantation. The associated risk factors and complications have re-gained recent interest. This study investigated risk factors, survival and complications associated with EAD in a large liver transplant center in Latin America. Methods: Retrospective, unicenter, cohort, based on data from adult patients undergoing first deceaseddonor liver transplant from January 2009 to December 2013. EAD was defined by one or more of the following:(i) bilirubin ≥10 mg/dL on postoperative day 7;(ii) international normalized ratio ≥1.6 on postoperative day 7, and (iii) alanine aminotransferase or aspartate aminotransferase > 2000 IU/L within the first seven days after transplant. Results: A total of 602 patients were included;of these 34.2% developed EAD. Donor risk factors were male ( P = 0.007), age between 50 and 59 years ( P = 0.034), overweight ( P = 0.028) or grade I obesity ( P = 0.012), sodium > 157 mmol/L ( P = 0.002) and grade IV ischemia/reperfusion injury ( P = 0.002). Cold ischemia time ≥10 h ( P = 0.008) and warm ischemia time ≥40 min ( P = 0.013) were the surgical factors. Male ( P < 0.001) was the only recipient protective factor. Compared with the non-EAD group, patients with EAD were submitted to more reoperations (24.3% vs. 13.4%, P = 0.001) and had higher graft loss rates (37.9% vs. 21.2%, P < 0.001), with similar patient survival rates ( P = 0.238). Conclusions: EAD risk factors are related to donor, surgical procedure and recipient. Donor risk factors for EAD were male, age between 50 and 59 years, donor overweight or grade Ⅰ obesity, sodium > 157 mmol/L and grade Ⅳ ischemia/reperfusion injury. Cold ischemia time ≥10 h and warm ischemia time ≥40 min were the surgical risk factors. Male was the only recipient protective factor. Patients with EAD had higher reoperations and graft loss rates.
文摘AIM: To compare deep sedation with propofol-fentanyl and midazolam-fentanyl regimens during upper gastrointestinal endoscopy. METHODS: After obtaining approval of the research ethics committee and informed consent, 200 patients were evaluated and referred for upper gastrointestinal endoscopy. Patients were randomized to receive propofol-fentanyl or midazolam-fentanyl (n = 100/group).We assessed the level of sedation using the observer's assessment of alertness/sedation (OAA/S) score and bispectral index (BIS). We evaluated patient and physician satisfaction, as well as the recovery time and complication rates. The statistical analysis was performed using SPSS statistical software and included the MannWhitney test, χ 2 test, measurement of analysis of variance, and the κ statistic. RESULTS: The times to induction of sedation, recovery, and discharge were shorter in the propofolfentanyl group than the midazolam-fentanyl group. According to the OAA/S score, deep sedation events occurred in 25% of the propofol-fentanyl group and 11% of the midazolam-fentanyl group (P = 0.014). Additionally, deep sedation events occurred in 19% of the propofol-fentanyl group and 7% of the midazolamfentanyl group according to the BIS scale (P = 0.039). There was good concordance between the OAA/S score and BIS for both groups (κ = 0.71 and κ = 0.63, respectively). Oxygen supplementation was required in 42% of the propofol-fentanyl group and 26% of the midazolam-fentanyl group (P = 0.025). The mean time to recovery was 28.82 and 44.13 min in the propofolfentanyl and midazolam-fentanyl groups, respectively (P < 0.001). There were no severe complications in either group. Although patients were equally satisfied with both drug combinations, physicians were more satisfied with the propofol-fentanyl combination. CONCLUSION: Deep sedation occurred with propofolfentanyl and midazolam-fentanyl, but was more frequent in the former. Recovery was faster in the propofol-fentanyl group.
文摘Mesoporous nanocrystal clusters of anatase TiO2 with large surface area and enhanced photocatalytic activity have been successfully synthesized. The synthesis involves the self-assembly of hydrophobic TiO2 nanocrystals into submicron clusters, coating of these clusters with a silica layer, thermal treatment to remove organic ligands and improve the crystallinity of the clusters, and finally removing silica to expose the mesoporous catalysts. With the help of the silica coating, the clusters not only maintain their small grain size but also keep their mesoporous structure after calcination at high temperatures （with BET surface area as high as 277 m2/g）. The etching of SiO2 also results in the clusters having high dispersity in water. We have been able to identify the optimal calcination temperature to produce TiO2 nanocrystal clusters that possess both high crystallinity and large surface area, and therefore show excellent catalytic efficiency in the decomposition of organic molecules under illumination by UV light. Convenient doping with nitrogen converts these nanocrystal clusters into active photocatalysts in both visible light and natural sunlight. The strategy of forming well-defined mesoporous clusters using nanocrystals promises a versatile and useful method for designing photocatalysts with enhanced activity and stability.
基金Supported by Sao Paulo State Research Foundation (FAPESP),No. 2009/07145-9 and 2010/11174-1National Counsel of Technological and Scientific Development (CNPq)Coordination for the Improvement of Higher Level Personnel (CAPES)
文摘Epigenetic alterations contribute significantly to the development and progression of gastric cancer,one of the leading causes of cancer death worldwide.Epigenetics refers to the number of modifications of the chromatin structure that affect gene expression without altering the primary sequence of DNA,and these changes lead to transcriptional activation or silencing of the gene.Over the years,the study of epigenetic processes has increased,and novel therapeutic approaches that target DNA methylation and histone modifications have emerged.A greater understanding of epigenetics and the therapeutic potential of manipulating these processes is necessary for gastric cancer treatment.Here,we review recent research on the effects of aberrant DNA and histone methylation on the onset and progression of gastric tumors and the development of compounds that target enzymes that regulate the epigenome.
文摘Inflammatory bowel disease(IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density(BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn's disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored.
文摘The aim of this work was to isolate and identify the yeasts prevalent in fresh grapes cultivated in the “São Francisco Valley” region (Brazil), as well as evaluating the cell growth of these indigenous yeasts during the fermentation of grape musts and their contribution to the improvement of wine aroma. The Chenin Blanc grape must fermented by H. opuntiae presented higher acceptance means at the three points analyzed (6.74, 6.78 and 7.30) and in the fermentation carried out by the yeasts H. opuntiae and S. cerevisiae, the highest mean acceptance (7.22) was observed after 120 hours, with no statistical difference from the sample fermented by H. opuntiae alone. Since these samples that showed higher acceptance means also receiving higher scores for purchasing intention, corresponding to the concepts of “definitely would buy” and “probably would buy”. The present study suggests that the fermentations of grape musts carried out by the yeast H. opuntiae and mixed cultures of H. opuntiae and Saccharomyces cerevisiae, positively influenced the sensory qualities of the wines and showed greater potential to increase the aroma of the musts and to develop specific wine styles.
