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| 1 | 四川唐家河自然保护区扭角羚冬春季日活动模式研究显示文摘根据相机陷阱调查获得照片的时间,研究了2008年12月~2009年5月唐家河自然保护区内野生扭角羚Budorcastaxicolor的日活动模式。通过对24个1km×1km样方的调查,共完成686个相机工作日的取样量,获得有效的扭角羚捕捉次数709次(冬季322次,春季387次),并分别计算出扭角羚冬季和春季在各时间段的相对活动强度指数RAI。结果显示,扭角羚在冬季和春季的日活动模式没有显著差异(χ2检验,P>0.1),每天都有3个活跃时期(凌晨、早上和下午)和3个紧随的不活跃时期。其中,冬季日活动的最高峰出现在下午17:00~18:00(RAI=12.42),最低谷出现在日出前3:00~6:00(RAI=0.00);春季最高峰出现在早上6:00~7:00(RAI=20.16),最低谷出现在日出前2:00~5:00(RAI=0.26)。在春季,扭角羚在上午活跃期的活动强度明显高于下午活跃期,而在冬季则相反。春季与冬季相比,扭角羚上午和下午的两个活跃时间段都有提前,可能是由于不同季节气温和光照差异的影响。研究表明,相机陷阱调查技术是研究野生动物在野外活动模式和活动节律的有效工具,可为今后深入开展扭角羚行为生态学研究和保护区内野生动物的管理提供基础的科学依据。 | 李明富 李晟 王大军 William J McShea 官天培 谌利民 | 2011 | 四川动物2011，30，6： | 54 |
| 2 | 初级保健中原发性醛固酮增多症的患病率和临床表现显示文摘原发性醛固酮增多症(primaryaldosteronism,PA)是一种异质性疾病,以高血压和相对自主于肾素血管紧张素系统产生过量醛固酮为特征。与心血管病风险相似的原发性高血压患者相比,PA患者发生心脑血管并发症的风险以及代谢综合征患病率增加,提示正确诊断PA的重要性。 | Monticone S Burrello J Tizzani D Bertello C Viola A Buffolo F Gabetti L Mengozzi G Williams TA Rabbia F Veglio F Mulatero P 练桂丽 叶鹏 | 2017 | 中华高血压杂志2017，25，5： | 58 |
| 3 | Transcriptional and signaling regulation in neural crest stem cell-derived melanocyte development: do all roads lead to Mitf?显示文摘人的 neurocristopathies 包括神经的冠(NC ) 的很多症候群,肿瘤,和 dysmorphologies 干细胞衍生物。在最近的年里,许多白看到基因在源于 NC 茎的 neurocristopathies 与 hypopigmentary 混乱和聋被联系了导出房间的 melanocyte 缺乏在开发期间。这些包括 PAX3, SOX10, MITF, SNAI2, EDNRB, EDN3,工具包,和 KITL。最近的研究在 melanocyte 开发在交往的基因的复杂网络揭示了令人吃惊的新卓见进 MITF 的一个中央角色。在这个观点,我们提供一些当前的调查结果的概述并且在 NC 茎期间探索这些基因的复杂功能的角色导出房间的 melanocyte 开发。 | Ling Hou William J Pavan | 2008 | Cell Research2008，18，12： | 30 |
| 4 | EPIC模型中作物生长与产量形成的数学模拟显示文摘侵蚀和生产力影响估算模型EPIC是世界上较有影响的水土资源管理和作物生产力评价动力学模型。文章简要介绍了EPIC模型中描述作物生长、产量形成和环境胁迫的主要数学方程,有助于理解EPIC模型模拟作物生长与产量形成的基本原理和基本过程,可供我国作物生长模拟与生产力定量评价研究中借鉴。最后指出了该模型中需要改进之处。 | 李军 邵明安 张兴昌 Williams J R | 2004 | 西北农林科技大学学报(自然科学版)2004，32，B11： | 21 |
| 5 | Design of 16S rRNA gene primers for 454 pyrosequencing of the human foregut microbiome显示文摘AIM:To design and validate broad-range 16S rRNA primers for use in high throughput sequencing to classify bacteria isolated from the human foregut microbiome.METHODS:A foregut microbiome dataset was constructed using 16S rRNA gene sequences obtained from oral,esophageal,and gastric microbiomes produced by Sanger sequencing in previous studies represented by 219 bacterial species.Candidate primers evaluated were from the European rRNA database.To assess the effect of sequence length on accuracy of classification,16S rRNA genes of various lengths were created by trimming the full length sequences.Sequences spanning various hypervariable regions were selected to simulate the amplicons that would be obtained using possible primer pairs.The sequences were compared with full length 16S rRNA genes for accuracy in taxonomic classification using online software at the Ribosomal Database Project (RDP).The universality of the primer set was evaluated using the RDP 16S rRNA database which is comprised of 433 306 16S rRNA genes,represented by 36 phyla.RESULTS:Truncation to 100 nucleotides(nt)downstream from the position corresponding to base 28 in the Escherichia coli 16S rRNA gene caused misclassification of 87(39.7%)of the 219 sequences,compared with misclassification of only 29(13.2%)sequences with truncation to 350 nt.Among 350-nt sequence reads within various regions of the 16S rRNA gene,the reverse read of an amplicon generated using the 343F/798R primers had the least(8.2%)effect on classification.In comparison,truncation to 900 nt mimicking single pass Sanger reads misclassified 5.0%of the 219 sequences.The 343F/798R amplicon accurately assigned 91.8%of the 219 sequences at the species level.Weighted by abundance of the species in the esophageal dataset,the 343F/798R amplicon yielded similar classification accuracy without a significant loss in species coverage(92%).Modification of the 343F/798R primers to 347F/803R increased their universality among foregut species.Assuming that a typicalpolymerase chain reaction can tolerate 2 mismatches between a primer and a template,the modified 347F and 803R primers should be able to anneal 98%and 99.6%of all 16S rRNA genes in the RDP database.CONCLUSION:347F/803R is the most suitable pair of primers for classification of foregut 16S rRNA genes but also possess universality suitable for analyses of other complex microbiomes. | Carlos W Nossa William E Oberdorf Jφrn A Aas Bruce J Paster Todd Z DeSantis Eoin L Brodie Daniel Malamud Michael A Poles Zhiheng Pei | 2010 | World Journal of Gastroenterology2010，16，33： | 16 |
| 6 | Anterior knee pain following primary total knee arthroplasty显示文摘Despite improvements in technique and technology for total knee arthroplasty(TKA),anterior knee pain impacts patient outcomes and satisfaction.Addressing the prosthetic and surgical technique related causes of pain after TKA,specifically as it relates to anterior knee pain,can aid surgeons in addressing these issues with their patients.Design features of the femoral and patellar components which have been reported as pain generators include: Improper femoral as well as patellar component sizing or designs that result in patellofemoral stuffing; a shortened trochlear groove distance from the flange to the intercondylar box; and then surgical technique related issues resulting in: Lateral patellar facet syndrome; overstuffed patella/flange combination; asymmetric patellar resurfacing,improper transverse plane component rotation resulting in patellar subluxation/tilt.Any design consideration that allows impingement of extensor mechanism anatomical elements has the possibility of impacting outcome by becoming a pain generator.As the number of TKA procedures continues to increase,it is increasingly critical to develop improved,evidence based prostheses that maximize function and patient satisfaction while minimizing pain and other complications. | David Shervin Katelyn Pratt Travis Healey Samantha Nguyen William M Mihalko Mouhanad M El-Othmani Khaled J Saleh | 2015 | World Journal of Orthopedics2015，6，10： | 15 |
| 7 | 在血压控制不良的高血压患者中使用数字化干预的家庭和在线血压管理:随机对照试验显示文摘HOME BP试验(The home and online management and evaluation of blood pressure)的目的是评估在初级预防中结合自我监测和自我管理的数字化干预在高血压管理中的作用。研究者纳入英国76个治疗中心经过治疗但血压控制不好(>140/90 mm Hg, 1 mm Hg=0.133 kPa)并能上网的患者622例,进行自动确定主要终点的公开随机对照试验。 | McMa-nus RJ Little P Stuart B Morton K Raftery J Kelly J Bradbury K Zhang J Zhu S Murray E May CR Mair FS Michie S Smith P Band R Ogburn E AllenJ Rice C Nut-tall J Williams B Yardley L 陈嘉睿(译) 叶鹏(审校) | 2021 | 中华高血压杂志2021，29，5： | 15 |
| 8 | 单程高增益1.9μm光纤气体拉曼激光器显示文摘报道了基于空心光子晶体光纤中氢气分子振动受激拉曼散射(SRS)的单程高增益1.9μm光纤气体激光器。用一个线偏振1064nm亚纳秒脉冲微芯激光器抽运一段长6.5m、充高压氢气的低损耗负曲率空心光纤,实现了到氢气分子一级振动斯托克斯波1907nm的有效转换。气压为2.3MPa时最大能量转换效率大于27%,相应的量子转换效率大于48%,激光平均功率约为10mW,峰值功率大于2000W。为实现高功率、窄线宽、大范围调谐的紧凑型中红外光纤激光器提供了一条潜在的有效途径。 | 王泽锋 于飞 William J Wadsworth Jonathan C Knight | 2014 | 光学学报2014，34，8： | 15 |
| 9 | 高危患者目标血压与心血管病预后显示文摘指南推荐血压目标值应〈140/90 mmHg(1mmHg=0.133kPa)以减少心血管事件的发生。但与其他心血管病预后(如冠状动脉事件)相比,包括脑卒中及心力衰竭在内的心血管病预后与收缩压下降关系更密切。一些心血管事件(如冠状动脉事件)风险在收缩压低时亦增高,风险-收缩压关系呈J形曲线,而脑卒中与血压不是J形曲线关系。 | B?hm M Schumacher H Teo KK Lonn EM Mahfoud F Mann JF Mancia G Redon J Schmieder RE Sliwa K Weber MA Williams BYusuf S 曲浥晨 叶鹏 | 2017 | 中华高血压杂志2017，25，6： | 14 |
| 10 | Delayed gastric emptying following pancreaticoduodenectomy:Incidence,risk factors,and healthcare utilization显示文摘AIM To characterize incidence and risk factors for delayed gastric emptying(DGE) following pancreaticoduodenectomy and examine its implications on healthcare utilization. METHODS A prospectively-maintained database was reviewed. DGE was classified using International Study Group of Pancreatic Surgery criteria. Patients who developed DGE and those who did not were compared. RESULTS Two hundred and seventy-six patients underwent pancreaticoduodenectomy(PD)(> 80% pyloruspreserving, antecolic-reconstruction). DGE developed in 49 patients(17.8%): 5.1% grade B, 3.6% grade C. Demographic, clinical, and operative variables were similar between patients with DGE and those without. DGE patients were more likely to present multiplecomplications(32.6% vs 4.4%, ≥ 3 complications, P < 0.001), including postoperative pancreatic fistula(POPF)(42.9% vs 18.9%, P = 0.001) and intra-abdominal abscess(IAA)(16.3% vs 4.0%, P = 0.012). Patients with DGE had longer hospital stay(median, 12 d vs 7 d, P < 0.001) and were more likely to require transitional care upon discharge(24.5% vs 6.6%, P < 0.001). On multivariate analysis, predictors for DGE included POPF [OR = 3.39(1.35-8.52), P = 0.009] and IAA [OR = 1.51(1.03-2.22), P = 0.035].CONCLUSION Although DGE occurred in < 20% of patients after PD, it was associated with increased healthcare utilization. Patients with POPF and IAA were at risk for DGE. Anticipating DGE can help individualize care and allocate resources to high-risk patients. | Somala Mohammed George Van Buren II Amy Mc Elhany Eric J Silberfein William E Fisher | 2017 | World Journal of Gastrointestinal Surgery2017，9，3： | 13 |
| 11 | Abdominal applications of diffusion-weighted magnetic resonance imaging: Where do we stand?显示文摘Diffusion-weighted imaging (DWI) is one of the magnetic resonance imaging (MRI) sequences providing qualitative as well as quantitative information at a cellular level. It has been widely used for various applications in the central nervous system. Over the past decade, various extracranial applications of DWI have been increasingly explored, as it may detect changes even before signal alterations or morphological abnormalities become apparent on other pulse sequences. Initial results from abdominal MRI applications are promising, particularly in oncological settings and for the detection of abscesses. The purpose of this article is to describe the clinically relevant basic concepts of DWI, techniques to perform abdominal DWI, its analysis and applications in abdominal visceral MR imaging, in addition to a brief overview of whole body DWI MRI. | Ajaykumar C Morani Khaled M Elsayes Peter S Liu William J Weadock Janio Szklaruk Jonathan Russell Dillman Asra Khan Thomas L Chenevert Hero K Hussain | 2013 | World Journal of Radiology2013，5，3： | 12 |
| 12 | Precore/basal core promoter mutants and hepatitis B viral DNA levels as predictors for liver deaths and hepatocellular carcinoma显示文摘AIM: To conduct a retrospective study in 400 chronic hepatitis B patients in order to identify hepatitis B viral factors associated with complications of liver disease or development of hepatocellular carcinoma.METHODS: The mean follow-up time was 83.6 ± 39.6 mo. Alpha-fetoprotein test and abdominal ultrasound were used for cancer surveillance. Hepatitis B basal core promoter mutants, precore mutants, genotypes, hepatitis B viral DNA (HBV DNA) level and hepatitis B e antigen (HBeAg) were measured. Univariate analysis and logistic regression were used to assess odds ratios for viral factors related to liver deaths and hepatocellular carcinoma development. RESULTS: During follow-up, 38 patients had liver deaths not related to hepatocellular carcinoma. On multivariate analysis, older age [odds ratio: 95.74 (12.13-891.31); P < 0.0001], male sex [odds ratio: 7.61 (2.20-47.95); P = 0.006], and higher log10 HBV DNA [odds ratio: 4.69 (1.16-20.43); P < 0.0001] were independently predictive for these liver related deaths. Also, 31 patients developed hepatocellular carcinoma. Multivariate analysis showed that older age [odds ratio: 26.51 (2.36-381.47); P = 0.007], presence of precore mutants [odds ratio: 4.23 (1.53-19.58); P = 0.02] and presence of basal core promoter mutants [odds ratio: 2.93 (1.24-7.57); P = 0.02] were independent predictors for progression to hepatocellular carcinoma.CONCLUSION: Our results show that high levels of baseline serum HBV DNA are associated with non- hepatocellular carcinoma-related deaths of liver failure, while genetic mutations in the basal core promoter and precore regions are predictive for development of hepatocellular carcinoma. | Myron J Tong Lawrence M Blatt Jia-Horng Kao Jason Tzuying Cheng William G Corey | 2006 | World Journal of Gastroenterology2006，12，41： | 11 |
| 13 | Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes显示文摘AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated TIPS.METHODS Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging(< 6 mo and > 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive expansion.RESULTS Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(8.45 mm, 5.58%, 56.04 mm^2, and 11.48%, respectively, P = 0.01).CONCLUSION Passive expansion of sm TIPS does occur but clinical outcomes of sm TIPS and m TIPS were similar. Sub-maximal dilation can prevent complications related to overshunting in select patients. | Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski | 2017 | World Journal of Hepatology2017，9，12： | 11 |
| 14 | Transcriptomic landscape regulated by the 14 types of bone morphogenetic proteins(BMPs)in lineage commitment and differentiation of mesenchymal stem cells(MSCs)显示文摘Mesenchymal stem cells(MSCs)are ubiquitously-existing multipotent progenitors that can self-renew and differentiate into multiple lineages including osteocytes,chondrocytes,adipocytes,tenocytes and myocytes.MSCs represent one of the most commonly-used adult progenitors and serve as excellent progenitor cell models for investigating lineagespecific differentiation regulated by various cellular signaling pathways,such as bone morphogenetic proteins(BMPs).As members of TGFb superfamily,BMPs play diverse and important roles in development and adult tissues.At least 14 BMPs have been identified in mammals.Different BMPs exert distinct but overlapping biological functions.Through a comprehensive analysis of 14 BMPs in MSCs,we demonstrated that BMP9 is one of the most potent BMPs in inducing osteogenic differentiation of MSCs.Nonetheless,a global mechanistic view of BMP signaling in regulating the proliferation and differentiation of MSCs remains to be fully elucidated.Here,we conducted a comprehensive transcriptomic profiling in the MSCs stimulated by 14 types of BMPs.Hierarchical clustering analysis classifies 14 BMPs into three subclusters:an osteo/chondrogenic/adipogenic cluster,a tenogenic cluster,and BMP3 cluster.We also demonstrate that six BMPs(e.g.,BMP2,BMP3,BMP4,BMP7,BMP8,and BMP9)can induce ISmads effectively,while BMP2,BMP3,BMP4,BMP7,and BMP11 up-regulate Smad-independent MAP kinase pathway.Furthermore,we show that many BMPs can upregulate the expression of the signal mediators of Wnt,Notch and PI3K/AKT/mTOR pathways.While the reported transcriptomic changes need to be further validated,our expression profiling represents the first-of-its-kind to interrogate a comprehensive transcriptomic landscape regulated by the 14 types of BMPs in MSCs. | Linghuan Zhang Qing Luo Yi Shu Zongyue Zeng Bo Huang Yixiao Feng Bo Zhang Xi Wang Yan Lei Zhenyu Ye Ling Zhao Daigui Cao Lijuan Yang Xian Chen Bin Liu William Wagstaff Russell R*Reid Hue H*Luu Rex C*Haydon Michael J*Lee Jennifer Moriatis Wolf Zhou Fu Tong-Chuan He Quan Kang | 2019 | Genes & Diseases2019，6，3： | 11 |
| 15 | Metformin does not improve survival in patients with hepatocellular carcinoma显示文摘AIM:To assess whether metformin,which has a chemopreventive effect in chronic liver disease,has any chemotherapeutic effect in hepatocellular carcinoma.METHODS:This was a retrospective study of 701 patients with newly diagnosed hepatocellular carcinoma(HCC)seen between January 2005 and June 2011 at Mayo Clinic,Rochester,Minnesota.This patient cohort was a part of the global HCC BRIDGE study,which is a large longitudinal study of HCC determining the realworld experience of HCC characteristics,management and patient outcomes.We defined significant metformin exposure as continuation of this agent at least 90d beyond diagnosis of HCC,and compared survival of diabetic patients on metformin to diabetic patients not on metformin and non-diabetics.RESULTS:Our cohort was 72.9%male,with a mean±SD age of 62.6±12.3 years.The most common etiologies of liver disease were hepatitis C(34%),alcoholic liver disease(29%),fatty liver disease(15%)and hepatitis B(9%).By univariate analysis,using diabetics not on metformin as the reference group,diabetic patients with HCC on metformin had no survival advantage,with a HR(95%CI)of 1.0(0.8-1.3).Non-diabetic HCC patients also did not appear to have a survival advantage as compared to diabetic HCC patients not on metformin,as demonstrated by a HR(95%CI)of1.1(0.7-1.7).Diabetics on metformin beyond 90 d after HCC diagnosis had a longer median survival at 34.2 mo,as compared to 25.5 mo among diabetic patients who were not on metformin or had discontinued metformin within 90 d after HCC diagnosis.This finding was likely due to potential survival bias among those who lived long enough to receive metformin.CONCLUSION:Although the literature suggests a chemotherapeutic effect in other malignancies,our study demonstrates no survival benefit to the use of metformin in diabetic patients with HCC. | Mamatha Bhat Roongruedee Chaiteerakij William S Harmsen Cathy D Schleck Ju Dong Yang Nasra H Giama Terry M Therneau Gregory J Gores Lewis R Roberts | 2014 | World Journal of Gastroenterology2014，20，42： | 11 |
| 16 | 国际糖尿病足工作组:糖尿病足溃疡分类指南——《国际糖尿病足工作组:糖尿病足防治国际指南(2019)》的一部分显示文摘国际糖尿病足工作组(IWGDF)自1999年以来一直以循证为基础发布糖尿病足病的预防和管理指南。本文中针对日常临床工作中糖尿病足溃疡的分类提出了新指南,并对既有的分类进行了综述。新指南只对现患糖尿病足溃疡进行分类,不包括用于定义未来溃疡风险的分类系统。本指南的制定是基于对现有文献的综述以及专家对最大程度影响临床结局的8个关键因素的鉴定。分类级别是根据关键因素的数量、内部和外部有效性验证以及使用意向而制定的。判定分类评分的关键因素有3种:患者相关的因素(终末期肾衰竭)、肢体相关的因素(周围动脉病变和保护性感觉丧失)和溃疡相关的因素(面积、深度、部位、单发或多发以及感染)。特殊分类系统要考虑以下5种临床情况:①卫生专业人员之间交流;②预测单个溃疡预后;③对个案临床决策的辅助;④伤口评估,有感染或无感染及周围动脉病变(评估灌注及血管重建的潜在益处);⑤用于地方、区域或国家人群结局的稽查。指南推荐:①医务人员之间交流使用SINBAD系统。②无适用于预测个体溃疡预后的分类。③感染的评估采用美国传染病学会/国际糖尿病足工作组(IDSA/IWGDF)分类系统。④评估灌注及血管重建的潜在获益使用创面、缺血、足感染(WIfI)系统。⑤人群结局的稽查使用SINBAD系统。 | Matilde Monteiro-Soares David Russell Edward J Boyko William Jeffcoate Joseph L Mills Stephan Morbach Fran Game 无 王爱红(译) 冉兴无(审校) | 2019 | 感染.炎症.修复2019，20，4： | 10 |
| 17 | Immunobiology of congenital cytomegalovirus infection of the central nervous system--the murine cytomegalovirus model显示文摘 | Irena Slavuljica Daria Kvestak Peter Csaba Huszthy Kate Kosmac William J Britt Stipan Jonjic | 2015 | Cellular & Molecular Immunology2015，12，2： | 10 |
| 18 | Colonic ulcerations may predict steroid-refractory course in patients with ipilimumab-mediated enterocolitis显示文摘AIM To investigate management of patients who develop ipilimumab-mediated enterocolitis, including association of endoscopic findings with steroid-refractory symptoms and utility of infliximab as second-line therapy.METHODS We retrospectively reviewed all patients at our centerwith metastatic melanoma who were treated with ipilimumab between March 2011 and May 2014. All patients received a standard regimen of intravenous ipilimumab 3 mg/kg every 3 wk for four doses or until therapy was stopped due to toxicity or disease progression. Basic demographic and clinical data were collected on all patients. For patients who developed grade 2 or worse diarrhea(increase of 4 bowel movements per day), additional data were collected regarding details of gastrointestinal symptoms, endoscopic findings and treatment course. Descriptive statistics were used.RESULTS A total of 114 patients were treated with ipilimumab during the study period and all were included. Sixteen patients(14%) developed ≥ grade 2 diarrhea. All patients were treated with high-dose corticosteroids(1-2 mg/kg prednisone daily or equivalent). Nine of 16 patients(56%) had ongoing diarrhea despite highdose steroids. Steroid-refractory patients received one dose of intravenous infliximab at 5 mg/kg, and all but one had brisk resolution of diarrhea. Fourteen of the patients underwent either colonoscopy or sigmoidoscopy with variable endoscopic findings, ranging from mild erythema to colonic ulcers. Among 8 patients with ulcers demonstrated by sigmoidoscopy or colonoscopy, 7 patients(88%) developed steroidrefractory symptoms requiring infliximab. With a median follow-up of 264 d, no major adverse events associated with prednisone or infliximab were reported.CONCLUSION In patients with ipilimumab-mediated enterocolitis, the presence of colonic ulcers on endoscopy was associated with a steroid-refractory course. | Animesh Jain Evan J Lipson William H Sharfman Steven R Brant Mark G Lazarev | 2017 | World Journal of Gastroenterology2017，23，11： | 8 |
| 19 | Crohn’s disease显示文摘 | Daniel C Baumgart William J Sandborn | 2012 | The Lancet2012，，9853： | 8 |
| 20 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
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