Helicobacter pylori (H. pylori) infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis (AG), or gastric intestinal metaplasia (GIM), and cancer. Variou...Helicobacter pylori (H. pylori) infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis (AG), or gastric intestinal metaplasia (GIM), and cancer. Various molecular alterations are identified not only in gastric cancer (GC) but also in precancerous lesions. H. pylori treatment seems to improve AG and GIM, but still remains controversial. In contrast, many studies, including meta-analysis, show that H. pylori eradication reduces GC. Molecular markers detected by genetic and epigenetic alterations related to carcinogenesis reverse following H. pylori eradication. This indicates that these changes may be an important factor in the identification of high risk patients for cancer development. Patients who underwent endoscopic treatment of GC are at high risk for development of metachronous GC. A randomized controlled trial from Japan concluded that prophylactic eradication of H. pylori after endoscopic resection should be used to prevent the development of metachronous GC, but recent retrospective studies did not show the tendency. Patients with precancerous lesions (molecular alterations) that do not reverse after H. pylori treatment, represent the “point of no return” and may be at high risk for the development of GC. Therefore, earlier H. pylori eradication should be considered for preventing GC development prior to the appearance of precancerous lesions.展开更多
Based on four phases of TM images acquired in 1990, 1995, 2000 and 2005, this paper took Kitakyushu in Japan as a case study to analyze spatial change of land use landscape and corresponding effects on environmental i...Based on four phases of TM images acquired in 1990, 1995, 2000 and 2005, this paper took Kitakyushu in Japan as a case study to analyze spatial change of land use landscape and corresponding effects on environmental issues guided by landscape ecology theory in virtue of combining technology of Remote Sensing with GIS. Firstly, land use types were divided into 6 classes （farmland, mountain, forestland, water body, urban land and unused land） according to national classification standard of land use, comprehensible ability of TM image and purpose of this study. Secondly, following the theory of landscape ecology analysis, 11 typical landscape indices were abstracted to evaluate the environmental effects and spatial feature changes of land use. Research results indicated that land use has grown more and more diversified and unbalanced, human activities have disturbed the landscape more seriously. Finally, transfer matrix of Markov was applied to forecast change process of land use in the future different periods, and then potential land use changes were also simulated from 2010 to 2050. Results showed that conversion tendency for all types of land use in Kitakyushu into urban construction land were enhanced. The study was anticipated to help local authorities better understand and address a complex land use system, and develop improved land use management strategies that could better balance urban expansion and ecological conservation.展开更多
For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review...For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review, we summarized the history of treatment of recurrent cervical cancer, and the current recommendation for chemotherapy and molecular targeted therapy. Eligible articles were identified by a search of the MEDLINE bibliographical database for the period up to November 30, 2014. The search strategy included the following any or all of the keywords： ＂uterine cervical cancer＂, ＂chemotherapy＂, and ＂targeted therapies＂. Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan and vinorelbine among others. Accordingly, promising agents were incorporated into phase III trials. To examine the best agent to combine with cisplatin, several landmark phase III clinical trials were conducted by Gynecologic Oncology Group （GOG） and Japan Clinical Oncology Group （JCOG）. Through, GOG204 and JCOG0505, paclitaxel/cisplatin （TP） and paclitaxel/carboplatin （TC） are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy, are very poor. Therefore new therapeutic strategies are urgently required. Molecular targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival （OS）. Although, the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments offer only modest gains in OS, p展开更多
Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NA...Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.展开更多
AIM: To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. METHODS: We investigated the clinical outcomes and risk factors for ...AIM: To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. METHODS: We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation and "silent" free air without endoscopically visible perforation detected only by computed tomography.RESULTS: Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. CONCLUSION: Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air.展开更多
The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone aft...The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery （RS） has not yet been established, and radiation therapy （RT） or concurrent chemoradiotherapy （CCRT） is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life （QOL） or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival （OS） with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin （TP） regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group （GOG）, had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial （RCT） of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable condition, it is 展开更多
AIM To clarify the diagnostic efficacy and limitations of endoscopic ultrasonography(EUS) and the characteristics of early gastric cancers(EGCs) that are indications for EUS-based assessment of cancer invasion depth.M...AIM To clarify the diagnostic efficacy and limitations of endoscopic ultrasonography(EUS) and the characteristics of early gastric cancers(EGCs) that are indications for EUS-based assessment of cancer invasion depth.METHODS We retrospectively investigated the cases of 153 EGC patients who underwent conventional endoscopy(CE) and EUS(20 MHz) before treatment.RESULTS We found that 13.7% were "inconclusive" cases with low-quality EUS images, including all nine of the cases with protruded(0-I)-type EGCs. There was no significant difference in the diagnostic accuracybetween CE and EUS. Two significant independent risk factors for misdiagnosis by EUS were identified-ulcer scarring [UL(+); odds ratio(OR) = 4.49, P = 0.003] and non-indication criteria for endoscopic resection(ER)(OR = 3.02, P = 0.03). In the subgroup analysis, 23.1% of the differentiated-type cancers exhibiting SM massive invasion(SM2) invasion(submucosal invasion ≥ 500 μm) by CE were correctly diagnosed by EUS, and 23.1% of the undifferentiated-type EGCs meeting the expanded-indication criteria for ER were correctly diagnosed by EUS.CONCLUSION There is no need to perform EUS for UL(+) EGCs or 0-I-type EGCs, but EUS may enhance the pretreatment staging of differentiated-type EGCs with SM2 invasion without UL or undifferentiated-type EGCs revealed by CE as meeting the expanded-indication criteria for ER.展开更多
Concurrent chemoradiotherapy （CCRT） is regarded as the standard treatment for locally advanced uterine cervical cancer （LACC）, including stage Ib2-IVa disease [International Federation of Gynecology and Obstetrics...Concurrent chemoradiotherapy （CCRT） is regarded as the standard treatment for locally advanced uterine cervical cancer （LACC）, including stage Ib2-IVa disease [International Federation of Gynecology and Obstetrics （FIGO） staging]. However, approximately a third of eligible patients in previous studies died of LACC despite receiving CCRT. The therapeutic significance of CCRT alone in stage Ⅲ-IVa disease has not yet been confirmed. Effective treatment of some LACC is beyond the scope of CCRT. The objective of the present review is to highlight some challenging work aimed at overcoming this seemingly intractable disease. CCRT with increased peak concentrations of cisplatin （CDDP）, surgery following CCRT, adjuvant chemotherapy （CT） following CCRT, and neoadjuvant CT followed by CCRT are strategies expected to enhance the therapeutic efficacy of CCRT. If patients with LACC were divided into those with low-risk or high-risk systemic disease or prognoses, novel strategies should be assessed in the group with high-risk disease.展开更多
AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SM...AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SMT).METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.RESULTS: The histological diagnoses were gastrointestinal stromal tumors(n = 7), leiomyoma(n =6), schwannoma(n = 2), aberrant pancreas(n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors' mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method(P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUSFNAB(P = 0.03). No complications were found in either method.CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUSFNAB should be performed for SMTs with extraluminal growth.展开更多
In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intri...In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intrinsic divertor for heliotron devices, accompanied with a relatively thick ergodic layer outside the confinement region. Edge and divertor plasma behavior from low density to high density regimes is presented, referring to the divertor detachment. The effect of the ergodic layer on the edge transport is also discussed. On the other hand, the LID is an advanced divertor concept which realizes a high pumping efficiency by the combination of an externally induced magnetic island and a closed pumping system. Experimental results to confirm the fundamental divertor performance of the LID are presented.展开更多
A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and avera...A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and averaged PNBI = 0.067 MW. Total injected heating energy was 1.3 G J, which was a quarter of the prepared RF heating energy. One of the keys to the success of the experiment was a dispersion of the local plasma heat load to divertors, accomplished by shifting the magnetic axis inward and outward.展开更多
AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been tr...AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.展开更多
AIM: To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and advers...AIM: To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.METHODS: A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords “cold polypectomy”. RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients’ demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.RESULTS: Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.CONCLUSION: Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.展开更多
The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed wi...The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed with schizophrenia and treated with LAI [32 patients were risperidone LAI (RLAI) and 8 patients were aripiprazole LAI (ALAI)]. However, in this paper, only three cases (one RLAI case and 2 ALAI cases) were selected to illustrate the diffusion effects of both LAI. Dorsogluteal intramuscular (IM) injection sites were measured at prone position using the “double cross” method. Before LAI injection, the distance from the epidermis to the under-fascia (DEUF), and distance from the epidermis to the iliac bone (DEI) at the IM injection site were assessed by using ultrasonography: 1) the injection needle was inserted to the gluteus medius, and 2) observed the diffusion status within the muscle injected RLAI and ALAI were confirmed using the B-mode ultrasonography. Both RLAI and ALAI were depicted as high echogenicity with acoustic shadowing. It was considered that the diffusion states of LAIs by ultrasonography were important time course evaluations providing objective evidence.展开更多
This paper reports that <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers can be synthesized by an extremely simple and easy approach of inducing a reaction through the addition ...This paper reports that <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers can be synthesized by an extremely simple and easy approach of inducing a reaction through the addition of NaOH aqueous solution to a mixed aqueous solution of Bi(NO<sub>3</sub>)<sub>3</sub>·5H<sub>2</sub>O and HNO<sub>3</sub> scanning electron microscopy images of the Bi<sub>2</sub>O<sub>3</sub> microflowers indicate that the Bi<sub>2</sub>O<sub>3</sub> nanorods grew radially from the centre of the microflower to form the microflower shape. The findings of this study show that control of the reaction temperature, reaction time, and raw material mixture ratio plays an important role in the formation of <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers. It is especially revealed that <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers can be formed at low temperatures with short reaction times. It has thus far been reported that flower-shaped Bi<sub>2</sub>O<sub>3</sub> particles or their precursors can be synthesized by the addition of additives such as organic molecules or certain inorganic ions. The present work reports on the discovery of ways to synthesize flower-shaped Bi<sub>2</sub>O<sub>3</sub> particles without the use of special additives.展开更多
Soft tissue engineering has been developed as a new strategy for repairing damaged or diseased soft tissues and organs to overcome the limitations of current therapies.Since most of soft tissues in the human body are ...Soft tissue engineering has been developed as a new strategy for repairing damaged or diseased soft tissues and organs to overcome the limitations of current therapies.Since most of soft tissues in the human body are usually supported by collagen fibers to form a three-dimensional microstructure,fiber-reinforced scaffolds have the advantage to mimic the structure,mechanical and biological environment of natural soft tissues,which benefits for their regeneration and remodeling.This article reviews and discusses the latest research advances on design and manufacture of novel fiber-reinforced scaffolds for soft tissue repair and how fiber addition affects their structural characteristics,mechanical strength and biological activities in vitro and in vivo.In general,the concept of fiber-reinforced scaffolds with adjustable microstructures,mechanical properties and degradation rates can provide an effective platform and promising method for developing satisfactory biomechanically functional implantations for soft tissue engineering or regenerative medicine.展开更多
An antenna array suitable for plasma heating and current drive has been designed for the ion cyclotron resonance frequency range （ICRF） heating on the EAST superconducting tokamak. The ICRF heating is planned to ope...An antenna array suitable for plasma heating and current drive has been designed for the ion cyclotron resonance frequency range （ICRF） heating on the EAST superconducting tokamak. The ICRF heating is planned to operate in a frequency range of 30 MHz to 80 MHz and hence the antenna geometry is optimized for 55 MHz. The design is based on the conventional strap antenna element. The coupling properties of the antenna are calculated with a slab model of the plasma for the antenna simulation. The coupling code is extended for the analysis of the toroidal antenna array separated by septa.展开更多
The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent （calcitonin） and an anabolic agent （vitamin D3） on treating the detrimental effects of Type 1 diabetes mel...The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent （calcitonin） and an anabolic agent （vitamin D3） on treating the detrimental effects of Type 1 diabetes mellitus （DM） on mandibular bone formation and growth. Forty 3-week-old male Wistar rats were divided into four groups： the control group （normal rats）, the control C＋D group （normal rats injected with calcitonin and vitamin D3）, the diabetic C＋D group （diabetic rats injected with calcitonin and vitamin D3） and the diabetic group （uncontrolled diabetic rats）. An experimental DM condition was induced in the male Wistar rats in the diabetic and diabetic C＋ D groups using a single dose of 60 mg.kg-1 body weight of streptozotocin. Calcitonin and vitamin D3 were simultaneously injected in the rats of the control C＋D and diabetic C＋D groups. All rats were killed after 4 weeks, and the right mandibles were evaluated by micro-computed tomography and histomorphometric analysis. Diabetic rats showed a significant deterioration in bone quality and bone formation （diabetic group）. By contrast, with the injection of calcitonin and vitamin D3, both bone parameters and bone formation significantly improved （diabetic C＋ D group） （P 〈 0.05）. These findings suggest that these two hormones might potentially improve various bone properties.展开更多
基金Supported by Grant,NIDDK,RO1DK63618 to KMD from the National Institutes of Health,Bethesda,MD
文摘Helicobacter pylori (H. pylori) infection is well known to be associated with the development of precancerous lesions such as chronic atrophic gastritis (AG), or gastric intestinal metaplasia (GIM), and cancer. Various molecular alterations are identified not only in gastric cancer (GC) but also in precancerous lesions. H. pylori treatment seems to improve AG and GIM, but still remains controversial. In contrast, many studies, including meta-analysis, show that H. pylori eradication reduces GC. Molecular markers detected by genetic and epigenetic alterations related to carcinogenesis reverse following H. pylori eradication. This indicates that these changes may be an important factor in the identification of high risk patients for cancer development. Patients who underwent endoscopic treatment of GC are at high risk for development of metachronous GC. A randomized controlled trial from Japan concluded that prophylactic eradication of H. pylori after endoscopic resection should be used to prevent the development of metachronous GC, but recent retrospective studies did not show the tendency. Patients with precancerous lesions (molecular alterations) that do not reverse after H. pylori treatment, represent the “point of no return” and may be at high risk for the development of GC. Therefore, earlier H. pylori eradication should be considered for preventing GC development prior to the appearance of precancerous lesions.
基金Sasakawa Scientific Foundation of Japan, No.20-238 National Basic Research Program of China （973 Program）, No.2006CB403200+1 种基金 National Natural Science Foundation of China, No.40261002 No.40561006
文摘Based on four phases of TM images acquired in 1990, 1995, 2000 and 2005, this paper took Kitakyushu in Japan as a case study to analyze spatial change of land use landscape and corresponding effects on environmental issues guided by landscape ecology theory in virtue of combining technology of Remote Sensing with GIS. Firstly, land use types were divided into 6 classes （farmland, mountain, forestland, water body, urban land and unused land） according to national classification standard of land use, comprehensible ability of TM image and purpose of this study. Secondly, following the theory of landscape ecology analysis, 11 typical landscape indices were abstracted to evaluate the environmental effects and spatial feature changes of land use. Research results indicated that land use has grown more and more diversified and unbalanced, human activities have disturbed the landscape more seriously. Finally, transfer matrix of Markov was applied to forecast change process of land use in the future different periods, and then potential land use changes were also simulated from 2010 to 2050. Results showed that conversion tendency for all types of land use in Kitakyushu into urban construction land were enhanced. The study was anticipated to help local authorities better understand and address a complex land use system, and develop improved land use management strategies that could better balance urban expansion and ecological conservation.
文摘For patients with primary stage IVB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review, we summarized the history of treatment of recurrent cervical cancer, and the current recommendation for chemotherapy and molecular targeted therapy. Eligible articles were identified by a search of the MEDLINE bibliographical database for the period up to November 30, 2014. The search strategy included the following any or all of the keywords： ＂uterine cervical cancer＂, ＂chemotherapy＂, and ＂targeted therapies＂. Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan and vinorelbine among others. Accordingly, promising agents were incorporated into phase III trials. To examine the best agent to combine with cisplatin, several landmark phase III clinical trials were conducted by Gynecologic Oncology Group （GOG） and Japan Clinical Oncology Group （JCOG）. Through, GOG204 and JCOG0505, paclitaxel/cisplatin （TP） and paclitaxel/carboplatin （TC） are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy, are very poor. Therefore new therapeutic strategies are urgently required. Molecular targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival （OS）. Although, the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments offer only modest gains in OS, p
文摘Neoadjuvant chemotherapy followed by surgery （NCS） has not been fully evaluated clinically. Currently, the main regimen of neoadjuvant chemotherapy （NAC） used in NCS includes cisplatin. The antitumor effects of NAC reduce lymph node metastasis and the tumor diameter in patients prior to surgery, and this can reduce the number of high risk patients who require postoperative radiation therapy. Many randomized controlled trials （RCTs） have examined the long-term prognosis of NCS compared to primary surgery, but the utility of NCS remains uncertain. The advent of concurrent chemoradiotherapy （CCRT） has markedly improved the outcome of radiotherapy （RT）, and CCRT is now used as a standard method in many cases of advanced bulky cervical cancer. NCS gives a better treatment outcome than radiation therapy alone, but it is important to verify that NCS gives a similar or better outcome compared to CCRT.
文摘AIM: To evaluate clinical outcomes and risk factors for endoscopic perforation during endoscopic submucosal dissection (ESD) in a prospective study. METHODS: We investigated the clinical outcomes and risk factors for the development of perforation in 98 consecutive gastric neoplasms undergoing ESD regarding. Demographic and clinical parameters including patient-, tumor-, and treatment-related factors, clinical parameters, and duration of hospital stay were analyzed for risk factors for perforation. In subgroup analysis, we also compared the clinical outcomes between perforation and "silent" free air without endoscopically visible perforation detected only by computed tomography.RESULTS: Perforation was identified in 8.2% of patients. All patients were managed conservatively by the administration of antibiotics. The mean procedure time was significantly longer in patients with endoscopic perforation than in those without. According to the receiver-operating characteristic analysis, the resulting cutoff value of the procedure time for perforation was 115 min (87.5% sensitivity, 56.7% specificity). Prolonged procedure time (≥ 115 min) was associated with an increased risk of perforation (odds ratio 9.15; 95%CI: 1.08-77.54; P = 0.04). Following ESD, body temperature and C-reactive protein level were significantly higher in patients with perforation than in those without (P = 0.02), whereas there was no difference between these patient groups on the starting day of oral intake or of hospitalization. In subgroup analysis, the post-ESD clinical course was not different between endoscopic perforation and silent free air. CONCLUSION: Only prolonged procedure time (≥ 115 min) was significantly associated with perforation. The clinical outcomes of perforation are favorable and are comparable to those of patients with or without silent free air.
文摘The aim of this review is to address the current status of adjuvant chemotherapy alone in early-stage cervical cancer treatments in the literature. At present, the therapeutic effect of adjuvant chemotherapy alone after radical surgery （RS） has not yet been established, and radiation therapy （RT） or concurrent chemoradiotherapy （CCRT） is recommended as the standard adjuvant therapy after RS for early-stage cervical cancer in various guidelines. The main purpose of adjuvant therapy after RS, however, should be to reduce extrapelvic recurrence rather than local recurrence, although adjuvant RT or CCRT has survival benefits for patients with intermediate- or high-risk factors for recurrence. Moreover, several studies reported that adjuvant therapies including RT were associated with a higher incidence of complications, such as lymphedema, bowel obstruction and urinary disturbance, and a lower grade of long-term quality of life （QOL） or sexual functioning than adjuvant chemotherapy alone. The effect of adjuvant chemotherapy alone for early-stage cervical cancer with intermediate- or high-risk factors for recurrence were not fully investigated in prospective studies, but several retrospective studies suggest that the adjuvant effects of chemotherapy alone are at least similar to that of RT or CCRT in terms of recurrence rate, disease-free survival, or overall survival （OS） with lower incidence of complications. Whereas cisplatin based combination regimens were used in these studies, paclitaxel/cisplatin （TP） regimen, which is currently recognized as a standard chemotherapy regimen for patients with metastatic, recurrent or persistent cervical cancer by Gynecologic Oncology Group （GOG）, had also survival benefit as an adjuvant therapy. Therefore, it may be worth considering a prospective randomized controlled trial （RCT） of adjuvant chemotherapy alone using TP regimen versus adjuvant RT as an alternative adjuvant therapy. Because early-stage cervical cancer is a curable condition, it is
文摘AIM To clarify the diagnostic efficacy and limitations of endoscopic ultrasonography(EUS) and the characteristics of early gastric cancers(EGCs) that are indications for EUS-based assessment of cancer invasion depth.METHODS We retrospectively investigated the cases of 153 EGC patients who underwent conventional endoscopy(CE) and EUS(20 MHz) before treatment.RESULTS We found that 13.7% were "inconclusive" cases with low-quality EUS images, including all nine of the cases with protruded(0-I)-type EGCs. There was no significant difference in the diagnostic accuracybetween CE and EUS. Two significant independent risk factors for misdiagnosis by EUS were identified-ulcer scarring [UL(+); odds ratio(OR) = 4.49, P = 0.003] and non-indication criteria for endoscopic resection(ER)(OR = 3.02, P = 0.03). In the subgroup analysis, 23.1% of the differentiated-type cancers exhibiting SM massive invasion(SM2) invasion(submucosal invasion ≥ 500 μm) by CE were correctly diagnosed by EUS, and 23.1% of the undifferentiated-type EGCs meeting the expanded-indication criteria for ER were correctly diagnosed by EUS.CONCLUSION There is no need to perform EUS for UL(+) EGCs or 0-I-type EGCs, but EUS may enhance the pretreatment staging of differentiated-type EGCs with SM2 invasion without UL or undifferentiated-type EGCs revealed by CE as meeting the expanded-indication criteria for ER.
文摘Concurrent chemoradiotherapy （CCRT） is regarded as the standard treatment for locally advanced uterine cervical cancer （LACC）, including stage Ib2-IVa disease [International Federation of Gynecology and Obstetrics （FIGO） staging]. However, approximately a third of eligible patients in previous studies died of LACC despite receiving CCRT. The therapeutic significance of CCRT alone in stage Ⅲ-IVa disease has not yet been confirmed. Effective treatment of some LACC is beyond the scope of CCRT. The objective of the present review is to highlight some challenging work aimed at overcoming this seemingly intractable disease. CCRT with increased peak concentrations of cisplatin （CDDP）, surgery following CCRT, adjuvant chemotherapy （CT） following CCRT, and neoadjuvant CT followed by CCRT are strategies expected to enhance the therapeutic efficacy of CCRT. If patients with LACC were divided into those with low-risk or high-risk systemic disease or prognoses, novel strategies should be assessed in the group with high-risk disease.
文摘AIM: To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy(EUS-FNAB) without cytology and mucosal cutting biopsy(MCB) in the histological diagnosis of gastric submucosal tumor(SMT).METHODS: We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.RESULTS: The histological diagnoses were gastrointestinal stromal tumors(n = 7), leiomyoma(n =6), schwannoma(n = 2), aberrant pancreas(n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors' mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method(P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUSFNAB(P = 0.03). No complications were found in either method.CONCLUSION: MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUSFNAB should be performed for SMTs with extraluminal growth.
基金supported by NIFS under Grant(No.NIFS05ULPP506)in part by the JSPS-CAS Core-University Program in the field of Plasma and Nuclear Fusion
文摘In the Large Helical Device （LHD）, two different divertor configurations, i.e. helical divertor （HD） and local island divertor （LID）, are utilized to control the edge plasma. The HD with two X-points is an intrinsic divertor for heliotron devices, accompanied with a relatively thick ergodic layer outside the confinement region. Edge and divertor plasma behavior from low density to high density regimes is presented, referring to the divertor detachment. The effect of the ergodic layer on the edge transport is also discussed. On the other hand, the LID is an advanced divertor concept which realizes a high pumping efficiency by the combination of an externally induced magnetic island and a closed pumping system. Experimental results to confirm the fundamental divertor performance of the LID are presented.
基金supported in part by the JSPS-CAS Core-University Program in the field of Plasma and Nuclear Fusion
文摘A long-pulse plasma discharge for more than 30 min. was achieved on the Large Helical Device （LHD）. A plasma of ne = 0.8 × 10^19 m^-3 and T10 = 2.0 keV was sustained with PICH = 0.52 MW, PECH = 0.1 MW and averaged PNBI = 0.067 MW. Total injected heating energy was 1.3 G J, which was a quarter of the prepared RF heating energy. One of the keys to the success of the experiment was a dispersion of the local plasma heat load to divertors, accomplished by shifting the magnetic axis inward and outward.
文摘AIM: To examine the efficacy of non-magnifying narrow-band imaging(NM-NBI) imaging for small signet ring cell carcinoma(SRC).METHODS: We retrospectively analyzed 14 consecutive small intramucosal SRCs that had been treated with endoscopic submucosal dissection(ESD) and 14 randomly selected whitish gastric ulcer scars(control). The strength and shape of the SRCs and whitish scars by NM-NBI and white-light imaging(WLI) were assessed with Image J(NIH, Bethesda).RESULTS: NM-NBI findings of SRC showed a clearly isolated whitish area amid the brown color of the surrounding normal mucosa. The NBI index, which indicates the potency of NBI for visualizing SRC, was significantly higher than the WLI index(P = 0.001), indicating SRC was more clearly identified by NM-NBI. Although the NBI index was not significantly different between SRCs and controls, the circle(C)-index, as an index of circularity of tumor shape, was significantly higher in SRCs(P = 0.001). According to the receiveroperating characteristic analysis, the resulting cut-off value of the circularity index(C-index) for SRC was 0.60(85.7% sensitivity, 85.7% specificity). Thus a lesion with a C-index ≥ 0.6 was significantly more likely to be an SRC than a gastric ulcer scar(OR = 36.0; 95%CI: 4.33-299.09; P = 0.0009).CONCLUSION: Small isolated whitish round area by NM-NBI endoscopy is a useful finding of SRCs which is the indication for ESD.
文摘AIM: To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.METHODS: A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords “cold polypectomy”. RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients’ demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.RESULTS: Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.CONCLUSION: Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.
文摘The aim of this study was to consider the characteristics of intramuscular diffusion status of risperidone and aripiprazole long acting injectable (LAI) by ultrasonography. Subjects were 40 adult subjects diagnosed with schizophrenia and treated with LAI [32 patients were risperidone LAI (RLAI) and 8 patients were aripiprazole LAI (ALAI)]. However, in this paper, only three cases (one RLAI case and 2 ALAI cases) were selected to illustrate the diffusion effects of both LAI. Dorsogluteal intramuscular (IM) injection sites were measured at prone position using the “double cross” method. Before LAI injection, the distance from the epidermis to the under-fascia (DEUF), and distance from the epidermis to the iliac bone (DEI) at the IM injection site were assessed by using ultrasonography: 1) the injection needle was inserted to the gluteus medius, and 2) observed the diffusion status within the muscle injected RLAI and ALAI were confirmed using the B-mode ultrasonography. Both RLAI and ALAI were depicted as high echogenicity with acoustic shadowing. It was considered that the diffusion states of LAIs by ultrasonography were important time course evaluations providing objective evidence.
文摘This paper reports that <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers can be synthesized by an extremely simple and easy approach of inducing a reaction through the addition of NaOH aqueous solution to a mixed aqueous solution of Bi(NO<sub>3</sub>)<sub>3</sub>·5H<sub>2</sub>O and HNO<sub>3</sub> scanning electron microscopy images of the Bi<sub>2</sub>O<sub>3</sub> microflowers indicate that the Bi<sub>2</sub>O<sub>3</sub> nanorods grew radially from the centre of the microflower to form the microflower shape. The findings of this study show that control of the reaction temperature, reaction time, and raw material mixture ratio plays an important role in the formation of <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers. It is especially revealed that <em>α</em>-Bi<sub>2</sub>O<sub>3</sub> microflowers can be formed at low temperatures with short reaction times. It has thus far been reported that flower-shaped Bi<sub>2</sub>O<sub>3</sub> particles or their precursors can be synthesized by the addition of additives such as organic molecules or certain inorganic ions. The present work reports on the discovery of ways to synthesize flower-shaped Bi<sub>2</sub>O<sub>3</sub> particles without the use of special additives.
基金The authors acknowledge the financial supports from the National Natural Science Foundation of China(Nos.31370959 and 61227902)the National Key Research and Development Program of China(No.2017YFC1104703)+3 种基金Beijing Nova Programme Interdisciplinary Cooperation Project(No.xxjc201616)Fok Ying Tung Education Foundation(No.141039)State Key Laboratory of New Ceramic and Fine Processing Tsinghua University(No.KF201714)International Joint Research Center of Aerospace Biotechnology and Medical Engineering,Ministry of Science and Technology of China,and the 111 Project(No.B13003).
文摘Soft tissue engineering has been developed as a new strategy for repairing damaged or diseased soft tissues and organs to overcome the limitations of current therapies.Since most of soft tissues in the human body are usually supported by collagen fibers to form a three-dimensional microstructure,fiber-reinforced scaffolds have the advantage to mimic the structure,mechanical and biological environment of natural soft tissues,which benefits for their regeneration and remodeling.This article reviews and discusses the latest research advances on design and manufacture of novel fiber-reinforced scaffolds for soft tissue repair and how fiber addition affects their structural characteristics,mechanical strength and biological activities in vitro and in vivo.In general,the concept of fiber-reinforced scaffolds with adjustable microstructures,mechanical properties and degradation rates can provide an effective platform and promising method for developing satisfactory biomechanically functional implantations for soft tissue engineering or regenerative medicine.
文摘An antenna array suitable for plasma heating and current drive has been designed for the ion cyclotron resonance frequency range （ICRF） heating on the EAST superconducting tokamak. The ICRF heating is planned to operate in a frequency range of 30 MHz to 80 MHz and hence the antenna geometry is optimized for 55 MHz. The design is based on the conventional strap antenna element. The coupling properties of the antenna are calculated with a slab model of the plasma for the antenna simulation. The coupling code is extended for the analysis of the toroidal antenna array separated by septa.
基金the National Plan for Science,Technology and Innovation(MAARIFAH)-King Abdulaziz City for Science Technology-the Kingdom of Saudi Arabia award number(12-MED2735-03)Science and Technology Unit,King Abdulaziz University for technical support
文摘The goal of this study was to assess the effect of the intermittent combination of an antiresorptive agent （calcitonin） and an anabolic agent （vitamin D3） on treating the detrimental effects of Type 1 diabetes mellitus （DM） on mandibular bone formation and growth. Forty 3-week-old male Wistar rats were divided into four groups： the control group （normal rats）, the control C＋D group （normal rats injected with calcitonin and vitamin D3）, the diabetic C＋D group （diabetic rats injected with calcitonin and vitamin D3） and the diabetic group （uncontrolled diabetic rats）. An experimental DM condition was induced in the male Wistar rats in the diabetic and diabetic C＋ D groups using a single dose of 60 mg.kg-1 body weight of streptozotocin. Calcitonin and vitamin D3 were simultaneously injected in the rats of the control C＋D and diabetic C＋D groups. All rats were killed after 4 weeks, and the right mandibles were evaluated by micro-computed tomography and histomorphometric analysis. Diabetic rats showed a significant deterioration in bone quality and bone formation （diabetic group）. By contrast, with the injection of calcitonin and vitamin D3, both bone parameters and bone formation significantly improved （diabetic C＋ D group） （P 〈 0.05）. These findings suggest that these two hormones might potentially improve various bone properties.
