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| 1 | Initial management for acute lower gastrointestinal bleeding显示文摘Acute lower gastrointestinal bleeding(LGIB) is a common indication for hospital admission. Patients with LGIB often experience persistent or recurrent bleeding and require blood transfusions and interventions, such as colonoscopic,radiological, and surgical treatments. Appropriate decision-making is needed to initially manage acute LGIB, including emergency hospitalization, timing of colonoscopy, and medication use. In this literature review, we summarize the evidence for initial management of acute LGIB. Assessing various clinical factors,including comorbidities, medication use, presenting symptoms, vital signs, and laboratory data is useful for risk stratification of severe LGIB, and for discriminating upper gastrointestinal bleeding. Early timing of colonoscopy had the possibility of improving identification of the bleeding source, and the rate of endoscopic intervention, compared with elective colonoscopy. Contrast-enhanced computed tomography before colonoscopy may help identify stigmata of recent hemorrhage on colonoscopy, particularly in patients who can be examined immediately after the last hematochezia. How to deal with nonsteroidal antiinflammatory drugs(NSAIDs) and antithrombotic agents after hemostasis should be carefully considered because of the risk of rebleeding and thromboembolic events. In general, aspirin as primary prophylaxis for cardiovascular events and NSAIDs were suggested to be discontinued after LGIB. Managing acute LGIB based on this information would improve clinical outcomes. Further investigations are needed to distinguish patients with LGIB who require early colonoscopy and hemostatic intervention. | Tomonori Aoki Yoshihiro Hirata Atsuo Yamada Kazuhiko Koike | 2019 | World Journal of Gastroenterology2019，25，1： | 28 |
| 2 | Role of regulatory T cell in the pathogenesis of inflammatorybowel disease显示文摘Regulatory T(Treg) cells play key roles in various immune responses. For example, Treg cells contribute to the complex pathogenesis of inflammatory bowel disease(IBD), which includes Crohn's disease and ulcerative colitis during onset or development of that disease. Many animal models of IBD have been used to investigate factors such as pathogenic cytokines, pathogenic bacteria, and T-cell functions, including those of Treg cells. In addition, analyses of patients with IBD facilitate our understanding of the precise mechanism of IBD. This review article focuses on the role of Treg cells and outlines the pathogenesis and therapeutic strategies of IBD based on previous reports. | akiko yamada rieko arakaki masako saito takaaki tsunematsu yasusei kudo naozumi ishimaru | 2016 | World Journal of Gastroenterology2016，22，7： | 24 |
| 3 | Effectiveness of probiotic therapy for the prevention of relapse in patients with inactive ulcerative colitis显示文摘AIM: to evaluate the effectiveness of probiotic therapy for suppressing relapse in patients with inactive ulcerative colitis(UC).METHODS: Bio-Three tablets, each containing 2 mg of lactomin(Streptococcus faecalis T-110), 10 mg of Clostridium butyricum TO-A, and 10 mg of Bacillus mesentericus TO-A, were used as probiotic therapy.Sixty outpatients with UC in remission were randomly assigned to receive 9 Bio-Three tablets/day(BioThree group) or 9 placebo tablets/day(placebo group)for 12 mo in addition to their ongoing medications.Clinical symptoms were evaluated monthly or on the exacerbation of symptoms or need for additional medication. Fecal samples were collected to analyze bacterial DNA at baseline and 3-mo intervals. Terminal restriction fragment length polymorphism and cluster analyses were done to examine bacterial components of the fecal microflora.RESULTS: Forty-six patients, 23 in each group,completed the study, and 14 were excluded. The relapse rates in the Bio-Three and placebo groups were respectively 0.0% vs 17.4% at 3 mo(P = 0.036), 8.7%vs 26.1% at 6 mo(P = 0.119), and 21.7% vs 34.8%(P = 0.326) at 9 mo. At 12 mo, the remission rate was 69.5% in the Bio-Three group and 56.6% in the placebo group(P = 0.248). On cluster analysis of fecal flora, 7 patients belonged to cluster Ⅰ, 32 to cluster Ⅱ,and 7 to cluster Ⅲ.CONCLUSION: Probiotics may be effective formaintaining clinical remission in patients with quiescent UC, especially those who belong to cluster Ⅰ on fecal bacterial analysis. | Yasushi Yoshimatsu Akihiro Yamada Ryuichi Furukawa Koji Sono Aisaku Osamura Kentaro Nakamura Hiroshi Aoki Yukiko Tsuda Nobuo Hosoe Nobuo Takada Yasuo Suzuki | 2015 | World Journal of Gastroenterology2015，21，19： | 21 |
| 4 | Removal of diminutive colorectal polyps: A prospective randomized clinical trial between cold snare polypectomy and hot forceps biopsy显示文摘AIM To compare the efficacy and safety of cold snare polypectomy(CSP) and hot forceps biopsy(HFB) for diminutive colorectal polyps.METHODS This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were en-bloc resection(endoscopic evaluation) and complete resection rates(pathological evaluation). The secondary outcome measures were the immediate bleeding or immediate perforation rate after polypectomy, delayed bleeding or delayed perforation rate after polypectomy, use of clipping for bleeding or perforation, and polyp retrieval rate. Prophylactic clipping after polyp removal wasn't routinely performed.RESULTS Two hundred eight patients were randomized into the CSP(102), HFB(106) and 283 polyps were evaluated(CSP: 148, HFB: 135). The en-bloc resection rate was significantly higher with CSP than with HFB [99.3%(147/148) vs 80.0%(108/135), P < 0.0001]. The complete resection rate was significantly higher with CSP than with HFB [80.4%(119/148) vs 47.4%(64/135), P < 0.0001]. The immediate bleeding rate was similar between the groups [8.6%(13/148) vs 8.1%(11/135), P = 1.000], and endoscopic hemostasis with hemoclips was successful in all cases. No cases of perforation or delayed bleeding occurred. The rate of severe tissue injury to the pathological specimen was higher HFB than CSP [52.6%(71/135) vs 1.3%(2/148), P < 0.0001]. Polyp retrieval failure was encountered CSP(7), HFB(2).CONCLUSION CSP is more effective than HFB for resecting diminutive polyps. Further long-term follow-up study is required. | Yoriaki Komeda Hiroshi Kashida Toshiharu Sakurai George Tribonias Kazuki Okamoto Masashi Kono Mitsunari Yamada Teppei Adachi Hiromasa Mine Tomoyuki Nagai Yutaka Asakuma Satoru Hagiwara Shigenaga Matsui Tomohiro Watanabe Masayuki Kitano Takaaki Chikugo Yasutaka Chiba Masatoshi Kudo | 2017 | World Journal of Gastroenterology2017，23，2： | 20 |
| 5 | Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy显示文摘Treatment strategies,whether as follow-up or'total incisional biopsy'for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen,are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic treatment.Based on the histological findings of the biopsy specimen,it is difficult to differentiate between reactive or regenerative changes,inflammation and neoplastic changes,intraepithelial and invasive tumors.Therefore,gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during follow-up.Recent advances in endoscopic modalities and treatment devices,such as image-enhanced endoscopy and highfrequency generators,may make endoscopic treatment,such as endoscopic submucosal dissection(ESD),a therapeutic option for gastric intraepithelial neoplasia,including low-grade neoplasms.Future studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness. | Tsutomu Nishida Shusaku Tsutsui Motohiko Kato Takuya Inoue Shunsuke Yamamoto Yoshito Hayashi Tomofumi Akasaka Takuya Yamada Shinichiro Shinzaki Hideki Iijima Masahiko Tsujii Tetsuo Takehara | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，6： | 18 |
| 6 | Pharmacological effects of saw palmetto extract in the lower urinary tract显示文摘锯矮棕榈条摘录(SPE ) ,从美国矮子手掌的成熟果浆的一篇摘录,广泛地在欧洲由于良性的 prostatic 增生(BPH ) 为尿机能障碍被用作治疗学的疗法。行动的众多的机制为 SPE 被建议了,包括 5 伪 - reductase 的抑制。今天,伪 1 -adrenoceptor 对手和 muscarinic cholinoceptor 对手通常与对 BPH 第二等的 voiding 症状在人的治疗被使用。在拿 SPE 的病人的 voiding 症状的改进可以在更低的尿道从它的绑定产生到 pharmacologically 相关的受体,例如伪 1 -adrenoceptors, muscarinic cholinoceptors, 1,4-dihyropyridine 受体和 vanilloid 受体。而且, SPE 的口头的管理被显示了在睾丸激素导致的老鼠前列腺稀释伪 1 -adrenoceptors 的起来规定。因此,在临床上相关的剂量的 SPE 可以在更低的尿道在药理学受体上施加直接效果,在有 BPH 和一个 overactive 膀胱的病人的从而改善的尿机能障碍。SPE 没在血与共同管理的药或严肃的不利事件有相互作用生物化学的参数,它的相对安全暗示,甚至与长期的吸入。与 BPH 在人进行的 SPE 的临床的试用(控制安慰剂、活跃控制的试用) 也被考察。这评论应该与 BPH 在病人的治疗贡献 SPE 的药理学效果的理解并且联系更低的尿道症状(LUTS ) 。 | Mayumi SUZUKI Yoshihiko ITO Tomomi FUJINO Masayuki ABE Keizo UMEGAKI Satomi ONOUE Hiroshi NOGUCHI Shizuo YAMADA | 2009 | Acta Pharmacologica Sinica2009，30，3： | 17 |
| 7 | Modified boron neutron capture therapy for malignant gliomas performed using epithermal neutron and two boron compounds with different accumulation mechanisms: an efficacy study based on findings on neuroimages显示文摘 | Miyatake S Kawabata S Kafimoto Y Aoki A Yokoyama K Yamada M Kuroiwa T Tsuji M Imahori Y Kirihata M Sakurai Y Masunaga S Nagata K Maruhashi A Ono K | 2005 | 中国神经肿瘤杂志2005，3，4： | 14 |
| 8 | Machine-learning-assisted discovery of polymers with high thermal conductivity using a molecular design algorithm显示文摘The use of machine learning in computational molecular design has great potential to accelerate the discovery of innovative materials.However,its practical benefits still remain unproven in real-world applications,particularly in polymer science.We demonstrate the successful discovery of new polymers with high thermal conductivity,inspired by machine-learning-assisted polymer chemistry.This discovery was made by the interplay between machine intelligence trained on a substantially limited amount of polymeric properties data,expertise from laboratory synthesis and advanced technologies for thermophysical property measurements.Using a molecular design algorithm trained to recognize quantitative structure—property relationships with respect to thermal conductivity and other targeted polymeric properties,we identified thousands of promising hypothetical polymers.From these candidates,three were selected for monomer synthesis and polymerization because of their synthetic accessibility and their potential for ease of processing in further applications.The synthesized polymers reached thermal conductivities of 0.18–0.41 W/mK,which are comparable to those of state-of-the-art polymers in non-composite thermo-plastics. | Stephen Wu Yukiko Kondo Masa-aki Kakimoto Bin Yang Hironao Yamada Isao Kuwajima Guillaume Lambard Kenta Hongo Yibin Xu Junichiro Shiomi Christoph Schick Junko Morikawa Ryo Yoshida | 2019 | npj Computational Materials2019，，1： | 14 |
| 9 | Endoscopic submucosal dissection for colorectal neoplasms:A review显示文摘The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their size.ESD has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal resection.Moreover,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically difficult.Therefore,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal lesions.On the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of perforation.To diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated complications.This review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure. | Taku Sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima Takahisa Matsuda Yutaka Saito | 2014 | World Journal of Gastroenterology2014，20，43： | 13 |
| 10 | Clinical utility of the platelet-lymphocyte ratio as a predictor of postoperative complications after radical gastrectomy for clinical T2-4 gastric cancer显示文摘AIM To identify simple and sensitive markers for postoperative complications after gastrectomy, the predictive values were compared among candidate preoperative factors. METHODS Three-hundred and twelve patients with previously untreated clinical T2-4 gastric cancer who underwent a D2 standard gastrectomy(distal gastrectomy or total gastrectomy) were included in the analysis.Correlations between 21 parameters that can be determined by preoperative routine blood tests and clinically relevant postoperative complications(grade Ⅱ or higher according to the Clavien-Dindo classification) were evaluated. The optimal cutoff values and clinical significance of the selected markers were further evaluated by subgroup analyses according to age, body mass index, operative procedure and clinical disease stage.RESULTS Sixty-six patients(21.1%) experienced grade Ⅱ or higher postoperative complications. The plateletlymphocyte ratio(PLR, total lymphocyte count/platelet count × 100) exhibited the highest area under the curve value(0.639) for predicting postoperative complications among the 21 parameters, and the optimal cutoff value was determined to be 0.71(sensitivity = 70%, specificity = 56%). In the univariate analysis, the odds ratio of a low PLR for the occurrence of postoperative complications was 2.94(95%CI: 1.66-5.35, P < 0.001), and a multivariate binomial logistic analysis involving other potential risk factors identified a low PLR as an independent risk factor for postoperative complications(OR = 3.32, 95%CI: 1.82-6.25, P < 0.001). In subgroups classified according to age, body mass index, operative procedure and clinical disease stage, the low PLR group exhibited an increased incidence of postoperative complications. CONCLUSION The preoperative PLR is a simple and useful predictor of complications after curative gastrectomy in patients with clinical T2-4 gastric cancer. | Kenichi Inaoka Mitsuro Kanda Hiroaki Uda Yuri Tanaka Chie Tanaka Daisuke Kobayashi Hideki Takami Naoki Iwata Masamichi Hayashi Yukiko Niwa Suguru Yamada Tsutomu Fujii Hiroyuki Sugimoto Kenta Murotani Michitaka Fujiwara Yasuhiro Kodera | 2017 | World Journal of Gastroenterology2017，23，14： | 13 |
| 11 | Nasogastric tube syndrome induced by an indwelling long intestinal tube显示文摘The nasogastric tube(NGT) has become a frequently used device to alleviate gastrointestinal symptoms. Nasogastric tube syndrome(NTS) is an uncommon but potentially life-threatening complication of an indwelling NGT. NTS is characterized by acute upper airway obstruction due to bilateral vocal cord paralysis. We report a case of a 76-year-old man with NTS, induced by an indwelling long intestinal tube. He was admitted to our hospital for treatment of sigmoid colon cancer. He underwent sigmoidectomy to release a bowel obstruction, and had a long intestinal tube inserted to decompress the intestinal tract. He presented acute dyspnea following prolonged intestinal intubation, and bronchoscopy showed bilateral vocal cord paralysis. The NGT was removed immediately, and tracheotomy was performed. The patient was finally discharged in a fully recovered state. NTS be considered in patients complaining of acute upper airway obstruction, not only with a NGT inserted but also with a long intestinal tube. | Naoki Sano Masayoshi Yamamoto Kentaro Nagai Keiichi Yamada Nobuhiro Ohkohchi | 2016 | World Journal of Gastroenterology2016，22，15： | 11 |
| 12 | 中国人与日本人β3肾上腺素能受体基因Trp64Arg突变的比较显示文摘目的 研究 β 3肾上腺素能受体 (β 3AR)基因Trp6 4Arg突变频率及其对体重、血脂、血压、心率及糖尿病发病的影响以及中日民族间的差异。方法 研究了 75 1例中国人该受体基因突变的临床特征 ,并与本文第一作者曾在日本做的研究进行了比较。中国人 :(1 )健康体检者 6 1 4人 ;(2 ) 2型糖尿病患者 1 37人。日本人 :(1 )居民 746人 ;(2 ) 2型糖尿病和 /或高脂血症的内分泌代谢病门诊患者 371人。均测定了身高、体重、血糖、血脂、肝功能。用PCR法扩增含有 β 3AR基因Trp6 4Arg片段 ,限制性内切酶消化 ,判断基因型。结果 (1 )中国人 β 3AR基因Trp6 4Arg平均突变率为 1 7.8% ,日本人为 2 1 .7% ,两国近似。 (2 )中国人的 β 3AR基因突变率随BMI增高而升高 ,女性肥胖组的基因频率与正常偏瘦组相比差异有显著意义 (P <0 .0 2 )。日本人无明显相关性。中国人该基因突变者的平均BMI与正常基因型相比均显著增高 ,(P分别 <0 .0 0 1与 0 .0 0 2 )。日本人则差异无显著意义。 (3)日本人的纯合子及中国人的杂合子及纯合子男性 β 3AR基因突变者的血胆固醇降低 ,差异有显著意义 ,(日本人P <0 .0 3。中国人P分别 <0 .0 0 1与 0 .0 0 5 )。 (4)日本人男性 β 3AR基因纯合子突变者的收缩压有增高的倾向 (P =0 .0 0 2 | 孙黎明 YokoIizuka ShunIshibashi Tananari Gotoda 赵蔚 刘铁群 王晓梅 曲建梅 于小静 刘雅卓 Nobuhiro Yamada | 2000 | 中华医学杂志2000，80，2： | 11 |
| 13 | 蛋白酶激活受体2在载脂蛋白E缺陷小鼠的血管炎症和动脉粥样硬化中发挥关键作用显示文摘凝血系统与血管炎症密切相关,尽管其潜在机制仍不清楚。最近的研究结果表明,蛋白酶激活受体(protease-activated receptor,PAR)2——活化因子X(activated factor X,FXa)的主要受体之一——在血管细胞和白细胞中均有表达,这提示PAR-2可能参与炎症性疾病的发病机制。 | Hara T Phuong PT Fukuda D Yamaguchi K Murata C Nishimoto S Yagi S Kusunose K Yamada H Soeki T Wakatsuki T Imoto I Shimabukuro M Sata M 刘青 叶鹏 | 2018 | 中华高血压杂志2018，26，6： | 11 |
| 14 | 腰椎椎间孔狭窄引起静息性腿痛显示文摘腰椎椎间孔狭窄(foraminal stenosis,FS)诊断困难,往往使腰椎管狭窄(canal stenosis,CS)常规手术的预后不尽如人意,有学者认为,近60%的术后持续疼痛来自于腰椎FS。 | Yamada K Aota Y Higashi T 杨庆磊 尹庆水 | 2014 | 中国骨科临床与基础研究杂志2014，6，3： | 11 |
| 15 | Low-grade myofibroblastic sarcoma of the palate显示文摘Low-grade myofibroblastic sarcoma(LGMS) is a rare,malignant tumor with myofibroblastic differentiation.Despite it being classified as a distinct entity by the World Health Organization,a few cases were reported in the oral and maxillofacial region.Here,a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate.Based on the histological and immunohistochemical features,a diagnosis of LGMS was established.The tumor was resected,and no recurrence was observed over 2 years.Although the tongue is the most preferred site for LGMS,it may occur in any region of the oral cavity. | Tomohiro Yamada Tomohide Yoshimura Naoya Kitamura Eri Sasabe Seiji Ohno Tetsuya Yamamoto | 2012 | International Journal of Oral Science2012，4，3： | 9 |
| 16 | Clinical significance of serum levels of vascular endothelial growth factor and its receptor in biliary disease and carcinoma显示文摘AIM: To investigate the clinical significance of serum vascular endothelial growth factor (VEGF) and soluble VEGF receptor-1 (VEGFR1/Flt-1) (sVEGFR1) levels in biliary diseases.METHODS: We analyzed the serum levels of these proteins in patients with acute cholangitis (group 1), biliary malignancies (group 2), and primary biliary cirrhosis or primary sclerosing cholangitis (group 3), and in healthy donors (group 4). The influence of inflammation was also analyzed. Serum VEGF levels were expressed as VEGF per platelet (VEGF/PLT, pg/106) in order to exclude the influence of platelet counts.RESULTS: sVEGFR1 levels were significantly higher in groups 1 and 2 than in the control group, but did not correlate with inflammatory markers. VEGF/PLT levels were generally higher in patients with active inflammation than in those with carcinoma. C-reactive protein strongly correlated with the levels of serum VEGF independently of platelet and leukocyte counts, even in cancer patients. In cancer patients, VEGF/PLT and sVEGFR1 levels might be indicators for evaluating the effect of medical treatment or the disease progression.CONCLUSION: Serum VEGF and VEGFR1 might be useful markers for gauging the clinical effect of various treatments on patients. | Munechika Enjoji Makoto Nakamuta Koji Yamaguchi Satoshi Ohta Kazuhiro Kotoh Marie Fukushima Masami Kuniyoshi Tomomi Yamada Masao Tanaka Hajime Nawata | 2005 | World Journal of Gastroenterology2005，11，8： | 9 |
| 17 | 精确测量的地幔体波走时及地幔非均匀性的强度(英文)显示文摘用波形相关法精确地测定了在世界各地发生的87个6级以上地震的P波, PP波和Pdiff波的503个走时数据。记录这些地震波形的是新建于西太平洋地区的海洋半球地震观测网。我们利用这些高精度的走时数据研究了地幔体波的走时残差的范围及地幔非均匀性的强度。结果表明,P波、PP波和Pdiff波的走时残差最大分别为9 s ,11 s和15 s ,这为地幔层析成像反演中应该使用的体波走时残差数据的范围提供了重要信息。超出这一范围的走时残差数据不应该用于反演中,以免歪曲成像结果。我们发现,当震中距小于40°时,P波走时残差的范围为-6到+9 s。而对于40°到99°之间的震中距,P波走时残差的范围为-3到+5s。由于震中距越大,P波穿透地幔越深,我们这一结果提供了直接和确凿的证据,表明上地幔和地幔转换带中的横向非均匀性的强度要远胜于下地幔。我们精确测量的Pdiff波的走时数据表明,在地幔底部存在显著的低速异常,可能与地幔热柱或者超级地幔柱有关。我们使用了一个最新的三维全球层析成像模型来解释这些体波走时数据的空间变化。 | Akira YAMADA Yuhei OHTA | 2006 | 地学前缘2006，13，2： | 9 |
| 18 | 根据血压等级确定脑卒中和冠状动脉粥样硬化性心脏病死亡的终生风险:日本EPOCH(观察队列的心血管预防证据)研究显示文摘在亚洲人群中.很少研究关注根据血压分类确定脑卒中和冠状动脉粥样硬化性心脏病(coronary heartdisease,CHD)的终生风险。该研究旨在用一个包含个体参与者数据的荟萃分析大数据库来评估它。该荟萃分析纳入来源于13个队列的107 737名日本人(男性占42.4%,平均年龄55.1岁)。在平均(15.2±5.3)年(1 559 136人年)的随访期.1922人死于脑卒中,913人死于CHDO研究者在调整其他死亡危险因素后估计风险。 | 陈嘉睿(译) 练桂丽(审校) Satoh M Ohkubo T Asayama K Murakami Y Sugiyama D Yamada M Saitoh S Sakata K Irie F Sairenchi T Ishikawa S Kiyama M Ohnishi H Miura K Imai Y Ueshima H Okamura T EPOCH-JAPAN research group | 2019 | 中华高血压杂志2019，27，4： | 9 |
| 19 | Clinical outcomes of ampullary neoplasms in resected margin positive or uncertain cases after endoscopic papillectomy显示文摘BACKGROUND Endoscopic papillectomy(EP) for benign ampullary neoplasms could be a lessinvasive alternative to pancreatoduodenectomy(PD). There are some problems and limitations with EP. The post-EP resection margins of ampullary tumors are often positive or uncertain because of the burning effect of EP. The clinical outcomes of resected margin positive or uncertain cases after EP remain unknown.AIM To investigate the clinical outcomes of resected margin positive or uncertain cases after EP.METHODS Between January 2007 and October 2018, all patients with ampullary tumors who underwent EP at Kobe University Hospital were included in this study. The indications for EP were as follows: adenoma, as determined by preoperative endoscopic biopsy, without bile/pancreatic duct extension, according to endoscopic ultrasound or intraductal ultrasound. The clinical outcomes of resected margin positive or uncertain cases after EP were retrospectively investigated.RESULTS Of the 45 patients, 29 were male, and 16 were female. The mean age of the patients was 65 years old. Forty-one patients(89.5%) underwent en bloc resection,and 4 patients(10.5%) underwent piecemeal resection. After EP, 33 tumors were histopathologically diagnosed as adenoma, and 12 were diagnosed as adenocarcinoma. The resected margins were positive or uncertain in 24 patients(53.3%). Of these cases, 15 and 9 were diagnosed as adenoma and adenocarcinoma, respectively. Follow-up observation was selected for all adenomas and 5 adenocarcinomas. In the remaining 4 adenocarcinoma cases,additional PD was performed. Additional PD was performed in 4 cases, and residual carcinoma was found after the additional PD in 1 of these cases. In the follow-up period, local tumor recurrence was detected in 3 cases. Two of these cases involved primary EP-diagnosed adenoma. The recurrent tumors were also adenomas detected by biopsy. The remaining case involved primary EPdiagnosed adenocarcinoma. The recurrent tumor was also an adenocarcinoma.All of the recurrent tumors were successfully treated with argon plasma coagulation(APC). There was no local or lymph node recurrence after the APC.The post-APC follow-up periods lasted for 57.1 to 133.8 mo. No ampullary tumor-related deaths occurred in all patients.CONCLUSION Resected margin positive or uncertain cases after EP could be managed by endoscopic treatment including APC, even in cases of adenocarcinoma. EP could become an effective less-invasive first-line treatment for early stage ampullary tumors. | Arata Sakai Masahiro Tsujimae Atsuhiro Masuda Takao Iemoto Shigeto Ashina Kohei Yamakawa Takeshi Tanaka Shunta Tanaka Yasutaka Yamada Ryota Nakano Yu Sato Manabu Kurosawa Takuya Ikegawa Seiji Fujigaki Takashi Kobayashi Hideyuki Shiomi Yoshifumi Arisaka Tomoo Itoh Yuzo Kodama | 2019 | World Journal of Gastroenterology2019，25，11： | 9 |
| 20 | Water and Nutrient Use Efficiency in Diploid, Tetraploid and Hexaploid Wheats显示文摘三双(Triticum boeotlcum, AA;Aegilops speltoides, BB 和 Ae.tauschii, DD ) ,二四倍体(T。dicoccoides, AABB 和 T。dicoccon, AABB ) 并且一六倍体(T.vulgare, AABBDD ) 小麦的变化,它在小麦的进化很重要在这研究被选择。盆栽试验在不同的水和滋养的条件(i)下面在小麦上被执行在 blomass ,收益,水使用效率( WUE ),和营养素理解差别( N , P 和 K )在在小麦的进化的 ploidies 之中的使用效率(举起和利用效率);(i i ) 使用效率在水和营养素上澄清水和滋养的条件的效果;并且(病) 在小麦的进化使用效率估计水和营养素的关系。我们的结果然后在小麦的进化期间从双 totetraploid 显示出那到六倍体,两根 blomass 并且未葬生物资源开始增加了然后减少。为蒸发的水消费显著地减少了,,与生长时期的衰落相关谷物产量,产量指数, WUE, N, P 和 K 举起效率,和 N, P andKutilization 效率显著地增加了。谷物产量,产量指数和 WUE 在一样的顺序减少了:T.vulgare >
T。dicoccon >
T。dicoccoides >
Ae。tauschii >
Ae。speltoides >
T.boeoticum。水强调显著地减少的根生物资源,未葬为由 47-52% 的蒸发的生物资源,收益,和水消费,而是显著地增加的 WUE。增加滋养的供应增加了小麦未葬生物资源,谷物收益,产量指数,为在不同的水层次下面的蒸发和 WUE 的水消费,而是在干旱条件下面的减少的根生物资源。通常,水应力和低滋养的供应导致了小麦的更低的 nutrientuptakeefficiency。然而,水和滋养的申请没在 nutrientutilizationefficiency 上有重要效果,建议小麦营养素利用效率被遗传型主要控制。比作另外的二双小麦, Ae。squarrosa (DD ) 有重要更高的 WUEand 滋养的利用效率,显示 D 染色体可以带控制水和营养素的高有效的利用的基因。重要关系在 WUE andN, P 和 K 利用效率之间被发现。 | Ming-Li Huang Xi-Ping Deng Yu-Zong Zhao Sheng-Lu Zhou Shinobu Inanaga Satoshi Yamada Kiyoshi Tanaka | 2007 | Journal of Integrative Plant Biology2007，49，5： | 8 |
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