|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | Molecular mechanisms of viral hepatitis induced hepatocellular carcinoma显示文摘Chronic infection with viral hepatitis affects half a billion individuals worldwide and can lead to cirrhosis,cancer,and liver failure.Liver cancer is the third leading cause of cancer-associated mortality,of which hepatocellular carcinoma(HCC)represents 90%of all primary liver cancers.Solid tumors like HCC are complex and have heterogeneous tumor genomic profiles contributing to complexity in diagnosis and management.Chronic infection with hepatitis B virus(HBV),hepatitis delta virus(HDV),and hepatitis C virus(HCV)are the greatest etiological risk factors for HCC.Due to the significant role of chronic viral infection in HCC development,it is important to investigate direct(viral associated)and indirect(immune-associated)mechanisms involved in the pathogenesis of HCC.Common mechanisms used by HBV,HCV,and HDV that drive hepatocarcinogenesis include persistent liver inflammation with an impaired antiviral immune response,immune and viral protein-mediated oxidative stress,and deregulation of cellular signaling pathways by viral proteins.DNA integration to promote genome instability is a feature of HBV infection,and metabolic reprogramming leading to steatosis is driven by HCV infection.The current review aims to provide a brief overview of HBV,HCV and HDV molecular biology,and highlight specific viral-associated oncogenic mechanisms and common molecular pathways deregulated in HCC,and current as well as emerging treatments for HCC. | Simmone D'souza Keith CK Lau Carla S Coffin Trushar R Patel | 2020 | World Journal of Gastroenterology2020，26，38： | 25 |
| 3 | Diagnosis of Crohn's disease in India where tuberculosis is widely prevalent显示文摘AIM:To define the parameters that positively predict diagnosis of Crohn's disease (CD) and differentiate it from gastrointestinal tuberculosis (GITB). METHODS:This prospective study over 3 years was carried out in the consecutive Indian patients with definite diagnosis of CD and equal numbers of patients with definite diagnosis of GITB. Demographic, clinical, laboratory, morphological and histological features were noted in all the patients. Serological tests such as p-ANCA, c-ANCA, IgA ASCA and IgG ASCA, were performed. Endoscopic biopsy and/or surgical tissue specimens were subjected to smear and culture for acid-fast bacilli (AFB) and tissue polymerase chain reaction for tuberculosis (TB PCR). Diagnosis of CD and GITB was based on the standard criteria. Data were analyzed using univariate Chi-square test and multiple logistic regression (MLR). RESULTS:The study is comprised of 26 patients with CD (age 36.6 ± 8.6 year, male:female, 16:10) and 26 patients with GITB (age 37.2 ± 9.6 year, male:female, 15:11). The following clinical variables between the two groups (CD vs TB) were significant in univariate analysis:duration of symptoms (58.1 ± 9.8 vs 7.2 ± 3.4 mo), diarrhoea (69.2% vs 34.6%), bleeding per rectum (30.7% vs 3.8%), fever (23.1% vs 69.2%), ascites (7.7% vs 34.6%) and extra-intestinal manifestations of inflammatory bowel disease (61.5% vs 23.1%). Of these, all except ascites and extra-colonic manifestations were found statistically significant by MLR. Accuracy of predicting CD was 84.62% based on the fever, bleeding P/R, diarrhoea and duration of symptoms while it was 63.4% when histology was reported as inflammatory bowel disease and 42.3% when there was recurrence of disease after surgery. Accuracy of predicting GITB was 73.1% when there was co-existing pulmonary lesions and/or abdominal lymphadenopathy;75% when tuberculosis was reported in histology;63.4% when granuloma was found in histology;82.6% when TB PCR was positive;and 61.5% when smear and/ or culture was positive for AFB. Serological test was not useful in differentiation of CD from GITB. Positivity rates for CD and GITB were:p-ANCA-3.8% and 3.8%, c-ANCA-3.8% and 0%, IgA ASCA-38.4% and 23.1%, and IgG ASCA-38.4% and 42.3%, respectively. CONCLUSION:Simple clinical parameters like fever, bleeding P/R, diarrhoea and duration of symptoms have the highest accuracy in differentiating CD from GITB. | Deepak N Amarapurkar Nikhil D Patel Priyamvada S Rane | 2008 | World Journal of Gastroenterology2008，14，5： | 24 |
| 4 | Antidiabetic and in vitro antioxidant potential of Hybanthus enneaspermus(Linn) F.Muell in streptozotocin—induced diabetic rats显示文摘Objective:To evaluate antidiabetic and antioxidant potential of Hybanthus enneaspermus in different models.Methods:The oral glucose tolerance test(OGTT) and normoglycemic effect of alcoholic extract of Hybanthus enneaspermus(AHE) were evaluated at a dose of 125,250 and 500mg/kg p.o.while hypoglycemic activity and effect on body weight were tested at 250 and 500 mg/kg p.o.per day for 21 days in Streptozotocin(STZ) induced diabetic rats.Further,glucose uptake by hemidiaphram was also evaluated.The total polyphenolic and flavonoid were determined and their correlation with various antioxidant assays was also determined.Results:The results showed high level of phenolic content in AHE.AHE also exhibited higher total antioxidant capacity,good reducing power and a significant scavenger of reactive oxygen species like DPPH radical,nitric oxide,hydrogen peroxide and deoxyribose.Furthermore there was a significant increase in the body weight and decrease in the blood glucose level on treatment with the AHE.AHE increased glucose uptake on isolated rat hemi-diaphragm compared to control group.Conclusions:AHE reduce blood glucose level in STZ-induced diabetic model.It does not show significant effect in normoglycemic study but showes significant effect in OGT.AHE has significant antioxidant activity,which may be attributed to high phenolic content. | Patel DK Kumar R Prasad SK Sairam K Hemalatha S | 2011 | Asian Pacific Journal of Tropical Biomedicine2011，1，4： | 22 |
| 5 | Management of pancreaticobiliary disease using a new intra-ductal endoscope:The Texas experience显示文摘AIM:To evaluate a new single-operator mini-endoscope, Spyglass,for its performance,feasibility and safety in the management of pancreaticobiliary disease. METHODS:In a multicenter retrospective analysis of patients undergoing intraductal endoscopy,we evaluated 128 patients(71 men,mean age 57.6 years).Indications were therapeutic(TX)in 72(56%) and diagnostic(DX)in 56(44%). RESULTS:Peroral endoscopy was performed in 121 and percutaneous in seven.TX indications included CBD stones in 41,PD stones in six,and biliary strictures in 25.DX indications included abnormal LFT’s in 15, abnormal imaging in 38 and cholangiocarcinoma staging in three.Visualization of the stone(s)was considered good in 31,fair in six,and poor in four. Advancement of the electrohydraulic lithotripsy probe was not possible in three patients and proper targeting of the lesion was partial in four patients.A holmium laser was used successfully in three patients.Ductal clearance was achieved in 37 patients after one procedure and in four patients after two procedures.Diagnosis of biliary strictures was modified in 20/29 and confirmed to be malignant in 10/23.Of the modified patients,no diagnosis was available in 17.Spyglass demonstrated malignancy in 8/17 and non-malignancy in nine.Suspected pathology by imaging studies and abnormal LFT’s was modified in 43/63(66%).Staging of cholangiocarcinoma demonstrated multicentric cholangiocarcinoma in 2/3.There was no morbidity associated with the use of Spyglass. CONCLUSION:Spyglass Spyscopeis a first generation, single operator miniature endoscope that can evaluate and treat various biliary and pancreatic tract diseases. | Douglas S Fishman Paul R Tarnasky Sandeep N Patel Isaac Raijman | 2009 | World Journal of Gastroenterology2009，15，11： | 22 |
| 6 | Diabetes mellitus:An overview on its pharmacological aspects and reported medicinal plants having antidiabetic activity显示文摘Diabetes mellitus is not a single disease but is a group of metabolic disorders affecting a huge numlier of population in the world.It is mainly characterized by chronic hyperglycemia,resulting from defects in insulin secretion or insulin action.It is predicated that the number of diabetes person in the world could reach upto 366 million by the year 2030.Even though the cases of diabetes are increasing day by day,except insulin and oral hypoglycemic drugs no other way of treatment has been successfully developed so far.Thus,the objective of the present review is to provide an insight over the pathophysiological and etiological aspects of diabetes mellitus along with the remedies available for this metabolic disorder.The review also contains brief idea about diabetes mellitus and the experimental screening model with their relevant mechanism and significance mainly used nowadays.Alloxan and streptozotocin are mainly used for evaluating the antidiabetic activity of a particular drug.This review contain list of medicinal plants which have been tested for their antidiabetic activity in the alloxan induced diabetic rat model.From the available data in the literature,it was found that plant having antidiabetic activity is mainly due to the presence of the secondary metabolite.Thus,the information provided in this review will help the researchers for the development of an alternative methods rather than insidin and oral hypoglycemic agents for the treatment of diabetes niellitus,which will minimize the complication associated with the diabetes and related disorder. | Patel DK Kumar R Laloo D Hemalatha S | 2012 | Asian Pacific Journal of Tropical Biomedicine2012，2，5： | 17 |
| 7 | An overview on antidiabetic medicinal plants having insulin mimetic property显示文摘Diabetes mellitus is one of the common metabolic disorders acquiring around 2.8%of the world's population and is anticipated to cross 5.4%by the year 2025.Since long back herbal medicines have been the highly esteemed source of medicine therefore,they have become a growing part of modern,high-tech medicine.In view of the above aspects the present review provides profiles of plants(65 species) with hypoglycaemic properties,available through literature source from various database with proper categorization according to the parts used,mode of reduction in blood glucose(insulinomimetic or insulin secretagugues activity) and active phyloconsliluents having insulin mimetics activity.From the review it was suggested that,plant showing hypoglycemic potential mainly belongs to the family Leguminoseae,Lamiaceae,Liliaceae,Cucurbitaceae, Asteraceae,Moraceae,Rosaceae and Araliaceae.The most active plants are Allium sativum. Gymnema sylvestre,Citrullus colocynthis,Trigonella foenum greacum,Momordica charantia and Ficuts bengalensis.The review describes some new bioactive drugs and isolated compounds from plants such as roseoside,epigallocatechin gallate,beta-pyrazol-1-ylalanine,cinchonain Ib,leucocyandin 3-O-beta-d-galactosyl cellobioside,leucopelargonidin-3- O-alpha-L rhamuoside,glycyrrhetinic acid,dehydrotrametenolic acid,strictinin,isostrictinin,pedunculagin, epicatechin and christinin-A showing significant insulinomimetic and antidiabetic activity with more efficacy than conventional hypoglycaemic agents.Thus,from the review majorly,the antidiabetic activity of medicinal plants is attributed to the presence of polyphenols,flavonoida, terpenoids,coumarins and other constituents which show reduction in blood glucose levels.The review also discusses the management aspect of diabetes mellitus using these plants and their active principles. | Patel DK Prasad SK Kumar R Hemalatha S | 2012 | Asian Pacific Journal of Tropical Biomedicine2012，2，4： | 15 |
| 8 | Pedalium murex Linn(Pedaliaceae) fruits:a comparative antioxidant activity of its different fractions显示文摘Objective:To examine the antioxidant activity and total phenolic content of different solvent fractions of Pedulium murex(P.murex)Linn fruits(Family:Pedaliaceae)as well as the correlation between the total antioxidant capacity and total phenolic content.Methods:In the present study,the antioxidant activities of P.murex were evaluated using six in-vitro assays,namely total antioxidant assay,DPPH assay,reducing power,nitric oxide scavenging,hydrogen peroxide scavenging and deoxyribose scavenging assays,and total phenol contents were also investigated.Results:The ethyl acetate(EA)fraction was found to have high levels of phenolic content(298.72±2.09 mg GAE/g).The EA fraction exhibit higher total antioxidant capacity,higher percentage of DPPH radical scavenging activity(135.11±2.95μg/mL),nitric oxide(200.57±4.5lμg/mL),hydrogen peroxide(2I7.91±6.12μg/mL),deoxyribose(250.01±4.68μg/mL)and higher reducing power.Correlation coefficient(r^2=0.914)was found to be significant between total phenolic content and total antioxidant activity.Conclusions:In general,the results indicate that the EA fractions are rich in phenolic antioxidants with potent free radical scavenging activity implying their importance to human health. | DK Patel R Kumar SK Prasad S Hemalatha | 2011 | Asian Pacific Journal of Tropical Biomedicine2011，1，5： | 12 |
| 9 | Degenerative meniscus: Pathogenesis, diagnosis, and treatment options显示文摘The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than onethird of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive Mc Murray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on nonsteroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients re-fractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well. | Richard Howell Neil S Kumar Nimit Patel James Tom | 2014 | World Journal of Orthopedics2014，5，5： | 8 |
| 10 | 固定低剂量三联抗高血压药物与常规治疗对斯里兰卡轻度至中度高血压患者血压控制的疗效差异:一项随机临床试验显示文摘控制不良的高血压是全球领先的公共卫生问题,需要新的治疗策略。该研究评估低剂量三联抗高血压药物治疗是否能达到比常规治疗更好的血压控制。研究者纳入2016年2月至2017年5月在斯里兰卡11所城市医院诊所就诊的需要开始抗高血压治疗(未治疗的患者)或接受单药治疗的患者,进行低剂量三联降压与常规治疗比较的随机、开放性试验,随访至2017年10月。 | Web-ster R Salam A de Silva HA Selak V Stepien S Rajapakse S Amarasekara S Amarasena N Billot L de Silva AP Fernando M Guggilla R Jan S Jayawardena J Maulik PK Mendis S Munasinghe J Naik N Prabhakaran D Ranasinghe G Thom S Tisserra N Senaratne V Wijekoon S Wijeyasingam S Rodgers A Patel A 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 7 |
| 11 | The hormone resistin links obesity to diabetes显示文摘 | Steppan CM Bailey ST Bhat S Brown EJ Banerjee RR Wright CM Patel HR Ahima RS Lazar MA | | 0，，： | 6 |
| 12 | 中心和外周动脉脉搏波传导速度测量的重复性:社区动脉粥样硬化风险研究显示文摘通过脉搏波传导速度(pulsewavevelocity,PwV)检测动脉硬化程度是当前对高血压和心血管病风险评估和分层所日渐常用的方式。颈股动脉脉搏波传导速度(catroidfemoralarteryPWV,cfPWV)是一项公认的测定中心动脉硬化程度的方式。 | Meyer ML Tanaka H Palta P Patel MD Camplain R Couper D Cheng S Al Qunaibet A Poon AK Heiss G 陈云 叶鹏 | 2016 | 中华高血压杂志2016，24，5： | 6 |
| 13 | Coagonist of glucagon-like peptide-1 and glucagon receptors ameliorates kidney injury in murine models of obesity and diabetes mellitus显示文摘AIM To investigate the role of glucagon-like peptide-1(GLP-1)/glucagon receptors coagonist on renal dysfunction associated with diabetes and obesity. METHODS Chronic high-fat diet fed C57 BL/6 J mice, streptozotocintreated high-fat diet fed C57 BL/6 J mice and diabeticC57 BLKS/J db/db mice were used as models of diabetes-induced renal dysfunction. The streptozotocintreated high-fat diet fed mice and db/db mice were treated with the GLP-1 and glucagon receptors coagonist(Aib2 C24 Chimera2, 150 μg/kg, sc) for twelve weeks, while in chronic high-fat diet fed mice, coagonist(Aib2 C24 Chimera2, 150 μg/kg, sc) treatment was continued for forty weeks. Kidney function, histology, fibrosis, inflammation, and plasma biochemistry were assessed at the end of the treatment. RESULTS Coagonist treatment decreased body weight, plasma lipids, insulin resistance, creatinine, blood urea nitrogen, urinary albumin excretion rate and renal lipids. In kidney, expression of lipogenic genes(SREBP-1 C, FAS, and SCD-1) was decreased, and expression of genes involved in β-oxidation(CPT-1 and PPAR-α) was increased due to coagonist treatment. In plasma, coagonist treatment increased adiponectin and FGF21 and decreased IL-6 and TNF-?. Coagonist treatment reduced expression of inflammatory(TNF-α, MCP-1, and MMP-9) and pro-fibrotic(TGF-β, COL1 A1, and α-SMA) genes and also improved histological derangement in renal tissue.CONCLUSION Coagonist of GLP-1 and glucagon receptors alleviated diabetes and obesity-induced renal dysfunction by reducing glucose intolerance, obesity, and hyperlipidemia. | Vishal J Patel Amit A Joharapurkar Samadhan G Kshirsagar Brijesh K Sutariya Maulik S Patel Hiren M Patel Dheerendra K Pandey Rajesh H Bahekar Mukul R Jain | 2018 | World Journal of Diabetes2018，9，6： | 5 |
| 14 | Evaluation of in vitro aldose reductase inhibitory potential of different fraction of Hybanthus enneaspermus Linn F.Muell显示文摘Objective:To evaluate the aldose reductase inhibitory(ARI)activity of different fractions of Hybanthus enneaspermus for potential use in diabetic cataract.Methods:Total phenol and flavonoid content of different fractions was determined.ARI activity of different fractions in rat lens was investigated in vitro.Results:The results showed significant level of phenolic and flavonoid content in ethyl acetate fraction[total phenol(212.15±0.79 mg/g),total flavonoid(39.11±2.27mg/g)]and aqueous fraction[total phenol(140.62±0.57mg/g),total flavonoid(26.07±1.49 mg/g)]as compared with the chloroform fraction[total phenol(68.56±0.51mg/g),total flavonoid(13.41±0.82mg/g)]and petrolium ether fraction[total phenol(36.68±0.43mg/g),total flavonoid(11.55±1.06mg/g)].There was a significant difference in the ARI activity of each fraction,and it was found to be the highest in ethyl acetate fraction[IC_(50)(49.26±1.76μg/mL)]followed by aqueous extract[IC_(50)(70.83±2.82μg/mL)]and it was least in the petroleum ether fraction[IC_(50)(118.89±0.71μg/mL)].Chloroform fraction showed moderate activity[IC_(50)(98.52±1.80μg/mL)].Conclusions:Different fractions showed significanct amount of ARI activity,where in ethyl acetate fraction it was found to be maximum which may be due to its high phenolic and flavonoid content.The extract after further evaluation may be used in the treatment of diabetic cataract. | Patel DK Kumar R Kumar M Sairarn K Hemalatha S | 2012 | Asian Pacific Journal of Tropical Biomedicine2012，2，2： | 4 |
| 15 | Green tea extract:A potential cause of acute liver failure显示文摘The use of herbal products has increased significantly in recent years.Because these products are not subject to regulation by the Food and Drug Administration and are often used without supervision by a healthcare provider,the indication for and consumption of these supplements is quite variable.Moreover,their use is generally regarded as safe and natural by the lay-public.Unfortunately,there has been an increase in the number of reported adverse events occurring with the use of herbal products.We present a case of acute impending liver failure in an adolescent male using a weightloss product containing green tea extract.Our case adds to the growing concern surrounding the ingestion of green tea extract and serves to heighten healthcare provider awareness of a potential green tea extract hepatotoxicity.Despite the generally touted benefits of green tea as a whole,clinical concern regarding its use is emerging and has been linked to its concentration in multiple herbal supplements.Interestingly,the suspected harmful compounds are those previously proposed to be advantageous for weight-loss,cancer remedy,and anti-inflammatory purposes.Yet,we emphasize the need to be aware of not just green tea extract,but the importance of monitoring patient use of all dietary supplements and herbal products. | Shreena S Patel Stacey Beer Debra L Kearney Garrett Phillips Beth A Carter | 2013 | World Journal of Gastroenterology2013，19，31： | 3 |
| 16 | Risk-adjustment in hepatobiliarypancreatic surgery显示文摘AIM: The present study evaluates the performance of the POSSUM, the American Society of Anesthetists (ASA),APACHE and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary (HPB) surgery.We describe especially the limitations and advantages of risk in stratifying the patients.METHODS: We investigated 177 randomly chosen patients undergoing eledive complex HPB surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors.Primary endpoint was in-hospital mortality and morbidity.Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality.RESULTS: The operative mortality in the series was 3.95% .This compared well with the p-POSSUM and APACHE predicted mortality of 4.31% and 4.29% respectively. Postoperative complications amounted to 45% with 24 (13.6%)patients having a major adverse event. On multivariate analysis the pre-operative POSSUM physiological score (OR = 1.18,P = 0.009) was superior in predicting complications compared to the ASA (P = 0.108), APACHE (P = 0.117)or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio (INR),pulse rate, and intra-operative blood loss were independent risk factors. A combination of the POSSUM variables and INR offered the optimal combination of risk factors for risk prognostication in HPB surgery.CONCLUSION: Morbidity for elective HPB surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities. | Hemant M Kocher Paris P Tekkis Palepu Gopal Ameet G Patel Simon Cottam Irving S Benjamin | 2005 | World Journal of Gastroenterology2005，11，16： | 3 |
| 17 | Treatment of C2 body fracture with unusual distractive and rotational components resulting in gross instability显示文摘Cervical fractures can result in severe neurological compromise and even death. One of the most commonly injured segments is the C2 vertebrae, which most frequently involves the odontoid process. In this report, we present the unusual case of a 28-year-old female who sustained a C2 vertebral body fracture(comminuted transverse fracture through the body and both transverse processes) that had both a significant distractive and rotational component, causing the fracture to be highly unstable. Application of halo bracing was unsuccessful. The patient subsequently required a C1-C4 posterior spinal fusion. Follow-up computer tomography imaging confirmed fusion and the patient did well clinically thereafter. | Darryl Lau Samuel S Shin Rakesh Patel Paul Park | 2013 | World Journal of Orthopedics2013，4，4： | 3 |
| 18 | Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology显示文摘Acute upper and lower gastrointestinal bleeding, enteral feeding, cecostomy tubes and luminal strictures are some of the common reasons for gastroenterology service. While surgery was initially considered the main treatment modality, the advent of both therapeutic endoscopy and interventional radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping and complementary in the management of these complex conditions. | David M Ray Indu Srinivasan Shou-jiang Tang Andreas S Vilmann Peter Vilmann Timothy C McCowan Akash M Patel | 2017 | World Journal of Radiology2017，9，3： | 2 |
| 19 | The effect of VE exposure on cadmium toxicity in mouse embryo cells in vitro 显示文摘 | Warren S Patel S Kapron CM | 2000 | Toxicology2000，142，： | 2 |
| 20 | Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes显示文摘 | Patel A MacMahon S Chalmers J | | New England Journal of Medicine0，，： | 2 |
您所在的机构暂未开通此部分的功能，请联系管理员