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| 1 | 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 |
| 2 | A randomized double-blind trial on perioperative administration of probiotics in colorectal cancer patients显示文摘AIM:To investigate whether probiotic bacteria,given perioperatively,might adhere to the colonic mucosa, reduce concentration of pathogens in stools,and modulate the local immune function. METHODS:A randomized,double-blind clinical trial was carried out in 31 subjects undergoing elective colorectal resection for cancer.Patients were allocated to receive either a placebo(group A,n=10),or a dose of 10 7 of a mixture of Bifidobacterium longum(BB536) and Lactobacillus johnsonii(La1)(group B,n=11),or the same mixture at a concentration of 10 9 (group C,n=10).Probiotics,or a placebo,were given orally 2 doses/d for 3 d before operation.The same treatment continued postoperatively from day two to day four. Stools were collected before treatment,during surgery (day 0)and 5 d after operation.During the operation, colonic mucosa samples were harvested to evaluate bacterial adherence and to assess the phenotype of dendritic cells(DCs)and lymphocyte subsets by surface antigen expression(flow cytometry).The presence of BB536 and La1 was evaluated by the random amplified polymorphism DNA method with specific polymerase chain reaction probes. RESULTS:The three groups were balanced for baseline and surgical parameters.BB536 was never found at any time-points studied.At day 0,La1 was present in 6/10(60%)patients in either stools or by biopsy in group C,in 3/11(27.2%)in group B,and none in the placebo group(P=0.02,C vs A).There was a linear correlation between dose given and number of adher- ent La1(P=0.01).The rate of mucosal colonization by enterobacteriacae was 30%(3/10)in C,81.8%(9/11) in B and 70%(7/10)in A(P=0.03,C vs B).The Enterobacteriacae count in stools was 2.4(log10 scale) in C,4.6 in B,and 4.5 in A(P=0.07,C vs A and B). The same trend was observed for colonizing enterococ- ci.La1 was not found at day+5.We observed greater expression of CD3,CD4,CD8,and naive and memory lymphocyte subsets in group C than in group A with a dose response trend(C>B>A).Treatment didnot affect DC phenotype or activation,but after ex vivo stimulation with lipopolysaccharides,groups C and B had a lower proliferation rate compared to group A (P=0.04).Moreover,dendritic phenotypes CD83-123, CD83-HLADR,and CD83-11c(markers of activation) were significantly less expressed in patients colonized with La1(P=0.03 vs not colonized). CONCLUSION:La1,but not BB536,adheres to the colonic mucosa,and affects intestinal microbiota byreducing the concentration of pathogens and modulates local immunity. | Luca Gianotti Lorenzo Morelli Francesca Galbiati Simona Rocchetti Sara Coppola Aldo Beneduce Cristina Gilardini Daniela Zonenschain Angelo Nespoli Marco Braga | 2010 | World Journal of Gastroenterology2010，16，2： | 18 |
| 3 | Challenges in the diagnosis and treatment of gestational trophoblastic neoplasia worldwide显示文摘Gestational trophoblastic neoplasia(GTN) is a rare tumor that originates from pregnancy that includes invasive mole, choriocarcinoma(CCA), placental site trophoblastic tumor and epithelioid trophoblastic tumor(PSTT/ETT). GTN presents different degrees of proliferation, invasion and dissemination, but, if treated in reference centers, has high cure rates, even in multi-metastatic cases.The diagnosis of GTN following a hydatidiform molar pregnancy is made according to the International Federation of Gynecology and Obstetrics(FIGO)2000 criteria: four or more plateaued human chorionic gonadotropin(hCG)concentrations over three weeks; rise in hCG for three consecutive weekly measurements over at least a period of 2 weeks or more; and an elevated but falling hCG concentrations six or more months after molar evacuation. However,the latter reason for treatment is no longer used by many centers. In addition,GTN is diagnosed with a pathological diagnosis of CCA or PSTT/ETT. For staging after a molar pregnancy, FIGO recommends pelvic-transvaginal Doppler ultrasound and chest X-ray. In cases of pulmonary metastases with more than 1cm, the screening should be complemented with chest computed tomography and brain magnetic resonance image. Single agent chemotherapy, usually Methotrexate(MTX) or Actinomycin-D(Act-D), can cure about 70% of patients with FIGO/World Health Organization(WHO) prognosis risk score ≤ 6(low risk), reserving multiple agent chemotherapy, such as EMA/CO(Etoposide,MTX, Act-D, Cyclophosphamide and Oncovin) for cases with FIGO/WHO prognosis risk score ≥ 7(high risk) that is often metastatic. Best overall cure rates for low and high risk disease is close to 100% and > 95%, respectively. The management of PSTT/ETT differs and cure rates tend to be a bit lower. The early diagnosis of this disease and the appropriate treatment avoid maternal death,allow the healing and maintenance of the reproductive potential of these women. | Antonio Braga Paulo Mora Andréia Cristina de Melo Angélica Nogueira-Rodrigues Joffre Amim-Junior Jorge Rezende-Filho Michael J Seckl | 2019 | World Journal of Clinical Oncology2019，10，2： | 15 |
| 4 | Acute abdominal obstruction:Colon stent or emergency surgery? An evidence-based review显示文摘According to the American Cancer Society and Colorectal Cancer Statistics 2017,colorectal cancer(CRC) is one of the most common malignancies in the United States and the second leading cause of cancer death in the world in 2018.Previous studies demonstrated that 8%-29% of patients with primary CRC present malignant colonic obstruction(MCO). In the past, emergency surgery has been the primary treatment for MCO, although morbidity and surgical mortality rates are higher in these settings than in elective procedures. In the 1990 s, selfexpanding metal stents appeared and was a watershed in the treatment of patients in gastrointestinal surgical emergencies. The studies led to high expectations because the use of stents could prevent surgical intervention, such as colostomy, leading to lower morbidity and mortality, possibly resulting in higher quality of life. This review was designed to provide present evidence of the indication, technique, outcomes, benefits, and risks of these treatments in acute MCO through the analysis of previously published studies and current guidelines. | Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Christopher C Thompson Eduardo Guimaraes Hourneaux de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，3： | 15 |
| 5 | Video capsule endoscopy vs double-balloon enteroscopy in the diagnosis of small bowel bleeding:A systematic review and metaanalysis显示文摘AIM To compare the diagnostic accuracy of video capsule endoscopy(VCE) and double-balloon enteroscopy(DBE) in cases of obscure gastrointestinal bleeding(OGIB) of vascular origin.METHODS MEDLINE(via PubMed), LILACS(via BVS) and Cochrane/CENTRAL virtual databases were searched for studies dated before 2017. We identified prospective and retrospective studies, including observational, cohort, single-blinded and multicenter studies, comparing VCE and DBE for the diagnosis of OGIB, and data of all the vascular sources of bleeding were collected. All patients were subjected to the same gold standard method. Relevant data were then extracted from each included study using a standardized extraction form. We calculated study variables(sensitivity, specificity, prevalence, positive and negative predictive values and accuracy) and performed a meta-analysis using Meta-Disc software.RESULTS In the per-patient analysis, 17 studies(1477 lesions) were included. We identified3150 exams(1722 VCE and 1428 DBE) in 2043 patients and identified 2248 sources of bleeding, 1467 of which were from vascular lesions. Of these lesions, 864(58.5%) were diagnosed by VCE, and 613(41.5%) were diagnosed by DBE. The pretest probability for bleeding of vascular origin was 54.34%. The sensitivity of DBE was 84%(95%CI: 0.82-0.86; heterogeneity: 78.00%), and the specificity was92%(95%CI: 0.89-0.94; heterogeneity: 92.0%). For DBE, the positive likelihood ratio was 11.29(95%CI: 4.83-26.40; heterogeneity: 91.6%), and the negative likelihood ratio was 0.20(95%CI: 0.15-0.27; heterogeneity: 67.3%). Performing DBE after CE increased the diagnostic yield of vascular lesion by 7%, from 83% to90%.CONCLUSION The diagnostic accuracy of detecting small bowel bleeding from a vascular source is increased with the use of an isolated video capsule endoscope compared with isolated DBE. However, concomitant use increases the detection rate of the bleeding source. | Hélcio Pedrosa Brito Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura Wanderley Marques Bernardo Dalton Marques Chaves Rogério Kuga Ethan Dwane Maahs Robson Kiyoshi Ishida Eduardo Turiani Hourneaux de Moura Eduardo Guimaraes Hourneaux de Moura | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，12： | 10 |
| 6 | Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease显示文摘AIM:To investigate the relationship between sense of coherence,psychological distress and health related quality of life in inflammatory bowel disease(IBD).METHODS:This cross-sectional study enrolled a consecutive sample of 147 IBD(aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service.Sixty-four participants met diagnostic criteria for Crohn's disease,while eightythree patients had ulcerative colitis.Socio-demographic data(education,age,race,gender,gross monthly income and marital status),disease-related variables(illness activity,relapse rate in past 2 years,history of surgery and time since diagnosis),sense of coherence(Antonovsky's SOC scale),psychological distress symptoms(Hospital Anxiety and Depression Scale) and health-related quality of life(HRQo L; WHOQOLBref) were assessed.Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQo L in patients with IBD and to provide indications for possible moderating or mediating effects.In addition,formal moderation and mediation analyses(Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC,psychological distress symptoms and HRQoL.RESULTS:Lower SOC scores(std beta=-0.504; P < 0.001),female gender(std beta = 0.176; P = 0.021) and White race(std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms,while lower levels of SOC(std beta =-0.438; P < 0.001) and higher relapse rate(std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms.A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms,as the interaction term(time since diagnosis X SOC) had beta coefficients of-0.191(P = 0.009) and-0.172(P = 0.026),respectively.Lower levels of anxiety symptoms(std beta =-0.369; P < 0.001),higher levels of SOC(std beta = 0.231; P = 0.016) and non-White race(std beta =-0.229; P = 0.006),i.e.,mixed-race,which represented the reference category,were independently associated with higher levels of overall HRQoL.Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL.In addition,anxiety mediated the association between SOC and satisfaction with health,as well as its relationship with physical,mental,and social relations HRQo L.Depressive symptoms also mediated the association between SOC and mental HRQoL.CONCLUSION:Our data indicated that SOC is an important construct,as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD. | Thiago H Freitas Elias Andreoulakis Gilberto S Alves Hesley LL Miranda Lúcia LBC Braga Thomas Hyphantis André F Carvalho | 2015 | World Journal of Gastroenterology2015，21，21： | 10 |
| 7 | Long-term outcomes after laparoscopic colectomy显示文摘AIM:To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection.METHODS:From February 2000 to December 2004,six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic(LPS,n = 330) or open(n = 332) colorectal resection.All patients were analyzed on an intention-to-treat basis.Long-term follow-up was carried out every 6 mo by office visits.In 526 cancer patients five-year overall and disease-free survival were evaluated.Median oncologic follow-up was 96 mo.RESULTS:Eight(4.2%) LPS group patients needed conversion to open surgery.Overall long-term morbidity rate was 7.6%(25/330) in the LPS vs 11.1%(37/332) in the open group(P = 0.17).In cancer patients,fiveyear overall survival was 68.6% in the LPS group and 64.0% in the Open group(P = 0.27).Excluding stage Ⅳ patients,five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group(P = 0.36).Further,no difference in recurrence rate was found when patients were stratified according to cancer stage.CONCLUSION:LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery.No difference between groups was found in overall and disease-free survival rates. | Marco Braga Nicolò Pecorelli Matteo Frasson Andrea Vignali Walter Zuliani Valerio Di Carlo | 2011 | World Journal of Gastrointestinal Oncology2011，3，3： | 8 |
| 8 | Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects显示文摘A gastrointestinal(GI) transmural defect is defined as total rupture of the GI wall,and these defects can be divided into three categories: perforations,leaks,and fistulas. Surgical management of these defects is usually challenging and may be associated with high morbidity and mortality rates. Recently,several novel endoscopic techniques have been developed,and endoscopy has become a firstline approach for therapy of these conditions. The use of endoscopic vacuum therapy(EVT) is increasing with favorable results. This technique involves endoscopic placement of a sponge connected to a nasogastric tube into the defect cavity or lumen. This promotes healing via five mechanisms,including macrodeformation,microdeformation,changes in perfusion,exudate control,and bacterial clearance,which is similar to the mechanisms in which skin wounds are treated with commonly employed wound vacuums. EVT can be used in the upper GI tract,small bowel,biliopancreatic regions,and lower GI tract,with variable success rates and a satisfactory safety profile. In this article,we review and discuss the mechanism of action,materials,techniques,efficacy,and safety of EVT in the management of patients with GI transmural defects. | Diogo Turiani Hourneaux de Moura Bruna Furia Buzetti Hourneaux de Moura Michael A Manfredi Kelly E Hathorn Ahmad N Bazarbashi Igor Braga Ribeiro Eduardo Guimaraes Hourneaux de Moura Christopher C Thompson | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，5： | 6 |
| 9 | Propofol vs traditional sedatives for sedation in endoscopy:A systematic review and meta-analysis显示文摘BACKGROUND Propofol is commonly used for sedation during endoscopic procedures.Data suggests its superiority to traditional sedatives used in endoscopy including benzodiazepines and opioids with more rapid onset of action and improved postprocedure recovery times for patients.However,Propofol requires administration by trained healthcare providers,has a narrow therapeutic index,lacks an antidote and increases risks of cardio-pulmonary complications.AIM To compare,through a systematic review of the literature and meta-analysis,sedation with propofol to traditional sedatives with or without propofol during endoscopic procedures.METHODS A literature search was performed using MEDLINE,Scopus,EMBASE,the Cochrane Library,Scopus,LILACS,BVS,Cochrane Central Register of Controlled Trials,and The Cumulative Index to Nursing and Allied Health Literature databases.The last search in the literature was performed on March,2019 with no restriction regarding the idiom or the year of publication.Only randomized clinical trials with full texts published were included.We divided sedation therapies to the following groups:(1)Propofol versus benzodiazepines and/or opiate sedatives;(2)Propofol versus Propofol with benzodiazepine and/or opioids;and(3)Propofol with adjunctive benzodiazepine and opioid versus benzodiazepine and opioid.The following outcomes were addressed:Adverse events,patient satisfaction with type of sedation,endoscopists satisfaction with sedation administered,dose of propofol administered and time to recovery post procedure.Meta-analysis was performed using RevMan5 software version 5.39.RESULTS A total of 23 clinical trials were included(n=3854)from the initial search of 6410 articles.For Group I(Propofol vs benzodiazepine and/or opioids):The incidence of bradycardia was not statistically different between both sedation arms(RD:-0.01,95%CI:-0.03–+0.01,I2:22%).In 10 studies,the incidence of hypotension was not statistically difference between sedation arms(RD:0.01,95%CI:-0.02–+0.04,I2:0%).Oxygen desaturation was higher in the propofol group but not statistically different between groups(RD:-0.03,95%CI:-0.06–+0.00,I2:25%).Patients were more satisfied with their sedation in the benzodiazepine+opioid group compared to those with monotherapy propofol sedation(MD:+0.89,95%CI:+0.62–+1.17,I2:39%).The recovery time after the procedure showed high heterogeneity even after outlier withdrawal,there was no statistical difference between both arms(MD:-15.15,95%CI:-31.85–+1.56,I2:99%).For Group II(Propofol vs propofol with benzodiazepine and/or opioids):Bradycardia had a tendency to occur in the Propofol group with benzodiazepine and/or opioidassociated(RD:-0.08,95%CI:-0.13–-0.02,I2:59%).There was no statistical difference in the incidence of bradycardia(RD:-0.00,95%CI:-0.08–+0.08,I2:85%),desaturation(RD:-0.00,95%CI:-0.03–+0.02,I2:44%)or recovery time(MD:-2.04,95%CI:-6.96–+2.88,I2:97%)between sedation arms.The total dose of propofol was higher in the propofol group with benzodiazepine and/or opiates but with high heterogeneity.(MD:70.36,95%CI:+53.11–+87.60,I2:61%).For Group III(Propofol with benzodiazepine and opioid vs benzodiazepine and opioid):Bradycardia and hypotension was not statistically significant between groups(RD:-0.00,95%CI:-0.002–+0.02,I2:3%;RD:0.04,95%CI:-0.05–+0.13,I2:77%).Desaturation was evaluated in two articles and was higher in the propofol+benzodiazepine+opioid group,but with high heterogeneity(RD:0.15,95%CI:0.08–+0.22,I2:95%).CONCLUSION This meta-analysis suggests that the use of propofol alone or in combination with traditional adjunctive sedatives is safe and does not result in an increase in negative outcomes in patients undergoing endoscopic procedures. | Aureo Augusto de Almeida Delgado Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Ahmad Najdat Bazarbashi Marcos Eduardo Lera dos Santos Wanderley Marques Bernardo Eduardo Guimaraes Hourneaux de Moura | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，12： | 6 |
| 10 | Carotid body tumours resection with ultrasound dissector显示文摘Carotid body tumour (CBT) is a rare neoplasm arising from paraganglion cells of the carotid body.1 Surgical resection of the CBT is considered the primary treatment option,and the only one which can allow a definitive cure.1-3 The resection is particularly difficult because the tumour is adherent to the carotid adventitia,is highly vascularized,often involves the cranial nerves,and is in a limited field for exposure,consequently,the intervention is associated with high morbidity due to risk of nervous injuries,stroke,was well as hemorrhage shock. | Joana Ferreira Alexandra Canedo Sandrina Braga Jogo Vasconcelos Ricardo Gouveia Victor Martins Pedro Brandāo António Vaz | 2013 | Chinese Medical Journal2013，，3： | 5 |
| 11 | Relationship between Th17 immune response and cancer显示文摘Cancer is the second leading cause of death worldwide and epidemiological projections predict growing cancer mortality rates in the next decades.Cancer has a close relationship with the immune system and,although Th17 cells are known to play roles in the immune response against microorganisms and in autoimmunity,studies have emphasized their roles in cancer pathogenesis.The Th17 immune response profile is involved in several types of cancer including urogenital,respiratory,gastrointestinal,and skin cancers.This type of immune response exerts pro and antitumor functions through several mechanisms,depending on the context of each tumor,including the protumor angiogenesis and exhaustion of T cells and the antitumor recruitment of T cells and neutrophils to the tumor microenvironment.Among other factors,the paradoxical behavior of Th17 cells in this setting has been attributed to its plasticity potential,which makes possible their conversion into other types of T cells such as Th17/Treg and Th17/Th1 cells.Interleukin(IL)-17 stands out among Th17-related cytokines since it modulates pathways and interacts with other cell profiles in the tumor microenvironment,which allow Th17 cells to prevail in tumors.Moreover,the IL-17 is able to mediate pro and antitumor processes that influence the development and progression of various cancers,being associated with variable clinical outcomes.The understanding of the relationship between the Th17 immune response and cancer as well as the singularities of carcinogenic processes in each type of tumor is crucial for the identification of new therapeutic targets. | Hanna Santos Marques Breno Bittencourt de Brito Filipe Antônio França da Silva Maria Luísa Cordeiro Santos Júlio César Braga de Souza Thiago Macêdo Lopes Correia Luana Weber Lopes Nayara Silva de Macêdo Neres Rafael Santos Dantas Miranda Dórea Anna Carolina Saúde Dantas Lorena Lôbo Brito Morbeck Iasmin Souza Lima Amanda Alves de Almeida Maiara Raulina de Jesus Dias Fabrício Freire de Melo | 2021 | World Journal of Clinical Oncology2021，12，10： | 5 |
| 12 | Pancreatitis after endoscopic retrograde cholangiopancreatography:A narrative review显示文摘Acute post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP)is a feared and potentially fatal complication that can be as high as up to 30%in high-risk patients.Pre-examination measures,during the examination and after the examination are the key to technical and clinical success with a decrease in adverse events.Several studies have debated on the subject,however,numerous topics remain controversial,such as the effectiveness of prophylactic medications and the amylase dosage time.This review was designed to provide an update on the current scientific evidence regarding PEP available in the literature. | Igor Braga Ribeiro Epifanio Silvino do Monte Junior Antonio Afonso Miranda Neto Igor Mendonça Proença Diogo Turiani Hourneaux de Moura Mauricio Kazuyoshi Minata Edson Ide Marcos Eduardo Lera dos Santos Gustavo de Oliveira Luz Sergio Eiji Matuguma Spencer Cheng Renato Baracat Eduardo Guimarães Hourneaux de Moura | 2021 | World Journal of Gastroenterology2021，27，20： | 5 |
| 13 | Current role and future perspectives of cardiac rehabilitation in coronary heart disease显示文摘Ischaemic heart disease(IHD)is a major cause of morbidity and mortality worldwide.While there have been major advances in this field,these patients are still a higher risk subgroup.As such,strategies to mitigate risk and tailor secondary prevention measures are of the utmost relevance.Cardiac rehabilitation(CR),encompassing several domains including exercise training,cardiovascular risk factor optimization,nutritional and psychological assessments,as well as other ancillary interventions has shown to be one of the pillars in the contemporary management of patients with IHD.Indeed,CR is associated with several benefits in this population,ranging from functional capacity to improvements in outcomes.Whilst this,there are still several issues concerning the optimal application of CR which are still not fully ascertained,such as lack of referral and completion,as well as questions related to programme design(particularly among patients with multiple comorbidities).In this review,we aim at presenting a pragmatic overview on the current role of CR in the management of individuals with IHD,while also discussing some of the caveats in the current data,as well as future concepts which could help improve the uptake and personalization of this pivotal time-tested intervention. | Eduardo M Vilela Ricardo Ladeiras-Lopes Ana Joao Joana Braga Susana Torres Sofia Viamonte José Ribeiro Madalena Teixeira José P Nunes Ricardo Fontes-Carvalho | 2021 | World Journal of Cardiology2021，13，12： | 5 |
| 14 | Propofol vs midazolam sedation for elective endoscopy in patients with cirrhosis:A systematic review and meta-analysis of randomized controlled trials显示文摘BACKGROUND Patients with cirrhosis frequently require sedation for elective endoscopic procedures.Several sedation protocols are available,but choosing an appropriate sedative in patients with cirrhosis is challenging.AIM To conduct a systematic review and meta-analysis to compare propofol and midazolam for sedation in patients with cirrhosis during elective endoscopic procedures in an attempt to understand the best approach.METHODS This systematic review and meta-analysis was conducted using the PRISMA guidelines.Electronic searches were performed using MEDLINE,EMBASE,Central Cochrane,LILACS databases.Only randomized control trials(RCTs)were included.The outcomes studied were procedure time,recovery time,discharge time,and adverse events(bradycardia,hypotension,and hypoxemia).The risk of bias assessment was performed using the Revised Cochrane Risk-of-Bias tool for randomized trials(RoB-2).Quality of evidence was evaluated by GRADEpro.The meta-analysis was performed using Review Manager.RESULTS The search yielded 3,576 records.Out of these,8 RCTs with a total of 596 patients(302 in the propofol group and 294 in the midazolam group)were included for the final analysis.Procedure time was similar between midazolam and propofol groups(MD:0.25,95%CI:-0.64 to 1.13,P=0.59).Recovery time(MD:-8.19,95%CI:-10.59 to-5.79,P<0.00001).and discharge time were significantly less in the propofol group(MD:-12.98,95%CI:-18.46 to-7.50,P<0.00001).Adverse events were similar in both groups(RD:0.02,95%CI:0-0.04,P=0.58).Moreover,no significant difference was found for bradycardia(RD:0.03,95%CI:-0.01 to 0.07,P=0.16),hypotension(RD:0.03,95%CI:-0.01 to 0.07,P=0.17),and hypoxemia(RD:0.00,95%CI:-0.04 to 0.04,P=0.93).Five studies had low risk of bias,two demonstrated some concerns,and one presented high risk.The quality of the evidence was very low for procedure time,recovery time,and adverse events;while low for discharge time.CONCLUSION This systematic review and meta-analysis based on RCTs show that propofol has shorter recovery and patient discharge time as compared to midazolam with a similar rate of adverse events.These results suggest that propofol should be the preferred agent for sedation in patients with cirrhosis. | John Alexander Lata Guacho Diogo Turiani Hourneaux de Moura Igor Braga Ribeiro Alberto Machado da Ponte Neto Shailendra Singh Marina Gammaro Baldavira Tucci Wanderley Marques Bernardo Eduardo Guimarães Hourneaux de Moura | 2020 | World Journal of Gastrointestinal Endoscopy2020，12，8： | 4 |
| 15 | Analysis of foundation sliding of an arch dam considering the hydromechanical behavior显示文摘This paper presents the application of a methodology which can be used to assess arch dam foundation stability,using the discrete element method(DEM)and the code 3DEC.A global three-dimensional model of a dam foundation was developed,in which some discontinuities were simulated and both the grout and drainage curtains were represented.The model,calibrated taking into account recorded data,was used to carry out nonlinear mechanical analysis.The same model was employed to perform a hydraulic analysis,based on equivalent continuum concepts,which allowed the water pressure pattern within the foundation to be obtained.These water pressures were applied on discontinuities involved in the possible sliding mechanism along the dam/foundation interface,and the safety of the dam/foundation system was evaluated using a process of reduction of strength characteristics,with the aim of calculating the minimum safety factors that ensure stability.Results were compared with those obtained with the usual bi-linear uplift pressure distribution at the base of the dam,commonly used in concrete dam design.The relevance of carrying out hydraulic analysis in arch dam foundation failure studies is highlighted. | Maria Luísa Braga FARINHA JoséVieira de LEMOS Emanuel MARANHA DAS NEVES | 2012 | Frontiers of Structural and Civil Engineering2012，6，1： | 4 |
| 16 | Combined laparoscopic spleen-preserving distal pancreatectomy and islet autotransplantation for benign pancreatic neoplasm显示文摘AIM:To evaluate the safety and feasibility of laparoscopic spleen-preserving distal pancreatectomy(LSPDP)with autologous islet transplantation(AIT)for benign tumors of the pancreatic body-neck.METHODS:Three non-diabetic,female patients(age37,44 and 35 years,respectively)were declared candidates for surgery,between May and September 2011,because of pancreatic body/neck cystic lesions.The planned operation was an LSPDP associated with AIT from the normal pancreas distal to the neoplasm.Islets isolation was performed on the residual pancreatic parenchyma after frozen section examination of the margin.Purified autologous islets were infused into the portal vein by a percutaneous transhepatic approach the day after surgery.RESULTS:The procedure was performed successfully in all the three cases,and the spleen was preserved along with its vessels.Mean operation time was 283±52 min and average blood loss was 133±57 mL.Residual pancreas weights were 33,22 and 30 g,and105.200,40.390 and 94.790 islet equivalents were isolated,respectively.Surgical complications occurred in one patient(grade A pancreatic fistula).Postoperative stays were 6,6 and 7 d,respectively.Histopathological evaluation revealed mucinous cystic neoplasm in cases1 and 3,and serous cystic neoplasm in patient 2.No postoperative insulin administration was required.One patient developed a transient partial portal thrombosis2 mo after islet infusion.Patients are insulin independent at a mean follow up of 8±2 mo.CONCLUSION:Combination of LSPDP and AIT is feasible and could be effective to minimize the surgical impact for benign neoplasm of pancreatic body-neck. | Gianpaolo Balzano Michele Carvello Lorenzo Piemonti Rita Nano Riccardo Ariotti Alessia Mercalli Raffaella Melzi Paola Maffi Marco Braga Carlo Staudacher | 2014 | World Journal of Gastroenterology2014，20，14： | 4 |
| 17 | ESPEN Guidelines on Enteral Nutrition: Surgery including Organ Transplantation显示文摘 | A. Weimann M. Braga L. Harsanyi A. Laviano O. Ljungqvist P. Soeters K.W. Jauch M. Kemen J.M. Hiesmayr T. Horbach E.R. Kuse K.H. Vestweber | 2006 | Clinical Nutrition2006，，2： | 3 |
| 18 | 石榴提取物抑制金黄色葡萄球菌的生长及其肠毒素产生显示文摘 | Braga L C 宋利萍(摘) 佟继铭(校) | 2006 | 国外医药(植物药分册)2006，21，1： | 3 |
| 19 | ESPEN Guidelines on Parenteral Nutrition: Surgery显示文摘 | M. Braga O. Ljungqvist P. Soeters K. Fearon A. Weimann F. Bozzetti | 2009 | Clinical Nutrition2009，，4： | 3 |
| 20 | Assessing the relationship between the rumen microbiota and feed efficiency in Nellore steers显示文摘Background:Ruminants rely upon a complex community of microbes in their rumen to convert host-indigestible feed into nutrients.However,little is known about the association between the rumen microbiota and feed efficiency traits in Nellore(Bos indicus)cattle,a breed of major economic importance to the global beef market.Here,we compare the composition of the bacterial,archaeal and fungal communities in the rumen of Nellore steers with high and low feed efficiency(FE)phenotypes,as measured by residual feed intake(RFI).Results:The Firmicutes to Bacteroidetes ratio was significantly higher(P<0.05)in positive-RFI steers(p-RFI,low feed efficiency)than in negative-RFI(n-RFI,high feed efficiency)steers.The differences in bacterial composition from steers with high and low FE were mainly associated with members of the families Lachnospiraceae,Ruminococcaceae and Christensenellaceae,as well as the genus Prevotella.Archaeal community richness was lower(P<0.05)in p-RFI than in n-RFI steers and the genus Methanobrevibacter was either increased or exclusive of p-RFI steers.The fungal genus Buwchfawromyces was more abundant in the rumen solid fraction of n-RFI steers(P<0.05)and a highly abundant OTU belonging to the genus Piromyces was also increased in the rumen microbiota of highefficiency steers.However,analysis of rumen fermentation variables and functional predictions indicated similar metabolic outputs for the microbiota of distinct FE groups.Conclusions:Our results demonstrate that differences in the ruminal microbiota of high and low FE Nellore steers comprise specific taxa from the bacterial,archaeal and fungal communities.Biomarker OTUs belonging to the genus Piromyces were identified in animals showing high feed efficiency,whereas among archaea,Methanobrevibacter was associated with steers classified as p-RFI.The identification of specific RFI-associated microorganisms in Nellore steers could guide further studies targeting the isolation and functional characterization of rumen microbes potentially important for the energy-harvesting efficiency of ruminants. | Déborah Romaskevis Gomes Lopes Márcio de Souza Duarte Alex J.La Reau Ibrahim Zuniga Chaves Tiago Antônio de Oliveira Mendes Edenio Detmann Cláudia Braga Pereira Bento Maria Eugênia Zerlotti Mercadante Sarah Figueiredo Martins Bonilha Garret Suen Hilário Cuquetto Mantovani | 2021 | Journal of Animal Science and Biotechnology2021，12，4： | 3 |
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