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| 1 | Laparoscopic natural orifice specimen extraction-colectomy: A systematic review显示文摘Over the last 20 years, laparoscopic colorectal surgery has shown equal efficacy for benign and malignant colorectal diseases when compared to open surgery. However, a laparoscopic approach reduces postoperative morbidity and shortens hospital stay. In the quest to optimize outcomes after laparoscopic colorectal surgery, reduction of access trauma could be a way to improve recovery. To date, one method to reduce access trauma is natural orifice specimen extraction(NOSE). NOSE aims to reduce access trauma in laparoscopic colorectal surgery. The specimen is delivered via a natural orifice and the anastomosis is created intracorporeally. Different methods are used to extract the specimen and to create a bowel anastomosis. Currently, specimens are delivered transcolonically, transrectally, transanally, or transvaginally. Each of these NOSEprocedures raises specific issues with regard to operative technique and application. The presumed benefits of NOSE-procedures are less pain, lower analgesia requirements, faster recovery, shorter hospital stay, better cosmetic results, and lower incisional hernia rates. Avoidance of extraction site laparotomy is the most important characteristic of NOSE. Concerns associated with the NOSE-technique include bacterial contamination of the peritoneal cavity, inflammatory response, and postoperative outcomes, including postoperative pain and the functional and oncologic outcomes. These issues need to be studied in prospective randomized controlled trials. The aim of this systematic review is to describe the role of NOSE in minimally invasive colorectal surgery. | Albert M Wolthuis Anthony de Buck van Overstraeten André D'Hoore | 2014 | World Journal of Gastroenterology2014，20，36： | 65 |
| 2 | A community-derived classification for extant lycophytes and ferns显示文摘发展史长通知了蕨类植物分类。当我们推断进化的树的能力改善了,针对认出生来的组的分类变得逐渐地预兆、稳定。这里,我们为 lycophytes 和蕨纲植物提供一个现代、全面分类,在下面,利用一条基于社区的途径类水平。我们 monophyly 用作主要标准让 taxa,而且目的识别保存两个广泛地被接受的存在 taxa 和界限并且与我们蕨类植物发展史的理解一致。总共,这个分类对待一在 337 个类, 51 个家庭, 14 目,和二个班估计了 11 916 种类。这个分类没在 lycophyte 和蕨纲植物上作为最后的词被打算分类,而是当前的假设的概括陈述,源于最好的可得到的数据并且在问题由熟悉植物的那些大多数塑造了。我们希望它将在蕨类植物上为最近的文学的那些想要的参考用作一个资源发展史和分类,为指导未来调查的一个框架,和推进讲话的刺激。 | Eric Schuettpelz Harald Schneider Alan R. Smith Peter Hovenkamp Jefferson Prado Germinal Rouhan Alexandre Salino Michael Sundue Thafs Elias Almeida Barbara Parris Emily B. Sessa Ashley R. Field Andre Luis de Gasper Carl J. Rothfels Michael D. Windham Marcus Lehnert Benjamin Dauphin Atsushi Ebihara Samuli Lehtonen Pedro Bond Schwartsburd Jordan Metzgar Li-Bing Zhang Li-Yaung Kuo Patrick J. Brownsey Masahiro Kato Marcelo Daniel Arana Francine C. Assis Michael S. Barker David S. Barrington Ho-Ming Chang Yi-Han Chang Yi-Shan Chao Cheng-Wei Chen De-Kui Chen Wen-Liang Chiou Vinicius Antonio de Oliveira Dittrich Yi-Fan Duan Jean-Yves Dubuisson Donald R. Farrar Susan Fawcett Jose Maria Gabriel y Galan Luiz Armando de Araujo Goes-Neto Jason R. Grant Amanda L. Grusz Christopher Haufler Warren Hauk Hai He Sabine Hennequin Regina Yoshie Hirai Layne Huiet Michael Kessler Petra Korall Paulo H. Labiak Anders Larsson Blanca Leen Chun-Xiang Li Fay-Wei Li Melanie Link-Perez Hong-Mei Liu Ngan Thi Lu Esteban I. Meza-Torres Xin-Yuan Miao Robbin Moran Claudine Massi Mynssens Nathalie Nagalingum Benjamin Ollgaard Alison M. Paul Jovani B. de S. Pereira Leon R. Perrie Monica Ponce Tom A. Ranker Christian Schulz Wataru Shinohara Alexander Shmakov Erin M. Sigel Filipe Soares de Souza Lana da Silva Sylvestre Weston Testo Luz Amparo Triana-Moreno Chie Tsutsumi Hanna Tuomisto IvAn A. Valdespino Alejandra Vasco Raquel Stauffer Viveros Alan Weakley Ran Wei Stina Weststrand Paul G. Wolf George Yatskievych Xiao-Gang Xu Yue-Hong Yan Liang Zhang Xian-Chun Zhang Xin-Mao Zhou | 2016 | Journal of Systematics and Evolution2016，54，6： | 44 |
| 3 | Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis显示文摘Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent illnesses.UC is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any age.The incidence of UC has increased worldwide over recent decades,especially in developing nations.In contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over time.It is important to emphasize that there is considerable variability in the phenotypic presentation of UC.Within this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor prognosis.In this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the disease.The aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis. | Bruno César da Silva Andre Castro Lyra Raquel Rocha Genoile Oliveira Santana | 2014 | World Journal of Gastroenterology2014，20，28： | 48 |
| 4 | Characterization of functional biliary pain and dyspeptic symptoms in patients with sphincter of Oddi dysfunction:Effect of papillotomy显示文摘AIM: To characterize functional biliary pain and other gastrointestinal (GI) symptoms in postcholecystectomy syndrome (PCS) patients with and without sphincter of Oddi dysfunction (SOD) proved by endoscopic sphincter of Oddi manometry (ESOM), and to assess the post- endoscopic sphincterotomy (EST) outcome. METHODS: We prospectively investigated 85 cholecystectomized patients referred for ERCP because of PCS and suspected SOD. On admission, all patients completed our questionnaire. Physical examination, laboratory tests, abdominal ultrasound, quantitative hepatobiliary scintigraphy (QHBS), and ERCP were performed in all patients. Based on clinical and ERCP findings 15 patients had unexpected bile duct stone disease and 15 patients had SOD biliary typeⅠ. ESOM demonstrated an elevated basal pressure in 25 patients with SOD biliary-type Ⅲ. In the remaining 30 cholecystectomized patients without SOD, the liver function tests, ERCP, QHBS and ESOM were all normal. As a control group, 30 ‘asymptomatic’ cholecystectomized volunteers (attended to our hospital for general cardiovascular screening) completed our questionnaire, which is consisted of 50 separate questions on GI symptoms and abdominal pain characteristics. Severity of the abdominal pain (frequency and intensity) was assessed with a visual analogue scale (VAS). In 40 of 80 patients having definite SOD (i.e. patients with SOD biliary typeⅠand those with elevated SO basal pressure on ESOM), an EST was performed just after ERCP. In these patients repeated questionnaires were filled at each follow-up visit (at 3 and 6 mo) and a second lookQHBS was performed 3 mo after the EST to assess the functional response to EST. RESULTS: The analysis of characteristics of the abdominal pain demonstrated that patients with common bile duct stone and definite SOD had a significantly higher score of symptomatic agreement with previously determined biliary-like pain features than patient groups of PCS without SOD and controls. In contrary, no significant differences were found when the pain severity scores were compared in different groups of PCS patients. In patients with definite SOD, EST induced a significant acceleration of the transpapillary bile flow; and based on the comparison of VASs obtained from the pre- and post-EST questionnaires, the severity scores of abdominal pain were significantly improved, however, only 15 of 35 (43%) patients became completely pain free. Post-EST severity of abdominal pain by VASs was significantly higher in patients with predominant dyspepsia at initial presentation as compared to those without dyspeptic symptoms. CONCLUSION: Persistent GI symptoms and general patient dissatisfaction is a rather common finding after EST in patients with SOD, and correlated with the presence of predominant dyspeptic symptoms at the initial presentation, but does not depend on the technical and functional success of EST. | László Madácsy Roland Fejes Gábor Kurucsai Ildikó Joó András Székely Viktória Bertalan Attila Szepes János Lonovics | 2006 | World Journal of Gastroenterology2006，12，42： | 33 |
| 5 | 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 |
| 6 | New ultrasound techniques for lymph node evaluation显示文摘Conventional ultrasound(US)is the recommended imaging method for lymph node(LN)diseases with the advantages of high resolution,real time evaluation and relative low costs.Current indications of transcutaneous ultrasound and endoscopic ultrasound include the detection and characterization of lymph nodes and the guidance for LN biopsy.Recent advances in US technology,such as contrast enhanced ultrasound(CEUS),contrast enhanced endoscopic ultrasound(CE-EUS),and real time elastography show potential to improve the accuracy of US for the differential diagnosis of benign and malignant lymph nodes.In addition,CEUS and CE-EUS have been also used for the guidance of fine needle aspiration and assessment of treatment response.Complementary to size criteria,CEUS could also be used to evaluate response of tumor angiogenesis to anti-angiogenic therapies.In this paper we review current literature regarding evaluation of lymphadenopathy by new and innovative US techniques. | Xin-Wu Cui Christian Jenssen Adrian Saftoiu Andre Ignee Christoph F Dietrich | 2013 | World Journal of Gastroenterology2013，19，30： | 25 |
| 7 | 天津市非道路移动源污染物排放清单开发显示文摘基于天津市非道路移动源污染管控需求,根据调研收集到的2015年非道路移动源活动水平数据,采用环保部《非道路移动污染源排放清单编制技术指南(试行)》推荐的核算方法,建立较为完整的天津市非道路移动源排放清单,分析污染物的时空分布.2015年,天津市非道路移动源排放CO 6.15×10~3t、HC 2.45×10~3t、NO_x2.90×10~4t、PM 1.45×10~3t、SO_21.37×10~4t.船舶污染物排放占比最高,为所有非道路移动源污染物排放总量的73.66%,主要分布于天津港区;其次是非道路移动机械,占21.66%,主要分布于市郊种植业和养殖业区县、城市建设和人群活动较为密集的城区;民航飞机和铁路机车占比较小,分别为3.55%和1.13%,主要分布于机场和铁路沿线.总体上,非道路移动源从3月开始排放量逐渐升高,而年底和年初(冬季)排放量相对较低. | 张意 Andre Michel 李东 张欣 吴琳 张衍杰 马超 邹超 毛洪钧 | 2017 | 环境科学2017，38，11： | 25 |
| 8 | Ag掺杂对TiO_2粉末结构的影响显示文摘采用溶胶-凝胶工艺制备了Ag掺杂的TiO_2粉末.通过XRD、SEM、EDX、DSC-TG、BET氮吸附法等研究了Ag掺杂对TiO2结构的影响,结果发现掺杂的Ag降低了TiO_2锐钛矿向金红石相转变的温度,促进了相转变.适量掺杂时,Ag抑制了锐钛矿粒子的生长,结果使锐钛矿粒子的粒径降低,TiO2_粉末的比表面积增加. | 何超 于云 周彩华 胡行方 André LARBOT | 2003 | 无机材料学报2003，18，2： | 25 |
| 9 | The Hedgehog signalling pathway in bone formation显示文摘The Hedgehog(Hh) signalling pathway plays many important roles in development,homeostasis and tumorigenesis.The critical function of Hh signalling in bone formation has been identified in the past two decades.Here,we review the evolutionariiy conserved Hh signalling mechanisms with an emphasis on the functions of the Hh signalling pathway in bone development,homeostasis and diseases.In the early stages of embryonic limb development,Sonic Hedgehog(Shh) acts as a major morphogen in patterning the limb buds.Indian Hedgehog(Ihh) has an essential function in endochondral ossification and induces osteoblast differentiation in the perichondrium.Hh signalling is also involved intramembrane ossification.Interactions between Hh and Wnt signalling regulate cartilage development,endochondral bone formation and synovial joint formation.Hh also plays an important role in bone homeostasis,and reducing Hh signalling protects against age-related bone loss.Disruption of Hh signalling regulation leads to multiple bone diseases,such as progressive osseous heteroplasia.Therefore,understanding the signalling mechanisms and functions of Hh signalling in bone development,homeostasis and diseases will provide important insights into bone disease prevention,diagnoses and therapeutics. | Jing Yang Philipp Andre Ling Ye Ying-Zi Yang | 2015 | International Journal of Oral Science2015，7，2： | 24 |
| 10 | Changes in lipid metabolism in chronic hepatitis C显示文摘AIM: To investigate the relationship between certain biochemical parameters of lipid metabolism in the serum and steatosis in the liver.METHODS: The grade of steatosis (0-3) and histological activity index (HAI, 0-18) in liver biopsy specimens were correlated with serum alanine aminotransferase (ALT), total cholesterol and triglyceride levels in 142 patients with chronic hepatitis C (CH-C), and 28 patients with non-alcoholic fatty liver disease (NAFLD) without hepatitis C virus (HCV) infection. The serum parameters were further correlated with 1 797 age and sex matched control patients without any liver diseases.RESULTS: Steatosis was detected in 90 out of 142 specimens (63%) with CH-C. The ALT levels correlated with the grade of steatosis, both in patients with CH-C and NAFLD (P<0.01). Inserting the score values of steatosis as part of the HAI, correlation with the ALT level (P<0.00001) was found. The triglyceride and cholesterol levels were significantly lower in patients with CH-C (with and without steatosis), compared to the NAFLD group and to the virus-free control groups.CONCLUSION: Our study confirms the importance of liver steatosis in CH-C which correlates with lower lipid levels in the sera. Inclusion of the score of steatosis into HAI, in case of CH-C might reflect the alterations in the liver tissue more precisely, while correlating with the ALT enzyme elevation. | Katalin Jármay Gizella Karácsony András Nagy Zsuzsa Schaff | 2005 | World Journal of Gastroenterology2005，11，41： | 22 |
| 11 | Management of biliary complications after orthotopic liver transplantation:The role of endoscopy显示文摘Biliary complications are signifi cant causes of morbidity and mortality after orthotopic liver transplantation (OLT). The estimated incidence of biliary complications after OLT ranges between 10%-25%,however,these numbers continue to decline due to improvement in surgical techniques. The most common biliary complications are strictures (both anastomotic and non-anastomotic) and bile leaks. Most of these problems can be appropriately managed with endoscopic retrograde colangiography (ERC). Other complications such as bile duct stones,bile casts,sphincter of Oddi dysfunction,and hemobilia,are less frequent and also can be managed with ERC. This article will review the risk factors,diagnosis,and endoscopic management of the most common biliary complications after OLT. | Maria C Londoo Domingo Balderramo Andrés Cárdenas | 2008 | World Journal of Gastroenterology2008，14，4： | 22 |
| 12 | Feasibility and safety of autologous bone marrow mononuclear cell transplantation in patients with advanced chronic liver disease显示文摘AIM: To evaluate the safety and feasibility of bone marrow cell (BMC) transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS: Ten patients (eight males) with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 ml of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS: The median age of the patients was 52 years (range 24-70 years). All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 (2.19 ± 0.9) and 4 mo (2.10 ± 1.0) after cell transplantation that baseline levels (2.78 ± 1.2). Albumin levels 4 mo after BMC infusion (3.73 ± 0.5) were higher than baseline levels (3.47 ± 0.5). International normalized ratio (INR) decreased from 1.48 (SD = 0.23) to 1.43 (SD = 0.23) one month after cell transplantation. CONCLUSION: BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease. | Andre Castro lyra Milena Botelho Pereira Soares luiz Flavio Maia da Silva Marcos Fraga Fortes André Goyanna Pinheiro Silva Augusto César de Andrade Mota Sheilla A Oliveira Eduardo lorens Braga Wilson Andrade de Carvalho Bernd Genser Ricardo Ribeiro dos Santos luiz Guilherme Costa lyra | 2007 | World Journal of Gastroenterology2007，13，7： | 21 |
| 13 | The Stripe Rust Resistance Gene Yr10 Encodes an Evolutionary-Conserved and Unique CC-NBS-LRR Sequence in Wheat显示文摘对用一条基于地图的克隆途径从摩洛人小麦(Triticum aestivum L.) 孤立的条纹锈的第一棵幼苗或所有阶段抵抗(R) R 基因作为 Yr10 被识别。这基因的克隆 4B 编码一高度,进化保存和唯一的 CCNBSLRR 定序。克隆 4E, Yr10 的一个相当或相同的事物,而是缺乏的抄写开始地点(TSS ) 和通常认为的 TATA 盒子和 CAAT 盒子,是可能的非表示的 pseudogene。克隆 4B 和 4E 是 84% 在 intron 和 LRR 领域相同、分叉。基因 silencing 和 transgenesis 与无毒害、剧毒的条纹锈尽力表明 Yr10 功能的差别与接种一起被使用。Yr10 CCNBSLRR 顺序在在小麦的已知的 CCNBSLRR R 基因之中是唯一的,但是高度保存相当或相同的事物(E = 0.0 ) 包括 Hordeum vulgare 和 Brachypodium distachyon 在 Aegilops tauschii 和另外的 monocots 被识别。相关序列也在玉米的 genomic 数据库被识别,米饭,并且在里面蜀黍。这是在有在它的本国的主人的有限相同,但是与在为条纹锈是主人或非主人的相关 monocots 的众多的相应 R 基因的植物的 CCNBSLRR 抵抗基因的第一份报告。这些结果越过种类代表基因进化和分散的一个唯一的例子。 | Wei Liu Michele Frick Rene Huel Cory L. Nykiforuk Xiaomin Wang Denis A. Gaudet Francois Eudes Robert L. Conner Alan Kuzyk Zhensheng Kang Andre Laroche | 2014 | Molecular Plant2014，7，12： | 21 |
| 14 | Contrast-enhanced ultrasound of histologically proven hepatic epithelioid hemangioendothelioma显示文摘AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P < 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE. | Yi Dong Wen-Ping Wang Vito Cantisani Mirko D'Onofrio Andre Ignee Lorenzo Mulazzani Adrian Saftoiu Zeno Sparchez Ioan Sporea Christoph F Dietrich | 2016 | World Journal of Gastroenterology2016，22，19： | 21 |
| 15 | Effects of octreotide on acute necrotizing pancreatitis in rabbits显示文摘AIM: To assess the role of oxygen-derived free radicals and cytokines in the pathogenesis of taurocholic acid-induced acute pancreatitis, and to evaluate the preventive effects of octreotide towards the development of acute pancreatitis. METHODS: Acute pancreatitis was induced in male New Zealand white rabbits by retrograde injection of 0.8 mL/kg·b·m, of 50 g/L sodium taurocholate(NaTC) in the pancreatic duct. Sham-operated animals served as control. Octreotide 1 mglkg·b.m.was administered subcutaneously before the induction of pancreatitis. Blood was taken from the jugular vein before and at 1, 3, 6, 12 and 24 h after pancreatitis induction.Serum activities of amylase, IL-6 and TNF-α and levels of malonyl dialdehyde (MDA), glutathione (GSH), glutathione peroxidase (GPx), catalase and superoxide dismutase (Mn-,Cu-,and Zn-SOD) in pancreatic tissue were measured.RESULTS: Serum TNF-α and IL-6 levels increased significantly 3 h after the onset of pancreatitis, and then returned to control level. The tissue concentration of MDA was significantly elevated at 24 h, while the GSH level and GP-x, catalase, Mn-SOD, Cu-, Zn-SOD activities were all significantly decreased in animals with pancreatitis as compared to the control. Octreotide pretreatment significantly reversed the changes in cytokines and reactive oxygen metabolites. Octreotide treatment did not alter the serum amylase activity and did not have any beneficial effects on the development of histopathological changes.CONCLUSION: Oxygen-derived free radicals and proinflammatory cytokines are generated at an early stage of NaTc-induced acute pancreatitis in rabbits. Prophylac ticoctreotide treatment can prevent release of cytokines and generation of reactive oxygen metabolites, but does not have any beneficial effects on the development of necrotizing pancreatitis. | Lászl6Czakó PéterHegyi TamásTakács CsabaGóg AndrásFarkas YvetteMándy Ilona Sz.Varga LászlóTiszlavicz JánosLonovics | 2004 | World Journal of Gastroenterology2004，10，14： | 21 |
| 16 | Epidural anesthesia improves pancreatic perfusion and decreases the severity of acute pancreatitis显示文摘AIM: To study the safety of epidural anesthesia(EA),its effect on pancreatic perfusion and the outcome of patients with acute pancreatitis(AP).METHODS: From 2005 to August 2010,patients with predicted severe AP [Ranson score ≥ 2,C-reactive protein > 100 or necrosis on computed tomography(CT)] were prospectively randomized to either a group receiving EA or a control group treated by patientcontrolled intravenous analgesia. Pain management was evaluated in the two groups every eight hours using the visual analog pain scale(VAS). Parameters for clinical severity such as length of hospital stay,use of antibiotics,admission to the intensive care unit,radiological/clinical complications and the need for surgical necrosectomy including biochemical data were recorded. A CT scan using a perfusion protocol was performed on admission and at 72 h to evaluate pancreatic blood flow. A significant variation in blood flow was defined as a 20% difference in pancreatic perfusion between admission and 72 h and was measured in the head,body and tail of the pancreas.RESULTS: We enrolled 35 patients. Thirteen were randomized to the EA group and 22 to the control group. There were no differences in demographic characteristics between the two groups. The Balthazar radiological severity score on admission was higher in the EA group than in the control group(mean score 4.15 ± 2.54 vs 3.38 ± 1.75,respectively,P = 0.347) and the median Ranson scores were 3.4 and 2.7 respectively(P = NS). The median duration of EA was 5.7 d,and no complications of the epidural procedure were reported. An improvement in perfusion of the pancreas was observed in 13/30(43%) of measurements in the EA group vs 2/27(7%) in the control group(P = 0.0025). Necrosectomy was performed in 1/13 patients in the EA group vs 4/22 patients in the control group(P = 0.63). The VAS improved during the first ten days in the EA group compared to the control group(0.2 vs 2.33,P = 0.034 at 10 d). Length of stay and mortality were not statistically different between the 2 groups(26 d vs 30 d,P = 0.65,and 0% for both respectively).CONCLUSION: Our study demonstrates that EA increases arterial perfusion of the pancreas and improves the clinical outcome of patients with AP. | Samira M Sadowski Axel Andres Philippe Morel Eduardo Schiffer Jean-Louis Frossard Alexandra Platon Pierre-Alexandre Poletti Leo Bühler | 2015 | World Journal of Gastroenterology2015，21，43： | 21 |
| 17 | Role of systemic inflammation in cirrhosis:From pathogenesis to prognosis显示文摘The natural history of cirrhosis can be divided into an initial stage, known as compensated cirrhosis, and an advanced stage which encompasses both decompensated cirrhosis and acute-on-chronic liver failure(ACLF). The latter syndrome has been recently described as an acute deterioration of liver function in patients with cirrhosis, which is usually triggered by a precipitating event and results in the failure of one or more organs and high short-term mortality rates. Each stage is characterized by distinctive clinical manifestations and prognoses. One of the key elements involved in cirrhosis physiopathology is systemic inflammation, recently described as one of the components in the cirrhosis-associated immune dysfunction syndrome. This syndrome refers to the combination of immune deficiency and exacerbated inflammation that coexist during the course of cirrhosis and relates to the appearance of clinical complications. Since systemic inflammation is often difficult to assess in cirrhosis patients, new objective, reproducible and readily-available markers are needed in order to optimize prognosis and lengthen survival. Thus, surrogate serum markers and clinical parameters of systemic inflammation have been sought to improve disease follow-up and management, especially in decompensated cirrhosis and ACLF. Leukocyte counts(evaluated as total leukocytes, total eosinophils or neutrophil:lymphocyte ratio) and plasma levels of procalcitonin or C-reactive protein have been proposed as prognostic markers, each with advantages and shortcomings. Research and prospective randomized studies that validate these and other markers are clearly warranted. | Melisa Dirchwolf Andres Eduardo Ruf | 2015 | World Journal of Hepatology2015，7，16： | 18 |
| 18 | H pylori (CagA) and Epstein-Barr virus infection in gastric carcinomas:Correlation with p53 mutation and c-Myc,Bcl-2 and Bax expression显示文摘AIM: To investigate the interrelationship between H pylori and Epstein-Barr virus (EBV) infection in the gastric carcinogenesis having in focus the p53 mutation and the c-Myc, Bcl-2 and Bax expression. METHODS: seventy-one gastric carcinoma tissues were assessed by polymerase chain reaction (PCR) for H pylori and in situ hybridization for EBV. c-Myc, Bcl-2 and Bax expression were detected by immunohistochemistry and single-stranded conformational polymorphism (SSCP) for p53 mutation. RESULTS: The positivity rates for H pylori and EBV were 94.4% and 8.45%, respectively. The majority of the cases displayed only the H pylori presence. All EBV positive cases were also H pylori positive. None infectious agent was observed in 5.55% of the cases. The intestinal type tumor was more frequent in the co-infected and non-infected groups. The female predominated in the non-infected group showing statistical significance (70.4% vs 29.6%, P=0.039). The Bcl-2 was only detected in the group exclusively infected by H pylori. However, c-Myc and Bax were detected in the three groups but with a low frequency in the co-infected group. Mutation of p53 was present in all groups, with the highest frequencies in the H pylori positive groups. CONCLUSION: The frequency of H pylori infection in gastric carcinomas was high. The presented data indicated that gastric carcinogenesis has different pathways depending of the presence of the two investigated infectious agents, suggesting a possible involvement of H pylori with apoptotic process. The low expression of c-Myc and Bax in the EBV-positive groups suggests that EBV may inhibit the expression of these proteins. Nevertheless, p53 mutation shows to be a relevant alteration, independent of both infectious agents. | Valeska Portela Lima Marcos Antonio Pereira de Lima Angela Rosa André Márcia Valéria Pitombeira Ferreira Marcos Aurélio Pessoa Barros Sílvia Helena Barem Rabenhorst | 2008 | World Journal of Gastroenterology2008，14，6： | 17 |
| 19 | 微生物入渗注浆法加固非饱和砂土的研究显示文摘微生物诱导碳酸钙沉积(MICP)是一项新兴的地基处理技术。以往研究中,主要是把灌输至饱和砂土中;然而最近研究者发现:MICP工法的不同会影响CaCO3的沉积和与砂颗粒结合的位置及效果,从而影响样品的强度和均匀性。与饱和土样中的灌浆法不同,通过向砂土试样中渗入或灌入微生物浆液,然后通过扫描电子显微镜(SEM)和无侧限抗压强度试验来考查其性能。结果表明:入渗法处理非饱和土样(无侧限抗压强度平均值为(19.7±5.86)MPa)效果要比灌浆法处理饱和土样(无侧限抗压强度平均值为(15.1±5.73)MPa)要好。 | Andres Quiros 张帅 程晓辉 | 2015 | 工业建筑2015，45，7： | 17 |
| 20 | Hemoconcentration is a poor predictor of severity in acute pancreatitis显示文摘AIM: To determine whether the hematocrit (Hct) at admission or at 24 h after admission was associated with severe acute pancreatitis (AP), organ failure (OF), and pancreatic necrosis.METHODS: A total of 336 consecutive patients with a first AP episode were studied. Etiology, Hct values at admission and at 24 h, development of severe AP according to Atlanta's criteria, pancreatic necrosis, OF and mortality were recorded. Hemoconcentration was defined as Hct level >44% for males and >40% for females. The t-test and χ2 test were used to assess the association of hemoconcentration to the severity, necrosis and OF.Diagnostic accuracy was also determined.RESULTS: Biliary disease was the most frequent etiology(n = 148). Mean Hct levels at admission were 41±6%for females and 46±7% for males (P<0.01). Seventyeight (23%) patients had severe AP, and OF developed in 45 (13%) patients. According to contrast-enhanced computed tomography scan, 36% (54/150) patients showed pancreatic necrosis. Hct levels were elevated in58% (55/96) and 61% (33/54) patients with interstitial and necrotizing pancreatitis, respectively. Neither Hct levels at admission nor hemoconcentration at 24 h were associated with the severity, necrosis or OF. Sensitivity,specificity and positive predictive values for both determinations were very low; and negative predictive values were between 61% and 86%, being the highest value for OF.CONCLUSION: Hct is not a useful marker to predict a worse outcome in acute pancreatitis. In spite of the high negative predictive value of hemoconcentration, the prognosis gain is limited due to an already high incidence of mild disease. | José M.Remes-Troche Andrés Duarte-Rojo Gustavo Morales Guillermo Robles-Díaz | 2005 | World Journal of Gastroenterology2005，11，44： | 16 |
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