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| 1 | Non-alcoholic fatty liver disease and the metabolic syndrome:An update显示文摘Sedentary lifestyle and poor dietary choices are leading to a weight gain epidemic in westernized countries, subsequently increasing the risk for developing the metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). NAFLD is estimated to affect approximate 30% of the general US population and is considered the hepatic manifestation of the metabolic syndrome. Recent findings linking the components of the metabolic syndrome with NAFLD and the progression to nonalcoholic steatohepatitis (NASH) will be reviewed; in particular, the role of visceral adipose tissue, insulin resistance, and adipocytokines in the exacerbation of these conditions. While no therapy has been proven effective for treating NAFLD/NASH, common recommendations will be discussed. | R Scott Rector John P Thyfault Yongzhong Wei Jamal A Ibdah | 2008 | World Journal of Gastroenterology2008，14，2： | 60 |
| 2 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 3 | Current oncologic applications of radiofrequency ablation therapies显示文摘Radiofrequency ablation (RFA) uses high frequency alternating current to heat a volume of tissue around a needle electrode to induce focal coagulative necrosis with minimal injury to surrounding tissues. RFA can be performed via an open, laparoscopic, or image guided percutaneous approach and be performed under general or local anesthesia. Advances in delivery mechanisms, electrode designs, and higher power generators have increased the maximum volume that can be ablated, while maximizing oncological outcomes. In general, RFA is used to control local tumor growth, prevent recurrence, palliate symptoms, and improve survival in a subset of patients that are not candidates for surgical resection. It's equivalence to surgical resection has yet to be proven in large randomized control trials. Currently, the use of RFA has been well described as a primary or adjuvant treatment modality of limited but unresectable hepatocellular carcinoma, liver metastasis, especially colorectal cancer metastases, primary lung tumors, renal cell carcinoma, boney metastasis and osteoid osteomas. The role of RFA in the primary treatment of early stage breast cancer is still evolving. This review will discuss the general features of RFA and outline its role in commonly encountered solid tumors. | Dhruvil R Shah Sari Green Angelina Elliot John P McGahan Vijay P Khatri | 2013 | World Journal of Gastrointestinal Oncology2013，5，4： | 33 |
| 4 | Nonalcoholic fatty liver disease and mitochondrial dysfunction显示文摘Nonalcoholic fatty liver disease (NAFLD) includes hepatic steatosis, nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. NAFLD is the most common liver disorder in the United States and worldwide. Due to the rapid rise of the metabolic syndrome, the prevalence of NAFLD has recently dramatically increased and will continue to increase. NAFLD has also the potential to progress to hepatocellular carcinoma (HCC) or liver failure. NAFLD is strongly linked to caloric overconsumption, physical inactivity, insulin resistance and genetic factors. Although significant progress in understanding the pathogenesis of NAFLD has been achieved in years, the primary metabolic abnormalities leading to lipid accumulation within hepatocytes has remained poorly understood. Mitochondria are critical metabolic organelles serving as 'cellular power plants'. Accumulating evidence indicate that hepatic mitochondrial dysfunction is crucial to the pathogenesis of NAFLD. This review is focused on the significant role of mitochondria in the development of NAFLD. | Yongzhong Wei R Scott Rector John P Thyfault Jamal A Ibdah | 2008 | World Journal of Gastroenterology2008，14，2： | 32 |
| 5 | Osteopontin as potential biomarker and therapeutic target in gastric and liver cancers显示文摘Gastric cancer and liver cancer are among the most common malignancies and the leading causes of death worldwide,due to late detection and high recurrence rates.Today,these cancers have a heavy socioeconomic burden,for which a full understanding of their pathophysiological features is warranted to search for promising biomarkers and therapeutic targets.Osteopontin (OPN) is overexpressed in most patients with gastric and liver cancers.Over the past decade,emerging evidence has revealed a correlation of OPN level and clinicopathological features and prognosis in gastric and liver cancers,indicating its potential as an independent prognostic indicator in such patients.Functional studies have verified the potential of OPN knockdown as a therapeutic approach in vitro and in vivo .Furthermore,OPN mediates multifaceted roles in the interaction between cancer cells and the tumor microenvironment,in which many details need further exploration.OPN signaling results in various functions,including prevention of apoptosis,modulation of angiogenesis,malfunction of tumor-associated macrophages,degradation of extracellular matrix,activation of phosphoinositide 3-kinase-Akt and nuclear factor-κB pathways,which lead to tumor formation and progression,particularly in gastric and liver cancers.This editorial aims to review recent findings on alteration in OPN expression and its clinicopathological associations with tumor progression,its potential as a therapeutic target,and putative mechanisms in gastric and liver cancers.Better understanding of the implications of OPN in tumorigenesis might facilitate development of therapeutic regimens to benefit patients with these deadly malignancies. | Dong-Xing Cao Zhi-Jie Li Xiao-Ou Jiang Yick Liang Lum Ester Khin Nikki P Lee Guo-Hao Wu John M Luk | 2012 | World Journal of Gastroenterology2012，18，30： | 29 |
| 6 | Current management of talar osteochondral lesions显示文摘Osteochondral lesions of the talus(OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation(BMS), or replacement procedures, such as autologous osteochondral transplantation(AOT). Reparative procedures are generally indicated for OLT < 150 mm^2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although shortand medium-term results have been reported, longterm studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures. | Arianna L Gianakos Youichi Yasui Charles P Hannon John G Kennedy | 2017 | World Journal of Orthopedics2017，8，1： | 23 |
| 7 | DSA检查对预测血管性截肢平面的初步研究显示文摘 目的:探讨术前准确确定因下肢动脉缺血需行截肢的平面的方法。方法:回顾性研究澳大利亚Austin医学中心202例病人的232条下肢截肢的DSA资料,建立一个“分数”标准,对下肢远端流出道动脉进行评分,以确定合适的截肢平面。结果:膝上截肢者分数<12分,截肢65条;膝下截肢者分数为12~19分,截肢74条;半足截肢20~25分,截肢66条;截趾>25分,截趾27趾。结论:用此标准可在术前较准确地预测截肢平面。鉴于该标准是建立于回顾性研究基础之上,尚需进行前瞻性研究。 | 谷涌泉 John P Royle | 2001 | 外科理论与实践2001，6，5： | 20 |
| 8 | 内侧固定平台单髁置换术后的冠状面下肢力线是翻修的影响因素显示文摘膝关节单髁置换术(unicompartmental knee arthroplasty,UKA)后患者冠状面的下肢力线被认为是影响手术长期疗效的一个重要因素,但关于最佳的UKA术后下肢力线还没有形成明确共识。一些研究主张术后下肢力线应保持在中立位,而另一些研究认为即使术后下肢力线存在10°的内翻也可获得良好的临床效果。 | Sean E Slaven John P Cody Robert A Sershon Henry Ho Robert H Hopper Jr Kevin B Fricka 李亚坤(整理) 张民(整理) | 2020 | 实用骨科杂志2020，26，12： | 15 |
| 9 | Quantitative Evaluation of Pain with Pain Index Extractecl from Electroencephalogram显示文摘 | Jian-Xiong An Yong Wang Doris K Cope John P Williams | 2017 | Chinese Medical Journal2017，，16： | 13 |
| 10 | China Patient-centered Evaluative Assessment of Cardiac Events Prospective Study of Acute Myocardial Infarction: Study Design显示文摘 | Rachel P Dreyer Xi Li Xue Du Nicholas S Downing Li Li Hai-Bo Zhang Fang Feng Wen-Chi Guan Xiao Xu Shu-Xia Li Zhen-Qiu Lin Frederick A Masoudi John A Spertus Harlan M Krumholz Li-Xin Jiang | 2016 | Chinese Medical Journal2016，，1： | 13 |
| 11 | Ovarian Damages Produced by Aerosolized Fine Particulate Matter (PM2.5) Pollution in Mice: Possible Protective Medications and Mechanisms显示文摘 | Hui-Fang Gai Jian-Xiong An Xiao-Yan Qian Yong-Jie Wei John P Williams Guo-Lan Gao | 2017 | Chinese Medical Journal2017，，12： | 13 |
| 12 | Cyclooxygenase-2 plays a central role in the genesis of pancreatitis and associated lung injury显示文摘BACKGROUND: The exact mechanism by which cyclooxy- genase-2 (COX-2) promotes inflammation in pancreatitis in obscure. This study was undertaken to investigate the role of COX-2 inhibition in an animal model of pancreati- tis , a disease process characterized by a systemic inflamma- tory response and ensuing neutrophil-mediated lung injury. METHODS: Pancreatitis was induced in 24 Sprague-Daw- ley rats by intraperitoneal injection of 20% L-arginine (500 mg/100 g body weight). The animals were randomized into 3 groups (8 rats in each group); controls and rats with pancreatitis intravenously resuscitated with either normal saline (0.9% NaCl 3 ml/kg) at 24 and 48 hours or COX-2 inhibitor (parecoxib 1 mg/kg). Pancreatic and lung inju- ries were assessed histologically. Lung injury was assessed utilizing wet;dry ratio and myeloperoxidase activity to in- dicate pulmonary neutrophil infiltration. A Western blot was used to determine COX-2 protein expression in pancrea- tic tissue. RESULTS: The animals treated with COX-2 inhibitors dis- played significantly less pancreatic and lung injuries than their normal saline counterparts. Histological pancreatic and lung injury scores were significantly reduced (P <0.05) in the COX-2 treated group. Lung wet: dry ratios were sig- nificantly improved and pulmonary neutrophil infiltration was attenuated in the COX-2 group (P<0.05). Western blot analysis confirmed attenuated COX-2 protein expression. CONCLUSION: This study shows, for the first time in a rat model, that adjuvant COX-2 inhibition significandy attenu- ates the severity of both pancreatitis and its associated sys- temic inflammatory response and end-organ injury. | Gavin O'Brien Conor J Shields Desmond C Winter John P Dillon | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，1： | 12 |
| 13 | Uterine Rbpj is required for embryonic-uterine orientation and decidual remodeling via Notch pathway-independent and -dependent mechanisms显示文摘协调的子宫胚胎的轴形成并且蜕膜的改变是哺乳动物的培植以后的胚胎开发的特点。胚胎子宫的取向在起始的培植被决定并且与蜕膜的开发同步。然而,控制这些事件的分子的机制留下尽管有它的发现逃犯很长时间以前。在现在的学习,我们发现了 Rbpj 的那子宫特定的删除,槽口发信号的原子变换器,在培植以后的阶段导致了反常胚胎子宫的取向和蜕膜的 patterning,导致实质的胚胎损失。我们进一步表明在胚胎附件以前, Rbpj 授与在时间上经由身体上与子宫的雌激素受体交往的子宫的腔形状转变(ERα) 以一种槽口小径无关的方式,它为在有子宫的轴的排列的胚胎取向的起始的建立是必要的。当时在培植以后的阶段, Rbpj 直接以一种槽口小径依赖者方式调整子宫的矩阵 metalloproteinase 的表示,它为正常被要求培植以后的蜕膜的改变。这些结果证明子宫的 Rbpj 为经由指示起始的胚胎子宫的取向并且以一种阶段特定的方式保证正常蜕膜的 patterning 的正常胚胎开发是必要的。我们的数据也证实正常哺乳动物的胚胎子宫的取向要求的概念合适的指导从发展地控制了子宫的发信号。 | Shuang Zhang Shuangbo Kong Bingyan Wang Xiaohong Cheng Yongjie Chen Weiwei Wu Qiang Wang Junchao Shi Ying Zhang Shumin Wang Jinhua Lu John P Lydon Francesco DeMayo Warren S Pear Hua Han Haiyan Lin Lei Li Hongmei Wang Yan-ling Wang Bing Li Qi Chen Enkui Duan Haibin Wang | 2014 | Cell Research2014，24，8： | 12 |
| 14 | Dickkopfs and Wnt/β-catenin signalling in liver cancer显示文摘Liver cancer is the fifth and seventh most common cause of cancer in men and women,respectively.Wnt/β-catenin signalling has emerged as a critical player in both the development of normal liver as well as an oncogenic driver in hepatocellular carcinoma(HCC).Based on the current understanding,this article summarizes the possible mechanisms for the aberrant activation of this pathway with specific focus on HCC.Furthermore,we will discuss the role of dickkopfs(DKKs)in regulating Wnt/β-catenin signalling,which is poorly understood and understudied.DKKs are a family of secreted proteins that comprise at least four members,namely DKK1-DKK4,which act as inhibitors of Wnt/β-catenin signalling.Nevertheless,not all members antagonize Wnt/β-catenin signalling.Their functional significance in hepatocarcinogenesis remains to be further characterized for which these studies should provide new insights into the regulatory role of DKKs in Wnt/β-catenin signalling in hepatic carcinogenesis.Because of the important oncogenic roles,there are an increasing number of therapeutic molecules targetingβ-catenin and the Wnt/β-catenin pathway for potential therapy of HCC. | Sarwat Fatima Nikki P Lee John M Luk | 2011 | World Journal of Clinical Oncology2011，2，8： | 11 |
| 15 | Prospective randomized controlled trial evaluating cap-assisted colonoscopy vs standard colonoscopy显示文摘AIM: To study the significance of cap-fitted colonoscopy in improving cecal intubation time and polyp detection rate. METHODS: This study was a prospective randomized controlled trial conducted from March 2008 to February 2009 in a tertiary referral hospital at Sydney. The primary end point was cecal intubation time and the secondary endpoint was polyp detection rate. Consecutive cases of total colonoscopy over a 1-year period were recruited. Randomization into either standard colonoscopy (SC) or cap-assisted colonoscopy (CAC) was performed after consent was obtained. For cases randomized to CAC, one of the three sizes of cap was used: D-201-15004 (with a diameter of 15.3 mm), D-201-14304 (14.6 mm) and D-201-12704 (13.0 mm). All of these caps were produced by Olympus Medical Systems, Japan. Independent predictors for faster cecal time and better polyp detection rate were also determined from this study. RESULTS: There were 200 cases in each group. There was no signif icant difference in terms of demographic characteristics between the two groups. CAC, when compared to the SC group, had no signif icant difference in terms of cecal intubation rate (96.0% vs 97.0%, P = 0.40) and time (9.94 ± 7.05 min vs 10.34 ± 6.82 min, P = 0.21), or polyp detection rate (32.8% vs 31.3%, P = 0.75). On the subgroup analysis, there was no significant difference in terms of cecal intubation time by trainees (88.1% vs 84.8%, P = 0.40), ileal intubation rate (82.5% vs 79.0%, P = 0.38) or total colonoscopy time (23.24 ± 13.95 min vs 22.56 ± 9.94 min, P = 0.88). On multivariate analysis, the independent determinants of faster cecal time were consultant-performed procedures (P < 0.001), male patients (P < 0.001), non-usage of hyoscine (P < 0.001) and better bowel preparation (P = 0.01). The determinants of better polyp detection rate were older age (P < 0.001), no history of previous abdominal surgery (P = 0.04), patients not having esophagogastroduodenoscopy in the same setting (P = 0.003), trainee-performed procedures (P = 0.01), usage of hyoscine (P = 0.01) and procedures performed for polyp follow-up (P = 0.01). The limitations of the study were that it was a single-center experience, no blinding was possible, and there were a large number of endoscopists. CONCLUSION: CAC did not signif icantly different from SC in term of cecal intubation time and polyp detection rate. | Hoi-Poh Tee Crispin Corte Hamdan Al-Ghamdi Emilia Prakoso John Darke Raman Chettiar Wassim Rahman Scott Davison Sean P Griffin Warwick S Selby Arthur J Kaffes | 2010 | World Journal of Gastroenterology2010，16，31： | 10 |
| 16 | Effects of anisotropy on time-depth relation in transversely isotropic medium with a vertical axis of symmetry显示文摘It is known that rock anisotropy can significantly influence the phase and energy velocities of an elastic wave,as well as its reflection/transmission(R/T)coefficients.As a result,it can distort the velocity analysis of seismic-reflection data.In this work we present a velocity analysis for seismic-reflection data based on the available anisotropic rock parameters.We analyzed the created errors on time-depth relation of the seismic-reflection data in neglecting rock anisotropy and/or neglecting the difference between energy velocity and phase velocity,including the case of wide-angle reflection.The calculated results show that the effect of rock anisotropy on time-depth relation of seismic-reflection data is dependent not only on the values of anisotropic parameters,but also on the space arrangement of both source and receiver-array.For all studied cases(weak,moderate or strong anisotropy),we found that the effect of rock anisotropy on time-depth relation could not be neglected.Nevertheless,for the case of weak anisotropy,the energy velocity may be replaceable by the phase velocity to obtain a very good approximation on time-depth relation.Consequently,the seismic-reflection data processing algorithm for numerical computations can be simplified. | FA Lin CASTAGNA John P ZENG ZhengWen BROWN Ray L ZHAO MeiShan | 2010 | Chinese Science Bulletin2010，55，21： | 9 |
| 17 | 多模式睡眠:慢性失眠的创新疗法显示文摘麻醉术不仅能保障手术无痛,在其发展过程中所产生的新发明和新理念如血库的建立、心肺复苏术的发明和推广、疼痛诊疗的普及等,还为人类健康做出了更多的重大贡献。被誉为'疼痛医学之父'的Bonica教授和'心肺复苏术之父'的Safar教授早已跨越时空和国界,成为全世界麻醉医师的骄傲。把麻醉技术用于失眠治疗一直是有远见的麻醉医务工作者探索的热点。美国著名麻醉学家、发明家和教育家Ralph Waters(1883—1979)教授,也是我国麻醉学科奠基者之一吴珏教授的导师,在1927年被聘任为世界首位麻醉学教授的仪式上,威斯康新大学校长幽默地称赞:Waters是大学聘任的第一位能让人睡觉的教授。事实上时至今日,即使最发达国家的公众,对一位麻醉医师的理解,也是能让人睡觉的人,这种现象揭示了公众对失眠问题的深刻认知和关注。据统计我国目前约有3.3亿人患有不同程度的失眠,其治疗是当今世界的医学难题。安建雄教授领衔的科研团队经过近10年的探索,率先提出并践行以病人自控睡眠为主导的多模式睡眠疗法,尽管在推广和广泛临床应用之前,还需要更多的研究和科学证据,但这种尝试不仅可以丰富麻醉学科内涵,还为严重失眠病人带来新的治疗选择。 | 安建雄 张建峰 赵倩男 张文浩 刘辉 钱晓焱 刘颖 王永 方七五 Williams John P | 2020 | 中华麻醉学杂志2020，40，5： | 9 |
| 18 | Redox therapeutics in hepatic ischemia reperfusion injury显示文摘Ischemia-reperfusion plays a major role in the injury experienced by the liver during transplantation. Much work has been done recently investigating the role of redox species in hepatic ischemia-reperfusion. As animal models are better characterized and developed, and more insights are gained into the pathophysiology of hepatic ischemia reperfusion injury in humans the questions into exactly how oxidants participate in this injury are becoming more refined. These questions include effects of cellular location, timing of injury, and ability of therapeutics to access this site are increasing our appreciation of the complexity of ischemia reperfusion and improving attempts to ameliorate its effects. In this review, we aim to discuss the various methods to alter redox chemistry during ischemia reperfusion injury and future prospects for preventing organ injury during hepatic ischemia reperfusion. | Rakesh P Patel John D Lang Alvin B Smith Jack H Crawford | 2014 | World Journal of Hepatology2014，6，1： | 9 |
| 19 | Establishing proof of concept:Platelet-rich plasma and bone marrow aspirate concentrate may improve cartilage repair following surgical treatment for osteochondral lesions of the talus显示文摘Osteochondral lesions of the talus are common injuries in the athletic patient. They present a challenging clinical problem as cartilage has a poor potential for healing. Current surgical treatments consist of reparative(microfracture) or replacement(autologous osteochondral graft) strategies and demonstrate good clinical outcomes at the short and medium term follow-up. Radiological findings and second-look arthroscopy however, indicate possible poor cartilage repair with evidence of fibrous infill and fissuring of the regenerative tissue following microfracture. Longer-term follow-up echoes these findings as it demonstrates a decline in clinical outcome. The nature of the cartilage repair that occurs for an osteochondral graft to become integrated with the native surround tissue is also of concern. Studies have shown evidence of poor cartilage integration,with chondrocyte death at the periphery of the graft, possibly causing cyst formation due to synovial fluid ingress. Biological adjuncts, in the form of platelet-rich plasma(PRP) and bone marrow aspirate concentrate(BMAC), have been investigated with regard to their potential in improving cartilage repair in both in vitro and in vitro settings. The in vitro literature indicates that these biological adjuncts may increase chondrocyte proliferation as well as synthetic capability, while limiting the catabolic effects of an inflammatory joint environment. These findings have been extrapolated to in vitro animal models, with results showing that both PRP and BMAC improve cartilage repair. The basic science literature therefore establishes the proof of concept that biological adjuncts may improve cartilage repair when used in conjunction with reparative and replacement treatment strategies for osteochondral lesions of the talus. | Niall A Smyth Christopher D Murawski Amgad M Haleem Charles P Hannon Ian Savage-Elliott John G Kennedy | 2012 | World Journal of Orthopedics2012，3，7： | 8 |
| 20 | Vanishing bile duct syndrome in human immunodeficiency virus infected adults:A report of two cases显示文摘Vanishing bile duct syndrome(VBDS) is a group of rare disorders characterized by ductopenia,the progressive destruction and disappearance of intrahepatic bile ducts leading to cholestasis.Described in association with medications,autoimmune disorders,cancer,transplantation,and infections,the specific mechanisms of disease are not known.To date,only 4 cases of VBDS have been reported in human immunodeficiency virus(HIV) infected patients.We report 2 additional cases of HIV-associated VBDS and review the features common to the HIV-associated cases.Presentation includes hyperbilirubinemia,normal liver imaging,and negative viral and autoimmune hepatitis studies.In HIV-infected subjects,VBDS occurred at a range of CD4+ T-cell counts,in some cases following initiation or change in antiretroviral therapy.Lymphoma was associated with two cases;nevirapine,antibiotics,and viral co-infection were suggested as etiologies in the other cases.In HIV-positive patients with progressive cholestasis,early identification of VBDS and referral for transplantation may improve outcomes. | Ana Paula Oppenheimer Christopher Koh Mary McLaughlin John C Williamson Thomas D Norton Jennifer Laudadio Theo Heller David E Kleiner Kevin P High Caryn G Morse | 2013 | World Journal of Gastroenterology2013，19，1： | 8 |
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