Efficacy and safety of cold snare polypectomy for sessile serrated polyps ≥ 10 mm: A systematic review and meta-analysis

BackgroundCold snare polypectomy (CSP) is a promising technique for the removal of sessile serrated polyps (SSPs) ≥ 10 mm. However, the efficacy and safety of this technique remain undetermined.AimsWe aimed to comprehensively evaluate the efficacy and safety of CSP for SSPs ≥ 10 mm.MethodsPubMed, EMBASE, Web of Science and Cochrane Library were searched up to January 2021.ResultsA total of 10 studies consisting of 1727 SSPs (range, 10–40 mm) from 1021 patients were included. The overall rates of technical success, adverse events (AEs) and residual SSPs were 100%, 0.7% and 2.9%, respectively. Subgroup analysis showed that the rates of technical success and AEs were comparable between CSP and cold endoscopic mucosal resection (EMR) (99.9% vs. 100% and 1.3% vs. 0.5%, respectively), between the proximal and distal colon (100% vs. 99.9% and 0.3% vs. 0, respectively), and between polyps of 10–19 mm and ≥20 mm (99.8% vs. 100% and 0.9% vs. 0, respectively). However, subgroup analysis showed that the rate of residual SSPs was slightly lower in CSP compared with cold EMR (1.3% vs. 3.9%), as well as in polyps of 10–19 mm compared with those ≥20 mm (3.1% vs. 4.7%).ConclusionCSP was an effective and safe technique for removing SSPs ≥ 10 mm.     

The rationality involved in the popular use of coffee (Coffea sp) and sunflower seed (Helianthus annuus) for the treatment of vitiligo: a case report

Introduction: Vitiligo is a dermatological disease that affects about 0.38% to 2.9% of the world population. Currently, the main treatments used for vitiligo involve the use of topical drugs such as corticosteroids and calcineurin inhibitors, phototherapy, systemic treatment with steroids and even surgical grafts and, in acute cases, depigmenting treatments. Natural products are an alternative for the treatment of vitiligo: mamacadela (Brosimum gaudichaudii), a plant rich in furanocoumarins, and sowthistle (Sonchus oleraceus), rich in phenolic substances, are already used to treat vitiligo. There are also popular reports of the use of a preparation containing coffee (Coffea sp) and sunflower seed (Helianthus annuus) to treat vitiligo. Case report: A female patient, 28 years old, diagnosed with vitiligo, reported having obtained a positive result in the repigmentation of the pale white patches after the daily use of a preparation containing coffee and sunflower seed for about one year. Discussion: Data from the scientific literature demonstrated that chemical constituents of these plants, such as chlorogenic acid and its isomers, which have antioxidant and anti-inflammatory action, and substances such as linoleic acid and vitamins E and B, which help in the process of melanin formation on the skin, may be responsible for the observed repigmentation of the patches. Further research on this case report is important for scientific validation and the development of new therapeutic options, especially with less adverse effects, in the treatment of vitiligo.     

基于中医古籍文献的升降散应用溯源及探析

通过对中医古籍中有关升降散论述的文献梳理,全面探讨其内涵。本方是在大黄、僵蚕为雏形的基础上增加蝉蜕、姜黄而成方,几经易名,终在杨璿《伤寒瘟疫条辨》中为后人所熟知。本方广泛用于治疗瘟疫,以丸剂、散剂为主,方便携带,便于服用;重用大黄旨在祛邪、逐秽;应用时视人之体质强弱和量其毒之轻重而判断用药多寡,并辅以米酒、生蜜等以顾护正气。杨璿将其由治疗“热疫”的专方扩展为治疗“表里三焦大热”的通用方剂,扩大了本方治疗疾病范围。     

Engraftable neural crest stem cells derived from cynomolgus monkey embryonic stem cells

Neural crest stem cells (NCSCs), a population of multipotent cells that migrate extensively and give rise to diverse derivatives, including peripheral and enteric neurons and glia, craniofacial cartilage and bone, melanocytes and smooth muscle, have great potential for regenerative medicine. Non-human primates provide optimal models for the development of stem cell therapies. Here, we describe the first derivation of NCSCs from cynomolgus monkey embryonic stem cells (CmESCs) at the neural rosette stage. CmESC-derived neurospheres replated on polyornithine/laminin-coated dishes migrated onto the substrate and showed characteristic expression of NCSC markers, including Sox10, AP2α, Slug, Nestin, p75, and HNK1. CmNCSCs were capable of propagating in an undifferentiated state in vitro as adherent or suspension cultures, and could be subsequently induced to differentiate towards peripheral nervous system lineages (peripheral sympathetic neurons, sensory neurons, and Schwann cells) and mesenchymal lineages (osteoblasts, adipocytes, chondrocytes, and smooth muscle cells). CmNCSCs transplanted into developing chick embryos or fetal brains of cynomolgus macaques survived, migrated, and differentiated into progeny consistent with a neural crest identity. Our studies demonstrate that CmNCSCs offer a new tool for investigating neural crest development and neural crest-associated human disease and suggest that this non-human primate model may facilitate tissue engineering and regenerative medicine efforts.     

Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke

BackgroundPeriodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear.Material and MethodsWe recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested.Results65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182–4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010–6.574; P = .048).ConclusionsSevere periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.