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| 1 | IMbrave150研究:免疫抑制剂治疗首次取得晚期肝细胞癌一线治疗成功显示文摘【据The New England Journal of Medicine 2020年5月报道】题:阿特朱单抗联合贝伐单抗在无法手术切除的晚期肝细胞癌中的疗效(作者Finn RS等)索拉非尼和仑伐替尼是目前晚期肝细胞癌(HCC)的标准一线治疗方案,可适当提高患者总生存率,但不良反应较多。PD-1抑制剂、阿特朱单抗(PD-L1抑制剂)以及贝伐单抗在Ⅰb期和Ⅱ期临床试验中显示出良好的客观缓解率。该研究探索了阿特朱单抗联合贝伐单抗对比单药索拉非尼治疗无法手术切除的晚期HCC的疗效和安全性。 | 刘昊天 钟鉴宏 FINN RS QIN S IKEDA M | 2020 | 临床肝胆病杂志2020，36，9： | 460 |
| 2 | Pathological classification of intrahepatic cholangiocarcinoma based on a new concept显示文摘Intrahepatic cholangiocarcinoma (ICC) arises from the lining epithelium and peribiliary glands of the intrahepatic biliary tree and shows variable cholangiocytic dif-f-e-re-ntiation. To date-,ICC was large-ly classifie-d into adenocarcinoma and rare variants. Herein,we propose to subclassify the former,based on recent progress in the-study of-ICC including the-gross classification and hepatic progenitor/stem cells and on the pathological similarities between biliary and pancreatic neoplasms. That is,ICC is classifiable into the conventional (bile duct) type,the bile ductular type,the intraductal neoplasm type and rare variants. The conventional type is further divided into the small duct type (peripheral type) and large bile duct type (perihilar type). The former is a tubular or micropapillary adenocarcinoma while the latter involves the intrahepatic large bile duct. Bile ductular type resembles proliferated bile ductules and shows a replacing growth of the hepatic parenchyma.Hepatic progenitor cell or stem cell phenotypes such as neural cell adhesion molecule expression are frequently expressed in the bile ductular type. Intraductal type includes papillary and tubular neoplasms of the bile duct (IPNBs and ITNBs) and a superficial spreading type. IPNB and ITNB show a spectrum from a preneoplastic borderline lesion to carcinoma and may have pancreatic counterparts. At invasive sites,IPNB is associated with the conventional bile duct ICC and mucinous carcinoma. Biliary mucinous cystic neoplasm with ovarian-like stroma in its wall is different from IPNB,particularly IPNB showing cystic dilatation of the affected ducts. Rare variants of ICC include squamous/adenosquamous cell carcinoma,mucinous/signet ring cell carcinoma,clear cell type,undifferentiated type,neuroendocrine carcinoma and so on. This classification of-ICC may ope-n up a ne-w fie-ld of-re-se-arch of-ICC and contribute-to the-clini cal approach to ICC. | Yasuni Nakanuma Yasunori Sato Kenichi Harada Mokoto Sasaski Hiroko Ikeda | 2010 | World Journal of Hepatology2010，2，12： | 34 |
| 3 | Newly-generated Daliangshan Fault Zone—Shortcutting on the central section of Xianshuihe-Xiaojiang fault system显示文摘The Daliangshan fault zone is the eastern branch in the central section of Xianshuihe-Xiaojiang fault system. It has been neglected for a long time, partly because of no destructive earthquake records along this fault zone. On the other hand, it is located on the remote and inaccessible plateau. So far it was excluded as part of the Xianshuihe-Xiaojiang fault system. Based on the interpretation of aerophotographs and field investigations, we document this fault zone in detail, and give an estimation of strike-slip rate about 3 mm/a in Late Quaternary together with age dating data. The results suggest that the Daliangshan fault zone is a newly-generated fault zone resulted from shortcutting in the central section of Xianshuihe-Xiaojiang fault system because of the clockwise rotation of the Southeastern Tibetan Crustal Block, which is bounded by the Xianshuihe-Xiaojiang fault system. Moreover, the shortcutting may make the Daliangshan fault zone replace the Anninghe and Zemuhe fault zones gradually, and finally, the later two fault zones will probably die out with the continuous clockwise rotation. | IKEDA Yasutaka TOGO Masayoshi TAJIKARA Masayoshi ECHIGO Tomoo OKADA Shinsuke | 2008 | Science China Earth Sciences2008，51，9： | 23 |
| 4 | 动脉粥样硬化血栓形成门诊患者1年内心血管事件的发生率显示文摘背景:目前,有关社区中动脉粥样硬化血栓形成稳定患者心血管(cardiovascular,CV)事件发生率的资料比较少,既往也无国际性队列研究对冠状动脉病(coronary artery disease,CAD)、脑血管病(cerebrovascular disease,CVD)、外周动脉病(peripheral arterial disease,PAD)确诊患者以及此类疾病高危患者不同事件的发生率进行评估。
目的:在患有动脉疾病的门诊患者或存在多个动脉粥样硬化血栓形成危险因素的门诊患者中确定当今世界1年内CV事件的发生率。
设计、地点及参试者:“减少动脉粥样硬化血栓形成维系健康(Reduction of Artherotllrombosis for Continued Health,REACH)”注册研究是一项国际前瞻性队列研究。研究人员于2003—2004年从44个国家、5587名医生入选68236例已确诊的动脉粥样硬化性血管病患者(CAD、PAD、CVD;n=55814)以及至少存在3个动脉粥样硬化血栓形成危险因素的患者(n=12422)。
主要观测指标:CV死亡、心肌梗死(myocardial infarction,MI)及卒中的发生率。结果:截至2006年7月,共有95.22%的患者(n=64977)提供了1年内的结局。心血管死亡、MI及卒中的总体发生率为4.24%;动脉粥样硬化性血管病患者为4.69%,仅存在多个危险因素的患者为2.15%。CAD、CVD及PAD患者CV死亡、MI及卒中的总体发生率分别为4.52%、6.47%和5.35%。CAD、CVD及PAD患者发生终点事件(即CV死亡、MI、卒中)以及因动脉粥样硬化血栓形成事件入院的几率分别为15.20%、14.53%和21.14%。上述事件发生率随症状性动脉疾病病变部位数量的增加而增加,仅存在危险因素的患者为5.31%,有1处症状性动脉疾病的患者为12.58%,有2处症状性动脉疾病的患者为21.14%,有3处症状性动脉疾病的患者为26.27%(趋势P〈0.001)。
结论:在这项当代大型国际研究中,患有动脉粥样硬化性血管病的门诊患者以及有动脉粥样硬化血栓形成危险的门诊患者CV事件的年发生率相对较高。存在多部位病变者CV事件的1年发生率升高。 | Gabriel Steg Deepak L. Bhatt Peter W. F. Wilson Ralph D' Agostino E. Magnus Ohman Joachim Roether Chiau-Suong Liau Alan T. Hirsch Jean-Louis Mas Yasuo Ikeda Michael J. Pencina Shinya Goto 徐成斌(译) 李呈亿(校) | 2007 | 美国医学会杂志(中文版)2007，26，4： | 20 |
| 5 | Uniform Strike-Slip Rate along the Xianshuihe-Xiaojiang Fault System and Its Implications for Active Tectonics in Southeastern Tibet显示文摘Xiamshuihe-Xiaojiang 差错系统上的最近的研究建议 LateQuaternary 走向滑倒率沿着全部段断层带是近似一致的,关于 15+-2 mm/a。这个近似一致的罢工强烈滑动率支持顺时针方向,旋转东南的西藏的外壳当模特儿。由接近, arc-shapedXianshuihe-Xiaojiangx 的几何学在一个球形的地球上作为一个小圆的部分指责系统, 15+-2mm/a 罢工滑倒率对应于顺时针方向东南的西藏的块在的旋转( 5.2+-0.7 )在杆附近的 X10^-7deg/a 尖速度( 21 deg N , 88 deg E )相对向东北西藏的块,近似一致的罢工滑动率 Xianshuihe-Xiaojiangfault 系统也暗示 Longmenshan 戳地区不是活跃的,否则至少它的活动有后来是很弱的晚第四级。而且,沿着 theXianshuihe-Xiaojiang 差错系统的全部的偏移量建议相对东北西藏的块的东南的 TibetanBlock 的侧面的挤出是相对 theTarim 北方中国的大约 160 km 和 200-240 km 块。西藏的外壳的侧面的挤出的这数量应该基于集体平衡计算提供了在印度和欧亚大陆之间的大约 13-24% 集中。假设 slip 15+-2 mm/a 评价在整个 Xianshuihe-Xiaojiang 差错系统的全部历史是不变的, 11+-1.5 妈被需要让 Xianshuihe-Xiaojiang 差错系统达到全部的偏移量的 160 km。这暗示在 theXianshuihe-Xiaojiang 差错系统力量上指责的离开滑倒在 11+-1.5 妈开始。 | HE Honglin RAN Hongliu Yasutaka IKEDA | 2006 | Acta Geologica Sinica(English Edition)2006，80，3： | 18 |
| 6 | Repeated Range Expansion and Glacial Endurance of Potentilla glabra(Rosaceae) in the Qinghai-Tibetan Plateau显示文摘To date,little is still known about how alpine species occurring in the Qinghai-Tibetan Plateau(QTP) responded to past climatic oscillations.Here,by using variations of the chloroplast trnT-L,we examined the genetic distribution pattern of 101 individuals of Potentilla glabra,comprising both the interior QTP and the plateau edge.Phylogenetic and network analyses of 31 recovered haplotypes identified three tentative clades(A,B and C).Analysis of molecular variance(AMOVA) revealed that most of the genetic variability was found within populations(0.693),while differentiations between populations were obviously distinct(Fst = 0.307).Two independent range expansions within clades A and B occurring at approximately 316 and 201 thousand years ago(kya) were recovered from the hierarchical mismatch analysis,and these two expansions were also confirmed by Fu's FS values and 'g' tests.However,distant distributions of clade C and private haplotypes from clades A and B suggest that they had survived the Last Glacial Maximum(LGM) and previous glaciers in situ since their origins.Our findings based on available limited samples support that multiple refugia of a few cold-enduring species had been maintained in the QTP platform during LGM and/or previous glacial stages. | Liu-Yang Wang Hiroshi Ikeda Teng-Liang Liu Yu-Jin Wang Jian-Quan Liu | 2009 | Journal of Integrative Plant Biology2009，51，7： | 15 |
| 7 | Correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis显示文摘AIM:To elucidate the correlation between hepatic blood flow and liver function in alcoholic liver cirrhosis(AL-LC).METHODS:The subjects included 35 patients with ALLC(34 men,1 woman;mean age,58.9±10.7 years;median age,61 years;range:37-76 years).All patientswere enrolled in this study after obtaining written informed consent.Liver function was measured with tests measuring albumin(Alb),prothrombin time(PT),brain natriuretic peptide(BNP),branched amino acid and tyrosine ratio(BTR),branched chain amino acid(BCAA),tyrosine,ammonia(NH3),cholinesterase(Ch E),immunoreactive insulin(IRI),total bile acid(TBA),and the retention rate of indocyanine green 15 min after administration(ICG R15).Hepatic blood flow,hepatic arterial tissue blood flow(HATBF),portal venous tissue blood flow(PVTBF),and total hepatic tissue blood flow(THTBF)were simultaneously calculated using xenon computed tomography.RESULTS:PVTBF,HATBF and THTBF were 30.2±10.4,20.0±10.7,and 50.3±14.9 m L/100 m L/min,respectively.Alb,PT,BNP,BTR,BCAA,tyrosine,NH3,Ch E,IRI,TBA,and ICG R15 were 3.50±0.50 g/d L,72.0%±11.5%,63.2±56.7 pg/m L,4.06±1.24,437.5±89.4μmol/L,117.7±32.8μmol/L,59.4±22.7μg/d L,161.0±70.8 IU/L,12.8±5.0μg/d L,68.0±51.8μmol/L,and 28.6%±13.5%,respectively.PVTBF showed a significant negative correlation with ICG R15(r=-0.468,P<0.01).No significant correlation was seen between ICG 15R,HATBF and THTBF.There was a significant correlation between PVTBF and Alb(r=0.2499,P<0.05),and NH3 tended to have an inverse correlation with PVTBF(r=-0.2428,P=0.0894).There were also many significant correlations between ICG R15 and liver function parameters,including Alb,NH3,PT,BNP,TBA,BCAA,and tyrosine(r=-0.2156,P<0.05;r=0.4318,P<0.01;r=0.4140,P<0.01;r=0.3610,P<0.05;r=0.5085,P<0.001;r=0.4496,P<0.01;and r=0.4740,P<0.05,respectively).CONCLUSION:Our investigation showed that there is a close correlation between liver function and hepatic blood flow. | Hideaki Takahashi Ryuta Shigefuku Yoshihito Yoshida Hiroki Ikeda Kotaro Matsunaga Nobuyuki Matsumoto Chiaki Okuse Shigeru Sase Fumio Itoh Michihiro Suzuki | 2014 | World Journal of Gastroenterology2014，20，45： | 14 |
| 8 | Postoperative bleeding in patients on antithrombotic therapy after gastric endoscopic submucosal dissection显示文摘AIM To investigated the relationship between postoperative bleeding following gastric endoscopic submucosal dissection(ESD) and individual antithrombotic agents.METHODS A total of 2488 gastric neoplasms in 2148 consecutive patients treated between May 2001 and June 2016 were studied. The antithrombotic agents were categorized into antiplatelet agents, anticoagulants, and other antithrombotic agents, and we included combination therapies [e.g., dual antiplatelet therapy(DAPT)]. The risk factors associated with post-ESD bleeding, namely, antithrombotic agents overall, individual antithrombotic agents, withdrawal or continuation of antithrombotic agents, and bleeding onset period(during the first six days or thereafter), were analyzed using univariate and multivariate analyses.RESULTS The en bloc resection and complete curative resection rates were 99.2% and 91.9%, respectively. Postoperative bleeding occurred in 5.1% cases. Bleeding occurred in 10.3% of the patients administered antithrombotic agents. Being male(P = 0.007), specimen size(P < 0.001), and antithrombotic agent used(P < 0.001) were independent risk factors for postoperative bleeding. Heparin bridging therapy(HBT)(P = 0.002) and DAPT/multidrug combinations(P < 0.001) were independent risk factors associated with postoperative bleeding. The bleeding rate of the antithrombotic agent continuation group was significantly higher than that of the withdrawal group(P < 0.01). Bleeding within postoperative day(POD) 6 was significantly higher in warfarin(P = 0.015), and bleeding after POD 7 was significantly higher in DAPT/multidrug combinations(P = 0.007). No thromboembolic events were reported.CONCLUSION We must closely monitor patients administered HBT and DAPT/multidrug combinations after gastric ESD, particularly those administered multidrug combinations after discharge. | Chiko Sato Kingo Hirasawa Ryonho Koh Ryosuke Ikeda Takehide Fukuchi Ryosuke Kobayashi Hiroaki Kaneko Makomo Makazu Shin Maeda | 2017 | World Journal of Gastroenterology2017，23，30： | 14 |
| 9 | Treatment of over 20 mm gastric cancer by endoscopic submucosal dissection using an insulation-tipped diathermic knife显示文摘AIM: To evaluate the effectiveness of endoscopic submucosal dissection using an insulation-tipped diathermic knife (IT-ESD) for the treatment of patients with over 20 mm early gastric cancer (EGC). METHODS: A total of 112 patients with over 10 mm EGC were treated with IT-ESD at Sumitomo Besshi Hospital and Shikoku Cancer Center in the 5 year period from January 2002 to December 2006, including 40 patients with over 20 mm EGC. We compared patient backgrounds, the one-piece resection rate, complete resection (CR) rate, operation time, bleeding rate, perforation rate between patients with over 20 mm EGC [over 20 mm group (21-40 mm)] and the remaining patients (under 20 mm group). RESULTS: We found no significant difference in the rate of underlying cardiopulmonary disease (over 20 mm group vs under 20 mm group, 5.0% vs 5.6%), one- piece resection rate (95% vs 96%), CR rate (85% vs 89%), operation time (72.3 min vs 66.5 min), bleeding rate (5% vs 4.2%), and perforation rate (0% vs 1.4%) between the 2 groups. Three patients in each group had submucosal invasion and two in each groups underwent additional surgery. CONCLUSION: There was no significant difference in the outcome resulting from IT-ESD between the 2 groups. Our study proves that IT-ESD is a feasible treatment for patients with over 20 mm mucosal gastric cancer although the long-term outcome should be evaluated in the future. | Shoji Hirasaki Hiromitsu Kanzaki Minoru Matsubara Kohei Fujita Fusao Ikeda Hideaki Taniguchi Eiichiro Yumoto Seiyuu Suzuki | 2007 | World Journal of Gastroenterology2007，13，29： | 13 |
| 10 | Hypofractionated stereotactic rad iotherapy alone without whole-brain irradiation for patien ts with solitary and oligo brain metastasis using noninvasive fixation of the skull显示文摘To evaluate the efficacy and toxicity of hypofractionated stereotactic radiotherapy(HSRT)using noninvasive fixation of the sk ull on solitary or oligo brain metastatic p atients as an alternative to stereotactic radiosurgery(SRS)using invasive fixation.The subjects were 87patients who had 4or fewer brain meta stases(50solitary,37oligometastases).Treatment was conducted on 159meta stases by using a linac-based stereotactic system.T he median isocentric dose was 35Gy in4fractions.Whole-brain irradiati on was not applied as an initial treatment.For the salvage treatmen t of metachronous brain metastases,repeat HSRT or whole-brain irradiation was applied.The actuarial1-year local tumor control rate was 81%.Treatment-related complicatio ns were observed in 4patients in the e arly period(<3months)and in 2patients in the late period.T he median survival period was 8.7mon ths.Metachronous brain metastases occurred in 30patients,and none of the 18patients who were eligible for salvage HSRT refused to re ceive it again.Hypofractionated stereotactic radiotherapy achieved tumor control and survival equivalent to those of SRS reported i n the literature.The results suggested that HSRT could be an alternative for solitary or oligo br ain metastatic patients with less to xicity and less invasiveness compared to | Aoyama H Shirato H Onimaru R Kagei K Ikeda J Ishii N Sawamura Y Miyasaka K | 2003 | 癌症2003，22，7： | 12 |
| 11 | Evaluation of magnifying colonoscopy in the diagnosis of serrated polyps显示文摘AIM:To elucidate the colonoscopic features of serrated lesions of the colorectum using magnifying colonoscopy.METHODS:Broad division of serrated lesions of the colorectum into hyperplastic polyps(HPs),traditional serrated adenomas(TSAs),and sessile serrated adenomas/polyps(SSA/Ps) has been proposed on the basis of recent molecular biological studies.However,few reports have examined the colonoscopic features of these divisions,including magnified colonoscopic findings.This study examined 118 lesions excised in our hospital as suspected serrated lesions after magnified observation between January 2008 and September 2011.Patient characteristics(sex,age),conventional colonoscopic findings(location,size,morphology,color,mucin) and magnified colonoscopic findings(pit pattern diagnosis) were interpreted by five colonoscopists with experience in over 1000 colonoscopies,and were compared with histopathological diagnoses.The pit patterns were categorized according to Kudo's classification,but a more detailed investigation was also performed using the subclassification [type Ⅱ-Open(type Ⅱ-O),type Ⅱ-Long(type Ⅱ-L),or type Ⅳ-Serrated(type Ⅳ-S)] proposed by Kimura T and Yamano H.RESULTS:Lesions comprised 23 HPs(23/118:19.5%),39 TSAs(39/118:33.1%:with cancer in one case),50 SSA/Ps(50/118:42.4%:complicated with cancer in three cases),and six others(6/118:5.1%).We excluded six others,including three regular adenomas,one hamartoma,one inflammatory polyp,and one juvenile polyp for further analysis.Conventional colonoscopy showed that SSA/Ps were characterized as larger in diameter than TSAs and HPs(SSA/P vs HP,13.62 ± 8.62 mm vs 7.74 ± 3.24 mm,P < 0.001;SSA/Ps vs TSA,13.62 ± 8.62 mm vs 9.89 ± 5.73 mm,P < 0.01);common in the right side of the colon [HPs,30.4%(7/23):TSAs,20.5%(8/39):SSA/P,84.0%(42/50),P < 0.001];flat-elevated lesion [HPs,30.4%(7/23):TSAs,5.1%(2/39):SSA/Ps,90.0%(45/50),P < 0.001];normal-colored or pale imucosa [HPs,34.8%(8/23):TSAs,10.3%(4/39):SSA/Ps,80%(40/50),P < 0.001];and with large amounts of mucin [HPs,21.7%(5/23):TSAs,17.9%(7/39):SSA/Ps,72.0%(36/50),P < 0.001].In magnified colonoscopic findings,17 lesions showed either type Ⅱ pit pattern alone or partial type Ⅱ pit pattern as the basic architecture,with 14 HPs(14/17,70.0%) and 3 SSA/Ps.Magnified colonoscopy showed the type Ⅱ-O pit pattern as characteristic of SSA/Ps [sensitivity 83.7%(41/49),specificity 85.7%(54/63)].Cancer was also present in three lesions,in all of which a type Ⅵ pit pattern was also present within the same lesion.There were four HPs and four TSAs each.The type Ⅳ-S pit pattern was characteristic of TSAs [sensitivity 96.7%(30/31),specificity 89.9%(72/81)].Cancer was present in one lesion,in which a type Ⅵ pit pattern was also present within the same lesion.In our study,serrated lesions of the colorectum also possessed the features described in previous reports of conventional colonoscopic findings.The pit pattern diagnosis using magnifying colonoscopy,particularly magnified colonoscopic findings using subclassifications of surface architecture,reflected the pathological characteristics of SSA/Ps and TSAs,and will be useful for colonoscopic diagnosis.CONCLUSION:We suggest that this system could be a good diagnostic tool for SSA/Ps using magnifying colonoscopy. | Shinya Ishigooka Masahito Nomoto Nobuyuki Obinata Yoshichika Oishi Yoshinori Sato Satoko Nakatsu Midori Suzuki Yoshiko Ikeda Tadateru Maehata Tomoaki Kimura Yoshiyuki Watanabe Takashi Nakajima Hiro-o Yamano Hiroshi Yasuda Fumio Itoh | 2012 | World Journal of Gastroenterology2012，18，32： | 11 |
| 12 | Elevation of the glycated albumin to glycated hemoglobin ratio during the progression of hepatitis C virus related liver fibrosis显示文摘AIM: To analyze the relationship between the glycated albumin (GA) to glycated hemoglobin (HbA1c) ratio and the histological grading of liver fibrosis.METHODS: The study retrospectively included consecutive hepatitis C virus positive chronic liver disease patients (n = 142) who had undergone percutaneous liver biopsy between January 2008 and March 2010 at our institution. The ratios of GA/HbA1c were calculated in all patients to investigate the relationship with the degree of the liver fibrosis. The values of the aspartate aminotransferase-to-platelet ratio index (APRI), an excellent marker for the evaluation of liver fibrosis, were also calculated. In addition, we combined the ratio of GA/HbA1c and the APRI in order to improve our ability to detect the presence of significant liver fibrosis. RESULTS: Sixty-one (43%) patients had either no fibrosis or minimal fibrosis (METAVIR score: F0-F1), while 25 (17%) had intermediate fibrosis (F2). Fifty-six (39%) patients had severe fibrosis (F3-F4) and 27 of them had cirrhosis (F4). The mean values of the GA/HbA1c increased with the progression of the fibrosis (F0-1: 2.83 ± 0.24, F2: 2.85 ± 0.24, F3: 2.92 ± 0.35, F4: 3.14 ± 0.54). There was a significant dif- ference between the F0-F1 vs F4, F2 vs F4, and F3 vs F4 groups (P < 0.01, P < 0.01, P < 0.01 and P < 0.05, respectively). The GA/HbA1c ratio was significantly higher in the patients with cirrhosis (F4) than in those without cirrhosis (F0-F3) (3.14 ± 0.54 vs 2.85 ± 0.28, P < 0.0001). The GA/HbA1c ratio was also significantly higher in the patients with severe fibrosis (F3-F4) than in those without severe liver fibrosis (F0-F2) (3.03 ± 0.41 vs 2.84 ± 0.24, P < 0.001). Furthermore, the GA/ HbA1c ratio was also significantly higher in the patients with significant fibrosis (F2-F4) than in those without significant liver fibrosis (F0-F1) (2.98 ± 0.41 vs 2.83 ± 0.24, P < 0.001). The diagnostic performance of the increased GA/HbA1c ratio (> 3.0) was as follows: its sensitivity and specificity for the detection of liver cirrhosis (F4) were 59.3% and 70.4%, respectively and its sensitivity and specificity for the detection of severe liver fibrosis (F3-F4) were 50.0% and 74.4%,respectively. With regard to the detection of significant fibrosis (F2-F4), its sensitivity was 44.4% and its specificity was 77.0%. Although even the excellent marker APRI shows low sensitivity (25.9%) for distinguishing patients with or without significant fibrosis, the combination of the APRI and GA/HbA1c ratio increased the sensitivity up to 42.0%, with only a modest decrease in the specificity (from 90.2% to 83.6%). CONCLUSION: The GA/HbA1c ratio increased in line with the histological severity of liver fibrosis, thus suggesting that this ratio is useful as a supportive index of liver fibrosis. | Nobuhiro Aizawa Hirayuki Enomoto Hiroyasu Imanishi Masaki Saito Yoshinori Iwata Hironori Tanaka Naoto Ikeda Yoshiyuki Sakai Tomoyuki Takashima Takashi Iwai Ei-ichiro Moriwaki Soji Shimomura Hiroko Iijima Hideji Nakamura Shuhei Nishiguchi | 2012 | World Journal of Hepatology2012，4，1： | 10 |
| 13 | 模糊数学法在餐饮食品微生物风险评估中的应用显示文摘为了保障餐饮食品安全和人民群众的身体健康,本文建立风险评价指标体系,确定各指标的评价等级集。选取某省4年间餐饮环节微生物监测历史数据,建立粗糙集决策模型,用粗糙集理论方法确定评价指标体系中各指标的权重值,确定隶属度矩阵,在此基础上建立模糊综合评价模型。总结了影响餐饮业微生物安全的主要因素:菌落总数、大肠菌群、沙门氏菌、金黄色葡萄球菌,得出这4项微生物指标在熟制品、生鲜食品、自制饮料、餐饮及加工用具中的评价值和隶属度矩阵。 | 张娜 郭庆启 韩春然 Shinya Ikeda 张守文 石彦国 | 2017 | 中国食品学报2017，17，8： | 10 |
| 14 | Endoscopic features of early-stage signet-ring-cell carcinoma of the stomach显示文摘AIM: To identify the features of early signet ring cell gastric carcinoma using magnification endoscopy with narrow band imaging(NBI).METHODS: A retrospective review was conducted of 12 cases of early signet ring cell gastric carcinoma who underwent treatment in a single institution between January 2009 and April 2013. All patients had magnification endoscopy with NBI and indigo carmine contrast to closely examine the mucosal architecture, including the microvasculature and arrangement of gastric pits. Histologic examination of the final endoscopic submucosal dissection or gastrectomy specimen was performed and compared with the endoscopic findings to identify patterns specific to signet ring cell carcinoma.RESULTS: Twelve patients with early signet ring cell gastric carcinoma were identified; 75% were male, and average age was 61 years. Most of the lesions were stage T1a(83%), while the remainder were T1b(17%). The mean lesion size was 1.4 cm2. On standard endoscopy, all 12 patients had a pale, flat lesion without any evidence of mucosal abnormality such as ulceration, elevation, or depression. On magnification endoscopywith NBI, all of the patients had irregularities in the glands and microvasculature consistent with early gastric cancer. In addition, all 12 patients exhibited the 'stretch sign', an elongation or expansion of the architectural structure. Histologic examination of the resected specimens demonstrated an expanded and edematous mucosal layer infiltrated with tumor cells.CONCLUSION: The 'stretch sign' appears to be specific for signet ring cell carcinoma and may aid in the early diagnosis and treatment of this aggressive pathology. | Chainarong Phalanusitthepha Kevin L Grimes Haruo Ikeda Hiroki Sato Chiaki Sato Chananya Hokierti Haruhiro Inoue | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，7： | 8 |
| 15 | Hepatitis C virus enhances incidence of idiopathic pulmonary fibrosis显示文摘AIM: To investigate the cumulative development incidence and predictive factors for idiopathic pulmonary fibrosis in hepatitis C virus (HCV) positive patients. METHODS: We studied 6150 HCV infected patients who were between 40-70 years old (HCV-group). Another 2050 patients with hepatitis B virus (HBV) were selected as control (HBV-group). The mean observation period was 8.0 ± 5.9 years in HCV-group and 6.3 ± 5.5 years in HBV-group. The primary goal is the development of idiopathic pulmonary fibrosis (IPF) in both groups. The cumulative appearance rate of IPF and independent factors associated with the incidence rate of IPF were calculated using the Kaplan- Meier method and the Cox proportional hazard model. All of the studies were performed retrospectively by collecting and analyzing data from the patient records in our hospital. RESULTS: Fifteen patients in HCV-group developedIPF. On the other hand, none of the patients developed IPF in HBV-group. In HCV-group, the cumulative rates of IPF development were 0.3% at 10th year and 0.9% at 20th year. The IPF development rate in HCV-group was higher than that in HBV-group (P = 0.021). The IPF development rate in patients with HCV or HBV was high with statistical significance in the following cases: (1) patients ≥ 55 years (P < 0.001); (2) patients who had smoking index (package per day × year) of ≥ 20 (P = 0.002); (3) patients with liver cirrhosis (P = 0.042). CONCLUSION: Our results indicate that age, smoking and liver cirrhosis enhance the development of IPF in HCV positive patients. | Yasuji Arase Fumitaka Suzuki Yoshiyuki Suzuki Norio Akuta Masahiro Kobayashi Yusuke Kawamura Hiromi Yatsuji Hitomi Sezaki Tetsuya Hosaka Miharu Hirakawa Satoshi Saito Kenji Ikeda Hiromitsu Kumada | 2008 | World Journal of Gastroenterology2008，14，38： | 8 |
| 16 | Coexistence of esophageal superficial carcinoma and multiple leiomyomas:A case report显示文摘平滑肌瘤是食管的最普通的良性瘤。他们通常作为单个损害或作为二或三个小瘤发生。仅仅包括超过 10 个小瘤的食道的多重平滑肌瘤的二个案例以前被报导了。而且,有食道的有鳞的房间癌覆闷死粘膜下层肿瘤的很少报告。我们描述作为有表面的食道的癌症与二或三个平滑肌瘤小瘤共存被诊断的一个 71 岁的人。在外科期间, 10 或一直不外科手术前地是明显的更多的小瘤在整个食管在粘膜下层和肌层是摸得出的。当食道的癌症的内部转移被怀疑,我们认为另外的淋巴是腺切除术,但是因为病人的严重血缺氧,不得不排除这种选择。显微镜检查表明所有小瘤是平滑肌瘤(20 损害,在直径的多达 3 厘米) ,并且癌房间的那侵略被限制到粘膜下层层 overlying 一个相对大的平滑肌瘤。这是与众多的独居的平滑肌瘤共存的表面的食道的癌症的第一份报告。多重极小的平滑肌瘤经常也在一个癌损害罐头的底作为内部转移,和一个平滑肌瘤被误诊作为肿瘤侵略被误诊。现在的案例证明那精确诊断与共存为病人的管理被要求表面的食道的癌症和多重平滑肌瘤。 | Takeshi Iwaya Chihaya Maesawa Noriyuki Uesugi Toshimoto Kimura Kenichiro Ikeda Yusuke Kimura Shingo Mitomo Kaoru Ishida Nobuhiro Sato Go Wakabayashi | 2006 | World Journal of Gastroenterology2006，12，28： | 7 |
| 17 | Phase Ⅱ study of protracted irinotecan infusion and a low-dose cisplatin for metastatic gastric cancer显示文摘AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or comple-tion of prior therapy at least 4 wk before enrollment; (4) adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regi-men consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 1, 2, 3, 15, 16, and 17. Treatment was repeated every 4 wk. RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31), 60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia oc-curred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients, respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths occurred.CONCLUSION: This regimen showed a high level of ac-tivity and acceptable toxicity in patients with metastatic gastric cancer. | Hiroshi Imamura Masataka Ikeda Hiroshi Furukawa Toshimasa Tsujinaka Kazumasa Fujitani Kenji Kobayashi Hiroyuki Narahara Michio Kato Haruhiko Imamoto Arimichi Takabayashi Hideaki Tsukuma | 2006 | World Journal of Gastroenterology2006，12，40： | 7 |
| 18 | Clinicopathological features of early gastric cancers arising in Helicobacter pylori uninfected patients显示文摘BACKGROUND Persistent Helicobacter pylori(H.pylori)infection causes chronic inflammation,atrophy of the gastric mucosa,and a high risk of developing gastric cancer.In recent years,awareness of eradication therapy has increased in Japan.As H.pylori infections decrease,the proportion of gastric cancers arising from H.pylori uninfected gastric mucosa will increase.The emergence of gastric cancer arising in H.pylori uninfected patients though rarely reported,is a concern to be addressed and needs elucidation of its clinicopathological features.AIM To evaluate the clinicopathological features of early gastric cancer in H.pyloriuninfected patients.METHODS A total of 2462 patients with 3375 instances of early gastric cancers that were treated by endoscopic submucosal dissection were enrolled in our study between May 2000 and September 2019.Of these,30 lesions in 30 patients were diagnosed as H.pylori-uninfected gastric cancer(Hp UIGC).We defined a patient as H.pylori-uninfected using the following three criteria:(1)The patient did not receive treatment for H.pylori,which was determined by investigating medical recordsand conducting patient interviews;(2)Lack of endoscopic atrophy;and(3)The patient was negative for H.pylori after being tested at least twice using various diagnostic methods,including serum anti-H.pylori-Ig G antibody,urease breath test,rapid urease test,and microscopic examination.RESULTS The frequency of Hp UIGC was 1.2%(30/2462)for the patients in our study.The study included 19 males and 11 females with a mean age of 59 years.The location of the stomach lesions was divided into three sections;upper third(U),middle third(M),lower third(L).Of the 30 lesions,15 were U,1 was M,and 14 were L.Morphologically,17 lesions were protruded and flat elevated type(0-I,0-IIa,0-IIa+IIc),and 13 lesions were flat and depressed type(0-IIb,0-IIc).The median tumor diameter was 8 mm(range 2-98 mm).Histological analysis revealed that22 lesions(73.3%)were differentiated type.The Hp UIGC lesions were classified into fundic gland type adenocarcinoma(7 cases),foveolar type welldifferentiated adenocarcinoma(8 cases),intestinal phenotype adenocarcinoma(7 cases),and pure signet-ring cell carcinoma(8 cases).Among 30 Hp UIGCs,24 lesions(80%)were limited to the mucosa;wherein,the remaining 6 lesions showed submucosal invasion.One of the submucosal invasive lesions showed more than 500μm invasion.The mucin phenotype analysis identified 7 Hp UIGC with intestinal phenotype and 23 with gastric phenotype.CONCLUSION We elucidated the clinicopathological characteristics of Hp UIGC,revealing recognition not only undifferentiated-type but also differentiated-type.In addition,intestinal phenotype tumors were also observed and could be an important tip. | Chiko Sato Kingo Hirasawa Yoko Tateishi Yuichiro Ozeki Atsushi Sawada Ryosuke Ikeda Takehide Fukuchi Masafumi Nishio Ryosuke Kobayashi Makomo Makazu Hiroaki Kaneko Yoshiaki Inayama Shin Maeda | 2020 | World Journal of Gastroenterology2020，26，20： | 7 |
| 19 | Submucosal tunnel endoscopy:Peroral endoscopicmyotomy and peroral endoscopic tumor resection显示文摘Peroral endoscopic myotomy(POEM) is an innovative,minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy(LHM), not only for all types of esophageal achalasia [classical(Ⅰ), vigorous(Ⅱ), spastic(Ⅲ), Chicago Classification], but also for advanced sigmoid type achalasia(S1 and S2), failed LHM, or other esophageal motility disorders(diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction(EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection(POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors(submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. | Nikolas Eleftheriadis Haruhiro Inoue Haruo Ikeda Manabu Onimaru Roberta Maselli Grace Santi | 2016 | World Journal of Gastrointestinal Endoscopy2016，8，2： | 7 |
| 20 | Two distinct pathways of p16 gene inactivation in gallbladder cancer显示文摘AIM: To examine the mechanism of inactivation of the p16 gene in gallbladder cancer,and to investigate p16 alterations and their correlation with clinicopathological features. METHODS: Specimens were collected surgically from 51 patients with gallbladder cancer. We evaluated the status of protein expression,loss of heterozygosity (LOH),homozygous deletion and promoter hypermethylation using immunohistochemistry,microsatellite analysis,quantitative real-time polymerase chain reaction (PCR) and methylation-specific PCR,respectively. In addition,mutations were examined by direct DNA sequencing. RESULTS: Homozygous deletions of the p16 gene exon2,LOH at 9p21-22,p16 promoter hypermethylation,and loss of p16 protein expression were detected in 26.0% (13/50),56.9% (29/51),72.5% (37/51) and 62.7% (32/51),respectively. No mutations were found. LOH at 9p21 correlated with the loss of p16 protein expression (P < 0.05). Homozygous deletion of the p16 gene,a combination LOH and promoter hypermethylation,and multiple LOH at 9p21 were significantly correlated with the loss of p16 protein expression (P < 0.05). LOH at 9p21 and promoter hypermethylation of the p16 gene were detected in 15.4% (2/13) and 92.3% (12/13) of the tumors with homozygous deletion of the p16 gene,respectively. P16 alterations were not associated with clinicopathological features. CONCLUSION: Our results suggest that LOH and homozygous deletion may be two distinct pathways in the inactivation of the p16 gene. Homozygous deletion,a combination of LOH and promoter hypermethylation,and multiple LOH are major mechanisms of p16 inactivation in gallbladder cancer. | Hiroyuki Tadokoro Takako Shigihara Tomomi Ikeda Masaru Takase Masafumi Suyama | 2007 | World Journal of Gastroenterology2007，13，47： | 6 |
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