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| 1 | Osteoarthritis:toward a comprehensive understanding of pathological mechanism显示文摘Osteoarthritis(OA) is the most common degenerative joint disease and a major cause of pain and disability in adult individuals. The etiology of OA includes joint injury, obesity, aging, and heredity. However, the detailed molecular mechanisms of OA initiation and progression remain poorly understood and, currently,there are no interventions available to restore degraded cartilage or decelerate disease progression. The diathrodial joint is a complicated organ and its function is to bear weight, perform physical activity and exhibit a joint-specific range of motion during movement. During OA development, the entire joint organ is affected, including articular cartilage, subchondral bone, synovial tissue and meniscus. A full understanding of the pathological mechanism of OA development relies on the discovery of the interplaying mechanisms among different OA symptoms, including articular cartilage degradation, osteophyte formation, subchondral sclerosis and synovial hyperplasia, and the signaling pathway(s) controlling these pathological processes. | Di Chen Jie Shen Weiwei Zhao Tingyu Wang Lin Han John L Hamilton Hee-Jeong Im | 2017 | Bone Research2017，5，1： | 121 |
| 2 | Environmental issues from coal mining and their solutions显示文摘The environmental challenges from coal mining include coal mine accidents,land subsidence,damage to the water environment,mining waste disposal and air pollution.These are either environmental pollution or landscape change.A conceptual framework for solving mine environmental issues is proposed.Clean processes,or remediation measures,are designed to address environmental pollution.Restoration measures are proposed to handle landscape change.The total methane drainage from 56 Chinese high methane concentration coal mines is about 101.94 million cubic meters.Of this methane,19.32 million,35.58 million and 6.97 million cubic meters are utilized for electricity generation,civil fuel supplies and other industrial purposes,respectively.About 39% of the methane is emitted into the atmosphere.The production of coal mining wastes can be decreased 10% by reuse of mining wastes as underground fills,or by using the waste as fuel for power plants or for raw material to make bricks or other infrastructure materials.The proper use of mined land must be decided in terms of local physical and socio-economical conditions.In European countries more than 50% of previously mined lands are reclaimed as forest or grass lands.However,in China more than 70% of the mined lands are reclaimed for agricultural purposes because the large population and a shortage of farmlands make this necessary.Reconstruction of rural communities or native residential improvement is one environmental problem arising from mining.We suggest two ways to reconstruct a farmer's house in China. | BIAN, Zhengfu INYANG, Hilary I DANIELS, John L OTTO, Frank STRUTHERS, Sue | 2010 | Mining Science and Technology2010，20，2： | 47 |
| 3 | Hepatic 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 | 2005 | World Journal of Gastroenterology2005，11，12： | 29 |
| 4 | The Plant Vascular System: Evolution, Development and Functions显示文摘The emergence of the tracheophyte-based vascular system of land plantshad major impacts on the evolution of terrestrial biology, in general,through its role in facilitating the development of plants with increasedstature, photosynthetic output, and ability to colonize a greatly expandedrange of environmental habitats. Recently, considerable progress hasbeen made in terms of our understanding of the developmental andphysiological programs involved in the formation and function of theplant vascular system. In this review, we first examine the evolutionaryevents that gave rise to the tracheophytes, followed by analysis of thegenetic and hormonal networks that cooperate to orchestrate vasculardevelopment in the gymnosperms and angiosperms. The two essentialfunctions performed by the vascular system, namely the delivery of resources (water, essential mineralnutrients, sugars and amino acids) to the various plant organs and provision of mechanical support arenext discussed. Here, we focus on critical questions relating to structural and physiological propertiescontrolling the delivery of material through the xylem and phloem. Recent discoveries into the role ofthe vascular system as an effective long-distance communication system are next assessed in termsof the coordination of developmental, physiological and defense-related processes, at the whole-plantlevel. A concerted effort has been made to integrate all these new findings into a comprehensive pictureof the state-of-the-art in the area of plant vascular biology. Finally, areas important for future researchare highlighted in terms of their likely contribution both to basic knowledge and applications to primaryindustry. | William J. Lucas Andrew Groover Raffael Lichtenberger Kaori Furuta Shri-Ram Yadav Yk Helariutta Xin-Qiang He Hiroo Fukuda Julie Kang Siobhan M. Brady John W. Patrick John Sperry Akiko Yoshida Ana-Flor López-Millan Michael A. Grusak Pradeep Kachroo | 2013 | Journal of Integrative Plant Biology2013，55，4： | 30 |
| 5 | Current management of talar osteochondral lesions显示文摘Osteochondral lesions of the talus(OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation(BMS), or replacement procedures, such as autologous osteochondral transplantation(AOT). Reparative procedures are generally indicated for OLT < 150 mm^2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although shortand medium-term results have been reported, longterm studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures. | Arianna L Gianakos Youichi Yasui Charles P Hannon John G Kennedy | 2017 | World Journal of Orthopedics2017，8，1： | 23 |
| 6 | Spatio-temporal variation of vegetation in an arid and vulnerable coal mining region显示文摘Environmental assessment in an arid coal mining area requires an understanding of the influences of coal mining,the arid climate and ecological remediation.To that end,we selected vegetation as the key environmental factor to observe.Remote sensing approaches to monitoring the spatio-temporal variation of vegetation caused by mining activities,the arid climate and ecological remediation in the Shengdong coal mining area are described.Over a large regional scale it was found that the vegetation was improved as a result of ecological remediation activities.At the local scale,however,the vegetation coverage and soil moisture in the mined areas were slightly lower than those in un-mined areas due to mining subsidence.These differences are partly attributed to ground fissures that injure root systems and increase the depletion of soil moisture.It is recommended that fissures be reduced and filled to lessen their adverse effects on the environment. | LEI Shaogang BIAN Zhengfu DANIELS John L HE Xiao | 2010 | Mining Science and Technology2010，20，3： | 20 |
| 7 | Necrotizing enterocolitis: A multifactorial disease with no cure显示文摘Necrotizing enterocolitis is an inflammatory bowel disease of neonates with significant morbidity and mortality in preterm infants. Due to the multifactorial nature o the disease and limitations in disease models, early diagnosis remains challenging and the pathogenesis elusive. Although preterm birth, hypoxic-ischemic events formula feeding, and abnormal bacteria colonization are established risk factors, the role of genetics and vasoactive/inflammatory mediators is unclear Consequently, treatments do not target the specific underlying disease processes and are symptomatic and surgically invasive. Breast-feeding is the most effective preventative measure. Recent advances in the prevention of necrotizing enterocolitis have focused on bioactive nutrients and trophic factors in human milk. Developmen of new disease models including the aspect of prematurity that consistently predisposes neonates to the disease with multiple risk factors will improve our understanding of the pathogenesis and lead to discovery of innovative therapeutics. | Kareena L Schnabl John E Van Aerde Alan BR Thomson Michael T Clandinin | 2008 | World Journal of Gastroenterology2008，14，14： | 19 |
| 8 | Role of LPS/CD14/TLR4-mediated inflammation in necrotizing enterocolitis:Pathogenesis and therapeutic implications显示文摘AIM:To establish the roles of lipopolysaccharide (LPS)/CD14/toll-like receptor 4 (TLR4)-mediated inflammation in a rat model of human necrotizing enterocolitis (NEC).METHODS: Six pairs of intestinal samples from human NEC were collected before and after recovery for histological and molecular analysis of inflammatory cytokines and signaling components. In the rat NEC model, we isolated 10-cm jejunum segments and divided them into six groups (n=6) for sham operation, treatment with LPS, bowel distension, combined bowel distension and LPS stimulation, and two therapeutic groups. The potential eff icacy of a recombinant CD18 peptide and a monoclonal CD14 antibody was evaluated in the latter two groups. The serum and tissue levels of several inflammatory mediators were quantified by real-time polymerase chain reaction, ELISA and immunoblotting.RESULTS: Human acute phase NEC tissues displayed significant increases (P<0.05) in levels of TLR4, CD14, myeloid differentiation protein (MD)-2, tumor necrosis factor (TNF)-α and nuclear factor-κB when compared to those after recovery. The histological and inflammatory picture of human NEC was reproduced in rats that were treated with combined bowel distension and LPS, but not in the sham-operated and other control rats. Serum levels of interleukin-6 and TNF-α were also elevated. The NEC pathology was attenuated by treating the NEC rats with a monoclonal CD14 antibody or an LPS-neutralizing peptide.CONCLUSION:LPS and distension are required to produce the histological and inflammatory features of NEC. A potential treatment option is blocking LPS activation and leukocyte infi ltration. | Kwong L Chan Kwong F Wong John M Luk | 2009 | World Journal of Gastroenterology2009，15，38： | 17 |
| 9 | Mechanisms, prevention and clinical implications of nonsteroidal anti-inflammatory drug-enteropathy显示文摘This article reviews the latest developments in understanding the pathogenesis, detection and treatment of small intestinal damage and bleeding caused by nonsteroidal anti-inflammatory drugs (NSAIDs). With improvements in the detection of NSAID-induced damage in the small intestine, it is now clear that this injury and the associated bleeding occurs more frequently than that occurring in the stomach and duodenum, and can also be regarded as more dangerous. However, there are no proven-effective therapies for NSAID-enteropathy, and detection remains a challenge, particularly because of the poor correlation between tissue injury and symptoms. Moreover, recent studies suggest that commonly used drugs for protecting the upper gastrointestinal tract (i.e., proton pump inhibitors) can significantly worsen NSAID-induced damage in the small intestine. The pathogenesis of NSAID-enteropathy is complex, but studies in animal models are shedding light on the key factors that contribute to ulceration and bleeding, and are providing clues to the development of effective therapies and prevention strategies. Novel NSAIDs that do not cause small intestinal damage in animal models offer hope for a solution to this serious adverse effect of one of the most widely used classes of drugs. | John L Wallace | 2013 | World Journal of Gastroenterology2013，19，12： | 15 |
| 10 | Beyond the Pediatric end-stage liver disease system: Solutions for infants with biliary atresia requiring liver transplant显示文摘Biliary atresia(BA), a chronic progressive cholestatic disease of infants, is the leading cause for liver transplant in children, especially in patients under two years of age. BA can be successfully treated with the Kasai portoenterostomy; however most patients still require a liver transplant, with up to one half of BA children needing a transplant by age two. In the current pediatric end-stage liver disease system, children with BA face the risk of not receiving a liver in a safe and timely manner. In this review, we discuss a number of possible solutions to help these children. We focus on two general approaches:(1) preventing/delaying need for transplantation, by optimizing the success of the Kasai operation; and(2) expediting transplantation when needed, by performing techniques other than the standard deceased-donor, whole, ABO-matched organ transplant. | Mary Elizabeth M Tessier Sanjiv Harpavat Ross W Shepherd Girish S Hiremath Mary L Brandt Amy Fisher John A Goss | 2014 | World Journal of Gastroenterology2014，20，32： | 14 |
| 11 | Direct reprogramming of human fibroblasts into dopaminergic neuron-like cells显示文摘外长的 dopaminergic 神经原(DA 神经原) 的移植是为治疗 Parkinson 的疾病(PD ) 的一条有希望的途径。然而,主要跌倒块是施主 DA 神经原的可靠来源的缺乏。这里,我们证明五 transcriptional 因素 Mash1, Ngn2, Sox2, Nurr1,和 Pitx3 的联合直接并且有效地装改编人成纤维细胞进 DA 像神经原的房间。为为 DA 神经原的各种各样的标记积极的染色的 reprogrammed 房间。他们也显示出典型 DA 举起和生产性质。而且,他们展出了 DA 神经原特定的 electrophysiological 侧面。最后,他们在一个老鼠 PD 模型提供了征兆的地势。因此,我们的直接 reprogrammed DA 像神经原的房间是为 PD 的房间代替治疗的有希望的来源。 | Xinjian Liu Fang Li Elizabeth A Stubblefield Barbara Blanchard Toni L Richards Gaynor A Larson Yujun He Qian Huang Aik-Choon Tan Dabing Zhang Timothy A Benke John R Sladek Nancy R Zahniser Chuan-Yuan Li | 2012 | Cell Research2012，22，2： | 14 |
| 12 | 基于GIS的农业面源硝酸盐地下水污染动态风险评价(英文)显示文摘地下水中的硝酸盐污染具有全球性,这不仅是一个环境问题,也是一个经济和人类健康问题。DRASTIC方法可以进行地下水污染的脆弱性评价,但是却没有涵盖风险的概念,也忽视了污染物随地表水流运动的动态特性。因此,所得结果可能有碍于“欧洲水管理框架指南”在地下水水质管理中的执行。笔者基于DRASTIC方法开发了一个动态风险评价方法,并将其运用于英国北爱尔兰Upper Bann流域中的一个小流域。研究区地下水硝酸盐污染风险评价结果表明,此方法将有效地帮助决策者在流域范围内开展农业面源地下水污染预防措施。“非常高风险”和“高风险”区分别占研究区面积的5.1%和10.5%。此结果可帮助当地政府针对流域内这些“非常高风险”和“高风险”区的特点制订地下水质保护政策。此方法同样适用于任何面源可溶性污染物的地下水污染动态风险评价。 | 杨悦所 Wang John L | 2007 | 吉林大学学报(地球科学版)2007，37，2： | 12 |
| 13 | A novel chemopreventive strategy based on therapeutic microRNAs produced in plants显示文摘 | Sizolwenkosi Mlotshwa Gail J Pruss John L MacArthur Matthew W Endres Celestia Davis Lome J Hofseth Maria Marjorette Pena Vicki Vance | 2015 | Cell Research2015，25，4： | 12 |
| 14 | 系统综述与网状Meta分析的PRISMA扩展声明显示文摘PRISMA声明旨在提高系统综述和META分析报告的完整性,该声明已经广泛用于指导系统综述和META分析的报告和发表。原始的PRISMA声明是针对两种干预措施比较的传统的系统综述与META分析而制定的,然而,随着多种干预措施比较的系统综述的发展,实施和报告这一类系统综述面临较大挑战。此时,针对网状META分析的PRISMA扩展声明应运而生,旨在提高网状META分析系统综述的报告质量。PRISMA扩展声明是由专家们通过DELPHI调查、面对面讨论和共识大会而最终确立的。PRISMA扩展声明是在原始PRISMA声明的报告清单的基础上经过修改,最终确定了32个条目,每个条目均与网状META分析报告的内容直接相关。本文对网状META分析的PRISMA扩展声明进行了阐述,对报告清单各条目进行了举例说明,并详细说明了在原始PRISMA声明的基础上新增和修改各条目的理由。此外,PRISMA扩展声明强调了在网状META分析的实际操作中需要重点关注的信息。本文的目标读者包括网状META分析的作者与读者,以及期刊杂志的编辑与同行评审。 | 李志霞 杨俊 叶欣 周凌波 杨智荣 孙凤 詹思延 Brian Hutton Georgia Salanti Deborah M.Caldwell Anna Chaimani Christopher H.Schmid Chris Cameron John P.A.Ioannidis Sharon Straus Kristian Thorlund Jeroen P.Jansen Cynthia Mulrow Ferrán Catalá-López Peter C.Gozsche Kay Dickersin Isabelle Boutron Douglas G.Altman David Moher | 2016 | 中国循证心血管医学杂志2016，8，6： | 11 |
| 15 | Recent trends in the surgical management of inflammatory bowel disease显示文摘Surgery is required in the vast majority of patients with Crohn’s disease (CD) and in approximately one-third of patients with ulcerative colitis (UC). Similar to medical treatments for IBD, significant advances have occurred in surgery. Advances in CD include an emphasis upon conservatism as exemplified by more limited resections, strictureplasties, and laparoscopic resections. The use of probiotics in selected patients has improved the outcome in patients with pouchitis following restorative proctocolectomy for UC. It is anticipated that ongoing discoveries in the molecular basis of IBD will in turn identify those patients who will best respond to surgery. | Robert E Roses John L Rombeau | 2008 | World Journal of Gastroenterology2008，14，3： | 10 |
| 16 | Effects of anisotropy on time-depth relation in transversely isotropic medium with a vertical axis of symmetry显示文摘It is known that rock anisotropy can significantly influence the phase and energy velocities of an elastic wave,as well as its reflection/transmission(R/T)coefficients.As a result,it can distort the velocity analysis of seismic-reflection data.In this work we present a velocity analysis for seismic-reflection data based on the available anisotropic rock parameters.We analyzed the created errors on time-depth relation of the seismic-reflection data in neglecting rock anisotropy and/or neglecting the difference between energy velocity and phase velocity,including the case of wide-angle reflection.The calculated results show that the effect of rock anisotropy on time-depth relation of seismic-reflection data is dependent not only on the values of anisotropic parameters,but also on the space arrangement of both source and receiver-array.For all studied cases(weak,moderate or strong anisotropy),we found that the effect of rock anisotropy on time-depth relation could not be neglected.Nevertheless,for the case of weak anisotropy,the energy velocity may be replaceable by the phase velocity to obtain a very good approximation on time-depth relation.Consequently,the seismic-reflection data processing algorithm for numerical computations can be simplified. | FA Lin CASTAGNA John P ZENG ZhengWen BROWN Ray L ZHAO MeiShan | 2010 | Chinese Science Bulletin2010，55，21： | 9 |
| 17 | Relationship between the exocrine and endocrine pancreas after acute pancreatitis显示文摘AIM:To determine the prevalence and time course of pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.METHODS:Relevant literature cited in three major biomedical journal databases(EMBASE,MEDLINE,and Scopus)was reviewed independently by two authors.There were no language constraints but the search was limited to human studies.Studies included were cohort studies of adult patients who were discharged after an attack of acute pancreatitis.Patients were excluded if they were under 18 years of age or had a previous diagnosis of prediabetes or diabetes mellitus,pancreatic exocrine insufficiency,or chronic pancreatitis.The main outcome measure was the prevalence of concomitant pancreatic exocrine insufficiency in patients who were diagnosed with prediabetes and diabetes mellitus after an attack of acute pancreatitis.Subgroup analysis was conducted for patients who were diagnosed with prediabetes only and those who were diagnosed withdiabetes mellitus only.Subgroup analysis looking at the time course of concomitant pancreatic exocrine and endocrine insufficiency was also conducted.Pooled prevalence and corresponding 95%confidence intervals were calculated for all outcome measures and P-values<0.05 were deemed statistically significant.RESULTS:Eight clinical studies comprising of 234patients met all eligibility criteria.The pooled prevalence of newly diagnosed prediabetes or diabetes in individuals after acute pancreatitis was 43%(95%CI:30%-56%).The pooled prevalence of pancreatic exocrine insufficiency in individuals after acute pancreatitis was 29%(95%CI:19%-39%).The prevalence of concomitant pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes was 40%(95%CI:25%-55%).The prevalence of concomitant pancreatic exocrine insufficiency among individuals with prediabetes alone and diabetes mellitus alone was 41%(95%CI:12%-75%)and 39%(95%CI:28%-51%),respectively.Further analysis showed that the prevalence of concomitant pancreatic exocrine insufficiency in individuals with prediabetes or diabetes decreases over time after an attack of acute pancreatitis.CONCLUSION:Pancreatic exocrine insufficiency occurs in 40%of individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.Further studies are needed to investigate the pathogenesis of diabetes in this setting. | Stephanie L M Das James I C Kennedy Rinki Murphy Anthony R J Phillips John A Windsor Maxim S Petrov | 2014 | World Journal of Gastroenterology2014，20，45： | 9 |
| 18 | Near-infrared fluorescence sentinel lymph node detection in gastric cancer: A pilot study显示文摘AIM: To investigate feasibility and accuracy of nearinfrared fluorescence imaging using indocyanine green: nanocolloid for sentinel lymph node(SLN) detection in gastric cancer.METHODS: A prospective, single-institution, phaseI feasibility trial was conducted. Patients suffering from gastric cancer and planned for gastrectomy were included. During surgery, a subserosal injection of 1.6 m L ICG:Nanocoll was administered around the tumor. NIR fluorescence imaging of the abdominal cavity was performed using the Mini-FLARE? NIR fluorescence imaging system. Lymphatic pathways and SLNs were visualized. Of every detected SLN, the corresponding lymph node station, signal-to-background ratio and histopathological diagnosis was determined. Patients underwent standard-of-care gastrectomy. Detected SLNs outside the standard dissection planes were also resected and evaluated.RESULTS: Twenty-six patients were enrolled. Four patients were excluded because distant metastases were found during surgery or due to technical failure of the injection. In 21 of the remaining 22 patients, at least 1 SLN was detected by NIR Fluorescence imaging(mean 3.1 SLNs; range 1-6). In 8 of the 21 patients, tumor-positive LNs were found. Overall accuracy of the technique was 90%(70%-99%; 95%CI), which decreased by higher p T-stage(100%, 100%, 100%, 90%, 0% for respectively Tx, T1, T2, T3, T4 tumors). All NIR-negative SLNs were completely effaced by tumor. Mean fluorescence signal-to-background ratio of SLNs was 4.4(range 1.4-19.8). In 8 of the 21 patients, SLNs outside the standard resection plane were identified, that contained malignant cells in 2 patients.CONCLUSION: This study shows successful use of ICG:Nanocoll as lymphatic tracer for SLN detection in gastric cancer. Moreover, tumor-containing LNs outside the standard dissection planes were identified. | Quirijn RJG Tummers Leonora SF Boogerd Wobbe O de Steur Floris PR Verbeek Martin C Boonstra Henricus JM Handgraaf John V Frangioni Cornelis JH van de Velde Henk H Hartgrink Alexander L Vahrmeijer | 2016 | World Journal of Gastroenterology2016，22，13： | 9 |
| 19 | Characterization of a critical role for CFTR chloride channels in cardioprotection against ischemia/ reperfusion injury显示文摘目的: 进一步描绘膀胱的纤维变性 transmembrane 传导力管理者(CFTR ) 的功能的角色在早、迟了(第二扇窗户) ischemic preconditioning (欧洲电脑生产厂商)- 并且 postconditioning (停靠港) 调停了对 ischemia/reperfusion (I/R ) 的 cardioprotection 损害。 | Sunny Yang XIANG Linda L YE Li-lu Marie DUAN Li-hui LIU Zhi-dong GE John A AUCHAMPACH Garrett J GROSS Dayue Darrel DUAN | 2011 | Acta Pharmacologica Sinica2011，32，6： | 9 |
| 20 | Assessment of lymph node involvement in colorectal cancer显示文摘Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with nodenegative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed. | Mark L H Ong John B Schofield | 2016 | World Journal of Gastrointestinal Surgery2016，8，3： | 8 |
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