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    题名 作者 年代 出处 被引量
1岩石断裂表面分形测量的尺度效应显示文摘分形几何用于定量描述复杂的自然现象和不规则物体已有许多成功的范例,如岩石断裂表面粗糙度的测量。然而,岩石断裂表面粗糙度一般不具有自相似分形性质。因此,表面分形测量结果受尺度的影响。通过对不同试件长度、测量尺规和测量仪器分辩率的实际测量结果,分析了岩石断裂表面分形测量中的尺度效应,提出了可靠的分形测量的途径。王金安 谢和平 田晓燕 Kwasniewski Marek A 2000岩石力学与工程学报2000,19,1:55
2Heparin improves organ microcirculatory disturbances in caerulein-induced acute pancreatitis in rats显示文摘AIM: Microcirculatory disturbances are important early pathophysiological events in various organs during acute pancreatitis. The aim of the study was to evaluate changes in rnicroperfusion of the pancreas, liver, kidney, stomach,colon, skeletal muscle, and to investigate the influence of heparin on the organ rnicrocirculation in caerulein-induced experimental acute pancreatitis.METHODS: Acute pancreatitis was induced by 4 intraperitoneal injections of caerulein (Cn) (15 μg/kg). The organ microcirculation was measured by laser Doppler flowrnetry. Serum interleukin 6 and hernatocrit levels were analysed.RESULTS: Acute pancreatitis resulted in a significant drop of microperfusion in all examined organs. Heparin administration (2×2.5 mg/kg) improved the rnicrocirculation in pancreas (36.9±4% vs75.9±10%), liver (56.6±6% vs 75.2±16%), kidney (45.1±6% vs79.3±5%), stomach (65.2±8% vs78.1±19%), colon (69.8±6% vs 102.5±19%),and skeletal muscle (59.2±6% vs 77.9±13%). Heparin treatment lowered IL-6 (359.0±66 U/mL vs 288.5±58 U/mL) and hematocrit level (53±4% vs 46±3%).CONCLUSION: Hepadn administration has a positive influence on organ microcirculatory disturbances accompanying experimental Cn-induced acute pancreatitis.Marek Dobosz Lucjanna Mionskowska Stanislaw Ha■ Sebastian Dobrowolski Dariusz Dymecki Zdzislaw Wajda 2004World Journal of Gastroenterology2004,10,17:34
3Nodular regenerative hyperplasia:Evolving concepts on underdiagnosed cause of portal hypertension显示文摘Nodular regenerative hyperplasia(NRH)is a rare liver condition characterized by a widespread benign transformation of the hepatic parenchyma into small regenerative nodules.NRH may lead to the development of non-cirrhotic portal hypertension.There are no published systematic population studies on NRH and our current knowledge is limited to case reports and case series.NRH may develop via autoimmune,hematological,infectious,neoplastic,or drug-related causes.The disease is usually asymptomatic,slowly or nonprogressive unless complications of portal hypertension develop.Accurate diagnosis is made by histopathology,which demonstrates diffuse micronodular transformation without fibrous septa.Lack of perinuclear collagen tissue distinguishes NRH from typical regenerative nodules in the cirrhotic liver.While the initial treatment is to address the underlying disease,ultimately the therapy is directed to the management of portal hypertension.The prognosis of NRH depends on both the severity of the underlying illness and the prevention of secondary complications of portal hypertension.In this review we detail the epidemiology,pathogenesis,diagnosis,management,and prognosis of NRH.Marek Hartleb Krzysztof Gutkowski Piotr Milkiewicz 2011World Journal of Gastroenterology2011,17,11:16
4Colorectal cancer screening:20 years of development and recent progress显示文摘Colorectal cancer(CRC)is the second most common cancer in Europe and its incidence is steadily increasing.This trend could be reversed through timely secondary prevention(screening).In the last twenty years,CRC screening programs across Europe have experienced considerable improvements(fecal occult blood testing;transition from opportunistic to population based program settings).The Czech Republic is a typical example of a country with a long history of nationwide CRC screening programs in the face of very high CRC incidence and mortality rates.Each year,approximately 8000 people are diagnosed with CRC and some 4000 die from this malignancy.Twenty years ago,the first pilot studies on CRC screening led to the introduction of the opportunistic Czech National Colorectal Cancer Screening Program in 2000.Originally,this program was based on the guaiac fecal occult blood test(FOBT)offered by general practitioners,followed by colonoscopy in cases of FOBT positivity.The program has continuously evolved,namely with the implementation of immunochemical FOBTs and screening colonoscopy,as well as the involvement of gynecologists.Since the establishment of the Czech CRC Screening Registry in 2006,2405850 FOBTs have been performed and 104565 preventive colonoscopies recorded within the screening program.The overall program expanded to cover 25.0%of the target population by 2011.However,stagnation in the annual number of performed FOBTs lately has led to switching to the option of a population-based program with personal invitation,which is currently being prepared.Miroslav Zavoral Stepan Suchanek Ondrej Majek Premysl Fric Petra Minarikova Marek Minarik Bohumil Seifert Ladislav Dusek 2014World Journal of Gastroenterology2014,20,14:16
5Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms显示文摘AIM: To review clinical and pathologic features of Gas-trointestinal stromal tumors (GISTs) occurring synchro-nously with other primary gastrointestinal neoplasms.METHODS: Twenty-eight patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed. RESULTS: The gastrointestinal stromal tumor occurred simultaneously with other primary GI malignancies in 14% of all patients with GIST. The synchronous stromal tumors were located in the stomach and were incidentally found during the operation. The coexistent neoplasms were colon adenocarcinoma, gastric cancer (2 cases) and gastric lymphoma.CONCLUSION: The synchronous occurrence of GISTs and other gastrointestinal malignancies is more common than it has been considered. The development of gastrointestinal stromal tumors and other neoplasms may involve the same carcinogenic agents.Marek Wronski Bogna Ziarkiewicz-Wroblewska Barbara Gornicka Wlodzimierz Cebulski Maciej Slodkowski Aleksander Wasiutynski Ireneusz W Krasnodebski 2006World Journal of Gastroenterology2006,12,33:14
6S100A8/A9 induces autophagy and apoptosis via ROS-mediated cross-talk between mitochondria and lysosomes that involves BNIP3显示文摘建筑群由 S100 钙绑定蛋白质家庭,的二个成员形成了 S100A8/A9,在不同起源的各种各样的房间施加导致 apoptosis 活动。这里,我们内在的分子的机制包含的现在的证据两个都规划了房间死亡我(PCD 我, apoptosis ) 并且象死亡一样的 PCD II (autophagy ) 。有 S100A8/A9 的房间的处理引起了 Beclin-1 表示以及 Atg12-Atg5 形成的增加。S100A8/A9-induced 房间死亡被特定的 PI3-kinase 班 III 禁止者部分禁止, 3-methyladenine (3 麻省) ,并且由液泡 H+-ATPase 禁止者, bafilomycin-A1 (Baf-A1 ) 。S100A8/A9 挑起了 BNIP3 的 translocation, BH3 仅仅 pro-apoptotic Bcl2 家庭成员,到线粒体。与这发现一致,螖 T M-BNIP3 overexpression 部分禁止了 S100A8/A9-induced 细胞死亡,减少的反应的氧种(ROS ) 产生,并且部分在 S100A8/A9-treated 细胞在 mitochondrial transmembrane 潜力免于减少。另外,任何一个螖 T M-BNIP3 overexpression 或 N-acetyl-L-cysteine 合作处理减少了在与 S100A8/A9 对待的房间的 lysosomal 激活。我们的数据显示 S100A8/A9-promoted 房间死亡通过线粒体的串音发生,经由 ROS 和这个过程的 lysosomes 包含 BNIP3。Saeid Ghavami Mehdi Eshragi Sudharsana R Ande Walter J Chazin Thomas Klonisch Andrew J Halayko Karol D Mcneill Mohammad Hashemi Claus Kerkhoff Marek Los 2010Cell Research2010,20,3:13
7Heterotopic pancreatic tissue in the gastric cardia: A case report and literature review显示文摘The heterotopic pancreas, which is usually described as an untypical presence of pancreatic tissue without any anatomic or vascular continuity with the pancreas, is relatively rare. Clinical manifestations may include bleeding, inflammation, pain and obstruction; however, in most cases it remains silent and is diagnosed during autopsy. Here, we report a case of ectopic pancreatic lesion located in the gastric cardia. The patient was a 73-year-old woman who had a history(over four months) of chronic epigastric pain accompanied by heartburn. Esophagogastroduodenoscopy revealed inflammatory changes throughout the stomach and lower esophagus, as well as a flat polypoid mass with benign features located in the gastric cardia, approx. 10 mm below the 'Z' line, measuring approx. 7 mm in diameter. Endoscopic biopsy forceps were used to remove the lesion. Histological examination of the lesion revealed the presence of heterotopic pancreatic tissue in the gastric mucosa. On the basis of the presented case, we suggest that pancreatic ectopia should be a part of differential diagnosis, not only when dealing with submucosal gastric lesions, but also with those that are small, flat and/or untypically located.Rafa? Filip Ewa Walczak Jacek Huk Rados?aw P Radzki Marek Bieńko 2014World Journal of Gastroenterology2014,20,44:12
8From the stomach to other organs:Helicobacter pylori and the liver显示文摘Many recent studies have examined the importance of Helicobacter pylori(H. pylori) infection in the pathogenesis of the diseases outside the stomach and explored the significance of this bacterium in the pathogenesis of some metabolic and cardiovascular diseases. Recent studies have provided evidence that H. pylori is also involved in the pathogenesis of some liver diseases. Many observations have proved that H. pylori infection is important in the development of insulin resistance, non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, liver fibrosis and cirrhosis. The worsening of liver inflammation of different origins also occurs during H. pylori infection. Some studies have indicated that H. pylori infection induces autoimmunological diseases in the liver and biliary tract. The potential significance of this bacterium in carcinogenesis is unclear, but it is within the scope of interest of many studies. The proposed mechanisms through which H. pylori impacts the development of hepatobiliary diseases are complex and ambiguous. The importance of other Helicobacter species in the development of hepatobiliary diseases is also considered because they could lead to the development of inflammatory, fibrotic and necrotic injuries of the liver and, consequently, to hepatocellular carcinoma. However, many contrary viewpoints indicate that some evidence is not convincing, and further studies of the subject are needed. This review presents the current knowledge about the importance of H. pylori in the pathogenesis of liver and in biliary diseases.Marek Waluga Michal Kukla Michal Zorniak Agata Bacik Rafal Kotulski 2015World Journal of Hepatology2015,7,18:11
9Serum adipokines in inflammatory bowel disease显示文摘AIM:To investigate serum adipokine levels in inflammatory bowel disease(IBD)patients before treatment and after achieving clinical remission.METHODS:Serum concentrations of six adipokines(tissue growth factor-β1,adiponectin,leptin,chemerin,resistin,and visfatin)were studied in 40 subjects with active IBD[24 subjects with Crohn’s disease(CD)and in 16 subjects with ulcerative colitis(UC)]before and after three months of therapy with corticosteroids and/or azathioprine.Clinical diagnoses were based on ileocolonoscopy,computed tomography or magnetic resonance enterography and histological examination of mucosal biopsies sampled during endoscopy.Serum levels of adipokines were assessed by an indirect enzyme-linked immunosorbent assay.The control group was comprised of 16 age-and sex-matched healthyvolunteers.RESULTS:Baseline leptin concentrations were significantly decreased in both types of IBD compared to controls(8.0±9.1 in CD and 8.6±6.3 in UC vs 16.5±10.1 ng/mL in controls;P<0.05),and significantly increased after treatment only in subjects with CD(14.9±15.1 ng/mL;P<0.05).Baseline serum resistin concentrations were significantly higher in CD(19.3±12.5ng/mL;P<0.05)and UC subjects(23.2±11.0 ng/mL;P<0.05)than in healthy controls(10.7±1.1 ng/mL).Treatment induced a decrease in the serum resistin concentration only in UC subjects(14.5±4.0 ng/mL;P<0.05).Baseline serum concentrations of visfatin were significantly higher in subjects with CD(23.2±3.2ng/mL;P<0.05)and UC(18.8±5.3 ng/mL;P<0.05)than in healthy controls(14.1±5.3 ng/mL).Treatment induced a decrease in the serum visfatin concentrations only in CD subjects(20.4±4.8 ng/mL;P<0.05).Serum levels of adiponectin,chemerin and tissue growth factor-β1 did not differ between CD and UC subjects compared to healthy controls and also were not altered by anti-inflammatory therapy.Clinical indices of IBD activity did not correlate with adipokine levels.CONCLUSION:IBD modulates serum adipokine levels by increasing resistin and visfatin release and suppressing leptin production.Marek Waluga Marek Hartleb Grzegorz Boryczka Micha Kukla Krystyna Zwirska-Korczala 2014World Journal of Gastroenterology2014,20,22:11
10Reduced interferon antagonism but similar drug sensitivity in Omicron variant compared to Delta variant of SARS-CoV-2 isolates显示文摘Dear Editor,Omicron(B.1.1.529),is a heavily mutated and highly contagious SARS-CoV-2 variant,which is currently causing large outbreaks in many countries.Protection provided by current vaccines is substantially reduced against Omicron.1,2 Moreover,many immunocompromised individuals cannot effectively be protected by vaccines.3 Hence,antiviral therapies will be essential to protect the most vulnerable individuals from severe COVID-19.Denisa Bojkova Marek Widera Sandra Ciesek Mark N.Wass Martin Michaelis Jindrich Cinatl Jr 2022Cell Research2022,32,3:10
11Epithelioid hemangioendothelioma of the liver as a rare indication for liver transplantation显示文摘AIM: To investigate the indications and outcomes of liver transplantation for hepatic epithelioid hemangioendothelioma(HEHE). METHODS: Between 1989 and August 2013, in the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, 1306 orthotopic liver transplantations(OLTx) were performed, including 72 retransplantations. Unresectable HEHE was an indication for OLTx in 10 patients(0.8% of primary OLTx), the mean age of the patients was 40.5 ± 13.3 years(range 23-65 years), and the male-to-female ratio was 2:8. Kaplan-Meier survival analysis in HEHE, hepatocellular carcinoma(HCC), and other OLTx recipients groups was performed. The differences in mortality were compared using the χ2 test. A P-value < 0.05 indicated statistical significance.RESULTS: No concomitant liver disease was found in any patient. There was no neoadjuvant chemotherapy or radiotherapy. Liver function test results were normal in most of the patients. The levels of alpha-fetoprotein, carcinoembryonic antigen, and carbohydrate antigen 19-9 were normal. In immunohistochemical staining, the neoplastic cells were positive for factor Ⅷ-related antigen, CD31, and CD34, which are endothelial cell markers, and negative for cytokeratin 19, cytokeratin 7, and HepPar-1. Nine patients were alive without tumor recurrence. One patient died 2 mo after OLTx due to septic complications. No morbidity was observed. Maximum follow-up was 11.4 years, with a minimum of 1 mo. The cumulative survival rate at the end of followup in HEHE patients was 87.5% compared with 54.3% in the HCC group and 76.3% in the other OLTx recipients group(χ2 test = 1.784, df = 2, P = 0.409).CONCLUSION: Unresectable HEHE, without extrahepatic metastases is an excellent indication for liver transplantation. Long-term survival is very good and much better than in HCC patients and the entire group of OLTx patients.Piotr Remiszewski Ewa Szczerba Piotr Kalinowski Beata Gierej Krzysztof Dudek Mariusz Grodzicki Marcin Kotulski Rafa Paluszkiewicz Waldemar Patkowski Krzysztof Zieniewicz Marek Krawczyk 2014World Journal of Gastroenterology2014,20,32:10
12Attenuation of dextran sodium sulphate induced colitis in matrix metalloproteinase-9 deficient mice显示文摘AIM: To study whether matrix metalloproteinase-9 (MMP-9) is a key factor in epithelial damage in the dextran sodium sulphate (DSS) model of colitis in mice.METHODS: MMP-9-deficient and wild-type (wt) mice were given 5% DSS in drinking water for 5 d followed by recovery up to 7 d. On d 5 and 12 after induction of colitis, gelatinases, MMP-2 and MMP-9, were measured in homogenates of colonic tissue by zymography and Western blot, whereas tissue inhibitor of metalloproteinases (TIMPs) were measured by reverse zymography. The gelatinolytic activity was also determined in supernatants of polymorphonuclear leukocytes (PMN) isolated from mice blood. Moreover, intestinal epithelial cells were stimulated with TNF-α to study whether these cells were able to produce MMPs. Finally, colonic mucosal lesions were measured by microscopic examination. RESULTS: On d 5 of colitis, the activity of MMP-9 was increased in homogenates of colonic tissues (0.24 ± 0.1 vs 21.3 ± 6.4, P < 0.05) and PMN from peripheral blood in wt (0.5 ± 0.1 vs 10.4 ± 0.7, P < 0.05), but not in MMP-9-deficient animals. The MMP-9 activity was also up-regulated by TNF-α in epithelial intestinal cells (2.5 ± 0.5 vs 14.7 ± 3.0, P < 0.05). Although colitis also led to increase of TIMP-1 activity, the MMP-9/TIMP-1 balance remained elevated. Finally, in the MMP-9-deficient colitic mice both the extent and severity of intestinal epithelialinjury were significantly attenuated when compared with wt mice. CONCLUSION: We conclude that DSS induced colitis is markedly attenuated in animals lacking MMP-9. This suggests that intestinal injury induced by DSS is modu-lated by MMP-9 and that inhibition of this gelatinase may reduce inflammation.Alfredo Santana Carlos Medina Maria Cristina Paz-Cabrera Federico Díaz-Gonzalez Esther Farré Antonio Salas Marek W Radomski Enrique Quintero 2006World Journal of Gastroenterology2006,12,40:9
13Catheter ablation of atrial fibrillation in elderly population显示文摘Background Although elderly patients have been included in published series of catheter ablation for atrial fibrillation (AF), clinicalbenefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volumecenter focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods Consecutive patientswho underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients wasdichotomized by the age of 70 years (394 elderly vs. 2803 younger subjects). Patients were followed in terms of arrhythmia status and sur-vival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. Results Elderly patients were more frequently females (49% vs.29%, P 〈 0.0001), had a history of hypertension (79% vs. 57%, P 〈 0.0001), diabetes (16% vs. 11%, P 〈 0.01), stroke (9% vs. 6%, P 〈 0.01),coronary/peripheral artery disease (14% vs. 8%, P 〈 0.0001), and CHAzDS2-VASc score (3.1 ± 1.3 vs. 1.5 ± 1.2 s, P 〈 0.0001). Major com-plications were more frequent in elderly (5.3% vs. 3.2%, P = 0.03); however, this difference was driven by vascular complications (3.6% vs.1.9%, P = 0.04). There were comparable rates of cerebrovascular (0.3 vs. 0.3%) or nonvascular complications (1.8 vs. 1.2%). Good arrhyth-mia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs: 44.2% vs.58.2% (P 〈 0.0001) and 78.2 vs. 83.2% (P 〈 0.01), respectively. Poor arrhythmia control was associated with relative risk of all-cause mor-tality of 2.7 (95% CI: 1.1-6.4) in elderly patients and 1.4 (95% CI: 0.9-2.0) in younger subjects. Conclusions Catheter ablation for AF inelderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients.Josef Kautzner Petr Peichl Marek Sramko Robert Cihak Bashar Aldhoon Dan Wichterle 2017Journal of Geriatric Cardiology2017,14,9:9
14Extraordinary evanescent field confinement waveguide sensor for mid-infrared trace gas spectroscopy显示文摘Nanophotonic waveguides are at the core of a great variety of optical sensors.These structures confine light along defined paths on photonic chips and provide light-matter interaction via an evanescent field.However,waveguides still lag behind free-space optics for sensitivity-critical applications such as trace gas detection.Short optical pathlengths,low interaction strengths,and spurious etalon fringes in spectral transmission are among the main reasons why on-chip gas sensing is still in its infancy.In this work,we report on a mid-infrared integrated waveguide sensor that successfully addresses these drawbacks.This sensor operates with a 107%evanescent field confinement factor in air,which not only matches but also outperforms free-space beams in terms of the per-length optical interaction.Furthermore,negligible facet reflections result in a flat spectral background and record-low absorbance noise that can finally compete with free-space spectroscopy.The sensor performance was validated at 2.566μm,which showed a 7 ppm detection limit for acetylene with only a 2 cm long waveguide.Marek Vlk Anurup Datta Sebastián Alberti Henock Demessie Yallew Vinita Mittal Ganapathy Senthil Murugan Jána Jagerská 2021Light(Science & Applications)2021,10,2:9
15Kidneys in chronic liver diseases显示文摘Acute kidney injury(AKI),defined as an abrupt increase in the serum creatinine level by at least 0.3 mg/dL,occurs in about 20% of patients hospitalized for decompensating liver cirrhosis.Patients with cirrhosis are susceptible to developing AKI because of the progressive vasodilatory state,reduced effective blood volume and stimulation of vasoconstrictor hormones.The most common causes of AKI in cirrhosis are pre-renal azotemia,hepatorenal syndrome and acute tubular necrosis.Differential diagnosis is based on analysis of circumstances of AKI development,natriuresis,urine osmolality,response to withdrawal of diuretics and volume repletion,and rarely on renal biopsy.Chronic glomerulonephritis and obstructive uropathy are rare causes of azotemia in cirrhotic patients.AKI is one of the last events in the natural history of chronic liver disease,therefore,such patients should have an expedited referral for liver transplantation.Hepatorenal syndrome(HRS) is initiated by progressive portal hypertension,and may be prematurely triggered by bacterial infections,nonbacterial systemic inflammatory reactions,excessive diuresis,gastrointestinal hemorrhage,diarrhea or nephrotoxic agents.Each type of renal disease has a specific treatment approach ranging from repletion of the vascular system to renal replacement therapy.The treatment of choice in type 1 hepatorenal syndrome is a combination of vasoconstrictor with albumin infusion,which is effective in about 50% of patients.The second-line treatment of HRS involves a transjugular intrahepatic portosystemic shunt,renal vasoprotection or systems of artificial liver support.Marek Hartleb Krzysztof Gutkowski 2012World Journal of Gastroenterology2012,18,24:8
16Neutrophil engagement and septic challenge in acute experimental pancreatitis in rats显示文摘AIM: To investigate the influence of neutrophil adhesion molecule blockade with monoclonal antibody (MoAb CD11b) and E. coli lipopolysaccharide (LPS)administration on experimental acute pancreatitis (AP).METHODS: AP was induced by four ip injections of cerulein (Cn) at 1-h intervals. MoAb CD 11b and LPS were administered at the beginning of the experiment.RESULTS: The neutrophil count and chemiluminescence were diminished at the beginning of AP. The oxidative stress parameters were found within the pancreatic gland. MoAb CD 11b used for AP resulted in a significant reduction of pancreatic infiltration and pancreatitis oxidative stress parameters. Serum interleukin-6 (IL-6)was not detected in AP animals, whereas high serum IL-6 concentration was noted only in animals receiving LPS.CONCLUSION: Neutrophils are involved in pancreatic damage in the early stage of AP. Neutrophil infiltration reduction protects the pancreatic gland from destruction during AP. LPS does not change the early course of Cn pancreatitis in rats.Stanisiaw Ha Marek Dobosz Jan J Kaczor Robert Rzepko Ewa Aleksandrowicz-Wrona Zdzislaw Wajda Zbigniew ledzi■ski Jacek Krajewski 2005World Journal of Gastroenterology2005,11,41:7
17大气二氧化氮与每日总死亡率、心血管和呼吸系统疾病死亡率的短期关联:398个城市的多中心分析显示文摘目的:采用统一的分析方案,评估全球多个国家/地区的二氧化氮(NO_(2))与总死亡率、心血管和呼吸系统疾病死亡率之间的短期关联。研究设计:采用两阶段的时间序列分析方法、过度离散的广义线性模型和多水平meta分析。研究地点:22个低到高收入国家/地区的398个城市。主要结局指标:1973—2018年逐日总死亡人数(6280万人)、心血管疾病死亡人数(1970万人)和呼吸系统疾病死亡人数(550万人)。结果:平均而言,NO_(2)浓度在滞后1天(前1天)每增加10μg/m^(3),会导致总死亡率、心血管和呼吸系统疾病死亡率分别增加0.46%(95%可信区间0.36%~0.57%)、0.37%(0.22%~0.51%)、0.47%(0.21%~0.72%)。在对共污染物(PM_(10)、PM_(2.5)、臭氧、二氧化硫和一氧化碳)进行调整后,这些关联仍然很稳定。所有3种死因的暴露-反应曲线几乎是线性的,没有明显的阈值。在398个城市中,可归因于高过假定零水平的NO_(2)浓度造成的死亡比例为1.23%(95%可信区间0.96%~1.51%)。结论:这项多中心研究提供了关于NO_(2)短期暴露与总死亡率、心血管和呼吸系统死亡风险之间的独立和线性关联的关键证据,说明通过加强NO_(2)的控制和监管限制标准,可获得人群水平的健康收益。孟夏 刘聪(校) 陈仁杰 郑湃(译) 阚海东(校) Francesco Sera Ana Vicedo-Cabrera Ai Milojevic Maria Guo Yuming Tong Shilu Micheline de Sousa Zanotti Stagliorio Coelh Paulo Hilario Nascimento Saldiva Eric Lavigne Patricia Matus Correa Nicolas Valdes Ortega Samuel Osorio Garcia Jan Kysely Ales Urban Hans Orru Marek Maasikmets Jouni J K Jaakkola Niilo Ryti Veronika Huber Alexandra Schneider Klea Katsouyanni Antonis Analitis Masahiro Hashizume Yasushi Honda Chris Fook Sheng Ng Baltazar Nunes João Paulo Teixeira Iulian Horia Holobaca Simona Fratianni Ho Kim Aurelio Tobias Carmeníniguez Bertil Forsberg ChristoferÅström Martina S Ragettli Yue-Liang Leon Guo Shih-Chun Pan Shanshan Li Michelle L Bell Antonella Zanobetti Joel Schwartz Tangchun Wu Antonio Gasparrini 2021英国医学杂志中文版2021,24,8:7
18Endosonography with linear array instead of endoscopic retrograde cholangiography as the diagnostic tool in patients with moderate suspicion of common bile duct stones显示文摘AIM: To evaluate the diagnostic efficiency of endoscopic ultrasound (EUS) as the main imaging modality in patients with moderate suspicion of common bile duct stones (CBDS).METHODS: 55 patients with moderate clinical suspicion of CBDS were prospectively included to the study and evaluated with EUS. This study was done in single blind method in the clinical and biochemical data of patients. EUS was done with echo-endoscope Pentax FG 32-UA (f=5-7,5 MHz) and Hitachi EUB 405 ultrasound machine. Patients diagnosed with CBDS by EUS were excluded from this study and treated with ERC. All the other patients were included to the follow up study obtained by mail every 6 months for clinical evaluation (need of ERC or surgery).RESULTS: CBDS was found in 4 patients by EUS. Diagnosis was confirmed in all cases on ERC. The remaining 51 patients without CBDS on EUS were followed up for 6-26 months (meanly 13 months) There were: 40 women, 42cholecystectomized patients, aged: 55 (mean). Biochemical values (mean values) were as follows: bilirubin: 14,9 μmol.L-1,alkaline phosphatase: 95 IU.L-,1 γ-GTP: 131 IU.L-1, ALT: 50IU.L-1, AST: 49 IU.L-1, Only 1 patient was lost for follow up.In the remaining 50 patients with follow up, there was only 1 (2 %) patient with persistent biliary symptoms in whom CBDS was finally diagnosed by ERC with ES. All other patients remained symptoms free on follow up and did not require ERC or biliary surgery.CONCLUSION: Vast majority of patients with moderate suspicion of CBDS and no stones on EUS with linear array can avoid invasive evaluation of biliary tree with ERC.Maciej Kohut Andrzej Nowak Ewa Nowakowska-Dufawa Tomasz Marek Roman Kaczor 2003World Journal of Gastroenterology2003,9,3:7
19Ghrelin and gastrin in advanced gastric cancer before and after gastrectomy显示文摘AIM: To investigate plasma ghrelin, gastrin and growth hormone secretagogue receptor (GHS-R) expression in advanced gastric cancer (GC) before and after resection. METHODS: Seventy subjects in whom endoscopy of the upper gastrointestinal tract was performed in the Department of General Surgery at Cracow University during the past decade: (1) 25 patients with GC associated with Helicobacter pylori (H. pylori) infection; (2) 10 patients with GC 4-5 years after (total or subtotal) gastrectomy; (3) 25 healthy H. pylori-negative controls, matched by age and BMI to the above two groups; and (4) 10 GC patients 4-5 years after total gastrectomy. Ghrelin and gastrin plasma concentrations were measured by specific radioimmunoassay under fasting conditions and postprandially at 60 and 90 min after ingestion of a mixed meal. GHS-R expression was examined in biopsy samples from intact healthy mucosa and GC tissue using semi-quantitative reverse transcription-polymerase chain reaction. RESULTS: In healthy controls, fasting plasma ghrelin levels were significantly elevated and declined markedly at 60 and 90 min after a mixed meal. The concomitant enhanced ghrelin, GHS-R and gastrin expression in GC tissue over that recorded in intact mucosa, and the marked rise in plasma gastrin in these subjects under fasting conditions indicate the role of these hormonal factors in GC formation. Fasting plasma levels and postprandial response of ghrelin and gastrin appear to be inversely correlated in healthy subjects. Feeding in the controls resulted in a significant fall in plasma ghrelin with a subsequent rise in plasma gastrin, but in H. pylori-positive GC patients submitted to total or distal gastrectomy, feeding failed to affect significantly the fall in plasma ghrelin that was recorded in these patients before surgery. Fasting ghrelin concentrations were significantly lower in patients 4-5 years after total gastrectomy compared to those in healthy controls and to these in GC patients before surgery. CONCLUSION: Elevated plasma gastrin and suppression of fasting ghrelin in patients with GC suggest the existence of a close relationship between these two hormones in gastric carcinogenesis.Anna Zub-Pokrowiecka Kazimierz Rembiasz Peter C Konturek Andrzej Budzyński Stanisaw J Konturek Marek Winiarski Wadysaw Bielański 2011World Journal of Gastroenterology2011,17,4:7
20Optimizing management of pancreaticopleural fistulas显示文摘AIM:To evaluate the management of pancreaticopleural fistulas involving early endoscopic instrumentation of the pancreatic duct.METHODS:Eight patients with a spontaneous pancre-aticopleural fistula underwent endoscopic retrograde cholang iopancreatography(ERCP) with an intentionto stent the site of a ductal disruption as the primarytreatment. Imaging features and management were evaluated retrospectively and compared with outcome.RESULTS:In one case,the stent bridged the site of aductal disruption. The fistula in this patient closed with in3 wk. The main pancreatic duct in this case appearednormal,except for a leak located in the body of the pancreas. In another patient,the papilla of Vater couldnot be found and cannulation of the pancreatic ductfailed. This patient underwent surgical treatment. In the remaining 6 cases,it was impossible to insert a stentinto the main pancreatic duct properly so as to coverthe site of leakage or traverse a stenosis situated down-stream to the fistula. The placement of the stent failed because intraductal stones(n = 2) and ductal strictures(n = 2) precluded its passage or the stent was too short to reach the fistula located in the distal part of the pancreas(n = 2) . In 3 out of these 6 patients,the pancre-aticopleural fistula closed on further medical treatment.In these cases,the main pancreatic duct was normalor only mildly dilated,and there was a leakage at the body/tail of the pancreas. In one of these 3 patients,additional percutaneous drainage of the peripancre atic fluid collections allowed better control of the leakageand facilitated resolution of the fistula. The remaining3 patients had a tight stenosis of the main pancreatic duct resistible to dilatation and the stent could not beinserted across the stenosis. Subsequent conservative treatment proved unsuccessful in these patients. Aftera failed the rapeutic ERCP,3 patients in our series developed superinfection of the pleural or peripancreatic fluid collections. Four out of 8 patients in our series required subsequent surgery due to a failed non-operative treat-ment. Distal pancreatectomy with splenectomy was performed in 3 cases. In one case,only external drainage of the pancreatic pseudocyst was done because of diffuse peripancreatic inflammatory infiltration precluding safe dissection. There were no perioperative mortalities.There was no recurrence of a pancreati copleural fistulain any of the patients.CONCLUSION:Optimal management of pancreaticopleural fistulas requires appropriate patient selection that should be based on the underlying pancreatic ductab normalities.Marek Wronski Maciej Slodkowski Wlodzimierz Cebulski Daniel Moronczyk Ireneusz W Krasnodebski 2011World Journal of Gastroenterology2011,17,42:6
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