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| 1 | Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases显示文摘AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%. | ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta mohamed el sorogy emad hamdy mohamed el hemly ahmed a el-geidi tharwat kandil mohamed el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan mohamed abdel wahab | 2017 | World Journal of Gastroenterology2017，23，38： | 15 |
| 2 | Predictors of long term survival after hepatic resection for hilar cholangiocarcinoma:A retrospective study of 5-year survivors显示文摘AIM:To determine predictors of long term survival after resection of hilar cholangiocarcinoma(HC) by comparing patients surviving > 5 years with those who survived < 5 years.METHODS:This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center,Mansoura University,Egypt between January 2002 and April 2013.All data of the patients were collected from the medical records.patients were divided into two groups according to their survival:patients surviving less than 5 years and those who survived > 5 years.RESULTS:There were 34(14%) long term survivors(5 year survivors) among the 243 patients.Fiveyear survivors were younger at diagnosis than those surviving less than 5 years(mean age,50.47 ± 4.45 vs 54.59 ± 4.98,p = 0.001).Gender,clinical presentation,preoperative drainage,preoperative serum bilirubin,albumin and serum glutamic-pyruvic transaminase were similar between the two groups.The level of CA 19-9 was significantly higher in patients surviving < 5 years(395.71 ± 31.43 vs 254.06 ± 42.19,p = 0.0001).Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year,includingyoung age(p = 0.001),serum CA19-9(p = 0.0001),non-cirrhotic liver(p = 0.02),major hepatic resection(p = 0.001),caudate lobe resection(p = 0.006),well differentiated tumour(p = 0.03),lymph node status(0.008),R0 resection margin(p = 0.0001) and early postoperative liver cell failure(p = 0.02).CONCLUSION:Liver status,resection of caudate lobe,lymph node status,R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival. | Mohamed Abd El Wahab Ayman El Nakeeb Ehab El Hanafy Ahmad M Sultan Ahmed Elghawalby Waleed Askr Mahmoud Ali Mohamed Abd El Gawad Tarek Salah | 2016 | World Journal of Gastrointestinal Surgery2016，8，6： | 10 |
| 3 | Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity显示文摘AIM To detect risk factors for post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) and investigate the predictors of its severity.METHODS This is a prospective cohort study of all patients who underwent ERCP.Pre-ERCP data,intraoperative data,and post-ERCP data were collected.RESULTS The study population consisted of 996 patients.Their mean age at presentation was 58.42(± 14.72) years,and there were 454 male and 442 female patients.Overall,PEP occurred in 102(10.2%) patients of the study population; eighty(78.4%) cases were of mild to moderate degree,while severe pancreatitis occurred in 22(21.6%) patients.No hospital mortality was reported for any of PEP patients during the study duration.Age less than 35 years(P = 0.001,OR = 0.035),narrower common bile duct(CBD) diameter(P = 0.0001) and increased number of pancreatic cannulations(P = 0.0001) were independent risk factors for the occurrence of PEP.CONCLUSION PEP is the most frequent and devastating complication after ERCP.Age less than 35 years,narrower median CBD diameter and increased number of pancreaticcannulations are independent risk factors for the occurrence of PEP.Patients with these risk factors are candidates for prophylactic and preventive measures against PEP. | Ayman El Nakeeb Ehab El Hanafy Tarek Salah Ehab Atef Hosam Hamed Ahmad M Sultan Emad Hamdy Mohamed Said Ahmed A El Geidie Tharwat Kandil Mohamed El Shobari Gamal El Ebidy | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，19： | 10 |
| 4 | Intraoperative endoscopic retrograde cholangiopancreatography: A useful tool in the hands of the hepatobiliary surgeon显示文摘AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones(CBDS).METHODS: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram(TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven CBDS.RESULTS: Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases(84.2%) where removal of stones were successful; passed stones in 6 cases(7.9%); short lower end stricture with small stones present in two cases(2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case(1.3%) which was treated by open hepaticojejunostomy; and one case(1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled. CONCLUSION: The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options. | Ayman El Nakeeb Ahmad M Sultan Emad Hamdy Ehab El Hanafy Ehab Atef Tarek Salah Ahmed A El Geidie Tharwat Kandil Mohamed El Shobari Gamal El Ebidy | 2015 | World Journal of Gastroenterology2015，21，2： | 6 |
| 5 | Impact of referral pattern and timing of repair on surgical outcome after reconstruction of post-cholecystectomy bile duct injury:A multicenter study显示文摘Background:Bile duct injury(BDI)after cholecystectomy remains a significant surgical challenge.No guideline exists to guide the timing of repair,while few studies compare early versus late repair BDI.This study aimed to analyze the outcomes in patients undergoing immediate,intermediate,and delayed repair of BDI.Methods:We retrospectively analyzed 412 patients with BDI from March 2015 to January 2020.The patients were divided into three groups based on the time of BDI reconstruction.Group 1 underwent an immediate reconstruction(within the first 72 hours post-cholecystectomy,n=156);group 2 underwent an intermediate reconstruction(from 4 days to 6 weeks post-cholecystectomy,n=75),and group 3 underwent delayed reconstruction(after 6 weeks post-cholecystectomy,n=181).Results:Patients in group 2 had significantly more early complications including anastomotic leakage and intra-abdominal collection and late complications including anastomotic stricture and secondary liver cirrhosis compared with groups 1 and 3.Favorable outcome was observed in 111(71.2%)patients in group 1,31(41.3%)patients in group 2,and 157(86.7%)patients in group 3(P=0.0001).Multivariate analysis identified that complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of favorable outcome in group 1,the use of external stent was an independent factor of favorable outcome in group 2,and level E4 BDI was an independent factor of unfavorable outcome in group 3.Transected BDI and level E4 BDI were independent factors of unfavorable outcome.Conclusions:Favorable outcomes were more frequently observed in the immediate and delayed reconstruction of post-cholecystectomy BDI.Complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of a favorable outcome. | Ayman El Nakeeb Ahmad Sultan Helmy Ezzat Mohamed Attia Mohamed Abd ElWahab Taha Kayed Ayman Hassanen Ahmad AlMalki Ahmed Alqarni Mohammed M Mohammed | 2021 | Hepatobiliary & Pancreatic Diseases International2021，20，1： | 4 |
| 6 | Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy显示文摘AIM:To elucidate surgical outcomes of pancreaticoduodenectomy(PD)in patients with liver cirrhosis.METHODS:We studied retrospectively all patients who underwent PD in our centre between January 2002and December 2011.Group A comprised patients with cirrhotic livers,and Group B comprised patients with non-cirrhotic livers.The cirrhotic patients had ChildPugh classes A and B(patient’s score less than 8).Preoperative demographic data,intra-operative data and postoperative details were collected.The primary outcome measure was hospital mortality rate.Secondary outcomes analysed included duration of the operation,postoperative hospital stay,postoperative morbidity and survival rate.RESULTS:Only 67/442 patients(15.2%)had cirrhotic livers.Intraoperative blood loss and blood transfusion were significantly higher in group A(P=0.0001).The mean surgical time in group A was significantly longer than that in group B(P=0.0001).Wound complications(P=0.02),internal haemorrhage(P=0.05),pancreatic fistula(P=0.02)and hospital mortality(P=0.0001)were significantly higher in the cirrhotic patients.Postoperative stay was significantly longer in group A(P=0.03).The median survival was 19 mo in group A and 24 mo in group B.Portal hypertension(PHT)was present in 16/67 cases of cirrhosis(23.9%).The intraoperative blood loss and blood transfusion were significantly higher in patients with PHT(P=0.001).Postoperative morbidity(0.07)and hospital mortality(P=0.007)were higher in cirrhotic patients with PHT.CONCLUSION:Patients with periampullary tumours and well-compensated chronic liver disease should be routinely considered for PD at high volume centres with available expertise to manage liver cirrhosis.PD is associated with an increased risk of postoperative morbidity in patients with liver cirrhosis;therefore,it is only recommended in patients with Child A cirrhosis without portal hypertension. | Ayman El Nakeeb Ahmad M Sultan Tarek Salah Mohamed El Hemaly Emad Hamdy Ali Salem Ahmed Moneer Rami Said Ahmed AbuEleneen Mostafa Abu Zeid Talaat Abdallah Mohamed Abdel Wahab | 2013 | World Journal of Gastroenterology2013，19，41： | 3 |
| 7 | Interrelationship between Toll-like receptors and infection after orthotopic liver transplantation显示文摘Early microbial recognition by the innate immune system is accomplished by Toll-like receptors(TLRs),with resultant initiation of a pro-inflammatory response against infecting organisms.In spite of presence of an abundance of Toll-like receptors on the surface of the liver,gut bacteria does not elicit an inflammatory reaction in healthy individuals due to tolerance to these TLRs,suggesting that the inflammatory responses seen in the liver are the result of breakdown of this tolerance.While orthotopic liver transplantation is often life saving in many instances,death following this procedure is most commonly due to infection that occurs in up to 80%of transplant recipients,most commonly due to microbial causes in up to 70%of cases and viral infections in 20%,while fungal infections affect only 8%of cases.The probability of acquiring infection following hepatic transplantation is heightened due to affection of the innate immune defense mechanisms of the host following this procedure.Single nucleotide polymorphisms of TLRs have been associated with increased likelihood of either development of post-transplant infection or eradication of infecting organism.However,conflicting reports from other studies reveal that prevalence of this single nucleotide polymorphism is not increased in infected patients. | Mahmoud El-Bendary Mustafa Naemattalah Ahmed Yassen Naser Mousa Dina Elhammady Ahmed M Sultan Mohamed Abdel-Wahab | 2020 | World Journal of Transplantation2020，10，6： | 3 |
| 8 | Aspartate transaminase to platelet ratio index in hepatitis C virus and Schistosomiasis coinfection显示文摘AIM: To assess the diagnostic accuracy,of aminotransferase-to-platelet ratio index(APRI) alone and with antischistosomal antibody(Ab) in patients with hepatitis C virus(HCV) and schistosomiasis coinfection. METHODS: This retrospective study included medical records of three hundred and eighty three Egyptianmen patients who had undergone percutaneous liver biopsy between January 2006 to April 2014 in tertiary care hospital in Qatar for diagnosis or monitoring purpose were selected. Data of patients > 18 years of age were included in the study. The values of HCV RNA titer and antischistosomal antibody titer were also taken into consideration. Patients were excluded from the study if they had any other concomitant chronic liver disease,including; history of previous antiviral or interferon therapy,immunosuppressive,therapy,chronic hepatitis B infection,human immunodeficiency virus co-infection,autoimmune hepatitis,decompensated liver disease,hepatocellular carcinoma,prior liver transplantation,and if no data about the liver biopsy present. RESULTS: Median age of patients was 46 years. About 7.1% had no fibrosis,whereas 30.4%,37.5%,20.4%,and 4.6% had fibrosis of stage Ⅰ,Ⅱ,Ⅲ,and Ⅳ respectively. In bivariate analysis,APRI score,levels of AST,platelet count and age of patient showed statistically significant association with liver fibrosis(P < 0.0001); whereas antischistosomal antibody titer(P = 0.52) and HCV RNA titer(P = 0.79) failed to show a significant association. The respective AUC values for no fibrosis,significant fibrosis,severe fibrosis and cirrhosis of APRI score were 63%,73.2%,81.1% and 88.9% respectively. This showed good sensitivity and specificity of APRI alone for grading of liver fibrosis. But the inclusion of anti-Schistosoma antibody did not improve the prediction of fibrosis stage. CONCLUSION: The study results suggest that noninvasive biochemical markers like APRI are sensitive and specific in diagnosing the degree of fibrosis and cirrhosis in patients with coinfection of HCV and schistosomiasis as compared to biopsy. The addition of antischistosomal Ab to APRI did not improve sensitivity for predicting the degree of cirrhosis. | Moutaz Derbala Mohammed Elshiekh Elbadri Aliaa Mohamed Amer Saad Al Kaabi Khaleel Hassan Sultan Yasser Medhat Kamel Eman Hassan Satti Elsayed Tony Yervant Avades Prem Chandra Fatma M Shebl | 2015 | World Journal of Gastroenterology2015，21，46： | 2 |
| 9 | Breaking wheat yield barriers requires integrated efforts in developing countries显示文摘Most yield progress obtained through the so called 'Green Revolution', particularly in the irrigated areas of Asia, has reached a limit, and major resistance genes are quickly overcome by the appearance of new strains of disease causing organisms.New plant stresses due to a changing environment are difficult to breed for as quickly as the changes occur.There is consequently a continual need for new research programs and breeding strategies aimed at improving yield potential, abiotic stress tolerance and resistance to new, major pests and diseases.Recent advances in plant breeding encompass novel methods of expanding genetic variability and selecting for recombinants, including the development of synthetic hexaploid, hybrid and transgenic wheats.In addition, the use of molecular approaches such as quantitative trait locus(QTL) and association mapping may increase the possibility of directly selecting positive chromosomal regions linked with natural variation for grain yield and stress resistance.The present article reviews the potential contribution of these new approaches and tools to the improvement of wheat yield in farmer's fields, with a special emphasis on the Asian countries, which are major wheat producers, and contain the highest concentration of resource-poor wheat farmers. | Saeed Rauf Maria Zaharieva Marilyn L Warburton ZHANG Ping-zhi Abdullah M AL-Sadi Farghama Khalil Marcin Kozak Sultan A Tariq | 2015 | Journal of Integrative Agriculture2015，14，8： | 2 |
| 10 | 油棕纤维增强聚合物混合动力汽车防撞箱的概念设计(英文)显示文摘采用混合概念设计方法,对油棕复合材料汽车防撞箱进行了概念设计。结合创新问题解决(TRIZ)理论、形态图和仿生学,考虑材料特性、功能规格、力识别、根本原因分析、几何形状和设计选择标准等方面的首要要求。该策略是利用自然物来激发五种创新的ACB结构的概念设计,并运用层次分析法进行两两分析来选择最佳的ACB概念设计。复合ACB的新概念设计考虑到了天然纤维的特性,而不像传统材料如钢合金和铝合金。排名最高(26.6%)的设计被选为最终的概念设计,该设计的最外层具有蜂窝结构,内部结构由蜘蛛网结构强化,中心部位是由啄木鸟海绵组织中提取的纤维泡沫结构支撑,以达到能量吸收能力最大化。新的设计可以解决ACB在碰撞过程中无法吸收最大冲击能量的主要原因-弯曲塌陷的问题。但是,为了生产和装配需要,最后的概念设计仍需修改,这些修改将在今后研究中完成。 | N S B YUSOF S M SAPUAN M T H SULTAN M JAWAID | 2020 | Journal of Central South University2020，27，1： | 2 |
| 11 | Application of multiresolution signal decomposition for monitoring short-duration variations in distribution systems显示文摘 | Gaouda A M Salama M M A Sultan M R | 2000 | IEEE Transaction on Power Delivery2000，15，2： | 2 |
| 12 | Gain scheduling adaptive control strategies for HVDC systems to accommodate large disturbances显示文摘 | Reeve J Sultan M | 1994 | IEEE Trans on PWRD1994，9，1： | 1 |
| 13 | Adances in crosslinking technology显示文摘 | Palmlf M | 1994 | Plast Rubb and Comp Proc Appl1994，21，： | 1 |
| 14 | New description of the genus Rotylenchus Filipjev,1936(Tylenchida:Hoplolaimidae)显示文摘 | SULTAN M S | 1984 | Indian J Nematol1984，14，2： | 1 |
| 15 | Quantitative organization of neurotransmitters in the deep cerebellar nuclei of the lurcher mutant显示文摘 | Sultan F Konig T Mock M | 2002 | J Comp Neurol2002，452，4： | 1 |
| 16 | Frey's Syndrome Prevention with Temporparietal Facial Flap Interposition显示文摘 | Sultan M R Wider T M Hugo N E | 1995 | Ann Plast Surg1995，34，3： | 1 |
| 17 | Prediction of alternative isoforms from exon expression levels in RNA-Seq experiments显示文摘 | Richard H Schulz M H Sultan M | 2010 | Nucleic Acids Res2010，38，： | 1 |
| 18 | Power quality detection and classification using wavelet multiresolution signal decomposition显示文摘 | GAOUDA A M SALAMA M M A SULTAN M R | 1999 | IEEE Trans- actions on Power Delivery1999，14，： | 1 |
| 19 | Physiological response to complex environments in annual Polygonum species of contrasting ecological breadth显示文摘 | Sultan S E Wilczek A M Belld L | 1998 | Oecologia1998，115，： | 1 |
| 20 | Quantitative organization of neurotransmitters in the deep cerebellar nuclei of the lurcher mutant 显示文摘 | Sultan F Konig T Mock M | 2002 | J Comp Neurol2002，452，： | 1 |
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