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    题名 作者 年代 出处 被引量
1Non-invasive means of measuring hepatic fat content显示文摘Hepatic steatosis affects 20% to 30% of the general adult population in the western world. Currently, the technique of choice for determining hepatic fat deposition and the stage of fibrosis is liver biopsy. However, it is an invasive procedure and its use is limited, particularly in children. It may also be subject to sampling error. Non-invasive techniques such as ultrasound, computerised tomography (CT), magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H MRS) can detect hepatic steatosis, but currently cannot distinguish between simple steatosis and steatohepatitis, or stage the degree of fibrosis accurately. Ultrasound is widely used to detect hepatic steatosis, but its sensitivity is reduced in the morbidly obese and also in those with small amounts of fatty infiltration. It has been used to grade hepatic fat content, but this is subjective. CT can detect hepatic steatosis, but exposes subjects to ionising radiation, thus limiting its use in longitudinal studies and in children. Recently, magnetic resonance (MR) techniques using chemical shift imaging have provided a quantitative assessment of the degree of hepatic fatty infiltration, which correlates well with liver biopsy results in the same patients. Similarly, in vivo 1H MRS is a fast, safe, non-invasive method forthe quantification of intrahepatocellular lipid (IHCL) levels. Both techniques will be useful tools in future longitudinal clinical studies, either in examining the natural history of conditions causing hepatic steatosis (e.g. non-alcoholic fatty liver disease), or in testing new treatments for these conditions.Sanjeev R Mehta E Louise Thomas Jimmy D Bell Desmond G Johnston Simon D Taylor-Robinson 2008World Journal of Gastroenterology2008,14,22:21
2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
3role of microRNAs in the main molecular pathways of hepatocellular carcinoma显示文摘Hepatocellular carcinoma(HCC) is the most common primary liver malignant neoplasia. HCC is characterized by a poor prognosis. The need to find new molecular markers for its diagnosis and prognosis has led to a progressive increase in the number of scientific studies on this topic. MicroRNAs(miRNAs) are small noncoding RNA that play a role in almost all main cellular pathways. miRNAs are involved in the regulation of expression of the major tumor-related genes in carcinogenesis, acting as oncogenes or tumor suppressor genes. The aim of this review was to identify papers published in 2017 investigating the role of miRNAs in HCC tumorigenesis. miRNAs were classified according to their role in the main molecular pathways involved in HCC tumorigenesis:(1) m TOR;(2) Wnt;(3) JAK/STAT;(4) apoptosis; and(5) MAPK. The role of miRNAs in prognosis/response prediction was taken into consideration. Bearing in mind that the analysis of miRNAs in serum and other body fluids would be crucial for clinical management, the role of circulating miRNAs in HCC patients was also investigated. The most represented mi RNA-regulated pathway in HCC is m TOR, but apoptosis, Wnt, JAK/STAT or MAPK pathways are also influenced by mi RNA expression levels. These miRNAs could thus be used in clinical practice as diagnostic, prognostic or therapeutic targets for HCC treatment.Francesco Vasuri Michela Visani Giorgia Acquaviva Thomas Brand Michelangelo Fiorentino Annalisa Pession Giovanni Tallini Antonia D’Errico Dario de Biase 2018World Journal of Gastroenterology2018,24,25:16
4Effect 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 2006World Journal of Gastroenterology2006,12,36:13
5S100A8/A9 induces autophagy and apoptosis via ROS-mediated cross-talk between mitochondria and lysosomes that involves BNIP3显示文摘建筑群由 S100 钙绑定蛋白质家庭,的二个成员形成了 S100A8/A9,在不同起源的各种各样的房间施加导致 apoptosis 活动。这里,我们内在的分子的机制包含的现在的证据两个都规划了房间死亡我(PCD 我, apoptosis ) 并且象死亡一样的 PCD II (autophagy ) 。有 S100A8/A9 的房间的处理引起了 Beclin-1 表示以及 Atg12-Atg5 形成的增加。S100A8/A9-induced 房间死亡被特定的 PI3-kinase 班 III 禁止者部分禁止, 3-methyladenine (3 麻省) ,并且由液泡 H+-ATPase 禁止者, bafilomycin-A1 (Baf-A1 ) 。S100A8/A9 挑起了 BNIP3 的 translocation, BH3 仅仅 pro-apoptotic Bcl2 家庭成员,到线粒体。与这发现一致,螖 T M-BNIP3 overexpression 部分禁止了 S100A8/A9-induced 细胞死亡,减少的反应的氧种(ROS ) 产生,并且部分在 S100A8/A9-treated 细胞在 mitochondrial transmembrane 潜力免于减少。另外,任何一个螖 T M-BNIP3 overexpression 或 N-acetyl-L-cysteine 合作处理减少了在与 S100A8/A9 对待的房间的 lysosomal 激活。我们的数据显示 S100A8/A9-promoted 房间死亡通过线粒体的串音发生,经由 ROS 和这个过程的 lysosomes 包含 BNIP3。Saeid Ghavami Mehdi Eshragi Sudharsana R Ande Walter J Chazin Thomas Klonisch Andrew J Halayko Karol D Mcneill Mohammad Hashemi Claus Kerkhoff Marek Los 2010Cell Research2010,20,3:13
6Consequences of bullying victimization in childhood and adolescence:A systematic review and meta-analysis显示文摘AIM To identify health and psychosocial problems associated with bullying victimization and conduct a meta-analysis summarizing the causal evidence.METHODS A systematic review was conducted using Pub Med, EMBASE, ERIC and Psyc INFO electronic databases up to 28 February 2015. The study included published longitudinal and cross-sectional articles that examined health and psychosocial consequences of bullying victimization. All meta-analyses were based on qualityeffects models. Evidence for causality was assessed using Bradford Hill criteria and the grading system developed by the World Cancer Research Fund.RESULTS Out of 317 articles assessed for eligibility, 165 satisfied the predetermined inclusion criteria for meta-analysis.Statistically significant associations were observed between bullying victimization and a wide range of adverse health and psychosocial problems. The evidence was strongest for causal associations between bullying victimization and mental health problems such as depression, anxiety, poor general health and suicidal ideation and behaviours. Probable causal associations existed between bullying victimization and tobacco and illicit drug use. CONCLUSION Strong evidence exists for a causal relationship between bullying victimization, mental health problems and substance use. Evidence also exists for associations between bullying victimization and other adverse health and psychosocial problems, however, there is insufficient evidence to conclude causality. The strong evidence that bullying victimization is causative of mental illness highlights the need for schools to implement effective interventions to address bullying behaviours.Sophie E Moore Rosana E Norman Shuichi Suetani Hannah J Thomas Peter D Sly James G Scott 2017World Journal of Psychiatry2017,7,1:12
7Affinity peptide developed by phage display selection for targeting gastric cancer显示文摘AIM:To develop an affinity peptide that binds to gastric cancer used for the detection of early gastric cancer.METHODS:A peptide screen was performed by biopanning the PhD-12 phage display library,clearing non-specific binders against tumor-adjacent normal appearing gastric mucosa and obtaining selective binding against freshly harvested gastric cancer tissues.Tumortargeted binding of selected peptides was confirmed by bound phage counts,enzyme-linked immunosorbent assay,competitive inhibition,fluorescence microscopy and semi-quantitative analysis on immunohistochemistry using different types of cancer tissues.RESULTS:Approximately 92.8% of the non-specific phage clones were subtracted from the original phage library after two rounds of biopanning against normal-appearing gastric mucosa.After the third round of positive screening,the peptide sequence AADNAKTKSFPV(AAD) appeared in 25%(12/48) of the analyzed phages.For the control peptide,these values were 6.8 ± 2.3,5.1 ± 1.7,3.5 ± 2.1,4.6 ± 1.9 and 1.1 ± 0.5,respectively.The values for AAD peptide were statistically signif icant(P < 0.01) for gastric cancer as compared with other histological classif ications and control peptide.CONCLUSION:A novel peptide is discovered to have a specific binding activity to gastric cancer,and can be used to distinguish neoplastic from normal gastric mucosa,demonstrating the potential for early cancer detection on endoscopy.Wen-Jie Zhang Yan-Xia Sui Arun Budha Jian-Bao Zheng Xue-Jun Sun Ying-Chun Hou Thomas D Wang Shao-Ying Lu 2012World Journal of Gastroenterology2012,18,17:12
8Intentional ingestions of foreign objects among prisoners: A review显示文摘The intentional ingestion of foreign objects(IIFO) is described more commonly in prison populations than in the general population, with an estimated annual incidence of 1 in 1900 inmates in our state correctional facilities. Incidents often involve ingestion of small metal objects(e.g., paperclips, razor blades) or other commonly available items like pens or eating utensils. Despite ingestion of relatively sharp objects, most episodes can be clinically managed with either observation or endoscopy. Surgery should be reserved for those with signs or symptoms of gastrointestinal perforation or obstruction. For those with a history of IIFO, efforts should focus on prevention of recurrenceas subsequent episodes are associated with higher morbidity, significant healthcare and security costs. The pattern of IIFO is often repetitive, with escalation both in frequency of ingestions and in number of items ingested. Little is known about successful prevention strategies, but efforts to monitor patients and provide psychiatric care are potential best-practice strategies. This article aims to provide state-of-the art review on the topic, followed by a set of basic recommendations.David C Evans Thomas R Wojda Christian D Jones Andrew J Otey Stanislaw P Stawicki 2015World Journal of Gastrointestinal Endoscopy2015,7,3:10
9Personalized targeted therapy for esophageal squamous cell carcinoma显示文摘Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial.Xiaozheng Kang Keneng Chen Yicheng Li Jianying Li Thomas A D'Amico Xiaoxin Chen 2015World Journal of Gastroenterology2015,21,25:10
10Current and future applications of in vitro magnetic resonance spectroscopy in hepatobiliary disease显示文摘原子磁性的回声光谱学允许细胞的生物化学和新陈代谢的学习,在整个身体在活体内并且在更高的磁场力量在试管内。因为这种技术非侵略、非选择,磁性的回声光谱学方法论广泛地在生物化学和药被使用了。房间,身体液体和纸巾的在试管内磁性的回声光谱学研究在医药生物化学被使用了调查 pathophysiological 过程,更最近,这种技术被医生使用了决定疾病畸形在活体内。这个加亮的话题说明在试管内的潜力在学习肝胆管系统的磁性的回声光谱学。在恶意、非恶意的肝疾病和胆汁作文的学习的磁性的回声光谱学学习的在试管内质子和磷的角色被讨论,特别地与关联词在活体内的参考整个身体的磁性的回声光谱学应用。在摘要,磁性的回声光谱学技术能在到内在的 pathophysiological 过程的疾病严厉和指针上提供非侵略的生物化学的信息。磁性的回声光谱学为疾病简历标记,以及估计的治疗学的反应作为一个屏蔽工具保持潜在的诺言。I Jane Cox Amar Sharif Jeremy FL Cobbold Howard C Thomas Simon D Taylor-Robinson 2006World Journal of Gastroenterology2006,12,30:10
11WJC 6~th Anniversary Special Issues(3):Cardiomyopathy Hypertrophic cardiomyopathy in 2013:Current speculations and future perspectives显示文摘Hypertrophic cardiomyopathy(HCM),the most variable cardiac disease in terms of phenotypic presentation and clinical outcome,represents the most common inherited cardiomyopathic process with an autosomal dominant trait of inheritance.To date,more than 1400 mutations of myofilament proteins associated with the disease have been identified,most of them 'private' ones.This striking allelic and locus heterogeneity of the disease certainly complicates the establishment of phenotype-genotype correlations.Additionally,topics pertaining to patients' everyday lives,such as sudden cardiac death(SCD)risk stratification and prevention,along with disease prognosis,are grossly related to the genetic variation of HCM.This review incorporates contemporary research findings and addresses major aspects of HCM,including preclinical diagnosis,genetic analysis,left ventricular outflow tract obstruction and SCD.More specifically,the spectrum of genetic analysis,the selection of the best method for obstruction alleviation and the need for a unique and accuratefactor for SCD risk stratification are only some of the controversial HCM issues discussed.Additionally,future perspectives concerning HCM and myocardial ischemia,as well as atrial fibrillation,are discussed.Rather than enumerating clinical studies and guidelines,challenging problems concerning the disease are critically appraised by this review,highlighting current speculations and recommending future directions.Georgios K Efthimiadis Efstathios D Pagourelias Thomas Gossios Thomas Zegkos 2014World Journal of Cardiology2014,6,2:9
12Vanishing bile duct syndrome in human immunodeficiency virus infected adults:A report of two cases显示文摘Vanishing bile duct syndrome(VBDS) is a group of rare disorders characterized by ductopenia,the progressive destruction and disappearance of intrahepatic bile ducts leading to cholestasis.Described in association with medications,autoimmune disorders,cancer,transplantation,and infections,the specific mechanisms of disease are not known.To date,only 4 cases of VBDS have been reported in human immunodeficiency virus(HIV) infected patients.We report 2 additional cases of HIV-associated VBDS and review the features common to the HIV-associated cases.Presentation includes hyperbilirubinemia,normal liver imaging,and negative viral and autoimmune hepatitis studies.In HIV-infected subjects,VBDS occurred at a range of CD4+ T-cell counts,in some cases following initiation or change in antiretroviral therapy.Lymphoma was associated with two cases;nevirapine,antibiotics,and viral co-infection were suggested as etiologies in the other cases.In HIV-positive patients with progressive cholestasis,early identification of VBDS and referral for transplantation may improve outcomes.Ana Paula Oppenheimer Christopher Koh Mary McLaughlin John C Williamson Thomas D Norton Jennifer Laudadio Theo Heller David E Kleiner Kevin P High Caryn G Morse 2013World Journal of Gastroenterology2013,19,1:8
13Current and future applications of magnetic resonance imaging and spectroscopy of the brain in hepatic encepha-lopathy显示文摘肝的脑病(他) 普通 neuro 精神病学的畸形,它从肝细胞失败或 portosystemic 与肝疾病和结果复杂化病人的功课正在推延。表明他是广泛地可变的并且从温和无临床症状的骚乱包含一个系列到深昏迷。研究兴趣集中于传播导出勇气的毒素的角色,特别地氨,胀大的大脑的开发和在导致全球 CNS 消沉和混乱功能的服的 neurotransmitter 系统的变化。直到最近,服的功能的直接调查有在人是困难的。然而,当磁性的回声光谱学( 1H 太太)检测的质子在大脑生物化学变化时,新磁性的回声成像( MRI )技术在大脑体积( coregistered MRI )和损害大脑功能( fMRI )提供对变化的评价的一个非侵略的工具,包括服的 osmolytes 的直接测量,例如 myoinositol ,充斥管理对细胞的动态平衡内在的过程的使挫折和夫酸安,包括细胞内部的水的累积。这些细胞内部的 osmolytes 的集中与 hyperammonaemia 改变。有 neuropsychiatric 缺陷并且自从先生系列的严厉的检测太太的代谢物畸形相互关联向正常术后疗法回来,技术可能具有在客观耐心的监视并且在估计各种各样的治疗政体的有效性的使用。VP Bob Graver M Alex Dresner Daniel M Forton Serena Counsell David J Larkman Nayna Patel Howard C Thomas Simon D Taylor-Robinson 2006World Journal of Gastroenterology2006,12,19:8
14Silicon and silicon nitride photonic circuits for spectroscopic sensing on-a-chip [Invited]显示文摘There is a rapidly growing demand to use silicon and silicon nitride(Si3N4) integrated photonics for sensing applications, ranging from refractive index to spectroscopic sensing. By making use of advanced CMOS technology,complex miniaturized circuits can be easily realized on a large scale and at a low cost covering visible to mid-IR wavelengths. In this paper we present our recent work on the development of silicon and Si3N4-based photonic integrated circuits for various spectroscopic sensing applications. We report our findings on waveguide-based absorption, and Raman and surface enhanced Raman spectroscopy. Finally we report on-chip spectrometers and on-chip broadband light sources covering very near-IR to mid-IR wavelengths to realize fully integrated spectroscopic systems on a chip.Ananth Z.Subramanian Eva Ryckeboer Ashim Dhakal Frédéric Peyskens Aditya Malik Bart Kuyken Haolan Zhao Shibnath Pathak Alfonso Ruocco Andreas De Groote Pieter Wuytens Daan Martens Francois Leo Weiqiang Xie Utsav Deepak Dave Muhammad Muneeb Pol Van Dorpe Joris Van Campenhout Wim Bogaerts Peter Bienstman Nicolas Le Thomas Dries Van Thourhout Zeger Hens Gunther Roelkens Roel Baets 2015Photonics Research2015,3,5:7
15Transradial versus transfemoral access for anterior circulation mechanical thrombectomy: analysis of 375 consecutive cases显示文摘Objective To compare transradial artery access(TRA)to the gold standard of transfemoral artery access(TFA)in mechanical thrombectomy(MT)for stroke caused by anterior circulation large vessel occlusion.Methods The clinical outcomes,procedural speed,angiographic efficacy and safety of both techniques were analysed in 375 consecutive cases over an 18-month period in a high volume statewide neurointerventional service.Results There was no significant difference in patient characteristics,stroke parameters,imaging techniques or intracranial techniques.The median time elapsed between CT scanning and reperfusion was 96.5 min(IQR 68-123)in the TFA group and 95 min(IQR 68-123)in the TRA group(p=0.456).Of 336 patients who were independent at presentation 58%(124/214)of the TFA group and 67%(82/122)of the TRA group had a modified Rankin score of 0-2 at 90-day follow-up(p=0.093).Cross-over from radial to femoral was 4.6%(4/130)compared with 1.6%cross-over from femoral to radial(4/245),but did not meet the predetermined level of statistical significance(OR2.92,95% CI 0.81 to 10.52,p=0.088) and did not impact median procedural speed.Adequate angiographic reperfusion,first pass reperfusion,embolisation to new territory and symptomatic intracranial haemorrhage were similar in both groups.There was a significant difference in major access site complications requiring an additional procedure.None of the TRA cases had a major access site complication but 6.5%(16/245)of the TFA cases did(p=0.003).Conclusion This study suggests that using TRA for anterior circulation MT is fast,efficacious,safe and not inferior to the gold standard of TFA.Timothy John Phillips Matthew Thomas Crockett Gregory D Selkirk Ruchi Kabra Albert Ho Yuen Chiu Tejinder Singh Constantine Phatouros William McAuliffe 2021Stroke & Vascular Neurology2021,6,2:7
16伴炎性肌纤维母细胞肿瘤样特征的去分化脂肪肉瘤显示文摘Lucas D R Shukla A Thomas D G 李岩(摘译 ) 张仁亚(审校) 2010临床与实验病理学杂志2010,26,5:6
17Randomized trial in malignant biliary obstruction:Plastic vs partially covered metal stents显示文摘AIM:To compare efficacy and complications of par-tially covered self-expandable metal stent(pcSEMS)to plastic stent(PS)in patients treated for malignant,infrahilar biliary obstruction.METHODS:Multicenter prospective randomized clinical trial with treatment allocation to a pcWallstent(SEMS)or a 10 French PS.Palliative patients aged≥18,for infrahilar malignant biliary obstruction and a Karnofsky performance scale index>60%from 6 participating North American university centers.Primary endpoint was time to stent failure,with secondary outcomes of death,adverse events,Karnofsky performance score and short-form-36 scale administered on a three-monthly basis for up to 2 years.Survival analyses were performed for stent failure and death,with Cox proportional hazards regression models to determine significant predictive characteristics.RESULTS:Eighty-five patients were accrued over 37mo,42 were randomized to the SEMS group and 83patients were available for analyses.Time to stent failure was 385.3±52.5 d in the SEMS and 153.3±19.8 d in the PS group,P=0.006.Time to death did not differ between groups(192.3±23.4 d for SEMS vs211.5±28.0 d for PS,P=0.70).The only significant predictor was treatment allocation,relating to the time to stent failure(P=0.01).Amongst other measured outcomes,only cholangitis differed,being more common in the PS group(4.9%vs 24.5%,P=0.029).The small number of patients in follow-up limits longitudinal assessments of performance and quality of life.From an initially planned 120 patients,only 85 patients were recruited.CONCLUSION:Partially covered SEMS result in a longer duration till stent failure without increased complication rates,yet without accompanying measurable benefits in survival,performance,or quality of life.Peter L Moses Khalid M AlNaamani Alan N Barkun Stuart R Gordon Roger D Mitty M Stanley Branch Thomas E Kowalski Myriam Martel Viviane Adam 2013World Journal of Gastroenterology2013,19,46:6
18大失血处理指南显示文摘编写本指南的目的是为了给医疗机构专业人员提供大失血处理的明确操作指南。产科大出血不包括在内,产科出血由皇家产科医学院负责编写。本指南总结了目前对大失血的处理意见及对2000年指南(Stainsby等)的更新。Stainsby D MacLennan S Thomas D 金希希(节译) 孟忠华(审校) 徐伟娟(审校) 2007国际输血及血液学杂志2007,30,6:6
19NOD2-mediated dysbiosis predisposes mice to transmissible colitis and colorectal cancer显示文摘Couturier-Maillard Aurélie Secher Thomas Rehman Ateequr Normand Sylvain De Arcangelis Adéle Haesler Robert Huot Ludovic Grandjean Teddy Bressenot Aude Delanoye-Crespin Anne Gaillot Olivier Schreiber Stefan Lemoine Yves Ryffel Bernhard Hot D 2013Journal of Clinical Investigation2013,,2:5
20预防术后肺部并发症对改善食管切除术临床结果的重要性显示文摘食管切除术后食管癌患者预后可能与包括患者年龄、肿瘤分期、手术方式、术后并发症在内的许多因素有关。肺部并发症是食管切除术后的主要并发症和死亡原因。许多研究显示,导致食管切除术后肺部并发症发生的术前因素包括高龄、营养不良及心肺储备低下(术前放化疗是否会增加术后肺部并发症发生率尚不明确):手术因素包括术中大量失血、手术时间过长、进展期食管癌、近端食管癌、手术范围过大如McKeown切除加三野淋巴结清扫:术后因素包括心房颤动、喉返神经损伤、吞咽异常。可能的预防措施有:术前戒烟、积极的术后排痰、恢复进食前要确保吞咽机制的完整性。Thomas A. D'Amico 2011中华胃肠外科杂志2011,14,9:5
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