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| 1 | Pathogenesis and clinical management of Helicobacter pylori gastric infection显示文摘Helicobacter pylori(H.pylori)is a gram-negative bacterium that infects approximately 4.4 billion individuals worldwide.However,its prevalence varies among different geographic areas,and is influenced by several factors.The infection can be acquired by means of oral-oral or fecal-oral transmission,and the pathogen possesses various mechanisms that improve its capacity of mobility,adherence and manipulation of the gastric microenvironment,making possible the colonization of an organ with a highly acidic lumen.In addition,H.pylori presents a large variety of virulence factors that improve its pathogenicity,of which we highlight cytotoxin associated antigen A,vacuolating cytotoxin,duodenal ulcer promoting gene A protein,outer inflammatory protein and gamma-glutamyl transpeptidase.The host immune system,mainly by means of a Th1-polarized response,also plays a crucial role in the infection course.Although most H.pylori-positive individuals remain asymptomatic,the infection predisposes the development of various clinical conditions as peptic ulcers,gastric adenocarcinomas and mucosa-associated lymphoid tissue lymphomas.Invasive and non-invasive diagnostic methods,each of them with their related advantages and limitations,have been applied in H.pylori detection.Moreover,bacterial resistance to antimicrobial therapy is a major challenge in the treatment of this infection,and new therapy alternatives are being tested to improve H.pylori eradication.Last but not least,the development of effective vaccines against H.pylori infection have been the aim of several research studies. | Breno Bittencourt de Brito Filipe Ant?nio Fran?a da Silva Aline Silva Soares Vinícius Afonso Pereira Maria Luísa Cordeiro Santos Mariana Miranda Sampaio Pedro Henrique Moreira Neves Fabrício Freire de Melo | 2019 | World Journal of Gastroenterology2019，25，37： | 84 |
| 2 | Triglyceride levels and apolipoprotein E polymorphism in patients with acute pancreatitis显示文摘BACKGROUND:Hypertriglyceridemia is an unusual cause of acute pancreatitis and sometimes considered to be an epiphenomenon.This study aimed to investigate the clinical and analytical features and the APOE genotypes in patients with acute pancreatitis and severe hypertriglyceridemia.METHODS:We undertook a one-year,prospective study of patients with acute pancreatitis whose first laboratory analysis on admission to the emergency department included measurement of serum triglycerides.The APOE genotype was determined and the patients answered an established questionnaire within the first 24 hours concerning their alcohol consumption,the presence of co-morbidities and any medications being taken.The patients' progression,etiological diagnosis,hospital stay and clinical and radiological severity were all recorded.RESULTS:Hypertriglyceridemia was responsible for 7 of 133 cases of pancreatitis (5%);the remaining cases were of biliary (53%),idiopathic (26%),alcoholic (11%) or other (5%) origin.Compared with these remaining cases,the patients with hypertriglyceridemia were significantly younger,had more relapses,and more often had diabetes mellitus.They usually consumed alcohol or consumed it excessively on the days before admission.Also,the ε4 allele of the APOE gene was more common in this group (P<0.05).CONCLUSION:One of 20 episodes of acute pancreatitis is caused by hypertriglyceridemia and it is linked to genetic (ε4 allele) and comorbid factors such as diabetes and,especially,alcohol consumption. | Radka Ivanova Susana Puerta Alfonso Garrido Ignacio Cueto Ana Ferro María José Ariza Andrés Cobos Pedro González-Santos Pedro Valdivielso | 2012 | Hepatobiliary & Pancreatic Diseases International2012，11，1： | 26 |
| 3 | Factors predicting poor prognosis in ischemic colitis显示文摘瞄准:决定临床、分析、内视镜的因素与有关是化学家大肠炎(IC ) 严厉。方法:85 个病人的一个总数从 1996 年 1 月在回顾的研究被注册到 2004 年 5 月。有 53 女性和 32 男性(年龄 74.6+/-9.4 年,范围 45-89 年) 。病人作为 IC 被诊断。下列变量包括年龄,性别,从到承认的症状的外观的时间的经期,病历,药,凳子频率,临床的症状和症状被分析,验血(血克和基本生物化学的侧面) ,和内视镜的调查结果。病人们在温和 IC 组和严重 IC 组(外科或死亡) 被划分。质的变量用 chi 平方测试被分析,参量的数据用学生的 t (P<0.05 ) 被分析。结果:温和 IC 组 69 个病人被在于(42 女性和 27 男性,平均年龄 74.7+/-12.4 年) 。严重 IC 组由 16 个病人组成(11 女性和 5 男性,平均 73.8+/-12.4 年的年龄) 。因为麦克匪特斯氏疗法(没有外科) 的失败,一个病人死了, 15 个病人经历了外科(6 在内视镜的诊断以后并且 9 在 peroperatory 以后诊断) 。85 个病人(9.6%) 中的八个死了,其它被跟随在上面作为为 9.6+/-3.5 瞬间的门诊病人。人口统计的数据,病历,药和凳子频率在两个组(P>0.05 ) 是类似的。说正经的有病的病人比稍微有病的病人有更少的便血(37.5% 对 86.9% , P = 0.000 ) 。更多的心悸亢进(45.4% 对 10.1% , P = 0.011 ) 并且假腹膜炎的更高的流行签名(75% 对 5.7% , P = 0.000 ) 当腹的疼痛的存在和紧张在二个组之间是类似的时,在严重 IC 组被观察。当承认时,有严重 IC 的二个病人有吃惊。关于分析数据,更严重有病的病人被发现比略微有病的病人有贫血症和血钠过少(37.5% 对 10.1% , P = 0.014 和 46.6% 对 14.9% , P = 0.012,分别地) 。狭窄是那比在稍微有病的病人更经常出现在严重有病的病人的唯一的内视镜的发现(66.6% 对 17.3% , P = 0.017 ) 。结论:能预言 IC 的差的预后是便血,心悸亢进和假腹膜炎,贫血症和血钠过少和狭窄的缺席的因素。 | Ramón A■ón Marta Maia Boscá Vicente Sanchiz Joan Tosca Pedro Almela Cirilo Amorós Adolfo Benages | 2006 | World Journal of Gastroenterology2006，12，30： | 21 |
| 4 | Efficacy of neoadjuvant therapy and surgical rescue for locally advanced hepatoblastomas:10 year single-center experience and literature review显示文摘AIM:To report our experience with long-term outcomes after multimodal management therapy.METHODS:An observational retrospective study was performed containing seven patients with hepatoblastoma(Hbl)treated in our institution,a tertiary referral center,from 2003 to 2011.Demographic,preoperative,surgical,and outcome variables were collected.A survival analysis and a review of the current literature related to combination neoadjuvant chemotherapy and surgical resection on Hbl were performed.RESULTS:The median age at surgery was 14.4 mo,with a male to female ratio of 4:3.Pretext staging at diagnosis was as follows:stageⅠ,4 cases;stageⅡ,2 patients;and stageⅢ,1 case.Mean pretreatment tumor volume was 735 cm3.Five out of seven patients received neoadjuvant chemotherapy according to SIOPEL-3 or SIOPEL-6 protocols.Tumor volume and alphafetoprotein levels significantly dropped after neoadjuvant therapy.Surgical procedures performed included hemihepatectomies,segmentectomies and atypical resection.All patients received chemotherapy after surgery.Median postoperative hospital stay was 8 d.All patients were alive and disease-free after a median follow-up period of 23 mo.With regards to the literature review,seventeen articles were found that were related to our search.CONCLUSION:Our series shows how multimodal management of Hbl,exhaustive control and a meticulous surgical approach leads to almost 100%complete resection with optimal postoperative results. | Dolores Ayllon Teran Oscar Gómez Beltran Rubén Ciria Bru Elena Mateos González María José Pea Rosa Antonio Luque Molina Pedro López Cillero Javier Briceo Delgado | 2014 | World Journal of Gastroenterology2014，20，29： | 12 |
| 5 | Myocardial infarction with non-obstructive coronary arteries: A comprehensive review and future research directions显示文摘Acute coronary syndromes constitute a variety of myocardial injury presentations that include a subset of patients presenting with myocardial infarction with non-obstructive coronary arteries(MINOCA).This acute coronary syndrome differs from type 1 myocardial infarction(MI)regarding patient characteristics,presentation,physiopathology,management,treatment,and prognosis.Two-thirds of MINOCA subjects present ST-segment elevation;MINOCA patients are younger,are more often female and tend to have fewer cardiovascular risk factors.Moreover,MINOCA is a working diagnosis,and defining the aetiologic mechanism is relevant because it affects patient care and prognosis.In the absence of relevant coronary artery disease,myocardial ischaemia might be triggered by an acute event in epicardial coronary arteries,coronary microcirculation,or both.Epicardial causes of MINOCA include coronary plaque disruption,coronary dissection,and coronary spasm.Microvascular MINOCA mechanisms involve microvascular coronary spasm,takotsubo syndrome(TTS),myocarditis,and coronary thromboembolism.Coronary angiography with non-significant coronary stenosis and left ventriculography are first-line tests in the differential study of MINOCA patients.The diagnostic arsenal includes invasive and non-invasive techniques.Medical history and echocardiography can help indicate vasospasm or thrombosis,if one finite coronary territory is affected,or specify TTS if apical ballooning is present.Intravascular ultrasound,optical coherence tomography,and provocative testing are encouraged.Cardiac magnetic resonance is a cornerstone in myocarditis diagnosis.MINOCA is not a benign diagnosis,and its polymorphic forms differ in prognosis.MINOCA care varies across centres,and future multi-centre clinical trials with standardized criteria may have a positive impact on defining optimal cardiovascular care for MINOCA patients. | Rafael Vidal-Perez Charigan Abou Jokh Casas Rosa Maria Agra-Bermejo Belén Alvarez-Alvarez Julia Grapsa Ricardo Fontes-Carvalho Pedro Rigueiro Veloso Jose Maria Garcia Acuña Jose Ramon Gonzalez-Juanatey | 2019 | World Journal of Cardiology2019，11，12： | 6 |
| 6 | 利拉鲁肽与格列美脲在单药治疗2型糖尿病中的比较(LEAD-3 Mono):一项随机、双盲、平行分组、52周的Ⅲ期临床试验显示文摘背景 2型糖尿病新的治疗策略,需要针对胰岛素-葡萄糖的相互作用,且同时要降低体重增加和发生低血糖的风险。本文作者旨在调查利拉鲁肽单药治疗2型糖尿病的安全性与有效性。
方法 采用双盲、双模拟、治疗一对照、平行分组的研究,746例早期2型糖尿病患者被随机分配到1次/d利拉鲁肽组[1.2mg(n=251)或1.8mg(n=247)]或格列美脲8mg组(n=248),分别治疗52周。主要结局指标为糖化血红蛋白(HbA1c)的改变程度。采用意向性治疗进行分析。该试验在ClinicalTrials.gov网站的注册编码为NTC00294723.
结果52周时,格列美脲组HbA,。下降了0.51%(s=1.20),而利拉鲁肽1.2mg组下降了0.84%(s=1.23)(差值为-0.33.95%CI-0.53~-0.13;P=0.0014),利拉鲁肽1.8mg组下降了1.14%(S=1.24)(差值为-062,95%CI-0.83—-0.42;P〈0.0001)。利拉鲁肽1.2mg组和1.8mg组各有5例和1例患者因呕吐停止治疗,而格列美脲组未出现这种情况。
结论 利拉鲁肽作为2型糖尿病的初始治疗药物安全有效,与格列美脲相比更能降低HbA1c以及体重、血压和低血糖的发生率。 | Alan Garber Robert Henry Robert Rather Pedro A Garcia-Hernandez Hiromi Rodriguez-Pattzi Israel Olvero-Alvarez Paula M Hale, Milan Zdravkovic Bruce Bode 邓斌(译) | 2009 | 世界临床医学2009，，6： | 5 |
| 7 | Less common etiologies of exocrine pancreatic insufficiency显示文摘Exocrine pancreatic insufficiency(EPI), an important cause of maldigestion and malabsorption, results from primary pancreatic diseases or secondarily impaired exocrine pancreatic function. Besides cystic fibrosis and chronic pancreatitis, the most common etiologies of EPI, other causes of EPI include unresectable pancreatic cancer, metabolic diseases(diabetes); impaired hormonal stimulation of exocrine pancreatic secretion by cholecystokinin(CCK); celiac or inflammatory bowel disease(IBD) due to loss of intestinal brush border proteins; and gastrointestinal surgery(asynchrony between motor and secretory functions, impaired enteropancreatic feedback, and inadequate mixing of pancreatic secretions with food). This paper reviews such conditions that have less straightforward associations with EPI and examines the role of pancreatic enzyme replacement therapy(PERT). Relevant literature was identified by database searches. Most patients with inoperable pancreatic cancer develop EPI(66%-92%). EPI occurs in patients with type 1(26%-57%) or type 2 diabetes(20%-36%) and is typically mild to moderate; by definition, all patients with type 3 c(pancreatogenic) diabetes have EPI. EPI occurs in untreated celiac disease(4%-80%), but typically resolves on a gluten-free diet. EPI manifests in patients with IBD(14%-74%) and up to 100% of gastrointestinal surgery patients(47%-100%; dependent on surgical site). With the paucity of published studies on PERT use for these conditions, recommendations for or against PERT use remain ambiguous. The authors conclude that there is an urgent need to conduct robust clinical studies to understand the validity and nature of associations between EPI and medical conditions beyond those with proven mechanisms, and examine the potential role for PERT. | Vikesh K Singh Mark E Haupt David E Geller Jerry A Hall Pedro M Quintana Diez | 2017 | World Journal of Gastroenterology2017，23，39： | 5 |
| 8 | Glycoprotein biomarkers for the detection of pancreatic ductal adenocarcinoma显示文摘Pancreatic cancer(Pa C) shows a clear tendency to increase in the next years and therefore represents an important health and social challenge. Currently, there is an important need to find biomarkers for PaC early detection because the existing ones are not useful for that purpose. Recent studies have indicated that there is a large window of time for PaC early detection, which opens the possibility to find early biomarkers that could greatly improve the dismal prognosis of this tumor. The present manuscript reviews the state of the art of the existing PaC biomarkers. It focuses on the anomalous glycosylation process and its role in PaC. Glycan structures of glycoconjugates such as glycoproteins are modified in tumors and these modifications can be detected in biological fluids of the cancer patients. Several studies have found serum glycoproteins with altered glycan chains in PaC patients, but they have not shown enough specificity for PaC. To find more specific cancer glycoproteins we propose to analyze the glycan moieties of a battery of glycoproteins that have been reported to increase in PaC tissues and that can also be found in serum. The combination of these new candidate glycoproteins with their aberrant glycosylation together with the existing biomarkers could result in a panel, which would expect to give better results as a new tool for early diagnosis of PaC and to monitor the disease. | Esther Llop Pedro E Guerrero AdriàDuran Sílvia Barrabés Anna Massaguer María JoséFerri Maite Albiol-Quer Rafael de Llorens Rosa Peracaula | 2018 | World Journal of Gastroenterology2018，24，24： | 4 |
| 9 | 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 |
| 10 | Recombinant streptokinase vs phenylephrine-based suppositories in acute hemorrhoids, randomized, controlled trial(THERESA-3)显示文摘AIM: To compare the efficacy and safety of recombinant streptokinase(rSK) and phenylephrine-based suppositories in acute hemorrhoidal disease.METHODS: A multicenter(14 sites), randomized(1:1), open, parallel groups, active controlled trial was done. After inclusion, subjects with acute symptoms of hemorrhoids, who gave their written, informed consent to participate, were centrally randomized to receive, as outpatients, rSK(200000 IU) or 0.25% phenylephrine suppositories, which had different organoleptic characteristics. Treatment was administered by the rectal route, one unit every 6 h during 48 h for rSK, and up to a maximum of 5 d(20 suppositories) for phenylephrine. Evaluations were performed at 3, 5 and 10 d postinclusion. The main end-point was the 5th-day complete clinical response(disappearance of pain and edema, and ≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were evaluated too. RESULTS: 5thday complete response rates were 83/110(75.5%) and 36/110(32.7%) with rSK and phenylephrine suppositories, respectively. This 42.7% difference(95%CI: 30.5-54.2) was highly significant(P < 0.001). The advantage was detected since the early 3rdday evaluation(37.3% vs 6.4% for the rSK and active control groups, respectively; P < 0.001) and was kept even at the late 10thday assessment(83.6% vs 58.2% for rSK and phenylephrine, respectively; P < 0.001). Time for complete response was significantly shorter(P = 0.031; log-rank test) in the rSK group(median: 4.9 d; 95%CI: 4.8-5.0) with respect to the active control(median: 9.8 d; 95%CI: 9.8-10.0). Thrombectomy was necessary in 1/59 and 8/57 patients with baseline thrombosis in the rSK and phenylephrine groups, respectively(P = 0.016). There were no adverse events attributable to the experimental treatment. CONCLUSION: rSK suppositories showed a significant advantage over a widely used over-the-counter phen-ylephrine preparation for the treatment of acute hemorrhoidal illness, with an adequate safety profile. | Francisco Hernández-Bernal Georgina Castellanos-Sierra Carmen M Valenzuela-Silva Karem M Catasús-lvarez Roselin Valle-Cabrera Ana Aguilera-Barreto Pedro A López-Saura | 2014 | World Journal of Gastroenterology2014，20，6： | 4 |
| 11 | Solid phase microextraction chemical biopsy tool for monitoring of doxorubicin residue during in vivo lung chemo-perfusion显示文摘Development of a novel in vivo lung perfusion(IVLP)procedure allows localized delivery of high-dose doxorubicin(DOX)for targeting residual micrometastatic disease in the lungs.However,DOX delivery via IVLP requires careful monitoring of drug level to ensure tissue concentrations of this agent remain in the therapeutic window.A small dimension nitinol wire coated with a sorbent of biocompatible morphology(Bio-SPME)has been clinically evaluated for in vivo lung tissue extraction and determination of DOX and its key metabolites.The in vivo Bio-SPME-IVLP experiments were performed on pig model over various(150 and 225 mg/m^(2))drug doses,and during human clinical trial.Two patients with metastatic osteosarcoma were treated with a single 5 and 7 μg/mL(respectively)dose of DOX during a 3-h IVLP.In both pig and human cases,DOX tissue levels presented similar trends during IVLP.Human lung tissue concentrations of drug ranged between 15 and 293 μg/g over the course of the IVLP procedure.In addition to DOX levels,Bio-SPME followed by liquid chromatography-mass spectrometry analysis generated 64 metabolic features during endogenous metabolite screening,providing information about lung status during drug administration.Real-time monitoring of DOX levels in the lungs can be performed effectively throughout the IVLP procedure by in vivo Bio-SPME chemical biopsy approach.Bio-SPME also extracted various endogenous molecules,thus providing a real-time snapshot of the physiology of the cells,which might assist in the tailoring of personalized treatment strategy. | Barbara Bojko Nikita Looby Mariola Olkowicz Anna Roszkowska Bogumiła Kupcewicz Pedro Reck dos Santos Khaled Ramadan Shaf Keshavjee Thomas K.Waddell German Goomez-Rios Marcos Tascon Krzysztof Gorynski Marcelo Cypel Janusz Pawliszyn | 2021 | Journal of Pharmaceutical Analysis2021，11，1： | 3 |
| 12 | Second-look surgery plus hyperthermic intraperitoneal chemotherapy for patients with colorectal cancer at high risk of peritoneal carcinomatosis:Does it really save lives?显示文摘The treatment of peritoneal carcinomatosis (PC) of colorectal origin with cytoreductive surgery(CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) has a 5-year recurrence-free or cure rate of at least 16%, so it is no longer labeled as a fatal disease, and offers prolonged survival for patients with a low peritoneal carcinomatosis index. Metachronous PC of colorectal origin is so predictable that there is a model which has been used to successfully determine the individual risk of each patient. Patients at risk are clearly identified; those with the highest risk have small peritoneal nodules present in the first surgery (70% probability of developing PC), ovarian metastases(60%), perforated tumor onset or intraoperative tumor rupture(50%). Current clinical, biological and imaging techniques still lack sufficient sensitivity to diagnose PC in its initial stages, when CRS plus HIPEC has a greater impact and a higher cure rate. Second-look surgery with HIPEC or prophylactic HIPEC at the time of the first intervention have been proposed as means of preventing and/or anticipating clinical or radiological relapse in at-risk patients. Both techniques have shown a significant decrease in peritoneal relapses and should be considered essential weapons in the management of colorectal cancer. | Delia Cortes-Guiral Dominique Elias Pedro Antonio Cascales-Campos Alfredo Badía Yébenes Ismael Guijo Castellano Ana Isabel León Carbonero JoséIgnacio Martín Valadés Jesus Garcia-Foncillas Damian Garcia-Olmo | 2017 | World Journal of Gastroenterology2017，23，3： | 3 |
| 13 | Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram:A comparison of shockable and non-shockable initial rhythms显示文摘AIM To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic electrocardiogram.METHODS From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnostic post-resuscitation electrocardiogram(defined as ST segment elevation or pre-sumably new left bundle branch block) whounderwent invasive coronary angiogram during hospitalization were included. For purpose of analysis and comparison, patients were classified in two groups: Initial shockable rhythm(ventricular tachycardia or ventricular fibrillation; n = 148, 72.9%) and initial non-shockable rhythm(n = 55, 27.1%). Baseline characteristics, coronary angiogram findings including Syntax Score and long-term survival rates were compared. RESULTS Sudden cardiac arrest was witnessed in 95.2% of cases, 66.7% were out-of-hospital patients and 72.4% were male. There were no significant differences in baseline characteristics between groups except for higher mean age(68.1 years vs 61 years, P = 0.001) in the nonshockable rhythm group. Overall 5-year mortality of the resuscitated patients was 37.4%. Patients with non-shockable rhythms had higher mortality(60% vs 29.1%, P < 0.001) and a worst neurological status at hospital discharge based on cerebral performance category score(CPC 1-2: 32.7% vs 53.4%, P = 0.02). Although there were no significant differences in global burden of coronary artery disease defined by Syntax Score(mean Syntax Score: 10.2 vs 10.3, P = 0.96) there was a trend towards a higher incidence of acute coronary lesions in patients with shockable rhythm(29.7% vs 16.4%, P = 0.054). There was also a higher need for ad-hoc percutaneous coronary intervention in this group(21.9% vs 9.1%, P = 0.03). CONCLUSION Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs nonshockable group. | Pedro Martínez-Losas Pablo Salinas Carlos Ferrera María Teresa Nogales-Romo Francisco Noriega María Del Trigo Iván Javier Núnez-Gil Luis Nombela-Franco Nieves Gonzalo Pilar Jiménez-Quevedo Javier Escaned Antonio Fernández-Ortiz Carlos Macaya Ana Viana-Tejedor | 2017 | World Journal of Cardiology2017，9，8： | 3 |
| 14 | Liraglutide versus glimepiride monotherapy for type 2 diabetes (LEAD-3 Mono): a randomised, 52-week, phase III, double-blind, parallel-treatment trial显示文摘 | Alan Garber Robert Henry Robert Ratner Pedro A Garcia-Hernandez Hiromi Rodriguez-Pattzi Israel Olvera-Alvarez Paula M Hale Milan Zdravkovic Bruce Bode | 2009 | The Lancet2009，，9662： | 2 |
| 15 | CD4+ T cells and natural killer cells: Biomarkers for hepatic fibrosis in human immunodeficiency virus/hepatitis C virus-coinfected patients显示文摘AIM To characterize peripheral blood natural killer(NK) cells phenotypes by flow cytometry as potential biomarker of liver fibrosis in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) coinfected patients.METHODS Peripheral mononuclear cells from 24 HIV/HCV(HBVnegative) coinfected and 5 HIV/HCV/HBV seronegative individuals were evaluated. HIV/HCV coinfected patients were divided in to groups: G1, patients with METAVIR F0-F2 and G2, patients with METAVIR F3-F4. NK surface cell staining was performed with: AntiCD3(APC/Cy7), anti-CD56(PE/Cy5), anti-CD57(APC), anti-CD25(PE), anti-CD69(FITC), anti-NKp30(PE), antiNKp46(PE/Cy7), anti-NKG2D(APC), anti-DNAM(FITC); anti-CD62L(PE/Cy7), anti-CCR7(PE), anti-TRAIL(PE), anti-Fas L(PE), anti CD94(FITC). Flow cytometry data acquisition was performed on BD FACSCanto, analyzed using Flow Jo software. Frequency of fluorescence was analyzed for all single markers. Clinical records were reviewed, and epidemiological and clinical data were obtained.RESULTS Samples from 11 patients were included in G1 and from 13 in G2. All patients were on ARV, with undetectable HIV viral load. Liver fibrosis was evaluated by transient elastography in 90% of the patients and with biopsy in 10% of the patients. Mean HCV viral load was(6.18 ± 0.7 log10). Even though, no major significant differences were observed between G1 and G2 regarding NK surface markers, it was found that patients with higher liver fibrosis presented statistically lower percentage of NK cells than individual with low to mild fibrosis and healthy controls(G2: 5.4% ± 2.3%, G1: 12.6% ± 8.2%, P = 0.002 and healthy controls 12.2% ± 2.7%, P = 0.008). It was also found that individuals with higher liver fibrosis presented lower CD4 LT count than those from G1(G2: 521 ± 312 cells/μL, G1: 770 ± 205 cells/μL; P = 0.035).CONCLUSION Higher levels of liver fibrosis were associated with lower percentage of NK cells and LTCD4+ count; and they may serve as noninvasive biomarkers of liver damage. | Natalia Laufer Diego Ojeda María Laura Polo Ana Martinez Héctor Pérez Gabriela Turk Pedro Cahn Norberto Walter Zwirner Jorge Quarleri | 2017 | World Journal of Hepatology2017，9，25： | 2 |
| 16 | Recombinant streptokinase vs hydrocortisone suppositories in acute hemorrhoids:A randomized controlled trial显示文摘AIM: To compare the efficacy and safety of recombinant streptokinase(rSK) vs hydrocortisone acetate-based suppositories in acute hemorrhoidal disease.METHODS: A multicenter(11 sites), randomized(1:1:1), open, controlled trial with parallel groups was performed. All participating patients gave their written,informed consent. After inclusion, patients with acute symptoms of hemorrhoids were centrally randomized to receive, as outpatients, by the rectal route, suppositories of rSK 200000 IU of one unit every 8 h(first 3 units)and afterwards every 12 h until 8 administrations were completed(schedule A), one unit every 8 h until 6 units were completed(schedule B), or 25 mg hydrocortisone acetate once every 8 h up to a maximum of 24 administrations. Evaluations were performed at 3, 5,and 10 d post-inclusion. The main end-point was the 5thday response(disappearance of pain and bleeding, and≥ 70% reduction of the lesion size). Time to response and need for thrombectomy were secondary efficacy variables. Adverse events were also evaluated.RESULTS: Groups were homogeneous with regards to demographic and baseline characteristics. Fifth day complete response rates were 156/170(91.8%; 95%CI:87.3-96.2), 155/170(91.2%; 95%CI: 86.6%-95.7%),and 46/170(27.1%; 95%CI: 20.1%-34.0%) with rSK(schedule A and B) and hydrocortisone acetate suppositories, respectively. These 64.6% and 63.9%differences(95%CI: 56.7%-72.2% and 55.7%-72.0%)were highly significant(P < 0.001). This advantage was detected since the early 3rd day evaluation(68.8% and64.1% vs 7.1% for the rSK and active control groups,respectively; P < 0.001) and was maintained even at the late 10 th day assessment(97.1% and 93.5% vs67.1% for rSK and hydrocortisone acetate, respectively;P < 0.001). Time to response was 3 d(95%CI: 2.9-3.1)for both rSK groups and 10 d(95%CI: 9.3-10.7) in the hydrocortisone acetate group. This difference was highly significant(P < 0.001). All subgroup stratified analyses(with or without thrombosis and hemorrhoid classification) showed a statistically significant advantage for the rSK groups. Thrombectomy was necessary in4/251 and 14/133 patients with baseline thrombosis in the rSK and hydrocortisone acetate groups, respectively(P < 0.001). There were no adverse events attributable to the experimental treatment.CONCLUSION: rSK suppositories showed a significant advantage over a widely-used over-the-counter hydrocortisone acetate preparation for the treatment of acute hemorrhoidal illness, as well as having an adequate safety profile. | Francisco Hernández-Bernal Georgina Castellanos-Sierra Carmen M Valenzuela-Silva Karem M Catasús-Alvarez Osmany Martínez-Serrano Odalys C Lazo-Diago Cimara H Bermúdez-Badell José R Causa-García Juan E Domínguez-Suárez Pedro A López-Saura 无 | 2015 | World Journal of Gastroenterology2015，21，23： | 2 |
| 17 | Oral refeeding in mild acute pancreatitis:An old challenge显示文摘Although the idea that pancreas rest has long been considered as a very relevant topic in acute pancreatitis (AP)therapy,the right time and type of diet to be offered to patients recovering from an acute attack are a great challenge to clinicians who treat this condition.Fortunately,the last decade was noted for several trials looking for the best answer to the question:'when and how to start oral refeeding in AP?'It is well known that 80%of patients present with mild disease characterized by usually uncomplicated clinical course are managed with pancreatic rest through nil per oral;while the use of specific nutritional intervention is an exception.Therefore,mild AP has been the most investigated form of AP and researchers have tried different kind of meals to offer calories and reduce costs by shortening hospitalization time.Usually in mild AP,the oral refeeding is introduced between the first 3 d and 7 d after hospitalization but,the type of diet and patients’tolerance have been scrutinized in detail with mixed results.Although 20%to 25%have pain recurrence requiring nutritional support and greater time of hospitalization,most patients seem to tolerate oral refeeding well.We propose analyzing the most recent investigations of this matter and their conclusions to develop a better understanding of the management of AP. | Júlio Maria F Chebli Pedro D Gaburri Liliana A Chebli | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 2 |
| 18 | Conservative management of perforated duodenal diverticulum: A case report and review of the literature显示文摘Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs. | David Martínez-Cecilia Alvaro Arjona Sánchez Manuel Gómez álvarez Eva Torres Tordera Antonio Luque Molina Victor Valentí Azcárate Javier Briceo Delgado Francisco Javier Padillo Pedro López-Cillero Sebastián Rufián Pea | 2008 | World Journal of Gastroenterology2008，14，12： | 2 |
| 19 | Effects of feeding yeast(Saccharomyces cerevisiae), organic selenium and chromium mixed on growth performance and carcass traits of hair lambs显示文摘Yeasts and organic minerals are used in diets to improve health, productive performance and some carcass characteristics of ruminants and non-ruminants. Thirty-two lambs(Pelibuey×Katahdin; BW=(30.55±1.67) kg; n=8) were used in a 56-d feeding experiment to study the effects of different levels of live yeast(Saccharomyces cerevisiae; yeast), selenium(Se) and chromium(Cr) mixed(Se-Cr), and a mixture of yeast-Se-Cr on growth performance and carcass traits. Animals were stratified by body weight(BW) and randomly assigned to one of four treatments: 1) control group(0.0 g kg–1 yeast); 2) yeast(1.50 g kg–1 dry matter intake(DMI) d–1); 3) Se-Cr premix(1.5 mg kg–1 DMI d–1 for each mineral); and 4) yeast-Se-Cr mixture. There were no treatment effects on final BW; whereas lambs fed Se-Cr or yeast-Se-Cr had higher(P<0.05) DMI than animals supplemented with only yeast. Average daily gain(ADG), gain:feed ratio, chop area, dorsal fat and carcass yield were similar(P>0.05) among treatment groups. In conclusion, supplementation with yeast, Se-Cr mixed or yeast-Se-Cr did not improve ADG, final BW, back fat content and carcass yield of growing of Pelibuey×Katahdin lambs. Supplementation with Se-Cr and yeast-Se-Cr increased DMI, and approximately 250 g ADG animal–1 d–1 was produced with no negative effects on growth and health of the animals. | Pedro A Hernández-García Alejandro Lara-Bueno Germán D Mendoza-Martínez José R Bárcena-Gama Fernando X Plata-Pérez Rufino López-Ordaz José A Martínez-García | 2015 | Journal of Integrative Agriculture2015，14，3： | 2 |
| 20 | Capsule endoscopy capture rate: Has 4 frames-per-second any impact over 2frames-per-second?显示文摘AIM: To compare the current capsule and a new prototype at 2 and 4 frames-per-second, respectively, in terms of clinical and therapeutic impact. METHODS: One hundred patients with an indication for capsule endoscopy were included in the study. All procedures were performed with the new device(SB24). After an exhaustive evaluation of the SB24 videos, they were then converted to 'SB2-like' videos for their evaluation. Findings, frames per finding, and clinical and therapeutic impact derived from video visualization were analyzed. Kappa index for interobserver agreement and χ2 and Student's t tests for qualitative/quantitative variables, respectively, were used. Values of P under 0.05 were considered statistically significant.RESULTS: Eighty-nine out of 100 cases included in the study were ultimately included in the analysis. The SB24 videos detected the anatomical landmarks(Zline and duodenal papilla) and lesions in more patients than the 'SB2-like' videos. On the other hand, the SB24 videos detected more frames per landmark/lesion than the 'SB2-like' videos. However, these differences were not statistically significant(P > 0.05). Both clinical and therapeutic impacts were similar between SB24 and 'SB2-like' videos(K = 0.954). The time spent by readers was significantly higher for SB24 videos visualization(P < 0.05) than for 'SB2-like' videos when all images captured by the capsule were considered. However, these differences become non-significant if we only take into account small bowel images(P > 0.05).CONCLUSION: More frames-per-second detect more landmarks, lesions, and frames per landmark/lesion, but is time consuming and has a very low impact on clinical and therapeutic management. | Ignacio Fernandez-Urien Cristina Carretero Erika Borobio Ana Borda Emilio Estevez Sara Galter Begoa Gonzalez-Suarez Benito Gonzalez Marisol Lujan Jose Luis Martinez Vanessa Martínez Pedro Menchén Javier Navajas Vicente Pons Cesar Prieto Julio Valle | 2014 | World Journal of Gastroenterology2014，20，39： | 2 |
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