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1High-intensity focused ultrasound ablation:An effective bridging therapy for hepatocellular carcinoma patients显示文摘AIM:To analyze whether high-intensity focused ultrasound(HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma(HCC).METHODS:From January 2007 to December 2010,49 consecutive HCC patients were listed for liver transplantation(UCSF criteria).The median waiting time for transplantation was 9.5 mo.Twenty-nine patients received transarterial chemoembolization(TACE) as a bringing therapy and 16 patients received no treatment before transplantation.Five patients received HIFU ablation as a bridging therapy.Another five patients with the same tumor staging(within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison.Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores,tumor size and number,and cause of cirrhosis.RESULTS:The HIFU group and TACE group showed no difference in terms of tumor size and tumor number.One patient in the HIFU group and no patient in the TACE group had gross ascites.The median hospital stay was 1 d(range,1-21 d) in the TACE group and two days(range,1-9 d) in the HIFU group(P < 0.000).No HIFU-related complication occurred.In the HIFU group,nine patients(90%) had complete response and one patient(10%) had partial response to the treatment.In the TACE group,only one patient(3%) had response to the treatment while 14 patients(48%) had stable disease and 14 patients(48%) had progressive disease(P = 0.00).Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list(P = 0.559).CONCLUSION:HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis.It may reduce the drop-out rate of liver transplant candidate.Tan To Cheung Sheung Tat Fan See Ching Chan Kenneth SH Chok Ferdinand SK Chu Caroline R Jenkins Regina CL Lo James YY Fung Albert CY Chan William W Sharr Simon HY Tsang Wing Chiu Dai Ronnie TP Poon Chung Mau Lo 2013World Journal of Gastroenterology2013,19,20:23
2Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome显示文摘BackgroundThere 是在质子泵禁止者(PPI ) 和 clopidogrel 之间的可能的不利相互作用上的大争论。另外, PPI 的使用是否少些影响 ticagrelor 遗体的临床的功效,知道。在经皮的冠的干预(一种总线标准) .MethodsWe 回顾地从 “ 分析了数据以后,我们试图与急性冠的症候群(交流)在病人在临床的结果上决定 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响;真实 world” ;,国际,在 2003 和 2014 之间的多中心登记( n = 15,401 )并且在1年的合成主要端点上估计了 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响(所有原因死亡收到 PPI 的病人更老,更经常女性,并且是更可能的有 comorbidities。没有协会为收到 clopidogrel 的病人在 PPI 使用和主要端点之间被观察(调整 HR:1.036;95% CI:0.903-1.189 ) 或 ticagrelor (调整 HR:2.320;95% CI:0.875-6.151 )(P 相互作用 = 0.2004 ) 。同样, PPI 的使用没与所有原因死亡,重新梗塞,或与交流后面的一种总线标准的为与任何一个 clopidogrel 对待的病人或 ticagrelor.ConclusionsIn 病人的严重流血的减少的风险的增加的风险被联系, PPI 的伴随物使用没在收到 clopidogrel 或 ticagrelor 的病人与不利结果的增加的风险被联系。我们的调查结果显示与 clopidogrel 或 ticagrelor 在联合使用 PPI 是合理的,特别在有胃肠的流血的更高的风险的病人。Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev 2016Journal of Geriatric Cardiology2016,13,3:12
3P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析显示文摘目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂(PPI)治疗对经皮冠状动脉介入(PCI)术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究,纳入2003至2014年因急性冠脉综合征人院行PCI术的患者,分为PPI组及非PPI组并随访1年,主要临床终点为全因死亡/再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类,将入组患者分为氯吡格雷组及替格瑞洛组,并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者,PPI组占54.8%,具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡/再发心肌梗死复合事件的发生差异无统计学意义(HR1.00,95%CI 0.86—1.18)。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组,不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异,联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险,尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。冯斯婷 严妍 范婧尧 王晓 郑文 聂绍平 Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev 2016中华医学杂志2016,96,33:6
4Impact of triple antithrombotic therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention in real-world practice显示文摘为在急性冠的症候群(交流) 和经皮的冠的干预(一种总线标准) 以后的口头的 anticoagulation (OAC ) 上的病人的 ObjectiveThe 最佳的 antithrombotic 政体仍然保持辩论。寻求回顾地在真实世界的 setting.MethodsWe 评估 OAC 正 clopidogrel 的功效和安全与或没有阿司匹林的这研究分析了数据从一国际,在 2003 和 2014 之间的多中心登记(n = 15,401 ) 。有在一种总线标准以后的交流和收到的 OAC 的病人被屏蔽。合成主要端点是 1 年的所有原因死亡,重新梗塞,或分析注册了 642 个病人包括的严重 bleeding.ResultsThe 期末考试有 OAC 和 clopidogrel (双治疗) 的 62 个病人(9.7%) ,和有阿司匹林, OAC 和 clopidogrel (三倍的治疗) 的联合的 580 个病人(90.3%) 。三倍的治疗上的病人更经常是女性的并且是更可能的有 comorbidities。关于在与三倍的治疗病人一起的双治疗之间的主要结束点没有重要差别[17.74% 对 17.24% ;unadjusted 危险比率(HR ) :1.035;95% 信心间隔(CI ) :0.556-1.929;调整 HR:1.026;95% CI:0.544-1.937 ] 。然而,重新梗塞率比三倍的治疗病人在双治疗是显著地更高的(14.52% 对 5.34% ;unadjusted HR:2.807;95% CI:1.329-5.928;调整 HR:2.333;95% CI:1.078-5.047 ) 。另外,在所有原因死亡和严重 bleeding.ConclusionsIn 的二政体之间没有差别有交流后面的一种总线标准并且与 OAC 的一个指示的真实病人,三倍的治疗没与双治疗相比与不利结果的增加的率被联系。而且,它减少了重新梗塞冒险并且没增加严重流血的风险。Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE SerGio Raooseiras-Roubin Emad Abu-Assi Jose P Simao Henriques: Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzalez-Juanate Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Morettil Zenon Huczek Toshiharu Fujii Luis cL Correia Masa-aki Kawashiri Sasko Kedev 2017Journal of Geriatric Cardiology2017,14,11:6
5Silicon carbide resonant tuning fork for microsensing applications in high-temperature and high G-shock environments显示文摘We present the fabrication and testing of a silicon carbide(SiC)balanced mass double-ended tuning fork that survives harsh environments without compromising the device strain sensitivity and resolution bandwidth.The device features a material stack that survives corrosive environments and enables high-temperature operation.To perform high-temperature testing,a specialized setup was constructed that allows the tuning fork to be characterized using traditional silicon electronics.The tuning fork has been operated at 600 ℃ in the presence of dry steam for short durations.This tuning fork has also been tested to 64 000 G using a hard-launch,soft-catch shock implemented with a light gas gun.However,the device still has a strain sensitivity of 66 Hz/με and strain resolution of 0.045 με in a 10 kHz bandwidth.As such,this balanced-mass double-ended tuning fork can be used to create a variety of different sensors including strain gauges,accelerometers,gyroscopes,and pressure transducers.Given the adaptable fabrication process flow,this device could be useful to micro-electro-mechanical systems(MEMS) designers creating sensors for a variety of different applications.David R Myers Kan Bun Cheng Babak Jamshidi Robert G Azevedo Debbie G Senesky Li Chen Mehran Mehregany Muthu B J Wijesundara Albert P Pisano 2012Engineering Sciences2012,10,5:6
6Gastric cancer in Alaska Native people: A cancer health disparity显示文摘AIM To evaluate recent trends in gastric cancer incidence, response to treatment, and overall survival among Alaska Native(AN) people. METHODS A retrospective analysis of the Alaska Native Medical Center patient database was performed. Patient history, clinical, pathological, response to treatment and patient outcomes were collected from one-hundred and thirty-two AN gastric cancer patients. The Surveillance, Epidemiology and End Result database 18 was used to collect comparison United States non-Hispanic White(NHW) and AN gastric cancer patient data between 2006-2014.RESULTS AN gastric cancer patients have a higher incidence rate, a poorer overall survival, and are diagnosed at a significantly younger age compared to NHW patients. AN patients differ from NHW patients in greater prevalence of non-cardia, diffuse subtype, and signet ring cell carcinomas. AN females were more likely to be diagnosed with later stage cancer, stage IV, compared to AN males. Diminished overall survival was observed among AN patients with increasing stage, O+ blood type, < 15 lymph nodes examined at resection, and no treatment. This study is the first report detailing the clinicopathologic features of gastric cancer in AN people with outcome data.CONCLUSION Our findings confirm the importance of early detection, treatment, and surgical resection for optimizing AN patient outcomes. Further research on early detection markers are warranted.Holly A Martinson Nancy J Shelby Steven R Alberts Matthew J Olnes 2018World Journal of Gastroenterology2018,24,25:6
7Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery显示文摘Over the last decade,with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer,there has been a significant increase in the literature regarding treatment options available to patients affected by this disease.That treatment related decisions should be made at a high volume multidisciplinary tumor board,after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision(TME)are accepted standard of care.More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders,which may be appropriate in 20%of patients.Patients with early T1 rectal cancers and favorable pathologic features can be cured with local excision only,with transanal minimal invasive surgery(TAMIS)because of its versatility and almost universal availability of the necessary equipment and skillset in the average laparoscopic surgeon,emerging as the leading option.Recent trials have raised concerns about the oncologic outcomes of the standard'top-down'TME hence transanal TME(Ta TME'bottom-up')approach has gained popularity as an alternative.The challenges are many,with a dearth of evidence of the oncologic superiority in the long-term for any given option.However,this review highlights recent advances in the role of chemoradiation only for complete pathologic responders,TAMIS for highly selected early rectal cancer patients and Ta TME as options to improve cure rates whilst maintaining quality of life in these patients,while we await the results of further definitive trials being currently conducted.Joseph M Plummer Pierre-Anthony Leake Matthew R Albert 2017World Journal of Gastrointestinal Surgery2017,9,6:6
8PLEIOTROPIC REGULATORY LOCUS 1 (PRL1) Integrates the Regulation of Sugar Responses with Isoprenoid Metabolism in Arabidopsis显示文摘在植物房间的 isoprenoids 的生合成从 mevalonate (MVA ) 在 cytosol 生产的先锋发生小径并且在由 methylerythritol 4 磷酸盐(MEP ) 的质体,小径,而是很少对协调两条小径的机制被知道。在 Arabidopsis thaliana 为如此的协作发信号的糖的重要性的证据被没有变化,在相关 MEP 小径抄本,蛋白质,或酶活动的层次显示出导出 MEP 的 isoprenoid 产品(叶绿素和类胡萝卜素) 的增加的累积的异种的描述这里提供。这异种被发现是新 loss-of-function 等位基因 PRL1 (多种的规章的地点 1 ) ,编码作为糖的一个全球管理者工作的保存 WD 蛋白质的基因,应力,和荷尔蒙回答,部分地由 SNF1 相关的蛋白质 kinases (SnRK1 ) 的抑制。与在 MVA 小径的主要的规章的酶的 phosphorylation 和 inactivation 的 SnRK1 kinases 的报导角色一致(hydroxymethylglutaryl 辅酶 -- reductase ) ,它的活动或蛋白质层次在 prl1 幼苗被减少。然而,导出 MVA 的结束产品(甾醇) 的累积在变异的幼苗是未改变的。蔗糖补充到野类型的幼苗 phenocopied prl1 变化以 isoprenoid 新陈代谢,建议观察 isoprenoid 显型从增加的糖累积导致 prl1 异种。在摘要, PRL1 看起来与糖,荷尔蒙,和压力回答协调 isoprenoid 新陈代谢。Ursula Flores-Perez Jordi Perez-Gil Marta Closa Louwrance R Wright Patricia Botella-Pavia Michael A. Phillips Albert Ferrer Jonathan Gershenzon Manuel Rodriguez-Concepcion 2010Molecular Plant2010,3,1:5
9Comparison of inhaled milrinone, nitric oxide and prostacyclin in acute respiratory distress syndrome显示文摘AIM To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome(ARDS).METHODS Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of i NO(20 ppm) or nebulized epoprostenol(10 μg/mL) was done in all patients. Thereafter, inhaled milrinone(1 mg/mL) alone followed by inhaled milrinone in association with inhaled nitric oxide(iN O) was administered. A jet nebulization device synchronized with the mechanical ventilation was use to administrate the epoprostenol and the milrinone. Hemodynamic measurements and partial pressure of arterial oxygen(PaO_2) were recorded before and after each inhaled therapyadministration.RESULTS The majority of ARDS were of pulmonary cause(n = 13) and pneumonia(n = 7) was the leading underlying initial disease. Other pulmonary causes of ARDS were: Post cardiopulmonary bypass(n = 2), smoke inhalation injury(n = 1), thoracic trauma and pulmonary contusions(n = 2) and aspiration(n = 1). Two patients had an extra pulmonary cause of ARDS: A polytrauma patient and an intra-abdominal abscess Inhaled nitric oxide, epoprostenol, inhaled milrinone and the combination of inhaled milrinone and i NO had no impact on systemic hemodynamics. No significant adverse events related to study medications were observed. The median increase of PaO 2 from baseline was 8.8 mmH g [interquartile range(IQR) = 16.3], 6.0 mm Hg(IQR = 18.4), 6 mm Hg(IQR = 15.8) and 9.2 mm Hg(IQR = 20.2) respectively with i NO, epoprostenol, inhaled milrinone, and i NO added to milrinone. Only i NO and the combination of inhaled milrinone and i NO had a statistically significant effect on PaO 2. CONCLUSION When comparing the effects of inhaled NO, milrinone and epoprostenol, only NO significantly improved oxygenation. Inhaled milrinone appeared safe but failed to improve oxygenation in ARDS.Martin Albert Daniel Corsilli David R Williamson Marc Brosseau Patrick Bellemare Stéphane Delisle Anne QN Nguyen France Varin 2017World Journal of Critical Care Medicine2017,6,1:4
10建立初级卒中中心的修订和更新意见来自脑卒中联盟的总结声明显示文摘背景和目的自从2000年脑卒中联盟发布首份关于建立初级卒中中心的推荐意见以来,初级卒中中心的组建和认证工作已出现迅速发展。本文的目的在于修订和更新我们关于初级卒中中心的推荐意见以反映最新资料和经验。方法我们使用MEDLINE和PubMed数据库回顾了相关文献(2000年3月至2011年1月),主要针对急性卒中的诊断、治疗和护理。如果发现有效且相关,同样对原始文献、汇总分析和其他治疗指南进行回顾并纳入分析。标明证据等级以反映当前指南发展的实际情况。结果基于文献回顾以及针对初级卒中中心的经验,一些要素的重要性已得到进一步的加强,同时增加了几个新的领域。这些内容包括:(1)急诊卒中团队的重要性;(2)配备遥测监控的卒中单元的重要性;(3)MRj和弥散加权序列进行脑成像的实施;(4)用磁共振血管成像或CT血管成像对脑血管系统进行评价;(5)心脏影像学检查;(6)康复治疗的早期启动;(7)由独立机构进行的认证,包括实地考察和疾病评价指标。结论基于上述证据,初级卒中中心的某些要素对于改善急性卒中患者的诊治特别重要。其他要素则集中于脑、脑血管系统和心脏的影像学检查。这些新的要素也许能改善在初级卒中中心接受诊治的卒中患者的治疗和转归。Mark J. Alberts Richard E. Latchaw Andy Jagoda Lawrence R Wechsler Todd Crocco Mary G. George E.S. Connolly Barbara Mancini Stephen Prudhomme Daryl Gress Mary E. Jensen Robert Bass Robert Ruff Kathy Foell Rocco A. Armonda Marian Emr Margo Warren Jim Baranski Michael D. Walker 黄志超(译) 张霞(译) 尤寿江(译) 曹勇军(译) 刘春风(译) 2012国际脑血管病杂志2012,20,7:3
11Emergence of scaling in random networks显示文摘Barabasi A -L Albert R 0,,:3
12Effect of peroral endoscopic myotomy on esophagogastric junction physiology in patients with achalasia显示文摘Tessa Verlaan Wout O. Rohof Albert J. Bredenoord Susanne Eberl Thomas R?sch Paul Fockens 2013Gastrointestinal Endoscopy2013,,1:2
13Comparison between three-dimensional speckle-tracking echocardiography and cardiac magnetic resonance imaging for quantification of left ventricular volumes and function显示文摘Sebastiaan A. Kleijn Wessel P. Brouwer Mohamed F.A. Aly Iris K. Rüssel Gerben J. de Roest Aernout M. Beek Albert C. van Rossum Otto Kamp 2012European Heart Journal – Cardiovascular Imaging2012,,10:2
14Peroral Endoscopic Myotomy for the Treatment of Achalasia: An International Prospective Multicenter Study显示文摘Daniel Von Renteln Karl–Hermann Fuchs Paul Fockens Peter Bauerfeind Melina C. Vassiliou Yuki B. Werner Gerald Fried Wolfram Breithaupt Henriette Heinrich Albert J. Bredenoord Jan F. Kersten Tessa Verlaan Michael Trevisonno Thomas R?sch 2013Gastroenterology2013,,2:2
15Emergence of scaling in random nctworks显示文摘Barabasi A L Albert R 1999Science1999,286,10:1
16Emergence of scaling in random networks显示文摘Barabasi A L Albert R 1999Science1999,286,:1
17Behavioral,endocrine,and immunological correlates of immigration by an aggressive male into a natural primate group显示文摘 Sapolsky R M Altmann J 1992Horm Behar1992,26,2:1
18Emergence of scaling in random networks显示文摘Barabcisi A L Albert R 1999Science1999,286,5439:1
19Emergence of scaling in random networks 显示文摘ARABAS I ALBERT R 1999Science1999,286,:1
20Statistical mechanics of complex networks显示文摘Albert R Barabasi A L 2002Review ofModemPhysics2002,74,1:1
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