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| 1 | Hepatogenic differentiation of human mesenchymal stem cells from adipose tissue in comparison with bone marrow mesenchymal stem cells显示文摘AIM: To investigate and compare the hepatogenic transdifferentiation of adipose tissue-derived stem cells (ADSC) and bone marrow-derived mesenchymal stem cells (BMSC) in vitro. Transdifferentiation of BMSC into hepatic cells in vivo has been described. Adipose tissue represents an accessible source of ADSC, with similar characteristics to BMSC.METHODS: BMSCs were obtained from patients under-going total hip arthroplasty and ADSC from human adi-pose tissue obtained from lipectomy. Cells were grown in medium containing 15% human serum. Cultures were serum deprived for 2 d before cultivating under similar pro-hepatogenic conditions to those of liver develop-ment using a 2-step protocol with sequential addition of growth factors, cytokines and hormones. Hepatic differ-entiation was RT-PCR-assessed and liver-marker genes were immunohistochemically analysed. RESULTS: BMSC and ADSC exhibited a fibroblastic mor-phology that changed to a polygonal shape when cells differentiated. Expression of stem cell marker Thy1 de-creased in differentiated ADSC and BMSC. However, the expression of the hepatic markers, albumin and CYPs increased to a similar extent in differentiated BMSC and ADSC. Hepatic gene activation could be attributed to in-creased liver-enriched transcription factors (C/EBPβ and HNF4α), as demonstrated by adenoviral expression vec-tors.CONCLUSION: Mesenchymal stem cells can be induced to hepatogenic transdifferentiation in vitro. ADSCs have a similar hepatogenic differentiation potential to BMSC, but a longer culture period and higher proliferation ca-pacity. Therefore, adipose tissue may be an ideal source of large amounts of autologous stem cells, and may become an alternative for hepatocyte regeneration, liver cell transplantation or preclinical drug testing. | Raquel Taléns-Visconti Ana Bonora Ramiro Jover Vicente Mirabet Francisco Carbonell José Vicente Castell María José Gómez-Lechón | 2006 | World Journal of Gastroenterology2006，12，36： | 35 |
| 2 | Triglyceride levels and apolipoprotein E polymorphism in patients with acute pancreatitis显示文摘BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe hypertriglyceridemia.METHODS:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum triglycerides.The APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being taken.The patients' progression,etiological diagnosis,hospital stay and clinical and radiological severity were all recorded.RESULTS:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) origin.Compared with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes mellitus.They usually consumed alcohol or consumed it excessively on the days before admission.Also,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption. | Radka Ivanova Susana Puerta Alfonso Garrido Ignacio Cueto Ana Ferro María José Ariza Andrés Cobos Pedro González-Santos Pedro Valdivielso | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 26 |
| 3 | Damage control orthopaedics: State of the art显示文摘Damage control orthopaedics(DCO) originally consisted of the provisional immobilisation of long bone-mainly femur-fractures in order to achieve the advantages of early treatment and to minimise the risk of complications, such as major pain, fat embolism, clotting, pathological inflammatory response, severe haemorrhage triggering the lethal triad, and the traumatic effects of major surgery on a patient who is already traumatised(the 'second hit' effect). In recent years, new locations have been added to the DCO concept, such as injuries to the pelvis, spine and upper limbs. Nonetheless, this concept has not yet been validated in well-designed prospective studies, and much controversy remains.Indeed, some researchers believe the indiscriminate application of DCO might be harmful and produce substantial and unnecessary expense. In this respect, too,normalised parameters associated with the acid-base system have been proposed,under a concept termed early appropriate care, in the view that this would enable patients to receive major surgical procedures in an approach offering the advantages of early total care together with the apparent safety of DCO. This paper discusses the diagnosis and treatment of severely traumatised patients managed in accordance with DCO and highlights the possible drawbacks of this treatment principle. | Enrique Guerado Maria Luisa Bertrand Juan Ramon Cano Ana María Cerván Adolfo Galán | 2019 | World Journal of Orthopedics2019，10，1： | 16 |
| 4 | Therapy with stem cells in inflammatory bowel disease显示文摘Inflammatory bowel disease(IBD) affects a part of the young population and has a strong impact upon quality of life. The underlying etiology is not known, and the existing treatments are not curative. Furthermore, a significant percentage of patients are refractory to therapy. In recent years there have been great advances in our knowledge of stem cells and their therapeutic applications. In this context, autologous hematopoietic stem cell transplantation(HSCT) has been used in application to severe refractory Crohn's disease(CD), with encouraging results. Allogenic HSCT would correct the genetic defects of the immune system, but is currently not accepted for the treatment of IBD because of its considerable risks. Mesenchymal stem cells(MSCs) have immune regulatory and regenerative properties, and low immunogenicity(both autologous and allogenic MSCs). Based on these properties, MSCs have been used via the systemic route in IBD with promising results, though it is still too soon to draw firm conclusions. Their local administration in perianal CD is the field where most progress has been made in recent years, with encouraging results. The next few years will be decisive for defining the role of such therapy in the management of IBD. | María del Pilar Martínez-Montiel Gonzalo Jesús Gómez-Gómez Ana Isabel Flores | 2014 | World Journal of Gastroenterology2014，20，5： | 13 |
| 5 | Metformin revisited: Does this regulator of AMP-activated protein kinase secondarily affect bone metabolism and prevent diabetic osteopathy?显示文摘Patients with long-term type 1 and type 2 diabetes mellitus(DM) can develop skeletal complications or 'diabetic osteopathy'. These include osteopenia, osteoporosis and an increased incidence of low-stress fractures. In this context, it is important to evaluate whether current anti-diabetic treatments can secondarily affect bone metabolism. Adenosine monophosphateactivated protein kinase(AMPK) modulates multiple metabolic pathways and acts as a sensor of the cellular energy status; recent evidence suggests a critical role for AMPK in bone homeostasis. In addition, AMPK activation is believed to mediate most clinical effects of the insulin-sensitizer metformin. Over the past decade, several research groups have investigated the effects of metformin on bone, providing a considerable body of pre-clinical(in vitro, ex vivo and in vivo) as well as clinical evidence for an anabolic action of metformin on bone. However, two caveats should be kept in mind when considering metformin treatment for a patient with type 2 DM at risk for diabetic osteopathy. In the first place, metformin should probably not be considered an antiosteoporotic drug; it is an insulin sensitizer with proven macrovascular benefits that can secondarily improve bone metabolism in the context of DM. Secondly, we are still awaiting the results of randomized placebo-controlled studies in humans that evaluate the effects of metformin on bone metabolism as a primary endpoint. | Antonio Desmond McCarthy Ana María Cortizo Claudia Sedlinsky | 2016 | World Journal of Diabetes2016，7，6： | 9 |
| 6 | Helicobacter pylori and corpus gastric pathology are associated with lower serum ghrelin显示文摘AIM To evaluate the association of Helicobacter pylori(H. pylori), cag A genotype, and type of gastric pathology with ghrelin, leptin and nutritional status.METHODS Fasted dyspeptic adults(18-70 years) referred for an upper digestive endoscopy were enrolled in this crosssectional study. Height and weight were assessed for body mass index(BMI) calculation. A sociodemographic survey was administered and nutrient intake was evaluated with 24 h dietary recalls. Serum total ghrelin and leptin levels were analyzed by enzymelinked immunosorbent assay. 13 C-Urea Breath Test was performed and four gastric biopsies were obtained during endoscopy for histopathology and H. pylori DNA amplification and genotyping. Data analysis was performed using χ2, Mann-Whitney U, Kruskal-Wallis tests, Spearman's correlation and linear regression.RESULTS One hundred and sixty-three patients(40.8 ± 14.0 years), 98/65 females/males, were included. Overall, persistent H. pylori prevalence was 53.4%(95%CI: 45.7%-65.8%). Neither nutrient intake nor BMI differed significantly between H. pylori positive and negative groups. Serum ghrelin was significantly lower in infected patients [median 311.0 pg/m L(IQR 230.0-385.5)] than in uninfected ones [median 355.0 pg/m L(IQR 253.8-547.8)](P = 0.025), even after adjusting for BMI and gender(P = 0.03). Ghrelin levels tended to be lower in patients carrying cag A positive strains both in the antrum and the corpus; however, differences with those carrying cag A negative strains did not reach statistical significance(P = 0.50 and P = 0.49, respectively). In addition, the type and severity of gastric pathology in the corpus was associated with lower serum ghrelin(P = 0.04), independently of H.pylori status. Conversely, leptin levels did not differ significantly between infected and uninfected patients [median 1.84 ng/m L(0.80-4.85) vs 1.84 ng/m L(0.50-5.09),(P = 0.51)]. CONCLUSION H. pylori infection and severity of gastric corpus pathology are associated with lower serum ghrelin. Further studies could confirm a lower ghrelin prevalence in cag A-positive patients. | Paula Mantero Gonzalo Sebastián Matus Rodolfo Ernesto Corti Ana María Cabanne Gerardo Gabriel Zerbetto de Palma Liliana Marchesi Olid María Marta Piskorz Marcela Beatriz Zubillaga Mariana Andrea Janjetic Cinthia Gabriela Goldman | 2018 | World Journal of Gastroenterology2018，24，3： | 8 |
| 7 | Subclinical carotid atherosclerosis predicts all-cause mortality and cardiovascular events in obese patients with negative exercise echocardiography显示文摘BACKGROUND Obesity is a major health problem due to its high prevalence. The relationship between obesity and cardiovascular disease is unclear. Some studies agree that certain conditions associated with obesity, such as physical inactivity or cardiovascular risk factors, are responsible for cardiovascular risk excess among obese people. Carotid intima-media thickness and carotid plaques(CP) have been associated with cardiovascular adverse events in healthy populations, and recent data suggest a higher prevalence of subclinical carotid atherosclerosis in obese and metabolically unhealthy patients. However, there are no studies correlating subclinical atherosclerosis and adverse events(AE) in obese subjects.AIM To determine the association between carotid disease and AE in obese patients with negative exercise echocardiography(EE).METHODS From January 1, 2006 to December 31, 2010, 2000 consecutive patients with a suspicion of coronary artery disease were submitted for EE and carotid ultrasonography. Exclusion criteria included previous vascular disease, left ventricular ejection fraction < 50%, positive EE, significant valvular heart disease and inferior to submaximal EE. An AE was defined as all-cause mortality,myocardial infarction and cerebrovascular accident. Subclinical atherosclerosis was defined as CP presence according to Manheim and the American Society of Echocardiography Consensus.RESULTS Of the 652 patients who fulfilled the inclusion criteria, 226(34.7%) had body mass indexes ≥ 30 kg/m2, and 76 of them(33.6%) had CP. During a mean follow-up time of 8.2(2.1) years, 27 AE were found(11.9%). Mean event-free survival at 1, 5 and 10 years was 99.1%(0.6), 95.1%(1.4) and 86.5%(2.7), respectively. In univariate analysis, CP predicted AE [hazard ratio(HR) 2.52, 95% confidence interval(CI) 1.17-5.46; P = 0.019]. In multivariable analysis, the presence of CP remained a predictor of AE(HR 2.26, 95%CI 1.04-4.95, P = 0.041). Other predictors identified were glomerular filtration rate(HR 0.98, 95%CI 0.96-0.99; P= 0.023), peak metabolic equivalents(HR 0.83, 95%CI 0.70–0.99, P = 0.034) and moderate mitral regurgitation(HR 5.02, 95%CI 1.42–17.75, P = 0.012).CONCLUSION Subclinical atherosclerosis defined by CP predicts AE in obese patients with negative EE. These patients could benefit from aggressive prevention measures. | Rafael Vidal-Perez Raúl Franco-Gutiérrez Alberto J Pérez-Pérez Virginia Franco-Gutiérrez Alberto Gascón-Vázquez Andrea López-López Ana María Testa-Fernández Carlos González-Juanatey | 2019 | World Journal of Cardiology2019，11，1： | 7 |
| 8 | Management of primary achalasia: The role of endoscopy显示文摘Achalasia is an oesophageal motor disorder which leads to the functional obstruction of the lower oesophageal sphincter(LES) and is currently incurable. The main objective of all existing therapies is to achieve a reduction in the obstruction of the distal oesophagus in order to improve oesophageal transit, relieve the symptomatology, and prevent long-term complications. The most common treatments used are pneumatic dilation(PD) and laparoscopic Heller myotomy, which involves partial fundoplication with comparable shortterm success rates. The most economic non-surgical therapy is PD, with botulinum toxin injections reserved for patients with a higher surgical risk for whom the former treatment option is unsuitable. A new technology is peroral endoscopic myotomy, postulated as a possible non-invasive alternative to surgical myotomy. Other endoluminal treatments subject to research more recently include injecting ethanolamine into the LES and using a temporary self-expanding metallic stent. At present, there is not enough evidence permitting a routine recommendation of any of these three novel methods. Patients must undergo follow-up after treatment to guarantee that their symptoms are under control and to prevent complications. Most experts are in favour of some form of endoscopic follow-up, however no established guidelines exist in this respect. The prognosis for patients with achalasia is good, although a recurrence after treatment using any method requires new treatment. | Marisol Luján-Sanchis Patricia Suárez-Callol Ana Monzá-Gallego Inmaculada Bort-Pérez Lydia Plana-Campos Luis Ferrer-Barceló Laura Sanchis-Artero María Llinares-Lloret Juan Antonio Tuset-Ruiz Javier Sempere-Garcia-Argüelles Pilar Canelles-Gamir Enrique Medina-Chuliá | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，6： | 5 |
| 9 | Validation of a new scoring system: Rapid assessment faecal incontinence score显示文摘AIM: To implement a quick and simple test- rapid assessment faecal incontinence score(RAFIS) and show its reliability and validity.METHODS: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected. In a single visit, patients were administered the RAFIS. The results obtained with the new score were compared with those of both Wexner score and faecal incontinence quality of life scale(FIQL) questionnaire. The patient withoutinfluence of the surgeon completed the test. The role of surgeon was explaining the meaning of each section and how he had to fill. Reliability of the RAFIS score was measured using intra-observer agreement and Cronbach's alpha(internal consistency) coefficient. Multivariate analysis of the main components within the different scores was performed in order to determine whether all the scores measured the same factor and to conclude whether the information could be encompassed in a single factor. A sample size of 50 patients with faecal incontinence was estimated to be enough to detect a correlation of 0.55 or better at 5% level of significance with 80% power.RESULTS: We analysed the results obtained by 53 consecutive patients with faecal incontinence(median age 61.55 ± 12.49 years) in the three scoring systems. A total of 208 healthy volunteers(median age 58.41 ± 18.41 years) without faecal incontinence were included in the study as negative controls. Pearson's correlation coefficient between 'state' and 'leaks' was excellent(r = 0.92, P < 0.005). Internal consistency in the comparison of 'state' and 'leaks' yielded also excellent correlation(Cronbach's α = 0.93). Results in each score were compared using regression analysis and a correlation value of r = 0.98 was obtained with Wexner score. As regards FIQL questionnaire, the values of 'r ' for the different subscales of the questionnaire were: 'lifestyle' r =-0.87, 'coping/behaviour' r =-0.91, 'depression' r =-0.36 and 'embarrassment' r =-0.90,(P < 0.01). A multivariate analysis showed that all the scoring systems measured the same factor. A single factor may explain 80.84% of the variability of FI, so all the scoring systems measure the same factor. Patient's continence improves when RAFIS and Jorge-Wexner scores show low values and when the values obtained in the FIQL questionnaire are high.CONCLUSION: RAFIS is a valid and reliable tool to assess Faecal Incontinence. | Fernando de la Portilla Arantxa Calero-Lillo Rosa M Jiménez-Rodríguez Maria L Reyes Manuela Segovia-González María Victoria Maestre Ana M García-Cabrera | 2015 | World Journal of Gastrointestinal Surgery2015，7，9： | 5 |
| 10 | Management of oligometastatic non-small cell lung cancer patients:Current controversies and future directions显示文摘Oligometastatic non-small cell lung cancer(NSCLC)describes an intermediate stage of NSCLC between localized and widely-disseminated disease.This stage of NSCLC is characterized by a limited number of metastases and a more indolent tumor biology.Currently,the management of oligometastatic NSCLC involves radical treatment(radiotherapy or surgery)that targets the metastatic lesions and the primary tumor to achieve disease control.This approach offers the potential to achieve prolonged survival in patients who,in the past,would have only received palliative measures.The optimal therapeutic strategies for the different scenarios of oligometastatic disease(intracranial vs extracranial disease,synchronous vs metachronous)remain undefined.Given the lack of head-to-head studies comparing radiotherapy to surgery in these patients,the decision to apply surgery or radiotherapy(with or without systemic treatment)must be based on prognostic factors that allow us to classify patients.This classification will allow us to select the most appropriate therapeutic strategy on an individualized basis.In the future,the molecular or microRNA profiles will likely improve the treatment selection process.The objective of the present article is to review the most relevant scientific evidence on the management of patients with oligometastatic NSCLC,focusing on the role of radiotherapy and surgery.We also discuss areas of controversy and future directions. | Felipe Counago Javier Luna Luis Leonardo Guerrero Blanca Vaquero María Cecilia Guillén-Sacoto Teresa González-Merino Begona Taboada Verónica Díaz Belén Rubio-Viqueira Ana Aurora Díaz-Gavela Francisco JoséMarcos Elia del Cerro | 2019 | World Journal of Clinical Oncology2019，10，10： | 5 |
| 11 | Role of advanced magnetic resonance imaging in the assessment of malignancies of the mediastinum显示文摘In the new era of functional magnetic resonance imaging(MRI), the utility of chest MRI is increasing exponentially due to several advances, including absence of ionizing radiation, excellent tissue contrast and high capability for lesion characterization and treatment monitoring. The application of several of these diagnostic weapons in a multiparametric fashion enables to better characterize thymic epithelial tumors and other mediastinal tumoral lesions, accurate assessment of the invasion of adjacent structures and detection of pathologic lymph nodes and metastasis. Also, 'do not touch lesions' could be identified with the associated impact in the management of those patients. One of the hotspots of the multiparametric chest MR is its ability to detect with acuity early response to treatment in patients with mediastinal malignant neoplasms. This has been related with higher rates of overall survival and progression free survival.Therefore, in this review we will analyze the current functional imaging techniques available(18 F-Fluorodeoxiglucose positron emission tomography/computed tomography, diffusion-weighted imaging, dynamic contrast-enhanced MRI, diffusion tensor imaging and MR spectroscopy) for the evaluation of mediastinal lesions, with a focus in their correct acquisition and post-processing. Also, to review the clinical applications of these techniques in the diagnostic approach of benign and malignant conditions of the mediastinum. | Jordi Broncano Ana María Alvarado-Benavides Sanjeev Bhalla Antonio álvarez-Kindelan Constantine A Raptis Antonio Luna | 2019 | World Journal of Radiology2019，11，3： | 4 |
| 12 | Outcome in obscure gastrointestinal bleeding after capsule endoscopy显示文摘AIM: To investigate the clinical impact of capsule endoscopy(CE) after an obscure gastrointestinal bleeding(OGIB) episode, focusing on diagnostic work-up, followup and predictive factors of rebleeding. METHODS: Patients who were referred to Hospital del Mar(Barcelona, Spain) between 2007 and 2009 for OGIB who underwent a CE were retrospectively analyzed. Demographic data, current treatment with non-steroid antiinflammtory drugs or anticoagulant drugs, hemoglobin levels, transfusion requirements, previous diagnostic tests for the bleeding episode, as well as CE findings(significant or non-significant), work-up and patient out-comes were analyzed from electronic charts. Variables were compared by χ 2 analysis and Student t test. Risk factors of rebleeding were assessed by Log-rank test, Kaplan-Meier curves and Cox regression model. RESULTS: There were 105 patients [45.7% women, median age of 72 years old(interquartile range 56-79)] and a median follow-up of 326 d(interquartile range 123-641) included in this study. The overall diagnostic yield of CE was 58.1%(55.2% and 63.2%, for patients with occult OGIB and overt OGIB, respectively). In 73 patients(69.5%), OGIB was resolved. Multivariate analysis showed that hemoglobin levels lower than 8 g/dL at diagnosis [hazard ratios(HR) = 2.7, 95%CI: 1.9-6.3], patients aged 70 years and above(HR = 2.1, 95%CI: 1.2-6.1) and significant findings in CE(HR = 2.4, 95%CI: 1.1-5.8) were independent predictors of rebleeding. CONCLUSION: One third of the patients presented with rebleeding after CE; risk factors were hemoglobin levels < 8 g/dL, age ≥ 70 years or the presence of significant lesions. | Alex Caas-Ventura Lucia Márque Xavier Bessa Josep Maria DedeuDepartment of Gastroenterology Hospital del Mar Research Institute Pompeu Fabra University Marc Puigvehí Sílvia Delgado-Aros Ines Ana Ibáez Agustin Seoane Luis Barranco Felipe Bory Montserrat Andreu Begoa González-Suárez | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，11： | 4 |
| 13 | Analysis of the postoperative hemostatic profile of colorectal cancer patients subjected to liver metastasis resection surgery显示文摘BACKGROUND Liver resection surgery has advanced greatly in recent years,and the adoption of fasttrack programs has yielded good results.Combination anesthesia (general anesthesia associated to epidural analgesia) is an anesthetic-analgesic strategy commonly used for the perioperative management of patients undergoing surgery of this kind,though there is controversy regarding the coagulation alterations it may cause and which can favor the development of spinal hematomas.AIM To study the postoperative course of liver resection surgery,an analysis was made of the outcomes of liver resection surgery due to colorectal cancer metastases in our centre in terms of morbiditymortality and hospital stay according to the anesthetic technique used (general vs combination anesthesia).METHODS A prospective study was made of 61 colorectal cancer patients undergoing surgery due to liver metastases under general and combination anesthesia between January 2014 and October 2015.The patient characteristics,intraoperative variables,postoperative complications,evolution of hemostatic parameters,and stay in intensive care and in hospital were analyzed.RESULTS A total of 61 patients were included in two homogeneous groups: general anesthesia (n = 30) and combination anesthesia (general anesthesia associated to epidural analgesia)(n = 31).All patients had normal coagulation values before surgery.The international normalized ratio (INR) in both the general and combination anesthesia groups reached maximum values at 2448 h (mean 1.37 and 1.45 vs 1.39 and 1.41,respectively),followed by a gradual decrease.There was less intraoperative bleeding in the combination anesthesia group (769 mL) than in the general anesthesia group (1200 mL)(P < 0.05).Of the 61 patients,38.8% in the general anesthesia group experienced some respiratory complication vs 6.6% in the combination anesthesia group (P < 0.001).The time to gastrointestinal tolerance was significantly correlated to the type of anesthesia,though not so the stay in critical care or the time to hospital discharge.CONCLUSION Epidural analgesia in liver resection surgery was seen to be safe,with good results in terms of pain control and respiratory complications,and with no associated increase in complications secondary to altered hemostasis. | Guillermo Perez Navarro Ana Maria Pascual Bellosta Sonia María Ortega Lucea Mario Serradilla Martín Jose Manuel Ramirez Rodriguez Javier Martinez Ubieto | 2019 | World Journal of Clinical Cases2019，7，17： | 4 |
| 14 | Celiac disease serology in patients with different pretest probabilities: Is biopsy avoidable?显示文摘AIM: To establish the diagnostic performance of sev-eral serological tests, individually and in combination, for diagnosing celiac disease (CD) in patients with different pretest probabilities, and to explore potential se- rological algorithms to reduce the necessity for biopsy. METHODS: We prospectively performed duodenal biopsy and serology in 679 adults who had either high risk (n = 161) or low risk (n = 518) for CD. Blood samples were tested using six assays (enzyme-linked immunosorbent assay) that detected antibodies to tissue transglutaminase (tTG) and deamidated gliadin peptide (DGP). RESULTS: CD prevalence was 39.1% in the high-risk population and 3.3% in the low-risk group. In high-risk patients, all individual assays had a high diagnostic efficacy [area under receiving operator characteristic curves (AU ROC): 0.968 to 0.999]. In contrast, assays had a lower diagnostic efficacy (AU ROC: 0.835 to 0.972) in the low-risk group. Using assay combinations, it would be possible to reach or rule out diagnosis of CD without biopsy in 92% of cases in both pretest populations. We observed that the new DGP/tTG Screen assay resulted in a surplus compared to more conventional assays in any clinical situation. CONCLUSION: The DGP/tTG Screen assay could be considered as the best initial test for CD. Combinations of two tests, including a DGP/tTG Screen, might be able to diagnose CD accurately in different clinical scenarios making biopsy avoidable in a high proportion of subjects. | Emilia Sugai María L Moreno Hui J Hwang Ana Cabanne Adriana Crivelli Fabio Nach-man Horacio Vázquez Sonia Niveloni Julio Argonz Roberto Mazure Graciela La Motta María E Caniggia Edgardo Smecuol Néstor Chopita Juan C Gómez Eduardo Maurińo Julio C Bai | 2010 | World Journal of Gastroenterology2010，16，25： | 4 |
| 15 | Presacral venous bleeding during mobilization in rectal cancer显示文摘AIM To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal cancer.METHODS A review of the databases MEDLINE? and Embase? was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were defined.RESULTS This is a review of 58 published articles on presacral venous plexus injury during the mobilization of the rectum and on techniques used to treat presacral venous bleeding. Due to the lack of cases published in the literature, there is no consensus on which is the best technique to use if there is presacral bleeding during mobilization in surgery for rectal cancer. This review may provide a tool to help surgeons make decisions regarding how to resolve this serious complication.CONCLUSION A series of alternative treatments are described; however, a conventional systematic review in which optimal treatment is identified could not be performed because few cases were analyzed in most publications. | Jose Enrique Casal Núnez Vincenzo Vigorita Alejandro Ruano Poblador Ana María Gay Fernández Maria ángeles Toscano Novella Nieves Cáceres Alvarado Lucinda Pérez Dominguez | 2017 | World Journal of Gastroenterology2017，23，9： | 4 |
| 16 | Beta-blocker therapy in elderly patients with renal dysfunction and heart failure显示文摘OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^2.We analyzed the relationship between treatment with BB and mortality or cardiovascular events.The mean age of our population was 82.6±4.1 years.Mean ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,and<30 m L/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving BB.The median follow-up was28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible. | Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón | 2021 | Journal of Geriatric Cardiology2021，18，1： | 3 |
| 17 | Effect of arsenic on tolerance mechanisms of two plant growth-promoting bacteria used as biological inoculants显示文摘Bacterial ability to colonize the rhizosphere of plants in arsenic(As) contaminated soils is highly important for symbiotic and free-living plant growth-promoting rhizobacteria(PGPR)used as inoculants, since they can contribute to enhance plant As tolerance and limit metalloid uptake by plants. The aim of this work was to study the effect of As on growth,exopolysaccharide(EPS) production, biofilm formation and motility of two strains used as soybean inoculants, Bradyrhizobium japonicum E109 and Azospirillum brasilense Az39. The metabolism of arsenate(As(V)) and arsenite(As(III)) and their removal and/or possible accumulation were also evaluated. The behavior of both bacteria under As treatment was compared and discussed in relation to their potential for colonizing plant rhizosphere with high content of the metalloid. B. japonicum E109 growth was reduced with As(III)concentration from 10 μM while A. brasilense Az39 showed a reduction of growth with As(III) from 500 μM. EPS and biofilm production increased significantly under 25 μM As(III)for both strains. Moreover, this was more notorious for Azospirillum under 500 μM As(III),where motility was seriously affected. Both bacterial strains showed a similar ability to reduce As(V). However, Azospirillum was able to oxidize more As(III)(around 53%) than Bradyrhizobium(17%). In addition, both strains accumulated As in cell biomass. The behavior of Azospirillum under As treatments suggests that this strain would be able to colonize efficiently As contaminated soils. In this way, inoculation with A. brasilense Az39 would positively contribute to promoting growth of different plant species under As treatment. | Ana L.Armendariz Melina A.Talano Ana L.Wevar Oller María I.Medina Elizabeth Agostini | 2015 | Journal of Environmental Sciences2015，27，7： | 3 |
| 18 | Skeletal muscle myogenesis is regulated by G protein-coupled receptor kinase 2显示文摘G 联合蛋白质的受体 kinase (GRK2 ) 2 是调整不同的膜 receptorsand 的重要 serine/threonine-kinase 细胞内部的蛋白质。在胚胎或成年苍蝇的果蝇 Gprk2 的变细导致了体的肌肉,纤维的损失,和不能飞行的 phenotype.In 的有缺点的区别脊椎动物, GRK2 hemizygous 老鼠少些,但是更包含了 hypertrophied 骨胳的肌肉纤维比野类型的 littermates.In C2C12 myoblasts , GRK2 kinase缺乏的异种( K220R )的 overexpression 引起了房间 intoimmature myotubes 的早熟的区别,它在尺寸是更宽的并且包含了更多的熔化原子核,当时 GRK2 overexpression b 熔化事件由提高的 GRK2 层次支持了的损害 differentiationand 少数被 p38MAPK 异种概括,它能由 GRK2 模仿 p38MAPK 的 theinhibitory phosphorylation,而在表示 GRK2 观察的弄钝的区别面对 p38MAPK 小径的一个组成地活跃的在上游的激发器克隆 wasrescued。这些结果建议 thatbalanced GRK2 功能为一个及时、完全的 myogenic 过程是必要的。 | Lucia Garcia-Guerra Rocio Vila-Bedmar Marta Carrasco-Rando Marta Cruces-Sande Mercedes Martin Ana Ruiz-Gomez Mar Ruiz-Gomez Margarita Lorenzo Sonia Fernandez-Veledo Federico Mayor Jr. Cristina Murga Iria Nieto-Vazquez | 2014 | Journal of Molecular Cell Biology2014，8，4： | 3 |
| 19 | Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram:A comparison of shockable and non-shockable initial rhythms显示文摘AIM To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic electrocardiogram.METHODS From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnostic post-resuscitation electrocardiogram(defined as ST segment elevation or pre-sumably new left bundle branch block) whounderwent invasive coronary angiogram during hospitalization were included. For purpose of analysis and comparison, patients were classified in two groups: Initial shockable rhythm(ventricular tachycardia or ventricular fibrillation; n = 148, 72.9%) and initial non-shockable rhythm(n = 55, 27.1%). Baseline characteristics, coronary angiogram findings including Syntax Score and long-term survival rates were compared. RESULTS Sudden cardiac arrest was witnessed in 95.2% of cases, 66.7% were out-of-hospital patients and 72.4% were male. There were no significant differences in baseline characteristics between groups except for higher mean age(68.1 years vs 61 years, P = 0.001) in the nonshockable rhythm group. Overall 5-year mortality of the resuscitated patients was 37.4%. Patients with non-shockable rhythms had higher mortality(60% vs 29.1%, P < 0.001) and a worst neurological status at hospital discharge based on cerebral performance category score(CPC 1-2: 32.7% vs 53.4%, P = 0.02). Although there were no significant differences in global burden of coronary artery disease defined by Syntax Score(mean Syntax Score: 10.2 vs 10.3, P = 0.96) there was a trend towards a higher incidence of acute coronary lesions in patients with shockable rhythm(29.7% vs 16.4%, P = 0.054). There was also a higher need for ad-hoc percutaneous coronary intervention in this group(21.9% vs 9.1%, P = 0.03). CONCLUSION Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs nonshockable group. | Pedro Martínez-Losas Pablo Salinas Carlos Ferrera María Teresa Nogales-Romo Francisco Noriega María Del Trigo Iván Javier Núnez-Gil Luis Nombela-Franco Nieves Gonzalo Pilar Jiménez-Quevedo Javier Escaned Antonio Fernández-Ortiz Carlos Macaya Ana Viana-Tejedor | 2017 | World Journal of Cardiology2017，9，8： | 3 |
| 20 | Is leptin related to systemic inflammatory response in acute pancreatitis?显示文摘瞄准:在尖锐胰腺炎评估在 leptin 和全身的发炎之间的关系。方法:有尖锐胰腺炎的连续病人被包括。身体集体索引和浆液样品在承认被获得。Leptin, TNF-alpha, IL-6, -8 和 -10 层次被 ELISA 决定。严厉根据亚特兰大标准被定义。结果:52 (29 女性) 病人们被学习。全面身体团索引在温和、严重的盒子之间是类似的,尽管有严重胰腺炎的女人有更低的身体团索引(P = 0.04 ) 并且男人证明更高的身体质量索引(P = 0.05 ) 。没有差别关于胰腺炎的严厉在 leptin 层次被发现,但是高水平趋于与增加的身体团索引和严重胰腺炎出现在男病人(P = 0.1 ) 。多,变量分析显示出的 A 在 leptin 层次和严厉之间的没有协会。与严厉联系的最强壮的 cytokine 是 IL-6。有另一 cytokines 的 leptin 的关联仅仅为 IL-8 显示出一个趋势(P = 0.058 ) 。结论:高身体团索引仅仅在男性与严厉被联系,它可能与机器人脂肪分发有关。浆液 leptin 似乎不在男性与严重结果在尖锐胰腺炎和它的协会在全身的煽动性的反应上起一个作用可能代表增加的脂肪过多的一个标记。 | Andrés Duarte-Rojo Ana Lezama-Barreda María Teresa Ramírez-Iglesias Mario Peláez-Luna Guillermo Robles-Díaz | 2006 | World Journal of Gastroenterology2006，12，27： | 2 |
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