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1亚太地区炎症性肠病处理共识意见(一)显示文摘虽然目前亚太地区尚无炎症性肠病(IBD)的大规模流行病学资料,但一系列研究显示其发病率和患病率呈上升趋势,与西方国家相比仍呈滞后现象,溃疡性结肠炎(UC)的发病率仍较克罗恩病(CD)高。除地域差异外,在一些多民族国家中,IBD尚可见种族差异。亚太地区IBD的遗传背景有异于西方国家,如据报道该地区CD患者未检出NOD2/CARD15变异。一般而言,该地区IBD患者的临床过程似不如西方国家严重。亚太地区IBD的诊断存在一些特殊问题。如缺乏IBD诊断金标准,存在多种小肠结肠炎,与IBD临床表现相似,使鉴别诊断特别困难。迄今为止,亚太地区IBD的诊断标准多采用西方国家的诊断标准。诊断必须逐步排除非IBD的小肠结肠炎,确诊应有典型的组织学表现,某些患者需借助随访和诊断性治疗才能确诊。进一步研究IBD发病机制将有助于开发更好的诊断标记物。亚太地区IBD的治疗亦存在特殊问题。由于诊断困难,IBD患者常未能及时接受适当的药物治疗,但该地区仍广泛采用药物治疗方案。结合西方指南和本地经验可制定类似的处理原则,以利诱导缓解和维持缓解。提倡逐级使用基于病变范围、活动性和严重度的阶梯式治疗方案,对不同病例采用综合性、个体化的方法。随着对IBD发病机制和亚太地区IBD独特性的深入理解,合理、实用的药物治疗指南和应用生物制剂治疗将改善该地区IBD的治疗前景。欧阳钦 Rakesh Tandon KL Goh 潘国宗 KM Fock Claudio Fiocchi SK Lam 萧树东 张虎 梁红亮 王玉芳 2006胃肠病学2006,11,4:123
2世界胃肠病学组织(WGO-OMGE)临床指南——发展中国家幽门螺杆菌感染显示文摘我非常高兴向大家推荐这份发展中国家幽门螺杆菌(H.priori)临床指南。该指南的编译是由数位在该领域具有丰富临床经验的世界知名专家共同完成的。Hunt RH Xiao SD Megraud F Leon-Barua R Bazzoli F Van der Merwe S vaz Coelho LG Fock KM Fedail S Cohen H Malfertheiner P Vakil N Hamid S Goh KL Wong BC Krabshuis JH 杜颖 丛衍群 戴宁 2007胃肠病学2007,12,1:85
3Viral and host causes of fatty liver in chronic hepatitis B显示文摘AIM: To investigate the viral and host causes of fatty liver in chronic hepatitis B patients and the role of fat deposits in liver damage.METHODS: A total of 164 patients (113 males and 51 females, average age 35±11.3 years, and range 10-62 years) with previously untreated chronic hepatitis B were included in the study. The patients were divided into two groups depending on the result of liver biopsy: group without steatosis (100 patients with <5% hepatosteatosis) and group with steatosis (64 patients with >5% hepatosteatosis). The groups were compared in terms of gender, body mass index (BMI), liver enzymes (ALT, AST, ALP, GGT), cholesterol, triglyceride, HBeAg, viral load, and histological findings. In the group with steatosis, the patients were subdivided depending on the degree of steatosis into mild group (45 patients with 5-24% steatosis), and severe group (19 patients with >25% steatosis). RESULTS: In the group of chronic hepatitis B with steatosis, the mean age, BMI, cholesterol, and triglyceride levels were significantly higher than those in the group without steatosis (P<0.05). Steatosis was found in 53 (46.9%) of male patients and 11 (22%) of female patients (P<0.05). No significant difference was found in the positivity of ALT, AST, ALP, GGT, HBeAg, viral load, histological activity index (HAI) and stage between the two groups (P>0.05). In the group with severe steatosis, the BMI was significantly higher than that in the group with mild steatosis (P<0.05). No significant difference was found in the other parameters between the groups (P>0.05). CONCLUSION: Steatosis in chronic hepatitis B appears to be a result of metabolic factors of the host rather than the effect of viruses. Steatosis is unrelated to the HAI and degree of fibrosis, which are considered as the histological indicators of liver damage.Emin Altiparmak Seyfettin K(o|¨)klü Mesut Yalinkilic Osman Yüksel Bahattin Cicek Ertugrul Kayacetin Tülin Sahin 2005World Journal of Gastroenterology2005,11,20:52
4亚太地区炎症性肠病处理共识意见(二)显示文摘欧阳钦 Rakesh Tandon KL Goh 潘国宗 KM Fock Claudio Fiocchi SK Lam 萧树东 张虎(翻译) 梁红亮(翻译) 王玉芳(翻译) 欧阳钦(审校) 2006胃肠病学2006,11,5:47
5MicroRNA in TLR signaling and endotoxin tolerance显示文摘Toll-like receptors(TLRs)in innate immune cells are the prime cellular sensors for microbial components.TLR activation leads to the production of proinflammatory mediators and thus TLR signaling must be properly regulated by various mechanisms to maintain homeostasis.TLR4-ligand lipopolysaccharide(LPS)-induced tolerance or cross-tolerance is one such mechanism,and it plays an important role in innate immunity.Tolerance is established and sustained by the activity of the microRNA miR-146a,which is known to target key elements of the myeloid differentiation factor 88(MyD88)signaling pathway,including IL-1 receptor-associated kinase(IRAK1),IRAK2 and tumor-necrosis factor(TNF)receptor-associated factor 6(TRAF6).In this review,we comprehensively examine the TLR signaling involved in innate immunity,with special focus on LPS-induced tolerance.The function of TLR ligand-induced microRNAs,including miR-146a,miR-155 and miR-132,in regulating inflammatory mediators,and their impact on the immune system and human diseases,are discussed.Modulation of these microRNAs may affect TLR pathway activation and help to develop therapeutics against inflammatory diseases.Md A Nahid Minoru Satoh Edward KL Chan 2011Cellular & Molecular Immunology2011,8,5:34
6世界胃肠病学组织全球指南——发展中国家幽门螺杆菌感染显示文摘世界上有一半人口感染幽门螺杆菌(H.pylori),其感染率因地理位置、种族、年龄和社会经济状况不同而存在很大差异.在发展中国家较高.发达国家较低。但总体而言,近年世界许多地区的H.pylori感染率均呈下降趋势。Hunt RH Xiao SD Megraud F Leon-Barua R Bazzoli F van der Merwe S Vaz Coelho LG Fock M Fedail S Cohen H Malfertheiner P Vakil N Hamid S Goh KL Wong BCY Krabshuis J Le Mair A 杜颖 戴宁 2011胃肠病学2011,16,7:27
7A GC-based metabonomics investigation of type 2 diabetes by organic acids metabolic profile显示文摘Yuan, KL Kong, HW Guan, YF Yang, J Xu, GX 2007中国生物学文摘2007,21,11:26
8亚太地区胃食管反流病的处理共识:更新版显示文摘背景与目的:自从2004年亚太地区胃食管反流病(GERD)共识发表以来,更多关于GERD流行病学和处理的文献资料相继出现。有必要对这些资料进行循证综述,对共识作出更新。方法:由多学科专家组应用德尔菲(Delphi)法制定共识条文,提呈相关资料,并对证据质量、推荐力度和共识水平进行分级。结果:亚洲GERD发生率日益增加。其危险因素包括老年、男性、种族、家族史、社会经济地位高、体重指数增加和吸烟。对于有典型症状而无报警症状的患者,对质子泵抑制剂(PPI)试验有症状应答具有诊断意义。如PPI试验失败,停止治疗后pH监测结果阴性可排除GERD。窄带成像、胶囊内镜检查和无线pH监测的作用尚未明确。亚洲诊断策略的制定须考虑到并存的胃癌和消化性溃疡。减轻体质量和抬高床头可改善反流症状。PPIs是最有效的内科治疗手段。对于非糜烂性反流病(NERD)患者,按需治疗较为适宜。有慢性咳嗽、喉炎和典型GERD症状的患者在排除非GERD病因后,应予PPI每天两次治疗。如有经验丰富的外科医师,GERD患者可行胃底折叠术。除临床试验外,GERD不应采用内镜治疗。结论:新的诊断方法和内镜治疗的作用有待进一步研究阐明。亚洲GERD诊断策略的制定须考虑到并存的胃癌和消化性溃疡。PPIs仍为治疗的基石。Kwong Ming Fock Nicholas J Talley Ronnie Fass Khean Lee Goh Peter Katelaris Richard Hunt Michio Hongo Tiing Leong Ang Gerald Holtmann Sanjay Nandurkar San Ren Lin Benjamin CY Wong Francis KL Chan Abdul Aziz Rani Young-Tae Bak Jose Sollano Khek Yu Ho Sathoporn Manatsathit 钱本余 2008胃肠病学2008,13,7:21
9全球195个国家18亿青少年健康调查:慢病占青少年疾病负担一半以上,是青年人健康状况每况愈下的主因显示文摘一项针对全球195个国家的18亿10-24岁的青少年健康状况的调查研究显示,这些年轻人正面临比25年前更大的健康挑战。文章称,目前的10.24岁的人口是有史以来最多的,截至2016年达到18亿,印度和中国拥有全球三分之一的青少年(6.22亿)。印度青少年人口增长了40%,然而,中国青少年人口从1990年的3.52亿减少到2016年的2.53亿。Azzopardi PS Hearps SJC Francis KL 2019疾病监测2019,34,3:16
10Effect of oral erythromycin on gastric and small bowel transit time of capsule endoscopy显示文摘AIM: To determine the effect of oral erythromycin on gastric and small bowel transit time of capsule endoscopy.METHODS: Consecutive patients who underwent capsule endoscopy du ring the 16-mo study period were either given 250 mg oral erythromycin, 1 h prior to swallowing the capsule endoscope or nothing. The gastric and small bowel transit time, and the small bowel image quality were compared.RESULTS: Twenty-four patients received oral erythromycin whereas 14 patients were not given any prokinetic agent.Patients who received erythromycin had a significantly lower gastric transit time than control (16 min vs70 min, P= 0.005),whereas the small bowel transit time was comparable between the two groups (227 min vs183 min, P = 0.18).Incomplete small bowel examination was found in three patients of the control group and in one patient of the erythromycin group. There was no significant difference in the overall quality of small bowel images between the two groups. A marked reduction in gastric transit time was noted in two patients who had repeat capsule endoscopy after oral erythromycin.CONCLUSION: Use of oral erythromycin significantly reduces the gastric transit time of capsule endoscopy.Wai K Leung Francis KL Chan Sara SL Fung Mei-Yin Wong Joseph JY Sung 2005World Journal of Gastroenterology2005,11,31:16
11身体功能恢复的脑卒中患者仍存在认知障碍、抑郁症状和重返社会障碍显示文摘脑卒中后的功能预后往往通过改良的Rankin量表进行评估,仅对主要日常生活活动能力进行评估。但脑卒中患者可能在重新融入社会生活的时候遇到困难,心理上感觉孤立,生活质量差,即便是身体功能完全恢复的患者也存在上述问题。Kapoor A Lanctt KL Bayley M Kiss A Herrmann N Murray BJ Swartz RH 刘莉 叶鹏 2017中华高血压杂志2017,25,5:16
12Management of early gastrointestinal neuroendocrine neoplasms显示文摘Neuroendocrine neoplasms (NENs) of the stomach, duo- denum, appendix or rectum that are small (≤ 1 cm) and well differentiated can be considered 'early' tumors, since they generally have a (very) good prognosis. In the new WHO classification of 2010, these neoplasms are called neuroendocrine tumors/ carcinoids (NETs), grade (G) 1 or 2, and distinguished from poorly differentiated neuroendocrine carcinomas (NECs), G3. NETs are increasing, with a rise in the age-adjusted incidence in the U.S.A. by about 700 % in the last 35 years. Improved early detection seems to be the main reason for these epidemiological changes. Both the better generalavailability of endoscopy, and imaging techniques, have led to a shift in the discovery of smaller-sized (≤ 10-20 mm) intestinal NETs/carcinoids and earlier tumor stages at diagnosis. Endoscopic screening is therefore effective in the early diagnosis, not only of colorectal adenocarcinomas, but also of NETs/carcinoids. Endoscopic removal, followed up with endoscopic surveillance is the treatment of choice in NETs/carcinoids of the stomach, duodenum and rectum that are ≤ 10 mm in size, have a low proliferative activity (G1), do not infiltrate the muscular layer and show no angioinvasion. In all the other intestinal NENs, optimal treatment generally needs surgery and/or medical therapy depending on type, biology and stage of the tumor, as well as the individual situation of the patient.Hans Scherübl Robert T Jensen Guillaume Cadiot Ulrich Stlzel Günter Klppel 2011World Journal of Gastrointestinal Endoscopy2011,3,7:13
13口服抗栓药物预防非瓣膜性房颤患者的卒中:美国心脏协会/美国卒中协会的科学建议显示文摘成年房颤患者的卒中发生率,依据合并症和既往脑血管事件史,为每年1%~20%不等(平均每年为4.5%)。对卒中风险的分层非常重要,因为用抗栓药降低房颤导致卒中的主要风险是出血。如华法令在减少缺血性事件风险的同时,每年有1%~12%戴若莲 糜建华 华驾略 董荃 苏爱萍 李焰生 Furie KL Goldstein LB Albers GW Khatri P Neyens R Turakhia MP Turan TN Wood KA 2012神经病学与神经康复学杂志2012,9,3:12
14与皮肤科有关的小儿传染性疾病的新进展显示文摘5年来,小儿传染病领域已取得不少进展,其中有许多与皮肤科有关。已经明确幼儿急疹的病原为人类疱疹病毒6型。尽管幼儿急疹的典型表现为婴幼儿的热退疹出,但不伴发疹的发热及不伴发热的出疹也认为与此病毒有关。现已证实,传染性红斑及猫抓病的病原分别为人类细小病毒B_(19)型及小的多型杆菌。先天梅毒的病例数日益剧增,由于父母滥用药物,使许多患儿未得到产前保健。脓疱疮的病原正由链球菌感染占优势转变成以金黄色葡萄球菌感染为主。Grossman KL 江超 1992国外医学(皮肤性病学分册)1992,18,2:12
15mi R-122 negatively correlates with liver fibrosis as detected by histology and FibroScan显示文摘AIM: To investigate whether expression of selected mi RNAs obtained from fibrotic liver biopsies correlate with fibrosis stage.METHODS: Altogether, 52 patients were enrolled in the study representing various etiologic backgrounds of fibrosis: 24 cases with chronic hepatitis infections(types B, C), 19 with autoimmune liver diseases(autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, overlapping syndrome cases), and 9 of mixed etiology(alcoholic and nonalcoholic steatosis, cryptogenic cases). Severity of fibrosis was determined by both histologic staging using the METAVIR scoring system and noninvasive transient elastography. Following RNAisolation, expression levels of mi R-21, mi R-122, mi R-214, mi R-221, mi R-222, and mi R-224 were determined using Taq Man Micro RNA Assays applying mi R-140 as the reference. Selection of mi RNAs was based on their characteristic up- or downregulation observed in hepatocellular carcinoma. Relative expression of mi RNAs was correlated with fibrosis stage and liver stiffness(LS) value measured by transient elastography, as well as with serum alanine aminotransferase(ALT) level.RESULTS: The expression of individual mi RNAs showed deregulated patterns in stages F1-F4 as compared with stage F0, but only the reduced level of mi R-122 in stage F4 was statistically significant(P < 0.04). When analyzing mi RNA expression in relation to fibrosis, levels of mi R-122 and mi R-221 showed negative correlations with fibrosis stage, and mi R-122 was found to correlate negatively and mi R-224 positively with LS values(all P < 0.05). ALT levels displayed a positive correlation with mi R-21(P < 0.04). Negative correlations were observed in the fibrosis samples of mixed etiology between mi R-122 and fibrosis stage and LS values(P < 0.05), and in the samples of chronic viral hepatitis, between mi R-221 and fibrosis stage(P < 0.01), whereas mi R-21 showed positive correlation with ALT values in the samples of autoimmune liver diseases(P < 0.03). The results also revealed a strong correlation between fibrosis stage and LS values(P < 0.01) when etiology of fibrosis was not taken into account.CONCLUSION: Reduced expression of mi R-122 in advanced fibrosis and its correlation with fibrosis stage and LS values seem to be characteristic of hepatic fibrosis of various etiologies.Tünde Halász Gábor Horváth Gabriella Pár Klára Werling András Kiss Zsuzsa Schaff Gábor Lendvai 2015World Journal of Gastroenterology2015,21,25:11
16氮肥对天敌自然控制作用的影响及其在稻田生态系统中的例证显示文摘施用氮肥后可以直接或间接地通过对植物—害虫—天敌三者之间关系的干预、改变寄主植物内的营养成分和次生化学物质的含量等从正反两个方面影响捕食性天敌的捕食能力。而氮肥对寄生性天敌的作用主要是通过干扰寄生蜂的寄主搜索和选择行为、影响天敌自身的生长发育、生殖和成虫性比以及改变寄主植物的形态和天敌所处的生境等。稻田生态系统中施用氮肥不仅可以改进节肢动物的营养条件和生境,而且还可以通过水生无脊椎动物群落的变化改变整个食物链的结构和动态。在施用氮肥的稻株上黑肩绿盲蝽对褐飞虱卵和若虫的捕食能力明显下降。稻田中诱捕到的寄生蜂种群数量也显著减少。这些结果表明天敌对害虫自然控制作用的下降可能是稻田过量施用氮肥后害虫种群增加的主要原因之一。吕仲贤 俞晓平 Heong KL 胡萃 2006浙江农业学报2006,18,2:10
17Neuroendocrine tumors of the small bowels are on the rise:Early aspects and management显示文摘Neuroendocrine tumors of the small bowel are on the rise. In the US they have increased by 300%-500% in the last 35 years. At the same time their prognosis is much improved. Today,most neuroendocrine tumors (NETs) of the duodenum are detected 'incidentally' and therefore recognized at an early stage. Duodenal NETs which are well differentiated,not larger than 10 mm and limited to the mucosa/submucosa can be endoscopically resected. The management of duodenal NETs ranging between 10 and 20 mm needs an interdisciplinary discussion. Endoscopic ultrasound is the method of choice to determine tumor size and depth of infiltration. Surgery is recommended for well-differentiated duodenal NET tumors greater than 20 mm,for localized sporadic gastrinomas (of any size) and for localized poorly differentiated NE cancers. Surgery is recommended for any ileal NET. Advanced ileal NETs with a carcinoid syndrome are treated with longacting somatostatin analogs. This treatment significantly improves (progression-free) survival in patients with metastatic NETs of the ileum. For optimal NET management,tumor biology,type,localization and stage of the neoplasm,as well as the patient's individual circumstances have to be taken into account.Hans Scherbl Robert T Jensen Guillaume Cadiot Ulrich Stlzel Gnter Klppel 2010World Journal of Gastrointestinal Endoscopy2010,2,10:10
18Intratumoral dendritic cell vaccin ation elicits potent tumoricidal im munity against malignant glioma in rats显示文摘Dendritic cells(DC)are attractive candidates for innovative cancer immunotherapy by virtu e of their ability to function as powe rful antigen presenting cells and elicit potent antitumor cytotoxic immune r esponses.With the aim of generating antitumor immunity,the authors sought to enhance in vivo tum or antigen presentation by using an i ntratumoral DC vaccination strateg y in the setting of partially irradiated intracranial brain tumo rs.Fisher rats,implanted with 9L gliomas in the right corpus striatum,w ere treated with freshly cultured,unpulsed syngeneic DC inoculated directly into the tumor bed.Intracranially inoculated DCs were found to drain to ipsilateral deep cervical lymph nodes.This was a ssociated with increased local and s ystemic antitumor cytoxicity,as evidenced by robust infiltration of treated tumors with CD4and CD8T ce lls as well as by increased IFN-gamma protein and message levels in in vitr o restimulated splenic lymphocytes.DC therapy resulted in prolonged survival and immunity to s ubsequent intracranial tumor re-ch allenge.These results demonstrate the viability of intratumoral DC vaccination as an effectiv e therapeutic strategy for intracra nial glioma.Ehtesham M Kabos P Gutierrez MA Samoto K Black KL Yu JS 2003癌症2003,22,7:8
19Statin use and risk of diabetes mellitus显示文摘The 3-hydroxy-methylglutaryl coenzyme A reductase inhibitors, statins, are widely used in the primary and secondary prevention of cardiovascular diseases to lower serum cholesterol levels. As type 2 diabetes mellitus is accompanied by dyslipidemia, statins have a major role in preventing the long term complications in diabetes and are recommended for diabetics with normal low density lipoprotein levels as well. In 2012, United States Food and Drug Administration released changes to statin safety label to include that statins have been found to increase glycosylated haemoglobin and fasting serum glucose levels. Many studies done on patients with cardiovascular risk factors have shown that statins have diabetogenic potential and the effect varies as per the dosage and type used. The various mechanisms for this effect have been proposed and one of them is downregulation of glucose transporters by the statins. The recommendations by the investigators are that though statins can have diabetogenic risk, they have more long term benefits which can outweigh the risk. In elderly patients and those with metabolic syndrome, as the risk of diabetes increase, the statins should be used cautiously. Other than a subset of population with risk for diabetes; statins still have long term survival benefits in most of the patients.Bharti Chogtu Rahul Magazine KL Bairy 2015World Journal of Diabetes2015,6,2:8
20Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder显示文摘The management of patients with irreparable rotator cuff tears remains a challenge for orthopaedic surgeons with the final treatment option in many algorithms being either a reverse shoulder arthroplasty or a tendon transfer. The long term results of these procedures are however still widely debated, especially in younger patients. A variety of arthroscopic treatment options have been proposed for patients with an irreparable rotator cuff tear without the presence of arthritis of the glenohumeral joint. These include a simple debridement with or without a biceps tenotomy, partial rotator cuff repair with or without an interval slide, tuberplasty, graft interposition of the rotator cuff, suprascapular nerve ablation, superior capsule reconstruction and insertion of a biodegradable spacer(Inspace) to depress the humeral head. These options should be considered as part of the treatment algorithm in patients with an irreparable rotator cuff and could be used as either as an interim procedure, delaying the need for more invasive surgery in the physiologically young and active, or as potential definitive procedures in the medically unfit.The aim of this review is to highlight and summarise arthroscopic procedures and the results thereof currently utilised in the management of these challenging patients.Cameron M Anley Samuel KL Chan Martyn Snow 2014World Journal of Orthopedics2014,5,5:8
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