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Effects of Hericium erinaceus polysaccharide in defense as well as apoptosis of the principal resistant internal organs within Muscovy goose reovirus-infected ducklings.
BACKGROUND AND AIMS No data appear to have been reported regarding bleeding risk among patients receiving antiplatelet and anticoagulant treatment during EUS-guided biliary drainage (BD) procedures. The aim of this study was to assess whether hemorrhagic adverse events associated with EUS-BD are increased in patients on antiplatelet and anticoagulant treatment. METHODS Patients receiving antiplatelet and/or anticoagulant treatment who underwent EUS-BD were retrospectively enrolled between May 2015 and August 2019. Patients who did not receive antiplatelet and/or anticoagulant treatment (AP/AC) and who underwent EUS-BD in the same period were also enrolled as a control group. RESULTS A total of 195 patients who underwent EUS-BD was enrolled in this study. Among these, 154 patients were allocated to the control group, and 41 patients to AP/AC group. Overall frequency of adverse events did not differ significantly between the control group (16.2%, 25/154) and AC/AP group (17.1%, 6/41; P=0.80). The overall bleeding event rate was 3.6% (7/195) with no significant difference between the 2 groups. No thromboembolic events were observed with or without interruption of antiplatelet and/or anticoagulant agents. According to logistic regression analysis, the use of antiplatelet and/or anticoagulant agents was not a risk factor significantly associated with bleeding events (OR, 2.96; 95% CI, 0.56-14.0; P=0.18). On the other hand, a long procedure time (>20 min) was an independent risk factor associated with bleeding events. CONCLUSIONS In conclusion, bleeding events appear infrequent among patients who undergo EUS-BD while continuing antiplatelet and/or anticoagulant agents. BACKGROUND AND AIMS Endoscopic intervention has emerged as a first-line option for management of symptomatic pancreatic necrosis, yet endoscopic debridement is limited by the lack of dedicated endoscopic tools intended for this purpose. The objectives of this study were to design and build a prototype necrosectomy device compatible for use with a flexible endoscope and capable of selective tissue fragmentation, and to test the prototype in benchtop and porcine models. METHODS A novel prototype, named the WAterjet Necrosectomy Device (WAND), was designed and developed, consisting of a single-use disposable endoscopic waterjet instrument capable of waterjet selection and independent tip articulation while fitting through a 2.8 mm working channel of a standard adult upper gastrointestinal endoscope. Benchtop, ex vivo, and in vivo (porcine) testing was performed in the initial stages of investigation. RESULTS The WAND was constructed capable of delivering a continuous waterjet force with a surface pressure of 0.72 bar at a flow rate of 0.37 L/minute. In phase I of testing, the WAND was able to achieve complete fragmentation of gelatin as a surrogate for pancreatic necrosis in benchtop testing. In phase II of testing, the WAND was able to achieve complete fragmentation of freshly explanted human pancreatic necrosis. In phase III of testing for safety in fresh necropsy swine, use of the WAND resulted in no significant tissue trauma, even when irrigation was applied at closer proximity and at more extended duration than would be anticipated in clinical use. CONCLUSION The WAND prototype delivers irrigation capable of fragmenting necrotic debris ex vivo and also avoiding trauma to healthy nontarget tissue. Planning is underway for first-in-human studies to assess the efficacy and safety of the WAND for endoscopic pancreatic necrosectomy. BACKGROUND AND AIMS Deep learning is an innovative algorithm based on neural networks. Wireless capsule endoscopy (WCE) is considered the criterion standard for detecting small-bowel diseases. Manual examination of WCE is time consuming and can benefit from automatic detection using artificial intelligence (AI). We aimed to perform a systematic review of current literature pertaining to deep learning implementation in WCE. METHODS We conducted a search in PubMed for all original publications on the subject of deep learning applications in WCE published between January 1, 2016, and December 15, 2019. Evaluation of the risk of bias was performed using tailored Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curves were plotted. RESULTS Of the 45 studies retrieved, 19 studies were included. All studies were retrospective. Deep learning applications for WCE included detection of ulcers, polyps, celiac disease, bleeding, and hookworm. Detection accuracy was above 90% for most studies and diseases. The pooled sensitivity and specificity for ulcer detection were 0.95 (95% CI, 0.89-0.98) and 0.94 (95% CI, 0.90-0.96), respectively. The pooled sensitivity and specificity for bleeding or bleeding source were 0.98 (95% CI, 0.96-0.99) and 0.99 (95% CI, 0.97-0.99), respectively. CONCLUSIONS Deep learning has achieved excellent performance for the detection of a range of diseases in WCE. Notwithstanding, current research is based on retrospective studies with a high risk of bias. Thus, future prospective multicenter studies are necessary in order for this technology to be implemented in the clinical use of WCE. BACKGROUND AND AIMS The incidence of surgery for nonmalignant colorectal polyps is rising. The aims of this study were to evaluate referral patterns to surgery for nonmalignant polyps, to compare outcomes between surgery versus endoscopic resection (ER), and to identify factors associated with surgery in a university-based tertiary care center. METHODS Patients referred to colorectal surgery (CRS) for nonmalignant colorectal polyps between 2014 and 2019 were selected from the institution's integrated data repository. Clinical characteristics were obtained through chart review. Multivariate analysis was performed to identify factors associated with surgery for nonmalignant polyps. RESULTS Six hundred sixty-four patients with colorectal lesions were referred to CRS, of which 315 were for nonmalignant polyps. Most (69%) of the referrals came from gastroenterologists. Of the 315 cases, 136 underwent surgery and 117 referred for attempt at ER. Complete ER was achieved in 87.2% (n=102), with polyp recurrence in 27.2% at a median of 14 months (0-72 months). When compared with surgery, ER was associated with a lower hospitalization rate (22.2% vs 95.6%; p less then 0.0001), shorter hospital stay (mean 0.5±0.9 vs 2.23±1 days; p less then 0.0001), and fewer adverse events (5.9% vs 22.8%; p=0.0002). Intramucosal adenocarcinoma on baseline pathology (OR, 5.7; 95% CI, 1.2-28.2) and referrals by academic gastroenterologists (OR, 2.5; 95% CI, 1.11-5.72) were associated with a higher likelihood of surgery on multivariate analysis. CONCLUSIONS Gastroenterologists commonly refer nonmalignant colorectal polyps to surgery, even though ER is effective and associated with lower morbidity. Both referrals from academic gastroenterologists and baseline pathology of intramucosal adenocarcinoma were factors associated with surgery. All colorectal polyps should be evaluated in a multidisciplinary approach to identify lesions suitable for ER before embarking in surgery. AIMS We have previously demonstrated that p-tyramine (TYR), an endogenous trace amine-associated receptor 1 agonist, passage across neuronal membranes involves a transporter exhibiting the pharmacological profile of Organic Cation Transporter 2 (OCT2). Since TYR is also a constituent of foodstuffs and produced by the intestinal microbiota, here we have investigated whether similar processes are involved in the passage of 100 nM TYR across apical and basolateral membranes of the Caco-2 human intestinal epithelial cell line. MATERIALS AND METHODS [3H]TYR transport across apical and basolateral membranes of Caco-2 cell monolayers was measured in the presence of inhibitors of TYR metabolizing enzymes. Cellular, apical, and basolateral compartments were collected at various timepoints, TYR concentrations calculated, and transport properties pharmacologically characterized. KEY FINDINGS Apical transport resulted in equimolar accumulation of TYR within cells. Pentamidine (OCT1/OCT2 inhibitor) decreased apical transport (P = 0.001) while atropine (OCT1 inhibitor) had no effect, suggesting apical transport involved OCT2. In contrast, basolateral transport resulted in 500-1000 nM cellular concentrations (P less then 0.0001) indicating the presence of an active transporter. Replacement of Na+ on an equimolar basis with choline resulted in loss of TYR transport (P = 0.017). Unexpectedly, this active transport was also atropine-sensitive (P = 0.020). Kinetic analysis of the active transporter revealed Vmax = 43.0 nM/s with a Kt = 33.1 nM. SIGNIFICANCE We have demonstrated for the first time that TYR is transported across Caco-2 apical membranes via facilitated diffusion by OCT2, whereas transport across basolateral membranes is by a Na+-dependent, atropine-sensitive, active transporter. AIMS Vitamin D is a well-known endocrine regulator of calcium/phosphate homeostasis and has been reported as having a wide range of activities that are potentially beneficial for human health. This study aimed to investigate the effects of pretreatment of vitamin D3 (100, 1000, and 10,000 IU/kg) against lipopolysaccharide (LPS)-induced cognitive impairment in rats. MAIN METHODS Male Wistar rats were divided into five groups. The passive avoidance test and Morris water maze (MWM) test were conducted to evaluate the learning and memory function. Oxidative stress markers including malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), total thiol content as well as interleukin (IL)-6 were evaluated in the hippocampus tissue. KEY FINDINGS The intraperitoneal (i.p.) injection of LPS (1 mg/kg) correlates with deficits in passive avoidance and spatial learning in the systemic inflammation model. However, pretreatment with vitamin D3 improved LPS-induced cognitive impairment. In addition, vitamin D3 decreased IL-6 and MDA levels, whereas the activities of CAT, SOD, and total thiol content in the hippocampus tissue were significantly increased. SIGNIFICANCE In conclusion, our results suggest that vitamin D3 plays a protective role against memory dysfunction caused by LPS-induced inflammation through inhibition of oxidative stress and inflammation in the hippocampus. Vitamin D may be a promising potential therapeutic supplement for the treatment or prevention of learning and memory disorders. AIMS Ischemia-reperfusion injury (IRI) is harmful to patients following kidney transplantation. Hypothermic machine perfusion (HMP) can be adopted to preserve grafts and reduce consequential injury. We hypothesized that aldehyde dehydrogenase 2 (ALDH2) partly mitigates kidney IRI via regulating excessive autophagy in HMP. MATERIALS AND METHODS The rabbits were assigned to 5 groups Normal, HMP, HMP + Alda-1, HMP + CYA and cold storage (CS). After the rabbit autologous kidney transplantation, renal pathology and function were evaluated by histological analysis, glomerular related proteins (desmin, nephrin), tubular injury factors (NGAL, Ki67), serum creatinine (Cr) and blood urea nitrogen (BUN). Oxidative stress molecular Malondialdehyde (MDA) and superoxide dismutase (SOD2) expression, as well as inflammatory cytokines (TNF-α, IL-6, IL-10) were assessed by immunohistochemistry. The expression of LC3, p62, ALDH2, p-Akt, mTOR, PTEN, p-PTEN, and 4-HNE were measured by immunohistochemistry, RT-PCR, Western blot analysis or ELISA.
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