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| 1 | Pancreatic cancer: A review of clinical diagnosis, epidemiology, treatment and outcomes显示文摘This review aims to outline the most up-to-date knowledge of pancreatic adenocarcinoma risk, diagnostics, treatment and outcomes, while identifying gaps that aim to stimulate further research in this understudied malignancy. Pancreatic adenocarcinoma is a lethal condition with a rising incidence, predicted to become the second leading cause of cancer death in some regions. It often presents at an advanced stage, which contributes to poor five-year survival rates of 2%-9%, ranking firmly last amongst all cancer sites in terms of prognostic outcomes for patients. Better understanding of the risk factors and symptoms associated with this disease is essential to inform both health professionals and the general population of potential preventive and/or early detection measures. The identification of high-risk patients who could benefit from screening to detect pre-malignant conditions such as pancreatic intraepithelial neoplasia, intraductal papillary mucinous neoplasms and mucinous cystic neoplasms is urgently required, however an acceptable screening test has yet to be identified. The management of pancreatic adenocarcinoma is evolving, with the introduction of new surgical techniques and medical therapies such as laparoscopic techniques and neo-adjuvant chemoradiotherapy, however this has only led to modest improvements in outcomes. The identification of novel biomarkers is desirable to move towards a precision medicine era, where pancreatic cancer therapy can be tailored to the individual patient, while unnecessary treatments that have negative consequences on quality of life could be prevented for others. Research efforts must also focus on the development of new agents and delivery systems. Overall, considerable progress is required to reduce the burden associated with pancreatic cancer. Recent, renewed efforts to fund large consortia and research into pancreatic adenocarcinoma are welcomed, but further streams will be necessary to facilitate the momentum needed to bring breakthroughs seen for other cancer sites. | Andrew McGuigan Paul Kelly Richard C Turkington Claire Jones Helen G Coleman R Stephen McCain | 2018 | World Journal of Gastroenterology2018，24，43： | 140 |
| 2 | 卫生经济学评价报告标准共识2022(CHEERS 2022):卫生经济学评价报告指导意见更新版显示文摘卫生经济学评价是对备选行动方案的成本和结果的比较分析。2013年发表的《卫生经济学评价报告标准共识》(CHEERS)提出了卫生经济学评价的特点,确保结果正确阐释,以支持决策制订。2013版CHEERS旨在指导研究报告撰写者准确报告卫生干预和对照措施、背景、过程、结果等评价细节,使审稿人理解文章内容,帮助读者使用研究结果。本版共识将取代2013版共识,其更加适用于各类卫生经济学评价,结合学科发展和方法更新的需要,更注重患者、公众等相关利益方的参与。本共识适用多种个体或人群健康干预措施(简单或复杂)在不同政策场景的应用分析,包括医疗服务、公共卫生、教育、社会服务等。本文概要介绍了CHEERS 2022共识中包含的28个检查项及每一个检查项的相关建议。CHEERS 2022共识主要用于指导研究人员撰写拟投递同行评议学术期刊的卫生经济学评价文章,亦可用于期刊编辑和审稿专家对待发表文章的评价。熟悉了解本共识要求,还有助于研究人员规划评价研究。随着决策透明度要求提高,本共识可支持卫生技术评估机构建立评价报告标准。 | Don Husereau Michael Drummond Federico Augustovski Esther de Bekker-Grob Andrew H Briggs Chris Carswell Lisa Caulley Nathorn Chaiyakunapruk Dan Greenberg Elizabeth Loder Josephine Mauskopf C Daniel Mullins Stavros Petrou Raoh-Fang Pwu Sophie Staniszewska on behalf of CHEERSISPOR Good Research Practices Task Force 肖月(译) 邱英鹏(译) 史黎炜(译) 张治国(译) 张歆(译) 王海银(译) 翟铁民(译) | 2022 | 英国医学杂志中文版2022，25，8： | 31 |
| 3 | Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt显示文摘AIM:To evaluate the effect of the shunting branch of the portal vein(PV)(left or right)and the initial stent position(optimal or suboptimal)of a transjugular intrahepatic portosystemic shunt(TIPS).METHODS:We retrospectively reviewed 307 consecu5tive cirrhotic patients who underwent TIPS placement for variceal bleeding from March 2001 to July 2010 at our center.The left PV was used in 221 patients and the right PV in the remaining 86 patients.And,224 and83 patients have optimal stent position and sub-optimal stent positions,respectively.The patients were followed until October 2011 or their death.Hepatic encephalopathy,shunt dysfunction,and survival were evaluated as outcomes.The difference between the groups was compared by Kaplan-Meier analysis.A Cox regression model was employed to evaluate the predictors.RESULTS:Among the patients who underwent TIPS to the left PV,the risk of hepatic encephalopathy(P=0.002)and mortality were lower(P<0.001)compared to those to the right PV.Patients who underwent TIPS with optimal initial stent position had a higher primary patency(P<0.001)and better survival(P=0.006)than those with suboptimal initial stent position.The shunting branch of the portal vein and the initial stent position were independent predictors of hepatic encephalopathy and shunt dysfunction after TIPS,respectively.And,both were independent predictors of survival.CONCLUSION:TIPS placed to the left portal vein with optimal stent position may reduce the risk of hepatic encephalopathy and improve the primary patency rates,thereby prolonging survival. | Ming Bai Chuang-Ye He Xing-Shun Qi Zhan-Xin Yin Jian-Hong Wang Wen-Gang Guo Jing Niu Jie-Lai Xia Zhuo-Li Zhang Andrew C Larson Kai-Chun Wu Dai-Ming Fan Guo-Hong Han | 2014 | World Journal of Gastroenterology2014，20，3： | 26 |
| 4 | PI3K-AKT-mTOR signaling in prostate cancer progression and androgen deprivation therapy resistance显示文摘前列腺癌症(PCa ) 是在在世界上的人之中的第二很普通的恶意。阉割抵抗的前列腺癌症(CRPC ) 是疾病的致命的形式,它在抵抗之上发展首先衬里雄激素剥夺治疗(ADT ) 。新兴的证据为在 CRPC 的发展和维护表明轴的 PI3K-AKT-mTOR 表明一个关键角色。这条小径,是在先进 PCas 的多数的 deregulated,与象蛋白质合成,增长,幸存,新陈代谢和区别那样的下游地细胞的过程为生长信号的集成用作批评连结,因此提供机制让癌症细胞克服压力与雄激素剥夺联系了。而且,现出症状之前的潜的研究阐明了在发信号的 PI3K-AKT-mTOR 和雄激素受体(AR ) 之间的一个直接连接削减,在 ADT 抵抗的发展期间揭示在这些小径之间的动态相互影响。因此,为 PI3K 小径的很多个新奇禁止者的继续的临床的发展有一个清楚的基本原理,它提供堵住 CRPC 生长和幸存的潜力。在这评论,我们将在 PCa 前进和阉割抵抗探索 PI3K-AKT-mTOR 小径的关联以便在先进 PCa 通知临床的发展特定的小径禁止者。另外,我们将在我们的临床的知识加亮当前的缺乏,最尤其是对能精确地为对 PI3K 小径禁止者的反应预言的 biomarkers 的需要。 | Merritt P Edlind Andrew C Hsieh | 2014 | Asian Journal of Andrology2014，16，3： | 20 |
| 5 | Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization显示文摘AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE. | Johnathan C Chung Neel K Naik Robert J Lewandowski Mary F Mulcahy Laura M Kulik Kent T Sato Robert K Ryu Riad Salem Andrew C Larson Reed A Omary | 2010 | World Journal of Gastroenterology2010，16，25： | 13 |
| 6 | 应用可扩展的套索回归模型对间皮瘤进行生存期预测:临床预测指标的使用和初始性能的说明显示文摘目的对恶性胸膜间皮瘤(MPM)进行准确的预后预测具有一定困难。我们研究一套健全的计算模型来量化常规可用临床数据的预后价值,它们构成了已发布的MPM预测模型的基础。 | 王臻(译) 施焕中(校) Andrew C Kidd Michael McGettrick Selina Tsim Daniel L Halligan Max Bylesjo Kevin G Blyth | 2018 | 英国医学杂志中文版2018，21，6： | 11 |
| 7 | Intentional ingestions of foreign objects among prisoners: A review显示文摘The intentional ingestion of foreign objects(IIFO) is described more commonly in prison populations than in the general population, with an estimated annual incidence of 1 in 1900 inmates in our state correctional facilities. Incidents often involve ingestion of small metal objects(e.g., paperclips, razor blades) or other commonly available items like pens or eating utensils. Despite ingestion of relatively sharp objects, most episodes can be clinically managed with either observation or endoscopy. Surgery should be reserved for those with signs or symptoms of gastrointestinal perforation or obstruction. For those with a history of IIFO, efforts should focus on prevention of recurrenceas subsequent episodes are associated with higher morbidity, significant healthcare and security costs. The pattern of IIFO is often repetitive, with escalation both in frequency of ingestions and in number of items ingested. Little is known about successful prevention strategies, but efforts to monitor patients and provide psychiatric care are potential best-practice strategies. This article aims to provide state-of-the art review on the topic, followed by a set of basic recommendations. | David C Evans Thomas R Wojda Christian D Jones Andrew J Otey Stanislaw P Stawicki | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，3： | 10 |
| 8 | Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: Can we do better?显示文摘The diagnostic approach to a possible pancreatic mass lesion relies first upon various non-invasive imaging modalities, including computed tomography, ultrasound, and magnetic resonance imaging techniques. Once a suspect lesion has been identified, tissue acquisition for characterization of the lesion is often paramount in developing an individualized therapeutic approach. Given the high prevalence and mortality associated with pancreatic cancer, an ideal approach to diagnosing pancreatic mass lesions would be safe, highly sensitive, and reproducible across various practice settings. Tools, in addition to radiologic imaging, currently employed in the initial evaluation of a patient with a pancreatic mass lesion include serum tumor markers, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA). EUS-FNA has grown to become the gold standard in tissue diagnosis of pancreatic lesions. | Andrew C Storm Linda S Lee | 2016 | World Journal of Gastroenterology2016，22，39： | 10 |
| 9 | 澳大利亚临床共识指南:儿童卒中的诊断和急性期处理显示文摘卒中是导致儿童死亡的十大原因之一,幸存的致残患儿将面临几十年的残疾生活,给患儿及其家庭带来了巨大负担。由于安全性和有效性的证据有限,以及诊断的延误,目前卒中患儿无法接受再灌注治疗。儿童卒中诊断和急性期处理的澳大利亚临床共识指南,旨在最大限度地减少临床诊疗中的不确定性,并记录与成人卒中不同的危险因素、病因和假性卒中情况的最佳证据。临床问题的阐述来自于对2007年至2017年数据库的系统检索,但仅限于英语和儿科研究。该指南应用SIGN方法和国家健康与医学研究委员会系统对证据进行筛选和分类,通过推荐、评估、发展和评价系统(GRADE系统)对推荐进行强弱分级。该指南提供了60多项基于证据的推荐,以帮助参与院前和急症处理的临床医师快速识别儿童卒中,选择最合适的初步检查方案来确定诊断、明确病因,并选择最恰当的干预措施以挽救脑组织、预防复发。同时,指南也提供了颅内压和先天性心脏病管理方面的推荐。该指南的实施需要将院前和急诊系统重组,包括建立区域性卒中网络,建立儿科卒中疾病编码,快速MRI,以及对能够提供再灌注治疗的初级儿科卒中中心进行认证。该指南能够审核治疗的基准时间线,获得急性期的干预措施及预后判断。它还将促进澳大利亚儿童卒中登记的发展,并与国际登记处建立数据联系,以便准确收集卒中发病率、治疗和结果相关的数据。 | Medley TL Miteff C Andrews I Ware T Cheung M Monagle P Mandelstam S Wray A Pridmore C Troedson C Dale RC Fahey M Sinclair A Walsh P Stojanovski S Macka MT 徐佳丽(译) 吴川杰(译) 肖潇(译) 吕俊萱(译) 张博维(译) 吉训明(译) | 2019 | 中国脑血管病杂志2019，16，4： | 9 |
| 10 | Real-time three-dimensional myocardial contrast echocardiography in assessment of myocardial perfusion defects显示文摘Background Both real-time three-dimensional echocardi ography (RT3DE) and myocardial contrast echocardiography (MCE) are novel imaging techniques. The purpose of this study was to confirm the feasibility and accuracy of RT3DE combined with MCE for quantitative evaluation of myocardial perfusion defects. Methods Thirteen dogs underwent ligation of the left anterior descending artery (LAD, n=6) or distal branch of the left circumflex artery (LCX, n=7) under general anaesthesia. Three to four ml of a perfluoropropane (C 3F 8) microbubble contrast agent was injected intravenously to assess the resulting myocardial perfusion defects with a commercially available Philips SONOS-7500 ultrasound system. After removal of the dog hearts, Evans blue dye was injected via the left and righ t coronary arteries to stain the myocardium at risk. In vitro anatomic measurements of myocardial mass after removal of the animals’ hearts were used as control s. Results Left ventricular (LV) mass determined by RT3DE ranged 36.7-68.9 g [mean, (54.6±9.6) g] before coronary artery ligation, and correlated highly (r=0.99) with in vitro measurement of LV mass [range, 38.9-71.1 g; mean, (55.6±9.3) g]. There was no significant difference between RT3DE and in vitro measurements of LV mass [range, 36.7-68.9 g; mean, (51.3±12.5) g. Or range, 38.9-71. 1 g; mean, (53.7±12.3) g, respectively] and under-perfused mass [range, 0-21.4 g; mean, (12.0±6.9) g. Or range, 0-19.8 g; mean, (10.8±6.3) g, respectively] after th e LAD ligation (P>0.05). Likewise, no significant difference was present between RT3DE and in vitro measurements of LV mass [range, 50.1-65.4 g; mean, (57.5±5.9 ) g. Or range, 51.5-65.8 g; mean, (57.3±6.4) g, respectively] and under-perfused m ass [range, 0-25.6 g; mean, (13.3±9.6) g. Or range, 0-22.7 g; mean, (12.8±8.1 ) g, respectively] after the LCX ligation (P>0.05). For all the animals with coronary ligation, LV mass measured by RT3DE ranged 35.9-68.6 g [mean, (54.8±10.0) g] a nd there was no significant difference between RT3DE and in vitro measurements of LV mass and under-perfused mass (P>0.05, r=0.99). Further, the under-perfused mass derived from RT3DE [range, 0-25.6 g; mean, (12.7±8.2) g] correlate d strongly with the in vitro measurements [range, 0-22.7 g; mean, (11.9±7.2) g] ( r=0.96). Conclusion RT3DE with MCE is a rapid and accurate method for estimating LV myocardial mass and quantifying perfusion defects. | 陈立新 王新房 Navin C anda Andrew P Miller 谢明星 庄磊 杨娅 王静 黄润青 杨颖 费洪文 王良玉 | 2004 | Chinese Medical Journal2004，，3： | 8 |
| 11 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis.We assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 12 | Primary squamous cell carcinoma of the rectum: An update and implications for treatment显示文摘AIM: To provide an update on the aetiology, pathogenesis, diagnosis, staging and management of rectal squamous cell carcinoma(SCC).METHODS: A systematic review was conducted according to the preferred reporting items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of Ovid MEDLINE was performed with the reference list of selected articles reviewed to ensure all relevant publications were captured. The search strategy was limited to the English language, spanning from 1946 to 2015. A qualitative analysis was undertaken examining patient demographics, clinical presentation, diagnosis, staging, treatment and outcome. The quantitaive analysis was limited to data extracted on treatment and outcomes including radiological, clinical and pathological complete response where available. The narrative and quantitative review were synthesised in concert.RESULTS: The search identified 487 articles in total with 79 included in the qualitative review. The quantitative analysis involved 63 articles, consisting of 43 case reports and 20 case series with a total of 142 individual cases. The underlying pathogenesis of rectal SCC while unclear, continues to be defined, with increasing evidence of a metaplasia-dysplasia-carcinoma sequence and a possible role for human papilloma virus in this progression. The presentation is similar to rectal adenocarcinoma, with a diagnosis confirmed by endoscopic biopsy. Many presumed rectal SCC's are in fact an extension of an anal SCC, and cytokeratin markers are a useful adjunct in this distinction. Staging is most accurately reflected by the tumour-nodemetastasis classification for rectal adenocarcinoma. It involves examining locoregional disease by way of magnetic resonance imaging and/or endorectal ultrasound, with systemic spread excluded by way of computed tomography. Positron emission tomography is integral in the workup to exclude an external siteof primary SCC with metastasis to the rectum. While the optimal treatment remains as yet undefined, recent studies have demonstrated a global shift away from surgery towards definitive chemoradiotherapy as primary treatment. Pooled overall survival was calculated to be 86% in patients managed with chemoradiation compared with 48% for those treated traditionally with surgery. Furthermore, local recurrence and metastatic rates were 25% vs 10% and 30% vs 13% for the chemoradiation vs conventional treatment cohorts.CONCLUSION: The changing paradigm in the treatment of rectal SCC holds great promise for improved outcomes in this rare disease. | Glen R Guerra Cherng H Kong Satish K Warrier Andrew C Lynch Alexander G Heriot Samuel Y Ngan | 2016 | World Journal of Gastrointestinal Surgery2016，8，3： | 5 |
| 13 | Controversies in fluid therapy: Type, dose and toxicity显示文摘Fluid therapy is perhaps the most common intervention received by acutely ill hospitalized patients; however, a number of critical questions on the efficacy and safety of the type and dose remain. In this review, recent insights derived from randomized trials in terms of fluid type, dose and toxicity are discussed. We contend that the prescription of fluid therapy is context-specific and that any fluid can be harmful if administered inappropriately. When contrasting ‘‘crystalloid vs colloid'', differences in efficacy are modest but differences in safety are significant. Differences in chloride load and strong ion difference across solutions appear to be clinically important. Phases of fluid therapy in acutely ill patients are recognized, including acute resuscitation, maintaining homeostasis, and recovery phases. Quantitative toxicity(fluid overload) is associated with adverse outcomes and can be mitigated when fluid therapy basedon functional hemodynamic parameters that predict volume responsiveness and minimization of non-essential fluid. Qualitative toxicity(fluid type), in particular for iatrogenic acute kidney injury and metabolic acidosis, remain a concern for synthetic colloids and isotonic saline, respectively. Physiologically balanced crystalloids may be the ‘‘default'' fluid for acutely ill patients and the role for colloids, in particular hydroxyethyl starch, is increasingly unclear. We contend the prescription of fluid therapy is analogous to the prescription of any drug used in critically ill patients. | Robert C McDermid Karthik Raghunathan Adam Romanovsky Andrew D Shaw Sean M Bagshaw | 2014 | World Journal of Critical Care Medicine2014，3，1： | 5 |
| 14 | Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus显示文摘AIM:To assess tumour regression grade(TRG)and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS:Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005and 2011 at a single institution were reviewed.Triplet neoadjuvant chemotherapy consisting of platinum,fluoropyrimidine and anthracycline was considered for operable patients(World Health Organization performance status≤2)with clinical stage T2-4 N0-1.Response to neoadjuvant chemotherapy(NAC)was assessed using TRG,as described by Mandard et al.In addition lymph node downstaging was also assessed.Lymph node downstaging was defined by cN1 at diagnosis:assessed radiologically(computed tomography,positron emission tomography,endoscopic ultrasonography),then pathologically recorded as N0 after surgery;ypN0 if NAC given prior to surgery,or pN0if surgery alone.Patients were followed up for 5 years post surgery.Recurrence was defined radiologically,with or without pathological confirmation.An association was examined between t TRG and lymph node downstaging with disease free survival(DFS)and a comprehensive range of clinicopathological characteristics.RESULTS:Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years(median follow up:2.552,95%CI:2.022-3.081).There was a 1.8%(n=4)inpatient mortality rate.One hundred and thirty-six(62.4%)patients received NAC,with 74.3%(n=101)of patients demonstrating some signs of pathological tumour regression(TRG 1-4)and 5.9%(n=8)having a complete pathological response.Forty four point one percent(n=60)had downstaging of their nodal disease(cN1 to ypN0),compared to only 15.9%(n=13)that underwent surgery alone(pre-operatively overstaged:cN1 to pN0),(P<0.0001).Response to NAC was associated with significantly increased DFS(mean DFS;TRG 1-2:5.1years,95%CI:4.6-5.6 vs TRG 3-5:2.8 years,95%CI:2.2-3.3,P<0.0001).Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC(median DFS;TRG 3-5 and nodal down-staging:5.533 years,95%CI:3.558-7.531 vs TRG 3-5 and no nodal down-staging:1.114 years,95%CI:0.961-1.267,P<0.0001).CONCLUSION:Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS. | Fergus Noble Luke Nolan Adrian C Bateman James P Byrne Jamie J Kelly Ian S Bailey Donna M Sharland Charlotte N Rees Timothy J Iveson Tim J Underwood Andrew R Bateman | 2013 | World Journal of Gastroenterology2013，19，48： | 4 |
| 15 | Campylobacter concisus and inflammatory bowel disease显示文摘Investigation of the possible role of Campylobacter concisus(C. concisus) in inflammatory bowel disease(IBD) is an emerging research area. Despite the association found between C. concisus and IBD, it has been difficult to explain how C. concisus, a bacterium that is commonly present in the human oral cavity, may contribute to the development of enteric diseases. The evidence presented in this review shows that some C. concisus strains in the oral cavity acquired zonula occludens toxin(zot) gene from a virus(prophage) and that C. concisus Zot shares conserved motifs with both Vibrio cholerae Zot receptor binding domain and human zonulin receptor binding domain. Both Vibrio cholerae Zot and human zonulin are known to increase intestinal permeability by affecting the tight junctions. Increased intestinal permeability is a feature of IBD. Based on these data, we propose that a primary barrier function defect caused by C. concisus Zot is a mechanism by which zot-positive C. concisus strains may trigger the onset and relapse of IBD. | Li Zhang Hoyul Lee Michael C Grimm Stephen M Riordan Andrew S Day Daniel A Lemberg | 2014 | World Journal of Gastroenterology2014，20，5： | 4 |
| 16 | Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study显示文摘 | William C Huang Andrew S Levey Angel M Serio Mark Snyder Andrew J Vickers Ganesh V Raj Peter T Scardino Paul Russo | 2006 | Lancet Oncology2006，，9： | 4 |
| 17 | Long-term stabilization of stage 4 colon cancer using sodium dichloroacetate therapy显示文摘Oral dichloroacetate sodium(DCA) has been investigated as a novel metabolic therapy for various cancers since 2007, based on data from Bonnet et al that DCA can trigger apoptosis of human lung, breast and brain cancer cells. Response to therapy in human studies is measured by standard response evaluation criteria for solid tumours definitions, which define 'response' by the degree of tumour reduction, or tumour disappearance on imaging. However, Blackburn et al have demonstrated that DCA can also act as a cytostatic agent in vitro and in vivo, without causing apoptosis(programmed cell death). A case is presented in which oral DCA therapy resulted in tumour stabilization of stage 4 colon cancer in a 57 years old female for a period of nearly 4 years, with no serious toxicity. Since the natural history of stage 4 colon cancer consists of steady progression leading to disability and death, this case highlights a novel use of DCA as a cytostatic agent with a potential to maintain long-term stability of advanced-stage cancer. | Akbar Khan Douglas Andrews Anneke C Blackburn | 2016 | World Journal of Clinical Cases2016，4，10： | 4 |
| 18 | Putting things in place for fertilization: discovering roles for importin proteins in cell fate and spermatogenesis显示文摘Importin 蛋白质原来通过原子毛孔在蛋白质运输为他们的中央角色被描绘,唯一的细胞内部的入口到原子核。这个重要函数必须紧被调整由抄写因素和另外的原子蛋白质控制存取到 genomic DNA,到完成细胞的行为影响的适当调整房间命运。调停 Importin 的 nucleocytoplasmic 运输依靠他们货物的特定的识别,与到不同、重叠的蛋白质子集的每 importin 绑定。importin 功能的知识关于三个关键发展系统实质地膨胀了:胚胎的干细胞,肌肉房间和细菌排队。自从为调整 nucleocytoplasmic 运输的潜力被建议贡献精子发生,在十年,我们和其它证明了进原子核的渡船抄写因素执行的 importins 另外的角色,它控制房间命运。这评论从哺乳动物的精子发生的研究介绍关键调查结果揭示男富饶和不孕由产生的潜在的新小径。germline 开始的这些研究照亮 importin 蛋白质在管理细胞的区别的新方法,经由指导到不同细胞内部的分隔空间并且由决定细胞的压力回答的蛋白质包括。 | Kate L Loveland Andrew T Major Romaly Butler Julia C Young David A Jan Yoichi Miyamoto | 2015 | Asian Journal of Andrology2015，17，4： | 3 |
| 19 | Environmental magnetism: Principles and applications显示文摘 | Liu Qingsong Roberts Andrew P Larrasoa?a Juan C Banerjee Subir K Guyodo Yohan Tauxe Lisa Oldfield Frank | 2012 | EN2012，，4： | 3 |
| 20 | Comparative transcriptomics of Central Asian Vitis vinifera accessions reveals distinct defense strategies against powdery mildew显示文摘Grape powdery mildew(PM),caused by the biotrophic ascomycete Erysiphe necator,is a devastating fungal disease that affects most Vitis vinifera cultivars.We have previously identified a panel of V.vinifera accessions from Central Asia with partial resistance to PM that possess a Ren1-like local haplotype.In this study,we show that in addition to the typical Ren1-associated late post-penetration resistance,these accessions display a range of different levels of disease development suggesting that alternative alleles or additional genes contribute to determining the outcome of the interaction with the pathogen.To identify potential Ren1-dependent transcriptional responses and functions associated with the different levels of resistance,we sequenced and analyzed the transcriptomes of these Central Asian accessions at two time points of PM infection.Transcriptomes were compared to identify constitutive differences and PM-inducible responses that may underlie their disease resistant phenotype.Responses to E.necator in all resistant accessions were characterized by an early up-regulation of 13 genes,most encoding putative defense functions,and a late down-regulation of 32 genes,enriched in transcriptional regulators and protein kinases.Potential Ren1-dependent responses included a hotspot of co-regulated genes on chromosome 18.We also identified 81 genes whose expression levels and dynamics correlated with the phenotypic differences between the most resistant accessions‘Karadzhandahal’,DVIT3351.27,and O34-16 and the other genotypes.This study provides a first exploration of the functions associated with varying levels of partial resistance to PM in V.vinifera accessions that can be exploited as sources of genetic resistance in grape breeding programs. | Katherine C H Amrine Barbara Blanco-Ulate Summaira Riaz Dániel Pap Laura Jones Rosa Figueroa-Balderas M Andrew Walker Dario Cantu | 2015 | Horticulture Research2015，2，1： | 3 |
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