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| 1 | TMPA卫星降水数据的评估与校正显示文摘卫星遥感降水由于时空分辨率的优势在现代水文模拟中正起着越来越大的作用。本研究对黄河源区的两套卫星降水产品(TMPA准实时3B42RT和研究数据3B42V6)进行了详细评估,结果表明,3B42RT与3B42V6相比会明显高估地面降水,而两者对降水事件的反演能力基本一致。通过引入'降水重心'的概念,两套卫星降水产品均可以基本反映降水的空间分布及长期演变过程。在两者尤其是3B42RT数据的校正中,首先将卫星数据与地面站点月降水对比,再等比例降尺度回日降水,然后尝试逐步订正和最优插值两种残差处理方法,从而使降水量和降水分布的精度进一步提高。最后用校正后的卫星降水驱动分布式水文模型,利用输出径流间接验证校正的效果。 | 孙乐强 郝振纯 王加虎 Ioan Nistor Ousmane Seidou | 2014 | 水利学报2014，45，10： | 37 |
| 2 | 为弥漫的甲状腺腺病理的评估的 ARFI elastography : 初步的结果显示文摘 AIM:To assess whether acoustic radiation force impulse(ARFI)elastography can differentiate normal from pathological thyroid parenchyma.METHODS:We evaluated 136 subjects(mean age 45.8±15.6 years,106 women and 30 men):44(32.3%) without thyroid pathology,48(35.3%)with BasedowGraves’disease(GD),37(27.2%)with chronic autoimmune thyroiditis(CAT;diagnosed by specific tests),4(2.9%)with diffuse thyroid goiter and 3(2.2%)cases with thyroid pathology induced by amiodarone.In all patients,10 elastographic measurements were made in the right thyroid lobe and 10 in the left thyroid lobe,using a 1-4.5 MHZ convex probe and a 4-9 MHz linear probe,respectively.Median values were calculated for thyroid stiffness and expressed in meters/second(m/s).RESULTS:Thyroid stiffness(TS)assessed by means of ARFI in healthy subjects(2±0.40 m/s)was significantly lower than in GD(2.67±0.53 m/s)(P<0.0001) and CAT patients(2.43±0.58 m/s)(P=0.0002),but the differences were not significant between GDvs CAT patients(P=0.053).The optimal cut-off value for the prediction of diffuse thyroid pathology was 2.36 m/s.For this cut-off value,TS had 62.5%sensitivity,79.5% specificity,87.6%predictive positive value,55.5% negative predictive value and 72.7%accuracy for the presence of diffuse thyroid gland pathology(AUROC=0.804).There were no significant differences between the TS values obtained with linear vs convex probes and when 5 vs 10 measurements were taken in each lobe(median values).CONCLUSION:ARFI seems to be a useful method for the assessment of diffuse thyroid gland pathology. | Ioan Sporea Roxana Sirli Simona Bota Mihaela Vlad Alina Popescu Ioana Zosin | 2012 | World Journal of Radiology2012，4，4： | 25 |
| 3 | Is ARFI elastography reliable for predicting fibrosis severity in chronic HCV hepatitis?显示文摘AIM:To determine whether acoustic radiation force impulse(ARFI) elastography is a reliable method for predicting fibrosis severity in patients with chronic hepatitis C virus(HCV) hepatitis.METHODS:We performed a multicenter study including 274 subjects with HCV chronic hepatitis in which we compared ARFI with liver biopsy(LB).In each patient we performed LB(evaluated according to the Metavir score) and ARFI measurements(using a Siemens Acuson S2000TM ultrasound system:10 valid measurements were performed and median values were calculated and expressed in meters/second(m/s).RESULTS:A direct,strong,correlation(Spearman r = 0.707) was found between ARFI measurements and fibrosis(P < 0.0001).For predicting the presence of fibrosis(F ≥ 1 Metavir),significant fibrosis(F ≥ 2),severe fibrosis(F ≥ 3) and cirrhosis(F = 4),the cutoff values of 1.19,1.21,1.58 and 1.82 m/s were determined,respectively,liver stiffness measurements had 73%,84%,84% and 91% Se respectively;93%,91%,94%,90% Sp,respectively;with AUROCs of 0.880,0.893,0.908 and 0.937,respectively.CONCLUSION:ARFI measurement is a reliable method for predicting the severity of fibrosis in HCV | Ioan Sporea Roxana Sirli Simona Bota Carmen Fierbinteanu-Braticevici Alina Popescu Radu Badea Monica Lupsor Ana Petrisor Mirela Dnil | 2011 | World Journal of Radiology2011，3，7： | 24 |
| 4 | Prognostic significance of tumor immune microenvironment and immunotherapy:Novel insights and future perspectives in gastric cancer显示文摘Despite a decrease in gastric cancer incidence, the development of novel biologic agents and combined therapeutic strategies, the prognosis of gastric cancer remains poor. Recently, the introduction of modern immunotherapy, especially using immune checkpoint inhibitors, led to an improved prognosis in many cancers. The use of immunotherapy was also associated with manageable adverse event profiles and promising results in the treatment of patients with gastric cancer, especially in heavily pretreated patients. These data have led to an accelerated approval of some checkpoint inhibitors in this setting. Understanding the complex relationship between the host immune microenvironment and tumor and the immune escape phenomenon leading to cancer occurrence and progression will subsequently lead to the identification of prognostic immune markers. Furthermore, this understanding will result in the discovery of both new mechanisms for blocking tumor immunosuppressive signals and pathways to stimulate the local immune response by targeting and modulating different subsets of immune cells. Due to the molecular heterogeneity of gastric cancers associated with differentclinico-biologic parameters, immune markers expression and prognosis, novel immunotherapy algorithms should be personalized and addressed to selected subsets of gastric tumors, which have been proven to elicit the best clinical responses. Future perspectives in the treatment of gastric cancer include tailored dual immunotherapies or a combination of immunotherapy with other targeted agents with synergistic antitumor effects. | Daniela Cornelia Lazǎr Mihaela Flavia Avram Ioan Romosan Mǎrioara Cornianu Sorina Tǎan Adrian Goldis | 2018 | World Journal of Gastroenterology2018，24，32： | 24 |
| 5 | 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 |
| 6 | Comparison of the liver stiffness measurement by transient elastography with the liver biopsy显示文摘AIM: To compare the liver stiffness (LS) measurement by transient elastography (TE) to the liver biopsy (LB)-considered the 'gold standard' in the evaluation of patients with chronic hepatitis C. METHODS: During a period of 12 mo, we evaluated 199 consecutive patients with chronic hepatitis due to hepatitis C virus (HCV), in which LB and LS assessments (by means of TE) were performed during the same session. RESULTS: Out of 199 patients, a valid measurement of the LS could not be obtained in 8. The mean value of LS in the cohort of 191 valid measurements was 8.45 ± 4.96 kPa, ranging from 2.3 to 38 kPa. The mean value of LS in patients with signifi cant fi brosis at biopsy (161 patients with F ≥ 2 according to Metavir) was 9.02 ± 5.15 kPa, significantly higher than in patients with no or mild fi brosis (30 patients with F < 2 Metavir): 5.39 ± 1.81 kPa (P < 0.0001). For a cut- off value of 6.8 kPa, the LS had a PPV of 98%, a NPV of 30.1%, a sensitivity of 59.6% and a specificity of 93.3% for the presence of signifi cant fi brosis (at least F2 Metavir), with a diagnostic performance of 77.3% (AUROC 0.773). Using this cut-off value, we reached the best discrimination between absence of fibrosis/ mild fibrosis (F < 2 Metavir) and the presence ofmoderate to severe fi brosis (F ≥ 2 Metavir). CONCLUSION: In patients with chronic hepatitis due to HCV, a cut-off value of 6.8 kPa measured by TE can differentiate between significant fibrosis and absent or mild fi brosis, with a PPV of 98%, a NPV of 30.1%, a sensitivity of 59.6%, a specificity of 93.3%, and a diagnostic performance of 77.3%. | Ioan Sporea Roxana ■irli Alexandra Deleanu Adriana Tudora Manuela Curescu Marioara Cornianu Daniela Lazǎr | 2008 | World Journal of Gastroenterology2008，14，42： | 20 |
| 7 | Epithelial-mesenchymal, mesenchymal-epithelial, and endothelial-mesenchymal transitions in malignant tumors: An update显示文摘Epithelial-to-mesenchymal transition(EMT) represents conversion of an epithelial cell in an elongated cell with mesenchymal phenotype, which can occur in physiologic and pathologic processes such as embryogenesis(type 1 EMT), wound healing and/or fibrosis(type 2 EMT) and malignant tumors(type 3 EMT). The proliferation rate, metastasizing and recurrence capacity, as also the individualized response at chemotherapics, in both epithelial and mesenchymal malignant tumors is known to be influenced by reversible switch between EMT and mesenchymal-to-epithelial transition(MET). Although much research work has already been done in these fields, the specific molecular pathways of EMT, relating to the tumor type and tumor localization, are yet to be elucidated. In this paper, based on the literature and personal experience of the authors, an update in the field of EMT vs MET in epithelial and mesenchymal tumors is presented. The authors tried to present the latest data about the particularities of these processes, and also of the so-called endothelialto-mesenchymal transition, based on tumor location. The EMT-angiogenesis link is discussed as a possible valuable parameter for clinical follow-up and targeted therapeutic oncologic management. The paper begins with presentation of the basic aspects of EMT, its classification and assessment possibilities, and concludes with prognostic and therapeutic perspectives. The particularities of EMT and MET in gastric and colorectal carcinomas, pancreatic cancer, hepatocellular and cholangiocarcinomas, and lung, breast and prostate cancers, respectively in sarcomas and gastrointestinal stromal tumors are presented in detail. | Simona Gurzu Sabin Turdean Attila Kovecsi Anca Otilia Contac Ioan Jung | 2015 | World Journal of Clinical Cases2015，3，5： | 20 |
| 8 | Liver stiffness measurements in patients with HBV vs HCV chronic hepatitis:A comparative study显示文摘AIM:To assess the values of liver stiffness (LS) in pa-tients with hepatitis B virus (HBV) chronic hepatitis and to compare them with those in patients with hepatitis C virus (HCV) chronic hepatitis. METHODS: The study included 140 patients with HBV chronic hepatitis, and 317 patients with HCV chronic hepatitis, in which LS was measured (FibroScan-Echo-sens) and liver biopsy was performed in the same session (assessed according to the Metavir score). RESULTS:According to the Metavir score of the 140 HBV patients: one had F0,32 had F1, 67 had F2,33 had F3 and 7 had F4. Of the 317 HCV patients:5 had F0, 34 had F1, 146 had F2, 93 had F3 and 39 had F4. For the same severity of fibrosis, the mean values of LS in HBV patients were similar to those in HCV patients:F1,6.5±1.9 kPa vs 5.8±2.1 kPa (P=0.0889); F2,7.1±2 kPa vs 6.9±2.5 kPa (P = 0.3369); F3,9.1±3.6 kPa vs 9.9±5 kPa (P=0.7038); F4,19.8± 8.6 kPa vs 17.3±6.1 kPa (P=0.6574). A signif icant direct correlation between LS measurements and fibrosis was found in HCV patients (Spearman’s r=0.578, P<0.0001), as well as in HBV patients (r=0.408, P<0.0001). The correlation was more signif icant in HCV than in HBV patients (Fisher’s Z-test,Z= 2.210,P=0.0271). CONCLUSION:In our group, the mean values of LS in patients with chronic B hepatitis were similar to those in patients with chronic HCV hepatitis, for the same stage of f ibrosis. Also, LS was correlated with the severity of fibrosis both in HBV and HCV chronic hepatitis patients. | Ioan Sporea Roxana Sirli Alexandra Deleanu Adriana Tudora Alina Popescu Manuela Curescu Simona Bota | 2010 | World Journal of Gastroenterology2010，16，38： | 19 |
| 9 | Value of transient elastography for the prediction of variceal bleeding显示文摘AIM:To determine if liver stiffness(LS) measurements by means of transient elastography(TE) correlate with the presence of significant esophageal varices(EV) and if they can predict the occurrence of variceal bleeding.METHODS:We studied 1000 cases of liver cirrhosis divided into 2 groups:patients without EV or with grade 1 varices(647 cases) and patients with significant varices(grade 2 and 3 EV)(353 cases).We divided the group of 540 cases with EV into another 2 subgroups:without variceal hemorrhage(375 patients) and patients with a history of variceal bleeding(165 cases).We compared the LS values between the groups using the unpaired t-test and we established cut-off LS values for the presence of significant EV and for the risk of bleeding by using the ROC curve.RESULTS:The mean LS values in the 647 patients without or with grade 1 EV was statistically significantly lower than in the 353 patients with significant EV(26.29 ± 0.60 kPa vs 45.21 ± 1.07 kPa,P < 0.0001).Using the ROC curve we established a cut-off value of 31 kPa for the presence of EV,with 83% sensitivity(95%CI:79.73%-85.93%) and 62% specificity(95% CI:57.15%-66.81%),with 76.2% positive predictive value(PPV)(95% CI:72.72%-79.43%) and 71.3% negative predictive value(NPV)(95% CI:66.37%-76.05%)(AUROC 0.7807,P < 0.0001).The mean LS values in the group with a history of variceal bleeding(165 patients) was statistically significantly higher than in the group with no bleeding history(375 patients):51.92 ± 1.56 kPa vs 35.20 ± 0.91 kPa,P < 0.0001).For a cut-off value of 50.7 kPa,LS had 53.33% sensitivity(95% CI:45.42%-61.13%) and 82.67% specificity(95% CI:78.45%-86.36%),with 82.71% PPV(95% CI:78.5%-86.4%) and 53.66% NPV(95% CI:45.72%-61.47%)(AUROC 0.7300,P < 0.0001) for the prediction of esophageal bleeding. | Ioan Sporea Iulia Ratiu Roxana Sirli Alina Popescu Simona Bota | 2011 | World Journal of Gastroenterology2011，17，17： | 14 |
| 10 | Mixed adenoneuroendocrine carcinoma of gastrointestinal tract: Report of two cases显示文摘Mixed adenoneuroendocrine carcinoma(MANEC) is a rare tumor of the gastrointestinal tract that consists of a dual adenocarcinomatous and neuroendocrine differentiation, each component representing at least 30% of the tumor. To date, only seven cases have been reported in the cecum, and less than 40 in the stomach. Our first case was diagnosed in a 74-years-old female as a polypoid lesion of the cecum with direct invasion in the transverse colon, without lymph node metastases. The second case was diagnosed in the stomach of a 46-years-old male as a polypoid tumor of the antral region that invaded the pancreas and presented metastases in 22 regional lymph nodes. The metastatic tissue was represented by the glandular component. In both cases, the tumor consisted of a moderately-differentiated tubular adenocarcinoma(with mucinous component in Case 1) intermingled with neuroendocrine carcinoma. Ki67 index was lower than 20% in Case 1, respectively higher than 20% in Case 2. The neuroendocrine component was marked by synaptophysin and neuron specific enolase, being negative for Keratins 7/20. The neuroendocrine component represented 60% in Case 1, and 40% in Case 2, respectively. The glandular components were marked by carcinoembryonic antigen, maspin and keratin 20/7(Case 1/2). Both cases were proved to be microsatellite stable. Independently by the localization and tumor stage, MANECs appear to be highly malignant tumors, with high risk for distant metastases. The aggressiveness seems to depend on the endocrine component, independent of its proportion. The neuroendocrine component could be a dedifferentiated adenocarcinoma with a neuroendocrine phenotype. | Simona Gurzu Zoltan Kadar Tivadar Bara Tivadar Jr. Bara Adrian Tamasi Leonard Azamfirei Ioan Jung | 2015 | World Journal of Gastroenterology2015，21，4： | 14 |
| 11 | Why,who and how should perform liver biopsy in chronic liver diseases显示文摘Chronic viral hepatitis is a common disease in the general population.During chronic hepatitis,the prognosis and clinical management are highly dependent on the extent of liver fibrosis.The fibrosis evaluation can be performed by FibroTest(using serological markers),by Elastography or FibroScan(a noninvasive percutaneous technique using the elastic properties of the hepatic tissue) and by liver biopsy(LB),considered to be the 'gold standard'.Currently,there are three techniques for performing LB:percutaneous,transjugular and laparoscopic.The percutaneous LB can be performed blind,ultrasound(US) guided or US assisted.There are two main categories of specialists who perform LB:gastroenterologists(hepatologists) and radiologists,and the specialty of the individual who performs the LB determines if the LB is performed under ultrasound guidance or not.There are two types of biopsy needles used for LB:cutting needles(Tru-Cut,Vim-Silverman) and suction needles(Menghini,Klatzkin,Jamshidi).The rate of major complications after percutaneous LB ranges from 0.09% to 2.3%,but the echo-guided percutaneous liver biopsy is a safe method for the diagnosis of chronic diffuse hepatitis(cost-effective as compared to blind biopsy) and the rate of complications seems to be related to the experience of the physician and the type of the needle used(Menghini type needle seems to be safer).Maybe,in a few years we will use non-invasive markers of fibrosis,but at this time,most authorities in the field consider that the LB is useful and necessary for the evaluation of chronic hepatopathies,despite the fact that it is not a perfect test. | Ioan Sporea Alina Popescu Roxana Sirli | 2008 | World Journal of Gastroenterology2008，14，21： | 12 |
| 12 | Is it better to use two elastographic methods for liver fibrosis assessment?显示文摘AIM:To find out if by combining 2 ultrasound based elastographic methods:acoustic radiation force impulse(ARFI)elastography and transient elastography(TE),we can improve the prediction of fibrosis in patients with chronic hepatitis C.METHODS:Our study included 197 patients with chronic hepatitis C.In each patient,we performed,in the same session,liver stiffness(LS)measurements by means of TE and ARFI,respectively,and liver biopsy(LB),assessed according to the Metavir score.10 LS measurements were performed both by TE and ARFI;median values were calculated and expressed in kilopascals(kPa)and meters/second(m/s),respectively.Only TE and ARFI measurements with IQR<30%andSR≥60%were considered reliable.RESULTS:On LB 13(6.6%)patients had F0,32(16.2%) had F1,52(26.4%)had F2,47(23.9%)had F3,and 53(26.9%)had F4.A direct,strong correlation was found between TE measurements and fibrosis(r=0.741),between ARFI and fibrosis(r=0.730)and also between TE and ARFI(r=0.675).For predicting significant fibrosis(F≥2),for a cutoff of 6.7 kPa,TE had 77.5% sensitivity(Se)and 86.5%specificity(Sp)[area under the receiver operating characteristic curve(AUROC)0.87] and for a cutoff of 1.2 m/s,ARFI had 76.9%Se and 86.7%Sp(AUROC 0.84).For predicting cirrhosis(F=4),for a cutoff of 12.2 kPa,TE had 96.2%Se and 89.6% Sp(AUROC 0.97)and for a cutoff of 1.8 m/s,ARFI had 90.4%Se and 85.6%Sp(AUROC 0.91).When both elastographic methods were taken into consideration,for predicting significant fibrosis(F≥2),(TE≥6.7 kPa and ARFI≥1.2 m/s)we obtained 60.5%Se,93.3% Sp,96.8%positive predictive value(PPV),41.4%negative predictive value(NPV)and 68%accuracy,while for predicting cirrhosis(TE≥12.2 kPa and ARFI≥1.8 m/s) we obtained 84.9%Se,94.4%Sp,84.9%PPV,94.4% NPV and 91.8%accuracy.CONCLUSION:TE used in combination with ARFI is highly specific for predicting significant fibrosis;therefore when the two methods are concordant,liver biopsy can be avoided. | Ioan Sporea Roxana Sirli Alina Popescu Simona Bota Radu Badea Monica Lupsor Mircea Focsa Mirela Danila | 2011 | World Journal of Gastroenterology2011，17，33： | 11 |
| 13 | Meta‐analysis: ARFI elastography versus transient elastography for the evaluation of liver fibrosis显示文摘 | Simona Bota Harald Herkner Ioan Sporea Petra Salzl Roxana Sirli Adriana M. Neghina Markus Peck‐Radosavljevic | 2013 | Liver Int2013，，8： | 9 |
| 14 | Systematic review of the old and new concepts in the epithelial-mesenchymal transition of colorectal cancer显示文摘Epithelial-to-mesenchymal transition(EMT) is defined as the transformation of an epithelial cell into a spindle cell with the loss of membrane E-cadherin expression and the gain of mesenchymal markers positivity. In the field of colorectal cancer(CRC), first data about EMT was published in 1995 and more than 400 papers had been written up to March 2016. Most of them are focused on the molecular pathways and experimentally-proved chemoresistance. In the present article, an update in the field of EMT in CRC based on the review of the literature and personal experience of the authors is presented. The information about the molecular and immunohistochemical(IHC) particularities of these processes and their possible role in the prognosis of CRC were also up-dated. This article focuses on the IHC quantification of the EMT, the immunoprofile of tumor buds and on the relation between EMT, angiogenesis, and stem cells activation. The EMT-induced chemoresistance vs chemotherapyor radiotherapy-induced EMT and cellular senescence was also synthesized for both conventional and targeted therapy. As a future perspective, the EMTangiogenesis-stemness link could be used as a possible valuable parameter for clinical follow-up and targeted therapeutic oncologic management of patients with CRC. Association of dexamethasone and angiotensin converting enzyme inhibitors combined with conventional chemotherapies could have clinical benefits in patients with CRC. The main conclusion is that, although many studies have been published, the EMT features are still incompletely elucidated and newly discovered EMT markers provide confusing data in understanding this complicated process, which might have significant clinical impact. | Simona Gurzu Camelia Silveanu Annamaria Fetyko Vlad Butiurca Zsolt Kovacs Ioan Jung | 2016 | World Journal of Gastroenterology2016，22，30： | 8 |
| 15 | Single skip metastasis in sentinel lymph node: In an early gastric cancer显示文摘Lymph node status is considered a key prognostic and predictive factor in patients with gastric cancer(GC).Although there is a practical approach to the intraoperative detection of sentinel lymph nodes(SLNs),such a procedure is not included in the European surgical protocol.In this report,we present a practical approach to SLN mapping in a representative case with early gastric cancer(EGC).A 74-year-old female was hospitalized with an endoscopically observed,superficially ulcerated tumor located in the antral region.Subtotal gastrectomy with D2 lymphadenectomy and SLN mapping was performed by injecting methylene blue dye into the peritumoral submucosal layer.An incidentally detected blue-stained lymph node located along the middle colic artery was also removed.This was detected 40 min after injection of the methylene blue.Histopathologic examination showed a p T1b-staged well-differentiated HER-2-negative adenocarcinoma.All of the 41 LNs located at the first,third,and fifth station of the regional LN compartments were found to be free of tumor cells.The only lymph node with metastasis was located along the middle colicartery and was considered a non-regional lymph node.This incidentally identified skip metastasis indicated stage Ⅳ GC.A classic chemotherapy regimen was given,and no recurrences were observed six months after surgery.In this representative case,low-cost SLN mapping,with a longer intraoperative waiting time,totally changed the stage of the tumor in a patient with EGC. | Tivadar Jr Bara Simona Gurzu Ioan Jung Zoltan Kadar Haruhiko Sugimura Tivadar Bara | 2015 | World Journal of Gastroenterology2015，21，33： | 8 |
| 16 | Staging of portal hypertension and portosystemic shunts using dynamic nuclear medicine investigations显示文摘AIM: To explore portal hypertension and portosys-temic shunts and to stage chronic liver disease (CLD) based on the pathophysiology of portal hemodynam-ics. METHODS: Per-rectal portal scintigraphy (PRPS) was performed on 312 patients with CLD and liver angio-scintigraphy (LAS) on 231 of them. The control group included 25 healthy subjects. We developed a new model of PRPS interpretation by introducing two new parameters,the liver transit time (LTT) and the circu-lation time between right heart and liver (RHLT). LTT for each lobe was used to evaluate the early portal hypertension. RHLT is useful in cirrhosis to detect liver areas missing portal in? ow. We calculated the classical per-rectal portal shunt index (PRSI) at PRPS and the hepatic perfusion index (HPI) at LAS. RESULTS: The normal LTT value was 24 ± 1 s. Abnor-mal LTT had PPV = 100% for CLD. Twenty-seven non-cirrhotic patients had LTT increased up to 35 s (median 27 s). RHLT (42 ± 1 s) was not related to liver disease. Cirrhosis could be excluded in all patients with PRSI < 5% (P < 0.01). PRSI > 30% had PPV = 100% for cirrhosis. Based on PRPS and LAS we propose the clas-sifi cation of CLD in 5 hemodynamic stages. Stage 0 is normal (LTT = 24 s,PRSI < 5%). In stage 1,LTT is increased,while PRSI remains normal. In stage 2,LTT is decreased between 16 s and 23 s,whereas PRSI is increased between 5% and 10%. In stage 3,PRSI is increased to 10%-30%,and LTT becomes undetect-able by PRPS due to the portosystemic shunts. Stage 4 includes the patients with PRSI > 30%. RHLT and HPI were used to subtype stage 4. In our study stage 0 had NPV = 100% for CLD,stage 1 had PPV = 100% for non-cirrhotic CLD,stages 2 and 3 represented the transition from chronic hepatitis to cirrhosis,stage 4 had PPV = 100% for cirrhosis. CONCLUSION: LTT allows the detection of early por-tal hypertension and of opening of transhepatic shunts. PRSI is useful in CLD with extrahepatic portosystemic shunts. Our hemodynamic model stages the evolution of portal hypertension and portosystemic shunts. It may be of use in the selection of patients for interferon therapy. | Mircea Dragoteanu Ioan A Balea Liliana A Dina Cecilia D Piglesan Ioana Grigorescu Stefan Tamas Sabin O Cotul | 2008 | World Journal of Gastroenterology2008，14，24： | 7 |
| 17 | Techniques and accuracy of thoracolumbar pedicle screw placement显示文摘Pedicle screw instrumentation has been used to stabilize the thoracolumbar spine for several decades. Although pedicle screws were originally placed via a freehand technique, there has been a movement in favor of pedicle screw placement with the aid of imaging. Such assistive techniques include fluoroscopy guidance and stereotactic navigation. Imaging has the benefit of increased visualization of a pedicle's trajectory, but can result in increased morbidity associated with radiation exposure, increased time expenditure, and possible workflow interruption. Many institutions have reported high accuracies with each of these three core techniques. However, due to differing definitions of accuracy and varying radiographic analyses, it is extremely difficult to compare studies side-by-side to determine which techniques are superior. From the literature, it can be concluded that pedicles of vertebrae within the mid-thoracic spine and vertebrae that have altered morphology due to scoliosis or other deformities are the most difficult to cannulate. Thus, spine surgeons would benefit the most from using assistive technologies in these circumstances. All other pedicles in thethoracolumbar spine should theoretically be cannulated with ease via a free-hand technique, given appropriate training and experience. Despite these global recommendations, appropriate techniques must be chosen at the surgeon's discretion. Such determinations should be based on the surgeon's experience and the specific pathology that will be treated. | Varun Puvanesarajah Jason A Liauw Sheng-fu Lo Ioan A Lina Timothy F Witham | 2014 | World Journal of Orthopedics2014，5，2： | 7 |
| 18 | Malignant hepatic vascular tumors in adults: Characteristics,diagnostic difficulties and current management显示文摘Malignant vascular tumors of the liver include rare primary hepatic mesenchymal tumors developed in the background of a normal liver parenchyma. Most of them are detected incidentally by the increased use of performing imaging techniques. Their diagnosis is challenging, involving clinical and imaging criteria, with final confirmation by histology and immunohistochemistry. Surgery represents the mainstay of treatment. Liver transplantation(LT) has improved substantially the prognosis of hepatic epithelioid hemangioendothelioma(HEHE), with 5-year patient survival rates of up to 81%, based on the European Liver Intestine Transplantation AssociationEuropean Liver Transplant Registry study. Unfortunately, the results of surgery and LT are dismal in cases of hepatic angiosarcoma(HAS). Due to the disappointing results of very short survival periods of approximately 6-7 mo after LT, because of tumor recurrence and rapid progression of the disease, HAS is considered an absolute contraindication to LT. Recurrences after surgical resection are high in cases of HEHE and invariably present in cases of HAS. The discovery of reliable prognostic markers and the elaboration of prognostic scores following LT are needed to provide the best therapeutic choice for each patient.Studies on a few patients have demonstrated the stabilization of the disease in a proportion of patients with hepatic vascular tumors using novel targeted antiangiogenic agents, cytokines or immunotherapy. These new approaches,alone or in combination with other therapeutic modalities, such as surgery and classical chemotherapy, need further investigation to assess their role in prolonging patient survival. Personalized therapeutic algorithms according to the histopathological features, behavior, molecular biology and genetics of the tumors should be elaborated in the near future for the management of patients diagnosed with primary malignant vascular tumors of the liver. | Daniela Cornelia Lazar Mihaela Flavia Avram Ioan Romosan Violetta Vacariu Adrian Goldis Marioara Cornianu | 2019 | World Journal of Clinical Oncology2019，10，3： | 7 |
| 19 | 液压胀形金属板材的塑性行为表征(英文)显示文摘采用圆形和椭圆形的模具进行液压胀形试验。利用最近提出的椭圆形模具胀形方法来确定等效应力—应变曲线。该方法将ARAMIS系统测得的实验数据与分析相结合。在使用椭圆形模具的液压胀形实验中,随着模具椭圆度的减小,等效应力—应变曲线逐渐远离圆形模具胀形的曲线。通过胀形测试来确定DC04钢板在正次应变范围内的成形极限图。 | Lucian LZRESCU Dan-Sorin COMSA Ioan NICODIM Ioan CIOBANU Dorel BANABIC | 2012 | 中国有色金属学会会刊:英文版2012，22，S2： | 6 |
| 20 | Ultrasound-based elastography for the diagnosis of portal hypertension in cirrhotics显示文摘Progressive fibrosis is encountered in almost all chronicliver diseases. Its clinical signs are diagnostic in advanced cirrhosis, but compensated liver cirrhosis is harder to diagnose. Liver biopsy is still considered the reference method for staging the severity of fibrosis, but due to its drawbacks(inter and intra-observer variability, sampling errors, unequal distribution of fibrosis in the liver, and risk of complications and even death), non-invasive methods were developed to assess fibrosis(serologic and elastographic). Elastographic methods can be ultrasound-based or magnetic resonance imaging-based. All ultrasoundbased elastographic methods are valuable for the early diagnosis of cirrhosis, especially transient elastography(TE) and acoustic radiation force impulse(ARFI) elastography, which have similar sensitivities and specificities, although ARFI has better feasibility. TE is a promising method for predicting portal hypertension in cirrhotic patients, but it cannot replace upper digestive endoscopy. The diagnostic accuracy of using ARFI in the liver to predict portal hypertension in cirrhotic patients is debatable, with controversial results in published studies. The accuracy of ARFI elastography may be significantly increased if spleen stiffness is assessed, either alone or in combination with liver stiffness and other parameters. Two-dimensional shearwave elastography, the Elast PQ technique and strain elastography all need to be evaluated as predictors of portal hypertension. | Roxana Sirli Ioan Sporea Alina Popescu Mirela Danila | 2015 | World Journal of Gastroenterology2015，21，41： | 6 |
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