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| 1 | Acute-on-chronic liver failure:Pathogenesis,prognostic factors and management显示文摘Acute-on-chronic liver failure(ACLF) is increasingly recognized as a complex syndrome that is reversiblein many cases. It is characterized by an acute deterioration of liver function in the background of a pre-existing chronic liver disease often associated with a high short-term mortality rate. Organ failure(OF) is always associated, and plays a key role in determining the course, and the outcome of the disease. The definition of ACLF remains controversial due to its overall ambiguity, with several disparate criteria among various associations dedicated to the study of liver diseases. Although the precise pathogenesis needs to be clarified, it appears that an altered host response to injury might be a contributing factor caused by immune dysfunction, ultimately leading to a pro-inflammatory status, and eventually to OF. The PIRO concept(Predisposition, Insult, Response and Organ Failure) has been proposed to better approach the underlying mechanisms. It is accepted that ACLF is a different and specific form of liver failure, where a precipitating event is always involved, even though it cannot always be ascertained. According to several studies, infections and active alcoholism often trigger ACLF. Viral hepatitis, gastrointestinal haemorrhage, or drug induced liver injury, which can also provoke the syndrome. This review mainly focuses on the physiopathology and prognostic aspects. We believe these features are essential to further understanding and providing the rationale for improveddisease management strategies. | Sara Blasco-Algora José Masegosa-Ataz María Luisa Gutiérrez-García Sonia Alonso-López Conrado M Fernández-Rodríguez | 2015 | World Journal of Gastroenterology2015，21，42： | 45 |
| 2 | Reactivation of hepatitis B virus infection after cytotoxic chemotherapy or immunosuppressive therapy显示文摘Reactivation of hepatitis B is defined as the recurrence or an abrupt rise in hepatitis B virus(HBV) replication,often accompanied by an increase in serum transaminase levels,and both events occurring in a patient with a previous inactive hepatitis B infection.This reactivation can occur in situations in which the ratio of HBV replication and immune response is altered.It can happen during the treatment of hemato-oncological malignancies with chemotherapy and in immunosuppression of autoimmune diseases.Clinical manifestations of hepatitis B reactivation are variable and can range from asymptomatic to acute hepatitis,which are sometimes serious and result in acute liver failure with risk of death,and usually occur in the periods between cycles or at the end of chemotherapy.Immunosuppressive drugs such as corticosteroids or azathioprine can induce HBV reactivation in patients carrying hepatitis B virus surface antigen(HBsAg) or anti-HBc,but much less frequently than chemotherapy treatments.The tumor necrosis factorαinhibitors infliximab,etanercept and adalimumab may cause reactivation of hepatitis B,and the overall frequency with infliximab may be similar(50%-66%) to that caused by chemotherapy.Baseline HBV serology is recommended for all patients receiving chemotherapy and immunosuppressive drugs,and HBsAg positive patients should receive anti-HBV prophylaxis to decrease virus reactivation and death rates. | María Luisa Manzano-Alonso Gregorio Castellano-Tortajada | 2011 | World Journal of Gastroenterology2011，17，12： | 31 |
| 3 | Helicobacter pylori infection: Beyond gastric manifestations显示文摘Helicobacter pylori(H.pylori)is a bacterium that infects more than a half of world’s population.Although it is mainly related to the development of gastroduodenal diseases,several studies have shown that such infection may also influence the development and severity of various extragastric diseases.According to the current evidence,whereas this bacterium is a risk factor for some of these manifestations,it might play a protective role in other pathological conditions.In that context,when considered the gastrointestinal tract,H.pylori positivity have been related to Inflammatory Bowel Disease,Gastroesophageal Reflux Disease,Non-Alcoholic Fatty Liver Disease,Hepatic Carcinoma,Cholelithiasis,and Cholecystitis.Moreover,lower serum levels of iron and vitamin B12 have been found in patients with H.pylori infection,leading to the emergence of anemias in a portion of them.With regards to neurological manifestations,a growing number of studies have associated that bacterium with multiple sclerosis,Alzheimer’s disease,Parkinson’s disease,and Guillain-Barrésyndrome.Interestingly,the risk of developing cardiovascular disorders,such as atherosclerosis,is also influenced by the infection.Besides that,the H.pylori-associated inflammation may also lead to increased insulin resistance,leading to a higher risk of diabetes mellitus among infected individuals.Finally,the occurrence of dermatological and ophthalmic disorders have also been related to that microorganism.In this sense,this minireview aims to gather the main studies associating H.pylori infection with extragastric conditions,and also to explore the main mechanisms that may explain the role of H.pylori in those diseases. | Maria Luisa Cordeiro Santos Breno Bittencourt de Brito Filipe Antonio França da Silva Mariana Miranda Sampaio Hanna Santos Marques Natalia Oliveira e Silva Dulciene Maria de Magalhaes Queiroz Fabricio Freire de Melo | 2020 | World Journal of Gastroenterology2020，26，28： | 34 |
| 4 | Risk factors associated with the development of ischemic colitis显示文摘AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003.IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible his-tology.Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of colitis.Cases were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was performed.RESULTS:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%women.The principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(P<0.001);diabetes mellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(P<0.001).Finally,the following variables were independently associated with the development of IC:diabetes mellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associated with diabetes,dyslipid-emia,presence of heart failure,peripheral arterial dis-ease and treatment with digoxin or ASA. | Joaquín Cubiella Fernández Luisa Núez Calvo Elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel Martínez Silva Javier Fernández Seara | 2010 | World Journal of Gastroenterology2010，16，36： | 27 |
| 5 | Damage control orthopaedics: State of the art显示文摘Damage control orthopaedics(DCO) originally consisted of the provisional immobilisation of long bone-mainly femur-fractures in order to achieve the advantages of early treatment and to minimise the risk of complications, such as major pain, fat embolism, clotting, pathological inflammatory response, severe haemorrhage triggering the lethal triad, and the traumatic effects of major surgery on a patient who is already traumatised(the 'second hit' effect). In recent years, new locations have been added to the DCO concept, such as injuries to the pelvis, spine and upper limbs. Nonetheless, this concept has not yet been validated in well-designed prospective studies, and much controversy remains.Indeed, some researchers believe the indiscriminate application of DCO might be harmful and produce substantial and unnecessary expense. In this respect, too,normalised parameters associated with the acid-base system have been proposed,under a concept termed early appropriate care, in the view that this would enable patients to receive major surgical procedures in an approach offering the advantages of early total care together with the apparent safety of DCO. This paper discusses the diagnosis and treatment of severely traumatised patients managed in accordance with DCO and highlights the possible drawbacks of this treatment principle. | Enrique Guerado Maria Luisa Bertrand Juan Ramon Cano Ana María Cerván Adolfo Galán | 2019 | World Journal of Orthopedics2019，10，1： | 16 |
| 6 | Tenofovir vs lamivudine plus adefovir in chronic hepatitis B:TENOSIMP-B study显示文摘AIM To demonstrate the non-inferiority(15% non-inferiority limit) of monotherapy with tenofovir disoproxil fumarate(TDF) vs the combination of lamivudine(LAM) plus adefovir dipivoxil(ADV) in the maintenance of virologic response in patients with chronic hepatitis B(CHB) and prior failure with LAM.METHODS This study was a Phase IV prospective, randomized, open, controlled study with 2 parallel groups(TDF and LAM+ADV) of adult patients with hepatitis B e antigen(HBe Ag)-negative CHB, prior failure with LAM, on treatment with LAM+ADV for at least 6 mo, without prior resistance to ADV and with an undetectable viral load at the start of the study, in 14 Spanish hospitals. The follow-up time for each patient was 48 wk after randomization, with quarterly visits in which the viral load, biochemical and serological parameters, adverse effects, adherence to treatment and consumption of hospital resources were analysed.RESULTS Forty-six patients were evaluated [median age: 55.4 years(30.2-75.2); 84.8% male], including 22 patients with TDF and 24 with LAM+ADV. During study development, hepatitis B virus DNA(HBV-DNA) remained undetectable, all patients remained HBe Ag negative, and hepatitis B surface antigen(HBs Ag) positive. Alanine aminotransferase(ALT) values at the end of the study were similar in the 2 groups(25.1± 7.65, TDF vs 24.22 ± 8.38, LAM+ADV, P = 0.646). No significant changes were observed in creatinine or serum phosphorus values in either group. No significant differences between the 2 groups were noted in the identification of adverse effects(AEs)(53.8%, TDF vs 37.5%, LAM+ADV, P = 0.170), and none of the AEs which occurred were serious. Treatment adherence was 95.5% and 83.3% in the TDF and the LAM+ADV groups, respectively(P = 0.488). The costs associated with hospital resource consumption were significantly lower with the TDF treatment than the LAM+ADV treatment(€4943 ± 1059 vs €5811 ± 1538, respectively, P < 0.001).CONCLUSION TDF monotherapy proved to be safe and not inferior to the LAM+ADV combination therapy in maintaining virologic response in patients with CHB and previous LAM failure. In addition, the use of TDF generated a significant savings in hospital costs. | Manuel Rodríguez Juan Manuel Pascasio Enrique Fraga Javier Fuentes Martín Prieto Gloria Sánchez-Antolín Jose Luis Calleja Esther Molina María Luisa García-Buey María Angeles Blanco Javier Salmerón María Lucía Bonet Jose Antonio Pons Jose Manuel González Miguel Angel Casado Francisco Jorquera 无 | 2017 | World Journal of Gastroenterology2017，23，41： | 16 |
| 7 | Prevalence of occult hepatitis B virus infection显示文摘Occult hepatitis B virus(HBV) infection(OBI) is characterized by the persistence of HBV DNA in the liver tissue in individuals negative for the HBV surface antigen.The prevalence of OBI is quite variable depending on the level of endemic disease in different parts of the world,the different assays utilized in the studies,and the different populations studied.Many studies have been carried out on OBI prevalence in different areas of the world and categories of individuals.The studies show that OBI prevalence seems to be higher among subjects at high risk for HBV infection and with liver disease than among individuals at low risk of infection and without liver disease. | Maria Luisa Gutiérrez-García Conrado M Fernandez-Rodriguez Jose Luis Lledo-Navarro Ingrid Buhigas-Garcia | 2011 | World Journal of Gastroenterology2011，17，12： | 10 |
| 8 | Intrahepatic endometriosis as differential diagnosis: Case report and literature review显示文摘Intrahepatic endometriosis is one of the rarest forms of atypical endometriosis; only eighteen cases have been reported in the English literature. We describe the case of a 32-year-old woman, who presented with persistent, non-cyclical upper right quadrant abdominal pain, a central liver cyst, and no history of endometriosis. Three years previous, she was diagnosed with an intrahepatic cyst. The lesion progressed and two laparoscopic deroofing-operations were performed, yet the diagnosis of intrahepatic endometriosis was never reached. She presented in our clinic with further progress of the cyst as well as obstruction of the intrahepatic biliary system. The magnetic resonance imaging showed a 9.5 cm × 12 cm, lobulated intrahepatic cyst. We performed an ultrasonic pericystectomy. Immunostaining confirmed intrahepatic endometriosis. Only one of the previously described eighteen patients with intrahepatic endometriosis presented with cyclical pain in the upper right abdominal quadrant accompanying menstruation. This lack of a 'typical' clinic makes it challenging to diagnose extragonadal endometriosis without histopathology. A previous history of endometriosis was described in only twelve cases, thus the diagnosis of this condition should not be limited to patients with a known history of endometriosis. Six of 18 patients were postmenopausal, demonstrating this condition is not limited to women of reproductive age. A preoperative diagnosis was only reached in seven of the previously described cases, highlighting the importance of preoperative biopsies. Yet due to the potential adverse effects, a transhepatic biopsy must be discussed individually. Although rare, intrahepatic endometriosis should always be considered as a differential diagnosis in women with recurrent hepatic cysts, regardless of age or previous medical history. In such cases, histology is essential and a pericystectomy should be performed as standard of care. | Georg Fluegen Frank Jankowiak Luisa Zacarias Foehrding Feride Kroepil Wolfram T Knoefel Stefan A Topp | 2013 | World Journal of Gastroenterology2013，19，29： | 9 |
| 9 | Prevention of hepatocellular carcinoma in patients with chronic hepatitis B显示文摘Patients with chronic hepatitis B are at significant risk for hepatocellular carcinoma(HCC). Globally,over half a million people each year are diagnosed with HCC,with marked geographical variations. Despite overwhelming evidence for a causal role of hepatitis B virus(HBV) infection in the development of HCC and a well-established relationship between high baseline hepatitis B viral load and cumulative risk of HCC,the molecular basis for this association has not been fully elucidated. In addition,a beneficial role for antiviral therapy in preventing the development of HCC has been difficult to establish. This review examines the biological and molecular mechanisms of HBV-related hepatocarcinogenesis,recent results on the effect of modern nucleos(t)ides on the rate of HCC development in high risk HBV cohorts and the potential mechanisms by which long-term antiviral therapy with potent inhibitors of HBV replication might reduce the risk of HCC in patients with chronic hepatitis B. Although evidence from randomized controlled trials shows the favourable effects of antiviral agentsin achieving profound and durable suppression of HBV DNA levels while improving liver function and histology,robust evidence of other long-term clinical outcomes,such as prevention of HCC,are limited. | Conrado M Fernández-Rodríguez María Luisa Gutiérrez-García | 2014 | World Journal of Gastrointestinal Pharmacology and Therapeutics2014，5，3： | 9 |
| 10 | Management of occult hepatitis B virus infection:An update for the clinician显示文摘Occult hepatitis B virus(HBV) infection(OBI) is defined by the presence of HBV DNA in the liver tissue of individuals who test negative for hepatitis B surface antigen(HBsAg).Patients who have recovered from acute hepatitis B can carry HBV genomes for a long time and show histological patterns of mild necro-inflammation,even fibrosis,years after the resolution of acute hepatitis,without showing any clinical or biochemical evidence of liver disease.At least in conditions of immunocompetence,OBI is inoffensive itself,but when other relevant causes of liver damage are present it might make the course of the liver disease worse.The risk of HBV transmission through transfusion is related to blood donations negative for HBsAg that have been collected during the pre-seroconversion period or during chronic OBI.Use of HBV nucleic acid amplification testing and multivalent anti-HBs antibodies in the HBsAg assays is recommended for detection of true and false OBI,respectively.It is not known if prior hepatitis B immunization with an optimal anti-HBs response in cases of HBV transmission through organ transplantation can effectively modulate or abort the infection.Use of anti-viral agents as prophylaxis in patients with serological evidence of past HBV infection prevents reactivation of OBI after transplantation in most cases.Reactivation of OBI has been observed in other conditions that cause immunosuppression,in which antiviral therapy could be delayed until the HBV DNA or HBsAg becomes detectable.OBI might contribute to the progression of liver fibrosis and hepatocellular carcinoma development in patients with chronic liver disease. | JoséLuis Lledó Conrado Fernández María Luisa Gutiérrez Sara Ocaa | 2011 | World Journal of Gastroenterology2011，17，12： | 9 |
| 11 | Gastroenterology case report of mesalazine-induced cardiopulmonary hypersensitivity显示文摘Mesalazine is a 5-aminosalicylic acid derivative that has been widely used to treat patients with inflammatory bowel disease. Accumulating evidence indicates that mesalazine has a very low rate of adverse drug reactions and is well tolerated by patients. However, a few cases of pulmonary and cardiac disease related to mesalazine have been reported in the past, though infrequently, preventing clinicians from diagnosing the conditions early. We describe the case of a 32-yearold man with ulcerative colitis who was admitted with a two-month history of persistent fever following mesalazine treatment initiated 14 mo earlier. At the time of admission, mesalazine dose was increased from 1.5 to 3.0 g/d, and antibiotic therapy was started with no improvement. Three weeks after admission, the patient developed dyspnea, non-productive cough, and chest pain. Severe eosinophilia was detected in laboratory tests, and a computed tomography scan revealed interstitial infiltrates in both lungs, as well as a large pericardial effusion. The bronchoalveolar lavage reported a CD4/CD8 ratio of 0.5, and an increased eosinophil count. Transbronchial biopsy examination showed a severe eosinophilic infiltrate of the lung tissue. Mesalazine-induced cardiopulmonary hypersensitivity was suspected after excluding other possible etiologies. Consequently, mesalazine treatment was suspended, and corticosteroid therapy was initiated, resulting in resolution of symptoms and radiologic abnormalities. We conclude that mesalazine-induced pulmonary and cardiac hypersensitivity should always be considered in the differential diagnosis of unexplained cardiopulmonary symptoms and radiographic abnormalities in patients with inflammatory bowel disease. | José Ferrusquía Isabel Pérez-Martínez Ricardo Gómez de la Torre María Luisa Fernández-Almira Ruth de Francisco Luis Rodrigo Sabino Riestra | 2015 | World Journal of Gastroenterology2015，21，13： | 5 |
| 12 | Oleanolic acid:a promising neuroprotective agent for cerebral ischemia显示文摘Stroke is considered the most common and severely disabling neurological disease.It is one of the leading causes of death after heart disease and cancer,causing 10%deaths worldwide and involving risk factors such as smoking,obesity and nutritional disbalance.Disability affects 75%of stroke survivors through severe mental and/or physical impairment depending on the affected brain | Caltana Laura Nieto María Luisa Brusco Alicia | 2015 | Neural Regeneration Research2015，10，4： | 5 |
| 13 | Fecal immunochemical test accuracy in average-risk colorectal cancer screening显示文摘AIM:To assess the fecal immunochemical test(FIT)accuracy for colorectal cancer(CRC)and advanced neoplasia(AN)detection in CRC screening.METHODS:We performed a multicentric,prospective,double blind study of diagnostic tests on asymptomatic average-risk individuals submitted to screening colonoscopy.Two stool samples were collected and the fecal hemoglobin concentration was determined in the first sample(FIT1)and the highest level of both samples(FITmax)using the OC-sensor.Areas under the curve(AUC)for CRC and AN were calculated.The best FIT1and FITmax cut-off values for CRC were determined.At this threshold,number needed to scope(NNS)to detect a CRC and an AN and the cost per lesion detected were calculated.RESULTS:About 779 individuals were included.An AN was found in 97(12.5%)individuals:a CRC in 5(0.6%)and an advanced adenoma(≥10 mm,villous histology or high grade dysplasia)in 92(11.9%)subjects.For CRC diagnosis,FIT1 AUC was 0.96(95%CI:0.95-0.98)and FITmax AUC was 0.95(95%CI:0.93-0.97).For AN,FIT1 and FITmax AUC were similar(0.72,95%CI:0.66-0.78 vs 0.73,95%CI:0.68-0.79,respectively,P=0.34).Depending on the number of determinations and the positivity threshold cut-off used sensitivity for AN detection ranged between 28%and 42%and specificity between 91%and 97%.At the best cut-off point for CRC detection(115 ng/mL),the NNS to detect a CRC were 10.2 and 15.8;and the cost per CRC was 1814€and 2985€on FIT1 and FITmax strategies respectively.At this threshold the sensitivity,NNS and cost per AN detected were 30%,1.76,and 306€,in FIT1 strategy,and 36%,2.26€and 426€,in FITmax strategy,respectively.CONCLUSION:Performing two tests does not improve diagnostic accuracy,but increases cost and NNS to detect a lesion. | Vicent Hernandez Joaquin Cubiella M Carmen Gonzalez-Mao Felipe Iglesias Concepción Rivera M Begoa Iglesias Lucía Cid Ines Castro Luisa de Castro Pablo Vega Jose Antonio Hermo Ramiro Macenlle Alfonso Martínez-Turnes David Martínez-Ares Pamela Estevez Estela Cid M Carmen Vidal Angeles López-Martínez Elisabeth Hijona Marta Herreros-Villanueva Luis Bujanda Jose Ignacio Rodriguez-Prada the COLONPREV study investigators | 2014 | World Journal of Gastroenterology2014，20，4： | 4 |
| 14 | Angiopoietin-2/angiopoietin-1 as non-invasive biomarker of cirrhosis in chronic hepatitis C显示文摘AIM To evaluate the efficacy of peripheral blood concentrations of angiopoietins(Ang) as cirrhosis biomarkers of chronic hepatitis C(CHC).METHODS Ang1 and Ang2 serum levels were measured by enzyme-linked immunosorbent assays(ELISA) in samples from 179 cirrhotic and non-cirrhotic CHC patients, classified according to the METAVIR system.Groups were compared by non-parametric MannWhitney U test. Subsequently, the association of peripheral concentrations of angiopoietins with the stage of fibrosis was analyzed using Spearman correlation test. Finally, the accuracy, sensitivity and specificity of circulating angiopoietins for cirrhosis diagnosis were determined by the study of the respective area under the curve of receiver operator characteristics(AUC-ROC).RESULTS Peripheral blood concentrations of Ang1 and Ang2 in CHC patients were significantly related to fibrosis. While Ang1 was decreased in cirrhotic subjects compared to non-cirrhotic(P < 0.0001), Ang2 was significantly increased as CHC progressed to the end stage of liver disease(P < 0.0001). Consequently, Ang2/Ang1 ratio was notably amplified and significantly correlated with fibrosis(P < 0.0001). Interestingly, the individual performance of each angiopoietin for the diagnosis of cirrhosis reached notable AUC-ROC values(above 0.7, both), but the Ang2/Ang1 ratio was much better(AUC-ROC = 0.810) and displayed outstanding values of sensitivity(71%), specificity(84%) and accuracy(82.1%) at the optimal cut-off(10.33). Furthermore, Ang2/Ang1 ratio improved the performance of many other previously described biomarkers or scores of liver cirrhosis in CHC.CONCLUSION Ang2/Ang1 ratio might constitute a useful tool for monitoring the progression of chronic liver disease towards cirrhosis and play an important role as therapeutic target. | ángel Hernández-Bartolomé Rosario López-Rodríguez María Jesús Borque Leticia González-Moreno Yolanda Real-Martínez Luisa García-Buey Ricardo Moreno-Otero Paloma Sanz-Cameno | 2016 | World Journal of Gastroenterology2016，22，44： | 4 |
| 15 | Beta-blocker therapy in elderly patients with renal dysfunction and heart failure显示文摘OBJECTIVE To assess the role of beta-blockers(BB)in patients with chronic kidney disease(CKD)aged≥75 years.METHODS AND RESULTS From January 2008 to July 2014,we included 390 consecutive patients≥75 years of age with ejection fraction≤35%and glomerular filtration rate(GFR)≤60 m L/min per 1.73 m^2.We analyzed the relationship between treatment with BB and mortality or cardiovascular events.The mean age of our population was 82.6±4.1 years.Mean ejection fraction was 27.9%±6.5%.GFR was 60-45 m L/min per 1.73 m^2 in 50.3%of patients,45-30 m L/min per 1.73 m^2 in 37.4%,and<30 m L/min per 1.73 m^2 in 12.3%.At the conclusion of follow-up,67.4%of patients were receiving BB.The median follow-up was28.04(IR:19.41-36.67)months.During the study period,211 patients(54.1%)died and 257(65.9%)had a major cardiovascular event(death or hospitalization for heart failure).BB use was significantly associated with a reduced risk of death(HR=0.51,95%CI:0.35-0.74;P<0.001).Patients receiving BB consistently showed a reduced risk of death across the different stages of CKD:stage IIIa(GFR=30-45 m L/min per 1.73 m^2;HR=0.47,95%CI:0.26-0.86,P<0.0001),stage IIIb(GFR 30-45 m L/min per 1.73 m^2;HR=0.55,95%CI:0.26-1.06,P=0.007),and stages IV and V(GFR<30 m L/min per 1.73 m~2;HR=0.29,95%CI:0.11-0.76;P=0.047).CONCLUSIONS The use of BB in elderly patients with HFr EF and renal impairment was associated with a better prognosis.Use of BB should be encouraged when possible. | Juan Martínez-Milla Marcelino Cortés García Julia Anna Palfy Mikel Taibo Urquía Marta López Castillo Ana Devesa Arbiol Ana Lucía Rivero Monteagudo María Luisa Martín Mariscal Inés Jiménez-Varas Sem Briongos Figuero Juan Antonio Franco-Pelaéz JoséTuñón | 2021 | Journal of Geriatric Cardiology2021，18，1： | 3 |
| 16 | Gastric cancer in relation to the intake of nutrients involved in one-carbon metabolism among MTHFR 677 TT carriers显示文摘 | Marcia V. Galván-Portillo Alejandra Cantoral Luis F. O?ate-Oca?a Jia Chen Roberto Herrera-Goepfert Luisa Torres-Sanchez Raul U. Hernandez-Ramirez Oswaldo Palma-Coca Lizbeth López-Carrillo | 2009 | European Journal of Nutrition2009，，5： | 3 |
| 17 | Review on thermal energy storage with phase change: materials, heat transfer analysis and applications显示文摘 | Belén Zalba José M a Mar??n Luisa F. Cabeza Harald Mehling | 2002 | Applied Thermal Engineering2002，，3： | 3 |
| 18 | Management of Helicobacter pylori infection in Latin America: A Delphi technique-based consensus显示文摘AIM: To optimize diagnosis and treatment guidelines for this geographic region, a panel of gastroenterologists, epidemiologists, and basic scientists carried out a structured evaluation of available literature.METHODS: Relevant questions were distributed among the experts, who generated draft statements for consideration by the entire panel. A modified three-round Delphi technique method was used to reach consensus. Critical input was also obtained from representatives of the concerned medical community. The quality of the evidence and level of recommendation supporting each statement was graded according to United States Preventive Services Task Force criteria.RESULTS: A group of ten experts was established. The survey included 15 open-ended questions that were distributed among the experts, who assessed the articles associated with each question. The levels of agreement achieved by the panel were 50% in the first round, 73.3% in the second round and 100% in the third round. Main consensus recommendations included:(1) when available, urea breath and stool antigen test(HpSA) should be used for non-invasive diagnosis;(2) detect and eradicate Helicobacter pylori(H. pylori) in all gastroscopy patients to decrease risk of peptic ulcer disease, prevent o retard progression in patients with preneoplastic lesions, and to prevent recurrence in patients treated for gastric cancer;(3) further investigate implementation issues and health outcomes of H. pylorieradication for primary prevention of gastric cancer in high-risk populations;(4) prescribe standard 14-d triple therapy or sequential therapy for first-line treatment;(5) routinely assess eradication success post-treatment in clinical settings; and(6) select second- and third-line therapies according to antibiotic susceptibility testing.CONCLUSION: These achievable steps toward better region-specific management can be expected to improve clinical health outcomes. | Antonio Rollan Juan Pablo Arab M Constanza Camargo Roberto Candia Paul Harris Catterina Ferreccio Charles S Rabkin Juan Cristóbal Gana Pablo Cortés Rolando Herrero Luisa Durán Apolinaria García Claudio Toledo Alberto Espino Nicole Lustig Alberto Sarfatis Catalina Figueroa Javier Torres Arnoldo Riquelme | 2014 | World Journal of Gastroenterology2014，20，31： | 2 |
| 19 | Susceptibility Genetic Variants Associated With Colorectal Cancer Risk Correlate With Cancer Phenotype显示文摘 | Anna Abulí Xavier Bessa Juan Ramón González Clara Ruiz–Ponte Alejandro Cáceres Jenifer Mu?oz Victoria Gonzalo Francesc Balaguer Ceres Fernández–Rozadilla Dolors González Luisa de Castro Juan Clofent Luís Bujanda Joaquín Cubiella Josep M a Re?é Juan Diego | 2010 | Gastroenterology2010，，3： | 2 |
| 20 | Effects of heavy metal concentrations (Cd, Zn and Pb) in agricultural soils near different emission sources on quality, accumulation and food safety in soybean [ Glycine max (L.) Merrill]显示文摘 | María Julieta Salazar Judith Hebelen Rodriguez Gastón Leonardo Nieto María Luisa Pignata | 2012 | Journal of Hazardous Materials2012，，： | 2 |
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