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| 1 | Portal 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 | 2010 | World Journal of Gastroenterology2010，16，2： | 75 |
| 2 | BCLC策略:预后预测和治疗推荐2022版更新显示文摘2018版BCLC预后和治疗推荐策略发布后,肝细胞癌(简称HCC)的研究又取得了重大进展。本次更新基于肝癌各领域的研究进展结果。重点关注影响策略的重要研究进展。虽然近年的研究结果成绩斐然,但将其引入为临床医生和研究者提供行动依据的循证模型指南来说证据效力依然不够确切。本文对该问题进行分析,阐述了为HCC患者制定个体化治疗临床决策所需的批判性思维和专业知识。 | Reig M Forner A Rimola J Ferrer-Fabrega J Burrel M Garcia-Criado A Kelley RK Galle PR Mazzaferro V Salem R Sangro B Singal AG Vogel A Fuster J Ayuso C Bruix J 刘永凡(摘译) 崔笑(摘译) 耿小平(审校) | 2022 | 肝胆外科杂志2022，30，5： | 80 |
| 3 | 患者肠道微生物群失调与肠上皮屏障功能障碍显示文摘最近的证据表明,在动物模型中,肠道病理学和微生物组与高血压之间存在联系。然而,这种关联在人类中是否存在尚不清楚。因此,该研究的目的是检验高血压患者具有明显特异的肠道微生物组以及肠上皮屏障功能标记物和微生物组组成可以预测收缩压变化的假设。研究者通过鸟枪法宏基因组学分析粪便样本显示微生物分类和功能变化,结果显示高血压患者和对照受试者之间丁酸盐产生存在差异。 | Kim S Goel R Kumar A Qi Y Lobaton G Hosaka K Mohammed M Handberg EM Richards EM Pepine CJ Raizada MK 刘青 叶鹏 | 2018 | 中华高血压杂志2018，26，9： | 45 |
| 4 | AGNP精神科治疗药物监测共识指南:2011显示文摘治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从'强烈推荐'到'可能有用'的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的'治疗参考浓度范围'和'剂量相关参考浓度范围'呈现给大家。本共识指南引入了'实验室警戒浓度'的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。 | Hiemke C Baumann P Bergemann N Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) | 2016 | 实用药物与临床2016，19，10： | 37 |
| 5 | 最新AD研究用诊断标准:IWG-2标准显示文摘在过去的8年中,国际工作组织(IWG)和美国国立老化研究院-阿尔茨海默协会(NIA-AA)建立了阿尔茨海默病(AD)诊断标准,它能更好地定义AD的临床表型,整合了生物标记物于诊断流程中,并覆盖了疾病的全程。本意见书充分地权衡了IWG标准的优缺点,建议改进诊断框架。依据这些改进,AD的诊断变得简单,只要有恰当的AD临床表型(典型或不典型)和与AD的病理相一致的病理生理学生物标志物出现。我们认为疾病的下游的定位性生物标志,如容积性磁共振成像(MRI)和氟脱氧葡萄糖-正电子发射型计算机断层成像(FDG-PET)等,适合更好地测量和监测疾病过程。本文还详述了非典型性AD、混合性AD和AD临床前期的特异诊断标准。 | 陈刚 曹雯炜 俞羚 糜建华 Dubois B Feldman HH Jacova C Hampel H Molinuevo JL Blennow K DeK osky ST Gauthier S Selkoe D Bateman R Cappa S Crutch S Engelborghs S Frisoni GB Fox NC Galasko D Habert MO Jicha GA Nordberg A Pasquier F Rabinovici G Robert P Rowe C Salloway S Sarazin M Epelbaum S de Souza LC Vellas B Visser PJ Schneider L Stern Y Scheltens P Cummings JL | 2014 | 神经病学与神经康复学杂志2014，11，3： | 31 |
| 6 | 尿钠排泄、血压、心血管病与死亡率的关系:社区前瞻性流行病学队列研究显示文摘WHO建议人群钠摄人<2 g/d作为预防心血管病的措施之一,但这一目标在任何国家都没有实现。该建议主要基于短期血压试验的个体水平数据,没有来自随机试验或观察性研究的关于低钠摄入与降低心血管事件的数据。前瞻性城市农村流行病学研究目前正在21个国家进行。该文对其中18个国家的数据进行分析,其中包含了临床结果数据。 | Mente A O'Donnell M Rangarajan S McQueen M Dagenais G Wielgosz A Lear S Ah STL Wei L Diaz R Avezum A Lopez-Jaramillo P Lanas F Mony P Szuba A Iqbal R Yusuf R Mohammadifard N Khatib R Yusoff K Ismail N Gulec S Rosengren A Yusufali A Kruger L Tsolekile LP Chifamba J Dans A Alhabib KF Yeates K Teo K Yusuf S 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 29 |
| 7 | 世界胃肠病学组织全球指南——发展中国家幽门螺杆菌感染显示文摘世界上有一半人口感染幽门螺杆菌(H.pylori),其感染率因地理位置、种族、年龄和社会经济状况不同而存在很大差异.在发展中国家较高.发达国家较低。但总体而言,近年世界许多地区的H.pylori感染率均呈下降趋势。 | Hunt RH Xiao SD Megraud F Leon-Barua R Bazzoli F van der Merwe S Vaz Coelho LG Fock M Fedail S Cohen H Malfertheiner P Vakil N Hamid S Goh KL Wong BCY Krabshuis J Le Mair A 杜颖 戴宁 | 2011 | 胃肠病学2011，16，7： | 27 |
| 8 | IDH1 and IDH2 mutations are prognostic but not predictive for outcome in anaplastic oligodendroglial tumors: a report of the European Organization for Research and Treat- ment of Cancer Brain Tumor Group显示文摘 | van den Bent M J Dubbink HJ Marie Y Brandes AA Taphoorn MJ Wesseling P Frenay M Tijssen CC Lacombe D ldbaih A van Marion R Kros JM Dinjens WN Gorlia T. Sanson M. | 2010 | 中国神经肿瘤杂志2010，8，1： | 22 |
| 9 | Land use/land cover classification and its change detection using multi-temporal MODIS NDVI data显示文摘用在复杂的灌溉的盆的遥感数据的陆地使用 / 登陆盖子(LULC ) 的详细分析为更好的水资源管理提供完全的侧面并且计划。用遥感数据,这研究提供更低的 Chenab 运河的详细陆地使用地图为 LULC 的从 2005 ~ 2012 的巴基斯坦的灌溉区域变化察觉。主要庄稼类型被用 MODIS 250 m 识别 NDVI 的时间的侧面界定 | M USMAN R LIEDLI M A SHAHID A ABBAS | 2015 | Journal of Geographical Sciences2015，25，12： | 19 |
| 10 | 低碳锰钢中周期性带状组织显示文摘用扫描电镜和电子探针研究了低碳锰钢中的周期性带状组织。结果表明,在全部研究用钢中,钢锭经热轧后均出现这种组织,其严重程度随钢的成分而异,并随坯到带加工顺序而增加。带状组织与锰的显微偏析等因素有关。适当的调整碳锰比及形成横跨铁素体带的转变产物可降低带状组织的严重程度。 | 刘国勋 关卓明 Notis M R Marder A R | 1993 | 北京科技大学学报1993，15，1： | 16 |
| 11 | 下肢浅静脉治疗术后的加压疗法:美国静脉论坛血管、外科学会、美国静脉学会、血管医学学会和国际静脉联盟的临床实践指南显示文摘一、指南的由来下肢浅静脉治疗术后应用压力治疗的方式是几代血管外科医师多年临床经验积累所得,现主要应用于大隐静脉剥脱术、下肢静脉点状剥脱术及静脉硬化治疗等。目前单就静脉硬化治疗而言,术后压力治疗的推荐也是基于相关文献及实验验证[1],但对于其他术式,尤其是对于大隐静脉的热消融术,目前还没有形成规范统一的建议,这也使得当前的压力治疗具有很大的临床差异性。 | Lurie F Lal BK Antignani PL Blebea J Bush R Caprini J Davies A Forrestal M Jacobowitz G Kalodiki E Killewich L Lohr J Ma H Mosti G Partsch H Rooke T Wakefield T 李丹(译) 陈程浩(译) 牛传强(译) 张靖(译) 黄建忠(译) | 2020 | 中华介入放射学电子杂志2020，8，4： | 16 |
| 12 | Extraskeletal myxoid chondrosarcoma metastatic to the pancreas: A case report显示文摘Extraskeletal myxoid chondrosarcoma (EMC) is a lowgrade sarcoma characterized by developing metastases and local recurrence in high rate. It is mainly deep seated in the proximal extremities. The most common metastatic sites are the lungs, soft tissues, lymph nodes, bones and the brain. To our knowledge, no case of clearly defined EMC has been reported to date developing a metastasis in the pancreas. We describe a case of a man suffering from EMC who developed a single pancreatic metastasis 20 years after the initial diagnosis. A 49-year-old man was submitted to surgical excision of an EMC, in left thigh, 20 years ago. Fourteen years after the initial diagnosis a local recurrence in left thigh occurred. Multiple lesions of metastatic origin, in both lungs, were excised via thoracotomies until the time being. In 2003, as a part of a periodically performed imaging control, an abdominal CT scan was performed revealing a solid lesion in the pancreas. Distal pancreatectomy was performed. The histopathology of the excised specimen proved to be the one of metastatic lesion of EMC. The above-mentioned case of EMC is, as far as we know, the first one described developing a certain pancreatic metastasis. | C Fotiadis A Charalambopoulos S Chatzikokolis GC Zografos M Genetzakis R Tringidou | 2005 | World Journal of Gastroenterology2005，11，14： | 14 |
| 13 | 大别山双河和碧溪岭超高压变质岩流体包裹体研究显示文摘对大别山双河和碧溪岭含柯石英榴辉岩和硬玉石英岩进行了详细的流体包裹体研究。根据流体包裹体的成分和盐度的不同 ,可以划分出至少五种类型不同的气液包裹体 :( 1) N2 包裹体 ;( 2 )高盐度流体包裹体 ;( 3) CO2 包裹体 ;( 4) CO2 -H2 O包裹体 ;( 5 )低盐度流体包裹体。N2 包裹体仅见于含柯石英榴辉岩 ,而高盐度流体包裹体则几乎存在于所有的榴辉岩和硬玉石英岩中。 CO2 包裹体沿榴辉岩中微剪切带分布 ,或存在于强变形的硬玉石英岩中 ,而低盐度流体包裹体分布较为局限。N2 和高盐度流体被认为是超高压变质作用平衡的产物 ,来源于变质前的古孔隙流体。而且榴辉岩中含有一系列盐度不同的流体显微域 ,其大小与矿物颗粒相当。在板块折返过程中 ,包裹体中流体可能发生迁移 ,但是不会超出寄主晶体的范围。CO2流体明显是外来的 ,可能来自共生大理岩或含碳酸盐的变质沉积岩。这与菱镁矿和柯石英等共生组合所指示的进变质过程中大理岩不存在脱碳反应的结论相一致。而低盐度流体则可能系顶峰变质矿物分解而成 。 | 傅斌 肖益林 J L R Touret A M Van den Kerkhof JHoefs 郑永飞 | 2000 | 岩石学报2000，16，1： | 14 |
| 14 | Effect of precut sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis:A systematic review and meta-analysis显示文摘AIM:To conduct a systemic review and meta-analysis to investigate the role of early precut technique.Multiple randomized controlled trails(RCTs)have reported conflicting results of the early precut sphincterotomy.METHODS:MEDLINE/PubMed,EMBASE,Cochrane Central Register of Controlled Trials and Database of Systematic Reviews,and recent abstracts from major conference proceedings were searched(June 2013).Randomized and non-randomized studies comparing early precut technique with prolonged standard methods were included.Pooled estimates of post-endoscopic retrograde cholangiopancreatography(ERCP)pancreatitis(PEP),cannulation and adverse events were analyzed by using odds ratio(OR).Random and fixed effects models were used as appropriate.Publication bias was assessed by funnel plots.Heterogeneity among studies was assessed by calculating I2 measure of inconsistency.RESULTS:Seven randomized and seven non-randomized trials met inclusion criteria.Meta-analysis of RCTs showed a decrease trend for PEP with early precut sphincterotomy but was not statistically significant(OR=0.58;95%CI:0.32-1.05;P=0.07).No heterogeneity was noted among the studies with I2 of 0%.CONCLUSION:Early precut technique for common bile duct cannulation decreases the trend of post-ERCP pancreatitis. | Abhishek Choudhary Jessica Winn Sameer Siddique Murtaza Arif Zainab Arif Ghassan M Hammoud Srinivas R Puli Jamal A Ibdah Matthew L Bechtold | 2014 | World Journal of Gastroenterology2014，20，14： | 13 |
| 15 | 非胰岛素依赖型糖尿病冠状动脉疾病的危险因素:英国糖尿病前瞻性研究(UKPDS:23)显示文摘目的:评价2型糖尿病患者冠状动脉疾病的基线危险因素。设计:对2 693例资料完整的患者进行年龄和性别调整的逐步选择过程分析,以确定哪些冠状动脉疾病的危险因素应纳入 Cox 比例风险模型。对象:3 055例白人患者,平均年龄52岁,均新近诊断为2型糖尿病,且无动脉粥样硬化相关疾病的证据。平均随访期7.9年。335例患者于10年内出现冠状动脉疾病。结局评定:具有明确异常心电图的心绞痛、致死或非致死性心肌梗塞。结果:冠状动脉疾病与低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、甘油三酯浓度升高、高血红蛋白 A_(1c)、高收缩压、高空腹血糖以及吸烟史密切相关。低密度脂蛋白胆固醇较高1/3对较低1/3区间的估计风险比为2.26(95%可信区间为1.70~3.00),高密度脂蛋白胆固醇为0.55(0.41~0.73),血红蛋白 A_(1c)为1.52(1.15~2.01),收缩压为1.82(1.34~2.47)。吸烟者的估计风险比为1.41(1.06~1.88)。结论:2型糖尿病患者中,存在冠状动脉疾病潜在的、可变的5种危险因素的交叉重叠影响。它们是低密度脂蛋白胆固醇浓度升高、高密度脂蛋白胆固醇浓度降低、高血压、高血糖和吸烟。 | R C Turner H Millns H A W Neil I M Stratton S E Manley D R Matthews R R Holman 赵维纲 | 1998 | 英国医学杂志中文版1998，0，3： | 11 |
| 16 | Computed tomography overestimation of esophageal tumor length: Implications for radiotherapy planning显示文摘AIM:To assess the relationship between preoperative computed tomography(CT)and postoperative pathological measurements of esophageal tumor length and the prognostic significance of CT tumor length data.METHODS:A retrospective study was carried out in 56 patients who underwent curative esophagogastrectomy.Tumor lengths were measured on the immediate preoperative CT and on the post-operative resection specimens.Inter-and intra-observer variations in CT measurements were assessed.Survival data were collected.RESULTS:There was a weak correlation between CT and pathological tumor length(r=0.30,P=0.025).CT lengths were longer than pathological lengths in 68%(38/56)of patients with a mean difference of 1.67 cm(95%CI:1.18-2.97).The mean difference in measurements by two radiologists was 0.39 cm(95% CI:-0.59-1.44).The mean difference between repeat CT measured tumor length(intra-observer variation) were 0.04 cm(95%CI:-0.59-0.66)and 0.47 cm (95%CI:-0.53-1.47).When stratified,patients not receiving neoadjuvant chemotherapy showed a strong correlation between CT and pathological tumor length(r =0.69,P=0.0014,n=37)than patients that did(r= 0.13,P=0.43,n=19).Median survival with CT tumor length>5.6 cm was poorer than with smaller tumors,but the difference was not statistically significant.CONCLUSION:Esophageal tumor length assessed using CT does not reflect pathological tumor extent and should not be the only modality used for management decisions,particularly for planning radiotherapy. | Karim Sillah Luke R Williams Hans-Ulrich Laasch Azeem Saleem Gillian Watkins Susan A Pritchard Patricia M Price Catharine M West Ian M Welch | 2010 | World Journal of Gastrointestinal Oncology2010，2，4： | 10 |
| 17 | Hepatic abscess induced by foreign body:Case report and literature review显示文摘Hepatic abscess due to perforation of the gastrointestinal tract caused by ingested foreign bodies is uncommon. Pre-operative diagnosis is difficult as patients are often unaware of the foreign body ingestion and symptoms and imagiology are usually non-specific. The authors report a case of 62-year-old woman who was admitted with fever and abdominal pain. Further investigation revealed hepatic abscess, without resolution despite antibiotic therapy. A liver abscess resulting from perforation and intra-hepatic migration of a bone coming from the pilorum was diagnosed by surgery. The literature concerning foreign body-induced perforation of the gastrointestinal tract complicated by liver abscess is reviewed. | Sofia A Santos Sara CF Alberto Elsa Cruz Eduardo Pires Tomás Figueira lia Coimbra José Estevez Mário Oliveira Luís Novais Joo R Deus | 2007 | World Journal of Gastroenterology2007，13，9： | 10 |
| 18 | Duodenal gangliocytic paraganglioma with lymph node metastases: a case report and comparative review of 31 cases显示文摘Gangliocytic paraganglioma(GP) is a rare tumor of uncertain origin most often located in the second portion of the duodenum. It is composed of three cellular components: Epithelioid endocrine cells, spindlelike/sustentacular cells, and ganglion-like cells. While this tumor most often behaves in a benign manner, cases with metastasis are reported. We describe the case of a 62-year-old male with a periampullary GP with metastases to two regional lymph nodes who was successfully treated with pancreaticoduodenectomy. Using Pub Med, EMBASE, EBSCOhost MEDLINE and CINAHL, and Google Scholar, we searched the literature for cases of GP with regional lymph node metastasis and evaluated the varying presentations, diagnostic workup, and disease management of identified cases. Thirty-one cases of GP with metastasis were compiled(30 with at least lymph node metastases and one with only distant metastasis to bone), with age at diagnosis ranging from 16 to 74 years. Ratio of males to females was 19:12. The most common presenting symptoms were abdominal pain(55%) and gastrointestinal bleeding or sequelae(42%). Twenty-five patients underwent pancreaticoduodenectomy. Five patients were treated with local resection alone. One patient died secondary to metastatic disease, and one died secondary to perioperative decompensation. The remainder did well, with no evidence of disease at follow-up from the most recent procedure(except two in which residual disease was deliberately left behind). Of the 26 cases with sufficient histological description, 16 described a primary tumor that infiltrated deep to the submucosa, and 3 described lymphovascular invasion. Of the specific immunohistochemistry staining patterns studied, synaptophysin(SYN) stained all epithelioid endocrine cells(18/18). Neuron specific enolase(NSE) and SYN stained most ganglion-like cells(7/8 and 13/18 respectively), and S-100 stained all spindle-like/sustentacular cells(21/21). Our literature review of published cases of GP with lymph node metastasis underscores the excellent prognosis of GP regardless of specific treatment modality. We question the necessity of aggressive surgical intervention in select patients, and argue that local resection of the mass and metastasis may be adequate. We also emphasize the importance of pre-surgical assessment with imaging studies, as well as post-surgical follow-up surveillance for disease recurrence. | Sahara J Cathcart Aaron R Sasson Jessica A Kozel Jennifer M Oliveto Quan P Ly | 2017 | World Journal of Clinical Cases2017，5，6： | 9 |
| 19 | Relationship between the exocrine and endocrine pancreas after acute pancreatitis显示文摘AIM:To determine the prevalence and time course of pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.METHODS:Relevant literature cited in three major biomedical journal databases(EMBASE,MEDLINE,and Scopus)was reviewed independently by two authors.There were no language constraints but the search was limited to human studies.Studies included were cohort studies of adult patients who were discharged after an attack of acute pancreatitis.Patients were excluded if they were under 18 years of age or had a previous diagnosis of prediabetes or diabetes mellitus,pancreatic exocrine insufficiency,or chronic pancreatitis.The main outcome measure was the prevalence of concomitant pancreatic exocrine insufficiency in patients who were diagnosed with prediabetes and diabetes mellitus after an attack of acute pancreatitis.Subgroup analysis was conducted for patients who were diagnosed with prediabetes only and those who were diagnosed withdiabetes mellitus only.Subgroup analysis looking at the time course of concomitant pancreatic exocrine and endocrine insufficiency was also conducted.Pooled prevalence and corresponding 95%confidence intervals were calculated for all outcome measures and P-values<0.05 were deemed statistically significant.RESULTS:Eight clinical studies comprising of 234patients met all eligibility criteria.The pooled prevalence of newly diagnosed prediabetes or diabetes in individuals after acute pancreatitis was 43%(95%CI:30%-56%).The pooled prevalence of pancreatic exocrine insufficiency in individuals after acute pancreatitis was 29%(95%CI:19%-39%).The prevalence of concomitant pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes was 40%(95%CI:25%-55%).The prevalence of concomitant pancreatic exocrine insufficiency among individuals with prediabetes alone and diabetes mellitus alone was 41%(95%CI:12%-75%)and 39%(95%CI:28%-51%),respectively.Further analysis showed that the prevalence of concomitant pancreatic exocrine insufficiency in individuals with prediabetes or diabetes decreases over time after an attack of acute pancreatitis.CONCLUSION:Pancreatic exocrine insufficiency occurs in 40%of individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.Further studies are needed to investigate the pathogenesis of diabetes in this setting. | Stephanie L M Das James I C Kennedy Rinki Murphy Anthony R J Phillips John A Windsor Maxim S Petrov | 2014 | World Journal of Gastroenterology2014，20，45： | 9 |
| 20 | High-flow nasal oxygen availability for sedation decreases the use of general anesthesia during endoscopic retrograde cholangiopancreatography and endoscopic ultrasound显示文摘AIM To examine whether high-flow nasal oxygen(HFNO) availability influences the use of general anesthesia(GA) in patients undergoing endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic ultrasound(EUS) and associated outcomes.METHODS In this retrospective study, patients were stratified into 3 eras between October 1, 2013 and June 30, 2014 based on HFNO availability for deep sedation at the time of their endoscopy. During the first and last 3-mo eras(era 1 and 3), no HFNO was available, whereas it was an option during the second 3-mo era(era 2). The primary outcome was the percent utilization of GA vs deep sedation in each period. Secondary outcomes included oxygen saturation nadir during sedation between periods, as well as procedure duration, and anesthesia-only time between periods and for GA vs sedation cases respectively.RESULTS During the study period 238 ERCP or EUS cases were identified for analysis. Statistical testing was employed and a P < 0.050 was significant unless the Bonferroni correction for multiple comparisons was used. General anesthesia use was significantly lower in era 2 compared to era 1 with the same trend between era 2 and 3(P = 0.012 and 0.045 respectively). The oxygen saturation nadir during sedation was significantly higher in era 2 compared to era 3(P < 0.001) but not between eras 1 and 2(P = 0.028) or 1 and 3(P = 0.069). The procedure time within each era was significantly longer under GA compared to deep sedation(P ≤ 0.007) as was the anesthesia-only time(P ≤ 0.001).CONCLUSION High-flow nasal oxygen availability was associated with decreased GA utilization and improved oxygenation for ERCP and EUS during sedation. | Roman Schumann Nikola S Natov Klifford A Rocuts-Martinez Matthew D Finkelman Tom V Phan Sanjay R Hegde Robert M Knapp | 2016 | World Journal of Gastroenterology2016，22，47： | 9 |
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