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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | Contribution of oxidative stress to pulmonary arterial hypertension显示文摘Recent data implicate oxidative stress as a mediator of pulmonary hypertension (PH) and of the associated pathological changes to the pulmonary vasculature and right ventricle (RV). Increases in reactive oxygen species (ROS), altered redox state, and elevated oxidant stress have been demonstrated in the lungs and RV of several animal models of PH, including chronic hypoxia, monocrotaline toxicity, caveolin-1 knock-out mouse, and the transgenic Ren2 rat which overexpresses the mouse renin gene. Generation of ROS in these models is derived mostly from the activities of the nicotinamide adenine dinucleotide phosphate oxidases, xanthine oxidase, and uncoupled endothelial nitric oxide synthase. As disease progresses circulating monocytes and bone marrow-derived monocytic progenitor cells are attracted to and accumulate in the pulmonary vasculature. Once established, these inflammatory cells generate ROS and secrete mitogenic and fibrogenic cytokines that induce cell proliferation and fibrosis in the vascular wall resulting in progressive vascular remodeling. Deficiencies in antioxidant enzymes also contribute to pulmonary hypertensive states. Current therapies were developed to improve endothelial function, reduce pulmonary artery pressure, and slow the progression of vascular remodeling in the pulmonary vasculature by targeting deficiencies in either NO (PDE-type 5 inhibition) or PGI 2 (prostacyclin analogs), or excessive synthesis of ET-1 (ET receptor blockers) with the intent to improve patient clinical status and survival. New therapies may slow disease progression to some extent, but long term management has not been achieved and mortality is still high. Although little is known concerning the effects of current pulmonary arterial hypertension treatments on RV structure and function, interest in this area is increasing. Development of therapeutic strategies that simultaneously target pathology in the pulmonary vasculature and RV may be beneficial in reducing mortality associated with RV failure. | Vincent G DeMarco Adam T Whaley-Connell James R Sowers Javad Habibi Kevin C Dellsperger | 2010 | World Journal of Cardiology2010，2，10： | 21 |
| 3 | 黄芪总黄酮对扑热息痛所致肝损伤的防护机理探讨显示文摘目的 :研究黄芪总黄酮对扑热息痛所致肝损伤的防护机理。方法 :用高压液相测定扑热息痛及代谢产物和苯巴比妥诱导睡眠模型研究黄芪总黄酮 (TFA)对扑热息痛的代谢及TFA抗扑热息痛所致损伤的机理。结果 :TFA可明显降低尿中硫醚胺酸的浓度 ,其变化与TFA浓度成反比 ;但对其它代谢产物的影响无明显统计学差异。苯巴比妥诱导小鼠睡眠实验结果显示 ,TFA (10 0mg·kg-1)本身对苯巴比妥代谢无明显影响 (P >0 .0 5 ) ,扑热息痛 (40 0mg·kg-1)可显著延长小鼠的睡眠时间 (P <0 .0 0 1) ;但TFA (10 0mg·kg-1)明显缩短扑热息痛所延长的苯巴比妥诱导的睡眠时间 (P <0 .0 0 5 )。结论 | 汪德清 Critchley Julian AJH 丁保国 马艳青 赵海潞 Thomas G Neil 田亚平 Tomlinson B rian Critchley Lester AH James Anthony Edward | 2001 | 中国中药杂志2001，26，9： | 13 |
| 4 | Consequences of bullying victimization in childhood and adolescence:A systematic review and meta-analysis显示文摘AIM To identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence.METHODS A systematic review was conducted using Pub Med, EMBASE, ERIC and Psyc INFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on qualityeffects models. Evidence for causality was assessed using Bradford Hill criteria and the grading system developed by the World Cancer Research Fund.RESULTS Out of 317 articles assessed for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis.Statistically significant associations were observed between bullying victimization and a wide range of adverse health and psychosocial problems. The evidence was strongest for causal associations between bullying victimization and mental health problems such as depression, anxiety, poor general health and suicidal ideation and behaviours. Probable causal associations existed between bullying victimization and tobacco and illicit drug use. CONCLUSION Strong evidence exists for a causal relationship between bullying victimization, mental health problems and substance use. Evidence also exists for associations between bullying victimization and other adverse health and psychosocial problems, however, there is insufficient evidence to conclude causality. The strong evidence that bullying victimization is causative of mental illness highlights the need for schools to implement effective interventions to address bullying behaviours. | Sophie E Moore Rosana E Norman Shuichi Suetani Hannah J Thomas Peter D Sly James G Scott | 2017 | World Journal of Psychiatry2017，7，1： | 12 |
| 5 | Calcium signaling and T-type calcium channels in cancer cell cycling显示文摘Regulation of intracellular calcium is an important signaling mechanism for cell proliferation in both normal and cancerous cells. In normal epithelial cells, free calcium concentration is essential for cells to enter and accomplish the S phase and the M phase of the cell cycle. In contrast, cancerous cells can pass these phases of the cell cycle with much lower cytoplasmic free calcium concentrations, indicating an alternative mechanism has developed for fulfilling the intracellular calcium requirement for an increased rate of DNA synthesis and mitosis of fast replicating cancerous cells. The detailed mechanism underlying the altered calcium loading pathway remains unclear; however, there is a growing body of evidence that suggests the T-type Ca2+ channel is abnormally expressed in cancerous cells and that blockade of these channels may reduce cell proliferation in addition to inducing apoptosis. Recent studies also show that the expression of T-type Ca2+ channels in breast cancer cells is proliferation state dependent, i.e. the channels are expressed at higher levels during the fast-replication period, and once the cells are in a non-proliferation state, expression of this channel isminimal. Therefore, selectively blocking calcium entry into cancerous cells may be a valuable approach for preventing tumor growth. Since T-type Ca2+ channels are not expressed in epithelial cells, selective T-type Ca2+ channel blockers may be useful in the treatment of certain types of cancers. | James T Taylor Xiang-Bin Zeng Jonathan E Pottle Kevin Lee Alun R Wang Stephenie G Yi lennifer A S Scruggs Suresh S Sikka Ming Li | 2008 | World Journal of Gastroenterology2008，14，32： | 12 |
| 6 | An epigenomic approach to therapy for tamoxifen-resistant breast cancer显示文摘Tamoxifen 是为雌激素受体 alpha 的前线治疗(ERα) 在绝经前的女人的积极的胸肿瘤。然而,到 tamoxifen 的抵抗发生在许多病人。嗯仍然与获得的 tamoxifen 抵抗在乳癌房间的生长起一个关键作用,建议那 ERα为治疗仍然是一个有效目标 tamoxifen 抵抗(Tam-R ) 乳癌。以识别 ERα 的新奇管理者;发信号,通过对 histone 甲基修饰词的一幅小规模的 siRNA 屏幕,我们发现了 WHSC1, histone H3K36 methyltransferase, ERα 的一个积极管理者;在乳癌房间发信号。我们证明 WHSC1 被招募到 ERα由 BET 蛋白质 BRD3/4 的基因,并且便于 ERα基因表示。小分子的赌注蛋白质禁止者 JQ1 potently 压制了经典 ERα发信号的小径和在文化的 Tam-R 乳癌房间的生长。用一个 Tam-R 乳癌异种皮移植老鼠模型,我们与 JQ1 和 ER degrader fulvestrant 由 JQ1 和联合治疗的强壮的长持续的效果在 vivo 反胸癌症活动示威了。一起拿,我们提供 epigenomic 蛋白质 BRD3/4 和 WHSC1 是雌激素受体发信号的必要管理者并且是为 Tam-R 乳癌的治疗的新奇治疗学的目标的证据。 | Qin Feng Zheng Zhang Martin J Shea Chad J Creighton Cristian Coarfa Susan G Hilsenbeck Rainer Lanz Bin He Lei Wang Xiaoyong Fu Agostina Nardone Yongcheng Song James Bradner Nicholas Mitsiades Constantine S Mitsiades C Kent Osborne Rachel Schiff Bert W O'Malley | 2014 | Cell Research2014，24，7： | 10 |
| 7 | Serial imaging of human embryonic stem-cell engraftment and teratoma formation in live mouse models显示文摘表示为基于 radiopharmaceutical 的成像为生物体之发光成像或 HSV1 thymidine kinase (HSV1-TK ) 编码任何一个萤火虫酶(fLuc ) 的记者 transgene 的 lentiviral 向量的二种新类型被构造监视人的胚胎的干细胞(hESC ) 在在移植以后的活老鼠的嫁接和增长。任何一个 transgene 的组成的表示没在文化改变 hESCs 的性质。我们下次在 SCID 鼠标监视了 teratomas 的形成到测试(1 ) 是否修改基因的 hESCs 维持他们的发展 pluripotency,并且(2 ) 是否支撑了记者基因表示,允许 noninvasive,在一个活鼠标模型的 hESC 衍生物的整个身体的成像。我们在接种以后从修改基因的房间以及野类型的 hESCs 2-4 月的两种类型观察了 teratoma 形成。用一个光成像系统,从 fLuc-transduced hESCs 的生物体之发光容易在在摸得出的肿瘤能被检测以前,长忍受 teratomas 的老鼠被检测。开发一个 noninvasive 成像方法对诊所更容易地可译,我们也利用了 HSV1-TK 和它的特定的底层, 1-(2 鈥 ? deoxy-2 鈥 ?fluoro- 尾 - D-arabinofuranosyl )-5-[125I]iodouracil ([125I ] FIAU ) ,记者 / 探查对。在全身的管理以后,[125I ] FIAU 是仅仅由编码 transgene 的 HSV1-TK 酶的 phosphorylated 并且在 transduced 以内保留(并且移植) 房间,由单个光子的排放允许敏感、量的成像计算了断层摄影术。象这些那样的 Noninvasive 成像方法可以使我们能在实时接受者以内重复地监视移植人的干细胞的存在和分发在上一通过记者基因的表达式长期。 | Martin G Pomper Holly Hammond Xiaobing Yu Zhaohui Ye Catherine A Foss Doris D Lin James J Fox Linzhao Cheng | 2009 | Cell Research2009，19，3： | 9 |
| 8 | 在结肠和直肠的癌症的淋巴节点收获: 当前的考虑显示文摘 The prognostic significance of identifying lymph node(LN) metastases following surgical resection for colon and rectal cancer is well recognized and is reflected in accurate staging of the disease.An established body of evidence exists,demonstrating an association between a higher total LN count and improved survival,particularly for node negative colon cancer.In node positive disease,however,the lymph node ratios may represent a better prognostic indicator,although the impact of this on clinical treatment has yet to be universally established.By extension,strategies to increase surgical node harvest and/or laboratory methods to increase LN yield seem logical and might improve cancer staging.However,debate prevails as to whether or not these extrapolations are clinically relevant,particularly when very high LN counts are sought.Current guidelines recommend a minimum of 12 nodes harvested as the standard of care,yet the evidence for such is questionable as it is unclear whether an increasing the LN count results in improved survival.Findings from modern treatments,including down-staging in rectal cancer using pre-operative chemoradiotherapy,paradoxically suggest that lower LN count,or indeed complete absence of LNs,are associated with improved survival;implying that using a specific number of LNs harvested as a measure of surgical quality is not always appropriate.The pursuit of a sufficient LN harvest represents good clinical practice;however,recent evidence shows that the exhaustive searching for very high LN yields may be unnecessary and has little in? uence on modern approaches to treatment. | James R McDonald Andrew G Renehan Sarah T O’Dwyer Najib Y Haboubi | 2012 | World Journal of Gastrointestinal Surgery2012，4，1： | 8 |
| 9 | Ultrahigh resolution optical coherence tomography with femtosecond Ti:sapphire laser and photonic crystal fiber显示文摘Optical coherence tomography (OCT) with ultrahigh axial resolution was achieved by the super-contin-uum generated by coupling femtosecond pulses from a commercial Ti:sapphire laser into an air-silica microstructure fiber. The visible spectrum of the super-continuum from 450 to 700 nm centered at 540 nm can be generated. A free-space axial OCT resolution of 0.64 μm was achieved. The sensitivity of OCT system was 108 dB with incident light power 3 mW at sample,only 7dB below the theoretical limit. Subcellular OCT imaging was also demonstrated,showing great potential for biomedical application. | XUE Ping James G FUJIMOTO | 2008 | Chinese Science Bulletin2008，53，13： | 8 |
| 10 | European evidence based consensus for endoscopy in inflammatory bowel disease显示文摘 | Vito Annese Marco Daperno Matthew D. Rutter Aurelien Amiot Peter Bossuyt James East Marc Ferrante Martin G?tz Konstantinos H. Katsanos Ralf Kie?lich Ingrid Ordás Alessandro Repici Bruno Rosa Shaji Sebastian Torsten Kucharzik Rami Eliakim | 2013 | Journal of Crohn’s and Colitis2013，，12： | 7 |
| 11 | Tight junction disruption: Helicobacter pylori and dysregulation of the gastric mucosal barrier显示文摘Long-term chronic infection with Helicobacter pylori(H. pylori) is a risk factor for gastric cancer development. In the multi-step process that leads to gastric cancer,tight junction dysfunction is thought to occur and serve as a risk factor by permitting the permeation of luminal contents across an otherwise tight mucosa. Mechanisms that regulate tight junction function and structure in the normal stomach,or dysfunction in the infected stomach,however,are largely unknown. Although conventional tight junction components are expressed in gastric epithelial cells,claudins regulate paracellular permeability and are likely the target of inflammation or H. pylori itself. There are 27 different claudin molecules,each with unique properties that render the mucosa an intact barrier that is permselective in a way that is consistent with cell physiology. Understanding the architecture of tight junctions in the normal stomach and then changes that occur during infection is important but challenging,because most of the reports that catalog claudin expression in gastric cancer pathogenesis are contradictory. Furthermore,the role of H. pylori virulence factors,such as cytotoxin-associated gene A and vacoulating cytotoxin,in regulating tight junction dysfunction during infection is inconsistent in different gastric cell lines and in vivo,likely because non-gastric epithelial cell cultures were initially used to unravel the details of their effects on the stomach. Hampering further study,as well,is the relative lack of cultured cell models that have tight junction claudins that are consistent with native tissues. This summary will review the current state of knowledge about gastric tight junctions,normally and in H. pylori infection,and make predictions about the consequences of claudin reorganization during H. pylori infection. | Tyler J Caron Kathleen E Scott James G Fox Susan J Hagen | 2015 | World Journal of Gastroenterology2015，21，40： | 7 |
| 12 | 急性冠状动脉综合征发生1个月后的生长分化因子15水平与主要出血风险增加相关显示文摘用双重抗血小板治疗的急性冠状动脉综合征(acutecoronarysyndromes,ACS)患者在初次就诊测量的生长分化因子15(growthdifferentiationfactor-15,GDF-15)与大出血相关。 | Lindholm D Hagstrm E James SK Becker RC Cannon CP Himmelmann A Katus HA Maurer G López-Sendón JL Steg PG Storey RF Siegbahn A Wallentin L 刘莉 叶鹏 | 2017 | 中华高血压杂志2017，25，5： | 5 |
| 13 | Football injuries of the ankle: A review of injury mechanisms, diagnosis and management显示文摘Football is the most popular sport worldwide and is associated with a high injury rate, most of which are the result of trauma from player contact. Ankle injuries are among the most commonly diagnosed injuries in the game. The result is reduced physical activity and endurance levels, lost game time, and considerable medical cost. Sports medicine professionals must employ the correct diagnostic tools and effective treatments and rehabilitation protocols to minimize the impact of these injuries on the player. This review examines the diagnosis, treatment, and postoperative rehabilitation for common football injuries of the ankle based on the clinical evidence provided in the current literature. | Raymond J Walls Keir A Ross Ethan J Fraser Christopher W Hodgkins Niall A Smyth Christopher J Egan James Calder John G Kennedy | 2016 | World Journal of Orthopedics2016，7，1： | 5 |
| 14 | 抗炎介质表达缺陷参与中性粒细胞型支气管哮喘发病机制:半乳糖凝集素-3和白细胞介素-1RA/白细胞介素-1beta比例显著下降显示文摘支气管哮喘(哮喘)是具有异质性的气道炎症性疾病,其主要特点表现为气道高反应和可变的气流受限。在哮喘的发病机制中,过敏原诱导的TH2淋巴细胞激活以及IL-5介导的嗜酸粒细胞渗出起到重要的作用。近年来发现超过50%的哮喘患者气道的嗜酸粒细胞水平并不增高,并将这种亚型定义为非嗜酸粒细胞型哮喘。其中部分患者表现为气道中性粒细胞明显增高,称为中性粒细胞型哮喘。 | 高鹏 Peter G Gibson Katherine J Baines Ian A Yang John W Upham Paul N Reynolds Sandra Hodge Alan L James Christine Jenkins Matthew J Peters 张捷 Jodie L Simpson | 2016 | 中华结核和呼吸杂志2016，39，11： | 5 |
| 15 | Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial显示文摘 | JY Douillard D Cunningham AD Roth M Navarro RD James P Karasek P Jandik T Iveson J Carmichael M Alakl G Gruia L Awad P Rougier | 2000 | The Lancet2000，，9209： | 4 |
| 16 | 气候变化和紫外线辐射对北极淡水鱼类及溯河产卵鱼类渔业的影响显示文摘北极淡水鱼类和洄游鱼类渔业为北方经济做出了重大贡献。但是,对于淡水水体,气候变化和增长的紫外线辐射对渔业产生的巨大影响有3个方面:可获鱼的数量、质量和捕捞成功率。因此,在这些影响发生作用之际,可能需要实质有效的适应行为以引导北极未来的渔业走向可持续性。当务之急是为商业渔业选择灵活和快速反应的'适宜管理'方式;改变生计渔业的当地土地和资源利用模式;改变很多休闲渔业的特性、管理方式和地点。总的来说,在气候变化及其对北极淡水水域和生物区影响的复杂性和不确定性情况下,为保证生态系统和主导鱼种有足够的恢复力和应对将来变化的能力,需要对渔业的各个方面实施更保守的管理办法。 | James D.Reist Frederick J.Wrona Terry D.Prowse J.Brian Dempson Michael Power Günter Kck Theresa J.Carmichael Chantelle D.Sawatzky Hannu Lehtonen Ross F.Tallman 曾首英 | 2006 | AMBIO-人类环境杂志2006，35，7： | 4 |
| 17 | Fecal lactoferrin accurately reflects mucosal inflammation in inflammatory bowel disease显示文摘BACKGROUND Studies have demonstrated a potential role for fecal biomarkers such as fecal calprotectin(FC)and fecal lactoferrin(FL)in monitoring inflammatory bowel diseases(IBD)-Crohn's disease(CD)and ulcerative colitis(UC).However,their correlation to endoscopic scores,disease severity and affected intestinal surface has not been extensively investigated.AIM To correlate FL,and for comparison white blood cell(WBC)and C-reactive protein(CRP),with endoscopic scores,disease extent and location in CD and UC.METHODS Retrospective analysis in 188 patients who had FL,CRP and WBC determined within 30 d of endoscopy.Disease location,disease extent(number of intestinal segments involved),disease severity(determined by endoscopic scores),timing of FL testing in relation to colonoscopy,as well as the use of effective fast acting medications(steroids and biologics)between colonoscopy and FL measurement,were recorded.RESULTS In 131 CD and 57 UC patients,both CRP and FL-but not WBC-distinguished disease severity(inactive,mild,moderate,severe).In patients receiving fastacting(steroids or biologics)treatment in between FL and colonoscopy,FL showed a higher correlation to endoscopic scores when tested before vs after the procedure(r=0.596,P<0.001,vs r=0.285,P=0.15 for the Simple Endoscopic Score for CD;and r=0.402,P=0.01 vs r=0.054 P=0.84 for Disease Activity Index).Finally,FL was significantly correlated with the diseased mucosal surface(colon-ileocolon>small bowel)and the number of inflamed colon segments.CONCLUSION FL and CRP separated disease severity categories with FL showing lower discriminating P-values.FL showed a close correlation with the involved mucosal surface and with disease extent and was more closely correlated to endoscopy when determined before the procedure–this indicating that inflammatory activity changes associated with therapy might be rapidly reflected by FL levels.FL can accurately and timely characterize intestinal inflammation in IBD. | Marrieth G Rubio Kofi Amo-Mensah James M Gray Vu Q Nguyen Sam Nakat Douglas Grider Kim Love James H Boone Dario Sorrentino | 2019 | World Journal of Gastrointestinal Pathophysiology2019，10，5： | 4 |
| 18 | Function of longitudinal vs circular muscle fibers in esophageal peristalsis, deduced with mathematical modeling显示文摘We summarize from previous works the functions of circular vs. longitudinal muscle in esophageal peristaltic bolus transport using a mix of experimental data, the conservation laws of mechanics and mathematical modeling. Whereas circular muscle tone generates radial closure pressure to create a local peristaltic closure wave, longitudinal muscle tone has two functions, one physiological with mechanical implications, and one purely mechanical. Each of these functions independently reduces the tension of individual circular muscle fibers to maintain closure as a consequence of shortening of longitudinal muscle locally coordinated with increasing circular muscle tone. The physiological function is deduced by combining basic laws of mechanics with concurrent measurements of intraluminal pressure from manometry, and changes in cross sectional muscle area from endoluminal ultrasound from which local longitudinal shortening (LLS) can be accurately obtained. The purely mechanical function of LLS was discovered from mathematical modeling of peristaltic esophageal transport with the axial wall motion generated by LLS. Physiologically, LLS concentrates circular muscle fibers where closure pressure is highest. However, the mechanical function of LLS is to reduce the level of pressure required to maintain closure. The combined physiological and mechanical consequences of LLS are to reduce circular muscle fiber tension and power by as much as 1/10 what would be requiredfor peristalsis without the longitudinal muscle layer, a tremendous benefit that may explain the existence of longitudinal muscle fiber in the gut. We also review what is understood of the role of longitudinal muscle in esophageal emptying, reflux and pathology. | James G Brasseur Mark A Nicosia Anupam Pal Larry S Miller | 2007 | World Journal of Gastroenterology2007，13，9： | 4 |
| 19 | Gastric intestinal metaplasia is associated with gastric dysplasia but is inversely correlated with esophageal dysplasia显示文摘AIM To determine which clinical factors might be associated with gastric intestinal metaplasia(IM) in a North American population.METHODS Pathology and endoscopy databases at an academicmedical center were reviewed to identify patients with and without gastric IM on biopsies for a retrospective cohort study. Patient demographics, insurance status, and other clinical factors were reviewed.RESULTS Four hundred and sixty-eight patients with gastric IM(mean age: 61.0 years ± 14.4 years, 55.5% female) and 171 without gastric IM(mean age: 48.8 years ± 20.8 years, 55.0% female) were compared. The endoscopic appearance of atrophic gastritis correlated with finding gastric IM on histopathology(OR = 2.05, P = 0.051). Gastric IM was associated with histologic findings of chronic gastritis(OR = 2.56, P < 0.001), gastric ulcer(OR = 6.97, P = 0.015), gastric dysplasia(OR = 6.11, P = 0.038), and gastric cancer(OR = 6.53, P = 0.027). Histologic findings of Barrett's esophagus(OR = 0.28, P = 0.003) and esophageal dysplasia(OR = 0.11, P = 0.014) were inversely associated with gastric IM. Tobacco use(OR = 1.73, P = 0.005) was associated with gastric IM.CONCLUSION Patients who smoke or have the endoscopic finding of atrophic gastritis are more likely to have gastric IM and should have screening gastric biopsies during esophagogastroduodenoscopy(EGD). Patients with gastric IM are at increased risk for having gastric dysplasia and cancer, and surveillance EGD with gastric biopsies in these patients might be reasonable. | Justin M Gomez James T Patrie Wissam Bleibel Jeanetta W Frye Bryan G Sauer Vanessa M Shami Edward B Stelow Christopher A Moskaluk Andrew Y Wang | 2017 | World Journal of Gastrointestinal Endoscopy2017，9，2： | 3 |
| 20 | Cervical inlet patch-optical coherence tomography imaging and clinical significance显示文摘AIM:To demonstrate the feasibility of optical coherence tomography(OCT)imaging in differentiating cervical inlet patch(CIP)from normal esophagus,Barrett'sesophagus(BE),normal stomach and duodenum. METHODS:This study was conducted at the Veterans Affairs Boston Healthcare System(VABHS).Patients undergoing standard esophagogastroduodenoscopy at VABHS,including one patient with CIP,one representative patient with BE and three representative normal subjects were included.White light video endoscopy was performed and endoscopic 3D-OCT images were obtained in each patient using a prototype OCT system.The OCT imaging probe passes through the working channel of the endoscope to enable simultaneous video endoscopy and 3D-OCT examination of the human gastrointestinal(GI)tract.Standard hematoxylin and eosin(H and E)histology was performed on biopsy or endoscopic mucosal resection specimens in order to compare and validate the 3D-OCT data. RESULTS:CIP was observed from a 68-year old male with gastroesophageal reflux disease.The CIP region appeared as a pink circular lesion in the upper esophagus under white light endoscopy.OCT imaging over the CIP region showed columnar epithelium structure,which clearly contrasted the squamous epithelium structure from adjacent normal esophagus.3D-OCT images obtained from other representative patients demonstrated distinctive patterns of the normal esophagus,BE,normal stomach,and normal duodenum bulb.Microstructures,such as squamous epithelium,lamina propria, muscularis mucosa,muscularis propria,esophageal glands,Barrett's glands,gastric mucosa,gastric glands, and intestinal mucosal villi were clearly observed with OCT and matched with H and E histology.These results demonstrated the feasibility of using OCT to evaluate GI tissue morphology in situ and in real-time. CONCLUSION:We demonstrate in situ evaluation of CIP microstructures using 3D-OCT,which may be a useful tool for future diagnosis and follow-up of patients with CIP. | Chao Zhou Tejas Kirtane Tsung-Han Tsai Hsiang-Chieh Lee Desmond C Adler Joseph M Schmitt Qin Huang James G Fujimoto Hiroshi Mashimo | 2012 | World Journal of Gastroenterology2012，18，20： | 3 |
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