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1瑞舒伐他汀对存在亚临床动脉粥样硬化的低危人群颈动脉内膜中层厚度进展的影响——METEOR试验显示文摘背景:动脉粥样硬化往往在机体出现症状之前就已有所进展。目前,我们尚不清楚Framingham风险评分(Framinghaln risk score,FRS)较低的轻中度亚临床动脉粥样硬化中年人群是否能从治疗中获益。 目的:评价为期2年的他汀类药物治疗能否减缓颈动脉内膜中层厚度(carotid intimamedia thickness,CIMT)继续增厚或使粥样斑块消退。 设计、地点及参试者:“瑞舒伐他汀对内膜中层厚度影响的测评研究(Measuring Effects on Intima-Media Thickness:an Evaluation of Rosuvastatin,METEOR)”是2002年8月至2006年5月在美国及欧洲61个基层医疗中心开展的一项随机、双盲、安慰剂对照研究,共纳入984名参试者,有的参试者仅以年龄(平均年龄,57岁)为冠心病的危险因素,有的参试者10年内FRS低于10%、CIMT重庞增厚(1.2~3.5mm)、LDL胆固醇水平有所升高(平均值,154mg/dL)。 干预:参试者服用40mg瑞舒伐他汀或安慰剂。 主要观测指标:12个颈动脉位点最大CIMT的变化率(经B超检测);颈总动脉位点、颈动脉窦位点及颈内动脉位点最大CIMT的变化,颈总动脉位点平均CIMT的变化。仅在瑞舒伐他汀组中评估CIMT的消退情况。 结果:瑞舒伐他汀组参试者LDL胆固醇平均(SD)水平由基线时的155(24.1)mg/dL降至78(27.5)mg/dL,平均降低49%(与安慰剂组相比P〈0.001)。瑞舒伐他汀组12个颈动脉位点最大CIMT的变化值为-0.0014(95%CI,-0.0041~0.0014)mm/y,安慰剂组12个颈动脉位点最大CIMT的变化值为Q0131(95%CI,Q0087~Q0174)mm/y(P〈0.001)。瑞舒伐他汀组颈总动脉位点最大CIMT的变化值为-0.0038(95%CI,-0.0064~-0.0013)mm/y(P〈0.001),颈动脉窦位点最大CIMT的变化值为-0.0040(95%CI,-0.0090~0.0010)mm/y(P〈0.001),颈内动脉位点最大CIMT的变化值为0.0039(95%CI,-0.0009~0.0088)mm/y(P=0.02)。瑞舒伐他汀组颈总动脉位点平均CIMT的变化值为0.0004(95%CI,-0.0011~0.0019)mm/y(P〈0.001)。P值均为与安慰剂组相比。总的来说,瑞舒伐他汀具有良好的耐受性,很少引发严重的心血管不良事件(在2年内有6名参试者[0.86%]出现8起不良事件[1.1%])。 结论:对于FRS低于10%的亚临床动脉粥样硬化中年人群而言,瑞舒伐他汀能够在2年内显著降低最大CIMT的进展速率,与安慰剂相比差异具有统计学显著性。但是,瑞舒伐他汀无法诱导病变消退。今后,我们仍需开展大型远期试验来明确上述研究结果的临床意义.John R. Crouse Ⅲ Joel S. Raichlen Ward A. Riley Gregory W. Evans Mike K. Palmer Daniel H. O' Leary Diederick E. Grobbee Michiel L. Bots 李军(译) 2007美国医学会杂志(中文版)2007,26,4:44
2基于国内外比较的我国遗体捐献工作的问题及对策解析显示文摘遗体(器官)捐献对个人而言是高尚人格的体现,对社会来说是促进医疗卫生事业不断进步的保障。中国有着世界上最为丰富的人口资源,但遗体捐献受多种因素制约发展不甚理想。本文对遗体(器官)捐献的社会意义,国内外的遗体(器官)捐献现状,影响我国遗体(器官)捐献事业发展的主要障碍,国外遗体(器官)捐献工作的成功经验,改善我国遗体(器官)捐献现状的对策等方面进行调查和分析,呼吁广大人民群众积极支持遗体捐献,相关部门不断完善遗体(器官)捐献体系,全社会共同努力促进遗体(器官)捐献事业健康发展。陈旦 李建平 黄菊芳 Daniel O Graney 潘爱华 2014中国临床解剖学杂志2014,32,5:34
3Hepatic steatosis is associated with an increased risk of carotid atherosclerosis显示文摘AIM: Although an association between helatic steatosis and vascular risk factors has been described, direct relationships between fatty liver and atherosclerosis have not yet been investigated. The aim of the present study has been to investigate those relationships.METHODS: The Study of Health in Pomerania examined a random population sample aged between 20 and 79 years.A study population of 4 222 subjects without hepatitis B and C infections and without liver cirrhosis was available for the present analysis. Hepatic steatosis was defined sonographically and intima-media thickness (IMT) as well as plaque prevalence were estimated by carotid ultrasound.RESULTS: The prevalence rate of hepatic steatosis was 29.9%. Among subjects aged ≥45 years, an association between hepatic steatosis and IMT of the carotid arteries was found in bivariate analysis, but not after adjustment for atherosclerotic risk factors. Individuals with fatty liver had more often carotid plaques than persons without fatty liver (plaque prevalence rate 76.8% vs 66.6%; P<0.001).This association persisted after adjustment for confounding factors and was predominantly present in subjects with no to mild alcohol consumption.CONCLUSION: There is an independent association between hepatic steatosis and carotid atherosclerotic plaques. Metabolic changes due to nonalcoholic fatty liver disease may explain this relationship.Henry V(o|¨)lzke Daniel M.Robinson Volker Kleine Roland Deutscher Wolfgang Hoffmann Jan Lüdemann Ulf Schminke Christof Kessler Ulrich John 2005World Journal of Gastroenterology2005,11,12:29
4Promoter hypermethylation of CDH1, FHIT, MTAP and PLAGL1 in gastric adenocarcinoma in individuals from Northern Brazil显示文摘AIM: To evaluate the methylation status of CDH1, FHIT, MTAP and PLAGL1 promoters and the association of these findings with clinico-pathological characteristics. METHODS: Methylation-specific PCR (MSP) assay was performed in 13 nonneoplastic gastric adenocarcinoma, 30 intestinal-type gastric adenocarcinoma and 35 diffuse- type gastric adenocarcinoma samples from individuals in Northern Brazil. Statistical analyses were performed using the chi-square or Fisher’s exact test to assess associations between methylation status and clinico- pathological characteristics. RESULTS: Hypermethylation frequencies of CDH1, FHIT, MTAP and PLAGL1 promoter were 98.7%, 53.9%, 23.1% and 29.5%, respectively. Hypermethylation of three or four genes revealed a significant association with diffuse-type gastric cancer compared with nonneoplastic cancer. A higher hypermethylation frequency wassignificantly associated with H pylori infection in gastric cancers, especially with diffuse-type. Cancer samples without lymph node metastasis showed a higher FHIT hypermethylation frequency. MTAP hypermethylation was associated with H pylori in gastric cancer samples, as well as with diffuse-type compared with intestinal-type. In diffuse-type, MTAP hypermethylation was associated with female gender. CONCLUSION: Our findings show differential gene methylation in tumoral tissue, which allows us to conclude that hypermethylation is associated with gastric carcinogenesis. MTAP promoter hypermethylation can be characterized as a marker of diffuse-type gastric cancer, especially in women and may help in diagnosis, prognosis and therapies. The H pylori infectious agent was present in 44.9% of the samples. This infection may be correlated with the carcinogenic process through the gene promoter hypermethylation, especially the MTAP promoter in diffuse-type. A higher H pylori infection in diffuse-type may be due to greater genetic predisposition.Mariana Ferreira Leal Eleonidas Moura Lima Patrícia Natália Oliveira Silva Paulo Pimentel Assumpo Danielle Queiroz Calcagno Spencer Luiz Marques Payo Rommel Rodríguez Burbano Marília de Arruda Cardoso Smith 2007World Journal of Gastroenterology2007,13,18:24
5Fatty liver disease in severe obese patients:Diagnostic value of abdominal ultrasound显示文摘AIM:To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive series of obese patients, who underwent bariatric surgery from October 2004 to May 2005, was selected. Ultrasonography was performed in all patients as part of routine preoperative time and an intraoperative wedge biopsy was obtained at the beginning of the bariatric surgery. The US and histological findings of steatosis were compared, considering histology as the gold standard. RESULTS: The study included 105 patients. The mean age was 37.2 ± 10.6 years and 75.2% were female. The histological prevalence of steatosis was 89.5%. The sensitivity and specificity of US in the diagnosis of hepatic steatosis were, respectively, 64.9% (95% CI: 54.9-74.3) and 90.9% (95% CI: 57.1-99.5). The positive predictive value and negative predictive value were, respectively, 98.4% (95% CI: 90.2-99.9) and 23.3% (95% CI: 12.3-39.0). The presence of steatosis onUS was associated to advanced grades of steatosis on histology (P = 0.016). CONCLUSION: Preoperative abdominal US in our series has not shown to be an accurate method for the diagnosis of hepatic steatosis in severe obese patients. Until another non-invasive method demonstrates better sensitivity and specificity values, histological evaluation may be recommended to these patients undergoing bariatric surgery.Alessandro de Moura Almeida Helma Pinchemel Cotrim Daniel Batista Valente Barbosa Luciana Gordilho Matteoni de Athayde Adimeia Souza Santos Almir Galvo Vieira Bitencourt Luiz Antonio Rodrigues de Freitas Adriano Rios Erivaldo Alves 2008World Journal of Gastroenterology2008,14,9:10
6MYC and gastric adenocarcinoma carcinogenesis显示文摘MYC is an oncogene involved in cell cycle regulation,cell growth arrest,cell adhesion,metabolism,ribosome biogenesis,protein synthesis,and mitochondrial function. It has been described as a key element of several carcinogenesis processes in humans. Many studies have shown an association between MYC deregulation and gastric cancer. MYC deregulation is also seen in gastric preneoplastic lesions and thus it may have a role in early gastric carcinogenesis. Several studies have suggested that amplification is the main mechanism of MYC deregulation in gastric cancer. In the present review,we focus on the deregulation of the MYC oncogene in gastric adenocarcinoma carcinogenesis,including its association with Helicobacter pylori (H pylori) and clinical applications.Danielle Queiroz Calcagno Mariana Ferreira Leal Paulo Pimentel Assumpo Marília de Arruda Cardoso Smith Rommel Rodríguez Burbano 2008World Journal of Gastroenterology2008,14,39:8
7Anti-tumour necrosis factor agent and liver injury:literature review,recommendations for management显示文摘Abnormalities in liver function tests,including transient and self-limiting hypertransaminasemia,cholestatic disease and hepatitis,can develop during treatment with anti-tumour-necrosis-factor(TNF)therapy.The optimal management of liver injury related to antiTNF therapy is still a matter of debate.Although some authors recommend discontinuing treatment in case of both a rise of alanine aminotransferase more than5 times the upper limit of normal,or the occurrence of jaundice,there are no standard guidelines for the management of anti-TNF-related liver injury.Bibliographical searches were performed in Pub Med,using the following key words:inflammatory bowel disease(IBD);TNF inhibitors;hypertransaminasemia;drugrelated liver injury;infliximab.According to published data,elevation of transaminases in patients with IBD treated with anti-TNF is a common finding,but resolution appears to be the usual outcome.Anti-TNF agents seem to be safe with a low risk of causing severe drugrelated liver injury.According to our centre experience,we found that hypertransaminasemia was a common,mainly self-limiting finding in our IBD cohort and was not correlated to infliximab treatment on both univariate and multivariate analyses.An algorithm for the management of liver impairment occurring during antiTNF treatment is also proposed and this highlights the need of a multidisciplinary approach and suggests liver biopsy as a key-point in the management decision in case of severe rise of transaminases.However,hepatic injury is generally self-limiting and drug withdrawal seems to be an exception.Roberta Elisa Rossi Ioanna Parisi Edward John Despott Andrew Kenneth Burroughs James O'Beirne Dario Conte Mark Ian Hamilton Charles Daniel Murray 2014World Journal of Gastroenterology2014,20,46:7
8Clinical implication of 14-3-3 epsilon expression in gastric cancer显示文摘AIM:To evaluate for the first time the protein and mRNA expression of 14-3-3εin gastric carcinogenesis.METHODS:14-3-3εprotein expression was determined by western blotting,and mRNA expression was examined by real-time quantitative RT-PCR in gastric tumors and their matched non-neoplastic gastric tissue samples.RESULTS:Authors observed a significant reduction of 14-3-3εprotein expression in gastric cancer(GC)samples compared to their matched non-neoplastic tissue.Reduced levels of 14-3-3εwere also associated with diffuse-type GC and early-onset of this pathology.Our data suggest that reduced 14-3-3εmay have a role in gastric carcinogenesis process.CONCLUSION:Our results reveal that the reduced 14-3-3εexpression in GC and investigation of 14-3-3ε interaction partners may help to elucidate the carcino-genesis process.Mariana Ferreira Leal Danielle Queiroz Calcagno Smia Demachki Paulo Pimentel Assumpo Roger Chammas Rommel Rodríguez Burbano Marília de Arruda Cardoso Smith 2012World Journal of Gastroenterology2012,18,13:6
9pRB expression in esophageal mucosa of individuals at high risk for squamous cell carcinoma of the esophagus显示文摘AIM: To investigate the pRb expression in a large group of patients with history of chronic exposure to the main risk factors for development of squamous cell carcinoma of the esophagus. METHODS: One hundred and seventy asymptomatic individuals at high risk for esophageal squamous cell carcinoma (consumption of more than 80 g of ethanol and 10 cigarettes/d for at least 10 years) underwent upper gastrointestinal endoscopy with biopsies of the esophageal mucosa. As a control group, specimens of esophageal mucosa obtained from 20 healthy subjects were also studied. Immunohistochemical assessment of the tissues was performed using a monoclonal antibody anti-pRB protein. RESULTS: Absence of the pRB staining, indicating loss of RB function, was observed in 33 (19.4%) of the individuals at risk for esophageal cancer, but in none of the healthy controls (P < 0.02). Loss of pRb expression increased in a stepwise fashion according to the severity of the histological findings (P < 0.005): normal mucosa (11/97 or 11.3%), chronic esophagitis (17/60 or 28.3%), low-grade dysplasia (3/10 or 30%), high-grade dysplasia 1/2 or 50%) and squamous cell carcinoma (1/1 or 100%). CONCLUSION: Our findings suggest that abnormal expression of the pRB protein may be implicated in the process of esophageal carcinogenesis. Additional studies are warranted to define the role of the pRBprotein as a biomarker for development of esophageal squamous cell carcinoma in individuals at high risk for this malignancy.Simone S Contu Paulo C Contu Daniel C Damin Renato B Fagundes Fabiano Bevilacqua Aline S Rosa Joo C Prolla Luis F Moreira 2007World Journal of Gastroenterology2007,13,11:5
10Metabolic syndrome and colorectal neoplasms:An ominous association显示文摘AIM:To evaluate the association of metabolic syndrome(MS) and colorectal cancer and adenomas in a Western country,where the incidence of MS is over 27%.METHODS:This was a prospective study between March 2013 and March 2014.MS was diagnosed according to the National Cholesterol Education ProgramATP III.Demographic characteristics,anthropometric measurements,metabolic risk factors,and colonoscopic pathologic findings were assessed in patients with MS(group 1) who underwent routine colonoscopy at our department.This data was compared with consecutive patients without metabolic syndrome(group 2),with no differences regarding sex and age.Patients with incomplete colonoscopy,family history,or past history of colorectal neoplasm were excluded.Informed consent was obtained and the ethics committee approved this study.Statistical analysis was performed using Student's t-test and χ2 test,with a P value ≤ 0.05 being considered statistically significant.RESULTS:Of 258 patients,129 had MS;51% males;mean-age 67.1 years(50-87).Among the MS group,94% had high blood pressure,91% had increased waist circumference,60% had diabetes,55% had low high-density lipoprotein cholesterol level,50% had increased triglyceride level,and 54% were obese [body mass index(BMI) 30 kg/m2].51% presented 4 criteria of MS.MS was associated with increased prevalence of adenomas(43% vs 25%,P = 0.004) and colorectal cancer(13% vs 5%,P = 0.027),compared with patients without MS.MS was also positively associated with multiple(≥ 3) adenomas(35% vs 9%,P = 0.024) and sessile adenomas(69% vs 53%,P = 0.05).No difference existed between location(P = 0.086),grade of dysplasia(P = 0.196),or size(P= 0.841) of adenomas.In addition,no difference was found between BMI(P = 0.078),smoking(P = 0.146),alcohol consumption(P = 0.231),and the presence of adenomas.CONCLUSION:MS is positively associated with adenomas and colorectal cancer.However,there is not enough information in western European countries to justify screening in patients with MS.To our knowledge,no previous study has evaluated this association in Portuguese patients.Daniel Trabulo Suzane Ribeiro Cláudio Martins Cristina Teixeira Cláudia Cardoso Jo?o Mangualde Ricardo Freire élia Gamito Ana L Alves Fátima Augusto Ana P Oliveira Isabelle Cremers 2015World Journal of Gastroenterology2015,21,17:5
11Feasibility study of computed vs measured high b-value(1400 s/mm2) diffusion-weighted MR images of the prostate显示文摘AIM: To evaluate the impact of computed b = 1400 s/mm2(C-b1400) vs measured b = 1400 s/mm2(M-b1400) diffusion-weighted images(DWI) on lesion detection rate, image quality and quality of lesion demarcation using a modern 3T-MR system based on a small-field-of-view sequence(sFOV). METHODS: Thirty patients(PSA: 9.5 ± 8.7 ng/mL; 68 ± 12 years) referred for magnetic resonance imaging(MRI) of the prostate were enrolled in this study. All measurements were performed on a 3T MR system.For DWI, a single-shot EPI diffusion sequence(b = 0, 100, 400, 800 s/mm2) was utilized. C-b1400 was cal-culated voxelwise from the ADC and diffusion images. Additionally, M-b1400 was acquired for evaluation and comparison. Lesion detection rate and maximum lesion diameters were obtained and compared. Image quality and quality of lesion demarcation were rated accord-ing to a 5-point Likert-type scale. Ratios of lesion-to-bladder as well as prostate-to-bladder signal intensity(SI) were calculated to estimate the signal-to-noise-ratio(SNR). RESULTS: Twenty-four lesions were detected on M-b1400 images and compared to C-b1400 images. C-b1400 detected three additional cancer suspicious lesions. Overall image quality was rated significantly better and SI ratios were significantly higher on C-b1400(2.3 ± 0.8 vs 3.1 ± 1.0, P < 0.001; 5.6 ± 1.8 vs 2.8 ± 0.9, P < 0.001). Comparison of lesion size showed no significant differences between C- and M-b1400(P = 0.22). CONCLUSION: Combination of a high b-value extrap-olation and sFOV may contribute to increase diagnostic accuracy of DWI without an increase of acquisition time, which may be useful to guide targeted prostate biopsies and to improve quality of multiparametric MRI(mMRI) especially under economical aspects in a pri-vate practice setting.Leonardo K Bittencourt Ulrike I Attenberger Daniel Lima Ralph Strecker Andre de Oliveira Stefan O Schoenberg Emerson L Gasparetto Daniel Hausmann 2014World Journal of Radiology2014,6,6:5
12The MRE11 GAR motif regulates DNA double-strand break processing and ATR activation显示文摘MRE11/RAD50/NBS1 建筑群是很快招募到 DNA 双海滨裂缝(DSB ) 的主要传感器。MRE11 被知道是由在它的 glycine-arginine-rich (长嘴硬鳞鱼) 以内的 PRMT1 的精氨酸 methylated 主题。在这研究,我们报导在 GAR 主题与离氨酸代替精氨酸并且产生 MRE11 缺乏 methylated 精氨酸的 RK 蛋白质。Mre11 RK/RK 老鼠对 γ 过分敏感;照耀(红外) 和从这些老鼠的房间显示了房间周期检查点缺点和染色体不稳定性。而且, Mre11 RK/RK MEF 展出了在 RPA 和 RAD51 的招募表明缺点和缺陷到损坏地点的 ATR/CHK1。M RK 形成的 RN 建筑群并且对 DNA 损坏并且通常的地点局部性响应红外激活 ATM 小径。M RK RN 建筑群在为响应红外在 vivo 观察的损害 DNA 结束切除术和 ATR 激活负责的 vitro 展出了 exonuclease 和 DNA 有约束力的缺点。我们的调查结果在 DSB 修理为 MRE11 长嘴硬鳞鱼主题的关键角色提供基因证据,并且在 MRE11 长嘴硬鳞鱼表明在 translational 以后修正之间的一个机械学的连接主题并且 DSB 处理,以及发信号的 ATR/CHK1 检查点。Zhenbao Yu Gillian Vogel Yan Coulombe Danielle Dubeau Elizabeth Spehalski Josee Hebert David O Ferguson Jean Yves Masson Stephane Richard 2012Cell Research2012,22,2:5
13Enhancing survival, engraftment, and osteogenic potential of mesenchymal stem cells显示文摘Mesenchymal stem cells(MSCs)are promising candidates for bone regeneration therapies due to their plasticity and easiness of sourcing.MSC-based treatments are generally considered a safe procedure,however,the long-term results obtained up to now are far from satisfactory.The main causes of these therapeutic limitations are inefficient homing,engraftment,and osteogenic differentiation.Many studies have proposed modifications to improve MSC engraftment and osteogenic differentiation of the transplanted cells.Several strategies are aimed to improve cell resistance to the hostile microenvironment found in the recipient tissue and increase cell survival after transplantation.These strategies could range from a simple modification of the culture conditions,known as cell-preconditioning,to the genetic modification of the cells to avoid cellular senescence.Many efforts have also been done in order to enhance the osteogenic potential of the transplanted cells and induce bone formation,mainly by the use of bioactive or biomimetic scaffolds,although alternative approaches will also be discussed.This review aims to summarize several of the most recent approaches,providing an up-to-date view of the main developments in MSCbased regenerative techniques.Daniel García-Sánchez Darío Fernández JoséC Rodríguez-Rey Flor M Pérez-Campo 2019World Journal of Stem Cells2019,11,10:4
14Hyperbaric oxygen therapy as a complementary treatment for radiation proctitis:Useless or useful?-A literature review显示文摘Radiotherapy(RT)is the backbone of multimodality treatment of more than half of cancer cases.Despite new modern RT techniques,late complications may occur such as radiation proctitis(RP).The natural history of RP is unpredictable.Minor symptoms may resolve spontaneously or require conservative treatment.On the other hand,for similar and uncomplicated clinical contexts,symptoms may persist and can even be refractory to the progressive increase in treatment measures.Over the last decades,an enormous therapeutic armamentarium has been considered in RP,including hyperbaric oxygen therapy(HBOT).Currently,the evidence regarding the impact of HBOT on RP and its benefits is conflicting.Additional prospective and randomised studies are necessary to validate HBOT’s effectiveness in the‘real world’clinical practice.This article reviewed the relevant literature on pathophysiology,clinical presentation,different classifications and discuss RP management including a proposal for a therapeutic algorithm with a focus on HBOT.Diogo Alpuim Costa Carla Espiney Amaro Ana Nunes Joana Santos Cardoso Pedro Modas Daniel Isabel Rosa João Vieira Branco 2021World Journal of Gastroenterology2021,27,27:4
15Uptake and mitochondrial dysfunction of alpha-synuclein in human astrocytes, cortical neurons and fibroblasts显示文摘The accumulation and aggregation of alpha-synuclein(α-syn)in several tissue including the brain is a major pathological hallmark in Parkinson’s disease(PD).In this study,we show that α-syn can be taken up by primary human cortical neurons,astrocytes and skin-derived fibroblasts in vitro.Our findings that brain and peripheral cells exposed to α-syn can lead to impaired mitochondrial function,leading to cellular degeneration and cell death,provides additional evidence for the involvement of mitochondrial dysfunction as a mechanism of toxicity of α-syn in human cells.Nady Braidy Wei-Ping Gai Ying Hua Xu Perminder Sachdev Gilles J Guillemin Xing-Mai Jiang J William O Ballard Martin P Horan Zhi Ming Fang Beng H Chong Daniel Kam Yin Chan 2013Translational Neurodegeneration2013,2,1:4
16Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria显示文摘BACKGROUND Surgical resection and radiofrequency ablation(RFA)represent two possible strategy in treatment of hepatocellular carcinoma(HCC)in Milan criteria.AIM To evaluate short-and long-term outcome in elderly patients(>70 years)with HCC in Milan criteria,which underwent liver resection(LR)or RFA.METHODS The study included 594 patients with HCC in Milan criteria(429 in LR group and 165 in RFA group)managed in 10 European centers.Statistical analysis was performed using the Kaplan-Meier method before and after propensity score matching(PSM)and Cox regression.RESULTS After PSM,we compared 136 patients in the LR group with 136 patients in the RFA group.Overall survival at 1,3,and 5 years was 91%,80%,and 76%in the LR group and 97%,67%,and 41%in the RFA group respectively(P=0.001).Diseasefree survival at 1,3,and 5 years was 84%,60%and 44%for the LR group,and 63%,36%,and 25%for the RFA group(P=0.001).Postoperative Clavien-Dindo IIIIV complications were lower in the RFA group(1%vs 11%,P=0.001)in association with a shorter length of stay(2 d vs 7 d,P=0.001).In multivariate analysis,Model for End-stage Liver Disease(MELD)score(>10)[odds ratio(OR)=1.89],increased value of international normalized ratio(>1.3)(OR=1.60),treatment with radiofrequency(OR=1.46),and multiple nodules(OR=1.19)were independent predictors of a poor overall survival while a high MELD score(>10)(OR=1.51)and radiofrequency(OR=1.37)were independent factors associated with a higher recurrence rate.CONCLUSION Despite a longer length of stay and a higher rate of severe postoperative complications,surgery provided better results in long-term oncological outcomes as compared to ablation in elderly patients(>70 years)with HCC in Milan criteria.Maria Conticchio Riccardo Inchingolo Antonella Delvecchio Letizia Laera Francesca Ratti Maximiliano Gelli Ferdinando Anelli Alexis Laurent Giulio Vitali Paolo Magistri Giacomo Assirati Emanuele Felli Taiga Wakabayashi Patrick Pessaux Tullio Piardi Fabrizio di Benedetto Nicola de'Angelis Javier Briceño AntonioRampoldi RenèAdam Daniel Cherqui Luca Antonio Aldrighetti Riccardo Memeo 2021World Journal of Gastroenterology2021,27,18:4
17Overweight and obesity in hip and knee arthroplasty:Evaluation of 6078 cases显示文摘AIM: To evaluate a possible association between thevarious levels of obesity and peri-operative characteristics of the procedure in patients who underwent endoprosthetic joint replacement in hip and knee joints. METHODS: We hypothesized that obese patients were treated for later stage of osteoarthritis, that more conservative implants were used, and the intraand perioperative complications increased for such patients. We evaluated all patients with body mass index(BMI) ≥ 25 who were treated in our institution from January 2011 to September 2013 for a primary total hip arthroplasty(THA) or total knee arthroplasty(TKA). Patients were split up by the levels of obesity according to the classification of the World Health Organization. Average age at the time of primary arthroplasty, preoperative Harris Hip Score(HHS), Hospital for Special Surgery score(HSS), gender, type of implanted prosthesis, and intra-and postoperative complications were evaluated.RESULTS: Six thousand and seventy-eight patients with a BMI ≥ 25 were treated with a primary THA or TKA. Age decreased significantly(P < 0.001) by increasing obesity in both the THA and TKA. HHS and HSS were at significantly lower levels at the time of treatment in the super-obese population(P < 0.001). Distribution patterns of the type of endoprostheses used changed with an increasing BMI. Peri- and postoperative complications were similar in form and quantity to those of the normal population. CONCLUSION: Higher BMI leads to endoprosthetic treatment in younger age, which is carried out at significantly lower levels of preoperative joint function.Daniel Guenther Stefan Schmidl Till O Klatte Harald K Widhalm Mohamed Omar Christian Krettek Thorsten Gehrke Daniel Kendoff Carl Haasper 2015World Journal of Orthopedics2015,6,1:4
18Prognostic value of pre-treatment F-18-FDG PET-CT in patients with hepatocellular carcinoma undergoing radioembolization显示文摘AIM To evaluate the value of pre-treatment 18F-FDG PET/CT in patients with HCC following liver radioembolization.METHODS We identified 34 patients with HCC who underwent an FDG PET/CT scan prior to hepatic radioembolization at our institution between 2009 and 2013. Patients wereseen in clinic one month after radioembolization and then at 2-3 mo intervals. We assessed the influence of FDG tumor uptake on outcomes including local liver control(LLC), distant liver control(DLC), time to distant metastases(DM), progression free survival(PFS) and overall survival(OS).RESULTS The majority of patients were males(n = 25, 74%), and had Child Pugh Class A(n = 31, 91%), with a median age of 68 years(46-84 years). FDG-avid disease was found in 19(56%) patients with SUVmax ranging from 3 to 20. Female patients were more likely to have an FDG-avid HCC(P = 0.02). Median follow up of patients following radioembolization was 12 months(1.2-62.8 mo). FDG-avid disease was associated with a decreased 1 year LLC, DLC, DM and PFS(P < 0.05). Using multivariate analysis, FDG avidity predicted for LLC, DLC, and PFS(all P < 0.05).CONCLUSION In this retrospective study, pre-treatment HCC FDGavidity was found to be associated with worse LLC, DLC, and PFS following radioembolization. Larger studies are needed to validate our initial findings to assess the role of F-18-FDG PET/CT scans as biomarker for patients with HCC following radioembolization.Yazan Abuodeh Arash O Naghavi Kamran A Ahmed Puja S Venkat Youngchul Kim Bela Kis Junsung Choi Benjamin Biebel Jennifer Sweeney Daniel A Anaya Richard Kim Mokenge Malafa Jessica M Frakes Sarah E Hoffe Ghassan El-Haddad 2016World Journal of Gastroenterology2016,22,47:3
19运动表现分析:过去、现在与未来显示文摘对运动表现分析的发展历程、现状、未来进行研究发现,运动表现分析起源于标记分析,历经一个多世纪的实践与研究完成了由方法向方法论的转型,进入21世纪后逐渐发展成为运动科学(Sports Science)的一个新兴分支学科。在运动表现分析实践中采用定性、定量以及两者相结合的方法对“人的运动”进行直接描述和分析,分析手段主要包括标记分析和移动分析,通常需要从方法和学科2个层面来理解其定义。技术和战术表现评估、信效度分析、负荷监控以及学科交叉研究是近年来运动表现分析领域的研究热点。运动表现分析相关专业的设立以及运动表现分析师这一新职业的出现有力地推动了运动训练的科学化。当前,运动表现分析的理论基础、技术手段、人才培养和学科影响力等方面还面临挑战,未来其理论体系将趋向完善,向分析智能化、服务对象大众化和人才培养专业化等方向发展。易清 黎涌明 张铭鑫 崔一雄 刘天彪 张绍良 龚炳南 黄展煜 周长敬 MiguelÁngel Gómez Ruano Daniel Memmert Peter O'Donoghue 刘鸿优 2023上海体育学院学报2023,47,2:3
20Conversion from prolonged intravenous fentanyl infusion to enteral methadone in critically ill children显示文摘AIM To describe our institutional experience with conversion from intravenous(IV) fentanyl infusion directly to enteral methadone and occurrence of withdrawal in critically ill mechanically ventilated children exposed to prolonged sedation and analgesia.METHODS With Institutional Review Board approval,we retrospectively studied consecutively admitted invasively mechanically ventilated children(0-18 years) sedated with IV fentanyl infusion > 5 d and subsequently converted directly to enteral methadone.Data were obtained onsubject demographics,illness severity,daily IV fentanyl and enteral methadone dosing,time to complete conversion,withdrawal scores(WAT-1),pain scores,and need for rescue opioids.Patients were classified as rapid conversion group(RCG) if completely converted ≤ 48 h and slow conversion group(SCG) if completely converted in > 48 h.Primary outcome was difference in WAT-1 scores at 7 d.Secondary outcomes included differences in overall pain scores,and differences in daily rescue opioids.RESULTS Compared to SCG(n = 21),RCG(n = 21) had lower median WAT-1 scores at 7 d(2.5 vs 5,P = 0.027).Additionally,RCG had lower overall median pain scores(3 vs 6,P = 0.007),and required less median daily rescue opioids(3 vs 12,P = 0.003) than SCG.The starting daily median methadone dose was 2.3 times the daily median fentanyl dose in the RCG,compared to 1.1 times in the SCG(P = 0.049).CONCLUSION We observed wide variation in conversion from IV fentanyl infusion directly to enteral methadone and variability in withdrawal in critically ill mechanically ventilated children exposed to prolonged sedation.In those children who converted successfully from IV fentanyl infusion to enteral methadone within a period of 48 h,a methadone:fentanyl dose conversion ratio of approximately 2.5:1 was associated with less withdrawal and reduced need for rescue opioids.Vijay Srinivasan Daniel Pung Sean P O'Neill 2017World Journal of Clinical Pediatrics2017,6,2:3
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