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| 1 | Spontaneous bacterial peritonitis显示文摘Since its initial description in 1964,research hastransformed spontaneous bacterial peritonitis (SBP)from a feared disease (with reported mortality of 90%)to a treatable complication of decompensated cirrhosis,albeit with steady prevalence and a high recurrencerate. Bacterial translocation,the key mechanism in thepathogenesis of SBP,is only possible because of theconcurrent failure of defensive mechanisms in cirrhosis.Variants of SBP should be treated. Leucocyte esterasereagent strips have managed to shorten the 'tap-to-shot' time,while future studies should look into theircombined use with ascitic fluid pH. Third generationcephalosporins are the antibiotic of choice becausethey have a number of advantages. Renal dysfunctionhas been shown to be an independent predictor ofmortality in patients with SBP. Albumin is felt to reducethe risk of renal impairment by improving effectiveintravascular volume,and by helping to bind pro-inflammatory molecules. Following a single episodeof SBP,patients should have long-term antibioticprophylaxis and be considered for liver transplantation. | Anastasios Koulaouzidis Shivaram Bhat Athar A Saeed | 2009 | World Journal of Gastroenterology2009，15，9： | 31 |
| 2 | Systematic review: Preventive and therapeutic applications of metformin in liver disease显示文摘Metformin, a biguanide derivative, is the most commonly prescribed medication in the treatment of type 2 diabetes mellitus. More recently, the use of metformin has shown potential as a preventive and therapeutic agent for a broad spectrum of conditions, including liver disease and hepatic malignancies. In this systematic review,we critically analyze the literature behind the potential use of metformin across the spectrum of liver disease and malignancies. The Pub Med and Ovid MEDLINE databases were searched from 2000 to March 2015, using a combination of relevant text words and MeS H terms: metformin and mammalian target of rapamycin, hepatitis B virus(HBV), hepatitis B virus(HCV), nonalcoholic fatty liver disease(NAFLD), hepatocellular carcinoma(HCC) or cholangiocarcinoma. The search results were evaluated for pertinence to the issue of metformin in liver disease as well as for quality of study design. Metformin has a number of biochemical effects that would suggest a benefit in treating chronic liver diseases, particularly in the context of insulin resistance and inflammation. However, the literature thus far does not support any independent therapeutic role in NAFLD or HCV. Nonetheless, there is Level Ⅲ evidence for a chemopreventive role in patients with diabetes and chronic liver disease, with decreased incidence of HCC and cholangiocarcinoma. The use of metformin seems to be safe in patients with cirrhosis, and provides a survival benefit. Once hepatic malignancies are already established, metformin does not offer any therapeutic potential. In conclusion, there is insufficient evidence to recommend use of metformin in the adjunctive treatment of chronic liver diseases, including NAFLD and HCV. However, there is good evidence for a chemopreventive role against HCC among patients with diabetes and chronic liver disease, and metformin should be continued in patients even with cirrhosis to provide this benefit. | Aparna Bhat Giada Sebastiani Mamatha Bhat | 2015 | World Journal of Hepatology2015，7，12： | 20 |
| 3 | Omental flaps reduces complications after pancreaticoduodenectomy显示文摘BACKGROUND:Major complications after pancreaticoduodenectomy are usually caused by a leaking pancreaticojejunal anastomosis.Omental flaps around various anastomoses were used to prevent the formation of fistula.METHODS:We reviewed 147 patients who had undergone pancreaticoduodenectomy between March 2006 and March2012.The patients were divided into 2 groups according to the application of omental flaps around various anastomoses:group A(101 patients)who underwent omental wrapping procedure;group B(46 patients)who did not undergo the omental wrapping procedure.Perioperative data of the two groups were reviewed to assess the effectiveness of omental flap procedure in the prevention of pancreatic fistula and other complications.RESULTS:No differences were observed in the clinical characteristics between the 2 groups.The incidences of pancreatic fistula(4.0%vs 17.4%),post-pancreatectomy hemorrhage(0vs 6.5%),biliary fistula(1.0%vs 13.0%),and delayed gastric emptying(4.0%vs 17.4%)were significantly less frequent in group A.The overall morbidity(18.8%vs 47.8%)and hospital stay(8.3 vs 9.6 days)were also significantly lower in group A than in group B.CONCLUSIONS:Omental flaps around various anastomoses after pancreaticoduodenectomy can reduce the incidences of pancreatic fistula,biliary fistula,post-pancreatectomy hemorrhage and delayed gastric emptying.This procedure is simple and effective to reduce the overall morbidity after pancreaticoduodenectomy. | Omar J Shah Sadaf A Bangri Manmohan Singh Reyaz A Lattoo Mohammad Y Bhat | 2015 | Hepatobiliary & Pancreatic Diseases International2015，14，3： | 19 |
| 4 | In vitro meat production: Challenges and benefits over conventional meat production显示文摘In vitro meat production system is the production of meat outside the food animals by culturing the stem cells derived from farm animals inside the bioreactor by using advanced tissue engineering techniques. Besides winning the favour of animal rights activists for its humane production of meat, in vitro meat production system also circumvents many of the issues associated with conventional meat production systems, like excessively brutal slaughter of food animals, nutrition-related diseases, foodborne illnesses, resource use, antibiotic-resistant pathogen strains, and massive emissions of methane that contribute to global warming. As the conditions in an in vitro meat production system are controlled and manipulatable, it will be feasible to produce designer, chemically safe and disease-free meat on sustainable basis. However, many challenges are to be faced before cultured meat becomes commercially feasible. Although, the production cost and the public acceptance are of paramount importance, huge funds are desperately required for further research in the field. | Zuhaib Fayaz Bhat Sunil Kumar Hina Fayaz | 2015 | Journal of Integrative Agriculture2015，14，2： | 17 |
| 5 | Antibacterial activity of lemongrass(Cymbopogon citratus) oil against some selected pathogenic bacterias显示文摘Objective:To find the effectiveness of essential oil of lemongrass for the treatment of pathogenic organisms.Methods:Lemongrass oil was investigated for activity against Staphylococcus aureus (S.aureus),Bacillus cereus(B.cereus),Bacillus subtilis(B.subtilis),Escherichia coli(E.coli), Klebsiella pneumoniae(K.pneumoniae) and Pseudomonas aeruginosa(P.aeruginosa),using Agar Diffusion Method and Broth Dilution Method.Minimum inhibitory concentration(MIC) and minimum bactericidal concentration(MBC) were determined by the Broth Dilution Method. The antibiotic susceptibility test against the test organisms was performed by Disc Diffusion Method.Results:Lemongrass was found effective against all the test organisms except P. aeruginosa.Gram positive organisms were found more sensitive to lemon grass oil as compared to gram negative organisms.The test organisms were found inhibited by Lemon grass oil at lower concentrations in Broth Dilution Method as compared to Agar Diffusion Method.Conclusions: The tested organisms,particularly gram-negative organisms had shown high resistance towards different antibiotics whereas they were found to be inhibited by lemongrass oil even at lower concentration.Thus lemongrass oil is effective against drug resistant organisms.It can be suggested that use of lemongrass oil would be helpful in the treatment of infections caused by multidrug resistant organisms. | Mohd Irfan Naik Bashir Ahmad Fomda Ebenezar Jaykumar Javid Ahmad Bhat | 2010 | Asian Pacific Journal of Tropical Medicine2010，3，7： | 14 |
| 6 | Implication of the intestinal microbiome in complications of cirrhosis显示文摘The intestinal microbiome(IM) is altered in patients with cirrhosis,and emerging literature suggests that this impacts on the development of complications.The Pub Med database was searched from January 2000 to May 2015 for studies and review articles on the composition,pathophysiologic effects and therapeutic modulation of the IM in cirrhosis.The following combination of relevant text words and MeS H terms were used,namely intestinal microbiome,microbiota,or dysbiosis,and cirrhosis,encephalopathy,spontaneous bacterial peritonitis,hepatorenal syndrome,variceal bleeding,hepatopulmonary syndrome,portopulmonary hypertension and hepatocellular carcinoma.The search results were evaluated for pertinence to the subject of IM and cirrhosis,as well as for quality of study design.The IM in cirrhosis is characterized by a decreased proportion of Bacteroides and Lactobacilli,and an increased proportion of Enterobacteriaceae compared to healthy controls.Except for alcoholic cirrhosis,the composition of the IM in cirrhosis is not affected by the etiology of the liver disease.The percentage of Enterobacteriaceae increases with worsening liver disease severity and decompensation and is associated with bacteremia,spontaneous bacterial peritonitis and hepatic encephalopathy.Lactulose,rifaximin and Lactobacillus-containing probiotics have been shown to partial y reverse the cirrhosis associated enteric dysbiosis,in conjunction with improvement in encephalopathy.The IM is altered in cirrhosis,and this may contribute to the development of complications associated with end-stage liver disease.Therapies such as lactulose,rifaximin and probiotics may,at least partially,reverse the cirrhosisassociated changes in the IM.This,in turn,may prevent or alleviate the severity of complications. | Mamatha Bhat Bianca M Arendt Venkat Bhat Eberhard L Renner Atul Humar Johane P Allard | 2016 | World Journal of Hepatology2016，8，27： | 13 |
| 7 | 早期血运重建及体外膜肺氧合支持治疗急性心肌梗死合并心原性休克的疗效观察及影响因素分析显示文摘目的:探讨早期血运重建及体外膜肺氧合(ECMO)治疗急性心肌梗死合并心原性休克患者的疗效,并分析影响其预后的因素。方法:回顾2018年1月至2019年12月郑州大学人民医院早期血运重建及ECMO救治的急性心肌梗死合并心原性休克66例患者的临床资料。收集并分析患者一般情况、临床特征、合并症、冠状动脉病变特点,ECMO前后血流动力学变化及应用时长、并发症及疗效,是否应用主动脉球囊反搏(IABP)及院内临床转归等。结果:66例患者平均年龄(56.6±11.7)岁,其中男性46例。患者入院均行早期血运重建:5例行冠状动脉旁路移植术(CABG);61例行经皮冠状动脉介入治疗(PCI),其中44例行入院即刻早期血运重建,17例行院内延迟早期血运重建;其中42例患者为多支冠状动脉病变。所有患者均应用ECMO辅助,其中39例使用了IABP。ECMO治疗后患者平均动脉压、中心静脉压、血乳酸水平及pH值均得到显著改善(P均<0.05)。66例患者中38例成功撤机,30例存活出院,36例死亡;并发症分别为20例肾功能不全或急性肾功能衰竭、11例消化道出血、5例脑出血、1例肺出血、9例下肢血栓及3例下肢缺血。多因素Logistic回归分析显示高血压,多脏器功能衰竭,发生至少2次呼吸心脏骤停、意识丧失及恶性心律失常事件为患者院内死亡的高危因素(P<0.05),应用IABP对院内结局无显著影响。结论:早期血运重建及ECMO用于救治急性心肌梗死合并心原性休克的患者是可行的。 | 韩宗茂 高洁 高传玉 张优 张静 朱中玉 齐大屯 黑飞龙 Rafiq Ahmed BHAT | 2021 | 中国循环杂志2021，36，5： | 12 |
| 8 | Metformin does not improve survival in patients with hepatocellular carcinoma显示文摘AIM:To assess whether metformin,which has a chemopreventive effect in chronic liver disease,has any chemotherapeutic effect in hepatocellular carcinoma.METHODS:This was a retrospective study of 701 patients with newly diagnosed hepatocellular carcinoma(HCC)seen between January 2005 and June 2011 at Mayo Clinic,Rochester,Minnesota.This patient cohort was a part of the global HCC BRIDGE study,which is a large longitudinal study of HCC determining the realworld experience of HCC characteristics,management and patient outcomes.We defined significant metformin exposure as continuation of this agent at least 90d beyond diagnosis of HCC,and compared survival of diabetic patients on metformin to diabetic patients not on metformin and non-diabetics.RESULTS:Our cohort was 72.9%male,with a mean±SD age of 62.6±12.3 years.The most common etiologies of liver disease were hepatitis C(34%),alcoholic liver disease(29%),fatty liver disease(15%)and hepatitis B(9%).By univariate analysis,using diabetics not on metformin as the reference group,diabetic patients with HCC on metformin had no survival advantage,with a HR(95%CI)of 1.0(0.8-1.3).Non-diabetic HCC patients also did not appear to have a survival advantage as compared to diabetic HCC patients not on metformin,as demonstrated by a HR(95%CI)of1.1(0.7-1.7).Diabetics on metformin beyond 90 d after HCC diagnosis had a longer median survival at 34.2 mo,as compared to 25.5 mo among diabetic patients who were not on metformin or had discontinued metformin within 90 d after HCC diagnosis.This finding was likely due to potential survival bias among those who lived long enough to receive metformin.CONCLUSION:Although the literature suggests a chemotherapeutic effect in other malignancies,our study demonstrates no survival benefit to the use of metformin in diabetic patients with HCC. | Mamatha Bhat Roongruedee Chaiteerakij William S Harmsen Cathy D Schleck Ju Dong Yang Nasra H Giama Terry M Therneau Gregory J Gores Lewis R Roberts | 2014 | World Journal of Gastroenterology2014，20，42： | 11 |
| 9 | Copy number variations are progressively associated with the pathogenesis of colorectal cancer in ulcerative colitis显示文摘AIM: To evaluate the association of known copy number variations(CNVs) in ulcerative colitis(UC) progressing to colorectal cancer.METHODS: Microsatellite instability analysis using the National Cancer Institute's panel of markers, and CNV association studies using Agilent 2 × 105 k arrays were done in tissue samples from four patient groups with UC: those at low risk(LR) or high risk of developing colorectal cancer, those with premalignant dysplastic lesions, and those with colitis-associated colorectal cancer(CAC). DNA from tissue samples of these groups were independently hybridized on arrays and analyzed. The data obtained were further subjected to downstream bioinformatics enrichment analysis to examine the correlation with CAC progression.RESULTS: Microarray analysis highlighted a progressive increase in the total number of CNVs [LR(n = 178) vs CAC(n = 958), 5.3-fold], gains and losses [LR(n = 37 and 141) vs CAC(n = 495 and 463), 13.4- and 3.3-fold, respectively], size [LR(964.2 kb) vs CAC(10540 kb), 10.9-fold] and the number of genes in such regions [LR(n = 119) vs CAC(n = 455), 3.8-fold]. Chromosomewise analysis of CNVs also showed an increase in the number of CNVs across each chromosome. There were 38 genes common to all four groups in the study; 13 of these were common to cancer genes from the Genetic Disease Association dataset. The gene set enrichment analysis and ontology analysis highlighted many cancerassociated genes. All the samples in the different groupswere microsatellite stable.CONCLUSION: Increasing numbers of CNVs are associated with the progression of UC to CAC, and warrant further detailed exploration. | Bhadravathi Marigowda Shivakumar Harish Rotti Thanvanthri Gururajan Vasudevan Aswath Balakrishnan Sanjiban Chakrabarty Ganesh Bhat Lakshmi Rao Cannanore Ganesh Pai Kapaettu Satyamoorthy | 2015 | World Journal of Gastroenterology2015，21，2： | 10 |
| 10 | 血管紧张素转换酶抑制剂和血管紧张素受体拮抗剂的使用与2019冠状病毒疾病检测阳性之间的关系显示文摘血管紧张素转换酶抑制剂(angiotensin-converting enzyme inhibitor,ACEI)和血管紧张素受体拮抗剂(angiotensin receptor blocker,ARB)在2019新型冠状病毒疾病(coronavirus disease 2019,COVID-19)全球大流行背景下的作用备受争议。此类药物是治疗一些慢性病的必须药物,有建议停止使用这些药物. | Mehta N KalraA Nowacki AS Anjewierden S Han Z Bhat p Rubio AEC Jacob M Procop GW Harrington S Milinovich A Svensson LG Jehi L Young JB Chung MK 周卫(译) 叶鹏(校) | 2020 | 中华高血压杂志2020，28，5： | 9 |
| 11 | A multi-locus backbone tree for Pestalotiopsis, with a polyphasic characterization of 14 new species显示文摘Pestalotiopsis is a taxonomically confused,pathogenic and chemically creative genus requiring a critical reexamination using a multi-gene phylogeny based on ex-type and ex-epitype cultures.In this study 40 isolates of Pestalotiopsis,comprised of 28 strains collected from living and dead plant material of various host plants from China were studied by means of morphology and analysis of ITS,β–tubulin and tef1 gene sequence data.Based on molecular and morphological data we describe 14 new species(Pestalotiopsis asiatica,P.chinensis,P.chrysea,P.clavata,P.diversiseta,P.ellipsospora,P.inflexa,P.intermedia,P.linearis,P.rosea,P.saprophyta,P.umberspora,P.unicolor and P.verruculosa)and three species are epitypified(P.adusta,P.clavispora and P.foedans).Of the 10 gene regions(ACT,β-tubulin,CAL,GPDH,GS,ITS,LSU,RPB 1,SSU and tef1)utilized to resolve cryptic Pestalotiopsis species,ITS,β–tubulin and tef1 proved to be the better markers.The other gene regions were less useful due to poor success in PCR amplification and/or in their ability to resolve species boundaries.As a single gene tef1 met the requirements for an ideal candidate and functions well for species delimitation due to its better species resolution and PCR success.Althoughβ-tubulin showed fairly good differences among species,a combination of ITS,β-tubulin and tef1 gene data gave the best resolution as compared to single gene analysis.This work provides a backbone tree for 22 ex-type/epitypified species of Pestalotiopsis and can be used in future studies of the genus. | Sajeewa S.N.Maharachchikumbura Liang Dong Guo Lei Cai Ekachai Chukeatirote Wen Ping Wu Xiang Sun Pedro W.Crous D.Jayarama Bhat Eric H.C.McKenzie Ali H.Bahkali Kevin D.Hyde | 2012 | Fungal Diversity2012，，5： | 9 |
| 12 | 腹腔镜远端胃癌根治术后并发症及预后危险因素分析显示文摘目的 :探讨腹腔镜辅助远端胃癌根治(LADG)术后并发症发生及远期预后的影响因素。方法 :收集2004年1月至2011年12月228例我科行LADG病人的临床病理资料,分析腹腔镜胃癌根治术后并发症发生及远期预后的影响因素。病人随访至2013年12月。结果:本研究33例发生术后并发症,发生率14.5%,主要为吻合口漏和狭窄、腹腔出血等。单因素分析表明:高龄(〉70岁)、吻合方式和淋巴结转移为影响术后并发症发生的危险因素(P〈0.05)。多因素分析表明:高龄以及毕Ⅱ式和Roux-en-Y吻合为影响术后并发症发生的独立因素(P〈0.05)。本研究随访中位时间43(2~117)个月,死亡33例,5年生存率82.9%。单因素分析表明:肿瘤分期、浸润程度、淋巴结转移、p TNM分期、肿瘤直径、吻合方式、术中出血量、手术时间、淋巴结清扫方式以及病理类型为影响LADG术后病人预后的危险因素(P〈0.05)。多因素分析表明:淋巴结转移以及病理类型为影响LADG术后病人预后的独立危险因素(P〈0.05)。结论 :高龄以及吻合方式是LADG术后并发症发生的独立危险因素。此外,淋巴结转移以及病理类型是术后远期预后的独立危险因素,可为临床判断胃癌预后提供依据。 | PAWAN Singh Bhat 潘睿俊 薛佩 臧潞 胡伟国 王明亮 陆爱国 郑民华 | 2015 | 外科理论与实践2015，20，5： | 9 |
| 13 | A study on p53 gene alterations in esophageal squamous cell carcinoma and their correlation to common dietary risk factors among population of the Kashmir valley显示文摘瞄准:为了系统地检验风险因素的关联的程度,例如年龄,与原因的体的 Tp53 分子损害消费了饮食的习惯和家庭倾向在北印度的 Kashmiri 人口之中提高食道的有鳞的房间癌(ESCC ) 的致癌作用严厉。方法:所有情况(n = 51 ) 并且控制(n = 150 ) 是克什米尔山谷的永久居民。基因改变在 Tp53 肿瘤的前 ons 5-8 被决定压制或在 45 个 ESCC 盒子之中的基因组织学地由 PCR-SSCP 分析证实了。为单个癌症盒子的数据(n = 45 ) 并且住院病人控制(n = 150 ) 与非癌症,疾病在癌症的家庭历史上包括了信息,与病人的年龄组一起的三十个占优势的普通饮食的风险因素。在到从这些参数的万物有灵论的数据的 p53 前 ons 的基因损害的关联被 Chi 平方测试与健康控制一起产生到所有 45 个组织学地证实的 ESCC 盒子。结果:(77.8%) 45 中的 35 个组织学地描绘了与 45 正常样品中的 1 个对比的有的类似的体细胞突变从一样的耐心的显示出的细菌线变化从邻近的区域获得了的肿瘤样品。 SSCP 分析表明了改变在 6 上在前被发现的那很普通的 p53 基因(77.7%),那没与个人和 clinicopathological 参数的年龄相关,但是与癌症的家庭历史显示出重要词语索引( P<0.05 )( CD = 58 ),在消费的一个未知地点,和饮食的习惯建议细菌线倾向局部地种芥属蔬菜“ Hakh ”( CD = 19.5 ),红 chillies ( CD = 20.2 ),热咸苏打茶( CD = 2.37 )并且本地烤的面包( CD = 1.1 )。结论:我们的学习建议那体的染色体变化特别在 6 Tp53 基因上的前,在人种上的食道的癌症病人之中,克什米尔山谷的同质的人口是仔细与到各种各样的普通饮食的风险因素,特别热的咸茶,肉,烤的面包和“ Hakh ”的继续的暴露有关,那富于 nitrosoamines 和家庭癌症历史。 | Imtiyaz Murtaza Dhuha Mushtaq Mushtaq A Margoob Amit Dutt Nisar Ahmad Wani Ishfaq Ahmad Mohan Lal Bhat | 2006 | World Journal of Gastroenterology2006，12，25： | 8 |
| 14 | Impella心脏轴流泵与心源性休克救治研究进展显示文摘心源性休克的常见原因包括急性心肌梗死、心肌病、心包疾病、心肌炎、开胸手术,其主要表现为心输出量下降、平均动脉压下降、终末靶器官灌注不足,休克进入死亡瀑布。尽管介入、溶栓技术取得很大进步,但ST段抬高型心肌梗死合并心源性休克患者住院病死率仍高达50%以上。Impella是心脏血流动力学辅助装置轴流泵,可稳定心源性休克患者血流动力学,减轻左心室负荷,增加器官的有效灌注,促进患者康复。本文就目前治疗心源性休克面临的挑战及Impella心脏轴流泵在心源性休克救治中作用的研究进展作一综述。 | 高传玉 Rafiq Ahmed BHAT 张静 张健 | 2019 | 中华实用诊断与治疗杂志2019，33，9： | 6 |
| 15 | The hormone resistin links obesity to diabetes显示文摘 | Steppan CM Bailey ST Bhat S Brown EJ Banerjee RR Wright CM Patel HR Ahima RS Lazar MA | | 0，，： | 6 |
| 16 | Single-operator, single-session EUS-guided anterograde cholangiopancreatography in failed ERCP or inaccessible papilla显示文摘 | Janak N. Shah Fernando Marson Frank Weilert Yasser M. Bhat Thai Nguyen-Tang Richard E. Shaw Kenneth F. Binmoeller | 2012 | Gastrointestinal Endoscopy2012，，1： | 5 |
| 17 | Efficacy of pancreatoscopy for pancreatic duct stones:A systematic review and meta-analysis显示文摘BACKGROUND Pancreatic duct stones can lead to significant abdominal pain for patients.Per oral pancreatoscopy(POP)-guided intracorporal lithotripsy is being increasingly used for the management of main pancreatic duct calculi(PDC)in chronic pancreatitis.POP uses two techniques:Electrohydraulic lithotripsy(EHL)and laser lithotripsy(LL).Data on the safety and efficacy are limited for this procedure.We performed a systematic review and meta-analysis with a primary aim to calculate the pooled technical and clinical success rates of POP.The secondary aim was to assess pooled rates of technical success,clinical success for the two individual techniques,and adverse event rates.AIM To perform a systematic review and meta-analysis of POP,EHL and LL for management of PDC in chronic pancreatitis.METHODS We conducted a comprehensive search of multiple electronic databases and conference proceedings including PubMed,EMBASE,Cochrane,Google Scholar and Web of Science databases(from 1999 to October 2019)to identify studies with patient age greater than 17 and any gender that reported on outcomes of POP,EHL and LL.The primary outcome assessed involved the pooled technical success and clinical success rate of POP.The secondary outcome included the pooled technical success and clinical success rate for EHL and LL.We also assessed the pooled rate of adverse events for POP,EHL and LL including a subgroup analysis for the rate of adverse event subtypes for POP:Hemorrhage,post-endoscopic retrograde cholangiopancreatography pancreatitis(PEP),perforation,abdominal pain,fever and infections.Technical success was defined as the rate of clearing pancreatic duct stones and clinical success as the improvement in pain.Randomeffects model was used for analysis.Heterogeneity between study-specific estimates was calculated using the Cochran Q statistical test and I2 statistics.Publication bias was ascertained,qualitatively by visual inspection of funnel plot and quantitatively by the Egger test.RESULTS A total of 16 studies including 383 patients met the inclusion criteria.The technical success rate of POP was 76.4%(95%CI:65.9-84.5;I2=64%)and clinical success rate was 76.8%(95%CI:65.2-85.4;I2=66%).The technical success rate of EHL was 70.3%(95%CI:57.8-80.3;I2=36%)and clinical success rate of EHL was 66.5%(95%CI:55.2-76.2;I2=19%).The technical success rate of LL was 89.3%(95%CI:70.5-96.7;I2=70%)and clinical success rate of LL was 88.2%(95%CI:66.4-96.6;I2=77%).The incidence of pooled adverse events for POP was 14.9%(95%CI:9.2-23.2;I2=49%),for EHL was 11.2%(95%CI:5.9-20.3;I2=15%)and for LL was 13.1%(95%CI:6.3-25.4;I2=31%).Subgroup analysis of adverse events showed rates of PEP at 7%(95%CI:3.5-13.6;I2=38%),fever at 3.7%(95%CI:2-6.9;I2=0),abdominal pain at 4.7%(95%CI:2.7-7.8;I2=0),perforation at 4.3%(95%CI:2.1-8.4;I2=0),hemorrhage at 3.4%(95%CI:1.7-6.6;I2=0)and no mortality.There was evidence of publication bias based on funnel plot analysis and Egger’s test.CONCLUSION Our study highlights the high technical and clinical success rates for POP,EHL and LL.POP-guided lithotripsy could be a viable option for management of chronic pancreatitis with PDC. | Syed M Saghir Harmeet S Mashiana Babu P Mohan Banreet S Dhindsa Amaninder Dhaliwal Saurabh Chandan Neil Bhogal Ishfaq Bhat Shailender Singh Douglas G Adler | 2020 | World Journal of Gastroenterology2020，26，34： | 5 |
| 18 | Impact of immunosuppression on incidence of post-transplant diabetes mellitus in solid organ transplant recipients:Systematic review and meta-analysis显示文摘BACKGROUND Solid organ transplantation is a life-saving intervention for end-stage organ disease.Post-transplant diabetes mellitus(PTDM)is a common complication in solid organ transplant recipients,and significantly compromises long-term survival beyond a year.AIM To perform a systematic review and meta-analysis to estimate incidence of PTDM and compare the effects of the 3 major immunosuppressants on incidence of PTDM.METHODS Two hundred and six eligible studies identified 75595 patients on Tacrolimus,51242 on Cyclosporine and 3020 on Sirolimus.Random effects meta-analyses was used to calculate incidence.RESULTS Network meta-analysis estimated the overall risk of developing PTDM was higher with tacrolimus(OR=1.495%CI:1.0–2.0)and sirolimus(OR=1.8;95%CI:1.5–2.2)than with Cyclosporine.The overall incidence of PTDM at years 2-3 was 17%for kidney,19%for liver and 22%for heart.The risk factors for PTDM most frequently identified in the primary studies were age,body mass index,hepatitis C,and African American descent.CONCLUSION Tacrolimus tends to exhibit higher diabetogenicity in the short-term(2-3 years post-transplant),whereas sirolimus exhibits higher diabetogenicity in the longterm(5-10 years post-transplant).This study will aid clinicians in recognition of risk factors for PTDM and encourage careful evaluation of the risk/benefit of different immunosuppressant regimens in transplant recipients. | Sreelakshmi Kotha Bishoy Lawendy Saira Asim Charlene Gomes Jeffrey Yu Ani Orchanian-Cheff George Tomlinson Mamatha Bhat | 2021 | World Journal of Transplantation2021，11，10： | 5 |
| 19 | Totally intracorporeal robot-assisted urinary diversion for bladder cancer(part 2).Review and detailed characterization of the existing intracorporeal orthotopic ileal neobladder显示文摘Objective:To review the most used intracorporeal orthotopic ileal neobladder(ICONB)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images.Methods:We performed a non-systematic review of the literature with the keywords“bladder cancer”,“urinary diversion”,“radical cystectomy”,and“neobladder”.Results:Forty studies were included in the analysis.The most frequent type of ICONB was the modified Studer“U”neobladder(70%)followed by the Hautmann“W”modified neobladder(7.5%),the“Y”neobladder(5%),and the Padua neobladder(5%).The operative time to perform a urinary diversion ranged from 124 to 553 min.The total estimated blood loss ranged from 200 to 900 mL.The rate of positive surgical margins ranged from 0%to 8.1%.Early minor and major complication rates ranged from 0%to 100%and from 0%to 33%,respectively.Late minor and major complication rates ranged from 0%to 70%and from 0%to 25%,respectively.Conclusion:The most frequent types of ICONB are Studer“U”neobladder,Hautmann“W”neobladder,“Y”neobladder,and the Padua neobladder.Randomized studies comparing the performance of the different types of ICONB,the performance in an intra or extracorporeal manner,or the performance of an ICONB versus ICIC are lacking in the literature.To this day,there are not sufficient quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used ICONB with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images of each technique. | Hugo Otaola-Arca Kulthe Ramesh Seetharam Bhat Vipul R.Patel Marcio Covas Moschovas Marcelo Orvieto | 2021 | Asian Journal of Urology2021，8，1： | 5 |
| 20 | Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease显示文摘AIM: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. METHODS: Sixty (mean age 40.0 ± 8.5 years, 75% male) NAFLD patients were included in the study. After baseline anthropometric measurement i.e., body mass index (BMI), waist circumference (WC); all patients were advised regular aerobic exercise for 30 min/d, for at least 5 d/wk and trained to achieve around 70% of his maximal heart rate. In addition, moderately energy restricted diet was advised to patients with high BMI (> 25 kg/m 2 ). Monthly follow up was done by measuring BMI, WC, aspartate aminotransferase, and alanine aminotransferase (ALT). Insulin resistance was calculated using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) model, at baseline and after 6mo. Insulin resistance was arbitrarily considered altered when it was ≥ 2. Liver biopsy was done in a section of patients at baseline and after 6 mo. RESULTS: Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC > 90 cm in men, > 80 cm in women). In the 45 exercise compliant patients insulin resistance decreased from 6.4 ± 6.1 to 1.3 ± 1.0, BMI from 26.7 ± 3.3 kg/m 2 to 25.0 ± 3.3 kg/m 2 , WC from 95.7 ± 8.9 cm to 90.8 ± 7.3 cm and ALT from 84.8 ± 43.5 U/L to 41.3 ± 18.2 U/L (P < 0.01). In 15 exercise noncompliant patient's insulin resistance, BMI, WC and ALT did not show significant change at 6 mo follow up. Six of 8 patients in compliant group on repeat liver biopsy showed significant change in steatosis and necroinflammation. Nonalcoholic steatohepatitis scores improved form 5.3 ± 1.5 to 3.35 ± 1.5. The decline in insulin resistance correlated with decline in ALT (P = 0.01, r s = 0.90) and liver histology (P = 0.03, r s = 0.73). CONCLUSION: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients. | Ganesh Bhat Chalamalasetty Sreenivasa Baba Amaresh Pandey Neeraj Kumari Gourdas Choudhuri | 2012 | World Journal of Hepatology2012，4，7： | 5 |
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