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| 1 | 全球生态系统服务与自然资本的价值估算显示文摘编者按:地球上的生态系统是一种复杂的生命支持系统,生态系统对人类的贡献,在生态学研究中经常用“社会效益和经济效益”来表述,是可以用经济价值来估算的。然而,由于其复杂性和不确定性,对这两个效益如何进行估价,一直是困扰生态学家和经济学家的重要问题。Cos... | Robert Costanza Ralph d'Arge Rudolf de Groot Stephen Farber Monica Grasso Bruce Hannon Karin Limburg Shahid Naeem Robert V.O'neill Jose Paruelo Robert G.Raskin Paul Sutton Marjan van den Belt 陶大立(译) | 1999 | 生态学杂志1999,18,2: | 38 |
| 2 | 最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。 | 陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL | 2014 | 神经病学与神经康复学杂志2014,11,3: | 31 |
| 3 | 阿尔泰—阿尔金地学断面地壳结构显示文摘根据阿尔泰—阿尔金地学断面的地震纵、横波资料 ,建立了地壳速度及泊松比结构 .测区的地壳具有明显的三分结构特征 ,其纵波速度自上而下依次为 6 .0~ 6 .3km s、6 .3~ 6 .6km s及 6 .9~ 7.0km s ;阿尔泰南缘的地壳最厚 ,为 5 6km ,准噶尔盆地的地壳最薄 ,为 4 6km ,大部分地区的地壳厚度为 5 0km左右 .准噶尔盆地与天山之间上地幔顶部的纵波速度为 7.7~ 7.8km s ;阿尔泰南缘及塔里木盆地上地幔顶部的纵波速度较高 ,为 7.9~ 8.0km s.测线南部 ,包括东天山及塔里木东缘 ,自地表至 30km深处的地壳纵波速度低 ,泊松比为 0 .2 5 ,表明上地壳主要为石英及花岗质成分 ;而测线北部 (包括阿尔泰及准噶尔盆地 )的中、上地壳则呈现较高的泊松比 (0 .2 6~ 0 .2 7) ,可能为基性地壳的体现 .厚 15~ 30km的下地壳纵波速度 (6 .9~ 7.0km s)较高 ,泊松比为 0 .2 6~ 0 .2 8,可能以镁铁质的麻粒岩成分为主 .位于天山及其南侧地壳中部的低速层 (VP=5 .9km s,σ=0 .2 5 )则可能为晚古生代的构造热事件中的花岗质侵入岩 . | 王有学 韩果花 姜枚 袁学诚 Walter D Mooney Robert G Coleman | 2004 | 地球物理学报2004,47,2: | 32 |
| 4 | Coordinated peak expression of MMP-26 and TIMP-4 in preinvasive human prostate tumor显示文摘因为早察觉和治疗为病人的医药管理是批评的,为早前列腺癌症诊断的新奇简历标记的鉴定是高度重要的。在基础房间层和地下室膜的连续性的混乱为高级职业人员静电干扰 intraepithelial 瘤形成(HGPIN ) 的前进是必要的到在人的前列腺的侵略腺癌。涉及变换到侵略显型的分子是强烈审查的题目。我们以前报导了矩阵 metalloproteinase-26 (MMP-26 ) 经由地下室膜蛋白质并且由激活 MMP-9 的酶原形式的劈开支持人的前列腺癌症房间的侵略。而且,我们发现了 metalloproteinases-4 (TIMP-4 ) 的那个织物禁止者是大多数有势力 MMP-26 的内长的禁止者。这里,我们更高示威(p<0.0001 ) 在 HGPIN 和癌症的 MMP-26 和 TIMP-4 表示,与非肿瘤的 acini 相比。他们的表示层次在 HGPIN 是最高的,但是在一样的纸巾在侵略癌症(为各个的 p<0.001 ) 衰退。连续前列腺癌症织物节染色的 Immunohistochemical 建议 MMP-26 和 TIMP-4 的 colocalization。现在的学习显示 MMP-26 和 TIMP-4 可以在 HGPIN 的变换期间起一个不可分的作用到侵略癌症并且可以也为早前列腺癌症诊断用作标记。房间研究(2006 ) 16:750-758。做 i:10.1038/sj .cr.7310089;出版联机 2006 年 8 月 29 日。 | Seakwoo Lee Kevin K Desai Kenneth A Iczkowski Robert G Newcomer Kevin J WU Yun-Ge Zhao Winston W Tan Mark D Roycik Qing-Xiang Amy Sang | 2006 | Cell Research2006,16,9: | 18 |
| 5 | 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 |
| 6 | Anticancer immunotherapy by CTLA-4 blockade: obligatory contribution of IL-2 receptors and negative prognostic impact of soluble CD25显示文摘堵住抗体 ipilimumab 的细胞毒素的 T 淋巴细胞 antigen-4 (CTLA-4 ) 在很少的病人导致变形黑瘤的调停免疫者的长期的控制。尽管 ipilimumab 无疑经由 immunostimulation 施加它的治疗学的效果,这样远的临床上有用的、 immunologically 相关的 biomarkers 预言治疗效率是逃犯的。这里,我们显示出 IL-2 的那中立化或堵住 α并且 βIL-2 受体的子单元(CD25 和 CD122,分别地) 否则在现出症状之前的潜的老鼠模型由 CTLA-4 封锁导致了,废除了 antitumor 效果和 intratumoral T 受动器对规章的房间(Tregs ) 的比率的伴随的改进,它是。CTLA-4 封锁导致了在失去了 FoxP3 表示并且在 regressing 肿瘤积累了的 IL-2-producing 受动器房间与伴随物上升表示 Lag3, ICOS, IL-10 和 Egr2 的一个镇压 CD4 + T 房间子集的减小。当 recombinant IL-2 改进了 CTLA-4 封锁的治疗学的功效时,圈套 IL-2 受体 α(IL-2Rα, sCD25 ) 禁止了 CTLA-4 的 anticancer 效果封锁。在收到 ipilimumab 的 262 个变形黑瘤病人, sCD25 的基线浆液集中代表了全面幸存的独立指示物,与预言到治疗的抵抗的高水平。总的来说,这些结果解开为在 CTLA-4 的 anticancer 活动的 IL-2 和 IL-2 受体的一个角色封锁。重要地,我们的学习提供第一 immunologically 相关的 biomarker,也就是提高的浆液 sCD25,那与黑瘤在病人预言抵抗到 CTLA-4 封锁。 | Dalil Hannani Marie Vetizou David Enot Sylvie Rusakiewicz Nathalie Chaput David Klatzmann Melanie Desbois Nicolas Jacquelot Nadege Vimond Salem Chouaib Christine Mateus James P Allison Antoni Ribas Jedd D Wolchok Jianda Yuan Philip Wong Michael Postow Andrzej Mackiewicz Jacek Mackiewicz Dirk Schadendorff Dirk Jaeger Alan J Korman Keith Bahjat Michele Maio Luana Calabro Michele WL Teng Mark J Smyth Alexander Eggennont Caroline Robert Guido Kroemer Laurence Zitvogel | 2015 | Cell Research2015,25,2: | 14 |
| 7 | Management of inflammatory bowel disease with Clostridium difficile infection显示文摘AIM To address the management of Clostridium difficile(C. difficile) infection(CDI) in the setting of suspected inflammatory bowel disease(IBD)-flare.METHODS A systematic search of the Ovid MEDLINE and EMBASE databases by independent reviewers identified 70 articles including a total of 932141 IBD patients or IBDrelated hospitalizations. RESULTS In those with IBD,CDI is associated with increased morbidity,including subsequent escalation in IBD medical therapy,urgent colectomy and increased hospitalization,as well as excess mortality. Vancomycincontaining regimens are effective first-line therapies for CDI in IBD inpatients. No prospective data exists with regards to the safety or efficacy of initiating or maintaining corticosteroid,immunomodulator,or biologic therapy to treat IBD in the setting of CDI. Corticosteroid use is a risk factor for the development of CDI,while immunomodulators and biologics are not. CONCLUSION Strong recommendations regarding when to initiate IBD specific therapy in those with CDI are precluded by a lack of evidence. However,based on expert opinion and observational data,initiation or resumption of immunosuppressive therapy after 48-72 h of targeted antibiotic treatment for CDI may be considered. | Julie D’Aoust Robert Battat Talat Bessissow | 2017 | World Journal of Gastroenterology2017,23,27: | 14 |
| 8 | Effect of nutritional counselling on hepatic,muscle and adipose tissue fat content and distribution in non-alcoholic fatty liver disease显示文摘AIM: To assess the effectiveness of the current UK clinical practice in reducing hepatic fat (IHCL). METHODS: Whole body MRI and 1H MRS were obtained, before and after 6 mo nutritional counselling, from liver, soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease (NAFLD). RESULTS: A 500 Kcal-restricted diet resulted in an average weight loss of 4% (-3.4 kg,) accompanied by significant reductions in most adipose tissue (AT) depots, including subcutaneous (-9.9%), abdominal subcutaneous (-10.2%) and intra-abdominal-AT (-11.4%). Intramyocellular lipids (IMCL) were significantly reduced in the tibialis muscle (-28.2%). Decreases in both IHCL (-39.9%) and soleus IMCL (-12.2%) content were also observed, although these were not significant. Several individuals showed dramatic decreases in IHCL, while others paradoxically showed increases in IHCL content. Changes in body composition were accompanied by improvements in certain liver function tests: serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT. Improvements in liver function tests were associated with reductions in intra-abdominal AT, but not with changes in IHCL. CONCLUSION: This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LFTs. | E Louise Thomas Audrey E Brynes Gavin Hamilton Nayna Patel Adam Spong Robert D Goldin Gary Frost Jimmy D Bell Simon D Taylor-Robinson | 2006 | World Journal of Gastroenterology2006,12,36: | 13 |
| 9 | Rectal cancer: An evidence-based update for primary care providers显示文摘Rectal adenocarcinoma is an important cause of cancer-related deaths worldwide, and key anatomic differences between the rectum and the colon have significant implications for management of rectal cancer. Many advances have been made in the diagnosis and management of rectal cancer. These include clinical staging with imaging studies such as endorectal ultrasound and pelvic magnetic resonance imaging, operative approaches such as transanal endoscopic microsurgery and laparoscopic and robotic assisted proctectomy, as well as refined neoadjuvant and adjuvant therapies. For stage Ⅱ and Ⅲ rectal cancers, combined chemoradiotherapy offers the lowest rates of local and distant relapse, and is delivered neoadjuvantly to improve tolerability and optimize surgical outcomes, particularly when sphincter-sparing surgery is an endpoint. The goal in rectal cancer treatment is to optimize diseasefree and overall survival while minimizing the risk of local recurrence and toxicity from both radiation and systemic therapy. Optimal patient outcomes depend on multidisciplinary involvement for tailored therapy. The successful management of rectal cancer requires a multidisciplinary approach, with the involvement of enterostomal nurses, gastroenterologists, medical and radiation oncologists, radiologists, pathologists and surgeons. The identification of patients who are candidates for combined modality treatment is particularly useful to optimize outcomes. This article provides an overview of the diagnosis, staging and multimodal therapy of patients with rectal cancer for primary care providers. | Wolfgang B Gaertner Mary R Kwaan Robert D Madoff Genevieve B Melton | 2015 | World Journal of Gastroenterology2015,21,25: | 13 |
| 10 | Metformin does not improve survival in patients with hepatocellular carcinoma显示文摘AIM:To assess whether metformin,which has a chemopreventive effect in chronic liver disease,has any chemotherapeutic effect in hepatocellular carcinoma.METHODS:This was a retrospective study of 701 patients with newly diagnosed hepatocellular carcinoma(HCC)seen between January 2005 and June 2011 at Mayo Clinic,Rochester,Minnesota.This patient cohort was a part of the global HCC BRIDGE study,which is a large longitudinal study of HCC determining the realworld experience of HCC characteristics,management and patient outcomes.We defined significant metformin exposure as continuation of this agent at least 90d beyond diagnosis of HCC,and compared survival of diabetic patients on metformin to diabetic patients not on metformin and non-diabetics.RESULTS:Our cohort was 72.9%male,with a mean±SD age of 62.6±12.3 years.The most common etiologies of liver disease were hepatitis C(34%),alcoholic liver disease(29%),fatty liver disease(15%)and hepatitis B(9%).By univariate analysis,using diabetics not on metformin as the reference group,diabetic patients with HCC on metformin had no survival advantage,with a HR(95%CI)of 1.0(0.8-1.3).Non-diabetic HCC patients also did not appear to have a survival advantage as compared to diabetic HCC patients not on metformin,as demonstrated by a HR(95%CI)of1.1(0.7-1.7).Diabetics on metformin beyond 90 d after HCC diagnosis had a longer median survival at 34.2 mo,as compared to 25.5 mo among diabetic patients who were not on metformin or had discontinued metformin within 90 d after HCC diagnosis.This finding was likely due to potential survival bias among those who lived long enough to receive metformin.CONCLUSION:Although the literature suggests a chemotherapeutic effect in other malignancies,our study demonstrates no survival benefit to the use of metformin in diabetic patients with HCC. | Mamatha Bhat Roongruedee Chaiteerakij William S Harmsen Cathy D Schleck Ju Dong Yang Nasra H Giama Terry M Therneau Gregory J Gores Lewis R Roberts | 2014 | World Journal of Gastroenterology2014,20,42: | 11 |
| 11 | Surveillance for hepatocellular carcinoma in chronic liver disease:Evidence and controversies显示文摘Primary liver cancer is the sixth most common cancer in the world and the third cause of cancer-related death.Hepatocellular carcinoma(HCC)represents more than90%of primary liver cancers and generally occurs in patients with underlying chronic liver disease such as viral hepatitis,hemochromatosis,primary biliary cirrhosis and non-alcoholic steatohepatitis.Especially cirrhotic patients are at risk of HCC and regular surveillance could enable early detection and therapy,with potentially improved outcome.We here summarize existing evidence for surveillance including ultrasound,other radiological modalities and various serum biomarkers,and current international guideline recommendations for surveillance.Ultrasound andα-fetoprotein(alone or in combination)are most frequently used for surveillance,but their sensitivities and specificities are still far from perfect,and evidence for surveillance remains weak and controversial.Various other potential surveillance tools have been tested,including serum markers as des-carboxyprothrombin,lectin-boundα-fetoprotein,and(most recently)circulating TIE2-expressing monocytes,and radiological investigations such as computed tomographyscan or magnetic resonance imaging-scan.Although early results appear promising,these tools have generally been tested in diagnostic rather than surveillance setting,and in most cases,no detailed information is available on their cost-effectiveness.For the near future,it remains important to define those patients with highest risk of HCC and most benefit from surveillance,and to restrict surveillance to these categories. | Suzanne van Meer Robert A de Man Peter D Siersema Karel J van Erpecum | 2013 | World Journal of Gastroenterology2013,19,40: | 10 |
| 12 | Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty显示文摘 | Susan Dawkes Graeme D Smith Lawrie Elliott Robert Raeside Jayne H Donaldson | 2016 | Journal of Geriatric Cardiology2016,13,5: | 10 |
| 13 | High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound显示文摘AIM To examine whether high-flow nasal oxygen(HFNO) availability influences the use of general anesthesia(GA) in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic ultrasound(EUS) and associated outcomes.METHODS In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras(era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era(era 2). The primary outcome was the percent utilization of GA vs deep sedation in each period. Secondary outcomes included oxygen saturation nadir during sedation between periods, as well as procedure duration, and anesthesia-only time between periods and for GA vs sedation cases respectively.RESULTS During the study period 238 ERCP or EUS cases were identified for analysis. Statistical testing was employed and a P < 0.050 was significant unless the Bonferroni correction for multiple comparisons was used. General anesthesia use was significantly lower in era 2 compared to era 1 with the same trend between era 2 and 3(P = 0.012 and 0.045 respectively). The oxygen saturation nadir during sedation was significantly higher in era 2 compared to era 3(P < 0.001) but not between eras 1 and 2(P = 0.028) or 1 and 3(P = 0.069). The procedure time within each era was significantly longer under GA compared to deep sedation(P ≤ 0.007) as was the anesthesia-only time(P ≤ 0.001).CONCLUSION High-flow nasal oxygen availability was associated with decreased GA utilization and improved oxygenation for ERCP and EUS during sedation. | Roman Schumann Nikola S Natov Klifford A Rocuts-Martinez Matthew D Finkelman Tom V Phan Sanjay R Hegde Robert M Knapp | 2016 | World Journal of Gastroenterology2016,22,47: | 9 |
| 14 | Macrophage migration inhibitory factor gene polymorphisms in inflammatory bowel disease: An association study in New Zealand Caucasians and meta-analysis显示文摘AIM:To investigate the association of macrophage migration inhibitory factor(MIF)promoter polymorphisms with inflammatory bowel disease(IBD)risk.METHODS:One thousand and six New Zealand Caucasian cases and 540 Caucasian controls were genotyped for the MIF SNP-173G>C(rs755622)and the repeat polymorphism CATT5-8(rs5844572)using a predesigned TaqMan SNP assay and capillary electrophoresis,respectively.Data were analysed for single site and haplotype association with IBD risk and phenotype.Meta-analysis was employed,to assess cumulative evidence of association of MIF-173G>C with IBD.All published genotype data for MIF-173G>C in IBD were identified using PubMed and subsequently searching the references of all PubMed-identified studies.Imputed genotypes for MIF-173G>C were generated from the Wellcome Trust Case Control Consortium(and National Institute of Diabetes and Digestive and Kidney Diseases).Separate meta-analyses were performed on Caucasian Crohn’s disease(CD)(3863 patients,6031controls),Caucasian ulcerative colitis(UC)(1260 patients,1987 controls),and East Asian UC(416 patients and 789 controls)datasets using the Mantel-Haenszel method.The New Zealand dataset had 93%power,and the meta-analyses had 100%power to detect an effect size of OR=1.40 atα=0.05,respectively.RESULTS:In our New Zealand dataset,single-site analysis found no evidence of association of MIF polymorphisms with overall risk of CD,UC,and IBD or disease phenotype(all P values>0.05).Haplotype analysis found the CATT5/-173C haplotype occurred at a higher frequency in New Zealand controls compared to IBD patients(0.6 vs 0.01;P=0.03,OR=0.22;95%CI:0.05-0.99),but this association did not survive bonferroni correction.Meta-analysis of our New Zealand MIF-173G>C data with data from seven additional Caucasian datasets using a random effects model found no association of MIF polymorphisms with CD,UC,or overall IBD.Similarly,meta-analysis of all published MIF-173G>C data from East Asian datasets(416UC patients,789 controls)found no association of this promoter polymorphism with UC. | James D Falvey Robert W Bentley Tony R Merriman Mark B Hampton Murray L Barclay Richard B Gearry Rebecca L Roberts | 2013 | World Journal of Gastroenterology2013,19,39: | 9 |
| 15 | Method for rapid on-site identification of VOCs显示文摘Rapid on-site identification of volatile organic compounds (VOCs) in ambient air is an important first step in remediation efforts. This study describes modification of a commercially available, portable GC/MS system and development of an analysis protocol for rapid (< 3 min) sampling and identification of VOCs typically found at contaminated sites at the low ppbv level. | Justin D Fair William F Bailey Robert A Felty Amy E Gifford Benjamin Shultes Leslie H Volles | 2009 | Journal of Environmental Sciences2009,21,7: | 8 |
| 16 | Subclinical atherosclerosis in northern and southern China: the Chinese paradox显示文摘背景冠的心疾病(CHD ) 的发生是更高的在北比在南部的中国,然而,在传统的 CHD 的差别冒险的,解释这。没有学习在可以帮助在发生解释差别的无临床症状的动脉粥样硬化检验了差别。这研究为在北、南部的中国之间的石灰化用冠的计算断层摄影术(CT ) 在无临床症状的动脉粥样硬化检验了这些差别。我们在一个大多中心选择了参加者的一件随机的样品的方法为冠的钙在一个北城市(诺思) 里扫描的进行中的流行病的学习(北京, n = 49 ) 并且在二个南部的城市(南方) 里(上海, n = 50,并且广州, n = 50 ) 。从三个领域中心的参加者(意味着年龄 67 年) 经历了用动脉粥样硬化扫描的多种族的学习为冠的钙测量扫描的冠的风险因素评估和心脏的 CT 协议。结果调整了在诺思中国(北京) 的转变木头的冠的动脉钙 20 是 3.1 +/-0.4 并且在华南(上海和广州) 是 2.2 +/- 0.3 (P = 0.04 ) 。为北京的北城市的吝啬的钙分数比广州的南部的城市的高三倍(P = 0.01 ) 并且比为上海的南部的城市高 2.5 倍(P = 0.03 ) 。结论无临床症状的动脉粥样硬化的程度在广州和上海的二个南部的城市里比那在北京的北城市里是显著地更高的,甚至在为标准心脏的风险因素调整以后。这发现建议标准风险因素充分不在临床的 CHD 发生解释北方南方差别。 | Jie Huang Yang-Feng Wu Xiao-Qing Liu Ding Ding Lian-Cheng Zhao Bin Lu Xian Li Nathan D Wong Laurie D Dustin Stanley P Azen Robert C Detrano | 2011 | Journal of Geriatric Cardiology2011,8,2: | 7 |
| 17 | Inpatient capsule endoscopy leads to frequent incomplete small bowel examinations显示文摘AIM:To examine the predictive factors of capsule endoscopy(CE) completion rate(CECR) including the effect of inpatient and outpatient status.METHODS:We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005.Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the procedure.CE exams were reviewed by two physicians who were unaware of the study hypotheses.After retrospective analysis,21 cases were excluded due to capsule malfunction,prior gastric surgery,endoscopic capsule placement or insufficient data.Of the remaining 334 exams [264 out-patient(OP),70 in-patient(IP)],CE indications,findings,location of the patients [IP vs OP and intensive care unit(ICU) vs general medical floor(GMF)] and gastrointestinal transit times were analyzed.Statistical analysis was completed using SPSS version 17(Chicago,IL).Chi-square,t test or fisher exact-tests were used as appropriate.Multivariate logistic regression analysis was used to identify variables associated with incomplete CE exams.RESULTS:The mean age for the entire study population was 54.7 years.Sixty-one percent of the study population was female,and gender was not different between IPs vs OPs(P = 0.07).The overall incomplete CECR was 14% in our study.Overt obscure gastrointestinal bleeding(OGB) was a significantly more common indication for the IP CE(P = 0.0001),while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams(P = 0.002 and P = 0.01,respectively).Occult OGB was the most common indication and arteriovenous malformations were the most common finding both in the IPs and OPs.The capsule did not enter the small bowel(SB) in 6/70 IPs and 8/264 OPs(P = 0.04).The capsule never reached the cecum in 31.4%(22/70) of IP vs 9.5%(25/264) of OP examinations(P < 0.001).The mean gastric transit time(GTT) was delayed in IPs compared to OPs,98.5 ± 139.5 min vs 60.4 ± 92.6 min(P = 0.008).Minimal SB transit time was significantly prolonged in the IP compared to the OP setting [IP = 275.1 ±111.6 min vs OP = 244.0 ± 104.3 min(P = 0.037)].CECR was also significantly higher in the subgroup of patients with OGB who had OP vs IP exams(95% vs 80% respectively,P = 0.001).The proportion of patients with incomplete exams was higher in the ICU(n = 7/13,54%) as compared to the GMF(n = 15/57,26%)(P = 0.05).There was only a single permanent SB retention case which was secondary to a previously unknown SB stricture,and the remaining incomplete SB exams were due to slow transit.Medications which affect gastrointestinal system motility were tested both individually and also in aggregate in univariate analysis in hospitalized patients(ICU and GMF) and were not predictive of incomplete capsule passage(P > 0.05).Patient location(IP vs OP) and GTT were independent predictors of incomplete CE exams(P < 0.001 and P = 0.008,respectively).CONCLUSION:Incomplete CE is a multifactorial problem.Patient location and related factors such as severity of illness and sedentary status may contribute to incomplete exams. | Cemal Yazici John Losurdo Michael D Brown Scott Oosterveen Robert Rahimi Ali Keshavarzian Leila Bozorgnia Ece Mutlu | 2012 | World Journal of Gastroenterology2012,18,36: | 6 |
| 18 | Recent trends in liver transplantation for alcoholic liver disease in the United States显示文摘AIM To examine temporal changes in the indications for liver transplantation(LT) and characteristics of patients transplanted for alcoholic liver disease(ALD).METHODS We performed a retrospective cohort analysis of trends in the indication for LT using the United Network for Organ Sharing(UNOS) database between 2002 and 2015. Patients were grouped by etiology of the liver disease and characteristics were compared using χ~2 and t-tests. Time series analysis was used identifying any year with a significant change in the number of transplants per year for ALD, and before and after eras were modeled using a general linear model. Subgroup analysis of recipients with ALD was performed by age group, gender, UNOS region and etiology(alcoholic cirrhosis, alcoholic hepatitis and hepatitis C-alcoholic cirrhosis dual listing).RESULTS Of 74216 liver transplant recipients, ALD(n = 9400, 12.7%) was the third leading indication for transplant after hepatitis C and hepatocellular carcinoma. Transplants for ALD, increased from 12.8%(553) in 2002 to 16.5%(1020) in 2015. Time series analysis indicated a significant increase in the number of transplants per year for ALD in 2013(P = 0.03). There were a stable number of transplants per year between 2002 and 2012(linear coefficient 3, 95%CI:-4.6, 11.2) an increase of 177 per year between 2013 and 2015(95%CI: 119, 234). This increase was significant for all age groups except those 71-83 years old, was observed for both genders, and was incompletely explained by a decrease in transplants for hepatitis C and ALD dual listing. All UNOS regions except region 9 saw an increase in the mean number of transplants per year when comparing eras, and this increase was significant in regions 2, 3, 4, 5, 6, 8, 10 and 11.CONCLUSION There has been a dramatic increase in the number of transplants for ALD starting in 2013. | Catherine E Kling James D Perkins Robert L Carithers Dennis M Donovan Lena Sibulesky | 2017 | World Journal of Hepatology2017,9,36: | 6 |
| 19 | Hepatic steatosis and fibrosis: Non-invasive assessment显示文摘Chronic liver disease is a major cause of morbidity and mortality worldwide and usually develops over many years, as a result of chronic inflammation and scarring, resulting in end-stage liver disease and its complications. The progression of disease is characterised by ongoing inflammation and consequent fibrosis, although hepatic steatosis is increasingly being recognised as an important pathological feature of disease, rather than being simply an innocent bystander. However, the current gold standard method of quantifying and staging liver disease, histological analysis by liver biopsy, has several limitations and can have associated morbidity and even mortality. Therefore, there is a clear need for safe and noninvasive assessment modalities to determine hepatic steatosis, inflammation and fibrosis. This review covers key mechanisms and the importance of fibrosis and steatosis in the progression of liver disease. We address non-invasive imaging and blood biomarker assessments that can be used as an alternative to information gained on liver biopsy. | Rustam N Karanjia Mary ME Crossey I Jane Cox Haddy KS Fye Ramou Njie Robert D Goldin Simon D Taylor-Robinson | 2016 | World Journal of Gastroenterology2016,22,45: | 6 |
| 20 | Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed. | Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee | 2014 | World Journal of Clinical Oncology2014,5,2: | 5 |