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| 1 | Convergence of neuro-endocrine-immune pathways in the pathophysiology of irritable bowel syndrome显示文摘Disordered signalling between the brain and the gut are generally accepted to underlie the functional bowel disorder, irritable bowel syndrome(IBS). However, partly due to the lack of disease-defining biomarkers, understanding the aetiology of this complex and multifactorial disease remains elusive. This common gastrointestinal disorder is characterised by alterations in bowel habit such as diarrhoea and/or constipation, bloating and abdominal pain, and symptom exacerbation has been linked with periods of stress, both psychosocial and infection-related. Indeed, a high level of comorbidity exists between IBS and stress-related mood disorders such as anxiety and depression. Moreover, studies have observed alterations in autonomic output and neuro-endocrine signalling in IBS patients. Accumulating evidence indicates that a maladaptive stress response, probably mediated by the stress hormone, corticotropin-releasing factor contributes to the initiation, persistence and severity of symptom flares.Other risk factors for developing IBS include a positive family history, childhood trauma, dietary factors and prior gastrointestinal infection. An emerging role has been attributed to the importance of immune factors in the pathophysiology of IBS with evidence of altered cytokine profiles and increased levels of mucosal immune cells. These factors have also been shown to have direct effects on neural signalling. This review discusses how pathological changes in neural, immune and endocrine pathways, and communication between these systems, contribute to symptom flares in IBS. | Maria M Buckley Siobhain M O'Mahony Dervla O'Malley | 2014 | World Journal of Gastroenterology2014,20,27: | 24 |
| 2 | Management of biliary complications after orthotopic liver transplantation:The role of endoscopy显示文摘Biliary complications are signifi cant causes of morbidity and mortality after orthotopic liver transplantation (OLT). The estimated incidence of biliary complications after OLT ranges between 10%-25%,however,these numbers continue to decline due to improvement in surgical techniques. The most common biliary complications are strictures (both anastomotic and non-anastomotic) and bile leaks. Most of these problems can be appropriately managed with endoscopic retrograde colangiography (ERC). Other complications such as bile duct stones,bile casts,sphincter of Oddi dysfunction,and hemobilia,are less frequent and also can be managed with ERC. This article will review the risk factors,diagnosis,and endoscopic management of the most common biliary complications after OLT. | Maria C Londoo Domingo Balderramo Andrés Cárdenas | 2008 | World Journal of Gastroenterology2008,14,4: | 22 |
| 3 | Oral purgative and simethicone before small bowel capsule endoscopy显示文摘AIM:To evaluate small bowel cleansing quality,diagnostic yield and transit time,comparing three cleansing protocols prior to capsule endoscopy.METHODS:Sixty patients were prospectively enrolled and randomized to one of the following cleansing protocols:patients in Group A underwent a 24 h liquid diet and overnight fasting;patients in Group B followed protocol A and subsequently were administered 2 L of polyethylene glycol(PEG) the evening before the procedure;patients in Group C followed protocol B and were additionally administered 100 mg of simethicone 30 min prior to capsule ingestion.Small bowel cleansing was independently assessed by two experienced endoscopists and classified as poor,fair,good or excellent according to the proportion of small bowel mucosa under perfect conditions for visualization.When there was no agreement between the two endoscopists,the images were reviewed and discussed until a consensus was reached.The preparation was considered acceptable if > 50% or adequate if > 75% of the mucosa was in perfect cleansing condition.The amount of bubbles was assessed independently and it was considered significant if it prevented a correct interpretation of the images.Positive endoscopic findings,gastric emptying time(GET) and small bowel transit time(SBTT) were recorded for each examination.RESULTS:There was a trend favoring Group B in achieving an acceptable(including fair,good or excellent) level of cleansing(Group A:65%;Group B:83.3%;Group C:68.4%) [P = not significant(NS)] and favoring Group C in attaining an excellent level of cleansing(Group A:10%;Group B:16.7%;Group C:21.1%)(P = NS).The number of patients with an adequate cleansing of the small bowel,corresponding to an excellent or good classification,was 5(25%) in Group A,5(27.8%) in Group B and 4(21.1%) in Group C(P = 0.892).Conversely,7 patients(35%) in Group A,3 patients(16.7%) in Group B and 6 patients(31.6%) in Group C were considered to have poor small bowel cleansing(P = 0.417),with significant fluid or debris such that the examination was unreliable.The proportion of patients with a significant amount of bubbles was 50% in Group A,27.8% in Group B and 15.8% in Group C(P = 0.065).This was significantly lower in Group C when compared to Group A(P = 0.026).The mean GET was 27.8 min for Group A,27.2 min for Group B and 40.7 min for Group C(P = 0.381).The mean SBTT was 256.4 min for Group A,256.1 min for Group B and 258.1 min for Group C(P = 0.998).Regarding to the rate of complete examinations,the capsule reached the cecum in 20 patients(100%) in Group A,16 patients(88.9%) in Group B and 17 patients(89.5%) in Group C(P = 0.312).A definite diagnosis based on relevant small bowel endoscopic lesions was established in 60% of the patients in Group A(12 patients),44.4% in Group B(8 patients) and 57.8% in Group C(11 patients)(P = 0.587).CONCLUSION:Preparation with 2 L of PEG before small bowel capsule endoscopy(SBCE) may improve small bowel cleansing and the quality of visualization.Simethicone may further reduce intraluminal bubbles.No significant differences were found regarding GET,SBTT and the proportion of complete exploration or diagnostic yield among the three different cleansing protocols. | Bruno Joel Ferreira Rosa Mara Barbosa Joana Magalhes Ana Rebelo Maria Joo Moreira José Cotter | 2013 | World Journal of Gastrointestinal Endoscopy2013,5,2: | 21 |
| 4 | Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis显示文摘AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic lesions.METHODS: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not significant.CONCLUSION: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis. | Chiang J Tyng Maria Fernanda A Almeida Paula NV Barbosa Almir GV Bitencourt José Augusto AG Berg Macello S Maciel Felipe JF Coimbra Luiz Henrique O Schiavon Maria Dirlei Begnami Marcos D Guimares Charles E Zurstrassen Rubens Chojniak | 2015 | World Journal of Gastroenterology2015,21,12: | 14 |
| 5 | Gut-brain connection: The neuroprotective effects of the anti-diabetic drug liraglutide显示文摘Long-acting glucagon-like peptide-1(GLP-1) analogues marketed for type 2 diabetes(T2D) treatment have been showing positive and protective effects in several different tissues, including pancreas, heart or even brain. This gut secreted hormone plays a potent insulinotropic activity and an important role in maintaining glucose homeostasis. Furthermore, growing evidences suggest the occurrence of several commonalities between T2 D and neurodegenerative diseases, insulin resistance being pointed as a main cause for cognitive decline and increased risk to develop dementia. In this regard, it has also been suggested that stimulation of brain insulin signaling may have a protective role against cognitive deficits. As GLP-1 receptors(GLP-1R) are expressed throughout the central nervous system and GLP-1 may cross the blood-brain-barrier, an emerging hypothesis suggests that they may be promising therapeutic targets against brain dysfunctional insulin signaling-related pathologies. Importantly, GLP-1 actions depend not only on the direct effect mediated by its receptor activation, but also on the gut-brain axis involving an exchange of signals between both tissues via the vagal nerve, thereby regulating numerous physiological functions(e.g., energy homeostasis, glucose-dependent insulin secretion, as well as appetite and weight control). Amongst the incretin/GLP-1 mimetics class of anti-T2 D drugs with an increasingly described neuroprotective potential, the already marketed liraglutide emerged as a GLP-1R agonist highly resistant to dipeptidyl peptidase-4 degradation(thereby having an increased half-life) and whose systemic GLP-1R activity is comparable to that of native GLP-1. Importantly, several preclinical studies showed anti-apoptotic, anti-inflammatory, anti-oxidant and neuroprotective effects of liraglutide against T2 D, stroke and Alzheimer disease(AD), whereas several clinical trials, demonstrated some surprising benefits of liraglutide on weight loss, microglia inhibition, behavior and cognition, and in AD biomarkers. Herein, we discuss the GLP-1 action through the gut-brain axis, the hormone's regulation of some autonomic functions and liraglutide's neuroprotective potential. | Emanuel Monteiro Candeias Inês Carolina Sebastio Susana Maria Cardoso Sónia Catarina Correia Cristina Isabel Carvalho Ana Isabel Plácido Maria Sancha Santos Catarina Resende Oliveira Paula Isabel Moreira Ana Isabel Duarte | 2015 | World Journal of Diabetes2015,6,6: | 9 |
| 6 | 腐植酸对黄瓜植株生长的影响涉及与硝酸盐浓度有关的细胞分裂素、多胺、矿质营养素浓度在植株根系和芽中的变化显示文摘许多研究报道腐植酸类物质能够促进不同环境下的幼苗栽培物的生长。然而对腐植酸促进植物生长的作用机理,科学工作者却知之甚少。腐植酸类物质对植物幼苗的影响涉及根质膜H+-ATP酶活性及根系和芽中硝酸根分布的主要作用,反过来,导致某些细胞分裂素,多聚胺与脱落酸根浓度的变化,从而促进新幼苗生长。这一观点,通过现阶段的试验可以得出。试验结果表明,植物根系所富集的腐植酸能显著增加植物幼苗的生长,这与植物根系H+-ATP酶活性增强有关,这种活性表现在植物幼芽中硝酸盐浓度的增加,根系浓度降低。这些作用与细胞分裂素和多胺物质的浓度在植物幼芽中显著提高是相伴随的,与植物根系浓度降低有关。同样地,多种细胞分裂素在植物幼芽和根系分布的变化与多种矿物营养素在植物幼芽和根系分布的显著变化是协调一致的。试验结果表明,腐植酸对黄瓜幼苗生长的促进作用与硝酸根的浓度直接有关,而硝酸根浓度的变化又影响了细胞分裂素和多胺物质在植物幼苗中的富集。 | Vero nica Mora Eva Bacaicoa Angel-Maria Zamarreo Elena Aguirre Maria Garnica Marta Fuentes Jose-Maria Garc a-Mina 张世万 周霞萍 | 2012 | 腐植酸2012,,2: | 8 |
| 7 | 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 |
| 8 | Pathophysiology of cystic fibrosis and drugs used in associated digestive tract diseases显示文摘Cystic fibrosis(CF)causes chronic infections in the respiratory tract and alters the digestive tract.This paper reviews the most important aspects of drug treatment and changes in the digestive tract of patients with CF.This is a review of the literature,emphasizing the discoveries made within the last 15 years by analyzing scientific papers published in journals indexed in the Scientific Electronic Library Online,Sciences Information,United States National Library of Medicine and Medical Literature Analysis and Retrieval System Online databases,both in English and Portuguese,using the key words:cystic fibrosis,medication,therapeutic,absorption,digestion.Randomized,observational,experimental,and epidemiological clinical studies were selected,among others,with statistical significance of 5%.This review evaluates the changes found in the digestive tract of CF patients including pancreatic insufficiency,constipation and liver diseases.Changes in nutritional status are also described.Clinical treatment,nutritional supplementation and drug management were classified in this review as essential to the quality of life of CF patients,and became available through public policies for monitoring and treating CF.The information gathered on CF and a multi professional approach to the disease is essential in the treatment of these patients. | Adriana Haack Giselle Gonalves Arago Maria Rita Carvalho Garbi Novaes | 2013 | World Journal of Gastroenterology2013,19,46: | 7 |
| 9 | Computed tomography and patient risk:Facts,perceptions and uncertainties显示文摘Since its introduction in the 1970s, computed tomography(CT) has revolutionized diagnostic decision-making. One of the major concerns associated with the widespread use of CT is the associated increased radiation exposure incurred by patients. The link between ionizing radiation and the subsequent development of neoplasia has been largely based on extrapolating data from studies of survivors of the atomic bombs dropped in Japan in 1945 and on assessments of the increased relative risk of neoplasia in those occupationally exposed to radiation within the nuclear industry. However, the association between exposure to low-dose radiation from diagnostic imaging examinations and oncogenesis remains unclear. With improved technology, significant advances have already been achieved with regards to radiation dose reduction. There are several dose optimization strategies available that may be readily employed including omitting unnecessary images at the ends of acquired series, minimizing the number of phases acquired, and the use of automated exposure control as opposed to fixed tube current techniques. In addition, new image reconstruction techniques that reduce radiation dose have been developed in recent years with promising results. These techniques use iterative reconstruction algorithms to attain diagnostic quality images with reduced image noise at lower radiation doses. | Stephen P Power Fiachra Moloney Maria Twomey Karl James Owen J O'Connor Michael M Maher | 2016 | World Journal of Radiology2016,8,12: | 7 |
| 10 | Timely reperfusion for ST-segment elevation myocardial infarction:Effect of direct transfer to primary angioplasty on time delays and clinical outcomes显示文摘Primary percutaneous coronary intervention(PPCI) is the preferred reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction(STEMI) when it can be performed expeditiously and by experienced operators. In spite of excellent clinical results this technique is associated with longer delays than thrombolysis and this fact may nullify the benefit of selecting this therapeutic option. Several strategies have been proposed to decrease the temporal delays to deliver PPCI. Among them,prehospital diagnosis and direct transfer to the cath lab,by-passing the emergency department of hospitals,has emerged as anattractive way of diminishing delays. The purpose of this review is to address the effect of direct transfer on time delays and clinical events of patients with STEMI treated by PPCI. | Rodrigo Estévez-Loureiro ángela López-Sainz Armo Pérez de Prado Carlos Cuellas Ramón Calvio Santos Norberto Alonso-Orcajo Jorge Salgado Fernández Jose Manuel Vázquez-Rodríguez Maria López-Benito Felipe Fernández-Vázquez | 2014 | World Journal of Cardiology2014,6,6: | 6 |
| 11 | Upper esophageal sphincter abnormalities are strongly predictive of treatment response in patients with achalasia显示文摘AIM: To investigate the relationship between upper esophageal sphincter abnormalities achalasia treatment METHODS: We performed a retrospective study of 41 consecutive patients referred for high resolution esophageal manometry with a final manometric diagnosis of achalasia. Patients were sub-divided by presence or absence of Upper esophageal sphincter(UES) abnormality, and clinical and manometric profiles were compared.Correlation between UES abnormality and sub-type(i.e.,hypertensive, hypotensive or impaired relaxation) and a number of variables, including qualitative treatment response, achalasia sub-type, co-morbid medical illness,psychiatric illness, surgical history, dominant presentingsymptom, treatment type, age and gender were also evaluated.RESULTS: Among all 41 patients, 24(58.54%) had a UES abnormality present. There were no significant differences between the groups in terms of age, gender or any other clinical or demographic profiles. Among those with UES abnormalities, the majority were either hypertensive(41.67%) or had impaired relaxation(37.5%) as compared to hypotensive(20.83%), although this did not reach statistical significance(P = 0.42). There was no specific association between treatment response and treatment type received; however, there was a significant association between UES abnormalities and treatment response. In patients with achalasia and concomitant UES abnormalities, 87.5% had poor treatment response, while only 12.5% had favorable response. In contrast, in patients with achalasia and no UES abnormalities, the majority(78.57%) had good treatment response, as compared to 21.43% with poor treatment response(P = 0.0001). After controlling for achalasia sub-type, those with UES abnormality had 26 times greater odds of poor treatment response than those with no UES abnormality(P = 0.009). Similarly, after controlling for treatment type, those with UES abnormality had 13.9 times greater odds of poor treatment response compared to those with no UES abnormality(P = 0.017).CONCLUSION: The presence of UES abnormalities in patients with achalasia significantly predicted poorer treatment response as compared to those with normal UES function. | Simon C Mathews Maria Ciarleglio Yamile Haito Chavez John O Clarke Ellen Stein Bani Chander Roland | 2014 | World Journal of Clinical Cases2014,2,9: | 5 |
| 12 | Radiofrequency ablation vs surgical resection in elderly patients with hepatocellular carcinoma in Milan criteria显示文摘BACKGROUND Surgical resection and radiofrequency ablation(RFA)represent two possible strategy in treatment of hepatocellular carcinoma(HCC)in Milan criteria.AIM To evaluate short-and long-term outcome in elderly patients(>70 years)with HCC in Milan criteria,which underwent liver resection(LR)or RFA.METHODS The study included 594 patients with HCC in Milan criteria(429 in LR group and 165 in RFA group)managed in 10 European centers.Statistical analysis was performed using the Kaplan-Meier method before and after propensity score matching(PSM)and Cox regression.RESULTS After PSM,we compared 136 patients in the LR group with 136 patients in the RFA group.Overall survival at 1,3,and 5 years was 91%,80%,and 76%in the LR group and 97%,67%,and 41%in the RFA group respectively(P=0.001).Diseasefree survival at 1,3,and 5 years was 84%,60%and 44%for the LR group,and 63%,36%,and 25%for the RFA group(P=0.001).Postoperative Clavien-Dindo IIIIV complications were lower in the RFA group(1%vs 11%,P=0.001)in association with a shorter length of stay(2 d vs 7 d,P=0.001).In multivariate analysis,Model for End-stage Liver Disease(MELD)score(>10)[odds ratio(OR)=1.89],increased value of international normalized ratio(>1.3)(OR=1.60),treatment with radiofrequency(OR=1.46),and multiple nodules(OR=1.19)were independent predictors of a poor overall survival while a high MELD score(>10)(OR=1.51)and radiofrequency(OR=1.37)were independent factors associated with a higher recurrence rate.CONCLUSION Despite a longer length of stay and a higher rate of severe postoperative complications,surgery provided better results in long-term oncological outcomes as compared to ablation in elderly patients(>70 years)with HCC in Milan criteria. | Maria Conticchio Riccardo Inchingolo Antonella Delvecchio Letizia Laera Francesca Ratti Maximiliano Gelli Ferdinando Anelli Alexis Laurent Giulio Vitali Paolo Magistri Giacomo Assirati Emanuele Felli Taiga Wakabayashi Patrick Pessaux Tullio Piardi Fabrizio di Benedetto Nicola de'Angelis Javier Briceño AntonioRampoldi RenèAdam Daniel Cherqui Luca Antonio Aldrighetti Riccardo Memeo | 2021 | World Journal of Gastroenterology2021,27,18: | 4 |
| 13 | Lamivudine therapy for children with chronic hepatitis B显示文摘瞄准:为了估计,为失败到的有长期的肝炎 B (CHB ) 的孩子的 lamivudine 治疗的有效性和副作用对作出回应或有禁止徵候到 interferon-alpha (IFN-alpha ) 治疗。方法:有 CHB 的 59 个孩子被对待, 100 片 mg lamivudine 药片每天为 12 瞬间口头上地给一次。丙氨酸 aminotransferase (中高音) 活动在它的中止以后在治疗和每 3 瞬间期间每月被评估。HBe 抗原, anti-HBe 抗体,在浆液的 HBV DNA 水平在基线和每六个月被评估在期间并且在 lamivudine 治疗以后。对 lamivudine 治疗的持续病毒的反应(SVR ) 被定义为永久(比在治疗的结束以后的 6 瞬间不短) ,也就是中高音活动正规化,到 anti-HBe 抗体的 HBeAg 的 seroconversion,和在浆液的无法发现的病毒的 HBV-DNA (比 200 个拷贝低每 mL ) 。lamivudine 治疗的副作用的分析有关测试在治疗以后在治疗,和每 3 瞬间期间每月在临床的访问期间执行了的主观、客观的症状,临床的考试,和实验室用一张问询表在病人和他们的父母的会见之上被基于。结果:中高音 normalisation 发生在 47 (79.7%) 病人在之间第一和 11 (th ) 治疗的瞬间(吝啬的 4.4+/-2.95 瞬间,中部 4.0 瞬间) ,并且在 18 (30.5%) 他们在治疗的 2 瞬间以后。在中高音正规化和孩子们的年龄的时间之间没有关联, HBV 感染的年龄, HBV 感染的持续时间,发炎活动分数(分级) ,阶段,在治疗前的中高音活动,浆液 HBV DNA 水平,和 lamivudine 每体重的 kg 开。HBeAg/anti HBe seroconversion 在 27.1% 盒子中被完成。seroconversion 的更高的率与更低的浆液 HBV DNA 水平和 HBV 感染的更长的持续时间被连接。在 HBeAg/anti HBeAb seroconversion 和孩子们之间没有连接,分级是年龄, HBV 感染的年龄,阶段,在治疗前的中高音活动,和 lamivudnie 每体重的 kg 开。没有抱怨或临床的症状在 lamivudine 治疗期间被观察。肾的功能或骨髓中毒的效果的缺陷病人在没有被注意。结论:为有长期的肝炎 B 的孩子的一年 lamivudine 治疗有效、很好容忍。HBeAg/HBeAb 和 SVR 的 Seroconversion 与更低的预告的处理浆液 HBV DNA 水平被连接。 | Anna Liberek Anna Szaflarska-Poplawska Maria Korzon Gra(?)yna (?)uczak Magdalena Góra-Gebka Ewa (?)o(s|')-Rycharska Wanda Bako Mieczyslawa Czerwionka-Szaflarska | 2006 | World Journal of Gastroenterology2006,12,15: | 4 |
| 14 | Finding the solution for incomplete small bowel capsule endoscopy显示文摘AIM:To evaluate whether the use of real time viewer(RTV)and administration of domperidone to patients with delayed gastric passage of the capsule could reduce the rate of incomplete examinations(IE)and improve the diagnostic yield of small bowel capsule endoscopy(SBCE).METHODS:Prospective single center interventional study,from June 2012 to February 2013.Capsule location was systematically checked one hour after ingestion using RTV.If it remained in the stomach,the patient received 10 mg domperidone per os and the location of the capsule was rechecked after 30 min.If the capsule remained in the stomach a second dose of10 mg of domperidone was administered orally.After another 30 min the position was rechecked and if the capsule remained in the stomach,it was passed into the duodenum by upper gastrointestinal(GI)endoscopy.The rate of IE and diagnostic yield of SBCE were compared with those of examinations performed before the use of RTV or domperidone in our Department(control group,January 2009-May 2012).RESULTS:Both groups were similar regarding age,sex,indication,inpatient status and surgical history.The control group included 307 patients,with 48(15.6%)IE.The RTV group included 82 patients,with3(3.7%)IE,P=0.003.In the control group,average gastric time was significantly longer in patients with IE than in patients with complete examination of the small bowel(77 min vs 26 min,P=0.003).In the RTV group,the capsule remained in the stomach one hour after ingestion in 14/82 patients(17.0%)vs 48/307(15.6%)in the control group,P=0.736.Domperidone did not significantly affect small bowel transit time(260min vs 297 min,P=0.229).The capsule detected positive findings in 39%of patients in the control group and 49%in the RTV group(P=0.081).CONCLUSION:The use of RTV and selective administration of domperidone to patients with delayed gastric passage of the capsule significantly reduces incomplete examinations,with no effect on small bowel transit time or diagnostic yield. | José Cotter Francisca Dias de Castro Joana Magalhes Maria Joo Moreira Bruno Rosa | 2013 | World Journal of Gastrointestinal Endoscopy2013,5,12: | 4 |
| 15 | Lymphocyte subsets in alcoholic liver disease显示文摘AIM:To compare lymphocyte subsets between healthy controls and alcoholics with liver disease.METHODS:The patient cohort for this study included individuals who were suspected to have alcoholic liver disease(ALD) and who had undergone liver biopsy(for disease grading and staging,doubts about diagnosis,or concurrent liver disease;n = 56).Normal controls included patients who were admitted for elective cholecystectomy due to non-complicated gallstones(n = 27).Formalin-fixed,paraffin-embedded liver biopsy specimens were sectioned and stained with hematoxylin and eosin and Perls' Prussian blue.The non-alcoholic steatohepatitis score was used to assess markers of ALD.Lymphocyte population subsets were determined by flow cytometry.T lymphocytes were identified(CD3+),and then further subdivided into CD4+ or CD8+ populations.B lymphocytes(CD19+) and natural killer(NK) cell numbers were also measured.In addition to assessing lymphocyte subpopulation differences between ALD patients and controls,we also compared subsets of alcoholic patients without cirrhosis or abstinent cirrhotic patients to normal controls.RESULTS:The patient cohort primarily consisted of older men.Active alcoholism was present in 66.1%.Reported average daily alcohol intake was 164.9 g and the average lifetime cumulative intake was 2211.6 kg.Cirrhosis was present in 39.3% of the patients and 66.1% had significant fibrosis(perisinusoidal and portal/periportal fibrosis,bridging fibrosis,or cirrhosis) in their liver samples.The average Mayo end-stage liver disease score was 7.6.No hereditary hemochromatosis genotypes were found.ALD patients(n = 56) presented with significant lymphopenia(1.5 × 109/L ± 0.5 × 109/L vs 2.1 × 109/L ± 0.5 × 109/L,P < 0.0001),due to a decrease in all lymphocyte subpopulations,except for NK lymphocytes:CD3+(1013.0 ± 406.2/mm3 vs 1523.0 ± 364.6/mm3,P < 0.0001),CD4+(713.5 ± 284.7/mm3 vs 992.4 ± 274.7/mm3,P < 0.0001),CD8+(262.3 ± 140.4/mm3 vs 478.9 ± 164.6/mm3,P < 0.0001),and CD19+(120.6 ± 76.1/mm3 vs 264.6 ± 88.0/mm3,P < 0.0001).CD8+ lymphocytes suffered the greatest reduction,as evidenced by an increase in the CD4+/CD8+ ratio(3.1 ± 1.3 vs 2.3 ± 0.9,P = 0.013).This ratio was associated with the stage of fibrosis on liver biopsy(rs = 0.342,P = 0.01) and with Child-Pugh score(rs = 0.482,P = 0.02).The number of CD8+ lymphocytes also had a positive association with serum ferritin levels(rs = 0.345,P = 0.009).Considering only patients with active alcoholism but not cirrhosis(n = 27),we found similar reductions in total lymphocyte counts(1.8 × 109/L ± 0.3 × 109/L vs 2.1 × 109/L ± 0.5 × 109/L,P = 0.018),and in populations of CD3+(1164.7 ± 376.6/mm3 vs 1523.0 ± 364.6/mm3,P = 0.001),CD4+(759.8 ± 265.0/mm3 vs 992.4 ± 274.7/mm3,P = 0.003),CD8+(330.9 ± 156.3/mm3 vs 478.9 ± 164.6/mm3,P = 0.002),and CD19+(108.8 ± 64.2/mm3 vs 264.6 ± 88.0/mm3,P < 0.0001).In these patients,the CD4+/CD8+ ratio and the number of NK lymphocytes was not significantly different,compared to controls.Comparing patients with liver cirrhosis but without active alcohol consumption(n = 11),we also found significant lymphopenia(1.3 × 109/L ± 0.6 × 109/L vs 2.1 × 109/L ± 0.5 × 109/L,P < 0.0001) and decreases in populations of CD3+(945.5 ± 547.4/mm3 vs 1523.0 ± 364.6/mm3,P = 0.003),CD4+(745.2 ± 389.0/mm3 vs 992.4 ± 274.7/mm3,P = 0.032),CD8+(233.9 ± 120.0/mm3 vs 478.9 ± 164.6/mm3,P < 0.0001),and CD19+(150.8 ± 76.1/mm3 vs 264.6 ± 88.0/mm3,P = 0.001).The NK lymphocyte count was not significantly different,but,in this group,there was a significant increase in the CD4+/CD8+ ratio(3.5 ± 1.3 vs 2.3 ± 0.9,P = 0.01).CONCLUSION:All patient subsets presented with decreased lymphocyte counts,but only patients with advanced fibrosis presented with a significant increase in the CD4+/CD8+ ratio. | Luís Costa Matos Paulo Batista Nuno Monteiro Joo Ribeiro Maria A Cipriano Pedro Henriques Fernando Giro Armando Carvalho | 2013 | World Journal of Hepatology2013,5,2: | 4 |
| 16 | Two-dimensional control of light with light on metasurfaces显示文摘The ability to control the wavefront of light is fundamental to focusing and redistribution of light,enabling many applications from imaging to spectroscopy.Wave interaction on highly nonlinear photorefractive materials is essentially the only established technology allowing the dynamic control of the wavefront of a light beam with another beam of light,but it is slow and requires large optical power.Here we report a proof-of-principle demonstration of a new technology for two-dimensional(2D)control of light with light based on the coherent interaction of optical beams on highly absorbing plasmonic metasurfaces.We illustrate this by performing 2D all-optical logical operations(AND,XOR and OR)and image processing.Our approach offers diffractionlimited resolution,potentially at arbitrarily-low intensity levels and with 100 THz bandwidth,thus promising new applications in space-division multiplexing,adaptive optics,image correction,processing and recognition,2D binary optical data processing and reconfigurable optical devices. | Maria Papaioannou Eric Plum João Valente Edward TF Rogers Nikolay I Zheludev | 2016 | Light(Science & Applications)2016,5,1: | 3 |
| 17 | Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and between cirrhotic and non-cirrhotic patients during antiviral therapy显示文摘AIM: To evaluate the impact of hepatitis C virus (HCV) infection with genotype 1 or 3 and the presence or absence of liver cirrhosis (LC) in the early viral kinetics response to treatment. METHODS: Naive patients (n = 46) treated with interferon-α (IFN-α) and ribavirin and followed up with frequent early HCV-RNA determinations were analysed. Patients were infected with genotype 1 (n = 28, 7 with LC) or 3 (n = 18, 5 with LC). RESULTS: The fi rst phase decline was larger in geno- type 3 patients than in genotype 1 patients (1.72 vs 0.95 log IU/mL, P < 0.001). The second phase slope decline was also larger in genotype 3 patients than in genotype 1 patients (0.87 vs 0.15 log/wk, P < 0.001). Differences were found in both cirrhotic and non-cirrhotic patients. Genotype 1 cirrhotic patients had a slower 2nd phase slope than non-cirrhotic patients (0.06 vs 0.18 log/wk, P < 0.02). None of genotype 1 cirrhotic patients had a 1st phase decline larger than 1 log (non-cirrhotic patients: 55%, P < 0.02). A similar trend toward a slower 2nd phase slope was observed in genotype 3 cirrhotic pa- tients but the 1st phase slope decline was not different. Sustained viral response was higher in genotype 3 pa- tients than in genotype 1 patients (72% vs 14%, P < 0.001) and in genotype 1 non-cirrhotic patients than in genotype 1 cirrhotic patients (19% vs 0%). A secondphase decline slower than 0.3 log/wk was predictive of non-response in all groups. CONCLUSION: Genotype 3 has faster early viral decline than genotype 1. Cirrhosis correlates with a slower 2nd phase decline and possibly with a lower 1st phase slope decline in genotype 1 patients. | José Eymard Medeiros-Filho Isabel Maria Vicente Guedes de Carvalho Mello Joo Renato Rebello Pinho Avidan U Neumann Fernanda de Mello Malta Luiz Caetano da Silva Flair José Carrilho | 2006 | World Journal of Gastroenterology2006,12,45: | 3 |
| 18 | Hepatitis B infection among adults in the philippines:A national seroprevalence study显示文摘AIM:To determine the prevalence of hepatitis B surface antigen(HBsAg)seropositivity among adult Filipinos.METHODS:Testing for HBsAg was performed on serum samples from persons aged ≥ 20 years old who participated in the National Nutrition and Health Survey(NNHeS)conducted in 2003.Information on age,sex,marital status,educational attainment,employment status,and income were collected.For this study,marital status was classified as never married or otherwise(i.e.,married,divorced,separated,widowed);educational attainment was classified as high school graduate or below or at least some tertiary education;and employment status was classified as currently employed or currently unemployed.Annual income was divided into 4 quartiles in Philippine pesos(PhP):Q1,≤ PhP 53064;Q2,PhP 53065-92192;Q3,PhP 92193-173387;and Q4,≥ PhP 173388.Prevalence estimates were weighted so that they represented the general population.Social and demographic factors were correlated with HBsAg seropositivity.Multivariate analysis was used to determine independent predictors of HBsAg seropositivity.RESULTS:A total of 2150 randomly selected adults,20 years and over,out of the 4753 adult participants of NNHeS were tested for HBsAg.The HBsAg seroprevalence was 16.7%(95%CI:14.3%-19.1%),which corresponded to an estimated 7278968 persons infected with hepatitis B.There was no significant difference between males and females(17.5% vs 16.0%;P = 0.555).This corresponded to an estimated 3721775 men and 3557193 women infected with hepatitis B.The HBsAg seroprevalence peaked at age 20-39 years old,with declining prevalence in the older age groups.The only independent predictor of HBsAg seropositivity was the annual income,with persons in the highest income quartile being less likely to be HBsAg positive(age-adjusted OR = 0.51;95%CI:0.30-0.86)compared to subjects in the lowest income quartile.Sex,marital status,educational attainment,and employment status were not found to be independent predictors of HBsAg seropositivity.CONCLUSION:The high HBsAg seroprevalence among adults in the Philippines classifies the country as hyperendemic for HBV infection and appears unchanged over the last few decades. | Stephen N Wong Janus P Ong Madalinee Eternity D Labio Oscar T Cabahug Maria Lourdes O Daez Erlinda V Valdellon Jose D Sollano Jr Marilyn O Arguillas | 2013 | World Journal of Hepatology2013,5,4: | 3 |
| 19 | Vitamin D deficiency in Crohn’s disease: Prevalence, risk factors and supplement use in an outpatient setting显示文摘 | Treasa Nic Suibhne Gerry Cox Martin Healy Colm O’Morain Maria O’Sullivan | 2011 | Journal of Crohn’s and Colitis2011,,2: | 3 |
| 20 | Quality of life, work productivity impairment and healthcare resources in inflammatory bowel diseases in Brazil显示文摘BACKGROUND Inflammatory bowel diseases(IBD)have been associated with a low quality of life(QoL)and a negative impact on work productivity compared to the general population.Information about disease control,patient-reported outcomes(PROs),treatment patterns and use of healthcare resources is relevant to optimizing IBD management.AIM To describe QoL and work productivity and activity impairment(WPAI),treatment patterns and use of healthcare resources among IBD patients in Brazil.METHODS A multicenter cross-sectional study included adult outpatients who were previously diagnosed with moderate to severe Crohn’s disease(CD)or ulcerative colitis(UC).At enrolment,active CD and UC were defined as having a Harvey Bradshaw Index≥8 or a CD Activity Index≥220 or calprotectin>200μg/g or previous colonoscopy results suggestive of inadequate control(per investigator criteria)and a 9-point partial Mayo score≥5,respectively.The PRO assessment included the QoL questionnaires SF-36 and EQ-5D-5L,the Inflammatory Bowel Disease Questionnaire(IBDQ),and the WPAI questionnaire.Information about healthcare resources and treatment during the previous 3 years was collected from medical records.Chi-square,Fisher’s exact and Student’s t-/Mann-Whitney U tests were used to compare PROs,treatment patterns and the use of healthcare resources by disease activity(α=0.05).RESULTS Of the 407 patients in this study(CD/UC:64.9%/35.1%,mean age 42.9/45.9 years,54.2%/56.6%female,38.3%/37.1%employed),44.7%/25.2%presented moderate-to-severe CD/UC activity,respectively,at baseline.Expressed in median values for CD/UC,respectively,the SF-36 physical component was 46.6/44.7 and the mental component was 45.2/44.2,the EQ-visual analog scale score was 80.0/70.0,and the IBDQ overall score was 164.0/165.0.Moderate to severe activity,female gender,being unemployed,a lower educational level and lower income were associated with lower QoL(P<0.05).Median work productivity impairment was 20%and 5%for CD and UC patients,respectively,and activity impairment was 30%,the latter being higher among patients with moderate to severe disease activity compared to patients with mild or no disease activity(75.0%vs 10.0%,P<0.001).For CD/UC patients,respectively,25.4%/2.8%had at least one surgery,38.3%/19.6%were hospitalized,and 70.7%/77.6%changed IBD treatment at least once during the last 3 years.The most common treatments at baseline were biologics(75.3%)and immunosuppressants(70.9%)for CD patients and 5-ASA compounds(77.5%)for UC patients.CONCLUSION Moderate to severe IBD activity,especially among CD patients,is associated with a substantial impact on QoL,work productivity impairment and an increased number of IBD surgeries and hospitalizations in Brazil. | Rogerio Serafim Parra Julio MF Chebli Heda MBS Amarante Cristina Flores Jose ML Parente Odery Ramos Milene Fernandes Jose JR Rocha Marley R Feitosa Omar Feres Antonio S Scotton Rodrigo B Nones Murilo M Lima Cyrla Zaltman Carolina D Goncalves Isabella M Guimaraes Genoile O Santana Ligia Y Sassaki Rogerio S Hossne Mauro Bafutto Roberto LK Junior Mikaell AG Faria Sender J Miszputen Tarcia NF Gomes Wilson R Catapani Anderson A Faria Stella CS Souza Rosana F Caratin Juliana T Senra Maria LA Ferrari | 2019 | World Journal of Gastroenterology2019,25,38: | 2 |