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| 1 | 氯吡格雷的使用与药物洗脱支架植入后远期临床结果显示文摘背景:近来的冠状动脉内药物洗脱支架研究提示,现行的抗血小板治疗方案可能并不足以预防后期支架内血栓形成。目的:于接受药物洗脱支架(drug-eluting stents,DESs)和裸金属支架(bare-metal stents,BMSs)治疗的冠状动脉病患者中评估氯吡格雷使用与患者远期结果的关系。设计、地点及患者:于连续患者中进行观察性研究。患者于2000年1月1日至2005年7月31日在杜克心脏治疗中心(一家位于北卡罗来纳州达累姆市的三级治疗中心)接受冠状动脉内支架治疗。于6、12、24个月时进行随访,直至2006年9月7日。研究人群包括4666例最初接受BMS(n=3165)或DES(n=1501)经皮冠状动脉介入治疗的患者。对随访6和12个月没有事件(没有死亡、心肌梗死或血管重建手术)的患者进行界标分析(landmark analysis)。在这些时间点上根据支架类型以及自我报告之氯吡格雷的使用情况将患者分为4组:DES使用氯吡格雷组、DES不用氯吡格雷组、BMS使用氯吡格雷组以及BMS不用氯吡格雷组。主要观测指标:随访24个月时死亡、非致命性心肌梗死以及死亡或心肌梗死之复合终点。结果:在6个月时没有事件发生的DES组患者(637例使用、579例未使用氯吡格雷)中,氯吡格雷的使用是随访24个月校正死亡率较低(使用2.0%比未使用5.3%;差异,-3.3%;95%CI,-6.3%至-0.3%;P=0.03)以及死亡或心肌梗死发生率较低(3.1%比7.2%;差异,-4.1%;95%CI,-7.6%至-0.6%;P=0.02)的显著预测指标。然而,在BMS组患者中(417例使用、1976例未用氯吡格雷),死亡(3.7%比4.5%;差异,-0.7%;95%CI,-2.9%至1.4%;P=0.50)以及死亡或心肌梗死发生率(5.5%比6.0%;差异,-0.5%;95%CI,-3.2%至2.2%;P:0.70)没有差异。在12个月随访没有事件发生的DES组患者(252例使用、276例未用氯吡格雷)中,氯吡格雷的使用依然可以预测24个月死亡(0%比3.5%;差异,-3.5%;95%CI,-5.9%至-1.1%;P=0.004)以及死亡或心肌梗死发生率(0%比4.5%;差异,-4.5%;95%CI,-7.1%至-1.9%;P〈0.001)较低。然而,在BMS组患者中(346例使用、1644例未用氯吡格雷),在死亡(3.3%比2.7%;差异,0.6%;95%CI,1.5%至2.8%;P=0.57)以及死亡或心肌梗死(4.7%比3.6%;差异,1.0%;95%CI,-1.6%至3.6%;P=0.44)发生方面,依然没有差异。结论:在接受DES治疗的患者中,延长氯吡格雷的使用可以使死亡以及死亡或心肌梗死的发生率下降。然而,使用氯吡格雷的适宜期限只能通过大型临床随机试验确定。 | Eric L Eisenstein, DBA Kevin J. Anstrom, PhD David F. Kong, MD Linda K. Shaw, MS Robert H. Tuttle, MSPH Daniel B. Mark, MD, MPH Judith M. Kramer, MD, MS Robert A. Harrington, MD David B. Matchar, MD David E. Kandzari, MD 1 Eric D. Peterson, MD, MPH Kevin A. Schulman, MD Robert M. Califf, MD 李呈亿(译) David E. Kandzari, MD | 2007 | 美国医学会杂志(中文版)2007,26,3: | 60 |
| 2 | 美国临床生化科学院检验医学实践指南:睾丸、前列腺、结直肠、乳腺及卵巢癌肿瘤标志物的应用显示文摘经美国临床生化科学院(NCAB)授权,由鄢盛恺教授组织学者、专家翻译审定2009年NCAB检验医学实践指南:睾丸、前列腺、结直肠、乳腺及卵巢癌中肿瘤标志物的应用单行本(Catharine M.Sturgeon教授和Eleftherios P.Diaman-dis教授编辑)。该指南包含第1至6章共6部分内容,参加指南制订的专家阵容强大,分别从临床及检验角度对睾丸、前列腺、结直肠、乳腺及卵巢癌中肿瘤标志物的检测与临床应用方面的问题进行了详细阐述与说明,是目前国内外在肿瘤实验诊断方面的纲领性应用文件。不仅适合广大检验人员、临床医护人员学习使用,也非常适合相关仪器试剂生产厂商研发应用。本指南由刘洋、薛丽、林文涛、李江、梁红艳、顾兵、潘世扬、郑磊等翻译,姜晓峰、沈文梅、田亚平、鄢盛恺审校,最后由鄢盛恺统稿审定。本指南的翻译出版,不仅有助于我国检验人员和医护人员合理的检测和应用睾丸、前列腺、结直肠、乳腺及卵巢癌肿瘤标志物,对我国检验医学指南的编写与应用也有一定的借鉴作用。本刊特在本期刊发,以飨广大读者。 | 鄢盛恺 Ulf-Hkan Stenman Rolf Lamerz Leendert H.Looijenga Nils Brünner Michael J.Duffy Caj Haglund Mads Holten-Andersen Hans JФrgen Nielsen Francisco J.Esteva Nadia Harbeck Daniel F.Hayes Rafael Molina Daniel W.Chan Robert C.Bast Jr Ie-Ming Shih Lori J.Sokoll Gyrgy Slétormos 刘洋 梁红艳 姜晓峰 田亚平 薛丽 林文涛 顾兵 潘世扬 沈文梅 郑磊 李江 | 2012 | 临床检验杂志2012,30,2: | 32 |
| 3 | 山西子宫颈癌筛查方法比较的可行性研究显示文摘〔目的〕在同一对象人群中同时比较六种宫颈癌及癌前病变筛查方法 ,并调查影响宫颈癌的危险因素 ,为进一步开展宫颈癌大样本人群的癌前筛查方法比较研究提供简单、可行且高效的依据。〔方法〕在山西宫颈癌高发地区对136位妇女同时采用以组织学为金标准的六种宫颈癌及癌前病变筛查方法筛查。同时 ,对该对象进行宫颈癌危险因素调查。〔结果〕该人群宫颈高度鳞状上皮内瘤变(HSIL)及癌的现患比率为8 8%(12/136)。各筛查方法的敏感度、特异度及准确性为 :3%醋酸染色后肉眼观察(0 250,0 850,0 795)、细胞学常规涂片(0 583,0 958 ,0 924)、ThinPrep涂片(0 818,0 966,0 953)、阴道镜检(0 583,0 825 ,0 803)、HPV自检(0 667 ,0 842,0 826)、ThinPrep检测HPV(0 917,0 853,0 859) ;宫颈荧光检查的敏感度为0 57,其特异度为0 55;该人群对筛查方法的顺应性为100 % ,对危险因素调查的顺应性为95 5 %。〔结论〕根据本可行性研究结果 ,认为该地区确属宫颈癌高发地区 ,且人群顺应性好 ,可以开展大规模的宫颈癌筛查方法的比较研究及危险因素调查研究。 | 杨玲 章文华 李爱玲 潘秦镜 吴令英 李凌 戎寿德 杨雪萍 马聪萍 Jerome L Belinson Robert G Pretorius 乔友林 | 2000 | 中国肿瘤2000,9,9: | 32 |
| 4 | 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 |
| 5 | Choledocholithiasis: Evolving standards for diagnosis and management显示文摘胆石病,导致外科的干预的最普通的医药条件之一,在美国影响成年人口的约 10 % 。胆总管石病与胆囊石头在大约病人的 10%-20% 发展,文学建议至少经历胆囊炎的病人的 3%-10% 将有胆总管(CBD ) 石头。CBD 石头可以外科手术前地, intraoperatively 或手术后地被发现多重形式为包括实验室测试,超声,计算断层摄影术扫描(CT ) ,和磁性的回声 cholangiopancreatography (MRCP ) 为胆总管石病估计病人是可得到的。Intraoperative 胆管造影术能习惯性地或有选择地在胆囊炎期间被使用诊断 CBD 石头。为 CBD 石头的最普通的干预是 ERCP。另外的通常使用的干预包括 intraoperative 胆汁管探索,任何一个 laparoscopic 或 open。经皮, transhepatic 石头移动胆汁的清理的另外的新奇技术被设计了。与这些技术灵巧的设备和有技能的专业人员的可获得性在机构之中变化。预定干预被临床的状况经常支配。 | Marilee L Freitas Robert L Bell Andrew J Duffy | 2006 | World Journal of Gastroenterology2006,12,20: | 30 |
| 6 | Role of the gut microbiota in inflammatory bowel disease pathogenesis: What have we learnt in the past 10 years?显示文摘Our understanding of the microbial involvement in inflammatory bowel disease(IBD) pathogenesis has increased exponentially over the past decade. The development of newer molecular tools for the global assessment of the gut microbiome and the identification of nucleotide-binding oligomerization domain-containing protein 2 in 2001 and other susceptibility genes for Crohn's disease in particular has led to better understanding of the aetiopathogenesis of IBD. The microbial studies have elaborated the normal composition of the gut microbiome and its perturbations in the setting of IBD. This altered microbiome or 'dysbiosis' is a key player in the protracted course of inflammation in IBD. Numerous genome-wide association studies have identified further genes involved in gastrointestinal innate immunity(including polymorphisms in genes involved in autophagy: ATG16L1 and IGRM), which have helped elucidate the relationship of the local innate immunity with the adjacent luminal bacteria. These developments have also spurred the search for specific pathogens which may have a role in the metamorphosis of the gut microbiome from a symbiotic entity to a putative pathogenic one. Here we review advances in our understanding of microbial involvement in IBD pathogenesis over the past 10 years and offer insight into how this will shape our therapeutic management of the disease in the coming years. | Georgina L Hold Megan Smith Charlie Grange Euan Robert Watt Emad M El-Omar Indrani Mukhopadhya | 2014 | World Journal of Gastroenterology2014,20,5: | 21 |
| 7 | Radioembolization for the treatment of unresectable hepatocellular carcinoma:A clinical review显示文摘Hepatocellular carcinoma(HCC)is the sixth most common cancer in the world.The majority of patients with HCC present with unresectable disease.These patients have historically had limited treatment options secondary to HCC demonstrating chemoresistance to the currently available systemic therapies.Additionally, normal liver parenchyma has shown intolerance to tumoricidal radiation doses,limiting the use of external beam radiation.Because of these limitations,novel percutaneous liver-directed therapies have emerged. The targeted infusion of radioactive microspheres (radioembolization)represents one such therapy. Radioembolization is a minimally invasive transcatheter therapy through which radioactive microspheres are infused into the hepatic arteries that supply tumor. Once infused,these microspheres traverse the hepatic vascular plexus and selectively implant within the tumor arterioles.Embedded within the arterioles, the 90Y impregnated microspheres emit high energy and low penetrating radiation doses selectively to the tumor.Radioembolization has recently shown promise for the treatment of patients with unresectable HCC. The objective of this review article is to highlight twocurrently available radioembolic devices(90Y,188Rh)and provide the reader with a recent review of the literature. | Saad M Ibrahim Robert J Lewandowski Kent T Sato Vanessa L Gates Laura Kulik Mary F Mulcahy Robert K Ryu Reed A Omary Riad Salem | 2008 | World Journal of Gastroenterology2008,14,11: | 14 |
| 8 | Characterisation and risk assessment of venous thromboembolism in gastrointestinal cancers显示文摘AIM To characterise venous thromboembolism(VTE) in gastrointestinal cancer and assess the clinical utility of risk stratification scoring. METHODS We performed a retrospective analysis using electronic patient records of 910 gastro-oesophageal(GO) cancer and 1299 colorectal cancer(CRC) patients referred to a tertiary cancer centre to identify the incidence of VTE, its relationship to chemotherapy and impact on survival.VTE risk scores were calculated using the Khorana index. Patients were classified as low risk(0 points), intermediate risk(1 to 2 points) or high risk(3 points). Data was analysed to determine the sensitivity of the Khorana score to predict VTE. RESULTS The incidence of VTE was 8.9% for CRC patients and 9.7% for GO cancer patients. Pulmonary emboli(PE) were more common in advanced than in localised CRC(50% vs 21% of events respectively) and lower limb deep vein thrombosis(DVT) were more common in localised than in advanced CRC(62% vs 39% of events respectively). The median time to VTE from cancer diagnosis was 8.3 mo for CRC patients compared to 6.7 mo in GO cancer. In localised CRC median time to VTE was 7.1 mo compared with 10.1 mo in advanced CRC. In contrast in GO cancer, the median time to VTE was 12.5 mo in localised disease and 6.8 mo in advanced disease. No survival difference was seen between patients with and without VTE in this cohort. The majority of patients with CRC in whom VTE was diagnosed had low or intermediate Khorana risk score(94% for localised and 97% in advanced CRC). In GO cancer, all patients scored either intermediate or high risk due to the primary site demonstrating a limitation of the risk assessment score in discriminating high and low risk patients with GO cancers. Additional risk factors were identified in this cohort including surgery, chemotherapy or hospital admission. Overall, 81% of patients with CRC and 77% of patients with GO cancer had one or more of these factors within 4 wk prior to diagnosis VTE. These should be factored into clinical risk assessment scores. CONCLUSION The Khorana score has low sensitivity for thrombotic events in CRC and cannot discriminate low risk patients in high risk cancer sites such as GO cancer. | Robert L Metcalf Eamon Al-Hadithi Nicholas Hopley Thomas Henry Clare Hodgson Antony McGurk Wasat Mansoor Jurjees Hasan | 2017 | World Journal of Gastrointestinal Oncology2017,9,9: | 10 |
| 9 | Recent trends in the surgical management of inflammatory bowel disease显示文摘Surgery is required in the vast majority of patients with Crohn’s disease (CD) and in approximately one-third of patients with ulcerative colitis (UC). Similar to medical treatments for IBD, significant advances have occurred in surgery. Advances in CD include an emphasis upon conservatism as exemplified by more limited resections, strictureplasties, and laparoscopic resections. The use of probiotics in selected patients has improved the outcome in patients with pouchitis following restorative proctocolectomy for UC. It is anticipated that ongoing discoveries in the molecular basis of IBD will in turn identify those patients who will best respond to surgery. | Robert E Roses John L Rombeau | 2008 | World Journal of Gastroenterology2008,14,3: | 10 |
| 10 | 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 |
| 11 | Genetic and molecular changes in ovarian cancer显示文摘Epithelial ovarian cancer represents the most lethal gynecological malignancy in the developed world, and can be divided into five main histological subtypes: high grade serous, endometrioid, clear cell, mucinous and low grade serous. These subtypes represent distinct disease entities, both clinically and at the molecular level. Molecular analysis has revealed significant genetic heterogeneity in ovarian cancer, particularly within the high grade serous subtype. As such, this subtype has been the focus of much research effort to date, revealing molecular subgroups at both the genomic and transcriptomic level that have clinical implications.However, stratification of ovarian cancer patients based on the underlying biology of their disease remains in its infancy. Here, we summarize the molecular changes that characterize the five main ovarian cancer subtypes, highlight potential opportunities for targeted therapeutic intervention and outline priorities for future research. | Robert L Hollis Charlie Gourley | 2016 | Cancer Biology & Medicine2016,13,2: | 8 |
| 12 | Evolution of surgical skills training显示文摘外科的训练正在变化:100 年传统被法律、道德的担心为耐心的安全,工作小时限制,手术室时间的费用,和复杂并发症正在质问。训练的外科的模拟和技巧提供一个机会在在生活病人上尝试他们前在手术室环境外面教并且练习先进技巧。当使用真实仪器和录像设备操作在一个盒子训练员模仿了“织物”,模拟训练能向前是同样直的。更先进的、虚拟现实模拟器现在为普遍使用可得到、准备好了。早系统表明了他们的有效性和歧视的能力。更新的系统启用全面课程和完整的程序的模拟的开发。医药教育是的毕业生的认证委员会(ACGME ) 要求了训练和评估的新奇方法的发展。外科的组织正在打电话让方法保证技巧的维护,并且,进展 surgical 训练信任外科医生作为技术上能干。在他们的当前的形式的模拟器被表明了改进外科的居民的手术室表演。训练课程标准化的开发仍然是一个迫切、重要的议程,特别地为最小的侵略外科。一条创新、进步的途径,从航空的域借经验,能为外科的训练的下一个世纪提供基础,保证产品的质量。当技术发展,我们练习的方法将继续演变,到医生和病人的利益。 | Kurt E Roberts Robert L Bell Andrew J Duffy | 2006 | World Journal of Gastroenterology2006,12,20: | 8 |
| 13 | High-throughput screening of mouse gene knockouts identifies established and novel skeletal phenotypes显示文摘Screening gene function in vivo is a powerful approach to discover novel drug targets. We present high-throughput screening(HTS) data for 3 762 distinct global gene knockout(KO) mouse lines with viable adult homozygous mice generated using either gene-trap or homologous recombination technologies. Bone mass was determined from DEXA scans of male and female mice at 14 weeks of age and by microCT analyses of bones from male mice at 16 weeks of age. Wild-type(WT) cagemates/littermates were examined for each gene KO. Lethality was observed in an additional 850 KO lines. Since primary HTS are susceptible to false positive findings, additional cohorts of mice from KO lines with intriguing HTS bone data were examined. Aging,ovariectomy, histomorphometry and bone strength studies were performed and possible non-skeletal phenotypes were explored. Together, these screens identified multiple genes affecting bone mass: 23 previously reported genes(Calcr, Cebpb, Crtap, Dcstamp, Dkk1, Duoxa2, Enpp1, Fgf23, Kiss1/Kiss1 r, Kl(Klotho),Lrp5, Mstn, Neo1, Npr2, Ostm1, Postn, Sfrp4, Slc30a5, Slc39a13, Sost, Sumf1, Src, Wnt10b), five novel genes extensively characterized(Cldn18, Fam20 c, Lrrk1, Sgpl1, Wnt16), five novel genes with preliminary characterization(Agpat2, Rassf5, Slc10a7, Slc26a7, Slc30a10) and three novel undisclosed genes coding for potential osteoporosis drug targets. | Robert Brommage Jeff Liu Gwenn M Hansen Laura L Kirkpatrick David G Potter Arthur T Ss Brian Zambrowicz David R Powell Peter Vogel | 2014 | Bone Research2014,2,3: | 7 |
| 14 | Dementia and osteoporosis in a geriatric population: Is there a common link?显示文摘AIM To determine the existence of a common pathological link between dementia and osteoporosis through reviewing the current evidence base. METHODS This paper reviews the current literature on osteoporosis and dementia in order to ascertain evidence of a common predisposing aetiology. A literature search of Ovid MEDLINE(1950 to June 2016) was conducted. The keywords 'osteoporosis', 'osteoporotic fracture', 'dementia' and 'Alzheimer's disease'(AD) were used to determine the theoretical links with the most significant evidence base behind them. The key links were found to be vitamins D and K, calcium, thyroid disease, statins, alcohol and sex steroids. These subjects were then searched in combination with the previous terms and the resulting papers manually examined. Theoretical, in vitro and in vivo research were all used to inform this review which focuses on the most well developed theoretical common causes for dementia(predominantly Alzheimer's type) and osteoporosis.RESULTS Dementia and osteoporosis are multifaceted disease processes with similar epidemiology and a marked increase in prevalence in elderly populations. The existence of a common link between the two has been suggested despite a lack of clear pathological overlap in our current understanding. Research to date has tended to be fragmented and relatively weak in nature with multiple confounding factors reflecting the difficulties of in vivo experimentation in the population of interest. Despite exploration of various possible mechanisms in search for a link between the two pathologies, this paper found that it is possible that these associations are coincidental due to the nature of the evidence available. One finding in this review is that prior investigation into common aetiologies has found raised amyloid beta peptide levels in osteoporotic bone tissue, with a hypothesis that amyloid beta disorders are systemic disorders resulting in differing tissue manifestations. However, our findings were that the most compelling evidence of a common yet independent aetiology lies in the APOE4 allele, which is a well-established risk for AD but also carries an independent association with fracture risk. The mechanism behind this is thought to be the reduced plasma vitamin K levels in individuals exhibiting the APOE4 allele which may be amplified by the nutritional deficiencies associated with dementia, which are known to include vitamins K and D. The vitamin theory postulates that malnutrition and reduced exposure to sunlight in patients with AD leads to vitamin deficiencies. CONCLUSION Robust evidence remains to be produced regarding potential links and regarding the exact aetiology of these diseases and remains relevant given the burden of dementia and osteoporosis in our ageing population. Future research into amyloid beta, APOE4 and vitamins K and D as the most promising aetiological links should be welcomed. | Candice L Downey Adam Young Emily F Burton Simon M Graham Robert J Macfarlane Eva-Maria Tsapakis Eleftherios Tsiridis | 2017 | World Journal of Orthopedics2017,8,5: | 6 |
| 15 | 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 |
| 16 | Reallocation of foliicolous species of the genus Strigula into six genera(lichenized Ascomycota,Dothideomycetes,Strigulaceae)显示文摘Strigula sensu lato has been previously defined based on phenotype characters as a rather broad genus including tropical to temperate species growing on a wide array of substrata.In this study,based on a multilocus phylogenetic approach,we show that foliicolous species form six well-delimited clades that correlate with diagnostic phenotype features,including thallus morphology,carbonization of the involucrellum and excipulum,ascospore dimensions,and type of macroconidia.Given the topology,with five of the six clades emerging on long stem branches,and the strong phenotypical differentiation between the clades,we recognize these at the genus level,making mostly use of previously established genus names.Four genera,namely Phylloporis,Puiggariella,Raciborskiella,and Racoplaca,are resurrected for the S.phyllogena,S.nemathora,S.janeirensis,and S.subtilissima groups,respectively,whereas one new genus,Serusiauxiella gen.nov.,is introduced for a novel lineage with peculiar macroconidia.The only sequenced non-foliicolous species,S.jamesii,is not closely related to these six foliicolous lineages but clusters with Flavobathelium and Phyllobathelium,revealing it as an additional undescribed genus-level lineage being treated elsewhere.Within the new genus Serusiauxiella,three new species are described:Serusiauxiella filifera sp.nov.,S.flagellata sp.nov.,and S.sinensis sp.nov.In addition,ten new combinations are proposed:Phylloporis austropunctata comb.nov.,P.radiata comb.nov.,P.vulgaris comb.nov.,Puiggariella confluens comb.et stat.nov.,P.nemathora comb.nov.,P.nigrocincta comb.nov.,Racoplaca maculata comb.nov.,R.melanobapha comb.nov.,R.transversoundulata,and R.tremens comb.nov.We also report on a peculiar,previously unrecognized growth behaviour of the macroconidial appendages in Strigula s.lat. | Shu‑Hua Jiang Robert Lücking Amanda Barreto Xavier‑Leite Marcela E.S.Cáceres AndréAptroot Carlos Vinas Portilla Jiang‑Chun Wei | 2020 | Fungal Diversity2020,,3: | 5 |
| 17 | Three-Year Efficacy and Safety of Tenofovir Disoproxil Fumarate Treatment for Chronic Hepatitis B显示文摘 | E. Jenny Heathcote Patrick Marcellin Maria Buti Edward Gane Robert A. De Man Zahary Krastev George Germanidis Samuel S. Lee Robert Flisiak Kelly Kaita Michael Manns Iskren Kotzev Konstantin Tchernev Peter Buggisch Frank Weilert Oya Ovunc Kurdas Mitchell L | 2011 | Gastroenterology2011,,1: | 5 |
| 18 | Colonic manifestations of PTEN hamartoma tumor syndrome: Case series and systematic review显示文摘AIM:To investigate our clinical experience with the colonic manifestations of phosphatase and tensin homolog on chromosome ten(PTEN)hamartoma tumor syndrome(PHTS)and to perform a systematic literature review regarding the same.METHODS:This study was approved by the appropriate institutional review board prior to initiation.A clinical genetics database was searched for patients with PHTS or a component syndrome that received gastrointestinal endoscopy or pathology interpretation at our center.These patient’s records were retrospectively reviewed for clinical characteristics(including family history and genetic testing),endoscopy results and pathology findings.We also performed a systematic review of the literature for case series of PHTS or component syndromes that reported gastrointestinal manifestations and investigations published after consensus diagnostic criteria were established in 1996.These results were compiled and reported.RESULTS:Eight patients from our institution met initial inclusion criteria.Of these,5 patients underwent4.2 colonoscopies at mean age 45.8±10.8 years.All were found to have colon polyps during their clinical course and polyp histology included adenoma,hyperplastic,ganglioneuroma and juvenile.No malignant lesions were identified.Two had multiple histologic types.One patient underwent colectomy due to innumerable polyps and concern for future malignant potential.Systematic literature review of PHTS patients undergoing endoscopy revealed 107 patients receiving colonoscopy at mean age 37.4 years.Colon polyps were noted in92.5%and multiple colon polyp histologies were reported in 53.6%.Common polyp histologies included hyperplastic(43.6%),adenoma(40.4%),hamartoma(38.3%),ganglioneuroma(33%)and inflammatory(24.5%)polyps.Twelve(11.2%)patients had colorectal cancer at mean age 46.7 years(range 35-62).Clinical outcomes secondary to colon polyposis and malignancy were not commonly reported.CONCLUSION:PHTS has a high prevalence of colon polyposis with multiple histologic types.It should be considered a mixed polyposis syndrome.Systematic review found an increased prevalence of colorectal cancer and we recommend initiating colonoscopy for colorectal cancer surveillance at age 35 years. | Peter P Stanich Robert Pilarski Jonathan Rock Wendy L Frankel Samer El-Dika Marty M Meyer | 2014 | World Journal of Gastroenterology2014,20,7: | 5 |
| 19 | Pharmacological effects of lipid-lowering drugs on circulating adipokines显示文摘The cardioprotective effects of lipid-lowering drugs have been primarily attributed to their effects on blood lipid metabolism.However,emerging evidence indicates that lipid-lowering drugs also modulate the synthesis and secretion of adipose tissue-secreted proteins referred to as adipokines.Adipokines influence energy homeostasis and metabolism and have also been shown to modulate the vascular inflammatory cascade.The purpose of this review will be to examine the reported effects of commonly used lipid-lowering drugs(statins,fibrates,niacin and omega-3-fatty acids) on the circulating concentrations of leptin,adiponectin,tumor necrosisfactor-α(TNF-α),Retinol binding protein 4(RBP4) and resistin.Overall,the lipid-lowering drugs reviewed have minimal effects on leptin and resistin concentrations.Conversely,circulating adiponectin concentrations are consistently increased by each lipid-lowering drug reviewed with the greatest effects produced by niacin.Studies that have examined the effects of statins,niacin and omega-3-fatty acids on TNF-α demonstrate that these agents have little effect on circulating TNF-α concentrations.Niacin and fibrates appear to lower RBP4 but not resistin concentrations.The results of the available studies suggest that a strong relationship exists between pharmacological reductions in blood lipids and adiponectin that is not obvious for other adipokines reviewed. | Desiree Wanders Eric P Plaisance Robert L Judd | 2010 | World Journal of Diabetes2010,1,4: | 5 |
| 20 | Mental and physical symptoms associated with lower social support for patients with hepatitis C显示文摘AIM: To systematically examine the impact of the hepatitis C virus (HCV) diagnosis on patients' level of social support in a large-scale study. METHODS: Patients evaluated and treated for HCV in a tertiary referral center were enrolled in a cross-sectional study. Demographic data, functional and emotional status as measured by the Hospital Anxiety and Depression Scale (HAD) and the Sickness Impact Profile (SIP), severity of liver disease, mode of acquisition, and physical and psychiatric comorbidities were collected from patients or abstracted from the medical record. All participants completed a semi-structured interview, addressing questions of social support. RESULTS: A total of 342 patients (mean age 45.2 years; 37% women) were enrolled. Ninety-two (27%) patients described lower levels of support by family and friends. Nearly half of the participants (45%) noted the loss of at least one relationship due to the disease. Fears related to transmitting the disease (25%) were common and often associated with ignorance or even discrimination by others (19%). Nearly one fifth of the patients did not share information about their disease with others to avoid being stigmatized. Lower levels of social support were significantly associated with living alone, being unemployed, being excluded from antiviral therapy, having psychiatric comorbidities, contracting HCV through intravenous drug use, having high levels of anxiety and depression as measured by the HAD and negative mood state as measured by the SIP. Patients reporting lower levels of social support also noted more physical symptoms as measured by the SIP. CONCLUSION: Patients with hepatitis C often face significant social problems, ranging from social isolation to familial stress. The most common concerns reflect a limited insight of patients and their relatives and friends about the disease, the risk factors for its spread, and about potential consequences. Our data suggest that educational interventions targeting support persons and the stressors identified in our findings may lessen or alleviate the social strains patients with hepatitis C experience. | Julie A Blasiole Laura Shinkunas Douglas R LaBrecque Robert M Arnold Susan L Zickmund | 2006 | World Journal of Gastroenterology2006,12,29: | 5 |