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| 1 | MicroRNAs in the prognosis and therapy of colorectal cancer: From bench to bedside显示文摘MicroRNAs(miRNAs) are small, single-stranded, noncoding RNAs that can post-transcriptionally regulate the expression of various oncogenes and tumor suppressor genes. Dysregulated expression of many miRNAs have been shown to mediate the signaling pathways critical in the multistep carcinogenesis of colorectal cancer(CRC). MiR NAs are stable and protected from RNase-mediated degradation, thereby enabling its detection in biological fluids and archival tissues for biomarker studies. This review focuses on the role and application of miRNAs in the prognosis and therapy of CRC. While stage Ⅱ CRC is potentially curable by surgical resection, a significant percentage of stage Ⅱ CRC patients do develop recurrence. MiRNA biomarkers may be used to stratify such high-risk population for adjuvant chemotherapy to provide better prognoses. Growing evidence also suggests that miRNAs are involved in the metastatic process of CRC. Certain of these miRNAs may thus be used as prognostic biomarkers to identify patients more likely to have micro-metastasis, who could be monitored more closely after surgery and/or given more aggressive adjuvant chemotherapy. Intrinsic and acquired resistance to chemotherapy severely hinders successful chemotherapy in CRC treatment. Predictive miRNA biomarkers for response to chemotherapy may identify patients who will benefit the most from a particular regimen and also spare the patients from unnecessary side effects. Selection of patients to receive the new targeted therapy is becoming possible with the use of predictive miRNA biomarkers. Lastly, forced expression of tumor suppressor miRNA or silencing of oncogenic miRNA in tumors by gene therapy can also be adopted to treat CRC alone or in combination with other chemotherapeutic drugs. | Kenneth KW To Christy WS Tong Mingxia Wu William CS Cho | 2018 | World Journal of Gastroenterology2018，24，27： | 29 |
| 2 | Early phase of acute pancreatitis: Assessment and management显示文摘Acute pancreatitis(AP) is a potentially life-threatening disease with a wide spectrum of severity. The overall mortality of AP is approximately 5%. According to the revised Atlanta classification system, AP can be classified as mild, moderate, or severe. Severe AP often takes a clinical course with two phases, an early and a late phase, which should both be considered separately. In this review article, we first discuss general aspects of AP, including incidence, pathophysiology, etiology, and grading of severity, then focus on the assessment of patients with suspected AP, including diagnosis and risk stratification, followed by the management of AP during the early phase, with special emphasis on fluid therapy, pain management, nutrition, and antibiotic prophylaxis. | Veit Phillip Jrg M Steiner Hana Algül | 2014 | World Journal of Gastrointestinal Pathophysiology2014，5，3： | 19 |
| 3 | Risk stratification for ST segment elevation myocardial infarction in the era of primary percutaneous coronary intervention显示文摘Acute coronary syndromes presenting with ST elevation are usually treated with emergency reperfusion/revascularisation therapy. In contrast current evidence and national guidelines recommend risk stratification for non ST segment elevation myocardial infarction(NSTEMI) with the decision on revascularisation dependent on perceived clinical risk. Risk stratification for STEMI has no recommendation. Statistical risk scoring techniques in NSTEMI have been demonstrated to improve outcomes however their uptake has been poor perhaps due to questions over their discrimination and concern for application to individuals who may not have been adequately represented in clinical trials. STEMI is perceived to carry sufficient risk to warrant emergency coronary intervention [by primary percutaneous coronary intervention(PPCI)] even if this results in a delay to reperfusion with immediate thrombolysis. Immediate thrombolysis may be as effective in patients presenting early, or at low risk, but physicians are poor at assessing clinical and procedural risks and currently are not required to consider this. Inadequate data on risk stratification in STEMI inhibits the option of immediate fibrinolysis, which may be cost-effective. Currently the mode of reperfusion for STEMI defaults to emergency angiography and percutaneous coronary intervention ignoring alternative strategies. This review article examines the current risk scores and evidence base for risk stratification for STEMI patients. The requirements for an ideal STEMI risk score are discussed. | Richard A Brogan Christopher J Malkin Philip D Batin Alexander D Simms James M McLenachan Christopher P Gale | 2014 | World Journal of Cardiology2014，6，8： | 6 |
| 4 | 有 atrial 纤维性颤动的病人的风险层化: Biomarkers 和其它未来观点显示文摘 Risk stratification of atrial fibrillation (AF) and adequate thromboembolism prophylaxis is the cornerstone of treatment in patients with AF. Current risk stratification schemes such as the CHADS 2 and CHA 2 DS 2 -VASc scores are based on clinical risk factors and suboptimally weight the risk/benefit of anticoagulation. Recently, the potential of biomarkers (troponin and NT-proBNP) in the RE-LY biomarker sub-analysis has been demonstrated. Echocardiography is also being evaluated as a possible approach to improve risk score performance. The authors present an overview on AF risk stratification and discuss future potential developments that may be introduced into our current risk stratification schemes. | Rui Providência Luís Paiva Sérgio Barra | 2012 | World Journal of Cardiology2012，4，6： | 3 |
| 5 | Predicting mortality in patients with acute heart failure:Role of risk scores显示文摘Acute heart failure is a leading cause of hospitalization and death,and it is an increasing burden on health care systems. The correct risk stratification of patients could improve clinical outcome and resources allocation,avoiding the overtreatment of low-risk subjects or the early,inappropriate discharge of high-risk patients. Many clinical scores have been derived and validated for in-hospital and post-discharge survival; predictive models include demographic,clinical,hemodynamic and laboratory variables. Data sets are derived from public registries,clinical trials,and retrospective data. Most models show a good capacity to discriminate patients who reach major clinical end-points,with C-indices generally higher than 0.70,but their applicability in realworld populations has been seldom evaluated. No study has evaluated if the use of risk score-based stratification might improve patient outcome. Some variables(age,blood pressure,sodium concentration,renal function) recur in most scores and should always be considered when evaluating the risk of an individual patient hospitalized for acute heart failure. Future studies will evaluate the emerging role of plasma biomarkers. | Andrea Passantino Francesco Monitillo Massimo Iacoviello Domenico Scrutinio | 2015 | World Journal of Cardiology2015，7，12： | 3 |
| 6 | Performance of risk stratification systems for gastrointestinal stromal tumors: A multicenter study显示文摘BACKGROUND Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumor type in the gastrointestinal system. Presently, various classification systems to prognosticate GISTs have been proposed.AIM To evaluate the application value of four different risk stratification systems for GISTs.METHODS Patients who were diagnosed with GISTs and underwent surgical resection at four hospitals from 1998 to 2015 were identified from a database. Risk of recurrence was stratified by the modified National Institute of Health(NIH)criteria, the Armed Forces Institute of Pathology(AFIP) criteria, the Memorial Sloan Kettering Cancer Center(MSKCC) prognostic nomogram, and the contour maps. Receiver operating characteristic(ROC) curves were established to compare the four abovementioned risk stratification systems based on the area under the curve(AUC).RESULTS A total of 1303 patients were included in the study. The mean age of the patients was 55.77 ± 13.70 yr; 52.3% of the patients were male. The mean follow-up period was 64.91 ± 35.79 mo. Approximately 67.0% the tumors were located in the stomach, and 59.5% were smaller than 5 cm; 67.3% of the patients had a mitotic count ≤ 5/50 high-power fields(HPFs). Thirty-four tumors ruptured before and during surgery. Univariate analysis demonstrated that tumor size > 5 cm(P <0.05), mitotic count > 5/50 HPFs(P < 0.05), non-gastric location(P < 0.05), and tumor rupture(P < 0.05) were significantly associated with increased recurrence rates. According to the ROC curve, the AFIP criteria showed the largest AUC(0.754).CONCLUSION According to our data, the AFIP criteria were associated with a larger AUC than the NIH modified criteria, the MSKCC nomogram, and the contour maps, which might indicate that the AFIP criteria have better accuracy to support therapeutic decision-making for patients with GISTs. | Tao Chen Liang-Ying Ye Xing-Yu Feng Hai-Bo Qiu Peng Zhang Yi-Xin Luo Li-Yi Yuan Xin-Hua Chen Yan-Feng Hu Hao Liu Yong Li Kai-Xiong Tao Jiang Yu Guo-Xin Li | 2019 | World Journal of Gastroenterology2019，25，10： | 2 |
| 7 | Predicting systemic spread in early colorectal cancer: Can we do better?显示文摘Through the implementation of national bowel cancer screening programmes we have seen a three-fold increase in early pT1 colorectal cancers, but how these lesions should be managed is currently unclear. Local excision can be an attractive option, especially for fragile patients with multiple comorbidities, but it is only safe from an oncological point of view in the absence of lymph node metastasis. Patient risk stratification through careful analysis of histopathological features in local excision or polypectomy specimens should be performed according to national guidelines to avoid under-or over-treatment. Currently national guidelines vary in their recommendations as to which factors should be routinely reported and there is no established multivariate risk stratification model to determine which patients should be offered major resectional surgery.Conventional histopathological parameters such as tumour grading or lymphovascular invasion have been shown to be predictive of lymph node metastasis in a number of studies but the inter-and intra-observer variation in reporting is high. Newer parameters including tumour budding and poorly differentiated clusters have been shown to have great potential, but again some improvement in the inter-observer variation is required. With the implementation of digital pathology into clinical practice, quantitative parameters like depth/area of submucosal invasion and proportion of stroma can be routinely assessed. In this review we present the various histopathological risk factors for predicting systemic spread in pT1 colorectal cancer and introduce potential novel quantitative variables and multivariable risk models that could be used to better define the optimal treatment of this increasingly common disease. | Scarlet Fiona Brockmoeller Nicholas Paul West | 2019 | World Journal of Gastroenterology2019，25，23： | 2 |
| 8 | SLITRK3 expression correlation to gastrointestinal stromal tumor risk rating and prognosis显示文摘AIM: To assess the influence of SLIT and NTRKlike family member 3(SLITRK3) on the prognosis of gastrointestinal stromal tumor(GIST) and determine whether SLITRK3 can help improve current risk stratification systems.METHODS: We hypothesized that SLITRK3 could be used as a prognostic molecular biomarker for GIST. 35 fresh tumor samples and 417 paraffin-embedded specimens from GIST patients were utilized. SLITRK3m RNA expression in GIST tumor tissue was detected by real-time polymerase chain reaction, and SLITRK3 protein levels were estimated by immunohistochemistry. The correlation of SLITRK3 expression with various tumor clinicopathological characteristics and follow-up data were analyzed.RESULTS: GIST tumors had high expression of SLITRK3 compared with adjacent normal tissues and the expression level gradually increased with risk grade. SLITRK3 protein expression was closely associated with gastrointestinal bleeding, tumor site, tumor size, mitotic index, and National Institutes of Health(NIH) classification. Survival analysis showed that SLITRK3 expression was closely correlated with overall survival and disease-free survival of GIST patients. Multivariate analysis also identified SLITRK3 expression, mitotic index, and NIH stage as significant risk factors of GIST recurrence.CONCLUSION: SLITRK3 expression is a highly significant predictor of GIST recurrence and metastasis. Combinations of SLITRK3 and NIH stage have strong predictive and prognostic value, and are feasible markers for clinical practice in gastrointestinal stromal tumor. | Chao-Jie Wang Zi-Zhen Zhang Jia Xu Ming Wang Wen-Yi Zhao Lin Tu Chun Zhuang Qiang Liu Yan-Yin Shen Hui Cao Zhi-Gang Zhang | 2015 | World Journal of Gastroenterology2015，21，27： | 2 |
| 9 | Validation of the six-and-twelve criteria among patients with hepatocellular carcinoma and performance score 1 receiving transarterial chemoembolization显示文摘BACKGROUND Transarterial chemoembolization(TACE)is recommended for patients with intermediate hepatocellular carcinoma(HCC)according to treatment guidelines.However,a large number of patients with advanced HCC also receive TACE in clinical practice,especially for those with liver-confined HCC and Eastern Cooperative Oncology Group score(ECOG)1.In view of previous studies,such patients have different prognoses from advanced HCC patients with macrovascular invasion or extrahepatic spread;therefore,patients with ECOG 1 alone might be classified into the intermediate stage and benefit from TACE treatment,but a study particularly focusing on such patients and exploring the effectiveness of TACE therapy is lacking.AIM To investigate treatment outcomes of TACE in HCC patients with ECOG 1 alone and propose a specific prognostic model.METHODS Patients from 24 Chinese tertiary hospitals were selected in this nationwide multicenter observational study from January 2010 to May 2016.Overall survival(OS)was estimated using Kaplan–Meier curves and compared by the log-rank test.Multivariate Cox regression was used to develop the potential prognostic models.The discriminatory ability of the models was compared and validated in various patient subgroups.The individual survival prediction for six-and-twelve(6&12)criteria,defined as the algebraic sum of tumor size(cm)and tumor number,was illustrated by contour plot of 3-year survival probability and nomogram.RESULTS A total of 792 eligible patients were included.During follow-up,median OS reached 18.9 mo[95%confidence interval(CI):16.9-21.0].Three independent multivariate analyses demonstrated that tumor size,tumor number,α-fetoprotein level,albumin–bilirubin grade and total bilirubin were prognostic factors of OS(P<0.05).The previously proposed 6&12 criteria was comparable or even better than currently proposed with the highest predictive ability.In addition,the 6&12 criteria was correlated with OS in various subgroups of patients.The patients were stratified into three strata with score≤6,>6 but≤12,and>12 with different median OS of 39.8 mo(95%CI:23.9-55.7),21.1 mo(95%CI:18.4-23.8)and 9.8 mo(95%CI:8.3-11.3),respectively(P<0.001).CONCLUSION TACE is effective for advanced HCC patients with ECOG 1 alone,and the 6&12 criteria may help with clinical decision-making. | Zhe-Xuan Wang Jing Li En-Xin Wang Dong-Dong Xia Wei Bai Qiu-He Wang Jie Yuan Xiao-Mei Li Jing Niu Zhan-Xin Yin Jie-Lai Xia Dai-Ming Fan Guo-Hong Han | 2020 | World Journal of Gastroenterology2020，26，15： | 2 |
| 10 | Effects of Preoperative Risk Stratification on Direct In-hospital Costs for Chinese Patients with Coronary Artery Bypass Graft:A Single Center Analysis显示文摘The purpose of this study was to analyze the components of inpatient costs for coronary artery bypass graft(CABG)according to preoperative risk stratification and to provide evidence for improvement of diagnosis-related groups(DRGs)payment.All patients(n=458)receiving an isolated CABG between January 2014 and December 2016 in a tertiary referral center,in southwest China,were analyzed.Hospital mortality was predicted by the EuroSCORE Ⅱ for each patient. The patients were subdivided into two groups according to the observed mortality(1.97%,9/458):a high-risk group(group H,predicted mortality≥1.97%)and a low-risk group(group L,predicted mortality<1.97%).Clinical outcomes,resource use,in-hospital direct costs,and reimbursement expenses were compared between the two groups.Significant differences existed between group L and group H in postoperative mortality(0.4% vs.3.4%;P=0.02),postoperative complications(10.6% vs.45.7%;P<0.001),postoperative length of hospital stay(17.5±4.9 days vs.18.8±6.5 days,P=0.01),in-hospital costs($20 256±3096vs.$23 334±6332;P<0.001),and reimbursement expenses($7775±2627 vs.$9639±3917;P<0.001).In general,a higher EuroSCORE Ⅱ was significantly associated with a worse clinical outcome and increased costs.The CABG cost data provide evidence for improvement of DRGs payment. Key words:coronary artery bypass graft;risk stratification;hospital costs;medical insurance | Mei YANG Jia HAO Zhao JIAN Ying-bin XIAO Lai-xin ZHOU | 2018 | Current Medical Science2018，38，6： | 1 |
| 11 | Electrophysiologic testing guided risk stratification approach for sudden cardiac death beyond the left ventricular ejection fraction显示文摘Sudden cardiac death threats ischaemic and dilated cardiomyopathy patients. Anti- arrhythmic protection may be provided to these patients with implanted cardiac defibrillators(ICD), after an efficient risk stratification approach. The proposed risk stratifier of an impaired left ventricular ejection fraction has limited sensitivity meaning that a significant number of victims will remain undetectable by this risk stratification approach because they have a preserved left ventricular systolic function. Current risk stratification strategies focus on combinations of non invasive methods like T wave alternans, late potentials, heart rate turbulence, deceleration capacity and others, with invasive methods like the electrophysiologic study. In the presence of an electrically impaired substrate with formed post myocardial infarction fibrotic zones, programmed ventricular stimulation provides important prognostic information for the selection of the patients expected to benefit from an ICD implantation, while due to its high negative predictive value, patients at low risk level may also be detected. Clustering evidence from different research groups and electrophysiologic labs support an electrophysiologic testing guided risk stratification approach for sudden cardiac death. | Konstantinos A Gatzoulis Dimitris Tsiachris Petros Arsenos Dimitris Tousoulis | 2016 | World Journal of Cardiology2016，8，1： | 1 |
| 12 | High-resolution computed tomography in patients with atypical 'cardiac' chest pain: a study investigating patients at 10-year cardiovascular risks defined by the Framingham and PROCAM scores显示文摘Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score >400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores. | Choon Kiat ANG Alan Yean Yip FONG Sze Piaw CHIN Tiong Kiam ONG Seyfarth M Tobias Chee Khoon LIEW Rapaee ANNUAR Houng Bang LIEW Kui Hian SIM | 2006 | Journal of Geriatric Cardiology2006，3，1： | 1 |
| 13 | Impact of recipient functional status on 1-year liver transplant outcomes显示文摘BACKGROUND The Karnofsky Performance Status(KPS)scale has been widely validated for clinical practice for over 60 years.AIM To examine the extent to which poor pre-transplant functional status,assessed using the KPS scale,is associated with increased risk of mortality and/or graft failure at 1-year post-transplantation.METHODS This study included 38278 United States adults who underwent first,non-urgent,liver-only transplantation from 2005 to 2014(Scientific Registry of Transplant Recipients).Functional impairment/disability was categorized as severe,moderate,or none/normal.Analyses were conducted using multivariableadjusted Cox survival regression models.RESULTS The median age was 56 years,31%were women,median pre-transplant Model for End-Stage for Liver Disease score was 18.Functional impairment was present in 70%;one-quarter of the sample was severely disabled.After controlling for key recipient and donor factors,moderately and severely disabled patients had a 1-year mortality rate of 1.32[confidence interval(CI):1.21-1.44]and 1.73(95%CI:1.56-1.91)compared to patients with no impairment,respectively.Subjects with moderate and severe disability also had a multivariable-adjusted 1-year graft failure rate of 1.13(CI:1.02-1.24)and 1.16(CI:1.02-1.31),respectively.CONCLUSION Pre-transplant functional status is a useful prognostic indicator for 1-year posttransplant patient and graft survival. | Natasha H Dolgin Babak Movahedi Frederick A Anderson Isabel MA Brüggenwirth Paulo N Martins Adel Bozorgzadeh | 2019 | World Journal of Transplantation2019，9，7： | 0 |
| 14 | Risk Stratification with Serum Cardiac Troponin I in Acute Myocardial Infarction on Admission显示文摘Objective To assess the prognostic significance of serum cardiac troponin I (cTnI) concentration in patients with acute myocardial infarction on admission. Methods Serum samples of 108 patients with established AMI were collected on admission for measuring cTnI and were grouped according to the intervals between the onset of chest pain and admission. Results In each of these groups, the serum cTnI concentrations in patients died after admission were significantly higher than those who survived (all P<0.05). Conclusions A higher serum cTnI concentration on admission in patients with AMI was associated with an increased risk of subsequent cardiac death during hospitalization. | 张铸 苏恩本 张寄南 杨志健 曹克将 马文珠 | 2001 | Journal of Nanjing Medical University2001，15，2： | 0 |
| 15 | BLEED-Myocardial Infarction Score:Predicting mid-term post-discharge bleeding events显示文摘AIM:To derive and validate a score for the prediction of mid-term bleeding events following discharge for myocardial infarction(MI).METHODS:One thousand and fifty patients admitted for MI and followed for 19.9 ± 6.7 mo were assigned to a derivation cohort.A new risk model,called BLEEDMI,was developed for predicting clinically significant bleeding events during follow-up(primary endpoint) and a composite endpoint of significant hemorrhage plus all-cause mortality(secondary endpoint),incorporating the following variables:age,diabetes mellitus,arterial hypertension,smoking habits,blood urea nitrogen,glomerular filtration rate and hemoglobin at admission,history of stroke,bleeding during hospitalization or previous major bleeding,heart failure during hospitalization and anti-thrombotic therapies prescribedat discharge.The BLEED-MI model was tested for calibration,accuracy and discrimination in the derivation sample and in a new,independent,validation cohort comprising 852 patients admitted at a later date.RESULTS:The BLEED-MI score showed good calibration in both derivation and validation samples(HosmerLemeshow test P value 0.371 and 0.444,respectively) and high accuracy within each individual patient(Brier score 0.061 and 0.067,respectively).Its discriminative performance in predicting the primary outcome was relatively high(c-statistic of 0.753 ± 0.032 in the derivation cohort and 0.718 ± 0.033 in the validation sample).Incidence of primary/secondary endpoints increased progressively with increasing BLEED-MI scores.In the validation sample,a BLEED-MI score below 2 had a negative predictive value of 98.7%(152/154) for the occurrence of a clinically significant hemorrhagic episode during follow-up and for the composite endpoint of post-discharge hemorrhage plus all-cause mortality.An accurate prediction of bleeding events was shown independently of mortality,as BLEED-MI predicted bleeding with similar efficacy in patients who did not die during follow-up:Area Under the Curve 0.703,Hosmer-Lemeshow test P value 0.547,Brier score 0.060;low-risk(BLEED-MI score 0-3) event rate:1.2%;intermediate risk(score 4-6) event rate:5.6%;high risk(score ≥ 7) event rate:12.5%.CONCLUSION:A new bedside prediction-scoring model for post-discharge mid-term bleeding has been derived and preliminarily validated.This is the first score designed to predict mid-term hemorrhagic risk in patients discharged following admission for acute MI.This model should be externally validated in larger cohorts of patients before its potential implementation. | Sérgio Barra Rui Providência Francisca Caetano Inês Almeida Luís Paiva Paulo Dinis António Leito Marques | 2013 | World Journal of Cardiology2013，5，6： | 0 |
| 16 | An Open Invitation to Join the International Brugada Electrocardiographic Indices Registry显示文摘Background:The Brugada Electrocardiographic Indices Registry is a comprehensive data registry composed of patients with Brugada patterns on the electrocardiogram(ECG).The aim is to test the hypotheses that(i)ECG indices combining both depolarization and repolarization abnormalities can better predict spontaneous ventricular arrhythmias than existing ECG markers in Brugada syndrome and(ii)that serial ECG measurements will provide additional information for risk stratifi cation,especially in asymptomatic patients.Methods:Patients with both Brugada pattern ECGs and Brugada syndrome are eligible for inclusion in this registry.Baseline characteristics and ECG variables refl ecting depolarization and repolarization will be determined.The primary outcome is spontaneous ventricular tachycardia/ventricular fi brillation or sudden cardiac death.Secondary outcomes are inducible ventricular tachycardia/ventricular fi brillation and syncope.Results:As of November 15,2019,39 investigators from 32 cities in 18 countries had joined this registry.As of December 15,2019,1383 cases had been enrolled.Conclusions:The Brugada Electrocardiographic Indices Registry will evaluate the disease life course,risk factors,and prognosis in a large series of Brugada patients.It will therefore provide insights for improving risk stratification. | Gary Tse Sharen Lee Xuan Jiang Dong Chang Yunfei Gu Zhengrong Huang Xintao Li Qunshan Wang Shaoying Zeng Guoliang Li Dan Hu Jiandong Zhou Qingpeng Zhang Gan-Xin Yan Yunlong Xia Fang Zhou Liu Tong Liu | 2020 | Cardiovascular Innovations and Applications2020，，1： | 0 |
| 17 | Diagnosis and management strategy of syncope显示文摘Syncope is a common symptom due to various causes, ranging from benign to life-threatening conditions.According to the evaluation and management of patients with syncope, they can be classified as being at short- or long-term risk.Risk stratification during initial evaluation is important for guiding the treatment, and reducing long-term morbidity and mortality.This paper introduces the new progress in the etiology, risk stratification, diagnostic methods and treatment strategies of syncope, and elaborates on the selection of initial assessment tools for syncope patients.In order to elevate the diagnostic accuracy rate of syncope, a systematic and holistic analysis of syncope patients was proposed, including the initial assessment of outpatients and emergency services as well as the observation and treatment during subsequent hospitalization.This paper suggests the management of syncope be considered as a focus, such as establishing syncope management units, taking structured care pathways,etc.Finally, it is suggested to make more efforts in aspects of randomized controlled trials, treatment and collaborative research in the future. | David G.Benditt | 2019 | 实用心电学杂志2019，28，4： | 0 |
| 18 | Risk stratification for coronary artery disease in multi-ethnic populations:Are there broader considerations for cost efficiency?显示文摘Coronary artery disease(CAD) screening and diagnosis are core cardiac specialty services.From symptoms,autopsy correlations supported reductions in coronary blood flow and dynamic epicardial and microcirculatory coronaries artery disease as etiologies.While angina remains a clinical diagnosis,most cases require correlation with a diagnostic modality.At the onset of the evidence building process much research,now factored into guidelines were conducted among population and demographics that were homogenous and often prior to newer technologies being available.Today we see a more diverse multi-ethnic population whose characteristics and risks may not consistently match the populations from which guideline evidence is derived.While it would seem veryunlikely that for the majority,scientific arguments against guidelines would differ,however from a translational perspective,there will be populations who differ and importantly there are cost-efficacy questions,e.g.,the most suitable first-line tests or what parameters equate to an adequate test.This article reviews non-invasive diagnosis of CAD within the context of multi-ethnic patient populations. | Pupalan Iyngkaran William Chan Danny Liew Jalal Zamani John D Horowitz Michael Jelinek David L Hare James A Shaw | 2019 | World Journal of Methodology2019，9，1： | 0 |
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