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| 1 | 极高强度他汀治疗对冠状动脉粥样硬化消退的影响——ASTEROID试验显示文摘背景:以前的血管内超声(intravascular ultrasound,IVUS)试验证实,他汀治疗可减缓或阻止动脉粥样硬化的进展,但是迄今尚无应用动脉粥样斑块体积百分比(percent atheroma volume,PAV)证实粥样硬化消退的确切证据。PAV是最严格的评价病变进展和消退的IVUS测量指标。
目标:评价极高强度他汀治疗是否能逆转IVUS确定的冠状动脉粥样硬化。
设计和地点:于美国、加拿大、欧洲和澳大利亚53个社区和3级保健中心进行前瞻性开标盲法终点试验(A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden,ASTEROID)。应用马达驱动回撤IVUS评价基线和治疗24个月时冠状动脉粥样斑块负荷。每对基线和随访IVUS测量结果均进行盲法分析。
病例:从2002年11月到2003年10月,507例患者有基线IVUS检查结果,并接受至少1个剂量的研究药物。在24个月后,349例患者具有可用于评估的系列IVUS检查结果。
干预:所有患者均接受瑞舒伐他汀40ms/d强化治疗。
主要观测指标:预先设定了两个一级疗效指标:PAV变化和基线最严重病变10min节段动脉粥样斑块体积变化。二级疗效指标为整个动脉标准化总斑块体积的变化。结果:平均(SD)LDL—C水平由基线时的130.4(34.3)ms/dL降至60.8(20.0)ms/扎,平均下降了53.2%(P〈0.001)。平均(SD)HDL-C水平从基线时的43.1(11.1)ms/dL升至49.0(12.6)ms/dL,平均增加了14.7%(P〈0.001)。整个血管PAV平均(SD)变化为-0.98%(3.15%),中位数为-0.79%(97.5%CI,-1.21%~-0.53%)(与基线比较,P〈0.001)。最严重病变10min节段斑块体积平均(SD)变化为-6.1(10.1)mm^3,中位数为-5.6mm^3(97.5%CI,-6.8~-4.0mm^3)(与基线比较,P〈0.001)。总斑块体积变化中位数降低了6.8%,平均减少了-14.7(25.7)mm^3,中位数为-12.5mm^3(95%CI,-15.1~-10.5mm^3)(与基线比较,P〈0.001)。不良事件少见,与其他他汀试验相似。
结论:应用瑞舒伐他汀40ms/d进行极高强度他汀治疗可使LDL-C平均水平达到60.8ms/dL,使HDL—C增加14.7%。这导致所有3个预先设定的IVUS斑块负荷指标均显示动脉粥样硬化消退。因此,将LDL-C降至低于目前指南规定的水平,同时显著提高HDL-C,可以使冠心病患者动脉粥样硬化斑块消退。这些变化对临床预后的影响尚需进一步研究确定。 | Steven E. Nissen Stephen J. Nicholls Ilks Sipahi Peter Libby Joel S. Raichlen Christie M. Ballantyne Jean Davignon Raimund Erbel Jean Charles Fruchart Jean-Claude Tardif Paul Schoenhagen Tim Crowe Valerie Cain Kathy Wolski Marlene Coormastic E. Murat Tuzcu 仝其广(译) 王淑敏(译) 胡大一(校) | 2006 | 美国医学会杂志(中文版)2006，25，4： | 341 |
| 2 | Liver cirrhosis and diabetes:Risk factors,pathophysiology,clinical implications and management显示文摘About 30% of patients with cirrhosis have diabetes mellitus(DM).Nowadays,it is a matter for debate whether type 2 DM in the absence of obesity and hypertriglyceridemia may be a risk factor for chronic liver disease.DM,which develops as a complication of cirrhosis,is known as 'hepatogenous diabetes'.Insulin resistance in muscular and adipose tissues and hyperinsulinemia seem to be the pathophysiologic bases of diabetes in liver disease.An impaired response of the islet β-cells of the pancreas and hepatic insulin resistance are also contributory factors.Non-alcoholic fatty liver disease,alcoholic cirrhosis,chronic hepatitis C(CHC) and hemochromatosis are more frequently associated with DM.Insulin resistance increases the failure of the response to treatment in patients with CHC and enhances progression of fibrosis.DM in cirrhotic patients may be subclinical.Hepatogenous diabetes is clinically different from that of type 2 DM,since it is less frequently associated with microangiopathy and patients more frequently suffer complications of cirrhosis.DM increases the mortality of cirrhotic patients.Treatment of the diabetes is complex due to liver damage and hepatotoxicity of oral hypoglycemic drugs.This manuscript will review evidence that exists in relation to:type 2 DM alone or as part of the metabolic syndrome in the development of liver disease;factors involved in the genesis of hepatogenous diabetes;the impact of DM on the clinical outcome of liver disease;the management of DM in cirrhotic patients and the role of DM as a risk factor for the occurrence and exacerbation of hepatocellular carcinoma. | Diego Garcia-Compean Joel Omar Jaquez-Quintana Jose Alberto Gonzalez-Gonzalez Hector Maldonado-Garza | 2009 | World Journal of Gastroenterology2009，15，3： | 112 |
| 3 | 叶酸对胃癌和其他胃肠道癌发生的干预作用──临床试验七年随访显示文摘目的:评估叶酸和β-湖萝卜素对胃癌及其他胃肠道癌发生的干预作用。方法:在上海10所医院进行随机双盲安 慰剂对照的临床研究。216例萎缩性胃炎患者分4组:①叶酸组,20mg/日,每月肌肉注射维生素B12 1mg,次年减 为每周服药2日,3月肌肉注射1次;②天然β-胡萝卜素组,30 mg/日,次年减为每周服2日,共工年;③合成β-胡萝卜 素组,用法同天然组;④安慰剂对照组。每1~3年胃镜及活检,随访6~7年(1994~2001年)。结果:叶酸组未发生胃 肠肿瘤,天然及合成组各发现胃癌1例,对照组发生胃癌3例,结肠癌及食管癌各1例。以胃癌发生为终点,各干预组 单独与对照组相比,未达统计学显著差异,但合并干预组已接近显著(P=0.06);以胃肠道癌为终点,叶酸组显著低 于对照组(P=0046),β-胡萝卜素组趋向显著(P=0.07~0.08),合并干预组非常显著(P=0.004),胃肠道癌风险明 显降低[比数比(OR)为0.12,95%可信区间(CI)为0.03~0.51]。叶酸组胃粘膜炎症和萎缩逆转稳定(P=0.04),肠化 逆转接近显著(P=0.06)。异型增生于12个月时显著逆转(P=0.017)。 | 朱舜时 Joel Mason 施尧 胡运彪 李蓉蓉 汪敏 周怡和 金冠球 谢宇野 邬桂泉 夏德凰 钱珍华 宋海连 屠伯强 张丽冬 Robert Russell 萧树东 | 2002 | 胃肠病学2002，7，2： | 51 |
| 4 | 瑞舒伐他汀对存在亚临床动脉粥样硬化的低危人群颈动脉内膜中层厚度进展的影响——METEOR试验显示文摘背景:动脉粥样硬化往往在机体出现症状之前就已有所进展。目前,我们尚不清楚Framingham风险评分(Framinghaln risk score,FRS)较低的轻中度亚临床动脉粥样硬化中年人群是否能从治疗中获益。
目的:评价为期2年的他汀类药物治疗能否减缓颈动脉内膜中层厚度(carotid intimamedia thickness,CIMT)继续增厚或使粥样斑块消退。
设计、地点及参试者:“瑞舒伐他汀对内膜中层厚度影响的测评研究(Measuring Effects on Intima-Media Thickness:an Evaluation of Rosuvastatin,METEOR)”是2002年8月至2006年5月在美国及欧洲61个基层医疗中心开展的一项随机、双盲、安慰剂对照研究,共纳入984名参试者,有的参试者仅以年龄(平均年龄,57岁)为冠心病的危险因素,有的参试者10年内FRS低于10%、CIMT重庞增厚(1.2~3.5mm)、LDL胆固醇水平有所升高(平均值,154mg/dL)。
干预:参试者服用40mg瑞舒伐他汀或安慰剂。
主要观测指标:12个颈动脉位点最大CIMT的变化率(经B超检测);颈总动脉位点、颈动脉窦位点及颈内动脉位点最大CIMT的变化,颈总动脉位点平均CIMT的变化。仅在瑞舒伐他汀组中评估CIMT的消退情况。
结果:瑞舒伐他汀组参试者LDL胆固醇平均(SD)水平由基线时的155(24.1)mg/dL降至78(27.5)mg/dL,平均降低49%(与安慰剂组相比P〈0.001)。瑞舒伐他汀组12个颈动脉位点最大CIMT的变化值为-0.0014(95%CI,-0.0041~0.0014)mm/y,安慰剂组12个颈动脉位点最大CIMT的变化值为Q0131(95%CI,Q0087~Q0174)mm/y(P〈0.001)。瑞舒伐他汀组颈总动脉位点最大CIMT的变化值为-0.0038(95%CI,-0.0064~-0.0013)mm/y(P〈0.001),颈动脉窦位点最大CIMT的变化值为-0.0040(95%CI,-0.0090~0.0010)mm/y(P〈0.001),颈内动脉位点最大CIMT的变化值为0.0039(95%CI,-0.0009~0.0088)mm/y(P=0.02)。瑞舒伐他汀组颈总动脉位点平均CIMT的变化值为0.0004(95%CI,-0.0011~0.0019)mm/y(P〈0.001)。P值均为与安慰剂组相比。总的来说,瑞舒伐他汀具有良好的耐受性,很少引发严重的心血管不良事件(在2年内有6名参试者[0.86%]出现8起不良事件[1.1%])。
结论:对于FRS低于10%的亚临床动脉粥样硬化中年人群而言,瑞舒伐他汀能够在2年内显著降低最大CIMT的进展速率,与安慰剂相比差异具有统计学显著性。但是,瑞舒伐他汀无法诱导病变消退。今后,我们仍需开展大型远期试验来明确上述研究结果的临床意义. | John R. Crouse Ⅲ Joel S. Raichlen Ward A. Riley Gregory W. Evans Mike K. Palmer Daniel H. O' Leary Diederick E. Grobbee Michiel L. Bots 李军(译) | 2007 | 美国医学会杂志(中文版)2007，26，4： | 44 |
| 5 | 核心稳定性在人体运动中的作用显示文摘在体育运动中,核心的主要作用是稳定身体、是肌肉发力的基础,这一点日益得到公认。从跑步到投掷等各项体育运动中,稳定的核心是有效发挥人体生物力学功能的关键因素,从而使肌肉发力最大化并最大限度减小关节负荷。我们将核心肌群的功能理解为中枢神经系统预设的程序,这个程序整合局部的、单关节和多个关节上的肌群活动,在保持整体稳定的同时完成体育动作。近端的稳定性是远端灵活性的基础,在这个基础上可以建立从近端向远端的发力模式,并且可以通过肌群的协同作用力在完成远端动作的同时保护远端关节。评估动态核心能力是一项重要任务,其中包括对躯干特定功能和三维运动能力的评估。运动康复训练计划应该包括核心能力的重建,并且应该将核心视为远端肢体运动的基础。 | W. Ben Kibler Joel Press Aaron Sciascia 周瑾(译) | 2008 | 北京体育大学学报2008，31，12： | 46 |
| 6 | 地下水铀污染的原位微生物还原与固定:在美国能源部田纳西橡树岭放射物污染现场的试验显示文摘总结了美国斯坦福大学和橡树岭国家实验室等在美国能源部田纳西州橡树岭综合试验基地进行的铀污染原位微生物修复阶段性试验结果.本试验利用微生物以乙醇为电子供体还原地下水和沉积物中的六价铀为不溶解的四价铀,使之原位固定化.随后通过加入溶解氧和硝酸盐来试验微生物还原后的地下水层中还原固定态铀的稳定性.通过预处理和长期间隔注入乙醇溶液,地下水中铀浓度从40~60mg·L-1降至0.03mg·L-1以下,达到了美国环保署饮用水的标准.还原的四价铀主要以U(Ⅳ)-Fe复合物的形态存在.结果表明,固定化后的四价铀只有在厌氧条件下才是稳定的,溶解氧和硝酸盐侵入地下水层后会使固定化的四价铀重新氧化为溶解态的六价铀.在试验过程中,采用多种分子生物学方法检测了微生物种群的变化和与铀氧化还原反应有关的功能微生物.本研究表明,在维持试验系统无氧和无硝酸盐的条件下,通过添加乙醇为电子供体可有效地促进地下水中土著功能微生物的活性,从而实现铀的原位还原固定与稳定. | 吴唯民 Jack Carley David Watson 顾宝华 Scott Brooks Shelly D.Kelly Kenneth Kemner Joy D.van Nostrand 吴力游 许玫英 周集中 罗剑 Erick Cardenas 黄家琪 Matthew W.Fields Terence L.Marsh James M.Tiedje Stefan J.Green Joel E.Kostka Peter K.Kitanidis Philip M.Jardme CraigS.Criddle | 2011 | 环境科学学报2011，31，3： | 28 |
| 7 | 慢性心力衰竭大鼠转化生长因子-β—Smads信号传导通路的调节异常显示文摘目的 探讨慢性缺血性心力衰竭大鼠转化生长因子 (transforminggrowthfactorTGF β) 信号传导蛋白 (Smads)的信号传导通路的变化 ,及与心肌梗死 (MI)后心力衰竭心脏重塑过程的关系。方法 大鼠经冠状动脉结扎 ,5d后经有创性血流动力学监测 ,试验分组 :(1)慢性心力衰竭组 (CHF) :左室舒张末压 (LVEDP)≥ 15mmHg (1mmHg =0 .133kPa) ,n =6 ;(2 )Sham组 :无冠状动脉结扎的手术对照组 ,n =6。 6周末 ,行逆行心脏体外灌流 ,应用胶原酶灌流心脏。分离活的心肌细胞和非心肌细胞。应用Westernblot测定TGF β1、β3 、Smad 2 /3、Smad 6蛋白表达水平。结果 非心肌细胞 :CHF组TGF β1明显增高 (P <0 .0 2 ) ,而TGF β3 明显减少 (P <0 .0 1) ,Smad 6明显下调 ;而Smad 3明显上调 (P <0 .0 2 ) ;心肌细胞 :CHF组TGF β3 明显减少 ,TGF β1明显增高 (P <0 .0 1) ;伴有Smad 2 /3明显下调 (P <0 .0 1) ;而Smad 6明显上调 (P <0 .0 5 )。结论 本研究首次证明了CHF大鼠心肌细胞和非心肌细胞的TGF β1、β3 和它们的信号转导通路特异性调节变化 ,TGF β | 高连如 John Teerlink Joel Karliner | 2001 | 中华心血管病杂志2001，29，3： | 23 |
| 8 | Implementation of enteral feeding protocol in an intensive care unit: Before-and-after study显示文摘AIM To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients.METHODS An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit(ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012(the Before group) and 2014-2015(the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection ControlService. Data from adult patients, readmissions excluded, who were treated for at least 7 d in the study unit were analysed. RESULTS In total, 231 patients were enrolled in the Before and 249 in the After group. The groups were comparable regarding demographics, patient profile, and severity of illness. Fewer patients were mechanically ventilated on admission in the After group(86.7% vs 93.1% in the Before group, P = 0.021). The prevalence of hospitalacquired infections, length of ICU stay and ICU, 30-and 60-d mortality did not differ between the groups. Patients in the After group had a lower 90-d(P = 0.026) and 120-d(P = 0.033) mortality. In the After group, enteral nutrition was prescribed less frequently(P = 0.039) on day 1 but significantly more frequently on all days from day 3. Implementation of the feeding protocol resulted in a higher cumulative amount of enterally(P = 0.049) and a lower cumulative amount of parenterally(P < 0.001) provided calories by day 7, with an overall reduction in caloric provision(P < 0.001). The prevalence of gastrointestinal symptoms was comparable in both groups, as was the frequency of prokinetic use. Underfeeding(total calories < 80% of caloric needs, independent of route) was observed in 59.4% of the study days Before vs 76.9% After(P < 0.001). Inclusion in the Before group, previous abdominal surgery, intraabdominal hypertension and the sum of gastrointestinal symptoms were found to be independent predictors of insufficient enteral nutrition.CONCLUSION The use of a nurse-driven feeding protocol improves the delivery of enteral nutrition in ICU patients without concomitant increases in gastrointestinal symptoms or intra-abdominal hypertension. | Martin Padar Gerli Uusvel Liis Starkopf Joel Starkopf Annika Reintam Blaser | 2017 | World Journal of Critical Care Medicine2017，6，1： | 22 |
| 9 | Oral purgative and simethicone before small bowel capsule endoscopy显示文摘AIM:To evaluate small bowel cleansing quality,diagnostic yield and transit time,comparing three cleansing protocols prior to capsule endoscopy.METHODS:Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols:patients in Group A underwent a 24 h liquid diet and overnight fasting;patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol(PEG) the evening before the procedure;patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion.Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor,fair,good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization.When there was no agreement between the two endoscopists,the images were reviewed and discussed until a consensus was reached.The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition.The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images.Positive endoscopic findings,gastric emptying time(GET) and small bowel transit time(SBTT) were recorded for each examination.RESULTS:There was a trend favoring Group B in achieving an acceptable(including fair,good or excellent) level of cleansing(Group A:65%;Group B:83.3%;Group C:68.4%) [P = not significant(NS)] and favoring Group C in attaining an excellent level of cleansing(Group A:10%;Group B:16.7%;Group C:21.1%)(P = NS).The number of patients with an adequate cleansing of the small bowel,corresponding to an excellent or good classification,was 5(25%) in Group A,5(27.8%) in Group B and 4(21.1%) in Group C(P = 0.892).Conversely,7 patients(35%) in Group A,3 patients(16.7%) in Group B and 6 patients(31.6%) in Group C were considered to have poor small bowel cleansing(P = 0.417),with significant fluid or debris such that the examination was unreliable.The proportion of patients with a significant amount of bubbles was 50% in Group A,27.8% in Group B and 15.8% in Group C(P = 0.065).This was significantly lower in Group C when compared to Group A(P = 0.026).The mean GET was 27.8 min for Group A,27.2 min for Group B and 40.7 min for Group C(P = 0.381).The mean SBTT was 256.4 min for Group A,256.1 min for Group B and 258.1 min for Group C(P = 0.998).Regarding to the rate of complete examinations,the capsule reached the cecum in 20 patients(100%) in Group A,16 patients(88.9%) in Group B and 17 patients(89.5%) in Group C(P = 0.312).A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A(12 patients),44.4% in Group B(8 patients) and 57.8% in Group C(11 patients)(P = 0.587).CONCLUSION:Preparation with 2 L of PEG before small bowel capsule endoscopy(SBCE) may improve small bowel cleansing and the quality of visualization.Simethicone may further reduce intraluminal bubbles.No significant differences were found regarding GET,SBTT and the proportion of complete exploration or diagnostic yield among the three different cleansing protocols. | Bruno Joel Ferreira Rosa Mara Barbosa Joana Magalhes Ana Rebelo Maria Joo Moreira José Cotter | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，2： | 21 |
| 10 | Prevalence of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis Among a Largely Middle-Aged Population Utilizing Ultrasound and Liver Biopsy: A Prospective Study显示文摘 | Christopher D. Williams Joel Stengel Michael I. Asike Dawn M. Torres Janet Shaw Maricela Contreras Cristy L. Landt Stephen A. Harrison | 2011 | Gastroenterology2011，，1： | 20 |
| 11 | 大学生智能手机问题性使用状况及与焦虑和抑郁情绪关系的初步研究显示文摘目的 比较不同社会人口学特征及智能手机使用特征在中国大学生是否手机问题性使用者中的发生率,以及焦虑、抑郁与智能手机问题性使用的初步关系.方法 按照我国现有的高等教育学校分类方式,采用分层随机抽样方法选取8所不同层次高等院校共35个混合教学大班的1205名学生,采用问题性手机使用问卷评估被试者手机使用情况,采用Zung焦虑自评量表、抑郁自评量表评估焦虑及抑郁症状水平.使用独立样本t检验及χ2检验等统计方法对1006份有效问卷进行分析.结果 在1006名受访者中,有207名被定义为智能手机问题性使用者,阳性率20.6%;高中文理分科情况(χ2=11.424,P〈0.01)、高低年级分组(χ2=5.868,P〈0.05)、每月平均生活费(χ2=12.713,P〈0.01)、每天手机使用时间(χ2=20.052,P〈0.01)、手机更换间隔(χ2=14.511,P〈0.01)、每月平均话费(χ2=13.107,P〈0.01)在智能手机问题性使用者和非问题性使用者间的分布差异有统计学意义;智能手机问题性使用者与非问题性使用者轻度及以上焦虑患病率分别为34.8%(72/207)和14.6%(117/799)(χ2=43.704,P〈0.01),差异有统计学意义;智能手机问题性使用者与非问题性使用者轻度及以上抑郁患病率分别为36.2%(75/207)和15.4%(123/799)(χ2=45.159,P〈0.01),差异有统计学意义.结论 高中文科生、低年级、高生活费、每日手机使用时间长、手机更换频率快及手机话费高等特征常见于大学生智能手机问题性使用者;智能手机问题性者更易出现焦虑和抑郁情绪. | 刘岳衡 龙江 Joel Billieux 齐畅 何浩宇 陈淑宝 吴秋霞 熊一凡 刘铁桥 | 2017 | 中华精神科杂志2017，50，4： | 15 |
| 12 | 青光眼视网膜神经纤维层厚度的光学相干断层扫描纵向评估显示文摘目的:纵向评估光学相干断层扫描(OCT)视盘周围神经纤维层厚度测量,并将这些检查与临床状态和自动视野计检查作横向比较。
方法:对参与前瞻性纵向研究的青光眼或疑似青光眼患者64只眼(37例)作回顾性评估。所有参与者每6个月作一次全面的临床评估、视野检查和OCT。视野进展按可重复性测量的视野平均偏差至少比基线降低2dB,OCT进展按可重复性测量视网膜神经纤维层平均厚度至少变薄20pro。
结果:每个患者在中位值为4.7年的随访中有5个可使用的OCT扫描。青光眼和疑似青光眼患者之间视网膜神经纤维层厚度线性回归斜度的差异对所有变量均不显著;然而,Kaplan-Meier生存曲线分析显示视野比OCT测量有较高的进展率。在随访期间66%的眼是稳定的。22%只有OCT进展,9%单有视野平均偏差进展。3%视野和OCT都有进展。
结论:OCT比全自动视野计对辨别青光眼进展有更大的可能性。这可能反映OCT的敏感性或在常规方法发现之前其真实损害就能被OCT发现。 | Gadi Wollstein Joel S. Schuman Lori L. Price Ali Aydin Paul C. Stark Ellen Hertzmark Edward Lai Hiroshi Ishikawa Cynthia Mattox James G. Fujimoto Lelia A. Paunescu 刘春(译) 朱志忠(校) | 2005 | 美国医学会眼科杂志(中文版)2005，17，4： | 14 |
| 13 | Does autologous blood transfusion during liver transplantation for hepatocellular carcinoma increase risk of recurrence?显示文摘AIM: To analyze outcomes in patients who underwent liver transplantation(LT) for hepatocellular carcinoma(HCC) and received autologous intraoperative blood salvage(IBS). METHODS: Consecutive HCC patients who underwent LT were studied retrospectively and analyzed according to the use of IBS or not. Demographic and surgical data were collected from a departmental prospective maintained database. Statistical analyses were performed using the Fisher's exact test and the Wilcoxon rank sum test to examine covariate differences between patients who underwent IBS and those who did not. Univariate and multivariate Cox regression models were developed to evaluate recurrence and death,and survival probabilities were estimated using the Kaplan-Meier method and compared by the log-rank test.RESULTS: Between 2002 and 2012,158 consecutive patients who underwent LT in the same medical center and by the same surgical team were identified. Among these patients,122(77.2%) were in the IBS group and 36(22.8%) in the non-IBS group. The overall survival(OS) and recurrence free survival(RFS) at 5 years were 59.7% and 83.3%,respectively. No differences in OS(P=0.51) or RFS(P=0.953) were detected between the IBS and non-IBS groups. On multivariate analysis for OS,degree of tumor differentiation remained as the only independent predictor. Regarding patients who received IBS,no differences were detected in OS or RFS(P=0.055 and P=0.512,respectively) according to the volume infused,even when outcomes at 90 d or longer were analyzed separately(P=0.518 for both outcomes).CONCLUSION: No differences in RFS or OS were detected according to IBS use. Trials addressing this question are justified and should be designed to detect small differences in long-term outcomes. | Raphael LC Araujo Carlos Andrés Pantanali Luciana Haddad Joel Avancini Rocha Filho Luiz Augusto Carneiro D’Albuquerque Wellington Andraus | 2016 | World Journal of Gastrointestinal Surgery2016，8，2： | 14 |
| 14 | Antibacterial activity and characterization of secondary metabolites isolated from mangrove plant Avicennia officinalis显示文摘Objective:To explore antibacterial activity and characterization of secondary metabolites isolated from mangrove plant Avicennia officinalis(A.officinalis).Methods:In the present study the leaf extracts of A.officinalis were examined for its antibacterial potential using five different solvents against some reference strains of human pathogenic bacteria for the crude extract.Maximum activity was observed for ethyl acetate and hence different concentrations like 15μL,25μL,and 50μL of ethyl extracts was checked for its antibacterial activity.Partial purification of crude extract was carried by column chromatography and fractions were analyzed using gas chromatography-mass spectrometry(GC-MS) to identify compounds.Results:The crude ethyl acetate extracts of A.officinalis showed remarkable antibacterial activity with zones of inhibition of 13 mm against Eschericia coli(E.coli) and 11 mm against Staphylococcus aureus (S.aureus).Fraction 13(ethyl acetate:methanol= 8:2) as the most potent one against with the minimal inhibitory concentration of 30 mm against E.coli and 25 mm against S.aureus.The GCMS resultsof active column fraction(F13) revealed that the active principals were a mixture of hydroxy- 4 methoxybenzoic acid,diethyl phthalate,oleic acid.Conclusions:The leaf extracts with proven antibacterial effects can clearly be directed towards cancer treatment as to inhibiting cancer cell growth.The limited number of test organisms owes to a constraint of resource.So,the effect of strong bursts of leaf extracts on human pathogenic bacteria should further be tested on a wide range of test organisms. | Valentin Bhimba B J Meenupriya Elsa Lycias Joel D Edaya Naveena Suman kumar M Thangaraj | 2010 | Asian Pacific Journal of Tropical Medicine2010，3，7： | 13 |
| 15 | Review of the current targeted therapies for non-small-cell lung cancer显示文摘The last decade has witnessed the development of oncogene-directed targeted therapies that have significantly changed the treatment of non-small-cell lung cancer(NSCLC). In this paper we review the data demonstrating efficacy of gefitinib, erlotinib, and afatinib, which target the epidermal growth factor receptor(EGFR), and crizotinib which targets anaplastic lymphoma kinase(ALK). We discuss the challenge of acquired resistance to these small-molecular tyrosine kinase inhibitors and review promising agents which may overcome resistance, including the EGFR T790 Mtargeted agents CO-1686 and AZD9291, and the ALKtargeted agents ceritinib(LDK378), AP26113, alectinib(CH/RO5424802), and others. Emerging therapies directed against other driver oncogenes in NSCLC including ROS1, HER2, and BRAF are covered as well. The identification of specific molecular targets in a significant fraction of NSCLC has led to the personalized deployment of many effective targeted therapies, with more to come. | Kim-Son H Nguyen Joel W Neal Heather Wakelee | 2014 | World Journal of Clinical Oncology2014，5，4： | 13 |
| 16 | Intraductal biliary and pancreatic endoscopy: An expanding scope of possibility显示文摘Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts. For many years, technological challenges have made performing these procedures difficult. The 'mother-baby' system and other various miniscopes have been developed, but routine use has been hampered due to complex setup, scope fragility and the time consuming, technically demanding nature of the procedure. Recently, the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options. The clinical utility of intraductal endoscopy is broad. It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue. Therapeutic interventions, such as electrohydraulic lithotripsy (EHL), laser lithotripsy, photodynamic therapy, and argon plasma coagulation (APC), may also be performed as part of intraductal endoscopy. Intraductal endoscopy significantly increases the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography (ERCP), and as technology progresses, it is likely that its utilization will only increase. In this review of intraductal endoscopy, we describe in detail the various endoscopic platforms and their diagnostic and clinical applications. | Joel R Judah Peter V Draganov | 2008 | World Journal of Gastroenterology2008，14，20： | 12 |
| 17 | Modified activated carbon with interconnected fibrils of iron-oxyhydroxides using Mn^(2+) as morphology regulator, for a superior arsenic removal from water显示文摘The arsenic removal efficiency of iron-modified activated carbons depends greatly on the number of available iron oxide surface sites, which are given by the surface area of the anchored particles. In this sense, aiming the generation of an adsorbent with superior arsenic adsorption capacity, we developed a protocol to anchor interconnected fibrils of iron oxyhydroxides, using Mn^(2+) as a morphology regulator. The protocol was based on a microwave-assisted hydrothermal method, using bituminous based activated carbon and both Fe^(2+) and Mn^(2+) ions in the hydrolysis solution. The elemental analysis of modified carbons revealed that Mn does not anchor to the carbon. However, when Mn is included in the hydrolysis solution, the iron content in the activated carbon increased up to 3.5 wt%,without considerable decreasing the adsorbent surface area. Under specific hydrothermal conditions, the Mn^(2+) promoted the formation of iron oxide nanoparticles shaped as interconnected fibrils. This material showed a superior arsenic adsorption capacity in comparison to similar iron modified activated carbons(5 mg As/g carbon, at 2 mg As/L),attributed to the increase in quantity and availability of active sites located on the novel interconnected fibrils of iron oxyhydroxides nanostructures. | Cesar Nieto-Delgado Joel Gutiérrez-Martínez J.Rene Rangel-Méndez | 2019 | Journal of Environmental Sciences2019，31，2： | 12 |
| 18 | Subclinical abnormal glucose tolerance is a predictor of death in liver cirrhosis显示文摘AIM:To determine if subclinical abnormal glucose tolerance(SAGT)has influence on survival of non-diabetic patients with liver cirrhosis.METHODS:In total,100 patients with compensatedliver cirrhosis and normal fasting plasma glucose were included.Fasting plasma insulin(FPI)levels were measured,and oral glucose tolerance test(OGTT)was performed.According to OGTT results two groups of patients were formed:those with normal glucose tolerance(NGT)and those with SAGT.Patients were followed every three months.The mean follow-up was932 d(range of 180-1925).Survival was analyzed by the Kaplan-Meyer method,and predictive factors of death were analyzed using the Cox proportional hazard regression model.RESULTS:Of the included patients,30 showed NGT and70 SAGT.Groups were significantly different only in age,INR,FPI and HOMA2-IR.Patients with SAGT showed lower 5-year cumulated survival than NGT patients(31.7%vs 71.6%,P=0.02).Differences in survival were significant only after 3 years of follow-up.SAGT,Child-Pugh B,and high Child-Pugh and Model for EndStage Liver Disease(MELD)scores were independent predictors of death.The causes of death in 90.3%of cases were due to complications related to liver disease.CONCLUSION:SAGT was associated with lower survival.SAGT,Child-Pugh B,and high Child-Pugh and MELD scores were independent negative predictors of survival. | Diego García-Compeán Joel Omar Jáquez-Quintana Fernando Javier Lavalle-González José Alberto González-González Linda Elsa Mu?oz-Espinosa Jesús Zacarías Villarreal-PérezEndocrinology Service and Department of Internal Medicine University Hospital 'Dr. José E. González' and Medical School Universidad Autónoma de Nuevo León Monterrey 64320 México Héctor J Maldonado-Garza | 2014 | World Journal of Gastroenterology2014，20，22： | 12 |
| 19 | 芍药苷促进糖尿病创面愈合显示文摘目的 研究芍药苷(paeoniflorin,PA)对糖尿病创面愈合作用及作用机制。方法 采用糖尿病小鼠全层皮肤切除夹板模型,HE染色及Masson染色观察创面组织形态改变;免疫荧光法检测血管新生。PA干预人脐静脉内皮细胞(human umbilical vein endothelial cells,HUVECs)和小鼠成纤维细胞(fibroblast,FB),MTS、BrdU和划痕实验检测细胞增殖和迁移能力;Matrigel实验检测HUVECs成管能力,qPCR检测FB中Collagen Ⅲ、Fibronectin、α-SMA mRNA的变化;免疫荧光法观察α-SMA在FB中的表达部位及表达量的变化。结果 与db/db模型组相比,PA组创面肉芽组织,胶原形成和新生毛细血管密度明显增加(P<0.01)。PA对HUVECs增殖无影响,可明显促进HUVECs迁移和成管的能力(P<0.05 ,P <0.01)。PA可明显增加FB增殖和迁移的能力,明显增加Collagen Ⅲ、α-SMA mRNA的表达(P<0.05 ,P <0.01),对Fibronectin mRNA的表达无影响,同时可增加α-SMA的荧光强度。结论 芍药苷可能通过促进细胞外基质生成和血管新生,促进糖尿病创面愈合。 | 房志锐 陈璐 李春晓 宋敏 张璐莎 Joel Wake Coffie 张丽媛 马璐璐 王虹 | 2019 | 中国药理学通报2019，35，8： | 12 |
| 20 | 天然β-胡萝卜素对胃癌前期病变的逆转作用显示文摘天然β-胡萝卜素对胃癌前期病变的逆转作用朱舜时,周怡和,夏德凰,金冠球,胡运彪,施尧,李蓉蓉,房静远,JoelMason,萧树东,江绍基萎缩性胃炎时粘膜萎缩、肠化和不典型增生是胃癌的癌前病变,逆转这些病变既是对萎缩性胄炎的治疗,也是对胃癌的预防。晚近... | 朱舜时 周怡和 夏德凰 金冠球 胡运彪 施尧 李蓉蓉 房静远 Joel Mason 萧树东 江绍基 | 1996 | 中华消化杂志1996，16，1： | 12 |
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