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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 | 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 |
| 3 | 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 |
| 4 | Global secretome analysis identifies novel mediators of bone metastasis显示文摘骨头是稳固的肿瘤的远转移的一个最普通的地点。分泌蛋白质被知道影响在变形癌症房间和骨头基质之间的病理学的相互作用。为了包括地介绍,分泌了与骨头转移联系的蛋白质,我们使用了量、非量的集体 spectrometry 全球性分析改变从多重种类和癌症的变形能力打的骨头的九根细胞线的 secretomes。由比较父母房间和他们的骨头的 secretomes 变形衍生物,我们识别了特别地在这些房间线与骨头转移被联系的分泌蛋白质。我们然后合并了大临床的转移数据集的生物信息的分析获得强烈与临床、试验性的骨头转移被联系的几个功能的班的候选人小说骨头转移蛋白质的一张表。选择蛋白质的功能的确认显示在 vivo,骨头转移能被高表示支持(1 ) 唾液的 cystatins CST1, CST2,和 CST4;(2 ) plasminogen 使活跃之物小块地和 PLAU;或(3 ) 骨胶原功能蛋白质 PLOD2 和 COL6A1。总的来说,我们的学习揭开了骨头转移并且因此的几个新分泌调停人证明 secretome 分析是为新奇 biomarkers 和候选人的鉴定的一个强大的方法治疗学的目标。 | Maria Andres Blanco Gary LeRoy Zia Khan Ma a Ale kovi Barry M Zee Benjamin A Garcia Yibin Kang | 2012 | Cell Research2012，22，9： | 12 |
| 5 | Role of mi RNAs and their potential to be useful as diagnostic and prognostic biomarkers in gastric cancer显示文摘Alterations in epigenetic control of gene expression play an important role in many diseases, including gastric cancer. Many studies have identified a large number of upregulated oncogenic mi RNAs and downregulated tumour-suppressor mi RNAs in this type of cancer. In this review, we provide an overview of the role of mi RNAs, pointing to their potential to be useful as diagnostic and/or prognostic biomarkers in gastric cancer. Moreover, we discuss the influence of polymorphisms and epigenetic modifications on mi RNA activity. | Kelly Cristina da Silva Oliveira Taíssa Maíra Thomaz Araújo Camila Inagaki Albuquerque Gabriela Alcantara Barata Carolina Oliveira Gigek Mariana Ferreira Leal Fernanda Wisnieski Fernando Augusto Rodrigues Mello Junior André Salim Khayat Paulo Pimentel de Assumpcao Rommel Mário Rodriguez Burbano Marília Cardoso Smith Danielle Queiroz Calcagno | 2016 | World Journal of Gastroenterology2016，22，35： | 11 |
| 6 | Biliary tract schwannoma:A rare cause of obstructive jaundice in a young patient显示文摘Schwannoma is a tumor derived from Schwann cells which usually arises in the upper extremities, trunk, head and neck, retroperitoneum, mediastinum, pelvis, and peritoneum. However, it can arise in the gastro-intestinal tract, including biliary tract. We present a 24-year-old male patient with obstructive jaundice, whose investigation with computed tomography abdomen showed focal wall thickening in the common hepatic duct, difficult to differentiate with hilar adenocarcinoma. He was diagnosed intraoperatively schwannoma of common bile duct and treated with local resection. The patient recovered well without signs of recurrence of the lesion after 12 mo. We also reviewed the common bile duct schwannoma related in the literature and evaluated the difficulty in pre and intraoperative differential diagnosis with adenocarcinoma hilar. Resection is the treatment of choice for such cases and the tumordid not recur in any of the resected cases. | Gilton Marques Fonseca André Luis Montagnini Manoel de Souza Rocha Rosely Antunes Patzina Mário Vinícius Angelete Alvarez Bernardes Ivan Cecconello José Jukemura | 2012 | World Journal of Gastroenterology2012，18，37： | 10 |
| 7 | Interrelationship between chromosome 8 aneuploidy,C-MYC amplification and increased expression in individuals from northern Brazil with gastric adenocarcinoma显示文摘AIM: To investigate chromosome 8 numerical aberra- tions, C-MYC oncogene alterations and its expression in gastric cancer and to correlate these findings with histo- pathological characteristics of gastric tumors. METHODS: Specimens were collected surgically from seven patients with gastric adenocarcinomas. Immu- nostaining for C-MYC and dual-color fluorescence in situ hybridization (FISH) for C-MYC gene and chromosome 8 centromere were performed. RESULTS: All the cases showed chromosome 8 aneu- ploidy and C-MYC amplification, in both the diffuse and intestinal histopathological types of Lauren. No significant difference (P < 0.05) was observed between the level ofchromosome 8 ploidy and the site, stage or histological type of the adenocarcinomas. C-MYC high amplification, like homogeneously stained regions (HSRs) and double minutes (DMs), was observed only in the intestinal-type. Structural rearrangement of C-MYC, like translocation, was observed only in the diffuse type. Regarding C-MYC gene, a significant difference (P < 0.05) was observed between the two histological types. The C-MYC protein was expressed in all the studied cases. In the intestinal- type the C-MYC immunoreactivity was localized only in the nucleus and in the diffuse type in the nucleus and cytoplasm. CONCLUSION: Distinct patterns of alterations between intestinal and diffuse types of gastric tumors support the hypothesis that these types follow different genetic path- ways. | Danielle Queiroz Calcagno Mariana Ferreira Leal Aline Damaceno Seabra Andre Salim Khayat Elizabeth Suchi Chen Samia Demachki Paulo Pimentel Assumpcao Mario Henrique Girao Faria Silvia Helena Barem Rabenhorst Márcia Valéria Pitombeira Ferreira Marília de Arruda Cardoso Smith Rommel Rodríguez Burbano | 2006 | World Journal of Gastroenterology2006，12，38： | 9 |
| 8 | Thalidomide induces mucosal healing in Crohn's disease: Case report显示文摘Crohn's disease is a chronic inflammatory disorder of the gastrointestinal tract that is defi ned by relapsing and remitting episodes. Tumor necrosis factor alpha (TNF-α) appears to play a central role in the pathophysiology of the disease. Standard therapies for inflammatory bowel disease fail to induce remission in about 30% of patients. Biological therapies have been associated with an increased incidence of infections, especially infection by Mycobacterium tuberculosis (Mtb). Thalidomide is an oral immunomodulatory agent with anti-TNF-α properties. Recent studies have suggested that thalidomide is effective in refractory luminal and fistulizing Crohn's disease. Thalidomide costimulates T lymphocytes, with greater effect on CD8+ than on CD4+ T cells, which contributes to the protective immune response to Mtb infection. We present a case of Crohn's disease with gastric, ileal, colon and rectum involvement as well as steroid dependency, which progressed with loss of response to infliximabafter three years of therapy. The thorax computed tomography scan demonstrated a pulmonary nodule suspected to be Mtb infection. The patient was started on thalidomide therapy and exhibited an excellent response. | Márcio Rios Leite Sandra Sousa Santos André Castro Lyra Jaciane Mota Genoile Oliveira Santana | 2011 | World Journal of Gastroenterology2011，17，45： | 9 |
| 9 | Transanal total mesorectal excision:Towards standardization of technique显示文摘AIM: To describe the role of Transanal total mesorectal excision(Ta TME) in minimally invasive rectal cancer surgery, to examine the differences in patient selection and in reported surgical techniques and their impactson postoperative outcomes and to discuss the future of Ta TME. METHODS: MEDLINE(Pub Med), EMBASE, and The Cochrane Library were systematically searched through the 1st of March 2015 using a predefined search strategy. RESULTS: A total of 20 studies with 323 patients were included. Most studies were single-arm prospective studies with fewer than 100 patients. Multiple transanal access platforms were used, and the laparoscopic approach was either multi- or single port. The procedure was initiated transanally or transabdominally. If a simultaneous approach with 2 operating surgeons was chosen, the operative time was significantly reduced. CONCLUSION: Ta TME was also associated with better TME specimens and a longer distal resection margin. Ta TME is thus feasible in expert hands, but the learning curve and safety profile are not well defined. Longterm follow-up regarding anal function and oncological outcomes should be performed in the future. | Albert M Wolthuis Gabriele Bislenghi Anthony de Buck van Overstraeten André D'Hoore | 2015 | World Journal of Gastroenterology2015，21，44： | 9 |
| 10 | Different risk factors influence peptic ulcer disease development in a Brazilian population显示文摘AIM: To investigate age, sex, histopathology and Helicobacter pylori (H. pylori) status, as risk factors for gastroduodenal disease outcome in Brazilian dyspeptic patients.tients submitted to upper gastroscopy at Hospital das Clinicas of Marilia, antral biopsy specimens were obtained and subjected to histopathology and H. pylori diagnosis. All patients presenting chronic gastritis (CG) and peptic ulcer (PU) disease localized in the stomach, gastric ulcer (GU) and/or duodenal ulcer (DU) were included in the study. Gastric biopsies (n = 668) positive for H. pylori by rapid urease test were investigated for vacuolating cytotoxin A (vacA ) medium (m) region mosaicism by polymerase chain reaction. Logistic regression analysis was performed to verify the association of age, sex, histopathologic alterations, H. pylori diagnosis and vacA m region mosaicism with the incidence of DU, GU and CG in patients. RESULTS: Of 1466 patients submitted to endoscopy, 1060 (72.3%) presented CG [male/female = 506/554; mean age (year) ± SD = 51.2 ± 17.81], 88 (6.0%) presented DU [male/female = 54/34; mean age (year) ± SD = 51.4 ± 17.14], and 75 (5.1%) presented GU [male/female = 54/21; mean age (year) ± SD = 51.3 ± 17.12] and were included in the comparative analysis. Sex and age showed no detectable effect on CG incidence (overall c 2 = 2.1, P = 0.3423). Sex [Odds ratios (OR) = 1.8631, P = 0.0058] but not age (OR = 0.9929, P = 0.2699) was associated with DU and both parameters had a highly significant effect on GU (overall c 2 = 30.5, P < 0.0001). The histopathological results showed a significant contribution of ageing for both atrophy (OR = 1.0297, P < 0.0001) and intestinal metaplasia (OR = 1.0520, P < 0.0001). Presence of H. pylori was significantly associated with decreasing age (OR = 0.9827, P < 0.0001) and with the incidence of DU (OR = 3.6077, P < 0.0001). The prevalence of m1 in DU was statistically significant (OR = 2.3563, P = 0.0018) but not in CG (OR = 2.678, P = 0.0863) and GU (OR = 1.520, P = 0.2863). CONCLUSION: In our population, male gender was a risk factor for PU; ageing for GU, atrophy and metapla-sia; and H. pylori of vacA m1 genotype for DU. | Rodrigo Buzinaro Suzuki Rodrigo Faria Cola Larissa Tranquilino Bardela Cola Camila Garcia Ferrari Fred Ellinger Altino Luiz Therezo Luis Carlos da Silva André Eterovic Márcia Aparecida Sperana | 2012 | World Journal of Gastroenterology2012，18，38： | 8 |
| 11 | Pathological aspects of so called 'hilar cholangiocarcinoma'显示文摘Cholangiocarcinoma(CC) arising from the large intrahepatic bile ducts and extrahepatic hilar bile ducts share clinicopathological features and have been called hilar and perihilar CC as a group.However,'hilar and perihilar CC' are also used to refer exclusively to the intrahepatic hilar type CC or,more commonly,the extrahepatic hilar CC.Grossly,a major distinction can be made between papillary and non-papillary tumors.Histologically,most hilar CCs are well to moderately differentiated conventional type(biliary) carcinomas.Immunohistochemically,CK7,CK20,CEA and MUC1 are normally expressed,being MUC2 positive in less than 50% of cases.Two main premalignant lesions are known:biliary intraepithelial neoplasia(BilIN) and intraductal papillary neoplasm of the biliary tract(IPNB).IPNB includes the lesions previously named biliary papillomatosis and papillary carcinoma.A series of 29 resected hilar CC from our archives is reviewed.Most(82.8%) were conventional type adenocarcinomas,mostly well to moderately differentiated,although with a broad morphological spectrum;three cases exhibited a poorly differentiated cell component resembling signet ring cells.IPNB was observed in 5(17.2%),four of them with an associated invasive carcinoma.A clear cell type carcinoma,an adenosquamous carcinoma and two gastric foveolar type carcinomas were observed. | Víctor M Castellano-Megías Carolina Ibarrola-de Andrés Francisco Colina-Ruizdelgado | 2013 | World Journal of Gastrointestinal Oncology2013，5，7： | 8 |
| 12 | Irritable bowel syndrome subtypes differ in body awareness, psychological symptoms and biochemical stress markers显示文摘AIM: To elucidate the differences in somatic, psycho-logical and biochemical pattern between the subtypes of irritable bowel syndrome (IBS). METHODS: Eighty IBS patients, 30 diarrhoea pre-dominant (D-IBS), 16 constipation predominant (C-IBS) and 34 alternating IBS (A-IBS) underwent physi-otherapeutic examinations for dysfunctions in body movements and awareness and were compared to an apparently healthy control group (AHC). All groups an-swered questionnaires for gastrointestinal and psycho-logical symptoms. Biochemical variables were analysed in blood. RESULTS: The D-IBS group showed less body aware-ness, less psychological symptoms, a more normal sense of coherence and psychosocial rating as well as higher C-peptide values. C-IBS had a higher degree of body dysfunction and psychological symptoms, as well as the lowest sense of coherence compared to controls and D-IBS. They also demonstrated the most elevated prolactin levels. A-IBS had the lowest degree of body disturbance, deteriorated quality of life and affected bi-ochemical pattern. All subtypes had higher pain scores compared to controls. In addition they all had signifi -cantly increased triglycerides and elevated morning cortisol levels, however, without statistical signifi cance compared with the controls.CONCLUSION: IBS subtypes showed different pro-files in body awareness, somatic and psychological symptoms and in biochemical variables. D-IBS differed compared to the other groups by lowered body aware-ness, less psychological symptoms and a higher sense of coherence and elevated C-peptide values. C-IBS and A-IBS subtypes suffered more from depression and anxiety, associated with a lower quality of life. These differences may be important and will be taken into account in our treatment of these patients. | Elsa M Eriksson Kristina I Andrén Henry T Eriksson Gran K Kurlberg | 2008 | World Journal of Gastroenterology2008，14，31： | 7 |
| 13 | Transcranial direct current stimulation in psychiatric disorders显示文摘The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally,we provide an overview of t DCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding t DCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding t DCS efficacy in psychiatry. | Gabriel Tortella Roberta Casati Luana V M Aparicio Antonio Mantovani Natasha Senco Giordano D’Urso Jerome Brunelin Fabiana Guarienti Priscila Mara Lorencini Selingardi Débora Muszkat Bernardo de Sampaio Pereira Junior Leandro Valiengo Adriano H Moffa Marcel Simis Lucas Borrione André R Brunoni | 2015 | World Journal of Psychiatry2015，5，1： | 6 |
| 14 | Tolvaptan, an oral vasopressin antagonist, in the treatment of hyponatremia in cirrhosis显示文摘 | Andrés Cárdenas Pere Ginès Paul Marotta Frank Czerwiec John Oyuang Mónica Guevara Nezam H Afdhal | 2011 | Journal of Hepatology2011，，3： | 6 |
| 15 | Compared efficacy of preservation solutions on the outcome of liver transplantation:Meta-analysis显示文摘AIM To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations.METHODS A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31^(st), 2017. The inclusion criteria were comparative, randomized controlled trials(RCTs) for deceased donor liver(DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin(UW) solution or histidinetryptophan-ketoglutarate(HTK), Celsior(CS) and Institut Georges Lopez(IGL-1) solutions. Fifteen RCTs(1830 livers) were included; the primary outcomes were primary non-function(PNF) and one-year posttransplant graft survival(OGS-1). RESULTS All trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1(RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1(RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes.CONCLUSION Alternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted. | Agnes Lilla Szilágyi Péter Mátrai Péter Hegyi Eszter Tuboly Daniella Pécz András Garami Margit Solymár Erika Pétervári Márta Balaskó Gábor Veres László Czopf Bastian Wobbe Dorottya Szabó Juliane Wagner Petra Hartmann | 2018 | World Journal of Gastroenterology2018，24，16： | 5 |
| 16 | Software for automated classification of probe-based confocal laser endomicroscopy videos of colorectal polyps显示文摘AIM:To support probe-based confocal laser endomi-croscopy (pCLE) diagnosis by designing software for the automated classification of colonic polyps. METHODS:Intravenous fluorescein pCLE imaging of colorectal lesions was performed on patients under-going screening and surveillance colonoscopies, followed by polypectomies. All resected specimens were reviewed by a reference gastrointestinal pathologist blinded to pCLE information. Histopathology was used as the criterion standard for the differentiation between neoplastic and non-neoplastic lesions. The pCLE video sequences, recorded for each polyp, were analyzed off-line by 2 expert endoscopists who were blinded to the endoscopic characteristics and histopathology. These pCLE videos, along with their histopathology diagnosis, were used to train the automated classification software which is a content-based image retrieval technique followed by k-nearest neighbor classification. The performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists was compared with that of automated pCLE software classification. All evaluations were performed using leave-one-patient- out cross-validation to avoid bias. RESULTS:Colorectal lesions (135) were imaged in 71 patients. Based on histopathology, 93 of these 135 lesions were neoplastic and 42 were non-neoplastic. The study found no statistical significance for the difference between the performance of automated pCLE software classification (accuracy 89.6%, sensitivity 92.5%, specificity 83.3%, using leave-one-patient-out cross-validation) and the performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists (accuracy 89.6%, sensitivity 91.4%, specificity 85.7%). There was very low power (< 6%) to detect the observed differences. The 95% confidence intervals for equivalence testing were:-0.073 to 0.073 for accuracy, -0.068 to 0.089 for sensitivity and -0.18 to 0.13 for specificity. The classification software proposed in this study is not a 'black box' but an informative tool based on the query by example model that produces, as intermediate results, visually similar annotated videos that are directly interpretable by the endoscopist. CONCLUSION:The proposed software for automated classification of pCLE videos of colonic polyps achieves high performance, comparable to that of off-line diagnosis of pCLE videos established by expert endoscopists. | Barbara André Tom Vercauteren Anna M Buchner Murli Krishna Nicholas Ayache Michael B Wallace | 2012 | World Journal of Gastroenterology2012，18，39： | 5 |
| 17 | Intestinal alkaline phosphatase in the colonic mucosa of children with inflammatory bowel disease显示文摘AIM:To investigate intestinal alkaline phosphatase(iAP) in the intestinal mucosa of children with inflammatory bowel disease(IBD).METHODS:Colonic biopsy samples were taken from 15 newly diagnosed IBD patients and from 10 healthy controls.In IBD patients,specimens were obtainedboth from inflamed and non-inflamed areas.The iAP mRNA and protein expression was determined by reverse transcription-polymerase chain reaction and Western blotting analysis,respectively.Tissue localization of iAP and Toll-like receptor(TLR) 4 was investigated by immunofluorescent staining.RESULTS:The iAP protein level in the inflamed mucosa of children with Crohn's disease(CD) and ulcerative colitis(UC) was significantly decreased when compared with controls(both P < 0.05).Similarly,we found a significantly decreased level of iAP protein in the inflamed mucosa in CD compared with non-inflamed mucosa in CD(P < 0.05).In addition,the iAP protein level in inflamed colonic mucosa in patients with UC was decreased compared with non-inflamed mucosa in patients with CD(P < 0.05).iAP protein levels in the non-inflamed mucosa of patients with CD were similar to controls.iAP mRNA expression in inflamed colonic mucosa of children with CD and UC was not significantly different from that in non-inflamed colonic mucosa with CD.Expression of iAP mRNA in patients with noninflamed mucosa and in controls were similar.Co-localization of iAP with TLR4 showed intense staining with a dotted-like pattern.iAP was present in the inflamed and non-inflamed mucosa of patients with CD,UC,and in control biopsy specimens,irrespective of whether it was present in the terminal ileum or in the colon.However,the fluorescent signal of TLR4 was more pronounced in the colon compared with the terminal ileum in all groups studied.CONCLUSION:Lower than normal iAP protein levels in inflamed mucosa of IBD patients may indicate a role for iAP in inflammatory lesions in IBD.Based on our results,administration of exogenous iAP enzyme to patients with the active form of IBD may be a therapeutic option. | Kriszta Molnár dám Vannay Beáta Szebeni Nóra Fanni Bánki Erna Sziksz ron Cseh Hajnalka Gyrffy Péter László Lakatos Mária Papp András Arató Gábor Veres | 2012 | World Journal of Gastroenterology2012，18，25： | 5 |
| 18 | Numerical and safety considerations about the Daguangbao landslide induced by the 2008 Wenchuan earthquake显示文摘The 2008 Wenchuan earthquake resulted in a large number of fatalities and caused significant economic losses.Thousands of landslides,many of which are very large,were triggered by the earthquake.A majority of catastrophic landslides were distributed along the central Longmenshan fault system,at the eastern margin of the Tibetan Plateau.Some of the landslides resulted in sudden damming of rivers causing flooding,which in turn induced secondary sliding disasters.Among the most significant landslides,the Daguangbao landslide was the largest in volume with the maximum thickness.For this,a numerical model of the Daguangbao landslide,using the material point method(MPM),was developed to simulate the interaction of the seismic loads imposed on the slope.The numerical results then are compared with the post-earthquake profile.As a consequence of the landslide,a nearly vertical head scarp with a maximum height of about 700 m was generated.This is considered as a high risk situation that requires constant monitoring and evaluation.Finally,we propose a methodology based on Bayesian networks(BNs)to manage the risk associated with the stability of the rockwall at the Daguangbao landslide site. | Manchao He L.Ribeiro e Sousa AndréMüller Eurípedes Vargas Jr. R.L.Sousa C.Sousa Oliveira Weili Gong | 2019 | Journal of Rock Mechanics and Geotechnical Engineering2019，11，5： | 4 |
| 19 | Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease显示文摘AIM:To evaluate the long-term effect of Endocinch treatment for gastroesophageal reflux disease(GERD).METHODS:After unblinding and crossover,50 patients(32 males,18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized,placebo-controlled,single-center study,and included in the present prospective open-label follow-up study.Initially,three gastroplications using the Endocinch device were placed under deep sedation in a standardized manner.Optional retreatment was offered in the first year with 1 or 2 extra gastroplications.At baseline,3 mo after(re) treatment and yearly proton pump inhibitor(PPI) use,GERD symptoms,quality of life(QoL) scores,adverse events and treatment failures(defined as:patients using > 50% of their baseline PPI dose or receiving alternative antireflux therapy) were assessed.Intention-to-treat analysis was performed.RESULTS:Median follow-up was 48 mo [interquartile range(IQR):38-52].Three patients were lost to follow-up.In 44% of patients retreatment was done after a median of 4 mo(IQR:3-8).No serious adverse events occurred.At the end of follow-up,symptom scores and4 out of 6 QoL subscales were improved(all P < 0.01compared to baseline).However,80% of patients required PPIs for their GERD symptoms.Ultimately,64% of patients were classified as treatment failures.In 60% a post-procedural endoscopy was carried out,of which in 16% reflux esophagitis was diagnosed.CONCLUSION:In the 4-year follow-up period,the subset of GERD patients that benefit from endoscopic gastroplication kept declining gradually,nearly half opted for retreatment and 80% required PPIs eventually. | Matthijs P Schwartz J Rieneke C Schreinemakers André J P M Smout | 2013 | World Journal of Gastrointestinal Pharmacology and Therapeutics2013，4，4： | 4 |
| 20 | Pathological features and diagnosis of intraductal papillary mucinous neoplasm of the pancreas显示文摘Intraductal papillary mucinous neoplasm(IPMN) of the pancreas is a noninvasive epithelial neoplasm of mucinproducing cells arising in the main duct(MD) and/or branch ducts(BD) of the pancreas.Involved ducts are dilated and filled with neoplastic papillae and mucus in variable intensity.IPMN lacks ovarian-type stroma,unlike mucinous cystic neoplasm,and is defined as a grossly visible entity(≥ 5 mm),unlike pancreatic intraepithelial neoplasm.With the use of high-resolution imaging techniques,very small IPMNs are increasingly being identified.Most IPMNs are solitary and located in the pancreatic head,although 20%-40% are multifocal.Macroscopic classification in MD type,BD type and mixed or combined type reflects biological differences with important prognostic and preoperative clinical management implications.Based on cytoarchitectural atypia,IPMN is classified into low-grade,intermediategrade and high-grade dysplasia.Based on histological features and mucin(MUC) immunophenotype,IPMNs are classified into gastric,intestinal,pancreatobiliary and oncocytic types.These different phenotypes can be observed together,with the IPMN classified according to the predominant type.Two pathways have been suggested:gastric phenotype corresponds to less aggressive uncommitted cells(MUC1-,MUC2-,MUC5 AC +,MUC6 +) with the capacity to evolve to intestinal phenotype(intestinal pathway)(MUC1-,MUC2 +,MUC5 AC +,MUC6- or weak +) or pancreatobiliary /oncocytic phenotypes(pyloropancreatic pathway)(MUC1 +,MUC 2-,MUC5 AC +,MUC 6 +) becoming more aggressive.Prognosis of IPMN is excellent but critically worsens when invasive carcinoma arises(about 40% of IPMNs),except in some cases of minimal invasion.The clinical challenge is to establish which IPMNs should be removed because of their higher risk of developing invasive cancer.Once resected,they must be extensively sampled or,much better,submitted in its entirety for microscopic study to completely rule out associated invasive carcinoma. | Víctor M Castellano-Megías Carolina Ibarrola-de Andrés Guadalupe López-Alonso Francisco Colina-Ruizdelgado | 2014 | World Journal of Gastrointestinal Oncology2014，6，9： | 4 |
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