目的本文试图通过对近半个世纪以来运动处方的产生及其发展过程,以及各阶段的特点进行分析和评价,为运动处方、运动康复疗法和机能评定在我国的普及应用提供理论和实践依据。方法采用计算机网络文献和资料收集法,对Medlin via Ovid、Pub...目的本文试图通过对近半个世纪以来运动处方的产生及其发展过程,以及各阶段的特点进行分析和评价,为运动处方、运动康复疗法和机能评定在我国的普及应用提供理论和实践依据。方法采用计算机网络文献和资料收集法,对Medlin via Ovid、PubMed、Sport Discus、CINAHL、CAM、EMbase和EBM Cochrane Databaseof SR 7个数据库进行检索,检索词为exercise prescription、physical tness、exercise therapy、tness assessment、exercise test、randomized,检索时间均从建库至2008年6月。然后对其中的随机和非随机对照研究,以及资料较全者纳入分析讨论。结果共检索到318篇文献,但其中涉及运动处方和机能评定的随机对照试验(RCT)仅有7篇,系统评价和Meta分析各1篇。我们对其中资料较全又有代表性的93篇文献进行了系统分析讨论。结果显示:最早的运动处方和机能评定研究可以追溯到1950年,其发展与运动康复疗法的发展密不可分。二十世纪70年代是运动处方发展的初始期,首先是在身体活动与心血管健康方面提出了运动处方的概念,而后逐步提出了针对个体的运动处方,进而开始把运动处方与体能测试联系在一起讨论。二十世纪80年代运动处方开始进入了全面发展的阶段,开始用体能测试指导运动处方,并使运动处方和机能评定进入实验阶段。二十世纪90年代运动处方开始与多种运动康复疗法相结合,针对多种疾病进行干预和治疗,并与多种体能训练方法相结合指导训练和康复,成为一种主要的非药物治疗手段。进入本世纪以后,运动处方和机能评定的研究得到了全面提高,开始出现非随机对照试验和RCT,一些先进的测试手段和分析方法开始应用于机能评定和运动处方的实施。结论运动处方的发展与运动康复疗法和运动机能评定的发展是密不可分的,机能评定和体能测试是执行和实施运动处方的基础。当今,�展开更多
Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomo...Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.展开更多
This review focuses on research findings in the area of diagnosis and pathogenesis of hepatitis C virus(HCV)infection over the last few decades.The information based on published literature provides an update on these...This review focuses on research findings in the area of diagnosis and pathogenesis of hepatitis C virus(HCV)infection over the last few decades.The information based on published literature provides an update on these two aspects of HCV.HCV infection,previously called blood transmitted non-A,non-B infection,is prevalent globally and poses a serious public health problem worldwide.The diagnosis of HCV infection has evolved from serodetection of non-specific and low avidity anti-HCV antibodies to detection of viral nucleic acid in serum using the polymerase chain reaction(PCR)technique.Current PCR assays detect viral nucleic acid with high accuracy and the exact copy number of viral particles.Moreover,multiplex assays using real-time PCR are available for identification of HCV-genotypes and their isotypes.In contrast to previous methods,the newly developed assays are not only fast and eco-nomic,but also resolve the problem of the window period as well as differentiate present from past infection.HCV is a non-cytopathic virus,thus,its pathogenesis is regulated by host immunity and metabolic changes including oxidative stress,insulin resistance and hepatic steatosis.Both innate and adaptive immunity play an important role in HCV pathogenesis.Cytotoxic lymphocytes demonstrate crucial activity during viral eradication or viral persistence and are influenced by viral proteins,HCV-quasispecies and several metabolic factors regulating liver metabolism.HCV pathogenesis is a very complex phenomenon and requires further study to determine the other factors involved.展开更多
Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosi...Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma.Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver(simple steatosis),a small percentage develops progressive liver disease.Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available.The treatment for ALD remains as it was 50 years ago:abstinence,nutritional support and corticosteroids(or pentoxifylline as an alternative if steroids are contraindicated).As for NAFLD,the treatment modality is mainly directed toward weight loss and co-morbidity management.Therefore,new pathophysiology directed therapies are urgently needed.However,the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy.Hence,a combination therapy towards multiple targets would eventually be required.In this review,we delineate the treatment options in ALD and NAFLD,including various new targeted therapies that are currently under investigation.We hope that soon we will be having an effective multi-therapeutic regimen for each disease.展开更多
Biochar is the carbon-rich product obtained from the thermochemical conversion of biomass under oxygen-limited conditions.Biochar has attained extensive attention due to its agronomical and environmental benefits in a...Biochar is the carbon-rich product obtained from the thermochemical conversion of biomass under oxygen-limited conditions.Biochar has attained extensive attention due to its agronomical and environmental benefits in agro-ecosystems.This work adopts the scientometric analysis method to assess the development trends of biochar research based on the literature data retrieved from the Web of Science over the period of 1998-2018.By analysing the basic characteristics of 6934 publications,we found that the number of publications grew rapidly since 2010.Based on a keyword analysis,it is concluded that scholars have had a fundamental recognition of biochar and preliminarily found that biochar application had agronomic and environmental benefits during the period of 1998-2010.The clustering results of keywords in documents published during 2011-2015 showed that the main research hotspots were“biochar production”,“biochar and global climate change”,“soil quality and plant growth”,“organic pollutants removal”,and“heavy metals immobilization”.While in 2016-2018,beside these five main research hotspots,“biochar and composting”topic had also received greater attention,indicating that biochar utilization in organic solid waste composting is the current research hotspot.Moreover,updated reactors(e.g.,microwave reactor,fixed-bed reactor,screw-feeding reactor,bubbling fluidized bed reactor,etc.)or technologies(e.g.,solar pyrolysis,Thermo-Catalytic Reforming process,liquefaction technology,etc.)applied for efficient energy production and modified biochar for environmental remediation have been extensively studied recently.The findings may help the new researchers to seize the research frontier in the biochar field.展开更多
Agricultural productivity is something on which economy highly depends.This is the one of the reasons that disease detection in plants plays an important role in agriculture field,as having disease in plants are quite...Agricultural productivity is something on which economy highly depends.This is the one of the reasons that disease detection in plants plays an important role in agriculture field,as having disease in plants are quite natural.If proper care is not taken in this area then it causes serious effects on plants and due to which respective product quality,quantity or productivity is affected.For instance a disease named little leaf disease is a hazardous disease found in pine trees in United States.Detection of plant disease through some automatic technique is beneficial as it reduces a large work of monitoring in big farms of crops,and at very early stage itself it detects the symptoms of diseases i.e.when they appear on plant leaves.This paper presents an algorithm for image segmentation technique which is used for automatic detection and classification of plant leaf diseases.It also covers survey on different diseases classification techniques that can be used for plant leaf disease detection.Image segmentation,which is an important aspect for disease detection in plant leaf disease,is done by using genetic algorithm.展开更多
Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,whic...Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,which should be detected to shorten the duration of patients'improvement,reduce health care cost,and lessen the incidence of various PICC-related complications.Therefore,this study aimed to outline current literature on PICC procedures,potential complications,and measures for prevention.Understanding evidence-based guidelines regarding insertion technique,early detection of complications,and care bundle of PICC is significant in complication prevention.Implementation of education,training,and appropriate multidisciplinary approaches on PICC care among nurses and caregivers is the key to preventing complications.Thus,the strict care of indwelling PICC lines,the targeted and reasonable PICCassociated complication prevention,and nursing care have a major clinical significance in reducing the occurrence of potential PICC complications.展开更多
Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely un...Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.展开更多
Wogonin is a plant flavonoid compound extracted from Scutellaria baicalensis(Huang-Qin or Chinese skullcap) and has been studied thoroughly by many researchers till date for its anti-viral, anti-oxidant, anti-cancerou...Wogonin is a plant flavonoid compound extracted from Scutellaria baicalensis(Huang-Qin or Chinese skullcap) and has been studied thoroughly by many researchers till date for its anti-viral, anti-oxidant, anti-cancerous and neuro-protective properties. Numerous experiments conducted in vitro and in vivo have demonstrated wogonin's excellent tumor inhibitory properties. The anticancer mechanism of wogonin has been ascribed to modulation of various cell signaling pathways, including serine-threonine kinase Akt(also known as protein kinase B) and AMP-activated protein kinase(AMPK) pathways, p53-dependent/independent apoptosis, and inhibition of telomerase activity. Furthermore, wogonin also decreases DNA adduct formation with a carcinogenic compound 2-Aminofluorene and inhibits growth of drug resistant malignant cells and their migration and metastasis, without any side effects. Recently, newly synthesized wogonin derivatives have been developed with impressive anti-tumor activity. This review is the succinct appraisal of the pertinent articles on the mechanisms of anti-tumor properties of wogonin. We also summarize the potential of wogonin and its derivatives used alone or as an adjunct therapy for cancer treatment. Furthermore, pharmacokinetics and side effects of wogonin and its analogues have also been discussed.展开更多
Hepatitis B （HBV） and hepatitis C （HCV） viral infection or co-infection leads to risk of development of chronic infection, cirrhosis and hepatocellular carcinoma （HCC）. Immigration and globalization have added t...Hepatitis B （HBV） and hepatitis C （HCV） viral infection or co-infection leads to risk of development of chronic infection, cirrhosis and hepatocellular carcinoma （HCC）. Immigration and globalization have added to the challenges of public health concerns regarding chronic HBV and HCV infections worldwide. The aim of this study is to review existing global literature across ethnic populations on HBV and HCV related human leukocyte antigen （HLA） associations in relation to susceptibility, viral persistence and treatment. Extensive literature search was conducted to explore the HLA associations in HBV and HCV infections reported across global populations over the past decade to understand the knowledge status, weaknesses and strengths of this information in different ethnic populations. HLA DR13 is consistently associated with HBV clearance globally. HLADRB1＊11/＊12 alleles and DQB1＊0301 are associated with HBV persistence but with HCV clearance worldwide. Consistent association of DRB1＊03 and ＊07 is observed with HCV susceptibility and non-responsiveness to HBV vaccination across the population. HLA DR13 is protective for vertical HBV and HCV transmission in Chinese and Italian neonates, but different alleles are associated with their susceptibility in these populations. HLA class I molecule interactions with Killer cell immunoglobulin like receptors （KIR） of natural killer （NK） cells modulate HCV infection outcome via regulating immune regulatory cells and molecules. HLA associations with HBV vaccination, interferon therapy in HBV and HCV, and with extra hepatic manifestations of viral hepatitis are also discussed. Systematic studies in compliance with global regulatory standards are required to identify the HLA specific viral epitope, stage specific T cell populations interacting with different HLA alleles during disease progression and viral clearance of chronic HBV or HCV infections among different ethnic populations. These studies would facilitate stage specific therapeutic stra展开更多
Diabetic nephropathy has been the cause of lot of morbidity and mortality in the diabetic population. The renin angiotensin system (RAS) is considered to be involved in most of the pathological processes that result i...Diabetic nephropathy has been the cause of lot of morbidity and mortality in the diabetic population. The renin angiotensin system (RAS) is considered to be involved in most of the pathological processes that result in diabetic nephropathy. This system has various subsystems which contribute to the disease pathology. One of these involves angiotensin II (Ang II) which shows increased activity during diabetic nephropathy. This causes hypertrophy of various renal cells and has a pressor effect on arteriolar smooth muscle resulting in increased vascular pressure. Ang II also induces inflammation, apoptosis, cell growth, migration and differentiation. Monocyte chemoattractant protein-1 production responsible for renal fibrosis is also regulated by RAS. Polymorphism of angiotensin converting enzyme (ACE) and Angiotensinogen has been shown to have effects on RAS. Available treatment modalities have proven effective in controlling the progression of nephropathy. Various drugs (based on antagonism of RAS) are currently in the market and others are still under trial. Amongst the approved drugs, ACE inhibitors and angiotensin receptor blockers (ARBs) are widely used in clinical practice. ARBs are shown to be superior to ACE inhibitors in terms of reducing proteinuria but the combined role of ARBs with ACE inhibitors in diabetic nephropathy is under debate.展开更多
Concentrations of Iron (Fe), As, and Cu in soil samples from the fields near the Baoshan Mine in Hunan Province, China, were analyzed and soil spectral reflectance was measured with an ASD FieldSpec FR spectroradiomet...Concentrations of Iron (Fe), As, and Cu in soil samples from the fields near the Baoshan Mine in Hunan Province, China, were analyzed and soil spectral reflectance was measured with an ASD FieldSpec FR spectroradiometer (Analytical Spectral Devices, Inc., USA) under laboratory condition. Partial least square regression (PLSR) models were constructed for predicting soil metal concentrations. The data pre-processing methods, first and second derivatives (FD and SD), baseline correction (BC), standard normal variate (SNV), multiplicative scatter correction (MSC), and continuum removal (CR), were used for the spectral reflectance data pretreatments. Then, the prediction results were evaluated by relative root mean square error (RRMSE) and coefficients of determination (R 2 ). According to the criteria of minimal RRMSE and maximal R 2 , the PLSR models with the FD pretreatment (RRMSE = 0.24, R 2 = 0.61), SNV pretreatment (RRMSE = 0.08, R 2 = 0.78), and BC-pretreatment (RRMSE = 0.20, R 2 = 0.41) were considered as the final models for predicting As, Fe, and Cu, respectively. Wavebands at around 460, 1 400, 1 900, and 2 200 nm were selected as important spectral variables to construct final models. In conclusion, concentrations of heavy metals in contaminated soils could be indirectly assessed by soil spectra according to the correlation between the spectrally featureless components and Fe; therefore, spectral reflectance would be an alternative tool for monitoring soil heavy metals contamination.展开更多
Flavonoids are a widely distributed group of phytochemicals having benzo-pyrone nucleus, and more than 4,000 different flavonoids have been described and categorized into flavonols, flavones, flavanones, isoflavones, ...Flavonoids are a widely distributed group of phytochemicals having benzo-pyrone nucleus, and more than 4,000 different flavonoids have been described and categorized into flavonols, flavones, flavanones, isoflavones, catechins and anthocyanidins. Flavonoids occurs naturally in fruits, vegetables, nuts, and beverages such as coffee, tea, and red wine, as well as in medical herbs. Flavonoids are responsible for the different colors of plant parts and are important constituents of the human diet. Flavanoids have different pharmacological activities, such as antioxidant, anti-allergic, antibacterial, anti-inflammatory, antimutagenic and anticancer activity. Naringenin belongs to the flavanones and is mainly found in fruits（grapefruit and oranges） and vegetables. Pharmacologically, it has anticancer, antimutagenic, anti-inflammatory, antioxidant, antiproliferative and antiatherogenic activities. Naringenin is used for the treatments of osteoporosis, cancer and cardiovascular diseases, and showed lipid-lowering and insulin-like properties. In the present review, detailed pharmacological and analytical aspects of naringenin have been presented, which revealed the impressive pharmacological profile and the possible usefulness in the treatment of different types of diseases in the future. The information provided in this communication will act as an important source for development of effective medicines for the treatment of various disorders.展开更多
Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading caus...Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however,about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features,diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.展开更多
AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with re...AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and strictures.RESULTS:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were stapled.The median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic leak.Among these,11 patients required reexploration and five were managed expectantly.The anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for malignancy.Ninteen(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal dilatation.On multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic stricture.CONCLUSION:Advance age is a risk factor for an anastomotic leak.An anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.展开更多
Traumatic injury to the pancreas is rare and difficult to diagnose.In contrast,traumatic injuries to the liver,spleen and kidney are common and are usually identified with ease by imaging modalities.Pancreatic injurie...Traumatic injury to the pancreas is rare and difficult to diagnose.In contrast,traumatic injuries to the liver,spleen and kidney are common and are usually identified with ease by imaging modalities.Pancreatic injuries are usually subtle to identify by different diagnostic imaging modalities,and these injuries are often overlooked in cases with extensive multiorgan trauma.The most evident findings of pancreatic injury are posttraumatic pancreatitis with blood,edema,and soft tissue infiltration of the anterior pararenal space.The alterations of post-traumatic pancreatitis may not be visualized within several hours following trauma as they are time dependent.Delayed diagnoses of traumatic pancreatic injuries are associated with high morbidity and mortality.Imaging plays an important role in diagnosis of pancreatic injuries because early recognition of the disruption of the main pancreatic duct is important.We reviewed our experience with the use of various imaging modalities for diagnosis of blunt pancreatic trauma.展开更多
文摘Objective:Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation(APACHE)II,Bedside Index of Severity in Acute Pancreatitis(BISAP),Ranson’s score and modified Computed Tomography Severity Index(CTSI)in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India.Methods:Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study.APACHE II,BISAP and Ranson’s score were calculated for all the cases.Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography(CT).Optimal cut-offs for these scoring systems and the area under the curve(AUC)were evaluated based on the receiver operating characteristics(ROC)curve and these scoring systems were compared prospectively.Results:Of the 50 cases,14 were graded as severe acute pancreatitis.Pancreatic necrosis was present in 15 patients,while 14 developed persistent organ failure and 14 needed intensive care unit(ICU)admission.The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis(0.919),pancreatic necrosis(0.993),organ failure(0.893)and ICU admission(0.993).APACHE II was the second most accurate in predicting severe acute pancreatitis(AUC 0.834)and organ failure(0.831).APACHE II had a high sensitivity for predicting pancreatic necrosis(93.33%),organ failure(92.86%)and ICU admission(92.31%),and also had a high negative predictive value for predicting pancreatic necrosis(96.15%),organ failure(96.15%)and ICU admission(95.83%).Conclusion:APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral,especially in resource-limited developing countries.
文摘This review focuses on research findings in the area of diagnosis and pathogenesis of hepatitis C virus(HCV)infection over the last few decades.The information based on published literature provides an update on these two aspects of HCV.HCV infection,previously called blood transmitted non-A,non-B infection,is prevalent globally and poses a serious public health problem worldwide.The diagnosis of HCV infection has evolved from serodetection of non-specific and low avidity anti-HCV antibodies to detection of viral nucleic acid in serum using the polymerase chain reaction(PCR)technique.Current PCR assays detect viral nucleic acid with high accuracy and the exact copy number of viral particles.Moreover,multiplex assays using real-time PCR are available for identification of HCV-genotypes and their isotypes.In contrast to previous methods,the newly developed assays are not only fast and eco-nomic,but also resolve the problem of the window period as well as differentiate present from past infection.HCV is a non-cytopathic virus,thus,its pathogenesis is regulated by host immunity and metabolic changes including oxidative stress,insulin resistance and hepatic steatosis.Both innate and adaptive immunity play an important role in HCV pathogenesis.Cytotoxic lymphocytes demonstrate crucial activity during viral eradication or viral persistence and are influenced by viral proteins,HCV-quasispecies and several metabolic factors regulating liver metabolism.HCV pathogenesis is a very complex phenomenon and requires further study to determine the other factors involved.
基金Supported by Merit Review grants BX001155 from the Department of Veterans Affairs,Office of Research and Development(Biomedical Laboratory Research and Development)to Kharbanda KK
文摘Alcoholic liver disease(ALD)and non-alcoholic fatty liver disease(NAFLD)are serious health problems worldwide.These two diseases have similar pathological spectra,ranging from simple steatosis to hepatitis to cirrhosis and hepatocellular carcinoma.Although most people with excessive alcohol or calorie intake display abnormal fat accumulation in the liver(simple steatosis),a small percentage develops progressive liver disease.Despite extensive research on understanding the pathophysiology of both these diseases there are still no targeted therapies available.The treatment for ALD remains as it was 50 years ago:abstinence,nutritional support and corticosteroids(or pentoxifylline as an alternative if steroids are contraindicated).As for NAFLD,the treatment modality is mainly directed toward weight loss and co-morbidity management.Therefore,new pathophysiology directed therapies are urgently needed.However,the involvement of several inter-related pathways in the pathogenesis of these diseases suggests that a single therapeutic agent is unlikely to be an effective treatment strategy.Hence,a combination therapy towards multiple targets would eventually be required.In this review,we delineate the treatment options in ALD and NAFLD,including various new targeted therapies that are currently under investigation.We hope that soon we will be having an effective multi-therapeutic regimen for each disease.
基金support by the National Natural Science Foundation of China(21537002,41422105,41671478)the Natural Science Foundation of Jiangsu Province,China(Project No.BK20130050).
文摘Biochar is the carbon-rich product obtained from the thermochemical conversion of biomass under oxygen-limited conditions.Biochar has attained extensive attention due to its agronomical and environmental benefits in agro-ecosystems.This work adopts the scientometric analysis method to assess the development trends of biochar research based on the literature data retrieved from the Web of Science over the period of 1998-2018.By analysing the basic characteristics of 6934 publications,we found that the number of publications grew rapidly since 2010.Based on a keyword analysis,it is concluded that scholars have had a fundamental recognition of biochar and preliminarily found that biochar application had agronomic and environmental benefits during the period of 1998-2010.The clustering results of keywords in documents published during 2011-2015 showed that the main research hotspots were“biochar production”,“biochar and global climate change”,“soil quality and plant growth”,“organic pollutants removal”,and“heavy metals immobilization”.While in 2016-2018,beside these five main research hotspots,“biochar and composting”topic had also received greater attention,indicating that biochar utilization in organic solid waste composting is the current research hotspot.Moreover,updated reactors(e.g.,microwave reactor,fixed-bed reactor,screw-feeding reactor,bubbling fluidized bed reactor,etc.)or technologies(e.g.,solar pyrolysis,Thermo-Catalytic Reforming process,liquefaction technology,etc.)applied for efficient energy production and modified biochar for environmental remediation have been extensively studied recently.The findings may help the new researchers to seize the research frontier in the biochar field.
文摘Agricultural productivity is something on which economy highly depends.This is the one of the reasons that disease detection in plants plays an important role in agriculture field,as having disease in plants are quite natural.If proper care is not taken in this area then it causes serious effects on plants and due to which respective product quality,quantity or productivity is affected.For instance a disease named little leaf disease is a hazardous disease found in pine trees in United States.Detection of plant disease through some automatic technique is beneficial as it reduces a large work of monitoring in big farms of crops,and at very early stage itself it detects the symptoms of diseases i.e.when they appear on plant leaves.This paper presents an algorithm for image segmentation technique which is used for automatic detection and classification of plant leaf diseases.It also covers survey on different diseases classification techniques that can be used for plant leaf disease detection.Image segmentation,which is an important aspect for disease detection in plant leaf disease,is done by using genetic algorithm.
文摘Peripherally inserted central catheter(PICC)is extensively used in critical care settings,because it plays a vital role in providing safe central venous entry.However,PICC is associated with several complications,which should be detected to shorten the duration of patients'improvement,reduce health care cost,and lessen the incidence of various PICC-related complications.Therefore,this study aimed to outline current literature on PICC procedures,potential complications,and measures for prevention.Understanding evidence-based guidelines regarding insertion technique,early detection of complications,and care bundle of PICC is significant in complication prevention.Implementation of education,training,and appropriate multidisciplinary approaches on PICC care among nurses and caregivers is the key to preventing complications.Thus,the strict care of indwelling PICC lines,the targeted and reasonable PICCassociated complication prevention,and nursing care have a major clinical significance in reducing the occurrence of potential PICC complications.
文摘Frozen shoulder is a common disease which causes significant morbidity. Despite over a hundred years of treating this condition the definition, diagnosis, pathology and most efficacious treatments are still largely unclear. This systematic review of current treatments for frozen shoulder reviews the evidence base behind physiotherapy, both oral and intra articular steroid, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release. Key areas in which future research could be directed are identified, in particular with regard to the increasing role of arthroscopic capsular release as a treatment.
基金supported by the 2015 scientific promotion program funded by Jeju National University
文摘Wogonin is a plant flavonoid compound extracted from Scutellaria baicalensis(Huang-Qin or Chinese skullcap) and has been studied thoroughly by many researchers till date for its anti-viral, anti-oxidant, anti-cancerous and neuro-protective properties. Numerous experiments conducted in vitro and in vivo have demonstrated wogonin's excellent tumor inhibitory properties. The anticancer mechanism of wogonin has been ascribed to modulation of various cell signaling pathways, including serine-threonine kinase Akt(also known as protein kinase B) and AMP-activated protein kinase(AMPK) pathways, p53-dependent/independent apoptosis, and inhibition of telomerase activity. Furthermore, wogonin also decreases DNA adduct formation with a carcinogenic compound 2-Aminofluorene and inhibits growth of drug resistant malignant cells and their migration and metastasis, without any side effects. Recently, newly synthesized wogonin derivatives have been developed with impressive anti-tumor activity. This review is the succinct appraisal of the pertinent articles on the mechanisms of anti-tumor properties of wogonin. We also summarize the potential of wogonin and its derivatives used alone or as an adjunct therapy for cancer treatment. Furthermore, pharmacokinetics and side effects of wogonin and its analogues have also been discussed.
文摘Hepatitis B （HBV） and hepatitis C （HCV） viral infection or co-infection leads to risk of development of chronic infection, cirrhosis and hepatocellular carcinoma （HCC）. Immigration and globalization have added to the challenges of public health concerns regarding chronic HBV and HCV infections worldwide. The aim of this study is to review existing global literature across ethnic populations on HBV and HCV related human leukocyte antigen （HLA） associations in relation to susceptibility, viral persistence and treatment. Extensive literature search was conducted to explore the HLA associations in HBV and HCV infections reported across global populations over the past decade to understand the knowledge status, weaknesses and strengths of this information in different ethnic populations. HLA DR13 is consistently associated with HBV clearance globally. HLADRB1＊11/＊12 alleles and DQB1＊0301 are associated with HBV persistence but with HCV clearance worldwide. Consistent association of DRB1＊03 and ＊07 is observed with HCV susceptibility and non-responsiveness to HBV vaccination across the population. HLA DR13 is protective for vertical HBV and HCV transmission in Chinese and Italian neonates, but different alleles are associated with their susceptibility in these populations. HLA class I molecule interactions with Killer cell immunoglobulin like receptors （KIR） of natural killer （NK） cells modulate HCV infection outcome via regulating immune regulatory cells and molecules. HLA associations with HBV vaccination, interferon therapy in HBV and HCV, and with extra hepatic manifestations of viral hepatitis are also discussed. Systematic studies in compliance with global regulatory standards are required to identify the HLA specific viral epitope, stage specific T cell populations interacting with different HLA alleles during disease progression and viral clearance of chronic HBV or HCV infections among different ethnic populations. These studies would facilitate stage specific therapeutic stra
文摘Diabetic nephropathy has been the cause of lot of morbidity and mortality in the diabetic population. The renin angiotensin system (RAS) is considered to be involved in most of the pathological processes that result in diabetic nephropathy. This system has various subsystems which contribute to the disease pathology. One of these involves angiotensin II (Ang II) which shows increased activity during diabetic nephropathy. This causes hypertrophy of various renal cells and has a pressor effect on arteriolar smooth muscle resulting in increased vascular pressure. Ang II also induces inflammation, apoptosis, cell growth, migration and differentiation. Monocyte chemoattractant protein-1 production responsible for renal fibrosis is also regulated by RAS. Polymorphism of angiotensin converting enzyme (ACE) and Angiotensinogen has been shown to have effects on RAS. Available treatment modalities have proven effective in controlling the progression of nephropathy. Various drugs (based on antagonism of RAS) are currently in the market and others are still under trial. Amongst the approved drugs, ACE inhibitors and angiotensin receptor blockers (ARBs) are widely used in clinical practice. ARBs are shown to be superior to ACE inhibitors in terms of reducing proteinuria but the combined role of ARBs with ACE inhibitors in diabetic nephropathy is under debate.
基金Project supported by the National Natural Science Foundation of China (No. 40571130)the Natural Science Foundation of Shanghai, China (No. 07ZR14032)
文摘Concentrations of Iron (Fe), As, and Cu in soil samples from the fields near the Baoshan Mine in Hunan Province, China, were analyzed and soil spectral reflectance was measured with an ASD FieldSpec FR spectroradiometer (Analytical Spectral Devices, Inc., USA) under laboratory condition. Partial least square regression (PLSR) models were constructed for predicting soil metal concentrations. The data pre-processing methods, first and second derivatives (FD and SD), baseline correction (BC), standard normal variate (SNV), multiplicative scatter correction (MSC), and continuum removal (CR), were used for the spectral reflectance data pretreatments. Then, the prediction results were evaluated by relative root mean square error (RRMSE) and coefficients of determination (R 2 ). According to the criteria of minimal RRMSE and maximal R 2 , the PLSR models with the FD pretreatment (RRMSE = 0.24, R 2 = 0.61), SNV pretreatment (RRMSE = 0.08, R 2 = 0.78), and BC-pretreatment (RRMSE = 0.20, R 2 = 0.41) were considered as the final models for predicting As, Fe, and Cu, respectively. Wavebands at around 460, 1 400, 1 900, and 2 200 nm were selected as important spectral variables to construct final models. In conclusion, concentrations of heavy metals in contaminated soils could be indirectly assessed by soil spectra according to the correlation between the spectrally featureless components and Fe; therefore, spectral reflectance would be an alternative tool for monitoring soil heavy metals contamination.
文摘Flavonoids are a widely distributed group of phytochemicals having benzo-pyrone nucleus, and more than 4,000 different flavonoids have been described and categorized into flavonols, flavones, flavanones, isoflavones, catechins and anthocyanidins. Flavonoids occurs naturally in fruits, vegetables, nuts, and beverages such as coffee, tea, and red wine, as well as in medical herbs. Flavonoids are responsible for the different colors of plant parts and are important constituents of the human diet. Flavanoids have different pharmacological activities, such as antioxidant, anti-allergic, antibacterial, anti-inflammatory, antimutagenic and anticancer activity. Naringenin belongs to the flavanones and is mainly found in fruits（grapefruit and oranges） and vegetables. Pharmacologically, it has anticancer, antimutagenic, anti-inflammatory, antioxidant, antiproliferative and antiatherogenic activities. Naringenin is used for the treatments of osteoporosis, cancer and cardiovascular diseases, and showed lipid-lowering and insulin-like properties. In the present review, detailed pharmacological and analytical aspects of naringenin have been presented, which revealed the impressive pharmacological profile and the possible usefulness in the treatment of different types of diseases in the future. The information provided in this communication will act as an important source for development of effective medicines for the treatment of various disorders.
文摘Hepatocellular carcinoma(HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide.Despite being the 6 th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however,about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features,diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research.
文摘AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent management.METHODS:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and strictures.RESULTS:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were stapled.The median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic leak.Among these,11 patients required reexploration and five were managed expectantly.The anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for malignancy.Ninteen(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal dilatation.On multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic stricture.CONCLUSION:Advance age is a risk factor for an anastomotic leak.An anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.
文摘Traumatic injury to the pancreas is rare and difficult to diagnose.In contrast,traumatic injuries to the liver,spleen and kidney are common and are usually identified with ease by imaging modalities.Pancreatic injuries are usually subtle to identify by different diagnostic imaging modalities,and these injuries are often overlooked in cases with extensive multiorgan trauma.The most evident findings of pancreatic injury are posttraumatic pancreatitis with blood,edema,and soft tissue infiltration of the anterior pararenal space.The alterations of post-traumatic pancreatitis may not be visualized within several hours following trauma as they are time dependent.Delayed diagnoses of traumatic pancreatic injuries are associated with high morbidity and mortality.Imaging plays an important role in diagnosis of pancreatic injuries because early recognition of the disruption of the main pancreatic duct is important.We reviewed our experience with the use of various imaging modalities for diagnosis of blunt pancreatic trauma.
