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| 1 | Changing face of hepatic encephalopathy:Role of inflammation and oxidative stress显示文摘The face of hepatic encephalopathy(HE) is changing.This review explores how this neurocognitive disorder,which is associated with both acute and chronic liver injury,has grown to become a dynamic syndrome that spans a spectrum of neuropsychological impairment,from normal performance to coma.The central role of ammonia in the pathogenesis of HE remains incontrovertible.However,over the past 10 years,the HE community has begun to characterise the key roles of inflammation,infection,and oxidative/nitrosative stress in modulating the pathophysiological effects of ammonia on the astrocyte.This review explores the current thoughts and evidence base in this area and discusses the potential role of existing and novel therapies that might abrogate the oxidative and nitrosative stresses inflicted on the brain in patients with,or at risk of developing,HE. | Amit S Seyan Robin D Hughes Debbie L Shawcross | 2010 | World Journal of Gastroenterology2010，16，27： | 23 |
| 2 | 皮质下小血管病诊断的共识声明显示文摘血管性认知损害是用于描述一组涉及大血管和小血管的散发性和遗传性异质性疾病的诊断术语。皮质下小血管病可导致腔隙性梗死和进行性白质损害。被称为宾斯旺格病(Binswanger's disease, BD)的进行性白质损害患者构成了从单纯血管性疾病到合并神经变性病变的疾病谱。BD患者是一个相对同质性的亚组,存在缺氧缺血、腔隙性梗死和炎症,它们协同作用破坏血脑屏障和髓鞘。通过临床、脑脊液、神经心理学和影像学检查获得的多模式疾病标记物能促进该亚组患者的鉴别。本共识声明确定了一系列基于基础病理学改变的潜在生物学标记物,这将有助于诊断以及将来协作性治疗试验的患者选择。 | Gary A Rosenberg Anders Wallin Joanna M Wardlaw Hugh S Markus Joan Montaner Leslie Wolfson Costantino Iadecola Berislav V Zlokovic Anne Joutel Martin Dichgans Marco Duering Reinhold Schmidt Amos D Korczyn Lea T Grinberg Helena C Chui Vladimir Hachinski 王训师 张劼 陈涵丰 俞娅美 徐子奇 罗本燕 | 2016 | 国际脑血管病杂志2016，24，6： | 18 |
| 3 | Pathophysiology of cerebral oedema in acute liver failure显示文摘Cerebral oedema is a devastating consequence of acute liver failure(ALF)and may be associated with the development of intracranial hypertension and death.In ALF,some patients may develop cerebral oedema and increased intracranial pressure but progression to lifethreatening intracranial hypertension is less frequent than previously described,complicating less than one third of cases who have proceeded to coma since the advent of improved clinical care.The rapid onset of encephalopathy may be dramatic with the development of asterixis,delirium,seizures and coma.Cytotoxic and vasogenic oedema mechanisms have been implicated with a preponderance of experimental data favouring a cytotoxic mechanism.Astrocyte swelling is the most consistent neuropathological finding in humans with ALF and ammonia plays a definitive role in the development of cytotoxic brain oedema.The mechanism(s)by which ammonia induces astrocyte swelling remains unclear but glutamine accumulation within astrocytes has led to the osmolyte hypothesis.Current evidence also supports an alternate‘Trojan horse’hypothesis,with glutamine as a carrier of ammonia into mitochondria,where its accumulation results in oxidative stress,energy failure and ultimately astrocyte swelling.Although a complete breakdown of the blood-brain barrier is not evident in human ALF,increased permeation to water and other small molecules such as ammonia has been demonstrated resulting from subtle alterations in the protein composition of paracellular tight junctions.At present,there is no fully efficacious therapy for cerebral oedema other than liver transplantation and this reflects our incomplete knowledge of the precise mechanisms underlying this process which remain largely unknown. | Teresa R Scott Victoria T Kronsten Robin D Hughes Debbie L Shawcross | 2013 | World Journal of Gastroenterology2013，19，48： | 8 |
| 4 | Osteoprotegerin: A Novel Secreted Protein Involved in the Regulation of Bone Density显示文摘 | W.S Simonet D.L Lacey C.R Dunstan M Kelley M.-S Chang R Lüthy H.Q Nguyen S Wooden L Bennett T Boone G Shimamoto M DeRose R Elliott A Colombero H.-L Tan G Trail J Sullivan E Davy N Bucay L Renshaw-Gegg T.M Hughes D Hill W Pattison P Campbell S Sander G Van | 1997 | Cell1997，，2： | 6 |
| 5 | 全科医生工作困难和压力应对能力及复原力:一项定性研究显示文摘背景'新自由主义'工作策略、工作环境艰苦、英国医疗服务体系(NHS)重组及工作量的增加,造成全科医生职业倦怠及数量短缺,诸如此类的报道越来越多。目的本文旨在探讨全科医生工作上的困难和压力以及其应对策略,尤其是最近NHS要求改变工作环境给全科医生造成的影响。设计与场所本研究为定性研究。研究数据来自两个讨论组的访谈及7个'一对一'电话访谈资料。方法采用方便抽样方法选择研究对象。对研究对象进行半结构化讨论组访谈及'一对一'电话访谈,调查当前英国全科医生的执业情况。对访谈数据进行主题分析。结果共22例全科医生参与研究,其中15例参与讨论组讨论,7例参与电话采访。受访者谈到全科医生正承受着前所未有的强大压力,这种压力与工作环境有关,因为工作环境使得其觉得应该做个'好'医生。许多研究报道了全职全科医生压力太大:工作压力引起情绪改变,导致睡眠不良,焦虑增加,与亲人之间关系紧张。有些人尝试通过减少工作量来改善这种状况。工作环境的变化使得全科医生几乎没有时间采取措施来提高复原力以做到工作与生活之间平衡良好以及更好地与同事相处。尽管有些全科医生能更有效地应对压力,但是其也承认,自己已经尽了最大努力来应对工作压力。结论 NHS诸多因素造成了全科医生在感情生活及工作压力上的明显改变。为促进全科医生提供有效的医疗服务,其复原力的构建应不仅局限于改善全科医生个人情况,还应包括系统地解决其工作上的困难与压力。 | CHESHIRE A RIDGE D HUGHES J 本刊编辑部 | 2017 | 中国全科医学2017，20，21： | 3 |
| 6 | Management of infected pancreatic necrosis in the setting of concomitant rectal cancer:A case report and review of literature显示文摘BACKGROUND Pancreatitis with infected necrosis is a severe complication of acute pancreatitis and carries with it high rates of morbidity and mortality. The management of infected pancreatic necrosis alongside concomitant colorectal cancer has never been described in literature.CASE SUMMARY A 77 years old gentleman presented to the Emergency Department of our hospital complaining of ongoing abdominal pain for 8 h. The patient had clinical features of pancreatitis with a raised lipase of 3810 U/L, A computed tomography(CT) abdomen confirmed pancreatitis with extensive peri-pancreatic edema. During the course of his admission, the patient had persistent high fevers and delirium thought secondary to infected necrosis, prompting the commencement of broad-spectrum antibiotic therapy with Piperacillin/Tazobactam. Subsequent CT abdomen confirmed extensive pancreatic necrosis(over 70%). Patient was managed with supportive therapy,nutritional support and gut rest initially and improved over the course of his admission and was discharged 42 d post admission. He represented 24 d following his discharge with fever and chills and a repeat CT abdomen scan noted gas bubbles within the necrotic pancreatic tissue thereby confirming infected necrotic pancreatitis. This CT scan also revealed asymmetric thickening of the rectal wall suspicious for malignancy. A rectal cancer was confirmed on flexible sigmoidoscopy. The patient underwent two endoscopic necrosectomies and was treated with intravenous antibiotics and was discharged after 28 d.Within 1 wk post discharge, the patient commenced a course of neoadjuvant radiotherapy and subsequently underwent concomitant chemotherapy prior to undergoing a successful Hartmann's procedure for treatment of his colorectal cancer.CONCLUSION This case highlights the efficacy of endoscopic necrosectomy, early enteral feeding and targeted antibiotic therapy for timely management of infected necrotic pancreatitis. The prompt resolution of pancreatitis permitted the patient to undergo neoadjuvant treatment and resection for his concomitant colorectal cancer. | Kihoon Choi David E Flynn Anitha Karunairajah Andrew Hughes Ambika Bhasin Benedict Devereaux Manju D Chandrasegaram | 2019 | World Journal of Gastrointestinal Surgery2019，11，4： | 2 |
| 7 | 责任制医疗照护机构——美国的经验与教训显示文摘Hugh Alderwick与同事强调:英国国家健康体系(NHS)的政策制定者应实事求是地看待新型医疗保健模式带来的潜在收益。英格兰国家健康体系(NHS)决策圈都在谈论源自美国的一个新概念——责任制医疗照护机构(ACOs)。英格兰NHS和卫生部长认为ACO(s以及相关的责任制医疗体系)是改进NHS服务的重要途径。 | Hugh Alderwick Stephen M Shortell Adam D M Briggs Elliott S Fisher 周红霞(译) 肖月(校) | 2019 | 中国医院院长2019，0，12： | 2 |
| 8 | 胸腹主动脉瘤:杂交修复术结果显示文摘目的:胸腹主动脉瘤(TAAA)的治疗依然是外科中最富挑战性的工作,特别是存在退行性变动脉瘤的老年患者同时患肺疾病更是如此。这篇更新后的单中心报道是关于我们对高危TAAA患者采用完全内脏动脉去分支化结合动脉瘤腔内隔绝的杂交修复术经验。方法:从2005年3月—2012年6月间58名患者在单中心接受解剖外内脏血管去分支化及随后的动脉瘤腔内隔绝术。内脏旁路的中位数为4支,最初的33例采用同期手术方式,而最近的25例采用分期手术。结果:患者中位年龄为69.0岁,50%为女性,所有患者存在严重合并症而不适合传统开放修复术。平均主动脉直径(6.7±1.2)cm,30 d/住院病死率、脑卒中率、永久性轻瘫/截瘫率分别为9%、0%以及4%。最近25例分期手术患者的这三种并发症率分别为4%、0%以及0%。平均随访时间(26±21)个月,内脏人工血管通畅率95.3%,所有闭塞的内脏人工血管均为肾动脉,无1例引起永久性截瘫,2例患者需再干预,1例出现Ib型内漏,1例出现III型内漏,5年免于再干预率为94%,Kaplan-Meier总体生存率为1年78%、5年62%,5年主动脉相关生存率为87%。结论:这些更新后的结果 ,继续支撑着这一观点:运用完全内脏动脉去分支联合动脉瘤腔内隔绝的杂交技术治疗高龄且不适合传统开放手术的高危TAAA患者是一种理想的选择,而采取分期手术的方式能取得更佳的结果。 | Gchad Hughes Nicholas D Andersen Jennifer M Hanna Richard L McCann 老启芳 | 2015 | 中国普通外科杂志2015，24，6： | 2 |
| 9 | Second order elastic deformation of solids显示文摘 | HUGHES D S KELLY J L | 1953 | Physical Review1953，92，5： | 1 |
| 10 | C/EBPα and HNF6 protein complex formation stimulates HNF6-dependent transcription by CBP coactivator recruitment in HepG2 cells显示文摘 | HUGHES D E RAUSA F M | 2006 | Hepatology2006，43，2： | 1 |
| 11 | Earing Quality,Insider Trading and the Cost of Capital显示文摘 | HUGHES J LIU J | 2005 | Journal of Accounting Research2005，43，5： | 1 |
| 12 | The aiding of a low-cost strapdown inertial measurement unit using vehicle model constraints for land vehicle applications显示文摘 | Dissanayake G Sukkarieh S Hugh D W | 2001 | IEEE Transactions on Robotics and Automation2001，17，5： | 1 |
| 13 | Changes in limestone sorbent morphology during CaO-CaCO3 looping at pilot scale显示文摘 | Hughes R W Macchi A Lu D Y | 2009 | Chemical Engineering & Technology2009，32，3： | 1 |
| 14 | Fluid capacity distributions of random porous media 显示文摘 | Chan D Y C Hughes B D Paterson L | 1988 | Transport in Porous Media1988，，3： | 1 |
| 15 | E mpiricial Assessment of the Impact of Audit Quality on Valuation of New Issues显示文摘 | Feltham G A J S Hughes D A Simunic | 1991 | Journal of Accounting and Economics1991，，： | 1 |
| 16 | Haploinsufficiency of delta- like 4 ligand results in embryonic lethality due to ma:or defects in arterial and vascular development显示文摘 | Gale N W Dominguez M G Noguera I Pan L Hughes V Va]enzuela D M | 2004 | Proc Natl Acad Sci USA2004，101，15： | 1 |
| 17 | Intrathecal repivacaine or bupivacaine with feutanyl for labour显示文摘 | Hughes D Hill D | 2001 | Br J Anaeesth2001，87，5： | 1 |
| 18 | New frontiers in food enzymology: recombinant lipoxygenases显示文摘 | Casey R West S I Hardy D David S Robinson Zecai W u Richard K Hughes | 1999 | Trends in Food Science & Technology1999，10，： | 1 |
| 19 | Food allergy显示文摘 | SCOTrH H SICHERER M D HUGH A | 2006 | Journal of Allergy and Clinical Immunology2006，117，2： | 1 |
| 20 | The epidemiology of depression in an elderly community population显示文摘 | Blazer D Hughes D C George L K | | 0，，03： | 1 |
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