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| 1 | Portal vein thrombosis:Insight into physiopathology,diagnosis,and treatment显示文摘Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient's outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients' future prognoses. | Francesca R Ponziani Maria A Zocco Chiara Campanale Emanuele Rinninella Annalisa Tortora Luca Di Maurizio Giuseppe Bombardieri Raimondo De Cristofaro Anna M De Gaetano Raffaele Landolfi Antonio Gasbarrini | 2010 | World Journal of Gastroenterology2010,16,2: | 75 |
| 2 | Anti-fungal and anti-bacterial activities of ethanol extracts of selected traditional Chinese medicinal herbs显示文摘Objective:To evaluate in ritro antimicrobial activities of selected 58 ethno-medicinal plant extracts with a view to assess their therapeutic potential.Methods:A total of 58 traditional Chinese medicinal plants were carefully selected based on the literature review and their traditional use.The antimicrobial activities of ethanol extracts of these medicinal plants were tested against fungi(Aspergillus funigaius),yeast(Candida albicans),gram-negative(Acirelobacter haumannii and Pseudornnruis aeruginosa)and gram-positive bacteria(Staphglococcus aureus).The activities were tested at three different concentrations of 1.00,0.10 and 0.01 mg/mL.The data was analysed using Gene data Screener program.Results:The measured antimicrobial activities indicated that out of the 58 plant extracts,15 extracts showed anti-fungal activity and 23 extracts exhibited anti-bacterial activity.Eight plant extracts have exhibited both anti-bacterial and anti-fungal activities.For instance,Eucommia ulmoides,Pohgonum cuspidcrtum,Poria cocas and Uncaria rhineophylla showed activity against both bacterial and fungal strains,indicating their broad spectrum of activity.Conclusions:The results revealed that the ethanol extracts of 30 plants out of the selected 58 possess significant antimicrobial activities.It is interesting to note that the findings from the current study are consistent with the traditional use.A clear correlation has also been found between the antimicrobial activity and the flavonoid content of the plant extracts which is in agreement with the literature.Hence.the results presented here can be used to guide the selection of potential plant species for the isolation and structure elucidation of novel antimicrobial compounds in order to establish the structure-activity relationship.This in turn is expected to lead the way to the discovery of novel antimicrobial agents for therapeutic use. | Lin Zhang Anjaneya S.Ravipati Sundar R Koyyalamudi Sang Chul Jeong Narsimha Reddy John Bartlett Paul T.Smith Mercedes de la Cruz Maria Cndida Monteiro ngeles Melguizo Ester Jimnez Francisca Vicente | 2013 | Asian Pacific Journal of Tropical Medicine2013,6,9: | 23 |
| 3 | 冠状动脉内影像学临床应用专家共识(第一部分):对冠状动脉介入治疗的指导与优化显示文摘欧洲心血管介入协会(EAPCI)专家组系统总结了血管内超声(IVUS)和光学相干断层成像(OCT)这两种血管内影像学检查临床应用指征的现有证据,提供了关于IVUS和OCT指导经皮冠状动脉介入治疗(PCI)的应用价值,并明确了最可能从腔内影像学指导的介入治疗中获得临床收益的患者或病变类型,同时详细论述了PCI前如何使用IVUS或OCT优化支架尺寸(支架长度和直径)和手术策略的选择。此外,专家推荐对支架失败(支架内再狭窄或支架内血栓形成)的患者应常规进行冠状动脉内影像学检查,并首选OCT。最后,重点论述了IVUS和OCT在指导PCI和评估支架失败两个方面的优势和局限性,并对未来需要深入研究的领域进行了展望。 | Lorenz Raber Gary S Mintz Konstantinos C Koskinas Thomas W Johnson Niels R Holm Yoshinubo Onuma Maria D Radu Michael Joner Bo Yu Haibo Jia Nicolas Meneveau Jose M.de la Torre Hemandez Javier Escaned Jonathan Hill Francesco Prati Antonio Colombo Carlo di Mario Evelyn Regar Davide Capodanno William Wijns Robert A Byme Giulio Guagliumi | 2019 | 中华心血管病杂志2019,47,1: | 17 |
| 4 | Microbiota modification by probiotic supplementation reduces colitis associated colon cancer in mice显示文摘AIM To investigate the effect of probiotic supplementation during the development of an experimental model of colitis associated colon cancer(CAC). METHODS C57 BL/6 mice received an intraperitoneal injection of azoxymethane(10 mg/kg), followed by three cycles of sodium dextran sulphate diluted in water(5% w/v). Probiotic group received daily a mixture of Lactobacillus acidophilus, Lactobacil us rhamnosus and Bifidobacterium bifidum. Microbiota composition was assessed by 16 Sr RNA Illumina Hi Seq sequencing. Colon samples were collected for histological analysis. Tumor cytokines was assessed by Real Time-PCR(Polymerase Chain Reaction); and serum cytokines by Multiplex assay. All tests were two-sided. The level of significance was set at P < 0.05. Graphs were generated and statistical analysis performed using the software Graph Pad Prism 5.0. The project was approved by the institutional review board committee. RESULTS At day 60 after azoxymethane injection, the mean number of tumours in the probiotic group was 40% lower than that in the control group, and the probiotic group exhibited tumours of smaller size(< 2 mm)(P < 0.05). There was no difference in richness and diversity between groups. However, there was a significant difference in beta diversity in the multidimensional scaling analysis. The abundance of the genera Lactobacillus, Bifidobacterium, Allobaculum, Clostridium XI and Clostridium XVⅢ increased in the probiotic group(P < 0.05). The microbial change was accompanied by reduced colitis, demonstrated by a 46% reduction in the colon inflammatory index; reduced expression of the serum chemokines RANTES and Eotaxin; decreased p-IKK and TNF-α and increased IL-10 expression in the colon. CONCLUSION Our results suggest a potential chemopreventive effect of probiotic on CAC. Probiotic supplementation changes microbiota structure and regulates the inflammatory response, reducing colitis and preventing CAC. | Maria Carolina S Mendes Daiane SM Paulino Sandra R Brambilla Juliana A Camargo Gabriela F Persinoti José Barreto C Carvalheira | 2018 | World Journal of Gastroenterology2018,24,18: | 17 |
| 5 | Evaluation of VEGF gene polymorphisms and proliferative diabetic retinopathy in Mexican population显示文摘● AIM: To assess if the included vascular endothelial growth factor(VEGF) polymorphisms rs3025035, rs3025021 and rs2010963 are associated to proliferative retinopathy in a Mexican population with type 2 diabetes mellitus(T2DM).● METHODS: A case-control study was conducted in adult individuals with T2 DM associated to proliferative retinopathy or non-proliferative retinopathy from Oct. 2014 to Jun. 2015 from the Retina Department of the Asociation to Prevent Blindness in Mexico. The selected patients were adults with a diagnosis of T2 DM ≥5y. All subjects had a comprehensive ocular examination and the classification of the retinopathy severity was made considering the Early Treatment Diabetic Retinopathy Study(ETDRS) standardization protocols. Genomic DNA was extracted from whole fresh blood. All samples were genotyped by q PCR for selected VEGF polymorphisms. Hardy-Weinberg equilibrium was calculated by comparing Chi-square values between the expected and the observed values for genotype counts.● RESULTS: In total 142 individuals were enrolled, 71 individuals with T2 DM and associated proliferative retinopathy and 71 individuals with non-proliferative retinopathy. One-sided Fisher's exact test was performed for rs3025021[OR(95% CI)=0.44(0.08-2.2); P=0.25] and rs2010963 [OR(95% CI)=0.63(0.25-1.6); P=0.23]. The minor allelic frequencies obtained were 26% for rs3025021, 10% for rs3025035 and 61% for rs2010963. The pairwise linkage disequilibrium between the three SNP was assessed, and was as follows: rs3025021 vs rs3025035: D'=1.0, r^2=0.1043, P≤0.0001; rs3025021 vs rs2010963: D'=0.442, r^2=0.0446, P=0.149; rs3025035 vs rs2010963: D'=0.505, r^2=0.0214, P=0.142.● CONCLUSION: This is the first analysis involving VEGFA polymorphisms and proliferative diabetic retinopathy in a Mexican population. A major finding of the present study is that none of the polymorphisms studied was significantly associated with proliferative retinopathy. Based on these results, we can infer that different populations have different associations for the same polymorphisms. | Roberto Gonzalez-Salinas Maria C Garcia-Gutierrez Gerardo Garcia-Aguirre Virgilio Morales-Canton Raul Velez-Montoya Vidal R Soberon-Ventura Victoria Gonzalez Rodrigo Lechuga Pablo Garcia-Solis David G Garcia-Gutierrez Marco Vinicio Garcia-Solis Manuel Saenz de Viteri Juan C Solis-S | 2017 | International Journal of Ophthalmology(English edition)2017,10,1: | 12 |
| 6 | Phase angle obtained by bioelectrical impedance analysis independently predicts mortality in patients with cirrhosis显示文摘AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis. | Giliane Belarmino Maria Cristina Gonzalez Raquel S Torrinhas Priscila Sala Wellington Andraus Luiz Augusto Carneiro D'Albuquerque Rosa Maria R Pereira Valéria F Caparbo Graziela R Ravacci Lucas Damiani Steven B Heymsfield Dan L Waitzberg | 2017 | World Journal of Hepatology2017,9,7: | 11 |
| 7 | Treatment of laryngopharyngeal reflux disease: A systematic review显示文摘BACKGROUNG For a long time,laryngopharyngeal reflux disease(LPRD)has been treated by proton pump inhibitors(PPIs)with an uncertain success rate.AIM To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.METHODS Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD.Clinical prospective or retrospective studies had to explore the impact of medical treatment(s)on the clinical presentation of suspected or confirmed LPRD.The criteria for considering studies for the review were based on the population,intervention,comparison,and outcome framework.RESULTS The search identified 1355 relevant papers,of which 76 studies met the inclusion criteria,accounting for 6457 patients.A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring(MII-pH).The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk.The most used PPIs were omeprazole,esomeprazole,rabeprazole,lansoprazole and pantoprazole with a success rate ranging from 18%to 87%.Other composite treatments have been prescribed including PPIs,alginate,prokinetics,and H2 Receptor antagonists.CONCLUSION Regarding the development of MII-pH and the identification of LPRD subtypes(acid,nonacid,mixed),future studies are needed to improve the LPRD treatment considering all subtypes of reflux. | Jerome R Lechien Francois Mouawad Maria R Barillari Andrea Nacci Seyyedeh Maryam Khoddami Necati Enver Sampath Kumar Raghunandhan Christian Calvo-Henriquez Young-Gyu Eun Sven Saussez | 2019 | World Journal of Clinical Cases2019,7,19: | 9 |
| 8 | Aquaporins:Their role in cholestatic liver disease显示文摘This review focuses on current knowledge on hepato-cyte aquaporins(AQPs)and their significance in bile formation and cholestasis.Canalicular bile secretion results from a combined interaction of several solute transporters and AQP water channels that facilitate water flow in response to the osmotic gradients created. During choleresis,hepatocytes rapidly increase their canalicular membrane water permeability by modulating the abundance of AQP8.The question was raised as to whether the opposite process,i.e.a decreased canalicular AQP8 expression would contribute to the development of cholestasis.Studies in several experimental models of cholestasis,such as extrahepatic obstructive cholestasis,estrogen-induced cholestasis, and sepsis-induced cholestasis demonstrated that the protein expression of hepatocyte AQP8 was impaired. In addition,biophysical studies in canalicular plasma membranes revealed decreased water permeability associated with AQP8 protein downregulation.The combined alteration in hepatocyte solute transporters and AQP8 would hamper the efficient coupling of osmotic gradients and canalicular water flow.Thus cholestasis may result from a mutual occurrence of impaired solute transport and decreased water permeability. | Guillermo L Lehmann Maria C Larocca Leandro R Soria Raúl A Marinelli | 2008 | World Journal of Gastroenterology2008,14,46: | 8 |
| 9 | Morphological and functional evaluation of chronic pancreatitis with magnetic resonance imaging显示文摘Magnetic resonance imaging(MRI)techniques for assessment of morphology and function of the pancreas have been improved dramatically the recent years and MRI is very often used in diagnosing and follow-up of chronic pancreatitis(CP)patients.Standard MRI including fat-suppressed T1-weighted and T2-weighted imaging techniques reveal decreased signal and glandular atrophy of the pancreas in CP.In contrast-enhanced MRI of the pancreas in CP the pancreatic signal is usually reduced and delayed due to decreased perfusion as a result of chronic inflammation and fibrosis.Thus,morphological changes of the ductal system can be assessed by magnetic resonance cholangiopancreatography(MRCP).Furthermore,secretin-stimulated MRCP is a valuable technique to evaluate side branch pathology and the exocrine function of the pancreas and diffusion weighted imaging can be used to quantify both parenchymal fibrotic changes and the exocrine function of the pancreas.These standard and advanced MRI techniques are supplementary techniques to reveal morphological and functional changes of the pancreas in CP.Recently,spectroscopy has been used for assessment of metabolite concentrations in-vivo in different tissues and may have the potential to offer better tissue characterization of the pancreas.Hence,the purpose of the present review is to provide an update on standard and advanced MRI techniques of the pancreas in CP. | Tine Maria Hansen Matias Nilsson Mikkel Gram Jens Brφndum Frφkjr | 2013 | World Journal of Gastroenterology2013,19,42: | 7 |
| 10 | Small molecules enable OCT4-mediated direct reprogramming into expandable human neural stem cells显示文摘 | Saiyong Zhu Raiesh Ambasudhan Woong Sun Hyun Jung Kim Maria Talantova Xiaojing Wang Mingliang Zhang Yu Zhang Timothy Laurent James Parker Han-Seop Kim Jeffrey D Zaremba Sofiyan Saleem Sara Sanz-Blasco Eliezer Masliah Scott R McKercher Yee Sook Cho Stuart A Lipton Janghwan Kim Sheng Ding | 2014 | Cell Research2014,24,1: | 6 |
| 11 | Secreted protein acidic and rich in cysteine(SPARC)induces epithelial-mesenchymal transition,enhancing migration and invasion,and is associated with high Gleason score in prostate cancer显示文摘Secreted protein acidic and rich in cysteine(SPARC)is a matricellular protein highly expressed in bone tissue that acts as achemoattractant factor promoting the arrival of prostate cancer(PCa)cells to the bone marrow.However,the contribution of SPARCduring the early stages of tumor progression remains unclear.In this study,we show that SPARC is highly expressed in PCa tissueswith a higher Gleason score.Through stable knockdown and overexpression of SPARC in PC3 and LNCaP cells,respectively,here wedem on strate that en doge nous SPARC induces the epithelial-mesenchymal tran sition(EMT),decreasing E-cadheri n and cytokeratin18 and increasing N-cadheri n and vime ntin.Moreover,SPARC in duces the expression of EMT regulatory tran scription factors Snailfamily transcriptional repressor 1(Snail),Snail family transcriptional repressor 2(Slug),and zinc finger E-box binding homeobox 1(Zeb1).In addition,SPARC knockdown in PC3 cells decreases migration and invasion in vitro,without modifying cell proliferation.Our results indicate that SPARC might facilitate tumor progression by modifying the cellular phenotype in cancer cells. | Fernanda Lopez-Moncada Maria Jose Torres Enrique A Castellon Hector R Contreras | 2019 | Asian Journal of Andrology2019,21,6: | 5 |
| 12 | Viral evasion of DNA-stimulated innate immune responses显示文摘导出病毒的 nucleic 酸的细胞的察觉到为对病毒感染的早防卫是必要的。在最近的年里,包括周期的 GMP 安培 synthase (cGAS ) 和 gamma-interferon-inducible 蛋白质(IFI16 ) ,察觉到蛋白质的 DNA 的发现导致了房间怎么对带 DNA 染色体的到来的病原体唤起强壮的天生的有免疫力的回答的理解。发信号由 DNA 传感器刺激了取决于适配器蛋白质圈套(干扰素基因的激发器) ,到启用抗病毒的蛋白质的表示,包括类型我干扰素。便于有效感染,病毒发展了大量避免策略,指向的主人 DNA 传感器,适配器蛋白质和抄写因素。在这评论, STING 小径的导致病毒的激活上的当前的文学被介绍,我们讨论在这条抗病毒的小径指向不同的步的最近识别的病毒的避免机制。 | Maria H Christensen Sфren R Paludan | 2017 | Cellular & Molecular Immunology2017,14,1: | 4 |
| 13 | Immunogenetic phenotypes in inflammatory bowel disease显示文摘当前接受的 etiopathogenic 假设建议长期的肠的发炎和煽动性的肠疾病(IBD ) 的相关全身的表明特征由于对居民钠的过分好攻击或病理学的有免疫力的回答细菌的成分。预先安排的因素是粘膜免疫者回答或障碍功能的基因 dysregulation,与环境刺激触发的发作。这些因素和他们的相互作用可以也是疾病显型和疾病前进的重要决定因素。免疫的出现基因显型把支持借给不同免疫者处理的危险性基因调整的建议假设,由钠抗原开车,表示了接着在 IBD 影响临床的显型的同样特定的有免疫力的显型病人。 | Maria C Dubinsky Kent Taylor Stephan R Targan Jerome I Rotter | 2006 | World Journal of Gastroenterology2006,12,23: | 4 |
| 14 | 严重肢体缺血患者血浆中促血管生成潜力与血浆MMP-9、TIMP-1和TIMP-2水平升高的相关性研究(英文)显示文摘本研究通过比较间歇性跛行(IC)和严重肢体缺血(CLI)患者的血液参数,选择合适的临床和生化特指标,以评估促血管生成的潜力和抑制血管生成的作用.结果表明,通过刺激下肢动脉疾病(LEAD)病人血浆中的血管生成,内皮生长因子A(VEGF-A)浓度会显著增加,同时依赖于循环受体sVEGFR-1和sVEGFR-2的抑制也会显著减少.与IC病人相比,CLI病人具有较高的VEGF-A、金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制因子1(TIMP-1)和TIMP-2浓度. | Radoslaw Wieczór Anna Maria Wieczór Arleta Kulwas Grzegorz Pulkowski Jacek Budzyński Danuta Rosc | 2019 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2019,20,8: | 3 |
| 15 | Pneumo-CT assessing response to neoadjuvant therapy in esophageal cancer: Imaging-pathological correlation显示文摘Pneumo-computed tomography (PnCT) is a technique primarily developed and used to study stenotic lesions of the esophagus, gastroesophageal junction and stom-ach for pre-surgical planning. It helps to define both upper and lower borders of neoplasms located in the aforementioned areas. It achieves maximum lumen distension with CO2 highlighting thickened areas of the esophageal wall, thus allowing an accurate quantifica-tion of their extents. Although there are other alterna-tives for distension (oral contrast agents, water and ef-fervescent granules), they may be suboptimal. Patients with locally advanced esophageal cancer have a dismal prognosis despite surgical resection. Therefore, neo-adjuvant treatment strategies using radiation therapy and chemotherapy were developed to improve sur-vival. Neoadjuvant therapy improves esophageal tumor prognosis in a substantial proportion of patients, and the use of imaging techniques is mandatory to detect their response. PnCT combined with virtual endoscopy and multiplanar reconstruction enhances morphologic details in esophageal cancer, and thus would allow animproved assessment of response to neoadjuvant treat-ment. Therefore, more information could be provided to assess the efficacy of pre-surgical treatment. We de-scribe the potential use of PnCT to assess the response to neoadjuvant therapy in esophageal cancer with an imaging pathologic correlation. | Marina Ulla Ernestina Gentile Ezequiel Levy Yeyati Maria L Diez Demetrio Cavadas Ricardo D Garcia-Monaco Pablo R Ros | 2013 | World Journal of Gastrointestinal Oncology2013,5,12: | 3 |
| 16 | Prognostic impact of the Bismuth-Corlette classification:Higher rates of local unresectability in stageⅢb hilar cholangiocarcinoma显示文摘Background:The Bismuth-Corlette(BC)classification is used to categorize hilar cholangiocarcinoma by proximal extension along the biliary tree.As the right hepatic artery crosses just behind the left bile duct,we hypothesized that BCⅢb tumors would have a higher likelihood of local unresectability due to involvement of the contralateral artery.Methods:A retrospective review of a prospectively maintained database identified patients with hilar cholangiocarcinoma taken to the operating room for intended curative resection between April 2008 and September 2016.Cases were assigned BC stages based on preoperative imaging.Results:Sixty-eight patients were included in the study.All underwent staging laparoscopy after which 16 cases were aborted for metastatic disease.Of the remaining 52 cases,14 cases were explored and aborted for locally advanced disease.Thirty-eight underwent attempt at curative resection.After exclud-ing cases aborted for metastatic disease,the chance of proceeding with resection was 55.6%for BCⅢb staged lesions compared to 80.0%of BCⅢa lesions and to 82.4%for BCⅠ-Ⅲa staged lesions(P<0.05).About 44.4%of BCⅢb lesions were aborted for locally advanced disease versus 17.6%of remaining BC stages.Conclusions:When hilar cholangiocarcinoma is preoperatively staged as BCⅢb,surgeons should antici-pate higher rates of locally unresectable disease,likely involving the right hepatic artery. | Michael J Passeri Maria R Baimas-George Jesse K Sulzer David A Iannitti John B Martinie Erin H Baker Lee M Ocuin Dionisios Vrochides | 2020 | Hepatobiliary & Pancreatic Diseases International2020,19,2: | 3 |
| 17 | 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 |
| 18 | 抑郁症的非药物治疗:系统性综述与证据图显示文摘背景抑郁症非药物治疗的疗效比较目前仍然不清楚。方法我们对一些系统性综述作了概述,回顾了随机对照试验(RCT),比较抑郁症非药物治疗的有效性和认知行为治疗(CBT)。对多个电子数据库在2016年2月之前发表的所有文献进行了检索,不限制语言。成对的评阅人进行资料纳入、数据提炼并评估偏倚的风险。在适用的时候进行了荟萃分析。结果我们收录了367项RCT,纳入了约2000名患者,进行了11种治疗,导出17项独立的头对头比较。通过标准化的量表评估,发现CBT、自然疗法、行为干预与躯体活动干预可以降低抑郁的严重程度。然而,这些非药物干预的相对疗效仍然缺乏。这些干预对临床缓解和复发的效果不清楚。CBT的发生率比抗抑郁药物更低。局限性由于证据缺乏一致性、证据不清或偏倚风险高,导致证据的质量只是低到中等,限制了我们研究结果的可信度。结论抑郁症的非药物治疗能减少抑郁症状,在轻度到重度抑郁症患者中,应当合并抗抑郁药物治疗,一同进行。对于非药物治疗的选择,应当根据患者的价值观、偏好、临床和社会因素来与患者共同作出决定。 | Wigdan H Farah Mouaz Alsawas Maria Mainou Fares Alahdab Magdoleen H Farah Ahmed T Ahmed Essa A Mohamed Jehad Almasri Michael R Gionfriddo Ana Castaneda-Guarderas Khaled Mohammed Zhen Wang Noor Asi Craig N Sawchuk Mark D Williams Larry J Prokop M Hassan Murad Annie LeBlanc | 2017 | 英国医学杂志中文版2017,20,11: | 2 |
| 19 | Therapeutic drug monitoring in patients with inflammatory bowel disease显示文摘Thiopurine analogs and anti-tumor necrosis factor(TNF)agents have dramatically changed the therapeutics of inflammatory bowel diseases(IBD),improving short and long-term outcomes.Unfortunately some patients do not respond to therapy and others lose response over time.The pharmacokinetic properties of these drugs are complex,with high inter-patient variability.Thiopurine analogs are metabolized through a series of pathways,which vary according to the patients’pharmacogenetic profile.This profile largely determines the ratios of metabolites,which are in turn associated with likelihoods of clinical efficacy and/or toxicity.Understanding these mechanisms allows for manipulation of drug dose,aiming to reduce the development of toxicity while improving the efficacy of treatment.The efficacy of anti-TNF drugs is influenced by many pharmacodynamic variables.Several factors may alter drug clearance,including the concomitant use of immunomodulators(thiopurine analogs and methotrexate),systemic inflammation,the presence of anti-drug antibodies,and body mass.The treatment of IBD has evolved with the understanding of the pharmacologic profiles of immunomodulating and TNF-inhibiting medications,with good evidence for improvement in patient outcomesobserved when measuring metabolic pathway indices.The role of routine measurement of metabolite/drug levels and antibodies warrants further prospective studies as we enter the era of personalized IBD care. | Andres J Yarur Maria T Abreu Amar R Deshpande David H Kerman Daniel A Sussman | 2014 | World Journal of Gastroenterology2014,20,13: | 2 |
| 20 | Safety and efficacy of protease inhibitors to treat hepatitis C after liver transplantation: A multicenter experience显示文摘 | Audrey Coilly Bruno Roche Jér?me Dumortier Vincent Leroy Danielle Botta-Fridlund Sylvie Radenne Georges-Philippe Pageaux Si-Nafaa Si-Ahmed Olivier Guillaud Teresa Maria Antonini Stéphanie Ha?m-Boukobza Anne-Marie Roque-Afonso Didier Samuel Jean-Charles Du | 2014 | Journal of Hepatology2014,,1: | 2 |