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| 1 | Management of non-variceal upper gastrointestinal tract hemorrhage:Controversies and areas of uncertainty显示文摘Upper gastrointestinal tract hemorrhage(UGIH) remains a common presentation requiring urgent evaluation and treatment.Accurate assessment,appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge.The advent of pharmacologic acid suppression,endoscopic hemostatic techniques,and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease(PUD) has revolutionized the treatment of UGIH.Despite this,acute UGIH still carries considerable rates of morbidity and mortality.This review aims to discuss current areas of uncertainty and controversy in the management of UGIH.Neoadjuvant proton pump inhibitor(PPI) therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non-variceal UGIH,and PPIs are extremely effective at promoting ulcer healing.However,neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality.The optimal timing of upper endoscopy in UGIH is often debated.Upon completion of volume resuscitation and hemodynamic stabilization,upper endoscopy should be performed within 24 h in all patients with evidence of UGIH for both diagnostic and therapeutic purposes.With rising healthcare cost paramount in today's medical landscape,the ability to appropriately triage UGIH patients is of increasing value.Upper endoscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low-risk lesions or admission for further monitoring and treatment in higher-risk lesions.Concomitant pharmacotherapy with non-steroidal anti-inflammatory drugs(NSAIDs) and antiplatelet agents,such as clopidogrel,has a major impact on the etiology,severity,and potential treatment of UGIH.Long-term PPI use in patients taking chronic NSAIDs or clopidogrel is discussed thoroughly in this review. | Eric P Trawick Patrick S Yachimski | 2012 | World Journal of Gastroenterology2012，18，11： | 19 |
| 2 | Effect of technical parameters on transjugular intrahepatic portosystemic shunts utilizing stent grafts显示文摘AIM: To assess the effect of technical parameters on outcomes of transjugular intrahepatic portosystemic shunt(TIPS) created using a stent graft.METHODS: The medical records of 68 patients who underwent TIPS placement with a stent graft from 2008 to 2014 were reviewed by two radiologists blinded to the patient outcomes.Digital Subtraction Angiographic images with a measuring catheter in two orthogonal planes was used to determine the TIPS stent-to-inferior vena cava distance(SIVCD),hepatic vein to parenchymal tract angle(HVTA),portal vein to parenchymal tract angle(PVTA),and the accessed portal vein.The length and diameter of the TIPS stent and the use of concurrent variceal embolization were recorded by review of the patient's procedure note.Data on re-intervention within 30 d of TIPS placement,recurrence of symptoms,and survival were collected through the patient's chart.Cox proportional regression analysis was performed to assess the effect of these technical parameters on primary patency of TIPS,time to recurrence of symptoms,and all-cause mortality.RESULTS: There was no significant associationbetween the SIVCD and primary patency(P = 0.23),time to recurrence of symptoms(P = 0.83),or allcause mortality(P = 0.18).The 3,6,and 12-mo primary patency rates for a SIVCD ≥ 1.5 cm were 82.4%,64.7%,and 50.3% compared to 89.3%,83.8%,and 60.6% for a SIVCD of < 1.5 cm(P = 0.29).The median time to stenosis for a SIVCD of ≥ 1.5 cm was 19.1 mo vs 15.1 mo for a SIVCD of < 1.5 cm(P = 0.48).There was no significant association between the following factors and primary patency: HVTA(P = 0.99),PVTA(P = 0.65),accessed portal vein(P = 0.35),TIPS stent diameter(P = 0.93),TIPS stent length(P = 0.48),concurrent variceal embolization(P = 0.13) and reinterventions within 30 d(P = 0.24).Furthermore,there was no correlation between these technical parameters and time to recurrence of symptoms or all-cause mortality.Recurrence of symptoms was associated with stent graft stenosis(P = 0.03).CONCLUSION: TIPS stent-to-caval distance and other parameters have no significant effect on primary patency,time to recurrence of symptoms,or all-cause mortality following TIPS with a stent-graft. | Brice Andring Sanjeeva P Kalva Patrick Sutphin Rajiv Srinivasa Alvin Anene Marc Burrell Yin Xi Anil K Pillai | 2015 | World Journal of Gastroenterology2015，21，26： | 7 |
| 3 | Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup显示文摘AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye Retroscope Randomized Clinical Evaluation(TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TERRACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy(SC) and Third Eye colonoscopy(TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects(51.0%),surveillance after previous polypectomy in 87(25.2%) and diagnostic workup in 82(23.8%).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate(ADR) with TEC of 23.2% compared to SC.Relative risk(RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92(P = 0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4% for screening,35.7% for surveillance,55.4% for diagnostic and 40.7% for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11(P = 0.815) for screening,3.15(P = 0.014) for surveillance,8.64(P = 0.039) for diagnostic and 3.34(P = 0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59 cm and 0.56 cm,respectively(P = NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients(ClinicalTrials.gov Identifier:NCT01044732). | Peter D Siersema Amit Rastogi Anke M Leufkens Paul A Akerman Kassem Azzouzi Richard I Rothstein Frank P Vleggaar Alessandro Repici Giacomo Rando Patrick I Okolo Olivier Dewit Ana Ignjatovic Elizabeth Odstrcil James East Pierre H Deprez Brian P Saunders Anthony N Kalloo Bradley Creel Vikas Singh Anne Marie Lennon Daniel C DeMarco | 2012 | World Journal of Gastroenterology2012，18，26： | 6 |
| 4 | Effect of age on aortic atherosclerosis显示文摘Objective To examine the association of atherosclerosis burden in the survivors of an asymptomatic elderly cohort study and its relationship to other coronary risk factors (specifically, age) by evaluating aortic atherosclerotic wall burden by magnetic resonance imaging (MRI). Methods A total of 312 participants in an ongoing observational cohort study underwent cardiac and descending thoracic aorta imaging by MRI. Maximum wall thickness was measured and the mean wall thickness calculated.Wall/outer wall ratio was used as a normalized wall index (NWI) adjusted for artery size difference among participants. Percent wall volume (PWV) was calculated as NWI ×100.Results In this asymptomatic cohort (mean age: 76 years), the mean (SD) aortic wall area andwall thicknesswere 222 ±45 mm2 and 2.7 ±0.4 mm, respectively. Maximum wall thickness was 3.4 ±0.6 mm, and PWV was 32% ±4%. Women appeared to have smaller wall area,but after correcting for their smaller artery size, had significantly higher PWV than men (P = 0.03). Older age was associatedwith larger wall area (P = 0.04 for trend) with similar PWVs. However, there were no statistically significant associations between standard risk factors,Framingham global risk, or metabolic syndrome status, therapy for cholesterol or hypertension, coronary or aortic calcium score, and the aortic wall burden. Aortic calcificationwas associated with coronary calcification. Conclusions Asymptomatic elderly in this cohort had a greater descending thoracic aortic wall volume that correlated with age, andwomen had a significantly increased PWV compared to men. In these survivors, the atherosclerotic aortic wall burden was not significantly associated with traditional risk factors or with coronary or aortic calcium scores or coronary calcium progression. Results suggest that age, or as yet unidentified risk factor(s), may be responsible for the increase in atherosclerosis. | Michael A. Chen Miwa Kawakubo Patrick M. Colletti Dongxiang Xu Laurie LaBree Dustin Robert Detrano Stanley P Azen Nathan D. Wong Xue-Qiao Zhao | 2013 | Journal of Geriatric Cardiology2013，10，2： | 6 |
| 5 | General competencies of problem‐based learning (PBL) and non‐PBL graduates显示文摘 | Katinka J A HPrince Patrick W L JVan Eijs Henny P ABoshuizen Cees P MVan Der Vleuten Albert J J AScherpbier | 2005 | Medical Education2005，，4： | 5 |
| 6 | Acute-on chronic liver failure显示文摘 | Rajiv Jalan Pere Gines Jody C Olson Rajeshwar P Mookerjee Richard Moreau Guadalupe Garcia-Tsao Vicente Arroyo Patrick S Kamath | 2012 | Journal of Hepatology2012，，6： | 4 |
| 7 | Clinical End Points in Coronary Stent Trials: A Case for Standardized Definitions显示文摘 | Donald E. Cutlip Stephan Windecker Roxana Mehran Ashley Boam David J. Cohen Gerrit-Anne van Es P Gabriel Steg Marie-angèle Morel Laura Mauri Pascal Vranckx Eugene McFadden Alexandra Lansky Martial Hamon Mitchell W. Krucoff Patrick W. Serruys | 2007 | Circulation2007，，17： | 4 |
| 8 | Poisson image editing显示文摘 | Patrick Pérez Michel Gangnet Andrew Blake | 2003 | ACM Transactions on Graphics (TOG)2003，，3： | 2 |
| 9 | Outcomes after arthroscopic repair of rotator cuff tears in the setting of mild to moderate glenohumeral osteoarthritis显示文摘BACKGROUND Rotator cuff pathology is a very common source of shoulder pain.Similarly,osteoarthritis of the glenohumeral joint can cause shoulder pain and produce similar symptoms.Surgical management can be indicated for both pathologies,however,outcomes data is limited when examining rotator cuff repair(RCR) in the setting of glenohumeral arthritis(GHOA).Thus,this study sought to determine outcomes for patients who undergo RCR in the setting of GHOA.AIM To evaluate if a relationship exists between outcomes of RCR in the setting of GHOA.METHODS This was a retrospective analysis of patients who underwent arthroscopic rotator cuff repair with concurrent glenohumeral osteoarthritis between 2010-2017.Patients were stratified based on rotator cuff tear size and glenohumeral osteoarthritis severity.Cohorts were paired 1:1 with patients without glenohumeral osteoarthritis.Patients included had a minimum two year follow-up.Rate of conversion to total shoulder arthroplasty,complication rates following initial surgery,and patient-reported outcome measures were collected.RESULTS A total of 142 patients were included.The number of patients that required total shoulder arthroplasty within two years after index surgery was low.2/71(2.8%) patients with GHOA,and 1/71(1.4%) without GHOA.Following rotator cuff repair,both groups showed favorable patientreported outcomes.CONCLUSION Patients with glenohumeral osteoarthritis who underwent arthroscopic rotator cuff repair showed comparable outcomes to patients without glenohumeral osteoarthritis. | Ian S Hong Allison J Rao Tyler L CarlLee Joshua D Meade Daniel J Hurwit Gregory Scarola David P Trofa Shadley C Schiffern Nady Hamid Patrick M Connor James E Fleischli Bryan Michael Saltzman | 2022 | World Journal of Orthopedics2022，13，7： | 2 |
| 10 | The effects of Spirulina on anemia and immune function in senior citizens显示文摘Anemia and immunological dysfunction(i.e.immunosenescence)are commonly found in older subjects and nutritional approaches are sought to counteract these phenomena.Spirulina is a filamentous and multicellular bule-green alga capable of reducing inflammation and also manifesting antioxidant effects.We hypothesized that Spirulina may ameliorate anemia and immunosenescence in senior citizens with a history of anemia.We enrolled 40 volunteers of both sexes with an age of 50 years or older who had no history of major chronic diseases.Participants took a Spirulina supplementation for 12 weeks and were administered comprehensive dietary questionnaires to determine their nutritional regimen during the study.Complete cell count(CCC)and indoleamine 2,3-dioxygenase(IDO)enzyme activity,as a sign of immune function,were determined at baseline and weeks 6 and 12 of supplementation.Thirty study participants completed the entire study and the data obtained were analyzed.Over the 12-week study period,there was a steady increase in average values of mean corpuscular hemoglobin in subjects of both sexes.In addition,mean corpuscular volume and mean corpuscular hemoglobin concentration also increased in male participants.Older women appeared to benefit more rapidly from Spirulina supplements.Similarly,the majority of subjects manifested increased IDO activity and white blood cell count at 6 and 12 weeks of Spirulina supplementation.Spirulina may ameliorate anemia and immunosenescence in older subjects.We encourage large human studies to determine whether this safe supplement could prove beneficial in randomized clinical trials. | Carlo Selmi Patrick SC Leung Laura Fischer Bruce German Chen-Yen Yang Thomas P Kenny Gerry R Cysewski M Eric Gershwin | 2011 | Cellular & Molecular Immunology2011，8，3： | 2 |
| 11 | IL-6 trans-signaling promotes pancreatitis-associated lung injury and lethality显示文摘 | Zhang Hong Neuh?fer Patrick Song Liang Rabe Bj?rn Lesina Marina Kurkowski Magdalena U Treiber Matthias Wartmann Thomas Regnér Sara Thorlacius Henrik Saur Dieter Weirich Gregor Yoshimura Akihiko Halangk Walter Mizgerd Joseph P Schmid Roland | 2013 | Journal of Clinical Investigation2013，，3： | 2 |
| 12 | Chronic intermittent hypoxia is a major trigger for non-alcoholic fatty liver disease in morbid obese显示文摘 | Judith Aron-Wisnewsky Caroline Minville Joan Tordjman Patrick Lévy Jean-Luc Bouillot Arnaud Basdevant Pierre Bedossa Karine Clément Jean-Louis Pépin | 2011 | Journal of Hepatology2011，，1： | 2 |
| 13 | Cardiac resynchronization therapy for the treatment of heart failure in patients with intraventricular conduction delay and malignant ventricular tachyarrhythmias显示文摘 | Steven L Higgins John D Hummel Imran K Niazi Michael C Giudici Seth J Worley Leslie A Saxon John P Boehmer Michael B Higginbotham Teresa De Marco Elyse Foster Patrick G Yong | 2003 | Journal of the American College of Cardiology2003，，8： | 2 |
| 14 | Effect of intensive treatment of hyperglycaemia on microvascular outcomes in type 2 diabetes: an analysis of the ACCORD randomised trial显示文摘 | Faramarz Ismail-Beigi Timothy Craven Mary Ann Banerji Jan Basile Jorge Calles Robert M Cohen Robert Cuddihy William C Cushman Saul Genuth Richard H Grimm Bruce P Hamilton Byron Hoogwerf Diane Karl Lois Katz Armand Krikorian Patrick O'Connor Rodica Pop-Bus | 2010 | The Lancet2010，，9739： | 2 |
| 15 | Large deletions within the first intron in VRN-1 are associated with spring growth habit in barley and wheat显示文摘 | Daolin Fu Péter Sz?cs Liuling Yan Marcelo Helguera Jeffrey S. Skinner Jarislav von Zitzewitz Patrick M. Hayes Jorge Dubcovsky | 2005 | Molecular Genetics and Genomics2005，，1： | 2 |
| 16 | Dual-domain point diffraction interferometer 显示文摘 | Patrick P Naulleau Kenneth A Goldberg | 1999 | Appl Opt1999，38，16： | 1 |
| 17 | The PolyMAX frequency domain method: a new standard for modal parameter estimation 显示文摘 | BART P HERMAN V D A PATRICK G | 2004 | Shock and Vibration2004，，11： | 1 |
| 18 | Perceived stress, intemal resources,and social support as determinants of mental health among young adults显示文摘 | Patrick A B Chamot E Thomas V P | 2004 | Quality Life Res2004，13，6： | 1 |
| 19 | Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis显示文摘 | Juan P Casas Weiliang Chua Stavros Loukogeorgakis Patrick Vallance Liam Smeeth Aroon D Hingorani Raymond J MacAllister | 2005 | The Lancet2005，，9502： | 1 |
| 20 | A Robotic Excavator |br Autonnmous Truck Loading显示文摘 | Anthony Stentz John Bares Sanjiv Singh Patrick P owe | | Autonomous Robots0，1099，： | 1 |
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