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| 1 | 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 |
| 2 | 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 |
| 3 | 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 |
| 4 | 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 |
| 5 | Hepatic ischemic preconditioning increases portal vein flow in experimental liver ischemia reperfusion injury显示文摘BACKGROUND: Ischemic preconditioning(IPC) has been shown to decrease liver injury and to increase hepatic microvascular perfusion after liver ischemia reperfusion. This study aimed to evaluate the effects of IPC on hemodynamics of the portal venous system. METHODS: Thirty-two rats were randomized into two groups: IPC group and control group. The rats of the IPC group underwent IPC by 10 minutes of liver ischemia followed by 10 minutes of reperfusion before liver ischemia, and the rats of the control group were subjected to 60 minutes of partial liver ischemia. Non-ischemic lobes were resected immediately after reperfusion. The animals were studied at 4 hours and 12 hours after reperfusion. Mean arterial pressure, heart rate, portal vein flow and pressure were analyzed. Blood was collected for the determination of the levels of aspartate aminotransferase, alanine aminotransferase, calcium, lactate, pH, bicarbonate, and base excess. RESULTS: IPC increased the mean portal vein flow at 4 hours and 12 hours after reperfusion. IPC recovered 78% of the meanportal vein flow at 12 hours after reperfusion. IPC decreased the levels of aspartate aminotransferase, alanine aminotransferase and lactate, and increased the levels of ionized calcium, bicarbonate and base excess at 12 hours after reperfusion. CONCLUSIONS: This study demonstrated that IPC increases portal vein flow and enhances hepatoprotective effects in liver ischemia reperfusion. The better recovery of portal vein flow after IPC may be correlated with the lower levels of transaminases and with the better metabolic profile. | Estela RR Figueira Joel A Rocha-Filho Mauro Nakatani Marcelo FS Buto Eduardo R Tatebe Vitor O Andre Ivan Cecconello Luiz AC D'Albuquerque | 2014 | Hepatobiliary & Pancreatic Diseases International2014，13，1： | 6 |
| 6 | Listeria monocytogenes following orthotopic liver transplantation:Central nervous system involvement and review of the literature显示文摘Listeria monocytogene is a well-recognized cause of bacteremia in immunocompromised individuals,including solid organ transplant recipients,but has been rarely reported following orthotopic liver transplantation. We describe a case of listeria meningitis that occurred within a week after liver transplantation. The patient developed a severe headache that mimicked tacrolimus encephalopathy,and was subsequently diagnosed with listeria meningitis by cerebrospinal fluid culture. The infection was successfully treated with three-week course of intravenous ampicillin. Recurrent hepatitis C followed and was successfully treated with interferon alfa and ribavirin. Fourteen cases of listeriosis after orthotopic liver transplantation have been reported in the English literature. Most reported cases were successfully treated with intravenous ampicillin. There were four cases of listeria meningitis,and the mortality of them was 50%. Early detection and treatment of listeria meningitis are the key to obtaining a better prognosis. | Shugo Mizuno Ivan R Zendejas Alan I Reed Robin D Kim Richard J Howard Alan W Hemming Denise C Schain Consuelo Soldevila-Pico Roberto J Firpi Shiro Fujita | 2007 | World Journal of Gastroenterology2007，13，32： | 2 |
| 7 | The Use of Preoperative Endoscopic Tattooing in Laparoscopic Colorectal Cancer Surgery for Endoscopically Advanced Tumors: A Prospective Comparative Clinical Study显示文摘 | Ivan Arteaga-González MD Antonio Martín-Malagón MD Eudaldo M. López-Tomassetti Fernández MD Javier Arranz-Durán MD Adolfo Parra-Blanco MD David Nicolas-Perez MD Enrique Quintero-Carrión MD Hermogenes Díaz Luis MD Angel Carrillo-Pallares MD PhD | 2006 | World Journal of Surgery2006，，4： | 2 |
| 8 | Short-term outcomes after laparoscopic colorectal surgery in patients with previous abdominal surgery: A systematic review显示文摘AIM: To perform a systematic review focusing on shortterm outcomes after colorectal surgery in patients with previous abdominal open surgery(PAOS).METHODS: A broad literature search was performed with the terms 'colorectal', 'colectomy', 'PAOS', 'previous surgery' and 'PAOS'. Studies were included if their topic was laparoscopic colorectal surgery in patients with PAOS, whether descriptive or comparative. Endpoints of interest were conversion rates, inadvertent enterotomy and morbidity. Analysis of articles was made according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses.RESULTS: From a total of 394 citations, 13 full-texts achieved selection criteria to be included in the study. Twelve of them compared patients with and without PAOS. All studies were retrospective and comparative and two were case-matched. The selected studies comprised a total of 5005 patients, 1865 with PAOS. Among the later, only 294(16%) had history of a midline incision for previous gastrointestinal surgery. Conversion rates were significantly higher in 3 of 12 studies and inadvertent enterotomy during laparoscopywas more prevalent in 3 of 5 studies that disclosed this event. Morbidity was similar in the majority of studies. A quantitative analysis(meta-analysis) could not be performed due to heterogeneity of the studies. CONCLUSION: Conversion rates were slightly higher in PAOS groups, although not statistical significant in most studies. History of PAOS did not implicate in higher morbidity rates. | Marleny Novaes Figueiredo Fabio Guilherme Campos Luiz Augusto D'Albuquerque Sergio Carlos Nahas Ivan Cecconello Yves Panis | 2016 | World Journal of Gastrointestinal Surgery2016，8，7： | 2 |
| 9 | Liver Planning Software Accurately Predicts Postoperative Liver Volume and Measures Early Regeneration显示文摘 | Amber L. Simpson David A. Geller Alan W. Hemming William R. Jarnagin Logan W. Clements Michael I. D’Angelica Prashanth Dumpuri Mithat G?nen Ivan Zendejas Michael I. Miga James D. Stefansic | 2014 | Journal of the American College of Surgeons2014，，： | 2 |
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