Establishing an endoscopic diagnostic process system (M-system) for gastric MALT lymphoma of superficial-spreading type.
- 作者列表："Peng T","Deng L","Wang Y","Wang R","Zeng F","Xie M","Gou X","Guo Y","Wu D","Peng F","Gao R","Ye X
OBJECTIVE:Gastric mucosa-associated lymphoid tissue lymphoma is a rare disease, which is associated with a low endoscopic diagnostic accuracy even on tissue biopsy. We aimed to establish a diagnostic process system (M-system) using detailed magnifying endoscopy images to improve the diagnostic efficiency of this disease. METHODS:First, 34 cases from 16 patients with the diagnosis of mucosa-associated lymphoid tissue lymphoma were collected as the study group. The control group included randomly selected patients who were diagnosed with early differentiated carcinoma, undifferentiated carcinoma or inflammation. Then, the endoscopic images of these patients were analyzed by senior physicians. Finally, the M-system was established based on the data extracted from the images reviewed, and its diagnostic efficiency for mucosa-associated lymphoid tissue lymphoma was validated by the junior physicians. RESULTS:A series of elements with high sensitivity and specificity for the diagnosis of mucosa-associated lymphoid tissue lymphoma on endoscopic images were extracted for the establishment of the M-system. Using the M-system, the diagnostic accuracy, sensitivity, specificity and correct indices of mucosa-associated lymphoid tissue lymphoma rose from 65.4 to 79.4%, 41.2 to 76.5%, 73.5 to 80.4% and 0.147 to 0.569%, respectively, all of which were statistically significant. CONCLUSIONS:The M-system can improve the diagnostic accuracy of mucosa-associated lymphoid tissue lymphoma of the superficial-spreading type on detailed magnifying endoscopy. This would help in the early diagnosis of the disease and treatment, which would translate into improved clinical outcomes.
目的: 胃粘膜相关淋巴组织淋巴瘤是一种罕见的疾病，即使在组织活检上，也与内镜诊断准确性低有关。我们的目的是建立一个诊断过程系统 (M系统) 使用详细的放大内镜图像，以提高这种疾病的诊断效率。 方法: 首先，收集16例黏膜相关淋巴组织淋巴瘤患者34例作为研究组。对照组随机选择确诊为早期分化癌、未分化癌或炎症的患者。然后，由高级医师分析这些患者的内镜图像。最后，根据所回顾的图像中提取的数据建立了M-系统，并由初级医师验证了其对黏膜相关淋巴组织淋巴瘤的诊断效率。 结果: 提取了一系列内镜图像上诊断黏膜相关淋巴组织淋巴瘤的敏感性和特异性较高的元素，用于建立M-系统。使用M-系统，黏膜相关淋巴组织淋巴瘤的诊断准确率、敏感性、特异性和正确指标分别从65.4上升到79.4% 、41.2上升到76.5% 、73.5上升到80.4% 、0.147上升到0.569%，均有统计学意义。 结论: M-系统在详细放大内镜下可提高浅表扩散型黏膜相关淋巴组织淋巴瘤的诊断准确率。这将有助于疾病的早期诊断和治疗，这将转化为改善的临床结果。
METHODS::The ATP binding-cassette superfamily corresponds the mostly transmembrane transporters family found in humans. These proteins actively transport endogenous and exogenous substrates through biological membranes in body tissues, so they have an important role in the regulation of many physiological functions necessary for human homeostasis, as well as in response regulation to several pharmacological substrates. The development of multidrug resistance has become one of the main troubles in conventional chemotherapy in different illnesses including cancer, being the increased efflux of antineoplastic drugs the main reason for this multidrug resistance, with a key role of the ABC superfamily. Likely, the interindividual variability in the pharmacological response among patients is well known, and may be due to intrinsically factors of the disease, genetic and environmental ones. Thus, the understanding of this variability, especially the genetic variability associated with the efficacy and toxicity of drugs, can provide a safer and more effective pharmacological treatment, so ABC genes are considered as important regulators due to their relationship with the reduction in pharmacological response. In this review, updated information about transporters belonging to this superfamily was collected, the possible role of these transporters in cancer, the role of genetic variability in their genes, as well as some therapeutic tools that have been tried to raise against main transporters associated with chemoresistance in cancer.
METHODS:BACKGROUND:Cholinergic neurotransmission regulates neuroinflammation in Parkinson disease (PD). RESEARCH DESIGN AND METHODS:The authors conducted a delayed-start study of donepezil for cognitive decline in non-demented PD patients. The study consisted of a 96-week randomized placebo-controlled double-blind phase 1, followed by a 24-week donepezil extension phase 2. The primary outcome measure was a change in the Mini-Mental State Examination (MMSE) at week 120. RESULTS:A total of 98 patients were randomly allocated to the early-start (donepezil-to-donepezil) and delayed-start (placebo-to-donepezil) groups. Mean (SD) of the baseline MMSE was 27.6 (2.0) and 28.0 (2.1), respectively. MMSE change at week 120 was better in the early-start group than in the delayed-start group, but the difference was not significant. The MMSE declined in apolipoprotein ε4 carriers, but not in non-carriers, and the factor interaction (intervention × ε4 genotype) was highly significant (P < 0.001). Analyzed with the interaction, the difference was significant (group difference 1.95 [0.33 to 3.57], P = 0.018). The MMSE decline slope in phase 1 was significantly better in the early-start group than in the delayed-start group (P = 0.048). CONCLUSIONS:Cognitive function deteriorated in ε4 carriers, but not in non-carriers, and early-start donepezil may postpone cognitive decline in the former.
METHODS::Since the discovery of dental pulp stem cells, a lot of teams have expressed an interest in dental pulp regeneration. Many approaches, experimental models and biological explorations have been developed, each including the use of stem cells and scaffolds with the final goal being clinical application in humans. In this review, the authors' objective was to compare the experimental models and strategies used for the development of biomaterials for tissue engineering of dental pulp with stem cells. Electronic queries were conducted on PubMed using the following terms: pulp regeneration, scaffold, stem cells, tissue engineering and biomaterial. The extracted data included the following information: the strategy envisaged, the type of stem cells, the experimental models, the exploration or analysis methods, the cytotoxicity or viability or proliferation cellular tests, the tests of scaffold antibacterial properties and take into account the vascularization of the regenerated dental pulp. From the 71 selected articles, 59% focused on the "cell-transplantation" strategy, 82% used in vitro experimentation, 58% in vivo animal models and only one described an in vivo in situ human clinical study. 87% used dental pulp stem cells. A majority of the studies reported histology (75%) and immunohistochemistry explorations (66%). 73% mentioned the use of cytotoxicity, proliferation or viability tests. 48% took vascularization into account but only 6% studied the antibacterial properties of the scaffolds. This article gives an overview of the methods used to regenerate dental pulp from stem cells and should help researchers create the best development strategies for research in this field.