|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Diabetic cardiomyopathy:Pathophysiology,diagnostic evaluation and management显示文摘Diabetes affects every organ in the body and cardiovascular disease accounts for two-thirds of the mortality in the diabetic population.Diabetes-related heart disease occurs in the form of coronary artery disease(CAD),cardiac autonomic neuropathy or diabetic cardiomyopathy(DbCM).The prevalence of cardiac failure is high in the diabetic population and DbCM is a common but underestimated cause of heart failure in diabetes.The pathogenesis of diabetic cardiomyopathy is yet to be clearly defined.Hyperglycemia,dyslipidemia and inflammation are thought to play key roles in the generation of reactive oxygen or nitrogen species which are in turn implicated.The myocardial interstitium undergoes alterations resulting in abnormal contractile function noted in DbCM.In the early stages of the disease diastolic dysfunction is the only abnormality,but systolic dysfunction supervenes in the later stages with impaired left ventricular ejection fraction.Transmitral Doppler echocardiography is usually used to assess diastolic dysfunction,but tissue Doppler Imaging and Cardiac Magnetic Resonance Imaging are being increasingly used recently for early detection of DbCM.The management of DbCM involves improvement in lifestyle,control of glucose and lipid abnormalities,and treatment of hypertension and CAD,if present.The role of vasoactive drugs and antioxidants is being explored.This review discusses the pathophysiology,diagnostic evaluation and management options of DbCM. | Joseph M Pappachan George I Varughese Rajagopalan Sriraman Ganesan Arunagirinathan | 2013 | World Journal of Diabetes2013，4，5： | 57 |
| 2 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 3 | Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis显示文摘AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality(OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites(OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed. | Jonathan G Stine Puja M Shah Scott L Cornella Sean R Rudnick Marwan S Ghabril George J Stukenborg Patrick G Northup | 2015 | World Journal of Hepatology2015，7，27： | 42 |
| 4 | A high-quality genome assembly of quinoa provides insights into the molecular basis of salt bladder-based salinity tolerance and the exceptional nutritional value显示文摘 | Changsong Zou Aojun Chen Lihong Xiao Heike M Muller Peter Ache Georg Haberer Meiling Zhang Wei Jia Ping Deng Ru Huang Daniel Lang Feng Li Dongliang Zhan Xiangyun Wu Hui Zhang Jennifer Bohm Renyi Liu Sergey Shabala Rainer Hedrich Jian-Kang Zhu Heng Zhang | 2017 | Cell Research2017，27，11： | 22 |
| 5 | Golgi protein-73:A biomarker for assessing cirrhosis and prognosis of liver disease patients显示文摘BACKGROUND Reliable biomarkers of cirrhosis,hepatocellular carcinoma(HCC),or progression of chronic liver diseases are missing.In this context,Golgi protein-73(GP73)also called Golgi phosphoprotein-2,was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells.As a result,GP73 expression was found primarily in biliary epithelial cells,with only slight detection in hepatocytes.However,in patients with acute or chronic liver diseases and especially in HCC,the expression of GP73 is significantly up-regulated in hepatocytes.So far,few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression.AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression.METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA(QUANTA Lite®GP73,Inova Diagnostics,Inc.,Research Use Only)in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa,Greece(n=366)and Debrecen,Hungary(n=266).Aspartate aminotransferase(AST)/Platelets(PLT)ratio index(APRI)was also calculated at the relevant time points in all patients.Two hundred and three patients had chronic hepatitis B,183 chronic hepatitis C,198 alcoholic liver disease,28 autoimmune cholestatic liver diseases,15 autoimmune hepatitis,and 5 with other liver-related disorders.The duration of follow-up was 50(57)mo[median(interquartile range)].The development of cirrhosis,liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines.In particular,the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein(AFP)determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients.RESULTS Increased serum levels of GP73(>20 units)were detected at initial evaluation in 277 out of 632 patients(43.8%).GP73-seropositivity correlated at baseline with the presence of cirrhosis(96.4%vs 51.5%,P<0.001),decompensation of cirrhosis(60.3%vs 35.5%,P<0.001),presence of HCC(18.4%vs 7.9%,P<0.001)and advanced HCC stage(52.9%vs 14.8%,P=0.002).GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score[Area under the curve(AUC)(95%CI):0.909(0.885-0.934)vs 0.849(0.813-0.886),P=0.003].Combination of GP73 with APRI improved further the accuracy(AUC:0.925)compared to GP73(AUC:0.909,P=0.005)or APRI alone(AUC:0.849,P<0.001).GP73 levels were significantly higher in HCC patients compared to non-HCC[22.5(29.2)vs 16(20.3)units,P<0.001)and positively associated with BCLC stage[stage 0:13.9(10.8);stage A:17.1(16.8);stage B:19.6(22.3);stage C:32.2(30.8);stage D:45.3(86.6)units,P<0.001]and tumor dimensions[very early:13.9(10.8);intermediate:19.6(18.4);advanced:29.1(33.6)units,P=0.004].However,the discriminative ability for HCC diagnosis was relatively low[AUC(95%CI):0.623(0.570-0.675)].Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline,was prognostic of higher rates of decompensation(P=0.036),HCC development(P=0.08),and liver-related deaths(P<0.001)during follow-up.CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination.In combination with APRI,its diagnostic performance can be further improved.Most importantly,the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and nonviral chronic liver diseases. | Nikolaos K Gatselis Tamás Tornai Zakera Shums Kalliopi Zachou Asterios Saitis Stella Gabeta Roger Albesa Gary L Norman Mária Papp George N Dalekos | 2020 | World Journal of Gastroenterology2020，26，34： | 21 |
| 6 | Choledochal cysts: Similarities and differences between Asian and Western countries显示文摘Choledochal cysts(CCs)are rare bile duct dilatations,intra-and/or extrahepatic,and have higher prevalence in the Asian population compared to Western populations.Most of the current literature on CC disease originates from Asia where these entities are most prevalent.They are thought to arise from an anomalous pancreaticobiliary junction,which are congenital anomalies between pancreatic and bile ducts.Some similarities in presentation between Eastern and Western patients exist such as female predominance,however,contemporary studies suggest that Asian patients may be more symptomatic on presentation.Even though CC disease presents with an increased malignant risk reported to be more than 10%after the second decade of life in Asian patients,this risk may be overstated in Western populations.Despite this difference in cancer risk,management guidelines for all patients with CC are based predominantly on observations reported from Asia where it is recommended that all CCs should be excised out of concern for the presence or development of biliary tract cancer. | George N Baison Morgan M Bonds William S Helton Richard A Kozarek | 2019 | World Journal of Gastroenterology2019，25，26： | 16 |
| 7 | Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study显示文摘 | Patrick Marcellin Edward Gane Maria Buti Nezam Afdhal William Sievert Ira M Jacobson Mary Kay Washington George Germanidis John F Flaherty Raul Aguilar Schall Jeffrey D Bornstein Kathryn M Kitrinos G Mani Subramanian John G McHutchison E Jenny Heathcote | 2012 | The Lancet2012，，： | 14 |
| 8 | miR-200 family expression is downregulated upon neoplastic progression of Barrett's esophagus显示文摘AIM: To investigate miR-200 family expression in Barrett's epithelium, gastric and duodenal epithelia, and esophageal adenocarcinoma. METHODS: Real-time reverse transcriptase-polymerase chain reaction was used to measure miR-200, ZEB1 and ZEB2 expression. Ingenuity Pathway Analysis of miR-200 targets was used to predict biological outcomes. RESULTS: Barrett's epithelium expressed lower levels of miR-141 and miR-200c than did gastric and duodenal epithelia (P < 0.001). In silico analysis indicated roles for the miR-200 family in molecular pathways that distinguish Barrett's epithelium from gastric and duodenalepithelia, and which control apoptosis and proliferation. All miR-200 members were downregulated in adenocarcinoma (P < 0.02), and miR-200c expression was also downregulated in non-invasive epithelium adjacent to adenocarcinoma (P < 0.02). The expression of all miR-200 members was lower in Barrett's epithelium derived high-grade dysplastic cell lines than in a cell line derived from benign Barrett's epithelium. We observed signif icant inverse correlations between miR-200 family expression and ZEB1 and ZEB2 expression in Barrett's epithelium and esophageal adenocarcinoma (P < 0.05). CONCLUSION: miR-200 expression might contribute to the anti-apoptotic and proliferative phenotype of Barrett's epithelium and regulate key neoplastic processes in this epithelium. | Cameron M Smith David I Watson Mary P Leong George C Mayne Michael Z Michael Bas PL Wijnhoven Damian J Hussey | 2011 | World Journal of Gastroenterology2011，17，8： | 13 |
| 9 | Severe scrub typhus infection: Clinical features, diagnostic challenges and management显示文摘Scrub typhus infection is an important cause of acute undifferentiated fever in South East Asia. The clinical picture is characterized by sudden onset fever with chills and non-specific symptoms that include headache, myalgia, sweating and vomiting. The presence of an eschar, in about half the patients with proven scrub typhus infection and usually seen in the axilla, groin or inguinal region, is characteristic of scrub typhus. Common laboratory findings are elevated liver transaminases, thrombocytopenia and leukocytosis. About a third of patients admitted to hospital with scrub typhus infection have evidence of organ dysfunction that may include respiratory failure, circulatory shock, mild renal or hepatic dysfunction, central nervous system involvement or hematological abnormalities. Since the symptoms and signs are non-specific and resemble other tropical infections like malaria, enteric fever, dengue or leptospirosis, appropriate laboratory tests are necessary to confirm diagnosis. Serological assays are the mainstay of diagnosis as they are easy to perform; the reference test is the indirect immunofluorescence assay(IFA) for the detection of Ig M antibodies. However in clinical practice, the enzyme-linked immuno-sorbent assay is done due to the ease of performing this test and a good sensitivity and sensitivity when compared with the IFA. Paired samples, obtained at least two weeks apart, demonstrating a ≥ 4 fold rise in titre, is necessary for confirmation of serologic diagnosis. The mainstay of treatment is the tetracycline group of antibiotics or chloramphenicol although macrolides are used alternatively. In mild cases, recovery is complete. In severe cases with multi-organ failure, mortality may be as high as 24%. | John Victor Peter Thomas I Sudarsan John Anthony J Prakash George M Varghese | 2015 | World Journal of Critical Care Medicine2015，4，3： | 13 |
| 10 | Duodenal adenocarcinoma: Advances in diagnosis and surgical management显示文摘Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma(DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multiinstitutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles. | Jordan M Cloyd Elizabeth George Brendan C Visser | 2016 | World Journal of Gastrointestinal Surgery2016，8，3： | 13 |
| 11 | Non-functional neuroendocrine tumors of the pancreas: Advances in diagnosis and management显示文摘Nonfunctional neuroendocrine tumors of the pancreas(NF-PNETs) are a heterogeneous group of neoplasms. Although rare, the incidence of NF-PNETs is increasing significantly. The classification of PNETs has evolved over the past decades and is now based on a proliferation grading system. While most NF-PNETs are slow growing, tumors with more aggressive biology may becomeincurable once they progress to unresectable metastatic disease. Tumors of higher grade can be suspected preoperatively based on the presence of calcifications, hypoenhancement on arterial phase computed tomography, positron emission technology avidity and lack of octreotide scan uptake. Surgery is the only curative treatment and is recommended for most patients for whom complete resection is possible. Liver-directed therapies(thermal ablation, transarterial embolization) can be useful in controlling unresectable hepatic metastatic disease. In the presence of unresectable progressive disease, somatostatin analogues, everolimus and sunitinib can prolong progression-free survival. This article provides a comprehensive review of NF-PNETs with special emphasis on recent advances in diagnosis and management. | Jordan M Cloyd George A Poultsides | 2015 | World Journal of Gastroenterology2015，21，32： | 11 |
| 12 | Incidence and analysis of radial head and neck fractures显示文摘AIM: To investigate several complications like persistent radial head dislocation, forearm deformity, elbow stiffness and nerve palsies, associated with radial head fractures. METHODS: This study reviewed the clinical records and trauma database of this level Ⅰ Trauma Center and identified all patients with fractures of the radial head and neck who where admitted between 2000 and 2010. An analysis of clinical records revealed 1047 patients suffering from fractures of the radial head or neck classified according to Mason. For clinical examination, range of motion, local pain and overall outcome were assessed. RESULTS: The incidence of one-sided fractures was 99.2% and for simultaneous bilateral fractures 0.8%. Non-operative treatment was performed in 90.4%(n = 947) of the cases, surgery in 9.6%(n = 100). Bony union was achieved in 99.8%(n = 1045) patients. Full satisfaction was achieved in 59%(n = 615) of the patients. A gender related significant difference(P = 0.035) in Mason type distribution-type Ⅲ fractures were more prominent in male patients vs type Ⅳ fractures in female patients-was observed in our study population. CONCLUSION: Mason typeⅠfractures can be treated safe conservatively with good results. In type Ⅱ to Ⅳ surgical intervention is usually considered to be indicated. | Florian M Kovar Manuela Jaindl Gerhild Thalhammer Schuster Rupert Patrick Platzer Georg Endler Ines Vielgut Florian Kutscha-Lissberg | 2013 | World Journal of Orthopedics2013，4，2： | 9 |
| 13 | It is safe to use transdermal glyceryl trinitrate to lower blood pressure in patients with acute ischaemic stroke with carotid stenosis显示文摘Background There is concern that blood pressure(BP)lowering in acute stroke may compromise cerebral perfusion and worsen outcome in the presence of carotid stenosis.We assessed the effect of glyceryl trinitrate(GTN)in patients with carotid stenosis using data from the Efficacy of Nitric Oxide in Stroke(ENOS)Trial.Methods ENOS randomised 4011 patients with acute stroke and raised systolic BP(140-220 mm Hg)to transdermal GTN or no GTN within 48 hours of onset.Those on prestroke antihypertensives were also randomised to stop or continue their medication for 7 days.The primary outcome was the modified Rankin Scale(mRS)at day 90.Ipsilateral carotid stenosis was split:<30%;30-<50%;50-<70%;≥70%.Data are ORs with 95%CIs adjusted for baseline prognostic factors.results 2023(60.5%)ischaemic stroke participants had carotid imaging.As compared with<30%,≥70%ipsilateral stenosis was associated with an unfavourable shift in mRS(worse outcome)at 90 days(OR 1.88,95%CI 1.44 to 2.44,p<0.001).Those with≥70%stenosis who received GTN versus no GTN had a favourable shift in mRS(OR 0.56,95%CI 0.34 to 0.93,p=0.024).In those with 50-<70%stenosis,continuing versus stopping prestroke antihypertensives was associated with worse disability,mood,quality of life and cognition at 90 days.Clinical outcomes did not differ across bilateral stenosis groups.Conclusions Following ischaemic stroke,severe ipsilateral carotid stenosis is associated with worse functional outcome at 90 days.GTN appears safe in ipsilateral or bilateral carotid stenosis,and might improve outcome in severe ipsilateral carotid stenosis. | Jason P Appleton Lisa J Woodhouse Andrew Belcher Daniel Bereczki Eivind Berge Valeria Caso Hui Meng Chang Hanne K Christensen Ronan Collins John Gommans Ann C Laska George Ntaios Serefnur Ozturk Gillian M Sare Szabolcs Szatmari Yongjun Wang Joanna M Wardlaw Nikola Sprigg Philip M Bath for the ENOS investigators | 2019 | Stroke & Vascular Neurology2019，4，1： | 6 |
| 14 | 羟乙基淀粉溶液在复苏肠缺血-再灌注休克中的作用显示文摘目的 比较不同剂量羟乙基淀粉溶液 ( HES)对兔肠缺血再灌注损伤所致休克的复苏作用。方法 32只新西兰白兔随机分为 4组 :模型对照、乳酸林格液复苏组 ( L RS,2 0 m l· kg- 1 · h- 1 ) ,小剂量 HES复苏组 ( HES2 ml· kg- 1· h- 1 + L RS18m l· kg- 1· h- 1 ) ,大剂量 HES复苏组 ( HES2 0 ml· kg- 1· h- 1 )。采用肠系膜上动脉夹闭 6 0 m in后松夹行再灌注制备肠缺血再灌注休克模型 ,松夹再灌注时同步进行液体复苏。观测各时间点的血流动力学参数 (平均动脉压、心率、心排血量、肠系膜上动脉血流 ) ,并通过测定肠黏膜CO2 分压和动脉血 CO2 分压的差值 (动脉二氧化碳间隙 )、肠黏膜 p H值、动脉血乳酸浓度和氧输送等指标间接评估组织氧合情况。实验结束后累计动物死亡数。结果 HES能明显提高肠缺血再灌注休克时的血流动力学参数 ,与对照组和 L RS组比较差异均有显著性 ( P均 <0 .0 5 ) ;小剂量 HES比大剂量 HES改善血流动力学参数的作用更平稳 ( P均 <0 .0 5 ) ,且较其他 3组能明显降低血乳酸浓度和动脉二氧化碳间隙 ,减轻 p Hi的降低 ( P均 <0 .0 5 ) ;而大剂量 HES对上述参数的影响不明显 ,并可见动物口鼻出血及死亡 ;小剂量或大剂量HES与其他两组比较均能使氧输送回升 ( P均 <0 .0 5 )。 | 涂自智 孙庆华 George Dimopoulos Suzana M Lobo Daniel de Backer 肖献忠 Jean-Louis Vincent | 2004 | 中国危重病急救医学2004，16，8： | 6 |
| 15 | Recent advances in microvascular autologous breast reconstruction after ablative tumor surgery显示文摘Breast cancer is a ubiquitous disease and one of the leading causes of death in women in western societies. With overall increasing survival rates, the number of patients who need post-mastectomy reconstruction is on the rise. Especially since its psychological benefits have been broadly recognized, breast reconstruction has become a key component of breast cancer treatment. Evolving from the early beginnings of breast reconstruction with synthetic implants in the 1960 s, microsurgical tissue transfer is on the way to become the gold standard for post oncology restoration of the breast. Particularly since the advent of perforator based free flap surgery, free tissue transfer has become as safe option for breast reconstruction with low morbidity. The lower abdominal skin and subcutaneous fat tissue typically offer enough volume to create an aesthetically satisfying breast mound. Nowadays, the most commonly used flap from this donor site is the deep inferior epigastric artery perforator flap. If the lower abdomen is not available as a donor site, the gluteal area and thigh provide a number of flaps suitable for breast recon-struction. If the required breast volume is small, and there is enough tissue available on the upper medial thigh, then a transverse upper gracilis flap may be a practicable method to reconstruct the breast. In case of a higher amount of required volume, a gluteal artery perforator flap is the best choice. However, what is crucial in addition to selecting the best flap option for the individual patient is the timing of the operation. In patients with confirmed post-mastectomy radiation therapy, it is advisable to perform microvascular breast reconstruction only in a delayed fashion. | Michael S Pollhammer Dominik Duscher Manfred Schmidt Georg M Huemer | 2016 | World Journal of Clinical Oncology2016，7，1： | 6 |
| 16 | Relation between microRNA expression and progression and prognosis of gastric cancer: a microRNA expression analysis显示文摘 | Tetsuya Ueda Stefano Volinia Hiroshi Okumura Masayoshi Shimizu Cristian Taccioli Simona Rossi Hansjuerg Alder Chang-gong Liu Naohide Oue Wataru Yasui Kazuhiro Yoshida Hiroki Sasaki Sachiyo Nomura Yasuyuki Seto Michio Kaminishi George A Calin Carlo M Croce | 2010 | Lancet Oncology2010，，2： | 4 |
| 17 | Procalcitonin,and cytokines document a dynamic inflammatory state in non-infected cirrhotic patients with ascites显示文摘AIM:To quantitate the simultaneous serum and ascitic fluid levels of procalcitonin and inflammatory markers in cirrhotics with and without ascites.METHODS:A total of 88 consecutive severe cirrhotic patients seen in a large city hospital liver clinic were studied and divided into two groups,those with and without ascites.Group 1 consisted of 41 cirrhotic patients with massive ascites,as demonstrated by necessity for therapeutic large-volume paracentesis.Group 2consisted of 47 cirrhotic patients without any clinically documented ascites to include either a recent abdominal computed tomography scan or ultrasound study.Serum and ascitic fluid levels of an array of inflammatory markers,including procalcitonin,were measured and compared to each other and a normal plasma panel(NPP).RESULTS:The values for inflammatory markers assayed in the serum of Groups 1 and 2,and ascitic fluid of the Group 1.The plasma levels of the inflammatory cytokines interleukin(IL)-2,IL-4,IL-6,IL-8,interferon gamma(IFNγ)and epidermal growth factor(EGF)were all significantly greater in the serum of Group 1as compared to that of the serum obtained from the Group 2 subjects(all P<0.05).There were significantly greater serum levels of IL-6,IL-8,IL-10,monocyte chemoattractant protein-1,tumor necrosis factor-α,vascular endothelial growth factor and EGF when comparing Group 2 to the NPP.There was no significant difference for IL-1A,IL-1B,IL-2,IL-4 and IFNγlevels between these two groups.Serum procalcitonin levels were increased in cirrhotics with ascites compared to cirrhotics without ascites,but serum levels were similar to ascites levels within the ascites group.Furthermore,many of these cytokines,but not procalcitonin,demonstrate an ascites-to-serum gradient.Serum procalcitonin does not demonstrate any significant difference segregated by liver etiology in the ascites group;but ascitic fluid procalcitonin is elevated significantly in car-diac cirrhosis/miscellaneous subgroup compared to the hepatitis C virus and alcoholic cirrhosis subgroups.CONCLUSION:Procalcitonin in the ascitic fluid,but not in the serum,differentiates between cirrhotic subgroup reflecting the dynamic interplay of ascites,bacterial translocation and the peri-peritoneal cytokine. | Bashar M Attar Christopher M Moore Magdalena George Nicolae Ion-Nedelcu Rafael Turbay Annamma Zachariah Guiliano Ramadori Jawed Fareed David H Van Thiel | 2014 | World Journal of Gastroenterology2014，20，9： | 4 |
| 18 | Molecular markers(PECAM-1,ICAM-3,HLA-DR)determine prognosis in primary non-Hodgkin's gastric lymphoma patients显示文摘瞄准:与主要 non-Hodgkin 的胃的淋巴瘤在病人调查 PECAM-1, ICAM-3 和 HLA 医生抗原的预示的意义。方法:我们免疫组织化学地在 36 个 B 房间麦芽类型主要胃的淋巴瘤病人学习了 PECAM-1, ICAM-3 和 HLA 医生抗原表示。十非恶意并且十个健康胃的织物标本被用作控制。Clinicopathological 和幸存数据与染色的结果被相关。结果:HLA 医生抗原表示在 33 个胃的淋巴瘤病人(91.7%) 和 6 个非恶意的病人(54.5%) 被检测。PECAM-1 染色了 10 个病人(27.8%) 的肿瘤房间, 9 个病人(25%) 的 endothelial 并且煽动性有良性的胃的疾病的 4 个病人(40%) 渗入。ICAM-3 表示在 17 个病人(47.2%) 的肿瘤房间上被观察,当 5 个非恶意的病人(50%) 被染色时积极也。任何一个都没为任何学习的基因健康控制被染色。在里面多,变量分析, HLA 医生抗原和 PECAM-1 被证明是与联系的统计上重要的独立预示的因素一赞成并且不利预后分别地(P=0.009 和 P=0.003 ) 。在 univariate 分析, PECAM-1 (+)/ICAM-3 (-) 和 HLA 医生(-)/ICAM-3 (-) 病人与确切相反的基因表示模式与那些相比展出了显著地减少的全面幸存(P=0.0041 和 P=0.0091,分别地) 。是 HLA 医生(+)/ICAM-3 (+)/PECAM-1 (-)(n=8 ) 的那些病人让显著地更高的幸存与这个组(n=24 )(P=0.0289 ) 的其余部分相比评价。结论:PECAM-1, ICAM-3 和 HLA 医生分别地是肿瘤扩大潜力和主人免疫者监视的代表性的标记。他们的联合使用可以帮助我们识别能得益于更好攻击的治疗学的协议的高风险的病人。 | Alexander Darom Ilias P Gomatos Emmanuel Leandros Emmu Chatzigianni Dimitris Panousopoulos Manousos M Konstadoulakis George Androulakis | 2006 | World Journal of Gastroenterology2006，12，12： | 4 |
| 19 | Brain changes in diabetes mellitus patients withgastrointestinal symptoms显示文摘Diabetes mellitus is a common disease and its prevalence is increasing worldwide. In various studies up to 30%-70% of patients present dysfunction and complications related to the gut. To date several clinical studies have demonstrated that autonomic nervous system neuropathy and generalized neuropathy of the central nervous system(CNS) may play a major role. This systematic review provides an overview of the neurodegenerative changes that occur as a consequence of diabetes with a focus on the CNS changes and gastrointestinal(GI) dysfunction. Animal models where diabetes was induced experimentally support that the disease induces changes in CNS. Recent investigations with electroencephalography and functional brain imaging in patients with diabetes confirm these structural and functional brain changes. Encephalographic studies demonstrated that altered insular processing of sensory stimuli seems to be a key player in symptom generation. In fact one study indicated that the more GI symptoms the patients experienced, the deeper the insular electrical source was located. The electroencephalography was often used in combination with quantitative sensory testingmainly showing hyposensitivity to stimulation of GI organs. Imaging studies on patients with diabetes and GI symptoms mainly showed microstructural changes,especially in brain areas involved in visceral sensory processing. As the electrophysiological and imaging changes were associated with GI and autonomic symptoms they may represent a future therapeutic target for treating diabetics either pharmacologically or with neuromodulation. | Anne M Drewes Eirik Søfteland Georg Dimcevski Adam D Farmer Christina Brock Jens B Frøkjær Klaus Krogh Asbjørn M Drewes | 2016 | World Journal of Diabetes2016，7，2： | 4 |
| 20 | Is the pain in chronic pancreatitis of neuropathic origin? Support from EEG studies during experimental pain显示文摘AIM: To prove the hypothesis that patients with chronic pancreatitis would show increased theta activity during painful visceral stimulation. METHODS: Eight patients and 12 healthy controls underwent an experiment where the esophagus was electrically stimulated at the pain threshold using a nasal endoscope. The electroencephalogram (EEG) was recorded from 64 surface electrodes and 'topographic matching pursuit' was used to extract the EEG information in the early brain activation after stimulation. RESULTS: A major difference between controls and patients were seen in delta and theta bands, whereas there were only minor differences in other frequency bands. In the theta band, the patients showed higher activity than controls persisting throughout the 450 ms of analysis with synchronous brain activation betweenthe channels. The main theta components oscillated with 4.4 Hz in the patients and 5.5 Hz in the controls. The energy in the delta (0.5-3.5 Hz) band was higher in the controls, whereas the patients only showed scattered activity in this band. CONCLUSION: The differences in the theta band indicate that neuropathic pain mechanisms are involved in chronic pancreatitis. This has important implications for the understanding and treatment of pain in these patients, which should be directed against drugs with effects on neuropathic pain disorders. | AsbjФrn M Drewes Maciej Gratkowski Saber AK Sami Georg Dimcevski Peter Funch-Jensen Lars Arendt-Nielsen | 2008 | World Journal of Gastroenterology2008，14，25： | 4 |
您所在的机构暂未开通此部分的功能，请联系管理员