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| 1 | 2018加拿大心境障碍与焦虑障碍治疗协作组/国际双相障碍学会指南:双相障碍的管理显示文摘加拿大心境障碍与焦虑障碍治疗协作组(Canadian Network for Mood and Anxiety Treatments,CANMAT)曾于2005年发布了第1版双相障碍管理指南,并分别于2007、2009和2013年对该指南进行了更新,其中最近的2次更新是与国际双相障碍学会(International Society for Bipolar Disorders,ISBD)合作完成。2018版CANMAT/ISBD双相障碍治疗指南(以下简称指南)反映了自2005年首版指南发表以来本领域取得的重大进展,包括疾病诊断与疾病管理的更新以及药物治疗与心理治疗的近期研究进展。这些前沿进展中综合考虑了循证证据的级别,并基于治疗疗效、临床实践经验、安全性、耐受性和药物导致的转相风险等,对一线、二线及三线治疗方案进行了简明而清晰的推荐。本指南中新增内容涵盖了双相Ⅰ型障碍(BD-Ⅰ)的躁狂发作急性期、抑郁发作急性期和双相障碍维持期的一线及二线治疗推荐等级划分。这种对治疗推荐等级的划分综合考虑了治疗方法对双相障碍不同时相的影响,将进一步帮助临床医生做出基于循证证据的治疗决策。锂盐、喹硫平、双丙戊酸盐、阿塞那平、阿立哌唑、帕利哌酮、利培酮和卡利拉嗪单药或联合使用被推荐为躁狂发作急性期的一线治疗选择。BD-Ⅰ抑郁期的一线治疗选择包括喹硫平、鲁拉西酮、锂盐、拉莫三嗪单药,鲁拉西酮联合锂盐或双丙戊酸盐或拉莫三嗪辅助治疗。尽管急性期治疗有效的药物通常应继续用于BD-Ⅰ的维持期治疗,但也存在一些特殊情况(例如抗抑郁药)。现有数据表明,锂盐、喹硫平、双丙戊酸盐、拉莫三嗪、阿塞那平和阿立哌唑单药或联合治疗应被视为维持治疗的初始或更换治疗方案时的一线选择。除了探讨BD-Ⅰ的相关问题外,本指南中还对双相Ⅱ型障碍(BD-Ⅱ)的临床管理进行了系统回顾并给予治疗推荐,同时针对特殊人群也有相关推荐,如处于各个生殖周期的女性、儿童、青少年和老年人。此外,本指南中还讨论了特定精神疾病及共病(如物质滥用、焦虑障碍和代谢性疾病)的影响。最后,本指南中概述了安全性和药物监测的相关问题。CANMAT/ISBD工作组希望本指南能够成为全球临床医生的实用工具。 | Lakshmi N Yatham Sidney H Kennedy Sagar V Parikh Ayal Sehaffer David J Bond Benicio N Frey Verinder Sharma Benjamin I Goldstein Soham Rej Serge Beaulieu Martin Alda Glenda MaeQueen Roumen V Milev Arun Ravindran Claire O'Donovan Diane Mclntosh Raymond W Lam Gustavo Vazquez Flavio Kapczinski Roger S Melntyre Jan Kozicky Shigenobu Kanba Beny Lafer Trisha Suppes Joseph R Calabrese Eduard Vieta Gin Malhi Robert M Post Michael Berk 胡晨(译) 王刚(译) | 2019 | 中华精神科杂志2019，52，1： | 25 |
| 2 | Intracellular HMGB1 as a novel tumor suppressor of pancreatic cancer显示文摘尽管有最近的进展, oncogenic K 地岬驾驶的胰腺的 ductal 腺癌(PDAC ) 在最致命的人的癌症之中留在现代医学。PDAC 的致病对内在的染色体不稳定性和外来的发炎激活部分可归因。然而,在在胰腺的 tumorigenesis 的这二个事件之间的分子的连接充分还没被建立了。这里,我们证明(HMGB1 ) 细胞内部的高活动性组盒子 1 显著地压制 oncogenic 由禁止染色体的 K-Ras-driven 胰腺的 tumorigenesis 调停不稳定性的支持 inflammatory nucleosome 版本。任何一个单身者的有条件的基因脱离或在胰的 HMGB1 的两等位基因在出生使老鼠变为极其敏感到先锋损害的 oncogenic K-Ras-driven 开始,包括胰腺的 intraepithelial 瘤, intraductal 乳突的 mucinous 瘤,和 mucinous 膀胱的瘤。在胰的 HMGB1 的损失与染色体重新整理和 telomere 畸形描绘的氧化 DNA 损坏和 chromosomal 不稳定性被联系。这些导致煽动性的 nucleosome 版本并且宣传 K-Ras-driven 胰腺的 tumorigenesis。细胞外的 nucleosomes 支持 interleukin 6 (IL-6 ) 由渗入 macrophages/neutrophils 的分泌物并且提高在胰腺的损害表明激活的 oncogenic K 地岬。到 IL-6 或 histone H3 或为先进 glycation 的受体的大美人的抵销的抗体结束产品都限制表明激活的 K 地岬,阻止癌症开发和转移 / 侵略,并且延长在 Pdx1-Cre 的动物幸存; K 地岬 G12D/+;Hmgb1/ 鼠标。由 glycyrrhizin 的 HMGB1 损失的药理学抑制在煽动性的条件下面在老鼠限制 oncogenic K-Ras-driven tumorigenesis。减少在 PDAC 病人的 HMGB1 的原子、全部的细胞的表示与差的全面幸存相关,在 PDAC 与预示、治疗学的关联作为新奇肿瘤 suppressor 支持细胞内部的 HMGB1。 | Rui Kang Yangchun Xie Qiuhong Zhang Wen Hou Qingping Jiang Shan Zhu Jinbao Liu Dexing Zeng Haichao Wang David L Bartlet Timothy R Billiar Herbert J Zeh III Michael T Lotze Daolin Tang | 2017 | Cell Research2017，27，7： | 22 |
| 3 | Metastatic type 1 gastric carcinoid:A real threat or just a myth?显示文摘AIM:To describe disease characteristics and treatment modalities in a group of rare patients with metastatic gastric carcinoid type 1(GCA1).METHODS:Information on clinical,biochemical,radiological,histopathological findings,the extent of the disease,as well as the use of different therapeutic modalities and the long-term outcome were recorded.Patients’data were assessed at presentation,and thereafter at 6 to 12 monthly intervals both clinically and biochemically,but also endoscopically and histopathologically.Patients were evaluated for the presence of specific symptoms;the presence of autoimmune disorders and the presence of other gastrointestinal malignancies in other family members were also recorded.The evaluation of response to treatment was defined using established WHO criteria.RESULTS:We studied twenty consecutive patients with a mean age of 55.1 years.The mean follow-up period was 83 mo.Twelve patients had regional lymph node metastases and 8 patients had liver metastases.The primary tumor mean diameter was 20.13±10.83mm(mean±SD).The mean Ki-67 index was 6.8%±11.2%.All but one patient underwent endoscopic or surgical excision of the tumor.The disease was stable in all but 3 patients who had progressive liver disease.All patients remained alive during the follow-up period.CONCLUSION:Metastatic GCA1 carries a good overall prognosis,being related to a tumor size of≥1 cm,an elevated Ki-67 index and high serum gastrin levels. | Simona Grozinsky-Glasberg Dimitrios Thomas Jonathan R Strosberg Ulrich-Frank Pape Stephan Felder Apostolos V Tsolakis Krystallenia I Alexandraki Merav Fraenkel Leonard Saiegh Petachia Reissman Gregory Kaltsas David J Gross | 2013 | World Journal of Gastroenterology2013，19，46： | 11 |
| 4 | Role of polyethylene particles in peri-prosthetic osteolysis:A review显示文摘There is convincing evidence that particles produced by the wear of joint prostheses are causal in the periprosthetic loss of bone,or osteolysis,which,if it progresses,leads to the phenomenon of aseptic loosening.It is important to fully understand the biology of this bone loss because it threatens prosthesis survival,and loosened implants can result in peri-prosthetic fracture,which is disastrous for the patient and presents a difficult surgical scenario.The focus of this review is the bioactivity of polyethylene(PE)particles,since there is evidence that these are major players in the development and progression of osteolysis around prostheses which use PE as the bearing surface.The review describes the biological consequences of interaction of PE particles with macrophages,osteoclasts and cells of the osteoblast lineage,including osteocytes.It explores the possible cellular mechanisms of action of PE and seeks to use the findings to date to propose potential nonsurgical treatments for osteolysis.In particular,a nonsurgical approach is likely to be applicable to implants containing newer,highly cross-linked PEs(HXLPEs),for which osteolysis seems to occur with much reduced PE wear compared with conventional PEs.The caveat here is that we know little as yet about the bioactivity of HXLPE particles and addressing this constitutes our next challenge. | Gerald J Atkins David R Haynes Donald W Howie David M Findlay | 2011 | World Journal of Orthopedics2011，2，10： | 11 |
| 5 | Intentional ingestions of foreign objects among prisoners: A review显示文摘The intentional ingestion of foreign objects(IIFO) is described more commonly in prison populations than in the general population, with an estimated annual incidence of 1 in 1900 inmates in our state correctional facilities. Incidents often involve ingestion of small metal objects(e.g., paperclips, razor blades) or other commonly available items like pens or eating utensils. Despite ingestion of relatively sharp objects, most episodes can be clinically managed with either observation or endoscopy. Surgery should be reserved for those with signs or symptoms of gastrointestinal perforation or obstruction. For those with a history of IIFO, efforts should focus on prevention of recurrenceas subsequent episodes are associated with higher morbidity, significant healthcare and security costs. The pattern of IIFO is often repetitive, with escalation both in frequency of ingestions and in number of items ingested. Little is known about successful prevention strategies, but efforts to monitor patients and provide psychiatric care are potential best-practice strategies. This article aims to provide state-of-the art review on the topic, followed by a set of basic recommendations. | David C Evans Thomas R Wojda Christian D Jones Andrew J Otey Stanislaw P Stawicki | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，3： | 10 |
| 6 | 英国胃肠病学会关于胃癌风险患者的诊断和管理指南显示文摘胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(H.pylori,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生存率的关键是在内镜检查前以非侵入性方式识别高危人群。然而,尽管生物标志物可能有助于检测慢性萎缩性胃炎,但尚无足够的证据支持其用于人群筛查。高质量内镜检查是胃癌早期发现的重要组成部分,图像增强内镜结合组织病理学活检是GA和GIM最佳的诊断方法,并能准确进行风险分层。按照悉尼标准从胃窦、角切迹、小弯和大弯进行活检,既能明确诊断,也能对胃癌进行风险分层。理想状态应当是在高质量内镜检查中对GA或GIM区域活检。英国属于低危地区,可根据需要接受常规诊断性胃镜检查,但没有足够证据支持筛查,对于广泛GA或GIM的患者,每3年检查内镜。对于胃异型增生和早期癌,只要满足标准,内镜下黏膜切除术或内镜黏膜下剥离术的治疗有效,成功率高,复发率低。 | Matthew Banks David Graham Marnix Jansen TakujiGotoda Sergio Coda Massimiliano di Pietro NoriyaUedo Pradeep Bhandari D Mark Pritchard Ernst J Kuipers Manuel Rodriguez-Justo Marco R Novelli KrishRagunath Neil Shepherd Mario Dinis-Ribeiro 乌雅罕(译) 张冬雪(译) 牛占岳(校) 刘鑫(校) 丁士刚(译/校) | 2020 | 中华胃肠内镜电子杂志2020，7，2： | 10 |
| 7 | Total pancreatectomy and islet autotransplantation: A decade nationwide analysis显示文摘AIM: To investigate outcomes and predictors of inhospital morbidity and mortality after total pancreatectomy(TP) and islet autotransplantation. METHODS: The nationwide inpatient sample(NIS) database was used to identify patients who underwent TP and islet autotransplantation(IAT) between 2002-2012 in the United States. Variables of interest were inherent variables of NIS database which included demographic data(age, sex, and race), comorbidities(such as diabetes mellitus, hypertension, and deficiency anemia), and admission type(elective vs nonelective). The primary endpoints were mortality and postoperative complications according to the ICD-9 diagnosis codes which were reported as the second to 25 th diagnosis of patients in the database. Risk adjusted analysis was performed to investigate morbidity predictors. Multivariate regression analysis was used to identify predictors of in-hospital morbidity.RESULTS: We evaluated a total of 923 patients who underwent IAT after pancreatectomy during 2002-2012. Among them, there were 754 patients who had TP + IAT. The most common indication ofsurgery was chronic pancreatitis(86%) followed by acute pancreatitis(12%). The number of patients undergoing TP + IAT annually significantly increased during the 11 years of study from 53 cases in 2002 to 155 cases in 2012. Overall mortality and morbidity of patients were 0% and 57.8 %, respectively. Postsurgical hypoinsulinemia was reported in 42.3% of patients, indicating that 57.7% of patients were insulin independent during hospitalization. Predictors of inhospital morbidity were obesity [adjusted odds ratio(AOR): 3.02, P = 0.01], fluid and electrolyte disorders(AOR: 2.71, P < 0.01), alcohol abuse(AOR: 2.63, P < 0.01), and weight loss(AOR: 2.43, P < 0.01). CONCLUSION: TP + IAT is a safe procedure with no mortality, acceptable morbidity, and achieved high rate of early insulin independence. Obesity is the most significant predictor of in-hospital morbidity. | Reza Fazlalizadeh Zhobin Moghadamyeghaneh Aram N Demirjian David K Imagawa Clarence E Foster Jonathan R Lakey Michael J Stamos Hirohito Ichii | 2016 | World Journal of Transplantation2016，6，1： | 9 |
| 8 | Driving vascular endothelial cell fate of human multipotent Isl1 heart progenitors with VEGF modified mRNA显示文摘multipotent 心祖先的不同家庭在哺乳动物的 cardiogenesis 期间在多样的心脏的、光滑的肌肉和 endothelial 房间系的产生起一个中央作用。驾驶这些 multipotent 祖先的房间命运决定的精确 paracrine 信号的鉴定,和小说的开发来临在 vivo 交付这些信号,是向开他们的再生治疗学的潜力的关键步。此处,我们识别了位于早人的胎儿的心(OFT-ECs ) 的流出道的人的心脏的 endothelial 中介的一个家庭,由 Isl1 和 CD144/vWF 的 coexpression 描绘了。由比较人的 OFT-ECs 和非心脏的 EC 表示的 angiocrine 因素,脉管的 endothelial 生长因素( VEGF ) A 作为最富有地表示的因素被识别,并且同种细胞的试金记录了它的能力驱使人的胚胎的干细胞(转换字符)的 endothelial 说明以一种 VEGF 受体依赖者方式导出 Isl1 +祖先。人的 Isl1-ECs (区分开来与导出 hESC 的 ISL1 + 祖先的 endothelial 房间) 以心脏的 endothelial 祖先的表示类似于 OFT-ECs -- 并且 endocardial 房间特定的基因,证实他们的机关特性。决定是否 VEGF -- A 可能是服务一在里面为人的导出转换字符的 Isl1-ECs 的 vivo 房间命运开关,我们证实化学上使用的一条新奇途径作为一个平台修改了 mRNA 为短暂,还在心血管的祖先的 paracrine 因素的高度有效的表示。VEGF 的 Overexpression -- A 支持在 vivo 的人的 Isl1 + 祖先的不仅 endothelial 说明而且嫁接,增长和幸存(减少的 apoptosis ) 。从人的 pluripotent 干细胞的心脏特定的人的 Isl1-ECs 的大规模推导,结合了能力驾驶跟随移植的 endothelial 说明,嫁接,和幸存,在心为脉管的新生建议新奇策略。 | Kathy O Lui Llor Lang Eduardo A Silva Lei Bu Makoto Sahara Ronald A Li David J Mooney Kenneth R Chien | 2013 | Cell Research2013，23，10： | 6 |
| 9 | Protective role of PI3-kinase/Akt/eNOS signaling in mechanical stress through inhibition of p38 mitogenactivated protein kinase in mouse lung显示文摘 | Xin-qi PENG Mahendra DAMARLA Jarrett SKIRBALL Stephanie NONAS Xiao-ying WANG Eugenia J HAN Emile J HASAN Xuan CAO Adel BOUEIZ Rachel DAMICO Rubin M TUDER Alfred M SClUTO Dana R ANDERSON Joe GNGARCIA David A KASS Paul M HASSOUN Jun-tian ZHANG | 2010 | Acta Pharmacologica Sinica2010，31，2： | 6 |
| 10 | Silicon carbide resonant tuning fork for microsensing applications in high-temperature and high G-shock environments显示文摘We present the fabrication and testing of a silicon carbide(SiC)balanced mass double-ended tuning fork that survives harsh environments without compromising the device strain sensitivity and resolution bandwidth.The device features a material stack that survives corrosive environments and enables high-temperature operation.To perform high-temperature testing,a specialized setup was constructed that allows the tuning fork to be characterized using traditional silicon electronics.The tuning fork has been operated at 600 ℃ in the presence of dry steam for short durations.This tuning fork has also been tested to 64 000 G using a hard-launch,soft-catch shock implemented with a light gas gun.However,the device still has a strain sensitivity of 66 Hz/με and strain resolution of 0.045 με in a 10 kHz bandwidth.As such,this balanced-mass double-ended tuning fork can be used to create a variety of different sensors including strain gauges,accelerometers,gyroscopes,and pressure transducers.Given the adaptable fabrication process flow,this device could be useful to micro-electro-mechanical systems(MEMS) designers creating sensors for a variety of different applications. | David R Myers Kan Bun Cheng Babak Jamshidi Robert G Azevedo Debbie G Senesky Li Chen Mehran Mehregany Muthu B J Wijesundara Albert P Pisano | 2012 | Engineering Sciences2012，10，5： | 6 |
| 11 | 澳大利亚人乳头状瘤病毒疫苗计划实施5年对年轻人群生殖器疣患病情况的影响:国家调查数据分析显示文摘目的评估2007年中开始的澳大利亚人乳头状瘤病毒(HPV)疫苗计划对生殖器疣患病情况的影响。设计国家调查数据趋势分析。数据来源数据收集于2004--2011年度澳大利亚8所性健康服务机构;其中2所最大的临床中心收集了自我报告的本中心2009年度HPV疫苗现状。研究对象2004--2011年度首次就诊的85770名澳大利亚出生的国民;其中7686(9.0%)名患生殖器疣。主要结局测量比较前疫苗时期(2004—2007年中)和疫苗时期(2007年中-2001年末)不同人群生殖器疣新发病率变化趋势。结果疫苗时期21岁以下和21~30岁女性诊断患有生殖器疣的比例明显下降,发病率分别从2007年度的11.5%和11.3%下降至2011年度的0.85%和3.1%,P均〈0.001。在30岁以上的女性中未发现发病率的明显下降。在21岁以下和21~30岁异性恋男性人群中疫苗时期生殖器疣的发病率较前疫苗时期明显下降,分别由2007年度12.1%和18.2%下降至2011年度2.2%和8.9%,P均〈0.001。30岁以上的异性恋男性人群中发病率无明显下降。2011年235名21岁以下女性在使用HPV疫苗后无新发生殖器疣病例。结论年轻女性生殖器疣发病率的显著下降和2011年度部分年轻女性使用疫苗后的零发病率,说明HPV疫苗获得实验室外的良好功效。异性恋男性生殖器疣发病率的显著下降可能是由于群体免疫所致。 | Hammad Ali,lecturer Basil Donovan, professor HandanWand,senior lecturer Tim R H Read, sexual health physician David G Regan,senior lecturer Andrew E Grulich, professor Christopher K FaMey, professor Rebecca J Guy, associate professor 尹婕(译) 潘凌亚(校) | 2013 | 英国医学杂志中文版2013，16，4： | 4 |
| 12 | Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade显示文摘 | Clifford R Jack David S Knopman William J Jagust Leslie M Shaw Paul S Aisen Michael W Weiner Ronald C Petersen John Q Trojanowski | 2010 | Lancet Neurology2010，，1： | 4 |
| 13 | Efficacy of boceprevir, an NS3 protease inhibitor, in combination with peginterferon alfa-2b and ribavirin in treatment-naive patients with genotype 1 hepatitis C infection (SPRINT-1): an open-label, randomised, multicentre phase 2 trial显示文摘 | Paul Y Kwo Eric J Lawitz Jonathan McCone Eugene R Schiff John M Vierling David Pound Mitchell N Davis Joseph S Galati Stuart C Gordon Natarajan Ravendhran Lorenzo Rossaro Frank H Anderson Ira M Jacobson Raymond Rubin Kenneth Koury Lisa D Pedicone Clifford | 2010 | The Lancet2010，，9742： | 3 |
| 14 | Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial显示文摘 | David N Krag Stewart J Anderson Thomas B Julian Ann M Brown Seth P Harlow Joseph P Costantino Takamaru Ashikaga Donald L Weaver Eleftherios P Mamounas Lynne M Jalovec Thomas G Frazier R Dirk Noyes André Robidoux Hugh MC Scarth Norman Wolmark | 2010 | Lancet Oncology2010，，10： | 3 |
| 15 | Accuracy of biometric formulae for intraocular lens power calculation in a teaching hospital显示文摘AIM: To evaluate the accuracy of three commonly used biometric formulae across different axial lengths(ALs) at one United States Veterans Affairs teaching hospital.METHODS: A retrospective chart review was conducted from November 2013 to May 2018. One eye of each patient who underwent cataract surgery with a monofocal intraocular lens(IOL) was included. The range of postoperative follow-up period was from 3 wk to 4 mo. The Holladay 2, Barrett Universal II, and Hill-Radial Basis Function(Hill-RBF) formulae were used to predict the postoperative refraction for all cataract surgeries. For each formula, we calculated the prediction errors [including mean absolute prediction error(MAE)] and the percentage of eyes within ±0.25 diopter(D) and ±0.5 D of predicted refraction. We performed subgroup analyses for short(AL<22.0 mm), medium(AL 22.0-25.0 mm), and long eyes(AL>25.0 mm).RESULTS: A total of 1131 patients were screened, and 909 met the inclusion criteria. Resident ophthalmologists were the primary surgeons in 710(78.1%) cases. We found no statistically significant difference in predictive accuracy among the three formulae over the entire AL range or in the short, medium, and long eye subgroups. Across the entire AL range, the Hill-RBF formula resulted in the lowest MAE(0.384 D) and the highest percentage of eyes with postoperative refraction within ±0.25 D(42.7%) and ±0.5 D(75.5%) of predicted. All three formulae had the highest MAEs(>0.5 D) and lowest percentage within ±0.5 D of predicted refraction(<55%) in short eyes.CONCLUSION: In cataract surgery patients at our teaching hospital, three commonly used biometric formulae demonstrate similar refractive accuracy across all ALs. Short eyes pose the greatest challenge to predicting postoperative refractive error. | Kevin S Tang Elaine M Tran Allison J Chen David R Rivera Jorge J Rivera Paul B Greenberg | 2020 | International Journal of Ophthalmology(English edition)2020，13，1： | 3 |
| 16 | Global burden of cancers attributable to infections in 2008: a review and synthetic analysis显示文摘 | Catherine de Martel Jacques Ferlay Silvia Franceschi Jér?me Vignat Freddie Bray David Forman Martyn Plummer | 2012 | Lancet Oncology2012，，6： | 3 |
| 17 | Changing local geographies of private residential care for older people 1983–1999: lessons for social policy in England and Wales显示文摘 | Gavin J Andrews David R Phillips | 2002 | Social Science & Medicine2002，，1： | 3 |
| 18 | Reproducibility of the diagnosis of dysplasia in Barrett esophagus: A reaffirmation显示文摘 | Elizabeth Montgomery Mary P Bronner John R Goldblum Joel K Greenson Marian M Haber John Hart Laura W Lamps Gregory Y Lauwers Audrey J Lazenby David N Lewin Marie E Robert Alicia Y Toledano Yu Shyr Kay Washington | 2001 | Human Pathology2001，，4： | 3 |
| 19 | Prognostic impact of the Bismuth-Corlette classification:Higher rates of local unresectability in stageⅢb hilar cholangiocarcinoma显示文摘Background:The Bismuth-Corlette(BC)classification is used to categorize hilar cholangiocarcinoma by proximal extension along the biliary tree.As the right hepatic artery crosses just behind the left bile duct,we hypothesized that BCⅢb tumors would have a higher likelihood of local unresectability due to involvement of the contralateral artery.Methods:A retrospective review of a prospectively maintained database identified patients with hilar cholangiocarcinoma taken to the operating room for intended curative resection between April 2008 and September 2016.Cases were assigned BC stages based on preoperative imaging.Results:Sixty-eight patients were included in the study.All underwent staging laparoscopy after which 16 cases were aborted for metastatic disease.Of the remaining 52 cases,14 cases were explored and aborted for locally advanced disease.Thirty-eight underwent attempt at curative resection.After exclud-ing cases aborted for metastatic disease,the chance of proceeding with resection was 55.6%for BCⅢb staged lesions compared to 80.0%of BCⅢa lesions and to 82.4%for BCⅠ-Ⅲa staged lesions(P<0.05).About 44.4%of BCⅢb lesions were aborted for locally advanced disease versus 17.6%of remaining BC stages.Conclusions:When hilar cholangiocarcinoma is preoperatively staged as BCⅢb,surgeons should antici-pate higher rates of locally unresectable disease,likely involving the right hepatic artery. | Michael J Passeri Maria R Baimas-George Jesse K Sulzer David A Iannitti John B Martinie Erin H Baker Lee M Ocuin Dionisios Vrochides | 2020 | Hepatobiliary & Pancreatic Diseases International2020，19，2： | 3 |
| 20 | 吃熟肉可以显著改变血肌酐浓度与eGFR显示文摘编辑:Traynor等认为,摄入肉食对血肌酐的浓度以及eGFR的影响较小(见本期第28页)。但是MDRD试验中产生公式的数据主要来源于禁食的病人(AS Levey,个人交流)。但在临床实践中,测定血肌酐与eGFR的标本在采集时通常不考虑病人近期的饮食情况。 | David J Preiss Ian M Godber Ian R Gunu 隋准 | 2007 | 英国医学杂志中文版2007，10，1： | 2 |
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