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| 1 | Patterns of local recurrence in rectal cancer after a multidisciplinary approach显示文摘Improvements in surgery and the application of combined approaches to fight rectal cancer have succeeded in reducing the local recurrence (LR) rate and when there is LR it tends to appear later and less often in isolation. Moreover, a subtle change in the distribution of LRs with respect to the pelvis has been observed. In general terms, prior to total mesorectal excision the most common LRs were central types (perianastomotic and anterior) while lateral and posterior forms (presa-cral) have become more common since the growth in the use of combined treatments. No differences have been reported in the current pattern of LRs as a function of the type of approach used, that is, neo-adjuvant therapies (short-term or long-course radiotherapy, orchemoradiotherapy versus extended lymphadenectomy, though there is a trend towards posterior or presacral LR in patients in the Western world and lateral LR in Asia. Nevertheless, both may arise from the same mechanism. Moreover, as well as the mode of treatment, the type of LR is related to the height of the initial tumor. Nowadays most LRs are related to the advanced nature of the disease. Involvement of the circumferential radial margin and spillage of residual tumor cells from lymphatic leakage in the pelvic side wall are two plausible mechanisms for the genesis of LR. The patterns of pelvic recurrence itself (pelvic subsites) also have important implications for prognosis and are related to the potential success of salvage curative approach. The re-operability for cure and prognosis are generally better for anastomotic and anterior types than for presacral and lateral recurrences. Overall survival after LR diagnosis is lower with radio or chemoradiotherapy plus optimal surgery approaches, compared to optimal surgery alone. | Jose M Enríquez-Navascués Nerea Borda Aintzane Liz-erazu Carlos Placer Jose L Elosegui Juan P Ciria Adelaida Lacasta Luis Bujanda | 2011 | World Journal of Gastroenterology2011,17,13: | 14 |
| 2 | Hepatitis B and inflammatory bowel disease: Role of antiviral prophylaxis显示文摘Hepatitis B virus (HBV) is a very common infection worldwide. Its reactivation in patients receiving immunosuppression has been widely described as being associated with significant morbidity and mortality unless anti-viral prophylaxis is administered. Treatment in inflammatory bowel disease (IBD) patients has changed in recent years and immunosuppression and biological therapies are now used more frequently than before. Although current studies have reported an incidence of hepatitis B in inflammatory bowel disease patients similar to that in the general population, associated liver damage remains an important concern in this setting. Liver dysfunction may manifest in several ways, from a subtle change in serum aminotransferase levels to fulminant liver failure and death. Patients undergoing double immunosuppression are at a higher risk, and reactivation usually occurs after more than one year of treatment. As preventive measures, all IBD patients should be screened for HBV markers at diagnosis and those who are positive for the hepatitis B surface antigen should receive antiviral prophylaxis before undergoing immunosuppression in order to avoid HBV reactivation. Tenofovir/entecavir are preferred to lamivudine as nucleos(t)ide analogues due to their better resistance profile. In patients with occult or resolved HBV, viral reactivation does not appear to be a relevant issue and regular DNA determination is recommended during immunosuppression therapy. Consensus guidelines on this topic have been published in recent years. The prevention and management of HBV infection in IBD patients is addressed in this review in order to address practical | Pilar López-Serrano Jose Lázaro Pérez-Calle Maria Dolores Sánchez-Tembleque | 2013 | World Journal of Gastroenterology2013,19,9: | 12 |
| 3 | Pathogenesis of occult chronic hepatitis B virus infection显示文摘Occult hepatitis B infection(OBI) is characterized by hepatitis B virus(HBV) DNA in serum in the absence of hepatitis B surface antigen(HBsAg) presenting HBsAg-negative and anti-HBc positive serological patterns.Occult HBV status is associated in some cases with mutant viruses undetectable by HBsAg assays;but more frequently it is due to a strong suppression of viral replication and gene expression.OBI is an entity with world-wide diffusion.The failure to detect HBsAg,despite the persistence of the viral DNA,is due in most cases to the strong suppression of viral replication and gene expression that characterizes this'occult'HBV infection;although the mechanisms responsible for suppression of HBV are not well understood.The majority of OBI cases are secondary to overt HBV infection and represent a residual low viremia level suppressed by a strong immune response together with histological derangements which occurred during acute or chronic HBV infection.Much evidence suggests that it can favour the progression of liver fibrosis and the development of hepatocellular carcinoma. | Rocio Aller de la Fuente María L Gutiérrez Javier Garcia-Samaniego Conrado Fernández-Rodriguez Jose Luis Lledó Gregorio Castellano | 2011 | World Journal of Gastroenterology2011,17,12: | 12 |
| 4 | Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation显示文摘Liver transplantation(LT) is the only potentially curative treatment for selected patients with cirrhosis and hepatocellular carcinoma(HCC) who are not candidates for resection. When the Milan criteria are strictly applied, 75% to85%of 3-to 4-year actuarial survival rates are achieved, but up to 20% of the patients experience HCC recurrence after transplantation. The Milan criteria are based on the preoperative tumor macromorphology, tumor size and number on computed tomography or magnetic resonance imaging that neither correlate well with posttransplant histological study of the liver explant nor accurately predict HCC recurrence after LT, since they do not include objective measures of tumor biology. Preoperative biological markers, including alpha-fetoprotein, desgamma-carboxiprothrombin or neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio, can predict the risk for HCC recurrence after transplantation.These biomarkers have been proposed as surrogate markers of tumor differentiation and vascular invasion, with varied risk magnitudes depending on the defined cutoffs. Different studies have shown that the combination of one or several biomarkers integrated into prognostic models predict the risk of HCC recurrence after LT more accurately than Milan criteria alone. In this review, we focus on the potential utility of these serum biological markers to improve the performance of Milan criteria to identify patients at high risk of tumoral Published online: January 27, 2019 recurrence after LT.Liver transplantation(LT) is the only potentially curative treatment for selected patients with cirrhosis and hepatocellular carcinoma(HCC) who are not candidates for resection. When the Milan criteria are strictly applied, 75% to85%of 3-to 4-year actuarial survival rates are achieved, but up to 20% of the patients experience HCC recurrence after transplantation. The Milan criteria are based on the preoperative tumor macromorphology, tumor size and number on computed tomography or magnetic resonance imaging that neither correlate well with posttransplant histological study of the liver explant nor accurately predict HCC recurrence after LT, since they do not include objective measures of tumor biology. Preoperative biological markers, including alpha-fetoprotein, desgamma-carboxiprothrombin or neutrophil-to-lymphocyte ratio and platelet-tolymphocyte ratio, can predict the risk for HCC recurrence after transplantation.These biomarkers have been proposed as surrogate markers of tumor differentiation and vascular invasion, with varied risk magnitudes depending on the defined cutoffs. Different studies have shown that the combination of one or several biomarkers integrated into prognostic models predict the risk of HCC recurrence after LT more accurately than Milan criteria alone. In this review, we focus on the potential utility of these serum biological markers to improve the performance of Milan criteria to identify patients at high risk of tumoral recurrence after LT. | Maria J Citores Jose L Lucena Sara de la Fuente Valentin Cuervas-Mons | 2019 | World Journal of Hepatology2019,11,1: | 12 |
| 5 | Timely reperfusion for ST-segment elevation myocardial infarction:Effect of direct transfer to primary angioplasty on time delays and clinical outcomes显示文摘Primary percutaneous coronary intervention(PPCI) is the preferred reperfusion therapy for patients presenting with ST-segment elevation myocardial infarction(STEMI) when it can be performed expeditiously and by experienced operators. In spite of excellent clinical results this technique is associated with longer delays than thrombolysis and this fact may nullify the benefit of selecting this therapeutic option. Several strategies have been proposed to decrease the temporal delays to deliver PPCI. Among them,prehospital diagnosis and direct transfer to the cath lab,by-passing the emergency department of hospitals,has emerged as anattractive way of diminishing delays. The purpose of this review is to address the effect of direct transfer on time delays and clinical events of patients with STEMI treated by PPCI. | Rodrigo Estévez-Loureiro ángela López-Sainz Armo Pérez de Prado Carlos Cuellas Ramón Calvio Santos Norberto Alonso-Orcajo Jorge Salgado Fernández Jose Manuel Vázquez-Rodríguez Maria López-Benito Felipe Fernández-Vázquez | 2014 | World Journal of Cardiology2014,6,6: | 6 |
| 6 | Transcatheter aortic valve implantation:Current status and future perspectives显示文摘Although surgical aortic valve replacement is the standard therapy for severe aortic stenosis(AS),about one third of patients are considered inoperable due to unacceptable surgical risk.Under medical treatment alone these patients have a very poor prognosis with a mortality rate of 50%at 2 years.Transcatheter aortic valve implantation(TAVI)has been used in these patients,and has shown robust results in the only randomized clinical trial of severe AS treatment performed so far.In this review,we will focus on the two commercially available systems:Edwards SAPIEN valve and CoreValve Revalving system.Both systems have demonstrated success rates of over 90%with 30-d mortality rates below 10%in the most recent transfemoral TAVI studies.Moreover,long-term studies have shown that the valves have good haemodynamic performance.Some studies are currently exploring the non-inferiority of TAVI procedures vs conventional surgery in high-risk patients,and long-term clinical results of the percutaneous valves.In this article we review the current status of TAVI including selection of patients,a comparison of available prostheses,results and complications of the procedure,clinical outcomes,and future perspectives. | Pablo Salinas Raul Moreno Jose L Lopez-Sendon | 2011 | World Journal of Cardiology2011,3,6: | 5 |
| 7 | Counter-regulatory phosphatases TNAP and NPP1 temporally regulate tooth root cementogenesis显示文摘Cementum is critical for anchoring the insertion of periodontal ligament fibers to the tooth root. Several aspects of cementogenesis remain unclear, including differences between acellular cementum and cellular cementum, and between cementum and bone.Biomineralization is regulated by the ratio of inorganic phosphate(Pi) to mineral inhibitor pyrophosphate(PPi), where local Piand PPi concentrations are controlled by phosphatases including tissue-nonspecific alkaline phosphatase(TNAP) and ectonucleotide pyrophosphatase/phosphodiesterase 1(NPP1). The focus of this study was to define the roles of these phosphatases in cementogenesis. TNAP was associated with earliest cementoblasts near forming acellular and cellular cementum. With loss of TNAP in the Alpl null mouse, acellular cementum was inhibited, while cellular cementum production increased, albeit as hypomineralized cementoid. In contrast, NPP1 was detected in cementoblasts after acellular cementum formation, and at low levels around cellular cementum. Loss of NPP1 in the Enpp1 null mouse increased acellular cementum, with little effect on cellular cementum.Developmental patterns were recapitulated in a mouse model for acellular cementum regeneration, with early TNAP expression and later NPP1 expression. In vitro, cementoblasts expressed Alpl gene/protein early, whereas Enpp1 gene/protein expression was significantly induced only under mineralization conditions. These patterns were confirmed in human teeth, including widespread TNAP, and NPP1 restricted to cementoblasts lining acellular cementum. These studies suggest that early TNAP expression creates a low PPienvironment promoting acellular cementum initiation, while later NPP1 expression increases PPi, restricting acellular cementum apposition. Alterations in PPihave little effect on cellular cementum formation, though matrix mineralization is affected. | Laura E Zweifler Mudita K Patel Francisco H Nociti Jr Helen F Wimer Jose L Milln Martha J Somerman Brian L Foster | 2015 | International Journal of Oral Science2015,7,1: | 5 |
| 8 | The role of leptin/adiponectin ratio in metabolic syndrome and diabetes显示文摘 | Patricio López-Jaramillo Diego Gómez-Arbeláez Jose López-López Cristina López-López Javier Martínez-Ortega Andrea Gómez-Rodríguez Stefany Triana-Cubillos | 2014 | Hormone Molecular Biology and Clinical Investigation2014,,1: | 4 |
| 9 | Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy显示文摘AIM To investigate the survival impact of clinicopathological factors, including pathological complete response(p CR) and tumor-infiltrating lymphocytes(s TIL) levels according to subtypes, in breast cancer(BC) patients who received neo-adjuvant chemotherapy(NAC).METHODS We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. s TIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preN AC core biopsy. p CR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, s TIL, p CR and survival were carried out using SPSSvs19.RESULTS Median age was 49 years(range 24-84 years) and the most frequent clinical stage was ⅢB(58.3%). Luminal A, Luminal B, HER2-enriched and(triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. p CR was observed in 11% and median percentage of s TIL was 40%(2%-95%) in the whole population. p CR was associated to Ct1-2(P = 0.045) and to high s TIL(P = 0.029) in the whole population. There was a slight trend towards significance for s TIL(P = 0.054) in Luminal A. s TIL was associated with grade Ⅲ(P < 0.001), no-Luminal A subtype(P < 0.001), RE-negative(P < 0.001), PgR-negative(P < 0.001), HER2-positive(P = 0.002) and p CR(P = 0.029) in the whole population. Longer disease-free survival was associated with grade Ⅰ-Ⅱ(P = 0.006), cN 0(P < 0.001), clinical stage Ⅱ(P = 0.004), ER-positive(P < 0.001), Pg R-positive(P < 0.001), luminal A(P < 0.001) and p CR(P = 0.002). Longer disease-free survival was associated with grade Ⅰ-Ⅱ in Luminal A(P < 0.001), N0-1 in Luminal A(P = 0.045) and TNBC(P = 0.01), clinical stage Ⅱ in Luminal A(P = 0.003) and TNBC(P = 0.038), and pC R in TNBC(P < 0.001). Longer overall survival was associated with grade Ⅰ-Ⅱ(P < 0.001), ER-positive(P < 0.001), PgR-positive(P < 0.001), Luminal A(P < 0.001), cN 0(P = 0.002) and p CR(P = 0.002) in the whole population. Overall survival was associated with clinical stage Ⅱ(P = 0.017) in Luminal A, older age(P = 0.042) in Luminal B, and pC R in TNBC(P = 0.005).CONCLUSION Predictive and prognostic values of clinicopathological features, like p CR and s TIL, differ depending on the evaluated molecular subtype. | Marco Galvez Carlos A Castaneda Joselyn Sanchez Miluska Castillo Lia Pamela Rebaza Gabriela Calderon Miguel De La Cruz Jose Manuel Cotrina Julio Abugattas Jorge Dunstan Henry Guerra Omar Mejia Henry L Gomez | 2018 | World Journal of Clinical Oncology2018,9,2: | 4 |
| 10 | Fecal immunochemical test accuracy in average-risk colorectal cancer screening显示文摘AIM:To assess the fecal immunochemical test(FIT)accuracy for colorectal cancer(CRC)and advanced neoplasia(AN)detection in CRC screening.METHODS:We performed a multicentric,prospective,double blind study of diagnostic tests on asymptomatic average-risk individuals submitted to screening colonoscopy.Two stool samples were collected and the fecal hemoglobin concentration was determined in the first sample(FIT1)and the highest level of both samples(FITmax)using the OC-sensor.Areas under the curve(AUC)for CRC and AN were calculated.The best FIT1and FITmax cut-off values for CRC were determined.At this threshold,number needed to scope(NNS)to detect a CRC and an AN and the cost per lesion detected were calculated.RESULTS:About 779 individuals were included.An AN was found in 97(12.5%)individuals:a CRC in 5(0.6%)and an advanced adenoma(≥10 mm,villous histology or high grade dysplasia)in 92(11.9%)subjects.For CRC diagnosis,FIT1 AUC was 0.96(95%CI:0.95-0.98)and FITmax AUC was 0.95(95%CI:0.93-0.97).For AN,FIT1 and FITmax AUC were similar(0.72,95%CI:0.66-0.78 vs 0.73,95%CI:0.68-0.79,respectively,P=0.34).Depending on the number of determinations and the positivity threshold cut-off used sensitivity for AN detection ranged between 28%and 42%and specificity between 91%and 97%.At the best cut-off point for CRC detection(115 ng/mL),the NNS to detect a CRC were 10.2 and 15.8;and the cost per CRC was 1814€and 2985€on FIT1 and FITmax strategies respectively.At this threshold the sensitivity,NNS and cost per AN detected were 30%,1.76,and 306€,in FIT1 strategy,and 36%,2.26€and 426€,in FITmax strategy,respectively.CONCLUSION:Performing two tests does not improve diagnostic accuracy,but increases cost and NNS to detect a lesion. | Vicent Hernandez Joaquin Cubiella M Carmen Gonzalez-Mao Felipe Iglesias Concepción Rivera M Begoa Iglesias Lucía Cid Ines Castro Luisa de Castro Pablo Vega Jose Antonio Hermo Ramiro Macenlle Alfonso Martínez-Turnes David Martínez-Ares Pamela Estevez Estela Cid M Carmen Vidal Angeles López-Martínez Elisabeth Hijona Marta Herreros-Villanueva Luis Bujanda Jose Ignacio Rodriguez-Prada the COLONPREV study investigators | 2014 | World Journal of Gastroenterology2014,20,4: | 4 |
| 11 | Aplastic anemia and severe pancytopenia during treatment with peg-interferon,ribavirin and telaprevir for chronic hepatitis C显示文摘Telaprevir and Boceprevir are the first direct acting antivirals approved for chronic hepatitis C in combination with peg-interferon alfa and ribavirin.Pancytopenia due to myelotoxicity caused by these drugs may occur,but severe hematological abnormalities or aplastic anemia(AA) have not been described.We collected all cases of severe pancytopenia observed during triple therapy with telaprevir in four Spanish centers since approval of the drug in 2011.Among 142 cirrhotic patients receiving treatment,7 cases of severe pancytopenia(5%) were identified and three were consistent with the diagnosis of AA.Mean age was 59 years,five patients had compensated cirrhosis and two patients had severe hepatitis C recurrence after liver transplantation.Severe pancytopenia was diagnosed a median of 10 wk after the initiation of therapy.Three patients had pre-treatment hematological abnormalities related to splenomegaly.In six patients,antiviral treatment was interrupted at the onset of hematological abnormalities.Two patients died due to septic complications and one patient due to acute alveolar hemorrhage.The remaining patients recovered.Severe pancytopenia and especially AA,are not rare during triple therapy with telaprevir in patients with advanced liver disease.Close monitoring is imperative in this setting to promptly detect serious hematological disorders and to prevent further complications. | Sabela Lens Jose L Calleja Ana Campillo Jose A Carrion Teresa Broquetas Christie Perello Juan de la Revilla Zoe Marino Maria-Carlota Londono Jose M Sanchez-Tapias Alvaro Urbano-Ispizua Xavier Forns | 2015 | World Journal of Gastroenterology2015,21,17: | 4 |
| 12 | Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents显示文摘AIM: To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. METHODS: Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness(CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. RESULTS: The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. CONCLUSION: The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness. | Regina Vila-Badia Francisco Martínez-Zambrano Otilia Arenas Emma Casas-Anguera Esther García-Morales Raúl Villellas José Ramón Martín María Belén Pérez-Franco Tamara Valduciel Diana Casellas Mar García-Franco Jose Miguel Joaquim Balsera Gemma Pascual Eugènia Julia Susana Ochoa | 2016 | World Journal of Psychiatry2016,6,2: | 4 |
| 13 | Hepatitis B and immunosuppressive therapies for chronic inflammatory diseases: When and how to apply prophylaxis, with a special focus on corticosteroid therapy显示文摘Currently immunosuppressive and biological agentsare used in a more extensive and earlier way in patients with inflammatory bowel disease, rheumatic or dermatologic diseases. Although these drugs have shown a significant clinical benefit, the safety of these treatments is a challenge. Hepatitis B virus(HBV) reactivations have been reported widely, even including liver failure and death, and it represents a deep concern in these patients. Current guidelines recommend to preemptive therapy in patients with immunosuppressants in general, but preventive measures focused in patients with corticosteroids and inflammatory diseases are scarce. Screening for HBV infection should be done at diagnosis. The patients who test positive for hepatitis B surface antigen, but do not meet criteria for antiviral treatment must receive prophylaxis before undergoing immunosuppression, including corticosteroids at higher doses than prednisone 20 mg/d during more than two weeks. Tenofovir and entecavir are preferred than lamivudine because of their better resistance profile in long-term immunosuppressant treatments. There is not a strong evidence, to make a general recommendation on the necessity of prophylaxis therapy in patients with inflammatory diseases that are taking low doses of corticosteroids in short term basis or low systemic bioavailability corticosteroids such as budesonide or beclomethasone dipropionate. In these cases regularly HBV DNA monitoring is recommended, starting early antiviral therapy if DNA levels begin to rise. In patients with occult or resolved hepatitis the risk of reactivation is much lower, and excepting for Rituximab treatment, the prophylaxis is not necessary. | Pilar López-Serrano Elsa de la Fuente Briongos Elisa Carrera Alonso Jose Lázaro Pérez-Calle Conrado Fernández | 2015 | World Journal of Hepatology2015,7,3: | 4 |
| 14 | Hepatic flow is an intraoperative predictor of early allograft dysfunction in whole-graft deceased donor liver transplantation: An observational cohort study显示文摘BACKGROUND Early allograft dysfunction(EAD)after liver transplantation(LT)is an important cause of morbidity and mortality.To ensure adequate graft function,a critical hepatocellular mass is required in addition to an appropriate blood supply.We hypothesized that intraoperative measurement of portal venous and hepatic arterial flow may serve as a predictor in the diagnosis of EAD.AIM To study whether hepatic flow is an independent predictor of EAD following LT.METHODS This is an observational cohort study in a single institution.Hepatic arterial blood flow and portal venous blood flow were measured intraoperatively by transit flow.EAD was defined using the Olthoff criteria.Univariate and multivariate analyses were used to determine the intraoperative predictors of EAD.Survival analysis and prognostic factor analysis were performed using the Kaplan-Meier and Cox regression models.RESULTS A total of 195 liver transplant procedures were performed between January 2008 and December 2014 in 188 patients.A total of 54(27.7%)patients developed EAD.The median follow-up was 39 mo.Portal venous flow,hepatic arterial flow(HAF)and total hepatic arterial flow were associated with EAD in both the univariate and multivariate analyses.HAF is an independent prognostic factor for 30-d patient mortality.CONCLUSION Intraoperative measurement of blood flow after reperfusion appears to be a predictor of EAD;Moreover,HAF should be considered a predictor of 30-d patient mortality. | Pablo Lozano Lominchar Maitane Igone Orue-Echebarria Lorena Martín Cristina Julia Lisbona María Magdalena Salcedo Luis Olmedilla Hemant Sharma Jose Manuel Asencio JoséAngel López-Baena | 2019 | World Journal of Hepatology2019,11,9: | 4 |
| 15 | Proteomic analysis for developing new biomarkers of hepatocellular carcinoma显示文摘AIM: To identify new markers of hepatocellular carcinoma (HCC) using a proteomic analysis. METHODS: Patients with liver cirrhosis of the three most frequent etiologies: hepatitis C virus, hepatitis B virus and alcoholic liver disease, were included in the study. The samples were analysed by 2D-electrophoresis in order to determine the differential protein expression. The proteins were separated according to the charge in immobilized pH 3-10 gradient strips and then by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Proteins of interest were excised, digested with trypsin and the resulting peptides were separated and identified. RESULTS: Three differentially expressed apolipoproteins (Apo) were identified based on the protein profile using proteomic techniques: Apo-A1, Apo-A4 and Apo-E. Apo-A4 levels were significantly lower in HCC than in non-HCC patients regardless of etiology (P < 0.01). Multivariate logistic regression showed that Apo-A4 and Apo-A1 were the only independent factors related to HCC diagnosis (P < 0.05). The receiver operating characteristic (ROC) curve including both Apo-A4 and Apo-A1 showed an area under the ROC of 0.944 (P < 0.001), a sensitivity of 0.89 and a specificity of 0.81 for diagnosis of HCC. CONCLUSION: Apo-A4 and Apo-A1 may be used clinically as biomarkers of HCC with a high sensibility and specificity. These findings may provide additional insights into the mechanism of HCC development and progression. | Maria Pleguezuelo Laura M Lopez-Sanchez Antonio Rodriguez-Ariza Jose L Montero Javier Briceno Ruben Ciria Jordi Muntane Manuel de la Mata | 2010 | World Journal of Hepatology2010,2,3: | 3 |
| 16 | A framework infrageneric classification of Carex (Cyperaceae) and its organizing principles显示文摘Phylogenetic studies of Carex L.(Cyperaceae)have consistently demonstrated that most subgenera and sections are para-or polyphyletic.Yet,taxonomists continue to use subgenera and sections in Carex classification.Why?The Global Carex Group(GCG)here takes the position that the historical and continued use of subgenera and sections serves to(i)organize our understanding of lineages in Carex,(ii)create an identification mechanism to break the~2000 species of Carex into manageable groups and stimulate its study,and(iii)provide a framework to recognize morphologically diagnosable lineages within Carex.Unfortunately,the current understanding of phylogenetic relationships in Carex is not yet sufficient for a global reclassification of the genus within a Linnean infrageneric(sectional)framework.Rather than leaving Carex classification in its current state,which is misleading and confusing,we here take the intermediate steps of implementing the recently revised subgeneric classification and using a combination of informally named clades and formally named sections to reflect the current state of our knowledge.This hybrid classification framework is presented in an order corresponding to a linear arrangement of the clades on a ladderized phylogeny,largely based on the recent phylogenies published by the GCG.It organizes Carex into six subgenera,which are,in turn,subdivided into 62 formally named Linnean sections plus 49 informal groups.This framework will serve as a roadmap for research on Carex phylogeny,enabling further development of a complete reclassification by presenting relevant morphological and geographical information on clades where possible and standardizing the use of formal sectional names. | Eric H.Roalson Pedro Jiménez-Mejías Andrew L.Hipp Carmen Benítez-Benítez Leo P.Bruederle Kyong-Sook Chung Marcial Escudero Bruce A.Ford Kerry Ford Sebastian Gebauer Berit Gehrke Marlene Hahn Muhammad Qasim Hayat Mathias H.Hoffmann Xiao-Feng Jin Sangtae Kim Isabel Larridon Étienne Léveillé-Bourret Yi-Fei Lu Modesto Luceño Enrique Maguilla Jose IgnacioMárquez-Corro Santiago Martín-Bravo Tomomi Masaki Mónica Míguez Robert F.C.Naczi Anton A.Reznicek Daniel Spalink Julian R.Starr Uzma Tamara Villaverde Marcia J.Waterway Karen L.Wilson and Shu-Ren Zhang | 2021 | Journal of Systematics and Evolution2021,59,4: | 3 |
| 17 | Papillary fistulotomy vs conventional cannulation for endoscopic biliary access:A prospective randomized trial显示文摘AIM To compare the cannulation success, biochemical profile, and complications of the papillary fistulotomy technique vs catheter and guidewire standard access.METHODS From July 2010 to May 2017, patients were prospectively randomized into two groups: Cannulation with a catheter and guidewire(Group Ⅰ) and papillary fistulotomy(Group Ⅱ). Amylase, lipase and C-reactive protein at T0, as well as 12 h and 24 h after endoscopic retrograde cholangiopancreatography, and complications(pancreatitis, bleeding, perforation) were recorded.RESULTS We included 102 patients(66 females and 36 males, mean age 59.11 ± 18.7 years). Group Ⅰ and Group Ⅱ had 51 patients each. The successful cannulation rates were 76.5% and 100%, respectively(P = 0.0002). Twelve patients(23.5%) in Group Ⅰ had a difficult cannulation and underwent fistulotomy, which led to successful secondary biliary access(Failure Group). The complication rate was 13.7%(2 perforations and 5 mild pancreatitis) vs 2.0%(1 patient with perforation and pancreatitis) in Groups Ⅰ and Ⅱ, respectively(P = 0.0597). CONCLUSION Papillary fistulotomy was more effective than guidewire cannulation, and it was associated with a lower profile of amylase and lipase. Complications were similar in both groups. | Carlos Kiyoshi Furuya Paulo Sakai Fabio Ramalho Tavares Marinho Jose Pinhata Otoch Spencer Cheng Lívia Lemes Prudencio Eduardo Guimaraes Hourneaux de Moura Everson Luiz de Almeida Artifon | 2018 | World Journal of Gastroenterology2018,24,16: | 2 |
| 18 | DNA damage induced by chronic inflammation contributes to colon carcinogenesis in mice显示文摘 | Meira Lisiane B Bugni James M Green Stephanie L Lee Chung-Wei Pang Bo Borenshtein Diana Rickman Barry H Rogers Arlin B Moroski-Erkul Catherine A McFaline Jose L Schauer David B Dedon Peter C Fox James G Samson Leona D | 2008 | Journal of Clinical Investigation2008,,7: | 2 |
| 19 | 接受纤溶治疗的ST段抬高心肌梗死患者在经皮冠状动脉介入治疗前服用氯吡格雷的效果:PCI-CLARITY研究显示文摘背景:关于经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)前氯吡格雷预治疗的益处目前仍有争议,并且其使用亦未获得普遍认可。
目的:于新近发生ST段抬高心肌梗死(ST—segment elevation myocardial infarction,STEMI)的患者中确定PCI前氯吡格雷预治疗预防严重不良心血管事件的效果是否优于PCI时开始采用氯吡格雷治疗。
设计、地点及参试者:CLARITY(PCI—Clopidogrel as Adjunctive Reperfusion Therapy)研究是一项于1863例患者中进行的前瞻性计划分析。这些患者均于CLARITY—TIMI(Thrombolysis in Myocardial Infarction)28试验中在血管造影后实施了PCI。CLARITY—TIMI28是一项在接受纤溶治疗的患者中进行的有关氯吡格雷效果的随机、双盲、安慰剂对照试验。患者于2003年2月至2004年10月入选自23个国家的319家医院。
干预:患者服用阿斯匹林并于纤溶治疗时开始随机接受氯吡格雷(300mg负荷剂量,以后75mg,每日1次)或安慰剂,直至冠状动脉造影前为止。造影在开始研究药物后2~8天进行。接受冠脉支架的患者建议于诊断性血管造影后给予开标氯吡格雷(包括负荷剂量)。
主要观测指标:一级终点为PCI至随机分组后30天心血管死亡、MI复发或脑卒中的复合发生率。二级终点包括在PCI之前发生的MI或脑卒中以及前述随机分组后30天相关终点。
结果:氯吡格雷预治疗可显著降低PCI后心血管死亡、MI或脑卒中的发生率(34[3.6%]比58[6.2%];校正优势比[odds ratio,OR],0.54[95%CI,0.35—0.85];P=0.008)。氯吡格雷预治疗还可降低PCI前MI或脑卒中的发生率(37[4.0%]比58[6.2%];OR,0.62[95%CI,0.40~0.95];P=0.03)。总体上,氯吡格雷预治疗可导致随机分组后30天心血管死亡、MI或脑卒中显著下降(70[7.5%]比112[12.0%];校正OR,0.59[95%CI,0.43~0.81];P=0.001;所需治疗例数=23)。TIMI严重或轻微出血的发生率未显著增加((18[20%]比17[1.9%];P〉0.99)。
结论:氯吡格雷预治疗可显著降低PCI前后心血管死亡或缺血并发症,而严重或轻微出血无显著增加。这些数据为STEMI患者早期使用氯吡格雷以及接受PCI的患者常规采用氯吡格雷预治疗方案提供了进一步的支持。 | Marc S. Sabatine Christopher P.Cannon C. Michael Gibson Jose L Lopez-Sendon Gilles Montalescot Pierre Theroux Basil S. Lewis Sabina A. Murphy Carolyn H. McCabe Eugene Braunwald 李呈亿(译) | 2006 | 美国医学会杂志(中文版)2006,25,4: | 2 |
| 20 | Translational pancreatic cancer research:a comparative study on patient-derived xenograft models显示文摘AIM To assess the viability of orthotopic and heterotopic patient-derived pancreatic cancer xenografts implanted into nude mice.METHODS This study presents a prospective experimental analytical follow-up of the development of tumours in mice upon implantation of human pancreatic adenocarcinoma samples. Specimens were obtained surgically from patients with a pathological diagnosis of pancreatic adenocarcinoma. Tumour samples from pancreatic cancer patients were transplanted into nude mice in three different locations(intraperitoneal, subcutaneous and pancreatic). Histological analysis(haematoxylin-eosin and Masson's trichrome staining) and immunohistochemical assessment of apoptosis(TUNEL), proliferation(Ki-67), angiogenesis(CD31) and fibrogenesis(α-SMA) were performed. When a tumour xenograft reached the target size, it was reimplanted in a new nude mouse. Three sequential tumour xenograft generations were generated(F1, F2 and F3).RESULTS The overall tumour engraftment rate was 61.1%. The subcutaneous model was most effective in terms of tissue growth(69.9%), followed by intraperitoneal(57.6%) and pancreatic(55%) models. Tumour development was faster in the subcutaneous model(17.7 ± 2.6 wk) compared with the pancreatic(23.1 ± 2.3 wk) and intraperitoneal(25.0 ± 2.7 wk) models(P = 0.064). There was a progressive increase in the tumour engraftment rate over successive generations for all three models(F1 28.1% vs F2 71.4% vs F3 80.9%, P < 0.001). There were no significant differences in tumour xenograft differentiation and cell proliferation between human samples and the three experimental models among the sequential generations of tumour xenografts. However, a progressive decrease in fibrosis, fibrogenesis, tumour vascularisation and apoptosis was observed in the three experimental models compared with the human samples. All three pancreatic patient-derived xenograft models presented similar histological and immunohistochemical characteristics.CONCLUSION In our experience, the faster development andgreatest number of viable xenografts could make the subcutaneous model the best option for experimentation in pancreatic cancer. | Mercedes Rubio-Manzanares Dorado Luis Miguel Marín Gómez Daniel Aparicio Sánchez Sheila Pereira Arenas Juan Manuel Praena-Fernández Juan Jose Borrero Martín Francisco Farfán López Miguel ángel Gómez Bravo Jordi Muntané Relat Javier Padillo Ruiz | 2018 | World Journal of Gastroenterology2018,24,7: | 2 |