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| 1 | Risk of cardiovascular,cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease显示文摘Non-alcoholic fatty liver disease(NAFLD)has emerged as a public health problem of epidemic proportions worldwide.Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease(CHD),abnormalities of cardiac function and structure(e.g.,left ventricular dysfunction and hypertrophy,and heart failure),valvular heart disease(e.g.,aortic valve sclerosis)and arrhythmias(e.g.,atrial fibrillation).Experimental evidence suggests that NAFLD itself,especially in its more severe forms,exacerbates systemic/hepatic insulin resistance,causes atherogenic dyslipidemia,and releases a variety of pro-inflammatory,pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications.Collectively,these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications.The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular,cardiac and arrhythmic complications,to briefly examine the putative biological mechanisms underlying this association,and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications. | Stefano Ballestri Amedeo Lonardo Stefano Bonapace Christopher D Byrne Paola Loria Giovanni Targher | 2014 | World Journal of Gastroenterology2014，20，7： | 55 |
| 2 | Contrast-enhanced ultrasound of histologically proven hepatic epithelioid hemangioendothelioma显示文摘AIM: To analyze contrast-enhanced ultrasound(CEUS) features of histologically proven hepatic epithelioid hemangioendothelioma(HEHE) in comparison to other multilocular benign focal liver lesions(FLL).METHODS: Twenty-five patients with histologically proven HEHE and 45 patients with histologically proven multilocular benign FLL were retrospectively reviewed. Four radiologists assessed the CEUS enhancement pattern in consensus.RESULTS: HEHE manifested as a single(n = 3) or multinodular(n = 22) FLL. On CEUS, HEHE showed rim-like(18/25, 72%) or heterogeneous hyperenhancement(7/25, 28%) in the arterial phase and hypoenhancement(25/25, 100%) in the portal venous and late phases(PVLP), a sign of malignancy. Eighteen patients showed central unenhanced areas(18/25, 72%); in seven patients(7/25, 28%), more lesions were detected in the PVLP. In contrast, all patients with hemangioma and focal nodular hyperplasia showed hyperenhancement as the most distinctive feature(P < 0.01).CONCLUSION: CEUS allows for characterization of unequivocal FLL. By analyzing the hypoenhancement in the PVLP, CEUS can determine the malignant nature of HEHE. | Yi Dong Wen-Ping Wang Vito Cantisani Mirko D'Onofrio Andre Ignee Lorenzo Mulazzani Adrian Saftoiu Zeno Sparchez Ioan Sporea Christoph F Dietrich | 2016 | World Journal of Gastroenterology2016，22，19： | 21 |
| 3 | Malignant peritoneal mesothelioma显示文摘Malignant mesothelioma is a highly aggressive neoplasm.The incidence of malignant mesothelioma is increasing worldwide.Diffuse malignant peritoneal mesothelioma(DMPM) represents one-fourth of all mesotheliomas.Association of asbestos exposure with DMPM has been observed,especially in males.The great majority of patients present with abdominal pain and distension,caused by accumulation of tumors and ascitic ? uid.In the past,DMPM was considered a pre-terminal condition;therefore attracted little attention.Patients invariably died from their disease within a year.Recently,several prospective trials have demonstrated a median survival of 40 to 90 mo and 5-year survival of 30% to 60% after combined treatment using cytoreductive surgery and perioperative intraperitoneal chemotherapy.This remarkable improvement in survival has prompted new search into the medical science related to DMPM,a disease previously ignored as uninteresting.This review article focuses on the key advances in the epidemiology,diagnosis,staging,treatments and prognosis of DMPM that have occurred in the past decade. | Stine Munkholm-Larsen Christopher Q Cao Tristan D Yan | 2009 | World Journal of Gastrointestinal Surgery2009，1，1： | 19 |
| 4 | Three-dimensional human facial morphologies as robust aging markers显示文摘老化与许多复杂疾病被联系。变老的过程的可靠预言为估计联系老化的疾病的风险是重要的。然而尽管有强烈研究,到目前为止没有可靠老化标记。这里,我们由检验人的 3D 美容成像特征是否能被用作可靠老化标记处理了这个问题。我们收集了 >300 幅 3D 人美容图象和越过 17 ~ 77 年的年龄散布得好的血侧面。由分析词法侧面,我们产生了变老的人的面部 phenome 的第一张全面地图。我们鉴别量的面部特征例如眼睛斜坡,高度与年龄联系了。我们构造了一个柔韧的年龄预言者并且发现平均,一样的按年代先后的年龄的人由 ± 不同;在美容的 6 年变老,与在年龄 40 以后增加的偏差。用这个预言者,我们识别了被健康指示物的层次显著地支持的慢、快的蒸化机。尽管有在在血的面部词法特征和健康指示物之间的一种靠近的关系,面部特征比血侧面是更可靠的老化 biomarkers 并且能更好比按年代先后的年龄反映一般健康地位。 | Weiyang Chen Wei Qian Gang Wu Weizhong Chen Bo Xian Xingwei Chen Yaqiang Cao Christopher D Green Fanghong Zhao Kun Tang Jing-Dong J Han | 2015 | Cell Research2015，25，5： | 17 |
| 5 | A pharmacological review on intraperitoneal chemotherapy for peritoneal malignancy显示文摘Perioperative intraperitoneal chemotherapy in combination with cytoreductive surgery has been shown to be of benefit for treating selected patients with peritoneal surface malignancy.It has become a new standard of care in the management of diffuse malignant peritoneal mesothelioma and peritoneal dissemination of appendiceal malignancy.Numerous recent publications on carcinomatosis from colorectal cancer and gastric cancer identify groups of patients that would benef it from this local-regional approach for prevention and treatment of carcinomatosis.This review focuses on pharmacological information regarding intraperitoneal chemotherapeutic agents commonly used in gastrointestinal oncology. | Tristan D Yan Christopher Qian Cao Stine Munkholm-Larsen | 2010 | World Journal of Gastrointestinal Oncology2010，2，2： | 14 |
| 6 | 肺栓塞的影像 应用螺旋CT的新观显示文摘肺栓塞是一种生前常被漏诊的疾病。其死亡率取决于诸多因素,未经治疗患者的年死亡率可高达 30%,是应用抗凝药物患者年死亡率(2.5%)的10倍以上。 | David M Hansell Christopher D R Flower 邢军 | 1998 | 英国医学杂志中文版1998，0，1： | 13 |
| 7 | Osteoporosis in primary biliary cholangitis显示文摘Primary biliary cholangitis(PBC) is an autoimmune cholestatic liver disease with multiple debilitating complications. Osteoporosis is a common complication of PBC resulting in frequent fractures and leading to significant morbidity in this population, yet evidence for effective therapy is lacking. We sought to summarize our current understanding of the pathophysiology of osteoporosis in PBC, as well as current and emerging therapies in order to guide future research directions. A complete search with a comprehensive literature review was performed with studies from Pub Med, EMBASE, Web of Science, Cochrane database, and the Countway Library. Osteoporosis in PBC is driven primarily by decreased bone formation, which differs from the increased bone resorption seen in postmenopausal osteoporosis. Despite this fundamental difference, current treatment recommendations are based primarily on experience with postmenopausal osteoporosis. Trials specific to PBC-related osteoporosis are small and have not consistently demonstrated a benefit in this population. As it stands, prevention of osteoporosis in PBC relies on the mitigation of risk factors such as smoking and alcohol use, as well as encouraging a healthy diet and weight-bearing exercise. The primary medical intervention for the treatment of osteoporosis in PBC remains bisphosphonates though a benefit in terms of fracture reduction has never been shown. This review outlines what is known regarding the pathogenesis of bone disease in PBC and summarizes current and emerging therapies. | Christopher J Danford Hirsh D Trivedi Konstantinos Papamichael Elliot B Tapper Alan Bonder | 2018 | World Journal of Gastroenterology2018，24，31： | 13 |
| 8 | 肿瘤坏死因子及其受体在鼠失血性休克引起的急性肺损伤中的作用显示文摘目的 探讨失血性休克引起的急性肺损伤与肿瘤坏死因子 α(TNF α)在肺组织表达的相关性。方法 通过心腔穿刺对C5 7小鼠采取 30 %全血容量复制失血性休克模型。肺组织TNF α表达采用酶联免疫吸附法方法进行测定。肺组织中性粒细胞 (PMN)浸润采用数字荧光显微镜免疫荧光技术进行检测。肺微血管通透性 (肺水肿 )采用伊文氏蓝方法进行测定。结果 ( 1)虽然失血性休克仅引起肺组织TNF α水平轻度和短暂的升高 ,且肺组织中性粒细胞 (PMN)浸润时相上早于TNF α水平的升高。但在TNF基因剔除 (KO)小鼠 ,失血性休克引起的肺组织PMN浸润和肺损伤明显轻于C5 7野生型小鼠 ;( 2 )给予失血前TNFKO小鼠低水平的重组TNF α即可导致失血性休克引起肺组织PMN浸润和急性肺损伤 ;( 3)失血性休克引起的肺组织PMN浸润和急性肺损伤在p5 5TNF受体KO动物显著减轻 ,而在p75TNFKO动物则不产生影响。结论 肺组织低水平TNF α足以介导失血性休克引起的PMN浸润和急性肺损伤 ;p5 5TNF受体在失血性休克引起的肺部急性炎症反应中起主导作用。 | 宋勇 施毅 Alden H Harken Xianzhong Meng Christopher D Raeburn | 2003 | 中华医学杂志2003，83，8： | 12 |
| 9 | Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome显示文摘BackgroundThere 是在质子泵禁止者(PPI ) 和 clopidogrel 之间的可能的不利相互作用上的大争论。另外, PPI 的使用是否少些影响 ticagrelor 遗体的临床的功效,知道。在经皮的冠的干预(一种总线标准) .MethodsWe 回顾地从 “ 分析了数据以后,我们试图与急性冠的症候群(交流)在病人在临床的结果上决定 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响;真实 world” ;,国际,在 2003 和 2014 之间的多中心登记( n = 15,401 )并且在1年的合成主要端点上估计了 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响(所有原因死亡收到 PPI 的病人更老,更经常女性,并且是更可能的有 comorbidities。没有协会为收到 clopidogrel 的病人在 PPI 使用和主要端点之间被观察(调整 HR:1.036;95% CI:0.903-1.189 ) 或 ticagrelor (调整 HR:2.320;95% CI:0.875-6.151 )(P 相互作用 = 0.2004 ) 。同样, PPI 的使用没与所有原因死亡,重新梗塞,或与交流后面的一种总线标准的为与任何一个 clopidogrel 对待的病人或 ticagrelor.ConclusionsIn 病人的严重流血的减少的风险的增加的风险被联系, PPI 的伴随物使用没在收到 clopidogrel 或 ticagrelor 的病人与不利结果的增加的风险被联系。我们的调查结果显示与 clopidogrel 或 ticagrelor 在联合使用 PPI 是合理的,特别在有胃肠的流血的更高的风险的病人。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev | 2016 | Journal of Geriatric Cardiology2016，13，3： | 12 |
| 10 | 联合应用氯吡格雷和质子泵抑制剂对急性冠状动脉综合征患者经皮冠状动脉介入术后预后的影响显示文摘目的探讨联合应用氯吡格雷和质子泵抑制剂(PPI)对急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后预后的影响。方法回顾性分析2003年至2014年来自10个国家(加拿大,巴西,德国,波兰,荷兰,西班牙,意大利,希腊,中国,日本)15个临床中心的ACS合并PCI术后18077例患者的临床资料。研究氯吡格雷、PPI与ACS患者PCI术后预后的关系。比较患者的基本临床特征、既往病史、生化指标、药物应用,以及终点事件的发生率情况。通过Cox回归模型进行分析及倾向性评分调整其他可能影响患者的预后因素包括人口学信息(年龄、性别)和临床指标,计算PPI这一干预因素的风险比并评价其是否能够明显影响患者的预后。结果基于国际多中心Blee MACs注册登记研究分析,排除关键数据缺失过多患者2676例。根据纳入与排除标准及倾向性评分调整整理后,再排除患者6461例,最终列队患者8940例。根据患者用药不同,将患者分为氯吡格雷+PPI组(4814例)和氯吡格雷组(4126例)。氯吡格雷+PPI组患者女性、高血压病史、高脂血症病史、糖尿病史、外周血管疾病史、既往急性心肌梗死史、慢性肾功能不全病史、消化道溃疡病史、冠状动脉旁路移植术病史、既往出血病史、恶性肿瘤病史、不稳定型心绞痛、非sT段抬高型心肌梗死、心功能Killip分级≥2级、经皮腔内冠状动脉成形术、出院后血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂应用比例、年龄和入院时血肌酐水平明显高于氯吡格雷组[25.4%(1225/4814)比21.0%(865/4126)、59.9%(2882/4814)比49.2%(2032/4126)、48.3%(2327/4814)比42.7%(1762/4126)、26.4%(1272/4814)比22.1%(910/4126)、8.0%(386/4814)比5.6%(231/4126)、12.3%(593/4814)比10.6%(436/4126)、2.0%(98/4814)比0.7%(30/4126)、2.3%(112/4814)比1.0%(42/4126)、3.6%(172/4814)比2.2%(92/4126)、4.5%(219/4814)比3.0%(123/4126)、8.0%(387/4814)比4.7%(193/4126)、13.4%(644/4814)比9.1%(374/4126)、29.1%(1400/4814)比15.9%(656/4126)、14.5%(699/4814)比11.2%(462/4126)、56.0%(2697/4814)比55.7%(2300/4126)、75.5%(3633/4814)比68.6%(2829/4126)、(66±12)岁比(61±13)岁、(10±6)mg/L比(9±4)mg/L];且入院时血红蛋白水平和出院后β受体阻滞剂应用比例明显低于氯吡格雷组[(138±19)g/L比(141±16)g/L、80.6%(3880/4814)比83.1%(3428/4126)],差异均有统计学意义(均P〈0.05)。调整前,氯吡格雷+PPI组主要终点事件(全因死亡/再发心肌梗死/出血)发生率明显高于氯吡格雷组,差异有统计学意义(风险比为1.331,95%置信区间为1.161-1.524)。调整后,氯吡格雷+PPI组主要终点事件(全因死亡/再发心肌梗死/出血)发生率与氯吡格雷组比较,差异无统计学意义(风险比为1.036,95%置信区间为0.903-1.189)。结论ACS患者PCI术后联合应用PPI与氯吡格雷是合理的,尤其在胃肠道出血高危患者中。 | 严研 王晓 范婧尧 聂绍平 Sergio Raposeiras-Roubin Emad Abu-Assi Jose Paulo Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose Ramon Gonzalez-Juanatey Stephen B. Wilton Wouter J. Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Testuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis Claudio Correia Masa-aki Kawashiri Sasko Kedev | 2017 | 中国医药2017，12，2： | 10 |
| 11 | Establishing proof of concept:Platelet-rich plasma and bone marrow aspirate concentrate may improve cartilage repair following surgical treatment for osteochondral lesions of the talus显示文摘Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus. | Niall A Smyth Christopher D Murawski Amgad M Haleem Charles P Hannon Ian Savage-Elliott John G Kennedy | 2012 | World Journal of Orthopedics2012，3，7： | 8 |
| 12 | Vanishing bile duct syndrome in human immunodeficiency virus infected adults:A report of two cases显示文摘Vanishing bile duct syndrome(VBDS) is a group of rare disorders characterized by ductopenia,the progressive destruction and disappearance of intrahepatic bile ducts leading to cholestasis.Described in association with medications,autoimmune disorders,cancer,transplantation,and infections,the specific mechanisms of disease are not known.To date,only 4 cases of VBDS have been reported in human immunodeficiency virus(HIV) infected patients.We report 2 additional cases of HIV-associated VBDS and review the features common to the HIV-associated cases.Presentation includes hyperbilirubinemia,normal liver imaging,and negative viral and autoimmune hepatitis studies.In HIV-infected subjects,VBDS occurred at a range of CD4+ T-cell counts,in some cases following initiation or change in antiretroviral therapy.Lymphoma was associated with two cases;nevirapine,antibiotics,and viral co-infection were suggested as etiologies in the other cases.In HIV-positive patients with progressive cholestasis,early identification of VBDS and referral for transplantation may improve outcomes. | Ana Paula Oppenheimer Christopher Koh Mary McLaughlin John C Williamson Thomas D Norton Jennifer Laudadio Theo Heller David E Kleiner Kevin P High Caryn G Morse | 2013 | World Journal of Gastroenterology2013，19，1： | 8 |
| 13 | 急性冠状动脉综合征患者经皮冠状动脉介入术后出血情况分析显示文摘目的分析急性冠状动脉综合征(ACS)经皮冠状动脉介入(PCI)术后出血情况。方法回顾性分析2003年1月至2014年12月来自11个国家16个临床中心的18077例行PCI的ACS患者的临床资料。根据是否出现出血事件,将患者分为出血组(558例)和非出血组(17519例),比较2组患者的基本临床特征、手术情况及生化指标。分析ACS患者PCI术后出血相关情况。结果马其顿中心数据因关键变量缺失过多而被排除患者2676例,故最终纳入10个国家15个中心15401例ACS患者。排除缺失数据,本研究共有12910例患者收集到出血部位的数据,409例患者存在出血事件。胃肠道是最常见出血部位,占48.7%(199/409),颅内出血占7.6%(31/409)。Logistic逐步回归方法多因素分析显示,既往出血病史、高血压病史是术后1年内消化道出血的危险因素。排除马其顿中心数据(2676例)与Cox回归模型和倾向性评分调整再排除5972例,剩余9429例作分层分析。根据是否联用质子泵抑制剂(PPI),将出院应用氯吡格雷生存患者8942例分为氯吡格雷联合应用PPI组(4814例)和氯吡格雷未联合应用PPI组(4126例);将出院应用替格瑞洛生存患者489例分为替格瑞洛联合应用PPI组(351例)和替格瑞洛未联合应用PPI组(138例)。Kaplan-Meier法分析显示氯吡格雷联合应用PPI组1年出血事件发生率明显高于氯吡格雷未联合应用PPI组,差异有统计学意义(P=0.004);替格瑞洛联合应用PPI组1年出血事件发生率与替格瑞洛未联合应用PPI组比较,差异无统计学意义(P=0.573)。结论ACS患者PCI术后最常见的出血部位为消化道,PPI与替格瑞洛联合应用在胃肠道出血风险较高患者中适用。 | 严研 王晓 范婧尧 聂绍平 宋现涛 Sergio Raposeiras-Roubin Emad Abu-Assi Jose Paulo Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose Ramon Gonza1ez-Juanatey Stephen B. Wilton Ivan Nufiez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Testuma Kawaji Zenon Huczek Toshiharu Fujii Luis Claudio Correia Masa-aki Kawashiri Sasko Kedev | 2017 | 中国医药2017，12，6： | 8 |
| 14 | Preassembly and ligand-induced restructuring of the chains of the IFN-γ receptor complex: the roles of Jak kinases, Statl and the receptor chains显示文摘 | Christopher D Krause Natasha Lavnikova Junxia Xie Erwen Mei Olga V Mirochnitchenko Yiwei Jia Robin M Hochstrasser Sidney Pestka | 2006 | Cell Research2006，16，1： | 7 |
| 15 | Obstructive sleep apnea syndrome and fatty liver: Association or causal link?显示文摘Obstructive sleep apnea (OSA) is a complex disorder that consists of upper airway obstruction, chronic intermittent hypoxia and sleep fragmentation. OSA is well known to be associated with hypoxia, insulin resistance and glucose intolerance, and these factors can occur in the presence or absence of obesity and metabolic syndrome. Although it is well established that insulin resistance, glucose intolerance and obesity occur frequently with non-alcoholic fatty liver disease (NAFLD), it is now becoming apparent that hypoxia might also be important in the development of NAFLD, and it is recognized that there is increased risk of NAFLD with OSA. This review discusses the association between OSA, NAFLD and cardiovascular disease, and describes the potential role of hypoxia in the development of NAFLD with OSA. | Mohamed H Ahmed Christopher D Byrne | 2010 | World Journal of Gastroenterology2010，16，34： | 7 |
| 16 | Selecting suitable solid organ transplant donors: Reducing the risk of donor-transmitted infections显示文摘Selection of the appropriate donor is essential to a successful allograft recipient outcome for solid organ transplantation. Multiple infectious diseases have been transmitted from the donor to the recipient via transplantation. Donor-transmitted infections cause increased morbidity and mortality to the recipient. In recent years, a series of high-profile transmissions of infections have occurred in organ recipients prompt-ing increased attention on the process of improving the selection of an appropriate donor that balances the shortage of needed allografts with an approach that mitigates the risk of donor-transmitted infection to the recipient. Important advances focused on improving donor screening diagnostics, using previously excluded high-risk donors, and individualizing the selection of allografts to recipients based on their prior infection history are serving to increase the donor pool and improve outcomes after transplant. This article serves to review the relevant literature surrounding this topic and to provide a suggested approach to the selection of an appropriate solid organ transplant donor. | Christopher S Kovacs Jr Christine E Koval David van Duin Amanda Guedes de Morais Blanca E Gonzalez Robin K Avery Steven D Mawhorter Kyle D Brizendine Eric D Cober Cyndee Miranda Rabin K Shrestha Lucileia Teixeira Sherif B Mossad | 2014 | World Journal of Transplantation2014，4，2： | 7 |
| 17 | Evaluation of Doppler-ultrasonography in the diagnosis of transjugular intrahepatic portosystemic shunt dysfunction: A prospective study显示文摘AIM To prospectively evaluate the performance of Dopplerultrasonography(US) for the detection of transjugular intrahepatic portosystemic shunt(TIPS) dysfunction within a multicenter cohort of cirrhotic patients.METHODS This study was conducted in 10 french teaching hospitals. After TIPS insertion, angiography and liver Doppler-US were carried out every six months to detect dysfunction(defined by a portosystemic gradient ≥ 12 mm Hg and/or a stent stenosis ≥ 50%). The association between ultrasonographic signs and dysfunction was studied by logistic random-effects models, and the diagnostic performance of each Doppler criterion was estimated by the bootstrap method. This study was approved by the ethics committee of Tours.RESULTS Two hundred and eighteen pairs of examinations performed on 87 cirrhotic patients were analyzed. Variables significantly associated with dysfunction were: The speed of flow in the portal vein(P = 0.008), the reversal of flow in the right(P = 0.038) and left(P = 0.049) portal branch, the loss of modulation of portal flow by the right atrium(P = 0.0005), ascites(P = 0.001) and the overall impression of the operator(P = 0.0001). The diagnostic performances of these variables were low; sensitivity was < 58% and negative predictive value was < 73%. Therefore, dysfunction cannot be ruled out from Doppler-US. CONCLUSION The performance of Doppler-US for the detection of TIPS dysfunction is poor compared to angiography. New tools are needed to improve diagnosis of TIPS dysfunction. | Charlotte Nicolas Amelie Le Gouge Louis d’Alteroche Jean Ayoub Monica Georgescu Vincent Vidal Denis Castaing Jean-Pierre Cercueil Patrick Chevallier Jerome Roumy Herve Trillaud Louis Boyer Vincent Le Pennec Christophe Perret Bruno Giraudeau Jean-Marc Perarnau STIC-TIPS group | 2017 | World Journal of Hepatology2017，9，27： | 6 |
| 18 | Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention显示文摘Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction(NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention(PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed. | Richard A Brogan Christopher J Malkin Philip D Batin Alexander D Simms James M McLenachan Christopher P Gale | 2014 | World Journal of Cardiology2014，6，8： | 6 |
| 19 | P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析显示文摘目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂(PPI)治疗对经皮冠状动脉介入(PCI)术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究,纳入2003至2014年因急性冠脉综合征人院行PCI术的患者,分为PPI组及非PPI组并随访1年,主要临床终点为全因死亡/再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类,将入组患者分为氯吡格雷组及替格瑞洛组,并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者,PPI组占54.8%,具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡/再发心肌梗死复合事件的发生差异无统计学意义(HR1.00,95%CI 0.86—1.18)。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组,不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异,联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险,尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。 | 冯斯婷 严妍 范婧尧 王晓 郑文 聂绍平 Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev | 2016 | 中华医学杂志2016，96，33： | 6 |
| 20 | Impact of triple antithrombotic therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention in real-world practice显示文摘为在急性冠的症候群(交流) 和经皮的冠的干预(一种总线标准) 以后的口头的 anticoagulation (OAC ) 上的病人的 ObjectiveThe 最佳的 antithrombotic 政体仍然保持辩论。寻求回顾地在真实世界的 setting.MethodsWe 评估 OAC 正 clopidogrel 的功效和安全与或没有阿司匹林的这研究分析了数据从一国际,在 2003 和 2014 之间的多中心登记(n = 15,401 ) 。有在一种总线标准以后的交流和收到的 OAC 的病人被屏蔽。合成主要端点是 1 年的所有原因死亡,重新梗塞,或分析注册了 642 个病人包括的严重 bleeding.ResultsThe 期末考试有 OAC 和 clopidogrel (双治疗) 的 62 个病人(9.7%) ,和有阿司匹林, OAC 和 clopidogrel (三倍的治疗) 的联合的 580 个病人(90.3%) 。三倍的治疗上的病人更经常是女性的并且是更可能的有 comorbidities。关于在与三倍的治疗病人一起的双治疗之间的主要结束点没有重要差别[17.74% 对 17.24% ;unadjusted 危险比率(HR ) :1.035;95% 信心间隔(CI ) :0.556-1.929;调整 HR:1.026;95% CI:0.544-1.937 ] 。然而,重新梗塞率比三倍的治疗病人在双治疗是显著地更高的(14.52% 对 5.34% ;unadjusted HR:2.807;95% CI:1.329-5.928;调整 HR:2.333;95% CI:1.078-5.047 ) 。另外,在所有原因死亡和严重 bleeding.ConclusionsIn 的二政体之间没有差别有交流后面的一种总线标准并且与 OAC 的一个指示的真实病人,三倍的治疗没与双治疗相比与不利结果的增加的率被联系。而且,它减少了重新梗塞冒险并且没增加严重流血的风险。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE SerGio Raooseiras-Roubin Emad Abu-Assi Jose P Simao Henriques: Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzalez-Juanate Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Morettil Zenon Huczek Toshiharu Fujii Luis cL Correia Masa-aki Kawashiri Sasko Kedev | 2017 | Journal of Geriatric Cardiology2017，14，11： | 6 |
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