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| 1 | Hepatic inflammation and progressive liver fibrosis in chronic liver disease显示文摘Chronic liver inflammation drives hepatic fibrosis,and current immunosuppressive,anti-inflammatory,and anti-viral therapies can weaken this driver.Hepatic fibrosis is reversed,stabilized,or prevented in 57%-79%of patients by conventional treatment regimens,mainly by their anti-inflammatory actions.Responses,however,are commonly incomplete and inconsistently achieved.The fibrotic mechanisms associated with liver inflammation have been clarified,and anti-fibrotic agents promise to improve outcomes as adjunctive therapies.Hepatitis C virus and immune-mediated responses can activate hepatic stellate cells by increasing oxidative stress within hepatocytes.Angiotensin can be synthesized by activated hepatic stellate cells and promote the production of reactive oxygen species.Anti-oxidants(Nacetylcysteine,S-adenosyl-L-methionine,and vitamin E)and angiotensin inhibitors(losartin)have had antifibrotic actions in preliminary human studies,and they may emerge as supplemental therapies.Anti-fibrotic agents presage a new era of supplemental treatment for chronic liver disease. | Albert J Czaja | 2014 | World Journal of Gastroenterology2014，20，10： | 46 |
| 2 | Structure and function of aggrecan显示文摘Aggrecan is the major proteoglycan in the articular cartilage. This molecule is important in the proper functioning of articular cartilage because it provides a hydrated gel structure (via its interaction with hyaluronan and link protein) that endows the cartilage with load-bearing properties. It is also crucial in chondroskeletal morphogenesis during development. Aggrecan is a multimodular molecule expressed by chondrocytes. Its core protein is composed of three globular domains (G1, G2, and G3) and a large extended region (CS) between G2 and G3 for glycosaminoglycan chain attachment. G1 comprises the amino terminus of the core protein. This domain has the same structural motif as link protein. Functionally, the G1 domain interacts with hyaluronan acid and link protein, forming stable ternary complexes in the extracellular matrix. G2 is homologous to the tandem repeats of G1 and of link protein and is involved in product processing. G3 makes up the carboxyl terminus of the core protein. It enhances glycosaminoglycan modification and product secretion. Aggrecan plays an important role in mediating chondrocyte-chondrocyte and chondrocyte-matrix interactions through its ability to bind hyaluronan. | CHRIS KIANI, LIWEN CHEN, YAO JIONG WU, ALBERT J YEE, BURTON B YANG, Sunnybrook and Women’s College Health Sciences Centre and Department of Laboratory Medicine and Patobiology, 2 Department of Surgeny, Faculty of Medicine, University of Toronto, Canada | 2002 | Cell Research2002，12，1： | 27 |
| 3 | Intraductal endoscopic radiofrequency ablation for the treatment of hilar non-resectable malignant bile duct obstruction显示文摘AIM: To evaluate the safety and technical success of endoscopic radiofrequency ablation(RFA) for palliative treatment of malignant hilar bile duct obstruction. METHODS: In this study, a recently CE and FDA-approved endoscopic RFA catheter was first tested in an ex vivo pig liver model to study the effect of electrosurgical variables on the extent of the area of induced necrosis. Subsequently, a retrospective analysis was conducted of all patients treated with endoscopic RFA for malignant biliary obstruction at our center between February 2012 and April 2013. All patients received an additional plastic stent implantation into the biliary tree following RFA. RESULTS: In the pig model, ablation time of 60-90 seconds using the bipolar soft coagulation mode at 8-10 watts with an effect of 8 was found to be the most feasible setting. Twelve patients(5 females, 7 males; mean age, 70 years) underwent 19 endoscopic RFA(range, 1-5) sessions. Deployment of RFA was successful in all patients. Systemic chemotherapy was administered in four patients. We observed biliary bleeding 4-6 wk after the intervention in three cases and two of these patients died: in one patient, spontaneous hemobilia occurred, whereas bleeding started during stent extraction in the other. In the third patient, bleeding was stopped by insertion of a non-covered self-expanding metal stent. Another three patients developed cholangitis during follow-up. Seven patients died during follow-up and median survival was 6.4 mo(95%CI: 0.05-12.7) from the time of the first RFA. CONCLUSION: Endoscopic RFA is an easy to perform and technically highly successful procedure. However, hemobilia possibly associated with RFA occurred in three of our patients. Therefore, larger prospective studies are needed to further evaluate the safety and efficacy of this promising new method. | Andrea Oliver Tal Johannes Vermehren Mireen FriedrichRust Jrg Bojunga Christoph Sarrazin Stefan Zeuzem Jrg Trojan Jrg Gerhard Albert | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，1： | 18 |
| 4 | Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis显示文摘The intestinal microbiome is a reservoir of microbial antigens and activated immune cells. The aims of this review were to describe the role of the intestinal microbiome in generating innate and adaptive immune responses, indicate how these responses contribute to the development of systemic immune-mediated diseases, and encourage investigations that improve the understanding and management of autoimmune hepatitis. Alterations in the composition of the intestinal microflora(dysbiosis) can disrupt intestinal and systemic immune tolerances for commensal bacteria. Toll-like receptors within the intestine can recognize microbe-associated molecular patterns and shape subsets of T helper lymphocytes that may cross-react with host antigens(molecular mimicry). Activated gutderived lymphocytes can migrate to lymph nodes, and gut-derived microbial antigens can translocate to extra-intestinal sites. Inflammasomes can form within hepatocytes and hepatic stellate cells, and they can drive the pro-inflammatory, immune-mediated, and fibrotic responses. Diet, designer probiotics, vitamin supplements, re-colonization methods, antibiotics, drugs that decrease intestinal permeability, and molecular interventions that block signaling pathways may emerge as adjunctive regimens that complement conventional immunosuppressive management. In conclusion, investigations of the intestinal microbiome are warranted in autoimmune hepatitis and promise to clarify pathogenic mechanisms and suggest alternative management strategies. | Albert J Czaja | 2016 | World Journal of Gastroenterology2016，22，42： | 16 |
| 5 | Magnetic resonance elastography is accurate in detecting advanced fibrosis in autoimmune hepatitis显示文摘To assess the value of magnetic resonance elastography(MRE) in detecting advanced fibrosis/cirrhosis in autoimmune hepatitis(AIH).METHODS In this retrospective study, 36 patients(19 treated and 17 untreated) with histologically confirmed AIH and liver biopsy performed within 3 mo of MRE were identified at a tertiary care referral center. Liver stiffness(LS) with MRE was calculated by a radiologist, and inflammation grade and fibrosis stage in liver biopsy was assessed by a pathologist in a blinded fashion. Two radiologistsevaluated morphological features of cirrhosis on conventional magnetic resonance imaging(MRI). Accuracy of MRE was compared to laboratory markers and MRI for detection of advanced fibrosis/cirrhosis.RESULTS Liver fibrosis stages of 0, 1, 2, 3 and 4 were present in 4, 6, 7, 6 and 13 patients respectively. There were no significant differences in distribution of fibrosis stage and inflammation grade between treated and untreated patient groups. LS with MRE demonstrated stronger correlation with liver fibrosis stage in comparison to laboratory markers for chronic liver disease(r = 0.88 vs-0.48-0.70). A trend of decreased mean LS in treated patients compared to untreated patients was observed(3.7 k Pa vs 3.84 k Pa) but was not statistically significant. MRE had an accuracy/sensitivity/specificity/positive predictive value/negative predictive value of 0.97/90%/100%/100%/90% and 0.98/92.3%/96%/92.3%/96% for detection of advanced fibrosis and cirrhosis, respectively. The performance of MRE was significantly better than laboratory tests for detection of advanced fibrosis(0.97 vs 0.53-0.80, P < 0.01), and cirrhosis(0.98 vs 0.58-0.80, P < 0.01) and better than conventional MRI for diagnosis of cirrhosis(0.98 vs 0.78, P = 0.002).CONCLUSION MRE is a promising modality for detection of advanced fibrosis and cirrhosis in patients with AIH with superior diagnostic accuracy compared to laboratory assessment and MRI. | Jin Wang Neera Malik Meng Yin Thomas C Smyrk Albert J Czaja Richard L Ehman Sudhakar K Venkatesh | 2017 | World Journal of Gastroenterology2017，23，5： | 15 |
| 6 | 气候变化和人类活动对鄱阳湖流域入湖输沙量影响的定量估算显示文摘采用Hydro Trend水文模型,以鄱阳湖流域的赣江、抚河、信江、饶河和修水为研究对象,基于1956-2010年鄱阳湖流域气候数据、水沙数据及其他相关资料,分别模拟了5个子流域的入湖水沙通量变化。在此基础上,探讨了气候变化、植被覆盖变化和水库修建活动对输沙量变化的影响,并定量估算了上述因子对流域输沙量变化的贡献。结果表明:1 1956-2010年,气候、植被和水库三种因子影响下的流域年均输沙量分别为15.5 Mt、20.8 Mt、8.5 Mt,而三种因子共同影响下的流域年均输沙量达到12.6 Mt。2 1956-2010年,植被覆盖变化使流域年均输沙量增加4.2 Mt,而水库拦截造成流域年均输沙量减少8.2 Mt,两者分别占实际年均输沙量的32.4%和63.2%。3 1956-1989年,植被覆盖变化导致的输沙增加量和水库修建拦截导致的输沙减少量均为5.1 Mt/a,两者对流域输沙量贡献持平;1990-2010年,水土流失加重导致的输沙增加量和水库拦截导致的输沙减少量分别为2.7 Mt/a和13.3 Mt/a,水库对入湖输沙量的影响效应是植被覆盖变化的5倍左右。 | 徐夏楠 高建华 贾建军 Albert J Kettner 邢飞 汪亚平 齐述华 廖富强 | 2015 | 地理研究2015，34，5： | 13 |
| 7 | Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome显示文摘BackgroundThere 是在质子泵禁止者(PPI ) 和 clopidogrel 之间的可能的不利相互作用上的大争论。另外, PPI 的使用是否少些影响 ticagrelor 遗体的临床的功效,知道。在经皮的冠的干预(一种总线标准) .MethodsWe 回顾地从 “ 分析了数据以后,我们试图与急性冠的症候群(交流)在病人在临床的结果上决定 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响;真实 world” ;,国际,在 2003 和 2014 之间的多中心登记( n = 15,401 )并且在1年的合成主要端点上估计了 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响(所有原因死亡收到 PPI 的病人更老,更经常女性,并且是更可能的有 comorbidities。没有协会为收到 clopidogrel 的病人在 PPI 使用和主要端点之间被观察(调整 HR:1.036;95% CI:0.903-1.189 ) 或 ticagrelor (调整 HR:2.320;95% CI:0.875-6.151 )(P 相互作用 = 0.2004 ) 。同样, PPI 的使用没与所有原因死亡,重新梗塞,或与交流后面的一种总线标准的为与任何一个 clopidogrel 对待的病人或 ticagrelor.ConclusionsIn 病人的严重流血的减少的风险的增加的风险被联系, PPI 的伴随物使用没在收到 clopidogrel 或 ticagrelor 的病人与不利结果的增加的风险被联系。我们的调查结果显示与 clopidogrel 或 ticagrelor 在联合使用 PPI 是合理的,特别在有胃肠的流血的更高的风险的病人。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev | 2016 | Journal of Geriatric Cardiology2016，13，3： | 12 |
| 8 | Difficult treatment decisions in autoimmune hepatitis显示文摘Treatment decisions in autoimmune hepatitis are complicated by the diversity of its clinical presentations,uncertainties about its natural history,evolving opinions regarding treatment end points,varied nature of refractory disease,and plethora of alternative immu-nosuppressive agents. The goals of this article are to review the difficult treatment decisions and to provide the bases for making sound therapeutic judgments. The English literature on the treatment problems in au-toimmune hepatitis were identifi ed by Medline search up to October 2009 and 32 years of personal experi-ence. Autoimmune hepatitis may have an acute severe presentation,mild in? ammatory activity,lack autoan-tibodies,exhibit atypical histological changes (centri-lobular zone 3 necrosis or bile duct injury),or have variant features reminiscent of another disease (overlap syndrome). Corticosteroid therapy must be instituted early,applied despite the absence of symptoms,or modified in an individualized fashion. Pursuit of normal liver tests and tissue is the ideal treatment end point,but this objective must be tempered against the risk of side effects. Relapse after treatment withdrawal requires long-term maintenance therapy,preferably with azathioprine. Treatment failure or an incomplete response warrants salvage therapy that can include conventional medications in modified dose or empiricaltherapies with calcineurin inhibitors or mycophenolate mofetil. Liver transplantation supersedes empirical drug therapy in decompensated patients. Elderly and pregnant patients warrant treatment modifications. Difficult treatment decisions in autoimmune hepatitis can be simplified by recognizing its diverse manifestations and individualizing treatment,pursuing realistic goals,applying appropriate salvage regimens,and identifying problematic patients early. | Albert J Czaja | 2010 | World Journal of Gastroenterology2010，16，8： | 9 |
| 9 | Examining pathogenic concepts of autoimmune hepatitis for cues to future investigations and interventions显示文摘BACKGROUND Multiple pathogenic mechanisms have been implicated in autoimmune hepatitis,but they have not fully explained susceptibility,triggering events,and maintenance or escalation of the disease.Furthermore,they have not identified a critical defect that can be targeted.The goals of this review are to examine the diverse pathogenic mechanisms that have been considered in autoimmune hepatitis,indicate investigational opportunities to validate their contribution,and suggest interventions that might evolve to modify their impact.English abstracts were identified in PubMed by multiple search terms.Full length articles were selected for review,and secondary and tertiary bibliographies were developed.Genetic and epigenetic factors can affect susceptibility by influencing the expression of immune regulatory genes.Thymic dysfunction,possibly related to deficient production of programmed cell death protein-1,can allow autoreactive T cells to escape deletion,and alterations in the intestinal microbiome may help overcome immune tolerance and affect gender bias.Environmental factors may trigger the disease or induce epigenetic changes in gene function.Molecular mimicry,epitope spread,bystander activation,neo-antigen production,lymphocytic polyspecificity,and disturbances in immune inhibitory mechanisms may maintain or escalate the disease.Interventions that modify epigenetic effects on gene expression,alter intestinal dysbiosis,eliminate deleterious environmental factors,and target critical pathogenic mechanisms are therapeutic possibilities that might reduce risk,individualize management,and improve outcome.In conclusion,diverse pathogenic mechanisms have been implicated in autoimmune hepatitis,and they may identify a critical factor or sequence that can be validated and used to direct future management and preventive strategies. | Albert J Czaja | 2019 | World Journal of Gastroenterology2019，25，45： | 7 |
| 10 | 颈椎术后并发第5颈椎神经根麻痹研究进展显示文摘第5颈椎(C5)神经根麻痹是一种颈椎减压术后比较常见但认知不足的潜在并发症,可见于颈椎前路或后路减压术后。尽管不同颈神经根均可累及,但最常见于C5神经根,因此临床常将其称为“术后C5神经根麻痹”。尽管有研究对术后C5神经根麻痹的可能原因进行了分析,但目前关于这些理论尚缺乏足够的临床和影像学资料证明其合理性。本文结合近年来国内外文献对颈椎术后C5神经根麻痹的发生率、发病机制、预防措施以及预后做一综合性分析。 | 胡勇 Todd J Albert | 2013 | 中华外科杂志2013，51，9： | 6 |
| 11 | Laparoscopic sleeve gastrectomy:More than a restrictive bariatric surgery procedure?显示文摘Sleeve gastrectomy(SG) is a restrictive bariatric surgery technique that was first used as part of restrictive horizontal gastrectomy in the original Scopinaro type biliopancreatic diversion. Its good results as a single technique have led to a rise in its use, and it is currently the second most performed technique worldwide. SG achieves clearly better results than other restrictive techniques and is comparable in some aspects to the Roux-en-Y gastric bypass, the current gold standard in bariatric surgery. These benefits have been associated with different pathophysiologic mechanisms unrelated to weight loss such as increased gastric emptying and intestinal transit, and activation of hormonal mechanisms such as increased GLP-1 hormone and decreased ghrelin. The aim of this review was to highlight the salient aspects of SG regarding its historical evolution, pathophysiologic mechanisms, main results, clinical applications and perioperative complications. | David Benaiges Antonio Más-Lorenzo Albert Goday José M Ramon Juan J Chillarón Juan Pedro-Botet Juana A Flores-Le Roux | 2015 | World Journal of Gastroenterology2015，21，41： | 6 |
| 12 | P2Y12受体抑制剂联合质子泵抑制剂对急性冠脉综合征患者缺血事件影响的临床分析显示文摘目的本研究旨在分析P2Y12受体抑制剂联合质子泵抑制剂(PPI)治疗对经皮冠状动脉介入(PCI)术后的急性冠脉综合征患者缺血事件的影响。方法基于国际多中心回顾性注册登记研究,纳入2003至2014年因急性冠脉综合征人院行PCI术的患者,分为PPI组及非PPI组并随访1年,主要临床终点为全因死亡/再发心肌梗死的复合终点。根据P2Y12受体抑制剂种类,将入组患者分为氯吡格雷组及替格瑞洛组,并比较不同药物与PPI联用发生临床终点事件的风险。结果研究入选9429例患者,PPI组占54.8%,具有更多高危因素。Cox回归结果提示PPI组较非PPI组全因死亡/再发心肌梗死复合事件的发生差异无统计学意义(HR1.00,95%CI 0.86—1.18)。根据P2Y12抑制剂种类不同分为氯吡格雷组和替格瑞洛组,不同P2Y12受体抑制剂联用PPI较未联用PPI患者的临床终点无差异,联用PPI的氯吡格雷组与替格瑞洛组的临床终点差异也无统计学意义。结论急性冠脉综合征患者PPI与P2Y12受体抑制剂联用不增加全因死亡和再发心肌梗死风险,尤其PPI联用氯吡格雷在患者的缺血事件上与替格瑞洛比较差异无统计学意义。 | 冯斯婷 严妍 范婧尧 王晓 郑文 聂绍平 Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D' Ascenzo Jorge Saucedo Jose R Conzalez-Juanatey Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiri Sasko Kedev | 2016 | 中华医学杂志2016，96，33： | 6 |
| 13 | Impact of triple antithrombotic therapy in patients with acute coronary syndrome undergoing percutaneous coronary intervention in real-world practice显示文摘为在急性冠的症候群(交流) 和经皮的冠的干预(一种总线标准) 以后的口头的 anticoagulation (OAC ) 上的病人的 ObjectiveThe 最佳的 antithrombotic 政体仍然保持辩论。寻求回顾地在真实世界的 setting.MethodsWe 评估 OAC 正 clopidogrel 的功效和安全与或没有阿司匹林的这研究分析了数据从一国际,在 2003 和 2014 之间的多中心登记(n = 15,401 ) 。有在一种总线标准以后的交流和收到的 OAC 的病人被屏蔽。合成主要端点是 1 年的所有原因死亡,重新梗塞,或分析注册了 642 个病人包括的严重 bleeding.ResultsThe 期末考试有 OAC 和 clopidogrel (双治疗) 的 62 个病人(9.7%) ,和有阿司匹林, OAC 和 clopidogrel (三倍的治疗) 的联合的 580 个病人(90.3%) 。三倍的治疗上的病人更经常是女性的并且是更可能的有 comorbidities。关于在与三倍的治疗病人一起的双治疗之间的主要结束点没有重要差别[17.74% 对 17.24% ;unadjusted 危险比率(HR ) :1.035;95% 信心间隔(CI ) :0.556-1.929;调整 HR:1.026;95% CI:0.544-1.937 ] 。然而,重新梗塞率比三倍的治疗病人在双治疗是显著地更高的(14.52% 对 5.34% ;unadjusted HR:2.807;95% CI:1.329-5.928;调整 HR:2.333;95% CI:1.078-5.047 ) 。另外,在所有原因死亡和严重 bleeding.ConclusionsIn 的二政体之间没有差别有交流后面的一种总线标准并且与 OAC 的一个指示的真实病人,三倍的治疗没与双治疗相比与不利结果的增加的率被联系。而且,它减少了重新梗塞冒险并且没增加严重流血的风险。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE SerGio Raooseiras-Roubin Emad Abu-Assi Jose P Simao Henriques: Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzalez-Juanate Stephen B Wilton Wouter J Kikkert Ivan Nunez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Morettil Zenon Huczek Toshiharu Fujii Luis cL Correia Masa-aki Kawashiri Sasko Kedev | 2017 | Journal of Geriatric Cardiology2017，14，11： | 6 |
| 14 | Silicon carbide resonant tuning fork for microsensing applications in high-temperature and high G-shock environments显示文摘We present the fabrication and testing of a silicon carbide(SiC)balanced mass double-ended tuning fork that survives harsh environments without compromising the device strain sensitivity and resolution bandwidth.The device features a material stack that survives corrosive environments and enables high-temperature operation.To perform high-temperature testing,a specialized setup was constructed that allows the tuning fork to be characterized using traditional silicon electronics.The tuning fork has been operated at 600 ℃ in the presence of dry steam for short durations.This tuning fork has also been tested to 64 000 G using a hard-launch,soft-catch shock implemented with a light gas gun.However,the device still has a strain sensitivity of 66 Hz/με and strain resolution of 0.045 με in a 10 kHz bandwidth.As such,this balanced-mass double-ended tuning fork can be used to create a variety of different sensors including strain gauges,accelerometers,gyroscopes,and pressure transducers.Given the adaptable fabrication process flow,this device could be useful to micro-electro-mechanical systems(MEMS) designers creating sensors for a variety of different applications. | David R Myers Kan Bun Cheng Babak Jamshidi Robert G Azevedo Debbie G Senesky Li Chen Mehran Mehregany Muthu B J Wijesundara Albert P Pisano | 2012 | Engineering Sciences2012，10，5： | 6 |
| 15 | Gastric cancer in Alaska Native people: A cancer health disparity显示文摘AIM To evaluate recent trends in gastric cancer incidence, response to treatment, and overall survival among Alaska Native(AN) people. METHODS A retrospective analysis of the Alaska Native Medical Center patient database was performed. Patient history, clinical, pathological, response to treatment and patient outcomes were collected from one-hundred and thirty-two AN gastric cancer patients. The Surveillance, Epidemiology and End Result database 18 was used to collect comparison United States non-Hispanic White(NHW) and AN gastric cancer patient data between 2006-2014.RESULTS AN gastric cancer patients have a higher incidence rate, a poorer overall survival, and are diagnosed at a significantly younger age compared to NHW patients. AN patients differ from NHW patients in greater prevalence of non-cardia, diffuse subtype, and signet ring cell carcinomas. AN females were more likely to be diagnosed with later stage cancer, stage IV, compared to AN males. Diminished overall survival was observed among AN patients with increasing stage, O+ blood type, < 15 lymph nodes examined at resection, and no treatment. This study is the first report detailing the clinicopathologic features of gastric cancer in AN people with outcome data.CONCLUSION Our findings confirm the importance of early detection, treatment, and surgical resection for optimizing AN patient outcomes. Further research on early detection markers are warranted. | Holly A Martinson Nancy J Shelby Steven R Alberts Matthew J Olnes | 2018 | World Journal of Gastroenterology2018，24，25： | 6 |
| 16 | General competencies of problem‐based learning (PBL) and non‐PBL graduates显示文摘 | Katinka J A HPrince Patrick W L JVan Eijs Henny P ABoshuizen Cees P MVan Der Vleuten Albert J J AScherpbier | 2005 | Medical Education2005，，4： | 5 |
| 17 | Emerging roles of the intestine in control of cholesterol metabolism显示文摘The liver is considered the major “control center” for maintenance of whole body cholesterol homeostasis. This organ is the main site for de novo cholesterol synthesis, clears cholesterol-containing chylomicron remnants and low density lipoprotein particles from plasma and is the major contributor to high density lipoprotein (HDL; good cholesterol) formation. The liver has a central position in the classical definition of the reverse cholesterol transport pathway by taking up periphery-derived cholesterol from lipoprotein particles followed by conversion into bile acids or its direct secretion into bile for eventual removal via the feces. During the past couple of years, however, an additional important role of the intestine in maintenance of cholesterol homeostasis and regulation of plasma cholesterol levels has become apparent. Firstly, molecular mechanisms of cholesterol absorption have been elucidated and novel pharmacological compounds have been identified that interfere with the process and positively impact plasma cholesterol levels. Secondly, it is now evident that the intestine itself contributes to fecal neutral sterol loss as a cholesterol-secreting organ. Finally, very recent work has unequivocally demonstrated that the intestine contributes significantly to plasma HDL cholesterol levels. Thus, the intestine is a potential target for novel anti-atherosclerotic treatment strategies that, in addition to interference with cholesterol absorption, modulate direct cholesterol excretion and plasma HDL cholesterol levels. | Janine K Kruit Albert K Groen Theo J van Berkel Folkert Kuipers | 2006 | World Journal of Gastroenterology2006，12，40： | 4 |
| 18 | SEMS vs cSEMS in duodenal and small bowel obstruction:High risk of migration in the covered stent group显示文摘AIM:To compare clinical success and complications of uncovered self-expanding metal stents(SEMS)vs covered SEMS(cSEMS)in obstruction of the small bowel.METHODS:Technical success,complications and outcome of endoscopic SEMS or cSEMS placement in tumor related obstruction of the duodenum or jejunum were retrospectively assessed.The primary end points were rates of stent migration and overgrowth.Secondary end points were the effect of concomitant biliary drainage on migration rate and overall survival.The data was analyzed according to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.RESULTS:Thirty-two SEMS were implanted in 20 patients.In all patients,endoscopic stent implantation was successful.Stent migration was observed in 9 of16 cSEMS(56%)in comparison to 0/16 SEMS(0%)implantations(P=0.002).Stent overgrowth did not significantly differ between the two stent types(SEMS:3/16,19%;cSEMS:2/16,13%).One cSEMS dislodged and had to be recovered from the jejunum by way of laparotomy.Time until migration between SEMS and cSEMS in patients with and without concomitant biliary stents did not significantly differ(HR=1.530,95%CI0.731-6.306;P=0.556).The mean follow-up was 57±71 d(range:1-275 d).CONCLUSION:SEMS and cSEMS placement is safe in small bowel tumor obstruction.However,cSEMS is accompanied with a high rate of migration in comparison to uncovered SEMS. | Oliver Waidmann Jrg Trojan Mireen Friedrich-Rust Christoph Sarrazin Wolf Otto Bechstein Frank Ulrich Stefan Zeuzem Jrg Gerhard Albert | 2013 | World Journal of Gastroenterology2013，19，37： | 4 |
| 19 | Non-classical phenotypes of autoimmune hepatitis and advances in diagnosis and treatment显示文摘Non-classical manifestations of autoimmune hepatitis can delay diagnosis and treatment.Our aims were to describe the clinical phenotypes that can confound the diagnosis,detail scoring systems that can ensure their recognition,and outline advances in treatment that can improve their outcome.Prime source and review articles in English were selected through Medline from 1970-2008 and assimilated into personal libraries spanning 32 years.Acute severe or asymptomatic presentations and atypical histological findings,including centrilobular zone 3 necrosis and concurrent bile duct changes,are compatible with the diagnosis.Cholangiographic abnormalities may be present in children and adults with the disease,and autoimmune hepatitis must be considered in patients without autoantibodies or with antimitochondrial antibodies and no other cholestatic features.Asymptomatic patients frequently become symptomatic;mild disease can progress;and there are no conf ident indices that justify withholding treatment.Two diagnostic scoring systems with complementary virtues have been developed to evaluate patients with confusing features.Normal liver tests and tissue constitute the optimal end point of treatment,and the f irst relapse is an indication for long-term azathioprine therapy.Cyclosporine,tacrolimus and mycophenolate mofetil are promising salvage therapies,and budesonide with azathioprine may be a superior frontline treatment.We conclude that the non-classical phenotypes of autoimmune hepatitis can be recognized promptly,diagnosed accurately,and treated effectively. | Albert J Czaja Yusuf Bayraktar | 2009 | World Journal of Gastroenterology2009，15，19： | 4 |
| 20 | Pulmonary hypertension in hereditary haemorrhagic telangiectasia显示文摘Hereditary haemorrhagic telangiectasia(HHT) is an autosomal dominant inherited disorder characterised by vascular malformations in predominantly the brain,liverand lungs.Pulmonary hypertension(PH) is increasingly recognised as a severe complication of HHT.PH may be categorised into two distinct types in patients with HHT.Post-capillary PH most often results from a high pulmonary blood flow that accompanies the high cardiac output state associated with liver arteriovenous malformations.Less frequently,the HHT-related gene mutations in ENG or ACVRL1 appear to predispose patients with HHT to develop pre-capillary pulmonary arterial hypertension.Differentiation between both forms of PH by right heart catheterisation is essential,since both entities are associated with severe morbidity and mortality with different treatment options.Therefore all HHT patients should be referred to an HHT centre. | Veronique MM Vorselaars Sebastiaan Velthuis Repke J Snijder Jan Albert Vos Johannes J Mager Martijn C Post | 2015 | World Journal of Cardiology2015，7，5： | 4 |
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