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1Portal vein thrombosis:Insight into physiopathology,diagnosis,and treatment显示文摘Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient's outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients' future prognoses.Francesca R Ponziani Maria A Zocco Chiara Campanale Emanuele Rinninella Annalisa Tortora Luca Di Maurizio Giuseppe Bombardieri Raimondo De Cristofaro Anna M De Gaetano Raffaele Landolfi Antonio Gasbarrini 2010World Journal of Gastroenterology2010,16,2:75
2帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh 2021中华肿瘤防治杂志2021,28,24:49
3Diarrhoea-predominant irritable bowel syndrome distinguishable by 16S rRNA gene phylotype quantification显示文摘AIM:To study whether selected bacterial 16S ribosomal RNA(rRNA)gene phylotypes are capable of disting- uishing irritable bowel syndrome(IBS). METHODS:The faecal microbiota of twenty volunteers with IBS,subdivided into eight diarrhoea-predominant (IBS-D),eight constipation-predominant(IBS-C)and four mixed symptom-subtype(IBS-M)IBS patients,and fifteen control subjects,were analysed at three time-points with a set of fourteen quantitative real-timepolymerase chain reaction assays.All assays targeted 16S rRNA gene phylotypes putatively associated with IBS,based on 16S rRNA gene library sequence analysis. The target phylotypes were affiliated with Actinobac-teria,Bacteroidetes and Firmicutes.Eight of the target phylotypes had less than 95%similarity to cultured bacterial species according to their 16S rRNA gene sequence.The data analyses were made with repeated-measures ANCOVA-type modelling of the data and principle component analysis(PCA)with linear mixed-effects models applied to the principal component scores. RESULTS:Bacterial phylotypes Clostridium cocleatum 88%,Clostridium thermosuccinogenes 85%,Coprobacillus catenaformis 91%,Ruminococcus bromii-like, Ruminococcus torques 91%,and R.torques 93%were detected from all samples analysed.A multivariate analysis of the relative quantities of all 14 bacterial 16S rRNA gene phylotypes suggested that the intestinal microbiota of the IBS-D patients differed from other sample groups.The PCA on the first principal component(PC1),explaining 30.36%of the observed variation in the IBS-D patient group,was significantly altered from all other sample groups(IBS-D vs control, P=0.01;IBS-D vs IBS-M,P=0.00;IBS-D vs IBS-C, P=0.05).Significant differences were also observed in the levels of distinct phylotypes using relative values in proportion to the total amount of bacteria.A phy- lotype with 85%similarity to C.thermosuccinogenes was quantified in significantly different quantities among the IBS-D and control subjects(-4.08±0.90 vs -3.33±1.16,P=0.04)and IBS-D and IBS-M subjects (-4.08±0.90 vs-3.08±1.38,P=0.05).Furthermore,a phylotype with 94%similarity to R.torques was more prevalent in IBS-D patients'intestinal micro- biota than in that of control subjects(-2.43±1.49 vs -4.02±1.63,P=0.01).A phylotype with 93%simi- larity to R.torques was associated with control sam- ples when compared with IBS-M(-2.41±0.53 vs -2.92±0.56,P=0.00).Additionally,a R.bromii-like phylotype was associated with IBS-C patients in com- parison to control subjects(-1.61±1.83 vs-3.69± 2.42,P=0.01).All of the above mentioned phylotype specific alterations were independent of the effect of time. CONCLUSION:Significant phylotype level alterationsin the intestinal microbiotas of IBS patients were observed,further emphasizing the possible contribution of the gastrointestinal microbiota in IBS.Anna Lyra Teemu Rinttil Janne Nikkil Lotta Krogius-Kurikka Kajsa Kajander Erja Malinen Jaana Mtt Laura Mkel Airi Palva 2009World Journal of Gastroenterology2009,15,47:26
4New aspects in the pathomechanism and diagnosis of the laryngopharyngeal reflux-clinical impact of laryngeal proton pumps and pharyngeal p H metry in extraesophageal gastroesophageal reflux disease显示文摘AIM:To determine the laryngeal H+K+-ATPase and pharyngeal p H in patients with laryngopharyngeal reflux(LPR)-symptoms as well as to assess the symptom scores during PPI therapy.METHODS:Endoscopy was performed to exclude neoplasia and to collect biopsies from the posterior cricoid area(immunohistochemistry and PCR analysis).Immunohistochemical staining was performed with monoclonal mouse antibodies against human H+K+-ATPase.Quantitative real-time RT-PCR for each of the H+K+-ATPase subunits was performed.The p H values were assessed in the aerosolized environment of the oropharynx(Dxp H Catheter) and compared to a subsequently applied combined p H/MII measurement.RESULTS:Twenty patients with LPR symptoms were included.In only one patient,the laryngeal H+K+-ATPase was verified by immunohistochemical staining.In another patient,real-time RT-PCR for each H+K+-ATPase subunit was positive.Fourteen out of twenty patients had pathological results in Dxp H,and 6/20 patients had pathological results in p H/MII.Four patients had pathological results in both functional tests.Nine out of twenty patients responded to PPIs.CONCLUSION:The laryngeal H+K+-ATPase can only be sporadically detected in patients with LPR symptoms and is unlikely to cause the LPR symptoms.Alternative hypotheses for the pathomechanism are needed.The role of pharyngeal p H-metry remains unclearand its use can only be recommended for patients in a research study setting.Valentin Becker Romina Drabner Simone Graf Christoph Schlag Simon Nennstiel Anna Maria Buchberger Roland M Schmid Dieter Saur Monther Bajbouj 2015World Journal of Gastroenterology2015,21,3:14
5Small bowel tumors detected and missed during capsule endoscopy: Single center experience显示文摘AIM:To characterize small bowel(SB)tumors detected by capsule endoscopy(CE),and identify missed tumors.METHODS:The study included 145 consecutive patients in whom 150 CEs were performed.Following CE,the medical records of the study population were reviewed.Results of double-or single-balloon enteroscopy performed after CE and the results of surgery in all patients operated on were retrieved.The patients were contacted through telephone interviews or postal mail.In addition,the national cancer registry and the polish clinical gastrointestinal stromal tumor(GIST)Registry were searched to identify missed neoplasms.RESULTS:Indications for CE included overt and occult obscure gastrointestinal bleeding(n=81,53.7%),anemia(n=19,12.7%),malabsorption(n=18,12%),abnormal CB follow through(n=9,6%),abdominal pain(n=7,5%),celiac disease(n=5,3%),neuroendocrine tumor(n=3,2%),Crohn’s disease(n=2,<2%),Peutz-Jeghers syndrome(n=2,<2%),other polyposes(n=2,<2%),and diarrhea(n=2,<2%).The capsule reached the colon in 115(76.6%)examinations.In 150 investigations,CE identified 15SB tumors(10%),14 of which were operated on or treated endoscopically.Malignancies included metastatic melanoma(n=1),adenocarcinoma(n=2),and GIST(n=3).Benign neoplasms included dysplastic Peutz-Jeghers polyps(n=4).Non-neoplastic masses included venous malformation(n=1),inflammatory tumors(n=2),and a mass of unknown histology(n=1).During the follow-up period,three additional SB tumors were found(2 GISTs and one mesenteric tumor of undefined nature).The National Cancer Registry and Polish Clinical GIST Registry revealed no additional SB neoplasms in the post-examination period(follow-up:range 4.2-102.5 mo,median 39 mo).The sensitivity of CE for tumor detection was 83.3%,and the negative predictive value was 97.6%.The specificity and positive predictive value were both 100%.CONCLUSION:Neoplasms may be missed by CE,especially in the proximal SB.In overt obscure gastrointestinal bleeding,complementary endoscopic and/or radiologic diagnostic tests are indicated.Edyta S Zagorowicz Anna M Pietrzak Ewa Wronska Jacek Pachlewski Piotr Rutkowski Ewa Kraszewska Jaroslaw Regula 2013World Journal of Gastroenterology2013,19,47:10
6Underexpression of LATS1 TSG in colorectal cancer is associated with promoter hypermethylation显示文摘AIM:To investigate large tumor suppressor 1 (LATS1 ) expression, promoter hypermethylation, and microsatellite instability in colorectal cancer (CRC).METHODS:RNA was isolated from tumor tissue of 142 CRC patients and 40 colon mucosal biopsies of healthy controls. After reverse transcription, quantitative polymerase chain reaction (PCR) was performed, and LATS1 expression was normalized to expression of the ACTB and RPL32 housekeeping genes. To analyze hypermethylation, genomic DNA was isolated from 44 tumor CRC biopsies, and methylation-specific PCR was performed. Microsatellite instability (MSI) status was checked with PCR using BAT26, BAT25, and BAT40 markers in the genomic DNA of 84 CRC patients, followed by denaturing gel electrophoresis. RESULTS:Decreased LATS1 expression was found in 127/142 (89.4%) CRC cases with the average ratio of the LATS1 level 10.33 ± 32.64 in CRC patients vs 32.85 ± 33.56 in healthy controls. The lowest expression was found in Dukes' B stage tumors and G1 (welldifferentiated) cells. Hypermethylation of the LATS1 promoter was present in 25/44 (57%) CRC cases analyzed. LATS1 promoter hypermethylation was strongly associated with decreased gene expression; methylated cases showed 162× lower expression of LATS1 than unmethylated cases. Although high-grade MSI (mutation in all three markers) was found in 14/84 (17%) cases and low-grade MSI (mutation in 1-2 markers) was found in 30/84 (36%) cases, we found no association with LATS1 expression. CONCLUSION:Decreased expression of LATS1 in CRC was associated with promoter hypermethylation, but not MSI status. Such reduced expression may promote progression of CRC.Piotr M Wierzbicki Krystian Adrych Dorota Kartanowicz Marcin Stanislawowski Anna Kowalczyk Janusz Godlewski Iwona Skwierz-Bogdanska Krzysztof Celinski Tomasz Gach Jan Kulig Bartlomiej Korybalski Zbigniew Kmiec 2013World Journal of Gastroenterology2013,19,27:8
7如何设计高质量针刺临床研究:基于证据的专家共识显示文摘本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究小组联合制订。该共识将有助于临床试验资助者、注册者以及期刊编辑等评估针刺RCT方案及研究结果的相关性、重要性和质量。张誉清 焦睿珉 Claudia M Witt 劳力行 刘建平 Lehana Thabane Karen J Sherman Mike Cummings Dawn P Richards Eun-Kyung Anna Kim Tae-Hun Kim Myeong Soo Lee Michael E Wechsler Benno Brinkhaus Jun J Mao Caroline A Smith 岗卫娟 刘保延 刘志顺 刘岩 郑晖 吴佳霓 AloBSO Carrasco-Labra Mohit Bhandari Philip J Devereaux 景向红 Gordon Guyatt 2022英国医学杂志中文版2022,25,6:7
8Contribution of functional KIR3DL1 to ankylosing spondylitis显示文摘Increasing evidence points to a role for killer immunoglobulin-like receptors(KIRs)in the development of autoimmune diseases.In particular,a positive association of KIR3DS1(activating receptor)and a negative association of KIR3DL1(inhibitory receptor)alleles with ankylosing spondylitis(AS)have been reported by several groups.However,none of the studies analyzed these associations in the context of functionality of polymorphic KIR3DL1.To better understand how the KIR3DL1/3DS1 genes determine susceptibility to AS,we analyzed the frequencies of alleles and genotypes encoding functional(KIR3DL1*F)and non-functional(KIR3DL1*004)receptors.We genotyped 83 AS patients and 107 human leukocyte antigen(HLA)-B27-positive healthy controls from the Russian Caucasian population using a two-stage sequence-specific primer PCR,which distinguishes KIR3DS1,KIR3DL1*F and KIR3DL1*004 alleles.For the patients carrying two functional KIR3DL1 alleles,those alleles were additionally genotyped to identify KIR3DL1*005 and KIR3DL1*007 alleles,which are functional but are expressed at low levels.KIR3DL1 was negatively associated with AS at the expense of KIR3DL1*F but not of KIR3DL1*004.This finding indicates that the inhibitory KIR3DL1 receptor protects against the development of AS and is not simply a passive counterpart of the segregating KIR3DS1 allele encoding the activating receptor.However,analysis of genotype frequencies indicates that the presence of KIR3DS1 is a more important factor for AS susceptibility than the absence of KIR3DL1*F.The activation of either natural killer(NK)or T cells via the KIR3DS1 receptor can be one of the critical events in AS development,while the presence of the functional KIR3DL1 receptor has a protective effect.Nevertheless,even individuals with a genotype that carried two inhibitory KIR3DL1 alleles expressed at high levels could develop AS.Ivan V Zvyagin Ilgar Z Mamedov Olga V Britanova Dmitriy B Staroverov Evgeni L Nasonov Anna G Bochkova Anna V Chkalina Alexei A Kotlobay Dmitriy O Korostin Denis V Rebrikov Sergey Lukyanov Yuri B Lebedev Dmitriy M Chudakov 2010Cellular & Molecular Immunology2010,7,6:5
9Software for automated classification of probe-based confocal laser endomicroscopy videos of colorectal polyps显示文摘AIM:To support probe-based confocal laser endomi-croscopy (pCLE) diagnosis by designing software for the automated classification of colonic polyps. METHODS:Intravenous fluorescein pCLE imaging of colorectal lesions was performed on patients under-going screening and surveillance colonoscopies, followed by polypectomies. All resected specimens were reviewed by a reference gastrointestinal pathologist blinded to pCLE information. Histopathology was used as the criterion standard for the differentiation between neoplastic and non-neoplastic lesions. The pCLE video sequences, recorded for each polyp, were analyzed off-line by 2 expert endoscopists who were blinded to the endoscopic characteristics and histopathology. These pCLE videos, along with their histopathology diagnosis, were used to train the automated classification software which is a content-based image retrieval technique followed by k-nearest neighbor classification. The performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists was compared with that of automated pCLE software classification. All evaluations were performed using leave-one-patient- out cross-validation to avoid bias. RESULTS:Colorectal lesions (135) were imaged in 71 patients. Based on histopathology, 93 of these 135 lesions were neoplastic and 42 were non-neoplastic. The study found no statistical significance for the difference between the performance of automated pCLE software classification (accuracy 89.6%, sensitivity 92.5%, specificity 83.3%, using leave-one-patient-out cross-validation) and the performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists (accuracy 89.6%, sensitivity 91.4%, specificity 85.7%). There was very low power (< 6%) to detect the observed differences. The 95% confidence intervals for equivalence testing were:-0.073 to 0.073 for accuracy, -0.068 to 0.089 for sensitivity and -0.18 to 0.13 for specificity. The classification software proposed in this study is not a 'black box' but an informative tool based on the query by example model that produces, as intermediate results, visually similar annotated videos that are directly interpretable by the endoscopist. CONCLUSION:The proposed software for automated classification of pCLE videos of colonic polyps achieves high performance, comparable to that of off-line diagnosis of pCLE videos established by expert endoscopists.Barbara André Tom Vercauteren Anna M Buchner Murli Krishna Nicholas Ayache Michael B Wallace 2012World Journal of Gastroenterology2012,18,39:5
10New genes emerging for colorectal cancer predisposition显示文摘Colorectal cancer(CRC)is one of the most frequent neoplasms and an important cause of mortality in the developed world.This cancer is caused by both genetic and environmental factors although 35%of the variation in CRC susceptibility involves inherited genetic differences.Mendelian syndromes account for about5%of the total burden of CRC,with Lynch syndrome and familial adenomatous polyposis the most common forms.Excluding hereditary forms,there is an important fraction of CRC cases that present familial aggregation for the disease with an unknown germline genetic cause.CRC can be also considered as a complex disease taking into account the common diseasecommom variant hypothesis with a polygenic model of inheritance where the genetic components of common complex diseases correspond mostly to variants of low/moderate effect.So far,30 common,low-penetrance susceptibility variants have been identified for CRC.Recently,new sequencing technologies including exomeand whole-genome sequencing have permitted to add a new approach to facilitate the identification of new genes responsible for human disease predisposition.By using whole-genome sequencing,germline mutations in the POLE and POLD1 genes have been found to be responsible for a new form of CRC genetic predisposition called polymerase proofreading-associated polyposis.Clara Esteban-Jurado Pilar Garre Maria Vila Juan José Lozano Anna Pristoupilova Sergi Beltrán Anna Abulí Jenifer Muoz Francesc Balaguer Teresa Ocaa Antoni Castells Josep M Piqué Angel Carracedo Clara Ruiz-Ponte Xavier Bessa Montserrat Andreu Luis Bujanda Trinidad Caldés Sergi Castellví-Bel 2014World Journal of Gastroenterology2014,20,8:3
11Barrett’s metaplasia glands are clonal, contain multiple stem cells and share a common squamous progenitor显示文摘Anna M Nicholson Trevor A Graham Ashley Simpson Adam Humphries Nicola Burch Manuel Rodriguez-Justo Marco Novelli Rebecca Harrison Nicholas A Wright Stuart A C McDonald Janusz A Jankowski 2012Gut2012,,10:3
12Rates and risk factors for suicidal ideation,suicide attempts and suicide deaths in persons with HIV:a systematic review and meta-analysis显示文摘Background People living with HIV/AIDS(PLWHA)must contend with a significant burden of disease.However,current studies of this demographic have yielded wide variations in the incidence of suicidality(defined as suicidal ideation,suicide attempt and suicide deaths).Aims This systematic review and meta-analysis aimed to assess the lifetime incidence and prevalence of suicidality in PLWHA.Methods Publications were identified from PubMed(MEDLINE),SCOPUS,OVID(MEDLINE),Joanna Briggs Institute EBP and Cochrane Library databases(from inception to before 1 February 2020).The search strategy included a combination of Medical Subject Headings associated with suicide and HIV.Researchers independently screened records,extracted outcome measures and assessed study quality.Data were pooled using a random-effects model.Subgroup and meta-regression analyses were conducted to explore the associated risk factors and to identify the sources of heterogeneity.Main outcomes were lifetime incidence of suicide completion and lifetime incidence and prevalence of suicidal ideation and suicide attempt.Results A total of 185199 PLWHA were identified from 40 studies(12 cohorts,27 cross-sectional and 1 nested case-control).The overall incidence of suicide completion in PLWHA was 10.2/1000 persons(95%CI:4.5 to 23.1),translating to 100-fold higher suicide deaths than the global general population rate of 0.11/1000 persons.The lifetime prevalence of suicide attempts was 158.3/1000 persons(95%CI:106.9 to 228.2)and of suicidal ideation was 228.3/1000 persons(95%CI:150.8 to 330.1).Meta-regression revealed that for every 10-percentage point increase in the proportion of people living with HIV with advanced disease(AIDS),the risk of suicide completion increased by 34 per 1000 persons.The quality of evidence by Grading of Recommendations,Assessment,Development and Evaluations for the suicide deaths was graded as‘moderate’quality.Conclusions The risk of suicide death is 100-fold higher in people living with HIV than in the general population.Lifetime incidence of suicidal ideation and attempts are substantially high.Suicide risk assessments should be a priority in PLWHA,especially for those with more advanced disease.Matt Pelton Matt Ciarletta Holly Wisnousky Nicholas Lazzara Monica Manglani Djibril M Ba Vernon M Chinchillli Ping Du Anna E Ssentongo Paddy Ssentongo 2021General Psychiatry2021,34,2:3
13Hedgehog signaling regulates epithelial-mesenchymal transition during biliary fibrosis in rodents and humans显示文摘Omenetti Alessia Porrello Alessandro Jung Youngmi Yang Liu Popov Yury Choi Steve S Witek Rafal P Alpini Gianfranco Venter Juliet Vandongen Hendrika M Syn Wing-Kin Baroni Gianluca Svegliati Benedetti Antonio Schuppan Detlef Diehl Anna Mae 2008Journal of Clinical Investigation2008,,10:3
14Liver fat deposition and mitochondrial dysfunction in morbid obesity:An approach combining metabolomics with liver imaging and histology显示文摘AIM: To explore the usefulness of magnetic resonance imaging(MRI) and spectroscopy(MRS) for assessment of non-alcoholic fat liver disease(NAFLD) as compared with liver histological and metabolomics findings. METHODS: Patients undergoing bariatric surgery following procedures involved in laparoscopic sleeve gastrectomy were recruited as a model of obesityinduced NAFLD in an observational, prospective, singlesite, cross-sectional study with a pre-set duration of 1 year. Relevant data were obtained prospectively and surrogates for inflammation, oxidative stress and lipid and glucose metabolism were obtained through standard laboratory measurements. To provide reliable data from MRI and MRS, novel procedures were designed to limit sampling variability and other sources of error using a 1.5T Signa HDx scanner and protocols acquired from the 3D or 2D Fat SAT FIESTA prescription manager. We used our previously described 1H NMRbased metabolomics assays. Data were obtained immediately before surgery and after a 12-mo period including histology of the liver and measurement of metabolites. Values from 1H NMR spectra obtained after surgery were omitted due to technical limitations.RESULTS: MRI data showed excellent correlation with the concentration of liver triglycerides, other hepatic lipid components and the histological assessment, w h i c h e xc l u d e d t h e p r e s e n c e o f n o n-a l c o h o l i c steatohepatitis(NASH). MRI was sufficient to follow up NAFLD in obese patients undergoing bariatric surgery and data suggest usefulness in other clinical situations. The information provided by MRS replicated that obtained by MRI using the-CH3 peak(0.9 ppm), the-CH2- peak(1.3 ppm, mostly triglyceride) and the-CH=CH- peak(2.2 ppm). No patient depicted NASH. After surgery all patients significantly decreased their body weight and steatosis was virtually absent even in patients with previous severe disease. Improvement was also observed in the serum concentrations of selected variables. The most relevant findings using metabolomics indicate increased levels of triglyceride and monounsaturated fatty acids in severe steatosis but those results were accompanied by a significant depletion of diglycerides, polyunsaturated fatty acids, glucose-6-phosphate and the ATP/AMP ratio. Combined data indicated the coordinated action on mitochondrial fat oxidation and glucose transport activity and may support the consideration of NAFLD as a likely mitochondrial disease. This concept may helpto explain the dissociation between excess lipid storage in adipose tissue and NAFLD and may direct the search for plasma biomarkers and novel therapeutic strategies. A limitation of our study is that data were obtained in a relatively low number of patients.CONCLUSION: MRI is sufficient to stage NAFLD in obese patients and to assess the improvement after bariatric surgery. Other data were superfluous for this purpose.Nahum Calvo Raúl Beltrán-Debón Esther Rodríguez-Gallego Anna Hernández-Aguilera Maria Guirro Roger Mariné-Casadó Lidón Millá Josep M Alegret Fàtima Sabench Daniel del Castillo María Vinaixa Miguelàngel Rodríguez Xavier Correig Roberto García-álvarez Javier A Menendez Jordi Camps Jorge Joven 2015World Journal of Gastroenterology2015,21,24:2
15Susceptibility Genetic Variants Associated With Colorectal Cancer Risk Correlate With Cancer Phenotype显示文摘Anna Abulí Xavier Bessa Juan Ramón González Clara Ruiz–Ponte Alejandro Cáceres Jenifer Mu?oz Victoria Gonzalo Francesc Balaguer Ceres Fernández–Rozadilla Dolors González Luisa de Castro Juan Clofent Luís Bujanda Joaquín Cubiella Josep M a Re?é Juan Diego 2010Gastroenterology2010,,3:2
16Embryonic stem cell-derived chondrogenic differentiation in vitro: activation by BMP-2 and BMP-4显示文摘Jan Kramer Claudia Hegert Kaomei Guan Anna M Wobus Peter K Müller Jürgen Rohwedel 2000Mechanisms of Development2000,,2:2
17The prevalence and etiology of elevated aminotransferase levels in the United States显示文摘Jeanne M Clark Frederick L Brancati Anna Mae Diehl 2003The American Journal of Gastroenterology2003,,5:2
18Procalcitonin as a diagnostic marker for sepsis: a systematic review and meta-analysis显示文摘Christina Wacker Anna Prkno Frank M Brunkhorst Peter Schlattmann 2013The Lancet Infectious Diseases2013,,5:2
19Hepatitis B virus subgenotype F3 reactivation with vaccine escape mutations:A case report and review of the literature显示文摘Hepatitis B represents a global health threat because its chronic course and sequelae contribute to a high morbidity and mortality. Hepatitis B virus(HBV) infection can be controlled by vaccines, antiviral treatment, and by interrupting transmission. Rare vaccine escape mutants are serious because they eliminate vaccine protection. Here, we present a 74-year-old vaccinated patient with HBV reactivation 11 years after kidney transplantation. The patient was HBV-positive but HBs Ag-negative prior to vaccination 6 years before transplantation. The reactivated virus was HBV genotype F3 with vaccine escape mutations G145 R, P120 Q, and Q129 P. The patient was successfully treated with entecavir. The epidemiological reasons for this subgenotype, which is extremely rare in Western Europe, were unclear. This case illustrates that second-generation vaccines are not always effective in a specific group of patients.Stefan Schlabe Kathrin van Bremen Souhaib Aldabbagh Dieter Glebe Corinna M Bremer Tobias Marsen Walter Mellin Veronica Di Cristanziano Anna M Eis-Hübinger Ulrich Spengler 2018World Journal of Hepatology2018,10,7:2
20指导性集体锻炼对治疗中的早期乳腺癌妇女的益处:实用性随机对照试验显示文摘目的确定12周指导性集体锻炼对治疗中的早期乳腺癌患者在机体功能和心理上的获益,并随访6个月。设计实用性、前瞻性、随机对照、开放性试验。地点苏格兰3家国家医疗卫生服务体系肿瘤门诊和社区运动设施。参加者共203位妇女参加研究;其中177位完成6个月随访。干预与常规护理相对照,干预组予12周指导性集体锻炼加常规护理。主要结果评价癌症治疗功能评价(FACT)问卷、贝克抑郁问卷、正性和负性情绪量表、体重指数、7日体力活动回忆问卷、12分钟步行实验和肩关节活动度评估。结果对基线值、研究中心、基线治疗和参加干预试验时的年龄进行校正后,综合效应模型的评估结果(干预组减对照组)显示第12周时:12分钟步行距离为129米(95%可信区间83~176),1周的中等强度活动时间182分钟(75~289),肩关节活动度2.6(1.6~3.7),乳腺癌特定的生活质量量表2.5(1.0~3.9),正性情绪4.0(1.8~6.3)。初步结果未发现干预锻炼对生活质量综合量表(FACT-G)有影响。随访6个月后,大多数效果维持不变,并且在乳腺癌特定的生活质量上得到改善。尚未有不良反应的报道。结论在12周干预锻炼结束时以及6个月后,指导性集体锻炼均显示出机体功能和心理上的获益。因此临床医生应该鼓励患者活动,决策者们应该考虑把体育锻炼纳入到癌症康复服务中来。试验注册号当前对照试验 ISRCTN12587864[controlled-trial.com]。Nanette Mutrie Anna M Campbell Fiona Whyte Alex McConnachie Carol Emslie Laura Lee Nora Kearney Andrew Walker Diana Ritchie 方桦(译) 王燕(校) 2007英国医学杂志中文版2007,10,4:2
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