|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Endoscopic treatment of esophageal varices in patients with liver cirrhosis显示文摘Variceal bleeding is a life-threatening complication of portal hypertension with a six-week mortality rate of approximately 20%. Patients with medium- or largesized varices can be treated for primary prophylaxis of variceal bleeding using two strategies: non-selective beta-blockers(NSBBs) or endoscopic variceal ligation(EVL). Both treatments are equally effective. Patients with acute variceal bleeding are critically ill patients. The available data suggest that vasoactive drugs, combined with endoscopic therapy and antibiotics, are the best treatment strategy with EVL being the endoscopic procedure of choice. In cases of uncontrolled bleeding, transjugular intrahepatic portosystemic shunt(TIPS) with polytetrafluoroethylene(PTFE)-covered stents are recommended. Approximately 60% of the patients experience rebleeding, with a mortality rate of 30%. Secondary prophylaxis should start on day six following the initial bleeding episode. The combination of NSBBs and EVL is the recommended management, whereas TIPS with PTFE-covered stents are the preferred option in patients who fail endoscopic and pharmacologic treatment. Apart from injection sclerotherapy and EVL, other endoscopic procedures, including tissue adhesives, endoloops, endoscopic clipping and argon plasma coagulation, have been used in the management of esophageal varices. However, their efficacy and safety, compared to standard endoscopic treatment, remain to be further elucidated. There are safety issues accompanying endoscopic techniques with aspiration pneumonia occurring at a rate of approximately 2.5%. In conclusion, future research is needed to improve treatment strategies, including novel endoscopic techniques with better efficacy, lower cost, and fewer adverse events. | Christos Triantos Maria Kalafateli | 2014 | World Journal of Gastroenterology2014，20，36： | 53 |
| 2 | Role of laparoscopic common bile duct exploration in the management of choledocholithiasis显示文摘Surgical fraternity has not yet arrived at any consensus for adequate treatment of choledocholithiasis. Sequential treatment in the form of pre-operative endoscopic retrograde cholangio-pancreatography followed by laparoscopic cholecystectomy(LC) is considered as optimal treatment till date. With refinements in technique and expertise in field of minimal access surgery, many centres in the world have started offering one stage management of choledocholithiasis by LC with laparoscopic common bile duct exploration(LCBDE). Various modalities have been tried for entering into concurrent common bile duct(CBD) [transcystic(TC) vs transcholedochal(TD)], for confirming stone clearance(intraoperative cholangiogram vs choledochoscopy), and for closure of choledochotomy(T-tube vs biliary stent vs primary closure) during LCBDE. Both TC and TD approaches are safe and effective. TD stone extraction is involved with an increased risk of bile leaks and requires more expertise in intra-corporeal suturing and choledochoscopy. Choice depends on number of stones, size of stone, diameter of cystic duct and CBD. This review article was undertaken to evaluate the role of LCBDE for the management of choledocholithiasis. | Nikhil Gupta | 2016 | World Journal of Gastrointestinal Surgery2016，8，5： | 40 |
| 3 | Clinical Research on Alzheimer's Disease: Progress and Perspectives显示文摘Alzheimer's disease(AD), the most common type of dementia, is becoming a major challenge for global health and social care. However, the current understanding of AD pathogenesis is limited, and no early diagnosis and disease-modifying therapy are currently available. During the past year, significant progress has been made in clinical research on the diagnosis, prevention, and treatment of AD.In this review, we summarize the latest achievements,including diagnostic biomarkers, polygenic hazard score,amyloid and tau PET imaging, clinical trials targeting amyloid-beta(Ab), tau, and neurotransmitters, early intervention, and primary prevention and systemic intervention approaches, and provide novel perspectives for further efforts to understand and cure the disease. | Bin-Lu Sun Wei-Wei Li Chi Zhu Wang-Sheng Jin Fan Zeng Yu-Hui Liu Xian-Le Bu Jie Zhu Xiu-Qing Yao Yan-Jiang Wang | 2018 | Neuroscience Bulletin2018，34，6： | 29 |
| 4 | Laparoscopic common bile duct exploration with primary closure is safe for management of choledocholithiasis in elderly patients显示文摘Background:Laparoscopic common bile duct exploration(LCBDE)is one of the minimally invasive options for choledocholithiasis.Primary closure of the common bile duct(CBD)upon completion of laparoscopic choledochotomy is safe in selected patients.The present study aimed to evaluate the feasibility and safety of primary closure of CBD after LCBDE in patients aged 70 years or older.Methods:A total of 116 patients(51 males and 65 females)who suffered from choledocholithiasis and underwent primary closure of the CBD(without T-tube drainage)after LCBDE from January 2003 to December 2017 were recruited.They were classified into two groups according to age:group A(≥70 years,n=56),and group B(<70 years,n=60).The preoperative characteristics,intraoperative details,and postoperative outcomes of the two groups were evaluated.Results:The mean operative time was 172.02 min for group A and 169.92 min for group B(P=0.853).The mean hospital stay was 7.40 days for group A and 5.38 days for group B(P<0.001).Bile leakage occurred in two patients in group A and one in group B(3.57%vs 1.67%,P=0.952).There were no significant differences in the rates of postoperative complications and mortality between the two groups.At median follow-up time of 60 months,stone recurrence was detected in one patient in group A and two in group B(1.79%vs 3.33%,P=1.000).Stenosis of CBD was not observed in group A and slight stenosis in one patient in group B(0 vs 1.67%,P=1.000).Conclusion:Primary closure of the CBD upon completion of laparoscopic choledochotomy is safe and feasible in elderly patients≥70 years old. | Xiang Wu Ze-Jian Huang Jin-Yi Zhong Yi-Hong Ran Ming-Lei Ma Hong-Wei Zhang | 2019 | Hepatobiliary & Pancreatic Diseases International2019，18，6： | 30 |
| 5 | Accurate definition and management of idiopathic sclerosing encapsulating peritonitis显示文摘AIM: To review the literature on idiopathic sclerosing encapsulating peritonitis(SEP), also known as abdominal cocoon syndrome. METHODS: The Pub Med, MEDLINE, Google Scholar, and Google databases were searched using specific key words to identify articles related to idiopathic SEP. These key words were 'sclerosing encapsulating peritonitis,' 'idiopathic sclerosing encapsulating peritonitis,' 'abdominal cocoon,' and 'abdominal cocoon syndrome.' The search included letters tothe editor, case reports, review articles, original articles, and meeting presentations published in the English-language literature from January 2000 to May 2014. Articles or abstracts containing adequate information about age, sex, symptom duration, initial diagnosis, radiological tools, and surgical approaches were included in the study. Papers with missing or inadequate data were excluded. RESULTS: The literature search yielded 73 articles on idiopathic(primary) SEP published in 23 countries. The four countries that published the greatest number of articles were India(n = 21), Turkey(n = 14), China(n = 8) and Nigeria(n = 3). The four countries that reported the greatest number of cases were China(n = 104; 53.88%), India(n = 35; 18.13%), Turkey(n = 17; 8.80%) and Nigeria(n = 5; 2.59%). The present study included 193 patients. Data on age could be obtained for 184 patients(range: 7-87 years; mean ± SD, 34.7 ± 19.2 years), but were unavailable for nine patients. Of the 184 patients, 122 were male and 62 were female; sex data could not be accessed in the remaining nine patients. Of the 149 patients whose preoperative diagnosis information could be obtained, 65(43.6%) underwent operations for abdominal cocoon, while the majority of the remaining patients underwent operations for a presumed diagnosis of intestinal obstruction and/or abdominal mass. Management information could be retrieved for 115 patients. Of these, 68 underwent excision + adhesiolysis(one laparoscopic); 24 underwent prophylactic appendectomy in addition to excision + adhesiolysis. Twenty patients underwent various resection and repair techniques along with excision + adhesiolysis. The remaining three patients were managed with antituberculosis therapy(n = 2) and immunosuppressive therapy(n = 1). CONCLUSION: Idiopathic SEP is a rare disorder characterized by frequently recurring bouts of intestinal obstruction. Surgical therapy is the gold standardmanagement strategy. | Sami Akbulut | 2015 | World Journal of Gastroenterology2015，21，2： | 29 |
| 6 | Hepatectomy with primary closure of common bile duct for hepatolithiasis combined with choledocholithiasis显示文摘AIM: To evaluate the feasibility of hepatectomy and primary closure of common bile duct for intrahepatic and extrahepatic calculi. METHODS: From January 2008 to May 2013, anatomic hepatectomy followed by biliary tract exploration without biliary drainage(non-drainage group) was performed in 43 patients with intrahepatic and extrahepatic calculi. After hepatectomy, flexible choledochoscopy was used to extract residual stones and observe the intrahepatic bile duct and common bile duct(CBD) for determination of biliary stricture and dilatation. Function of the sphincter of Oddi was determined by manometry of the CBD. Primary closure of the CBD without T-tube drainage or bilioenteric anastomosis was performed when there was no biliary stricture or sphincter of Oddi dysfunction. Dexamethasone and anisodamine were intravenously injected 2-3 d after surgery to prevent postoperative retrograde infection due to intraoperative bile duct irrigation, and to maintain relaxation of the sphincter of Oddi, respectively. During the same period, anatomic hepatectomy followed by biliary tract exploration with biliary drainage(drainage group) was performed in 48 patients as the control group. Postoperative complications and hospital stay were compared between the two groups.RESULTS: There was no operative mortality in either group of patients. Compared to intrahepatic and extrabiliary drainage, hepatectomy with primary closure of the CBD(non-drainage) did not increase the incidenceof complications, including residual stones, bile leakage, pancreatitis and cholangitis(P > 0.05). Postoperative hospital stay and costs were nevertheless significantly less in the non-drainage group than in the drainage group. The median postoperative hospital stay was shorter in the non-drainage group than in the drainage group(11.2 ± 2.8 d vs 15.4 ± 2.1 d, P = 0.000). The average postoperative cost of treatment was lower in the non-drainage group than in the drainage group(29325.6 ± 5668.2 yuan vs 32933.3 ± 6235.1 yuan, P = 0.005). CONCLUSION: Hepatectomy followed by choledochoendoscopic stone extraction without biliary drainage is a safe and effective treatment of hepatolithiasis combined with choledocholithiasis. | Chang-Ku Jia Jie Weng You-Ke Chen Qing-Zhuang Yang Yu Fu Qi-Fan Qin Wei-Ming Yu | 2015 | World Journal of Gastroenterology2015，21，12： | 27 |
| 7 | State-of-the-art review on frequency response of wind power plants in power systems显示文摘With an increasing penetration of wind power in the modern electrical grid, the increasing replacement of large conventional synchronous generators by wind power plants will potentially result in deteriorated frequency regulation performance due to the reduced system inertia and primary frequency response. A series of challenging issues arise from the aspects of power system planning,operation, control and protection. Therefore, it is valuable to develop variable speed wind turbines(VSWTs) equipped with frequency regulation capabilities that allow them to effectively participate in addressing severe frequency contingencies. This paper provides a comprehensive surveyon frequency regulation methods for VSWTs. It fully describes the concepts, principles and control strategies of prevailing frequency controls of VSWTs, including future development trends. It concludes with a performance comparison of frequency regulation by the four main types of wind power plants. | Ziping WU Wenzhong GAO Tianqi GAO Weihang YAN Huaguang ZHANG Shijie YAN Xiao WANG | 2018 | Journal of Modern Power Systems and Clean Energy2018，6，1： | 26 |
| 8 | The biomass and aboveground net primary productivity of Schima superba-Castanopsis carlesii forests in east China显示文摘The biomass and productivity of Schima superba-Castanopsis carlesii forests in Tiantong,Zhejiang Province,were determined using overlapping quadrants and stem analyses.The total community biomass was(225.3±30.1) t hm-2,of which the aboveground parts accounted for 72.0% and the underground parts accounted for 28.0%.About 87.2% of biomass existed in the tree layer.The resprouting biomass was small,of which over 95.0% occurred in the shrub layer.The productivity of the aboveground parts of the community was(386.8±98.9) g m-2a-1,in which more than 96.0% was present at the tree level.The trunk's contribution to productivity was the greatest,while that of leaves was the smallest.In China,the community biomass of subtropical evergreen broadleaved forests differs significantly with the age of the forest.The community biomass of the 52-year-old S.superba-C.carlesii forests in this study was lower than the average biomass of subtropical evergreen broadleaved forests in China,and was lower than the biomass of other subtropical evergreen broadleaved forests elsewhere in the world.Moreover,its productivity was lower than the model estimate,indicating that without disturbance,this community has great developmental potential in terms of community biomass and productivity. | YANG TongHui1,2,SONG Kun1,DA LiangJun1*,LI XiuPeng3 & WU JianPing1 1School of Resources and Environment Science,East China Normal University,Shanghai 200062,China 2Ningbo Academy of Agricultural Science,Ningbo 315040,China 3Ningbo Technology Extension Center for Forestry and Specialty Forest Products,Ningbo 315012,China | 2010 | Science China(Life Sciences)2010，53，7： | 23 |
| 9 | Impact of Laparoscopic Versus Open Hepatectomy on Perioperative Clinical Outcomes of Patients with Primary Hepatic Carcinoma显示文摘Objective To compare the perioperative outcomes of patients with primary hepatic carcinoma treated with laparoscopic hepatectomy(LH) with those treated with open hepatectomy(OH). Methods From January 2010 to August 2014, 100 patients with primary hepatic carcinoma were randomly divided into the LH group and OH group respectively, 50 patients in each group. And the incision length, blood loss, operative time, postoperative liver function, anus exhaust time, complications, length of postoperative hospital stay, and cost measures were compared. Results LH could achieve shorter incision length, less blood loss, more rapid recovery in liver function and gastrointestinal function, and shorter postoperative hospital stay length compared with OH for primary hepatic carcinoma patients(all P<0.05). However, LH could not significantly shorten operative time, and reduce postoperative complications and hospitalization cost(all P>0.05). Conclusion Compared with OH, LH could improve perioperative outcomes of primary hepatic carcinoma patients. | Hai-tao Jiang Jing-yu Cao | 2015 | Chinese Medical Sciences Journal2015，30，2： | 23 |
| 10 | Changed clinical aspects of primary liver cancer in China during the past 30 years显示文摘BACKGROUND: Primary liver cancer (PLC) is one of the most frequently seen tumors in China. Thirty years ago, patients with PLC were often detected at relatively late stage, with a palpable mass or marked clinical symptoms and poor prognosis. In the past 30 years, the diagnosis and treatment of PLC have been greatly improved with better prognosis. METHODS: In order to study the changes of PLC during the 30 years, the clinical data of 3250 patients with PLC from 10 medical institutions of China were collected, ana- lyzed , and compared with those of 3254 PLC patients be- fore the 30 years. RESULTS: In the 3250 patients aged 1-80 years, with an average age of 49.1 years, the male to female ratio (2.3:1) was lower than that before the 30 years. 73.5% of the 3250 patients sought medical advice within 3 months after the onset of the disease in contrast to 63.8% before the 30 years. Compared with those patients before the 30 years the symptoms and signs were alleviated generally. The HBsAg positive rate was 81.0%, but the HCV-Ab positive rate was 13.2%. The AFP level in 75% of patients was elevated, but in the remaining 25% was normal. 1912 patients (58.8%) were confirmed pathologically. Among them 1755 patients (91.8%) had hepatocellular carcinoma. The overall resec- tion rate was 46.3%. Those who had early, middle, late stage carcinoma accounted for 29.9%, 51.5%, and 18.6%respectively in contrast to 0.4%, 47.0%, and 52.6% repor- ted before the 30 years. The 1-, 3-, 5-year survival rates of the patients were 66.1%, 39.7%, and 32.5% respectively, whereas 93.5%, 70.1%, and 59.1% for the early stage pa- tients, and 65.3%, 30.5%, and 23.5% for the middle stage patients. The half and 1-year survival rates of the late stage patients were 52.5%, and 14.7%, respectively. CONCLUSION: Comparison with the clinical data before and after the 30 years show that PLC can be diagnosed ear- ly. More PLC patients tend to undergo resection while re- ceiving a better conservative treatment, which ensures a prognosis. | Bing-Hui Yang, Jing-Lin Xia, Li-Wen Huang, Zhao-You Tang, Ming-Shan Chen, Jin-Qing Li, An-Min Liang, Qin-Guo Mo, Hui-Shan Lu, Chao-Liu Dai, Lu-Nan Yan, Zhi-Jian Yu, Rong-Sheng Rao, Le-Qun Li, Zhi-Xiong Su, Zhuang-Wei Fang Shanghai, China Liver Cancer Institute & Zhongshan Hospital, Fudan University, Shanghai 200032, China Tumor Hospital, Zhongshan University, Guangzhou 510000, China Tumor Hospital, Guangxi Medical Universi- ty, Nanning 530000, China Xiehe Hospital, Fujian Medical University, Fuzhou 350000, China Second Hos- pital, Chinese Medical University, Shenyang 110000, China Huaxi Hospital, Sichuan University, Chengdu 610041, China Hospital Affiliated to Nantong Medical University, Nantong 226000 , China Second Hospital, Jiangxi Medical University, Nanchang 330000 , China First Hospital Affiliated to Guangxi Medical University, Nanning 530000 , China People’s Hospital of Hainan Province, Haikou 570000, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，2： | 20 |
| 11 | Diagnosis of IgG4-related sclerosing cholangitis显示文摘IgG4-related sclerosing cholangitis(IgG4-SC)is often associated with autoimmune pancreatitis.However,the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis(PSC),and the presence of segmental stenosis suggests cholangiocarcinoma(CC).IgG4-SC responds well to steroid therapy,whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention.Since IgG4-SC was first described,it has become a third distinct clinical entity of sclerosing cholangitis.The aim of this review was to introduce the diagnostic methods for IgG4-SC.IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical,serological,morphological,and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis.When intrapancreatic stenosis is detected,pancreatic cancer or CC should be ruled out.If multiple intrahepatic stenoses are evident,PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining.Associated inflammatory bowel disease is suggestive of PSC.If stenosis is demonstrated in the hepatic hilar region,CC should be discriminated by ultrasonography,intraductal ultrasonography,bile duct biopsy,and a higher cutoff serum IgG4 level of 182 mg/dL. | Takahiro Nakazawa Itaru Naitoh Kazuki Hayashi Katsuyuki Miyabe Shuya Simizu Takashi Joh | 2013 | World Journal of Gastroenterology2013，19，43： | 20 |
| 12 | Intraperitoneal perfusion of cytokine-induced killer cells with local hyperthermia for advanced hepatocellular carcinoma显示文摘AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients. | Xiao-Pu Wang Meng Xu Hong-Fei Gao Jian-Fu Zhao Ke-Cheng Xu | 2013 | World Journal of Gastroenterology2013，19，19： | 20 |
| 13 | A risk score model for predicting cardiac rupture after acute myocardial infarction显示文摘Background:Cardiac rupture (CR) is a major lethal complication of acute myocardial infarction (AMI).However,no valid risk score model was found to predict CR after AMI in previous researches.This study aimed to establish a simple model to assess risk of CR after AMI,which could be easily used in a clinical environment.Methods:This was a retrospective case-control study that included 53 consecutive patients with CR after AMI during a period from January 1,2010 to December 31,2017.The controls included 524 patients who were selected randomly from 7932 AMI patients without CR at a 1:10 ratio.Risk factors for CR were identified using univariate analysis and multivariate logistic regression.Risk score model was developed based on multiple regression coefficients.Performance of risk model was evaluated using receiveroperating characteristic (ROC) curves and internal validity was explored using bootstrap analysis.Results:Among all 7985 AMI patients,53 (0.67%) had CR (free wall rupture,n=39;ventricular septal rupture,n=14).Hospital mortalities were 92.5% and 4.01% in patients with and without CR (P<0.001).Independent variables associated with CR included:older age,female gender,higher heart rate at admission,body mass index (BMI)<25 kg/m^2,lower left ventricular ejection fraction (LVEF) and no primary percutaneous coronary intervention (pPCI) treatment.In ROC analysis,our CR risk assess model demonstrated a very good discriminate power (area under the curve [AUC]= 0.895,95% confidence interval:0.845–0.944,optimism-corrected AUC= 0.821,P<0.001).Conclusion:This study developed a novel risk score model to help predict CR after AMI,which had high accuracy and was very simple to use. | Yuan Fu Kui-Bao Li Xin-Chun Yang | 2019 | Chinese Medical Journal2019，，9： | 19 |
| 14 | Autoantibodies in primary biliary cirrhosis:Recent progress in research on the pathogenetic and clinical significance显示文摘Primary biliary cirrhosis(PBC)is a chronic progressive cholestatic liver disease characterized by immunemediated destruction of the small-and medium-sized intrahepatic bile ducts and the presence of antimitochondrial antibodies(AMA)in the serum.AMA are detected in over 90%of patients with PBC,whereas their prevalence in the general population is extremely low,varying from 0.16%to 1%.Previous studies have shown that the unique characteristics of biliary epithelial cells undergoing apoptosis may result in a highly direct and very specific immune response to mitochondrial autoantigens.Moreover,recent studies have demonstrated that serum from AMA-positive PBC patients is reactive with a number of xenobiotic modified E2 subunits of the pyruvate dehydrogenase complex,which is not observed in the serum of normal individuals.These findings indicate that chemicals originating from the environment may be associated with a breakdown in the tolerance to mitochondrial autoantigens.While it is currently generally accepted that AMA are the most specific serological markers of PBC,more than 60 au-toantibodies have been investigated in patients with PBC,and some have previously been considered specific to other autoimmune diseases.This review covers the recent progress in research on the pathogenetic and clinical significance of important autoantibodies in PBC.Determining the pathogenic role of those autoantibodies in PBC remains a priority of basic and clinical research. | Satoshi Yamagiwa Hiroteru Kamimura Masaaki Takamura Yutaka Aoyagi | 2014 | World Journal of Gastroenterology2014，20，10： | 19 |
| 15 | Primary biliary cirrhosis: Clinical and laboratory criteria for its diagnosis显示文摘Primary biliary cirrhosis(PBC) is a chronic progressive cholestatic granulomatous, and destructive inflammatory lesion of small intralobular and septal bile ducts, which is likely to be caused by an autoimmune mechanism with a the presence of serum antimitochondrial antibodies and a potential tendency to progress to cirrhosis. Despite the fact that the etiology of this disease has beenunknown so far, there has been a considerable body of scientific evidence that can reveal the clinical and laboratory signs of PBC and the individual components of its pathogenesis and elaborate diagnostic criteria for the disease and its symptomatic therapy. Deficiencies in autoimmune tolerance are critical factors for the initiation and perpetuation of the disease. The purpose of this review is to summarize the data available in the literature and the author's findings on clinical and laboratory criteria for the diagnosis of PBC. This review describes the major clinical manifestations of the disease and the mechanisms of its development. It presents the immunological, biochemical, and morphological signs of PBC and their significance for its diagnosis. A great deal of novel scientific evidence for the problem of PBC has been accumulated. However, the inadequate efficiency of therapy for the disease lends impetus to the quest for its etiological factors and to further investigations of its pathogenetic mechanisms and, on this basis, to searches for new methods for its early diagnosis. | Vasiliy Ivanovich Reshetnyak | 2015 | World Journal of Gastroenterology2015，21，25： | 19 |
| 16 | Estimations of primary production and export production in the South China Sea based on sediment trap experiments显示文摘The results of time series sediment trap experiments in the South China Sea show that particulate organic carbon (POC) fluxes are influenced by the monsoons. The increase of productivity in the northern South China Sea is mainly due to northeast monsoon while in the central South China Sea the influence of southwest monsoon becomes more prominent. The annual primary production and export production calculated based on POC fluxes are 53 0-63 4 and 10 32-12 93 gC·m -2·a -1, respectively. The enhancement of POC flux during monsoon period suggest that higher palaeoproductivity or organic carbon accumulation rate in glacial age in the South China Sea might be the result of strengthening of the monsoons. | Jianfang Chen Lianfu Zheng M. G. Wiesner Ronghua Chen Yulong Zheng H. K. Wong | 1998 | Chinese Science Bulletin1998，43，7： | 18 |
| 17 | Liver transplantation for hilar cholangiocarcinoma显示文摘The most appropriate treatment for Klatskin tumor(KT)with a curative intention is multimodal therapy based on achieving resection with tumour-free margins(R0resections)combined with other types of neoadjuvant or adjuvant treatment(the most important factor affecting KT survival is the possibility of R0 resections,achieving 5-year survival rate of 40%-50%).Thirty to forty percent of patients with KT are inoperable and present a 5-year survival rate of 0%.In irresectable non-disseminated KT patients,using liver transplantation without neoadjuvant treatment,the 5-year survival rate increase to 38%,reaching 50%survival in early stage.In selected cases,with liver transplantation and neoadjuvant treatment(chemotherapy and radiotherapy),the actuarial survival rate is 65%at 5 years and 59%at 10 years.In conclusion,correct staging,neoadjuvant treatment,living donor and priority on the liver transplant waiting list may lead to improved results. | Ricardo Robles Francisco Sánchez-Bueno Pablo Ramírez Roberto Brusadin Pascual Parrilla | 2013 | World Journal of Gastroenterology2013，19，48： | 17 |
| 18 | Distinctive inflammatory bowel disease phenotype in primary sclerosing cholangitis显示文摘AIM:To review the current literature for the specificclinical characteristics of inflammatory bowel disease(IBD)associated with primary sclerosing cholangitis(PSC).METHODS:A systematical review for clinical characteristics of IBD in PSC was performed by conducting a broad search for'primary sclerosing cholangitis'in Pubmed.'Clinical characteristics'were specified into five predefined subthemes:epidemiology of IBD in PSC,characteristics of IBD in PSC(i.e.,location,disease behavior),risk of colorectal cancer development,IBD recurrence and de novo disease after liver transplantation for PSC,and safety and complications after proctocolectomy with ileal pouchanal anastomosis.Papers were selected for inclusion based on their relevance to the subthemes,and were reviewed by two independent reviewers.Only full papers relevant to PSC-IBD were included.Additionally the references of recent reviews for PSC(<5 years old)were scrutinized for relevant articles.RESULTS:Initial literature search for PSC yielded 4704results.After careful review 65 papers,comprising a total of 11406 PSC-IBD patients,were selected and divided according to subtheme.Four manuscripts overlapped and were included in two subthemes.Prevalence of IBD in PSC shows a large variance,ranging from 46.5%to 98.7%with ulcerative colitis(UC)being the most common type(>75%).The highest IBD rates in PSC are found in papers reviewing both endoscopic and histological data for IBD diagnosis.Although IBD in PSC is found to be a quiescent disease,pancolitis occurs often,with rates varying from 35%to 95%.Both backwash ileitis and rectal sparing are observed infrequently.The development of dysplasia or colorectal carcinoma is increased in PSC-IBD;the cumulative 10 years risk varying between 0%and11%.Exacerbation of IBD is common after liver transplantation for PSC and de novo disease is seen in1.3%to 31.3%of PSC-IBD patients.The risk for development of pouchitis in PSC-IBD is found to besignificant,affecting 13.8%to 90%of the patients after proctocolectomy with ileo anal-pouch anastomosis.CONCLUSION:IBD in primary sclerosing cholangitis represents a distinct phenotype that differs from UC and Crohn’s disease and therefore requires specialized management. | A Boudewijn de Vries Marcel Janse Hans Blokzijl Rinse K Weersma | 2015 | World Journal of Gastroenterology2015，21，6： | 17 |
| 19 | Biological productivity and carbon cycling in the Arctic Ocean显示文摘Primary production, bacterial production, par-ticulate organic carbon fluxes and organic carbon burial rates were quantified during the summer period of 1999 in the Arctic Ocean via 14C uptake, 3H uptake, 234Th/238U disequilibrium and 210Pbex dating, respectively. The integrated primary production in the water column was as high as 197 mmolC/(m2·d) in the Chukchi shelf and was 3.8 mmolC/(m2·d) in the Canada Basin. These rates are higher than those reported previously. The ratios of bacterial production to primary production in the study region were higher than 0.5, indicating that microbial activity is not depressed but important in cold Arctic waters. 234Th/238U dis-equilibria were evident at the station in the Canada Basin. The presence of significant 234Th deficiency suggested that scavenging and removal processes are also important to bio-geochemical cycles of trace elements in the Arctic Ocean. Particulate organic carbon export flux was estimated to be 1.0 mmolC/(m2·d). Measurements of sediment | CHEN Min HUANG Yipu GUO Laodong CAI Pinghe YANG Weifeng LIU Guangshan QIU Yusheng | 2002 | Chinese Science Bulletin2002，47，12： | 17 |
| 20 | Estrogen up-regulates MMP2/9 expression in endometrial epithelial cell via VEGF-ERK1/2 pathway显示文摘Objective:To study the effect of estrogen on anovulatory dysfunctional uterine bleeding(ADUB).Methods:Primary endometrial epithelial cells of Hainan Lizu female was cultured and hydrolylic activity of gelalinase was determined by gelatin zymography analysis.Cellular mRNA and protein synthesis was blocked respectively to determine whether the increased expression of MMP-2/9 was induced by estrogen.The expression of VEGF was blocked by siRNA.After treatment with various factors.MMP-9,VEGF,total Erk and phosphorylated Erk expression in primary uterine epithelial cells was detected by Western blotting analysis.Cell MMP-2/9mRNA levels was measured by real-time RT-PCR.Results:The activity and expression of MMP2/9 was inereased in the endometrium of patients with ADUB.Estrogen could up-regulate the expression of VEGF and activate Erk 1/2-Elk1 signal path.After interference by siRNA,ERK1/2 pathway was blocked in cells,and the expression of MMP-2/9 was down-regulated.ERK1/2 specific blocker U0126 blocked ERK phosphorylation,and it could down-regulate the expression of MMP-2/9.Conclusions:The results showed that the estrogen can increase the expression of VEGF,and thus activate ERK1/2 pathway to induce MMP-2/9 expression. | Bao Shan Wang Li Shu-Ying Yang Zhuo-Ri Li | 2013 | Asian Pacific Journal of Tropical Medicine2013，6，10： | 16 |
您所在的机构暂未开通此部分的功能，请联系管理员