|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | 成人自发性脑出血处理指南——2007年更新版:美国心脏协会/美国卒中协会卒中委员会、高血压研究委员会、医疗质量和转归研究跨学科工作组指南:美国神经病学学会确认本指南作为神经科医生教学工具的价值显示文摘目的:本指南旨在为急性自发性脑出血的诊断和治疗提供最新的综合性推荐意见。方法:通过Medline正式检索截止2006年8月的相关文献,并将撰写委员会已知相关问题的其他论文作为补充,用证据表合并资料。采用美国心脏协会卒中委员会的证据水平分级标准对每项推荐意见进行分级。由5位同行评议专家和卒中委员会领导委员会成员对指南草案进行发表前审阅。预期本指南在3年内完全更新。结果:本文陈述了脑出血的诊断、动脉血压和颅内压增高的处理、脑出血内科并发症的治疗以及复发性脑出血的预防等方面的循证指南。对重组Ⅶ因子延缓早期出血的近期试验进行了讨论。对自发性脑出血治疗的各种外科手术方法提出了推荐意见。最后,对脑出血患者的撤销治疗和临终问题进行了分析。 | Joseph Broderick Sander Connolly Edward Feldmann Daniel Hanley Carlos Kase Derk Krieger Marc Mayberg Lewis Morgenstern Christopher S. Ogilvy Paul Vespa Mario Zuccarello 王玉洁(译) 刘娟(译) 白璇(译) 李新辉 孙虹(译) 姚志成(译) 张慧(译) 牛英翔(译) | 2007 | 国际脑血管病杂志2007，15，7： | 234 |
| 2 | Efficacy of current guidelines for the treatment of spontaneous bacterial peritonitis in the clinical practice显示文摘AIM: To verify the validity of the International Ascites Club guidelines for treatment of spontaneous bacterial peritonitis (SBP) in clinical practice. METHODS: All SBP episodes occurring in a group of consecutive cirrhotics were managed accordingly and included in the study. SBP was diagnosed when the ascitic fluid polymorphonuclear (PMN) cell count was > 250 cells/mm3, and empirically treated with cefotaxime. RESULTS: Thirty-eight SBP episodes occurred in 32 cirrhotics (22 men/10 women; mean age: 58.6 ± 11.2 years). Prevalence of SBP, in our population, was 17%. Ascitic fluid culture was positive in nine (24%) cases only. Eleven episodes were nosocomial and 71% community-acquired. Treatment with cefotaxime was successful in 59% of cases, while 41% of episodes required a modification of the initial antibiotic therapy because of a less-than 25% decrease in ascitic PMN count at 48 h. Change of antibiotic therapy led to the resolution of infection in 87% of episodes. Among the cases with positive culture, the initial antibiotic therapy with cefotaxime failed at a percentage (44%) similar to that of the whole series. In these cases, the isolated organisms were either resistant or with an inherent insufficient susceptibility to cefotaxime. CONCLUSION: In clinical practice, ascitic PMN count is a valid tool for starting a prompt antibiotic treatment andevaluating its efficacy. The initial treatment with cefotaxime failed more frequently than expected. An increase in healthcare-related infections with antibiotic-resistant pathogens may explain this finding. A different first-line antibiotic treatment should be investigated. | Stefania Angeloni Cinzia Leboffe Antonella Parente Mario Venditti Alessandra Giordano Manuela Merli Oliviero Riggio | 2008 | World Journal of Gastroenterology2008，14，17： | 42 |
| 3 | Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy显示文摘Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones(CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound(EUS) and magnetic resonance cholangiography(MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and costeffectiveness of imaging techniques used to identifyCBDS increase together in a parallel way, the concept of 'risk of carrying CBDS' has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of 'under-studying' by poor diagnostic work up or 'over-studying' by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. 'Low risk' patients do not require further examination before laparoscopic cholecystectomy. Two main 'philosophical approaches' face each other for patients with an 'intermediate to high risk' of carrying CBDS: on one hand, the 'laparoscopy-first' approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the 'endoscopy-first' attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative cholangiography, EUS and MRC are reported to have similar results. Regarding management, the recent literature seems to show better short and long term outcome of surgery in terms of retained stones and need for further procedures. Nevertheless, open surgery is invasive, whereas the laparoscopic common bile duct clearance is time consuming, technically demanding and involves dedicated instruments. Thus, although no consensus has been achieved and CBDS management seems more conditioned by the availability of instrumentation, personnel and skills than cost-effectiveness, endoscopic treatment is largely preferred worldwide. | Renato Costi Alessandro Gnocchi Francesco Di Mario Leopoldo Sarli | 2014 | World Journal of Gastroenterology2014，20，37： | 48 |
| 4 | 人外周血NK细胞亚群、表型和生物学特征显示文摘目的:探讨人外周血NK细胞的异质性和生物学特征。方法:利用多种标记抗体进行细胞表面和细胞内细胞毒效应分子染色,再利用流式细胞仪在单个细胞水平上分析NK细胞亚群的多样性和生物学特征。结果:NK细胞可分为CD56+、CD56+CD16+和CD16+三个亚群。所有CD56+NK细胞均表达CD95,但表达水平的高(CD95bright)和低(CD95dim)不同。在CD95bright和CD8+细胞亚群中有43.5%的细胞同时表达颗粒酶B和穿孔素。而CD56+CD16+和CD16+细胞表达CD95均为CD95bright,同时表达颗粒酶B(83.6%)和穿孔素(89.8%)。结论:NK细胞乃异质性群体,随着CD56表达减少和CD16表达增加,其生物效应功能逐渐成熟。 | 吴长有 刘杰 杨滨燕 Mario Roedere | 2005 | 中国免疫学杂志2005，21，7： | 34 |
| 5 | 对我国生态系统服务研究局限性的思考及建议显示文摘自1997年生态系统服务的概念引入我国以来,我国学术界关于生态系统服务的研究呈现指数水平上升,但是研究的内容局限于不同区域和不同类型生态系统服务的价值化评估,评估结果的科学性和现实有效性受到质疑。本文结合我国目前的实际需求,我国生态系统服务研究的误区以及对千年生态系统评估(MA)研究成果的思考,认为目前和日后生态系统服务研究可以加强如下几个方面的研究:一是生态系统服务对人类福祉贡献的研究;二是生态系统服务功能退化现状的研究;三是生态系统服务退化原因和对策的研究,以丰富我国生态系统服务研究的内容,并为生态系统服务价值评估研究提供基础和补充。 | 杨光梅 李文华 闵庆文 甄霖 Mario Lucas | 2007 | 中国人口·资源与环境2007，17，1： | 34 |
| 6 | 完全切除的Ⅰ期,Ⅱ期和ⅢA期非小细胞肺癌术后放疗联合辅助化疗对生存率的影响:国际诺维本辅助治疗组织随机临床试验显示文摘研究背景:1998年术后放疗( post operative radiotherapy, PORT )的meta分析表明术后放疗相关死亡率风险增加21%,术后放疗的作用一直是探讨的热点。PORT对于pN0和pN1患者显示出较差的生存率,而对于Ⅲ期和pN2的患者仅轻微提高生存率。通过对术后放疗研究,辅助放疗的作用地位明显下降,随之出现的其他变化如顺铂的使用增加。 | Douillard JY Rosell R de Lena Mario 金冶宁 | 2009 | 中国癌症杂志2009，19，3： | 33 |
| 7 | 成人自发性脑出血处理指南——2007年更新版 美国心脏协会/美国卒中协会卒中委员会、高血压研究委员会、医疗质量和转归研究跨学科工作组指南 美国神经病学学会确认本指南作为神经科医生教学工具的价值显示文摘目的:本指南旨在为急性自发性脑出血的诊断和治疗提供最新的综合性推荐意见。方法:通过Medline正式检索截止2006年8月的相关文献,并将撰写委员会已知相关问题的其他论文作为补充,用证据表合并资料。采用美国心脏协会卒中委员会的证据水平分级标准对每项推荐意见进行分级。由5位同行评议专家和卒中委员会领导委员会成员对指南草案进行发表前审阅。预期本指南在3年内完全更新。结果:本文陈述了脑出血的诊断、动脉血压和颅内压增高的处理、脑出血内科并发症的治疗以及复发性脑出血的预防等方面的循证指南。对重组Ⅶ因子延缓早期出血的近期试验进行了讨论。对自发性脑出血治疗的各种外科手术方法提出了推荐意见。最后,对脑出血患者的撤销治疗和临终问题进行了分析。 | Joseph Broderick Sander Connolly Edward Feldmann Daniel Hanley Carlos Kase Derk Krieger Marc Mayberg Lewis Morgenstern Christopher S.Ogilvy Paul Vespa Mario Zuccarello 王玉洁 刘娟 白璇 李新辉 孙虹 姚志成 张慧 牛英翔 | 2008 | 中华脑血管病杂志(电子版)2008，2，1： | 29 |
| 8 | Gastric cancer: Current status of lymph node dissection显示文摘D2 procedure has been accepted in Far East as the standard treatment for both early(EGC) and advanced gastric cancer(AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials(RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council(MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recur-rence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC. | Maurizio Degiuli Giovanni De Manzoni Alberto Di Leo Domenico D'Ugo Erica Galasso Daniele Marrelli Roberto Petrioli Karol Polom Franco Roviello Francesco Santullo Mario Morino | 2016 | World Journal of Gastroenterology2016，22，10： | 29 |
| 9 | Sevoflurane post-conditioning protects isolated rat hearts against ischemia-reperfusion injury via activation of the ERK1/2 pathway显示文摘瞄准: 在 sevoflurane 调查细胞外的调整信号的 kinases (英皇家空军之阶级最低之兵) 的角色在 vitro 的调节以后的导致的 cardioprotection。 | Hong XIE Jing ZHANG Jiang ZHU Li-xin LIU Mario REBECCHI Su-mei HU Chen WANG | 2014 | Acta Pharmacologica Sinica2014，35，12： | 27 |
| 10 | Neoadjuvant chemotherapy for gastric cancer. Is it a must or a fake?显示文摘AIM To investigate the neoadjuvant chemotherapy(NAC) effect on the survival of patients with proper stomach cancer submitted to D2 gastrectomy.METHODS We proceeded to a review of the literature with Pub Med, Embase, ASCO and ESMO meeting abstracts as well as computerized use of the Cochrane Library for randomized controlled trials(RCTs) comparing NAC followed by surgery(NAC + S) with surgery alone(SA) for gastric cancer(GC). The primary outcome was the overall survival rate. Secondary outcomes were the site of the primary tumor, extension of node dissection according to Japanese Gastric Cancer Association(JGCA) performed in both arms, disease-specific(DSS) and disease-free survival(DFS) rates, clinical and pathological response rates and resectability rates after perioperative treatment. RESULTS We identified a total of 16 randomized controlled trials comparing NAC + S(n = 1089) with SA(n = 973) published in the period from January 1993-March 2017. Only 6 of these studies were well-designed, structured trials in which the type of lymph node(LN) dissection performed or at least suggested in the trial protocol was reported. Two out of three of the RCTs with D2 lymphadenectomy performed in almost all cases failed to show survival benefit in the NAC arm. Inthe third RCT, the survival rate was not even reported, and the primary end points were the clinical outcomes of surgery with and without NAC. In the remaining three RCTs, D2 lymph node dissection was performed in less than 50% of cases or only recommended in the 'Study Treatment' protocol without any description in the results of the procedure really perfomed. In one of the two studies, the benefit of NAC was evident only for esophagogastric junction(EGJ) cancers. In the second study, there was no overall survival benefit of NAC. In the last trial, which documented a survival benefit for the NAC arm, the chemotherapy effect was mostly evident for EGJ cancer, and more than one-fourth of patients did not have a proper stomach cancer. Additionally, several patients did not receive resectional surgery. Furthermore, the survival rates of international reference centers that provide adequate surgery for homogeneous stomach cancer patients' populations are even higher than the survival rates reported after NAC followed by incomplete surgery.CONCLUSION NAC for GC has been rapidly introduced in international western guidelines without an evidence-based medicinerelated demonstration of its efficacy for a homogeneous population of patients with only stomach tumors submitted to adequate surgery following JGCA guidelines with extended(D2) LN dissection. Additional larger sample-size multicentre RCTs comparing the newer NAC regimens including molecular therapies followed by adequate extended surgery with surgery alone are needed. | Rossella Reddavid Silvia Sofia Paolo Chiaro Fabio Colli Renza Trapani Laura Esposito Mario Solej Maurizio Degiuli | 2018 | World Journal of Gastroenterology2018，24，2： | 25 |
| 11 | 从土壤腐殖质分组到分子有机质组学认识土壤有机质本质显示文摘梳理了与土壤生态系统功能相联系的,特别是对固碳减排的土壤有机质本质认识的研究进展及路径,探讨了经典腐殖质学说存在的问题,概述了新近的有机质保护稳定学说及腐殖质组学学说,并追溯了生物标志物有机质分子研究,最后从土壤学的基本理念和理论出发讨论和重新认识土壤有机质的本质及其价值。从形成条件、分离条件和分子鉴定等多方面分析,土壤腐殖质形成和稳定学说越来越显示出局限性;而面向气候变化的碳固定研究可以深入探析土壤有机质的复杂存在状态。越来越认识到土壤有机质是投入土壤的有机物质经不同程度生物利用或降解的产物残留,只是被土壤不同程度地区隔和封闭,本质上仍是分子量变化极大的生命源有机物的集合。因此,可通过生物标志物分子作为靶标在土壤中提取和识别,该技术的发展将孕育萌生土壤有机质分子组学。后者可以用于判读土壤有机质的结构支撑、反应活性和促生功能等方面的本质差别,这些差别可能是由有机分子组成结构及存在状态所决定而不是由有机分子稳定性决定的。从这个概念出发,类似于土壤微生物分子生态,土壤有机质的丰度、组成、结构与功能间的联系可能是土壤有机质本质的核心问题。对这种关系的量化和参数化表征可用以探索土壤有机质永续固定,且可以保持生命活性的土壤有机质的管理策略及技术,并配合土壤的团聚体理论诠释土壤的本质和生态系统功能服务,这将是未来土壤学服务人类可持续发展的理论立足点。 | 潘根兴 丁元君 陈硕桐 孙景玲 冯潇 张晨 Marios Doross 郑聚锋 张旭辉 程琨 刘晓雨 卞荣军 李恋卿 | 2019 | 地球科学进展2019，34，5： | 25 |
| 12 | 胆囊癌的临床诊疗现状与挑战显示文摘胆囊癌在胃肠道癌症中位居第五位,同时它也是胆道最常见的恶性肿瘤,约占80%~95%。这种肿瘤预后不佳,总体5年生存率低于5%,平均中位生存期〈6个月。因为胆囊癌在进展时可以没有任何症状,所以早期诊断是至关重要。术前诊断为胆囊结石,而术后确诊为胆囊癌的发生率为0.5%~1.5%。如果术前怀疑患者胆囊癌,则不应通过腹腔镜手术。流行病学研究已经确定了胆囊癌的发病率有地理和种族的显著差异:美洲的印第安人高发,东南亚地区也比较高,但在美洲和世界的其他地区发病率较低。环境诱发因素在胆囊癌的发展过程中发挥关键作用,胆石症、胆道和寄生虫感染的慢性炎症是最好的例证。在过去的10年里,改进成像技术和改良根治的手术方法可改善患者的预后,并帮助延长胆囊癌患者的存活时间。对于R0切除的胆囊癌患者,其总体5年生存率为21%~69%。在将来,潜在的诊断标志物的发展将对那些种族易感性或已知胆道解剖异常的人群提供早期筛查诊断的机会。 | Mislav Raki? Leonardo Patrlj Mario Kopljar Robert Kli?ek Marijan Kolovrat Bozo Loncar Zeljko Busic 冯铁诚 | 2016 | 中国普通外科杂志2016，25，2： | 24 |
| 13 | 产量与经济效益共赢的高效生态农业模式:以弘毅生态农场为例显示文摘化学物质的大量投入以及元素不能循环导致农田生态系统退化,耕地质量和产量均呈下降趋势,食物链受到污染.本研究从低产田开始,通过秸秆养牛、腐熟牛粪还田恢复地力;以物理+生物方法控制虫害;以人工+机械管理杂草,停用农药、化肥和除草剂,同时不用地膜、人工合成激素、转基因种子生产优质安全食品,并在线上与线下销售.10年的长期实验结果表明,所在村庄农田生态环境改善,减少农药用量58.3%;物理+生物控虫效果明显,每盏灯年捕获量从2009年的33 kg下降到2014年的2.1 kg,下降93.8%;年消耗秸秆1000 t,秸秆利用率从1.1%提高到62.5%.有机肥还田提高了土壤生物多样性,有机果园蚯蚓数量317条m^(-2),而普通果园只有16条m^(-2);大量有机肥还田(75 t hm^(-2)),土壤有机质从实验初期的0.7%提高到2.4%.粮食产量从最初的11.43 t hm^(-2)提高到目前的17.43 t hm^(-2),其中冬小麦(Triticum aestivum)、夏玉米(Zea mays)、大豆(Glycine max(Linn.)Merr.)和花生(Arachis hypogaea Linn.)产量分别超出山东省平均水平42.6%,60.9%,32.2%和38.1%.由于质量好,产品已销售往除西藏以外的30个省、市、自治区,经济效益明显,平均每公顷效益是普通农田的3~5倍,带动所在村庄67户农民从事高效生态农业.本研究可为国家制定生态农业发展规划、精准扶贫、农村环境保护等提供科学依据. | 蒋高明 郑延海 吴光磊 刘慧 池云花 冯素飞 李勇 李彩虹 李宗奉 苏本营 董群 乌云塔娜 LUCAS Mario LEFORT Zoe REGOLINI Margot 曾祥伟 贺新华 郭立月 战丽杰 唐海龙 韦继光 周平 曾彦 杨煜 宋守宽 刘秀 甄珍 刘海涛 孟杰 李静 李霄 李占 丁娜 博文静 虞晓凡 程达 梁啸天 李立君 徐磊 谷仙 宋彦洁 MUMINOV A. Mahmud 刘滨扬 赫晓霞 刘美珍 宁堂原 王空军 徐玉新 陈文浩 | 2017 | 科学通报2017，62，4： | 24 |
| 14 | Systemic inflammation and immune response after laparotomy vs laparoscopy in patients with acute cholecystitis, complicated by peritonitis显示文摘AIM: To evaluate acute cholecystitis, complicated by peritonitis, acute phase response and immunological status in patients treated by laparoscopic or open approach. METHODS: From January 2002 to May 2012, we conducted a prospective randomized study on 45 consecutive patients (27 women, 18 men; mean age 58 years). These subjects were taken from a total of 681 patients who were hospitalised presenting similar preoperative findings: acute upper abdominal pain with tenderness, involuntary guarding under the right hypochondrium and/or in the flank; fever higher than 38 ℃, leukocytosis greater than 10 × 10 9 /L or both, and ultrasonographic evidence of calculous cholecystitis possibly complicated by peritonitis. These patients had undergone cholecystectomy for acute calculous cholecystitis,complicated by bile peritonitis. Randomly, 23 patients were assigned to laparoscopic cholecystectomy (LC), and 22 patients to open cholecystectomy (OC). Blood samples were collected from all patients before operation and at days 1, 3 and 6 after surgery. Serum bacteraemia, endotoxaemia, white blood cells (WBCs), WBC subpopulations, human leukocyte antigen-DR (HLA-DR), neutrophil elastase, interleukin-1 (IL-1) and IL-6, and C-reactive protein (CRP) were measured at 0, 30, 60, 90, 120 and 180 min, at 4, 6, 12, 24 h, and then daily (8 A.M.) until post-operative day 6.RESULTS: The two groups were comparable in the severity of peritoneal contamination as indicated by the viable bacterial count (open group = 90% of positive cultures vs laparoscopic group = 87%) and endotoxin level (open group = 33.21 ± 6.32 pg/mL vs laparoscopic group = 35.02 ± 7.23 pg/mL). Four subjects in the OC group (18.1%) and 1 subject (4.3%) in the LC group (P < 0.05) developed intra-abdominal abscess. Severe leukocytosis (range 15.8-19.6/mL) was observed only after OC but not after LC, mostly due to an increase in neutrophils (days 1 and 3, P < 0.05). This value returned to the normal range within 3-4 d after LC and 5-7 d after OC. Other WBC types and lymphocyte subpopulations showed no significant variation. On the first day after surgery, a statistically significant difference was observed in HLA-DR expression between LC (13.0 ± 5.2) and OC (6.0 ± 4.2) (P < 0.05). A statistically significant change in plasma elastase concentration was recorded post-operatively at days 1, 3, and 6 in patients from the OC group when compared to the LC group (P < 0.05). In the OC group, the serum levels of IL-1 and IL-6 began to increase considerably from the first to the sixth hour after surgery. In the LC group, the increase of serum IL-1 and IL-6 levels was delayed and the peak values were notably lower than those in the OC group. Significant differences between the groups, for these two cytokines, were observed from the second to the twenty-fourth hour (P < 0.05) after surgery. The mean values of serum CRP in the LC group on post-operative days (1 and 3) were also lower than those in the OC group (P < 0.05). Systemic concentration of endotoxin was higher in the OC group at all intra-operative sampling times, but reached significance only when the gallbladder was removed (OC group = 36.81 ± 6.4 ρg/mLvs LC group = 16.74 ± 4.1 ρg/mL, P < 0.05). One hour after surgery, microbiological analysis of blood cultures detected 7 different bacterial species after laparotomy, and 4 species after laparoscopy (P < 0.05). CONCLUSION: OC increased the incidence of bacteraemia, endotoxaemia and systemic inflammation compared with LC and caused lower transient immunological defense, leading to enhanced sepsis in the patients examined. | Federico Sista Mario Schietroma Giuseppe De Santis Antonella Mattei Emanuela Marina Cecilia Federica Piccione Sergio Leardi Francesco Carlei Gianfranco Amicucci | 2013 | World Journal of Gastrointestinal Surgery2013，5，4： | 23 |
| 15 | Type 2 diabetes mellitus and Alzheimer's disease显示文摘Epidemiological and biological evidences support a link between type 2 diabetes mellitus(DM2) and Alzheimer's disease(AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Futuretrials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes. | Mario Barbagallo Ligia J Dominguez | 2014 | World Journal of Diabetes2014，5，6： | 22 |
| 16 | Diagnosis and treatment of hepatocellular carcinoma: An update显示文摘Hepatocellular carcinoma(HCC) is one of the most common malignancies leading to high mortality rates in the general population; in cirrhotic patients, it is the primary cause of death. The diagnosis is usually delayed in spite of at-risk population screening recommendations, i.e., patients infected with hepatitis B or C virus. Hepatocarcinogenesis hinges on a great number of genetic and molecular abnormalities that lead to tumor angiogenesis and foster their dissemination potential. The diagnosis is mainly based on imaging studies such as computed tomography and magnetic resonance, in which lesions present a characteristic classical pattern of early arterial enhancement followed by contrast medium 'washout' in late venous phase. On occasion, when imaging studies are not conclusive, biopsy of the lesion must be performed to establish the diagnosis. The Barcelona Clinic Liver Cancer staging method is the most frequently used worldwide and recommended by the international guidelines of HCC management. Currently available treatments include tumor resection, liver transplant, sorafenib and locoregional therapies(alcoholization, radiofrequency ablation, chemoembolization). The prognosis of hepatocarcinoma is determined according to the lesion's stage and in cirrhotic patients, on residual liver function. Curative treatments, such as liver transplant, are sought in patients diagnosed in early stages; patients in more advanced stages, were not greatly benefitted by chemotherapy in terms of survival until the advent of target molecules such as sorafenib. | Javier Tejeda-Maldonado Ignacio García-Juárez Jonathan Aguirre-Valadez Adrián González-Aguirre Mario Vilatobá-Chapa Alejandra Armengol-Alonso Francisco Escobar-Penagos Aldo Torre Juan Francisco Sánchez-ávila Diego Luis Carrillo-Pérez | 2015 | World Journal of Hepatology2015，7，3： | 22 |
| 17 | Downstaging disease in patients with hepatocellular carcinoma outside up-to-seven criteria: Strategies using degradable starch microspheres transcatheter arterial chemo-embolization显示文摘AIM: To evaluate the downstaging rates in hepatitis C virus-patients with hepatocellular carcinoma(HCC), treated with degradable starch microspheres transcatheter arterial chemoembolization(DSM-TACE), to reach new-Milan-criteria(nM C) for transplantation. METHODS: This study was approved by the Ethics Committee of our institution. From September 2013 to March 2014 eight patients(5 men and 3 women) with liver cirrhosis and multinodular HCC, that did not meet n MC at baseline, were enrolled in this study. Patients who received any other type of treatment such as termal ablation or percutaneous ethanol injection were excluded. DSM-TACE was performed in all patients using Embo Cept? S and doxorubicin. Baseline and follow-up computed tomography or magnetic resonance imaging was assessed measuring the longest enhancing axial dimension of each tumor according to the modified Response Evaluation Criteria In Solid Tumors measure-ments, and medical records were reviewed.RESULTS: DSM-TACE was successfully performed in all patients without major complication. We treated 35 lesions(mean 4.3 per patient). Six of eight patients(75%) had their HCC downstaged to meet nM C. Every patient whose disease was downstaged eventually underwent transplantation. The six patients who received transplant were still living at the time of this writing, without recurrence of HCC. Baseline age(P = 0.25), Model for End-stage Liver Disease score(P = 0. 77), and α-fetoprotein level(P = 1.00) were similar between patients with and without downstaged HCC. CONCLUSION: DSM-TACE represents a safely and effective treatment option with similar safety and efficacy of conventional chemoembolization and could be successfully performed also for downstaging disease in patients without n MC, allowing them to reach liver transplantation. | Antonio Orlacchio Fabrizio Chegai Stefano Merolla Simona Francioso Costantino Del Giudice Mario Angelico Giuseppe Tisone Giovanni Simonetti | 2015 | World Journal of Hepatology2015，7，12： | 23 |
| 18 | Evidence that chronic hypoxia causes reversible impairment on male fertility显示文摘瞄准:在人的精子发生的参数和他们的复原时间上评估长期的组织缺氧的效果。方法:六男健康的山缓慢艰辛地旅行 ers 的 Seminological 参数在海水平在 normoxia 被评估。在到高度的 26 天暴露以后(从 2 000 m 到 5 600 m,古代蒙古帝国旧都遗迹远征) 一样的参数再在回到海水平以后被评估。这些参数再次在 6 个月以后在 1 个月以后然后再被评估。结果:精子计数被发现在回到海水平以后立即更低(P = 0.0004 ) 并且再在一个月以后(P = 0.0008 ) 。正常层次在 6 个月以后被到达。精子的活动性(%) 不在回到海水平以后立即显示出减小(P = 0.0583 ) ,而在 1 个月以后这减小是重要的(P = 0.0066 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。在回到海以后立即增加的反常或不成熟的精子(%) 铺平(P = 0.0067 ) 然后再在 1 个月以后(P = 0.0004 ) 。在 6 个月以后,到起始的值有完全的恢复。在精液的能动精子的全部的数字被发现在回到海水平以后立即更低(P = 0.0024 ) 然后再在 1 个月以后(P = 0.0021 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。结论:在 6 个月在精子发生和男富饶的生理的机制显示氧供应的影响以后,长期的组织缺氧在以前的 normoxic 条件的恢复导致精子减少的一个状态和如此的 seminological 参数的正规化。 | Vittore Verratti Francesco Berardinelli Camillo Di Giulio Gerardo Bosco Marisa Cacchio Mario Pellicciotta Michele Nicolai Stefano Martinotti Raffaele Tenaglia | 2008 | Asian Journal of Andrology2008，10，4： | 21 |
| 19 | Pancreatic metastases from renal cell carcinoma:The state of the art显示文摘Pancreatic metastases are rare,with a reported incidence varying from 1.6%to 11%in autopsy studies of patients with advanced malignancy.In clinical series,the frequency of pancreatic metastases ranges from 2%to 5%of all pancreatic malignant tumors.However,the pancreas is an elective site for metastases from carcinoma of the kidney and this peculiarity has been reported by several studies.The epidemiology,clinical presentation,and treatment of pancreatic metastases from renal cell carcinoma are known from singleinstitution case reports and literature reviews.Thereis currently very limited experience with the surgical resection of isolated pancreatic metastasis,and the role of surgery in the management of these patients has not been clearly defined.In fact,for many years pancreatic resections were associated with high rates of morbidity and mortality,and metastatic disease to the pancreas was considered to be a terminal-stage condition.More recently,a significant reduction in the operative risk following major pancreatic surgery has been demonstrated,thus extending the indication for these operations to patients with metastatic disease. | Roberto Ballarin Mario Spaggiari Nicola Cautero Nicola De Ruvo Roberto Montalti Cristina Longo Anna Pecchi Patrizia Giacobazzi Giuseppina De Marco Giuseppe D’Amico Giorgio Enrico Gerunda Fabrizio Di Benedetto | 2011 | World Journal of Gastroenterology2011，17，43： | 21 |
| 20 | Helicobacter pylori and oral pathology:Relationship with the gastric infection显示文摘Helicobacter pylori(H.pylori)has been found in the oral cavity and stomach,and its infection is one of the most frequent worldwide.We reviewed the literature and conducted a Topic Highlight,which identified studies reporting an association between H.pylori-infection in the oral cavity and H.pylori-positive stomach bacterium.This work was designed to determine whether H.pylori is the etiologic agent in periodontal disease,recurrent aphthous stomatitis(RAS),squamous cell carcinoma,burning and halitosis.Record selection focused on the highest quality studies and meta-analyses.We selected 48 articles reporting on the association between saliva and plaque and H.pylori-infection.In order to assess periodontal disease data,we included 12 clinical trials and 1 meta-analysis.We evaluated 13 published articles that addressed the potential association with RAS,and 6 with squamous cell carcinoma.Fourteen publications focused on our questions on burning and halitosis.There is a close relation between H.pylori infection in the oral cavity and the stomach.The mouth is the first extra-gastric reservoir.Regarding the role of H.pylori in the etiology of squamous cell carcinoma,no evidence is still available. | Isabel Adler Andrea Muio Silvia Aguas Laura Harada Mariana Diaz Adriana Lence Mario Labbrozzi Juan Manuel Muio Boris Elsner Alejandra Avagnina Valeria Denninghoff | 2014 | World Journal of Gastroenterology2014，20，29： | 21 |
您所在的机构暂未开通此部分的功能，请联系管理员