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| 1 | Cardiac autonomic neuropathy in patients with diabetes mellitus显示文摘Cardiac autonomic neuropathy(CAN)is an often overlooked and common complication of diabetes mellitus.CAN is associated with increased cardiovascular morbidity and mortality.The pathogenesis of CAN is complex and involves a cascade of pathways activated by hyperglycaemia resulting in neuronal ischaemia and cellular death.In addition,autoimmune and genetic factors are involved in the development of CAN.CAN might be subclinical for several years until the patient develops resting tachycardia,exercise intolerance,postural hypotension,cardiac dysfunction and diabetic cardiomyopathy.During its sub-clinical phase,heart rate variability that is influenced by the balance between parasympathetic and sympathetic tones can help in detecting CAN before the disease is symptomatic.Newer imaging techniques(such as scintigraphy)have allowed earlier detection of CAN in the pre-clinical phase and allowed better assessment of the sympathetic nervous system.One of the main difficulties in CAN research is the lack of a universally accepted definition of CAN;however,the Toronto Consensus Panel on Diabetic Neuropathy has recently issued guidance for the diagnosis and staging of CAN,and also proposed screening for CAN in patients with diabetes mellitus.A major challenge,however,is the lack of specific treatment to slow the progression or prevent the development of CAN.Lifestyle changes,improved metabolic control might prevent or slow the progression of CAN.Reversal will require combination of these treatments with new targeted therapeutic approaches.The aim of this article is to review the latest evidence regarding the epidemiology,pathogenesis,manifestations,diagnosis and treatment for CAN. | Gerasimos Dimitropoulos Abd A Tahrani Martin J Stevens | 2014 | World Journal of Diabetes2014，5，1： | 48 |
| 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 |
| 3 | 簇毛麦对不同白粉病菌菌系的抗性反应及其在小麦遗传背景下的表达显示文摘对引自原苏联的簇毛麦(HaynaldiavilosaL.Schur2n=14VV)及其与硬粒小麦杂交育成的双二倍体TH1TH1WTH2WTH3TH3W,普通小麦-簇毛麦6D/6V异代换系及普通小麦亲本和已知抗白粉病基因的18个小麦品种为供试材料,用84个来自美国、德国、中国的小麦白粉病菌菌系进行苗期接种鉴定。发现簇毛麦及其衍生系对所有参试的白粉病菌系表现免疫和抗,比供试的已知抗性基因的18个小麦品种抗性强,抗谱广。其抗性基因在81086A、D311、墨75、陕7859、宛7107、冀麦30等小麦遗传背景下均能很好表达。 | 陈孝 施爱农 尚立民 Leath Steven Murphy J Paul | 1997 | 植物病理学报1997，27，1： | 34 |
| 4 | 上海26万妇女乳房自我检查随机试验显示文摘目的论证指导妇女进行乳房自我检查(BSE)是否能有效降低乳腺癌患者的死亡率。方法自1989年10月起,上海26.6万名年龄在30~64岁的妇女,随机进入指导组(132979名)和对照组(133085名)。在指导组,最初先由医务人员做规范的BSE手法演示,随后的4年中,使用BSE录像带进行二次强化教育,并定期进行BSE指导和在医务人员监察下进行BSE操作。本研究进行5年,全部活动均被记录。队列人群随访到2000年7月,乳腺癌患者的生存状况随访到2001年12月。统计分析采用Kaplan-Meier方法、Logrank检验以及Cox模型。结果指导组检出乳腺癌864例,其中死于乳腺癌133例;对照组检出乳腺癌896例,其中死于乳腺癌130例。两组乳腺癌病例的肿块大小、TNM分期和累积死亡率的差异均无统计学意义(P均>0.05)。但是指导组比对照组有较多和较小的纤维腺瘤被检出(P<0.01)。结论对人群开展BSE教育和指导,未能降低人群的乳腺癌死亡率;接受BSE教育的妇女比没有接受教育的妇女可检出较多的和较小的良性乳房肿块。 | 高道利 David BThomas Roberta M Ray 王文婉 Charlene J Allison 陈范良 Peggy Porter 胡永伟 赵关林 潘雷达 李雯瑾 武春园 Zakia Coriaty Ilonka Evans 林明纲 Helge Stalsberg Steven Gself | 2005 | 中华肿瘤杂志2005，27，6： | 14 |
| 5 | Encapsulating peritoneal sclerosis显示文摘Encapsulating peritoneal sclerosis(EPS) is a debilitating condition characterized by a fibrocollagenous membrane encasing the small intestine, resulting in recurrent small bowel obstructions. EPS is most commonly associated with long-term peritoneal dialysis, though medications, peritoneal infection, and systemic inflammatory disorders have been implicated. Many cases remain idiopathic. Diagnosis is often delayed given the rarity of the disorder combined with non-specific symptoms and laboratory findings. Although cross-sectional imaging with computed tomography of the abdomen can be suggestive of the disorder, many patients undergo exploratory laparotomy for diagnosis. Mortality approaches 50% one year after diagnosis. Treatment for EPS involves treating the underlying condition or eliminating possible inciting agents(i.e. peritoneal dialysis, medications, infections) and nutritional support, frequently with total parenteral nutrition. EPSspecific treatment depends on the disease stage. In the inflammatory stage, corticosteroids are the treatment of choice, while in the fibrotic stage, tamoxifen may be beneficial. In practice, distinguishing between stages may be difficult and both may be used. Surgical intervention, consisting of peritonectomy and enterolysis, is timeconsuming and high-risk and is reserved for situations in which conservative medical therapy fails in institutions with surgical expertise in this area. Herein we review the available literature of the etiology, pathogenesis, diagnosis, and treatment of this rare, but potentially devastating disease. | Christopher J Danford Steven C Lin Martin P Smith Jacqueline L Wolf | 2018 | World Journal of Gastroenterology2018，24，28： | 13 |
| 6 | A functional C-terminal TRAF3-binding site in MAVS participates in positive and negative regulation of the IFN antiviral response显示文摘病毒的 RNA 的识别由 cytosolic 传感器 retinoic 组织酸可诱导的基因 --(RIG-I ) 我导致表明与类型的产生达到顶点的串联的激活我干扰素(IFN ) 抗病毒的反应。对病毒的病原体的抗病毒、煽动性的回答的发作要求表明改编者, kinases 和 transcriptional 蛋白质到 mitochondrial 的调整空间与时间的招募抗病毒的发信号蛋白质(MAVS ) 。我们以前示威了 serine/threonine kinase IKKε被招募到 MAVS 后面的仙台或小囊的口炎病毒(VSV ) 感染的 C 终端区域,在 Lys500 由 MAVS 的连接 Lys63 的 polyubiquitination 调停了,导致下游的 IFN 发信号的抑制(Paz 等,摩尔房间 Biol, 2009 ) 。在这研究,我们证明 MAVS 的 C 终点在 MAVS 的 aa450-468 区域怀有一个新奇 TRAF3 有约束力的地点。一个一致交往 TRAF 主题(提姆) , 455-PEENEY-460,在这以内,地点为 TRAF3 绑定和 IFN 抗病毒的反应基因的激活被要求,而 TIM 的变化消除 TRAF3 绑定和下游的 IFN 反应。有表示 MAVS 的一个变异提姆的版本的构造的 MAVS −/− 老鼠胚胎成纤维细胞的宪法没能恢复抗病毒的反应或块 VSV 复制,而野类型的 MAVS 重新组成 VSV 复制的抗病毒的抑制。而且, IKKε 的招募;到在经由 Lys500 的 MAVS 的一个邻近的 C 终端地点(aa 468-540 ) , ubiquitination 减少了 TRAF3 绑定和蛋白质稳定性,因此贡献 IKKε调停 IFN 反应关机。这研究证明 MAVS 怀有功能的 C 终端参予 IFN 抗病毒的反应的积极、否定的规定的 TRAF3 有约束力的地点。 | Suzanne Paz Myriam Vilasco Steven J Werden Meztli Arguello Deshanthe Joseph-Pillai Tiejun Zhao Thi Lien-Anh Nguyen Qiang Sun Eliane F Meurs Rongtuan Lin John Hiscott | 2011 | Cell Research2011，21，6： | 12 |
| 7 | Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures显示文摘Endoscopic submucosal dissection(ESD) is a wellestablished, minimally invasive treatment for superficial neoplasms of the gastrointestinal tract. The universal adoption of ESD has been limited by its slow learning curve, long procedure times, and high risk of complications. One technical challenge is the lack of a second hand that can provide traction, as in conventional surgery. Reliable tissue retraction that exposes the submucosal plane of dissection would allow for safer and more efficient dissection. Magnetic anchor guided endoscopic submucosal dissection(MAGESD) has potential benefits compared to other current traction methods. MAG-ESD offers dynamic tissue retraction independent of the endoscope mimicking a surgeon's 'second hand'. Two types of magnets can be used: electromagnets and permanent magnets. In this article we review the MAG-ESD technology, published work and studies of magnets in ESD. We also review the use of magnetic anchor guidance systems in natural orifice transluminal endoscopic surgery and the idea of magnetic non-contact retraction using surface ferromagentization. We discuss the current limitations, the future potential of MAG-ESD and the developments needed for adoption of this technology. | Mohamed Mortagy Neal Mehta Mansour A Parsi Seiichiro Abe Tyler Stevens John J Vargo Yutaka Saito Amit Bhatt | 2017 | World Journal of Gastroenterology2017，23，16： | 12 |
| 8 | Bacterial biota in reflux esophagitis and Barrett's esophagus显示文摘AIM: To identify the bacterial flora in conditions such as Barrett's esophagus and reflux esophagitis to determine if they are similar to normal esophageal flora.METHODS: Using broad-range 16S rDNA PCR,esophageal biopsies were examined from 24 patients [9with normal esophageal mucosa, 12 with gastroesophageal reflux disease (GERD), and 3 with Barrett's esophagus].Two separate broad-range PCR reactions were performed for each patient, and the resulting products were cloned.In one patient with Barrett's esophagus, g9 PCR clones were analyzed.RESULTS: Two separate clones were recovered from each patient (total = 48), representing 24 different species, with 14 species homologous to known bacteria,5 homologous to unidentified bacteria, and 5 were not homologous (<97% identity) to any known bacterial 16S rDNA sequences. Seventeen species were found in the reflux esophagitis patients, 5 in the Barrett's esophagus patients, and 10 in normal esophagus patients.Further analysis concentrating on a single biopsy from an individual with Barrett's esophagus revealed the presence of 21. distinct bacterial species. Members of four phyla were represented, including Bacteroidetes,Firmicutes, Proteobacteria, and Actinobacteria.Microscopic examination of each biopsy demonstrated bacteria in intimate association with the distal esophageal epithelium, suggesting that the presence of these bacteria is not transitory.CONCLUSION: These findings provide evidence for a complex, residential bacterial population in esophageal reflux-related disorders. While much of this biota is present in the normal esophagus, more detailed comparisons may help identify potential disease associations. | Zhiheng Pei Liying Yang Richard M Peek Jr Steven M Levine David T Pride Martin J Blaser | 2005 | World Journal of Gastroenterology2005，11，46： | 11 |
| 9 | Role of the endothelium in inflammatory bowel diseases显示文摘Inflammatory bowel diseases(IBD) are a complex group of diseases involving alterations in mucosal immunity and gastrointestinal physiology during both initiation and progressive phases of the disease.At the core of these alterations are endothelial cells,whose continual adjustments in structure and function coordinate vascular supply,immune cell emigration,and regulation of the tissue environment.Expansion of the endothelium in IBD(angiogenesis),mediated by inflammatory growth factors,cytokines and chemokines,is a hallmark of active gut disease and is closely related to disease severity.The endothelium in newly formed or inflamed vessels differs from that in normal vessels in the production of and response to inflammatory cytokines,growth factors,and adhesion molecules,altering coagulant capacity,barrier function and blood cell recruitment in injury.This review examines the roles of the endothelium in the initiation and propagation of IBD pathology and distinctive features of the intestinal endothelium contributing to these conditions. | Walter E Cromer J Michael Mathis Daniel N Granger Ganta V Chaitanya J Steven Alexander | 2011 | World Journal of Gastroenterology2011，17，5： | 10 |
| 10 | 静脉血栓栓塞症的抗血栓治疗:美国《胸科学》杂志指南显示文摘包括深静脉血栓和肺栓塞在内的静脉血栓栓塞症是癌症患者的主要并发症,发生率为4%~20%,并且是常见的潜在致命性急症。本文介绍了美国《胸科学》杂志指南中VET的抗血栓治疗的部分内容,其以第9版《美国胸内科医师学会循证临床实践指南》中的《静脉血栓栓塞症的抗血栓治疗:抗血栓治疗和阻止血栓形成》一文为参照,基于静脉血栓栓塞症治疗的Ⅲ期试验的发表年份,对口服抗凝剂(达比加群、利伐沙班、阿哌沙班、依度沙班)进行先后阐述(但是这一排序并不是指南专家组对药剂的优劣排序),以为临床医生提供参考。 | Kearon C Akl EA Ornelas J Blaivas A Jimenez D Bounameaux H Huisman M King CS MorrisT Sood N Stevens SM Vintch JRE Wells P Woller SC Moores CL 本刊编辑部 | 2016 | 中国全科医学2016，19，9： | 10 |
| 11 | Proteasome inhibition-induces endoplasmic reticulum dysfunction and cell death of human cholangiocarcinoma cells显示文摘AIM: To determine if proteasome inhibition induces apoptosis in human cholangiocarcinoma cells, and if so, to elucidate the cellular mechanisms. METHODS: Studies were performed in the human KMCH, KMBC, and Mz-ChA-1 cholangiocarcinoma, and normal rat cell lines. MG132, a peptide aldehyde, which inhibits the chymotrypsin-like activity of the proteaosome was employed for this study. Apoptosis was assessed morphologically by 4'-6-Diamidino-2-phenylindole (DAPI) nuclear staining and fluorescence microscopy. Mitochondrial membrane potential was examined using a fluorescent unquenching assay. Ultrastructural changes during cell death were examined using transmission electron microscopy (TEM). Caspase 3/7 activity was assessed using an enzymatic-based fluorescent assay. Cytosolic-free calcium concentrations were measured using Fura-2 and digitized fluorescent microscopy. RESULTS: MG132, a proteasome inhibitor, induced apoptosis in all the cholangiocarcinoma cell lines examined. In contrast, minimal cytotoxicity was observed in normal rat cholangiocytes. Apoptosis was time-and -concentration-dependent. There was no change in the mitochondrial membrane potential between treated and untreated cells. Ultrastructural examination by transmission electron microscopy displayed the classic features of apoptosis, but in addition, there was also dramatic vacuolization of the endoplasmic reticulum (ER). Unexpectedly, no increase in caspase 3/7 activity was observed in MG132 treated cells, nor did the pancaspase inhibitor, Q-VD-OPh prevent cell death. The protein synthesis inhibitor, cycloheximide, blocked apoptosis induced by proteosome inhibitor indicating that ER dysfunction was dependent upon the formation of new proteins. CONCLUSION: Proteosome inhibition induces ERdysfunction and caspase-independent cell death selectively in human cholangiocarcinoma cells. Proteasome inhibitors warrant evaluation as anticancer agents for the treatment of human cholangiocarcinoma. | Yucel Ustundag Steven F Bronk Gregory J Gores | 2007 | World Journal of Gastroenterology2007，13，6： | 9 |
| 12 | Functional brain imaging of gastrointestinal sensation in health and disease显示文摘It has since long been known, from everyday experience as well as from animal and human studies, that psychological processes-both affective and cognitive- exert an influence on gastrointestinal sensorimotor function. More specifi cally, a link between psychological factors and visceral hypersensitivity has been suggested, mainly based on research in functional gastrointestinal disorder patients. However, until recently, the exact nature of this putative relationship remained unclear, mainly due to a lack of non-invasive methods to study the (neurobiological) mechanisms underlying this relationship in non-sleeping humans. As functional brain imaging, introduced in visceral sensory neuroscience some 10 years ago, does provide a method for in vivo study of brain-gut interactions, insight into the neurobiological mechanisms underlying visceral sensation in general and the influence of psychological factors more particularly, has rapidly grown. In this article, an overview of brain imaging evidence on gastrointestinal sensation will be given, with special emphasis on the brain mechanisms underlying the interaction between affective & cognitive processes and visceral sensation. First, the reciprocal neural pathways between the brain and the gut (brain- gut axis) will be briefky outlined, including brain imaging evidence in healthy volunteers. Second, functional brain imaging studies assessing the influence of psychological factors on brain processing of visceral sensation in healthy humans will be discussed in more detail. Finally, brain imaging work investigating differences in brain responses to visceral distension between healthy volunteers and functional gastrointestinal disorderpatients will be highlighted. | Lukas Van Oudenhove Steven J Coen Qasim Aziz | 2007 | World Journal of Gastroenterology2007，13，25： | 9 |
| 13 | Colonic ulcerations may predict steroid-refractory course in patients with ipilimumab-mediated enterocolitis显示文摘AIM To investigate management of patients who develop ipilimumab-mediated enterocolitis, including association of endoscopic findings with steroid-refractory symptoms and utility of infliximab as second-line therapy.METHODS We retrospectively reviewed all patients at our centerwith metastatic melanoma who were treated with ipilimumab between March 2011 and May 2014. All patients received a standard regimen of intravenous ipilimumab 3 mg/kg every 3 wk for four doses or until therapy was stopped due to toxicity or disease progression. Basic demographic and clinical data were collected on all patients. For patients who developed grade 2 or worse diarrhea(increase of 4 bowel movements per day), additional data were collected regarding details of gastrointestinal symptoms, endoscopic findings and treatment course. Descriptive statistics were used.RESULTS A total of 114 patients were treated with ipilimumab during the study period and all were included. Sixteen patients(14%) developed ≥ grade 2 diarrhea. All patients were treated with high-dose corticosteroids(1-2 mg/kg prednisone daily or equivalent). Nine of 16 patients(56%) had ongoing diarrhea despite highdose steroids. Steroid-refractory patients received one dose of intravenous infliximab at 5 mg/kg, and all but one had brisk resolution of diarrhea. Fourteen of the patients underwent either colonoscopy or sigmoidoscopy with variable endoscopic findings, ranging from mild erythema to colonic ulcers. Among 8 patients with ulcers demonstrated by sigmoidoscopy or colonoscopy, 7 patients(88%) developed steroidrefractory symptoms requiring infliximab. With a median follow-up of 264 d, no major adverse events associated with prednisone or infliximab were reported.CONCLUSION In patients with ipilimumab-mediated enterocolitis, the presence of colonic ulcers on endoscopy was associated with a steroid-refractory course. | Animesh Jain Evan J Lipson William H Sharfman Steven R Brant Mark G Lazarev | 2017 | World Journal of Gastroenterology2017，23，11： | 8 |
| 14 | One hundred and seventy-eight consecutive pancreatoduodenectomies without mortality:role of the multidisciplinary approach显示文摘BACKGROUND:Pancreatoduodenectomy offers the only chance of cure for patients with periampullary cancers.This,however,is a major undertaking in most patients and is associated with a significant morbidity and mortality.A multidisciplinary approach to the workup and follow-up of patients undergoing pancreatoduodenectomy was initiated at our institution to improve the diagnosis,resection rate,mortality and morbidity.We undertook the study to assess the effect of this approach on diagnosis,resection rates and short-term outcomes such as morbidity and mortality.METHODS:A prospective database of patients presenting with periampullary cancers to a single surgeon between April 2004 and April 2010 was reviewed.All cases were discussed at a multidisciplinary meeting comprising surgeons,gastroenterologists,radiologists,oncologists,radiation oncologists,pathologists and nursing staff.A standardized investigation and management algorithm was followed.Complications were graded according to the Clavien-Dindo classification.RESULTS:A total of 295 patients with a periampullary lesion were discussed and 178 underwent pancreatoduodenectomy (resection rate 60%).Sixty-one patients (34%) required either a vascular or an additional organ resection.Eighty-nine patients experienced complications,of which the commonest was blood transfusion (12%).Thirty-four patients (19%) had major complications,i.e.grade 3 or above.There was no in-hospital,30-day or 60-day mortality.CONCLUSIONS:Pancreatoduodenectomy can safely be performed in high-volume centers with very low mortality.The surgeon's role should be careful patient selection,intensive preoperative investigations,use of a team approach,and an unbiased discussion at a multidisciplinary meeting to optimize the outcome in these patients. | Jaswinder S Samra Raul Alvarado Bachmann Julian Choi Anthony Gill Michael Neale Vikram Puttaswamy Cameron Bell Ian Norton Sarah Cho Steven Blome Ritchie Maher Sivakumar Gananadha Thomas J Hugh | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，4： | 8 |
| 15 | 腰椎骨盆固定和三角固定术在不稳定型骶骨骨折治疗中的应用显示文摘骶骨是构成骨盆后环的蕈要结构和脊柱重力线分佑到两侧髋臼的枢纽部位,垂直不稳定型骶骨骨折多由高能量损伤引起,常合并神经损伤和多发性创伤而引起骨盆环不稳定,特殊类型的骶骨骨折可引起脊柱一骨盆的不稳定。近年来,随着研究的深入,多种内固定方法用于垂直不稳定型骶骨骨折的治疗,包括横向固定装置,如骶髂螺钉、骶骨棒、 | 易成腊 Steven Morgan David J Hak | 2011 | 中华创伤骨科杂志2011，13，4： | 8 |
| 16 | National trends in resection of the distal pancreas显示文摘AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement Project(NSQIP,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal pancreatectomy.Utilization of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIP by the exploratory laparoscopy or unlisted procedure current procedural terminology codes.In SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER Program Code Manual,third edition procedure codes.We analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative resection.RESULTS:NIS,NSQIP and SEER identified 4242,2681 and 11 082 DP resections,respectively.Overall,laparoscopy was utilized in 15%(NIS) and 27%(NSQIP).No significant increase was seen over the course of the study.Resection was performed for malignancy in 59%(NIS) and 66%(NSQIP).Neither patient Body mass index nor comorbidities were associated with operative approach(P = 0.95 and P = 0.96,respectively).Mortality(3% vs 2%,P = 0.05) and reoperation(4% vs 4%,P = 1.0) was not different between laparoscopy and open groups.Overall complications(10% vs 15%,P < 0.001),hospital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,P = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,P < 0.001) were less when laparoscopy was utilized.One and two year survival after resection for malignancy were unchanged over the course of the study(ductal adenocarinoma 1-year 63.6% and 2-year 35.1%,P = 0.53;intraductal papillary mucinous neoplasm and nueroendocrine 1-year 90% and 2-year 84%,P = 0.25).The majority of resections were performed in teaching hospitals(77% NIS and 85% NSQIP),but minimally invasive surgery(MIS) was not more likely to be used in teaching hospitals(15% vs 14%,P = 0.26).Hospitals in the top decile for volume were more likely to be teaching hospitals than lower volume deciles(88% vs 43%,P < 0.001),but were no more likely to utilize MIS at resection.Complication rate in teaching and the top decile hospitals was not significantly decreased when compared to non-teaching(15% vs 14%,P = 0.72) and lower volume hospitals(14% vs 15%,P = 0.99).No difference was seen in the median number of lymph nodes and lymph node ratio in N1 disease when compared by year(P = 0.17 and P = 0.96,respectively).CONCLUSION:There appears to be an overall underutilization of laparoscopy for DP.Centralization does not appear to be occurring.Survival and lymph node harvest have not changed. | Armando Rosales-Velderrain Steven P Bowers Ross F Goldberg Tatyan M Clarke Mauricia A Buchanan John A Stauffer Horacio J Asbun | 2012 | World Journal of Gastroenterology2012，18，32： | 8 |
| 17 | Diagnostic and therapeutic direct peroral cholangioscopy using an intraductal anchoring balloon显示文摘AIM:To report our experience using a recently introduced anchoring balloon for diagnostic and therapeutic direct peroral cholangioscopy(DPOC).METHODS:Consecutive patients referred for diagnostic or therapeutic peroral cholangioscopy were evaluated in a prospective cohort study.The patients underwent DPOC using an intraductal anchoring balloon,which was recently introduced to allow consistent access to the biliary tree with an ultraslim upper endoscope.The device was later voluntarily withdrawn from the market by the manufacturer.RESULTS:Fourteen patients underwent DPOC using the anchoring balloon.Biliary access with an ultraslim upper endoscope was accomplished in all 14 patients.In 12(86%) patients,ductal access required sphincteroplasty with a 10-mm dilating balloon.Intraductal placement of the ultraslim upper endoscope allowed satisfactory visualization of the biliary mucosa to the level of the confluence of the right and left hepatic ducts in 13 of 14 patients(93%).Therapeutic interventions by DPOC were successfully completed in all five attempted cases(intraductal biopsy in one and DPOC guided laser lithotripsy in four).Adverse events occurred in a patient on immunosuppressive therapy who developed an intrahepatic biloma at the site of the anchoring balloon.This required hospitalization and antibiotics.Repeat endoscopic retrograde cholangiopancreatography 8 wk after the index procedure showed resolution of the biloma.CONCLUSION:Use of this anchoring balloon allowed consistent access to the biliary tree for performance of diagnostic and therapeutic DPOC distal to the biliary bifurcation. | Mansour A Parsi Tyler Stevens John J Vargo | 2012 | World Journal of Gastroenterology2012，18，30： | 8 |
| 18 | Circular smooth muscle contributes to esophageal shortening during peristalsis显示文摘AIM:To study the angle between the circular smooth muscle(CSM) and longitudinal smooth muscle(LSM) fibers in the distal esophagus.METHODS:In order to identify possible mechanisms for greater shortening in the distal compared to proximal esophagus during peristalsis,the angles between the LSM and CSM layers were measured in 9 cadavers.The outer longitudinal layer of the muscularis propria was exposed after stripping the outer serosa.The inner circular layer of the muscularis propria was then revealed after dissection of the esophageal mucosa and the underlying muscularis mucosa.Photographs of each specimen were taken with half of the open esophagus folded back showing both the outer longitudinal and inner circular muscle layers.Angles were measured every one cm for 10 cm proximal to the squamocolumnar junction(SCJ) by two independent investigators.Two human esophagi were obtained from organ transplant donors and the angles between the circular and longitudinal smooth muscle layers were measured using micro-computed tomography(micro CT) and Image J software.RESULTS:All data are presented as mean ± SE.The CSM to LSM angle at the SCJ and 1 cm proximal to SCJ on the autopsy specimens was 69.3 ± 4.62 degrees vs 74.9 ± 3.09 degrees,P = 0.32.The CSM to LSM angle at SCJ were statistically significantly lower than at 2,3,4 and 5 cm proximal to the SCJ,69.3 ± 4.62 degrees vs 82.58 ± 1.34 degrees,84.04 ± 1.64 degrees,84.87 ± 1.04 degrees and 83.72 ± 1.42 degrees,P = 0.013,P = 0.008,P = 0.004,P = 0.009 respectively.The CSM to LSM angle at SCJ was also statistically significantly lower than the angles at 6,7 and 8 cm proximal to the SCJ,69.3 ± 4.62 degrees vs 80.18 ± 2.09 degrees,81.81 ± 1.75 degrees and 80.96 ± 2.04 degrees,P = 0.05,P = 0.02,P = 0.03 respectively.The CSM to LSM angle at 1 cm proximal to SCJ was statistically significantly lower than at 3,4 and 5 cm proximal to the SCJ,74.94 ± 3.09 degrees vs 84.04 ± 1.64 degrees,84.87 ± 1.04 degrees and 83.72 ± 1.42 degrees,P = 0.019,P = 0.008,P = 0.02 respectively.At 10 cm above SCJ the angle was 80.06 ± 2.13 degrees which is close to being perpendicular but less than 90 degrees.The CSM to LSM angles measured on virtual dissection of the esophagus and the stomach on micro CT at the SCJ and 1 cm proximal to the SCJ were 48.39 ± 0.72 degrees and 50.81 ± 1.59 degrees.Rather than the angle of the CSM and LSM being perpendicular in the esophagus we found an acute angulation between these two muscle groups throughout the lower 10 cm of the esophagus.CONCLUSION:The oblique angulation of the CSM may contribute to the significantly greater shortening of distal esophagus when compared to the mid and proximal esophagus during peristalsis. | Anil K Vegesna Keng-Yu Chuang Ramashesai Besetty Steven J Phillips Alan S Braverman Mary F Barbe Michael R Ruggieri Larry S Miller | 2012 | World Journal of Gastroenterology2012，18，32： | 7 |
| 19 | CaMKII in cerebral ischemia显示文摘神经原上的 Ischemic 侮辱触发引起 Ca 导致 neuronal 房间死亡(excitotoxicity ) 的 2+ 超载的过多的、病理学的 glutamate 版本。Ca 2+/calmodulin (凸轮) 依赖者蛋白质 kinase II (CaMKII ) 是位于 neuronal 粘性下面并且学习的生理的有刺激性的 glutamate 信号的一个主要调停人。Glutamate 刺激在 T286 触发 CaMKII 的 autophosphorylation,使 kinase 成为 “ 的一个过程; autonomous”(从 Ca 2+ 刺激的部分活跃的独立人士) 并且那为 synaptic 的形式被要求粘性。最近的研究为侮辱以后的 neuroprotection 作为潜在的药目标也建议了自治 CaMKII 活动,在在 neuronal 文化的 glutamate 侮辱以后并且在在 vivo 的焦点的服的局部缺血以后。然而, CaMKII 和凸轮 kinase 家庭的另外的成员在 neuronal 死亡和幸存的规定被含有。这里,我们在 excitotoxicity 和服的局部缺血讨论过去的调查结果和凸轮 kinase 功能的可能的机制,与 CaMKII 和它的规定的一个焦点。 | Steven J COULTRAP Rebekah S VEST Nicole M ASHPOLE Andy HUDMON K Ulrich BAYEF | 2011 | Acta Pharmacologica Sinica2011，32，7： | 6 |
| 20 | 帕博利珠单抗联合以铂类为基础的化疗治疗非小细胞肺癌合并稳定性脑转移患者的结局:KEYNOTE-021、-189和-407研究的汇总分析显示文摘背景与目的此项探索性分析回顾评价了晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者的结局,旨在确定基线时合并脑转移是否会影响一线应用帕博利珠单抗联合化疗(pembrolizumab plus chemotherapy,PC)比对单用化疗的疗效。患者和方法对KEYNOTE-021队列G(非鳞癌)、KEYNOTE-189(非鳞癌)和KEYNOTE-407(鳞癌)三项研究晚期NSCLC患者的数据进行汇总分析。患者接受含铂两药化疗和/或35个周期帕博利珠单抗治疗(每3周200 mg)。所有研究均纳入了经治或初治的稳定性脑转移患者(KEYNOTE-189与KEYNOTE-407研究纳入初治脑转移患者)。经治的脑转移患者已处于病情稳定的状态≥2周(KEYNOTE-021队列G患者≥4周),无新发或脑转移病灶扩大的证据且入组前至少3天以上未使用激素。初治的无症状脑转移患者需定期接受脑部影像学检查。结果共纳入1298例患者,其中171例有基线脑转移,1127例无脑转移。两组的中位随访时间(范围)在数据截止时分别为10.9(0.1-35.1)个月和11.0(0.1-34.9)个月。合并脑转移和无脑转移患者的总生存期[0.48(95%CI:0.32-0.70)和0.63(95%CI:0.53-0.75)]和无进展生存期[0.44(95%CI:0.31-0.62)和0.55(95%CI:0.48-0.63)]的风险比(PC/化疗)相似。合并脑转移的患者中,PC组和单用化疗组患者的中位总生存期分别为18.8个月和7.6个月,中位无进展生存期分别为6.9个月和4.1个月。无论是否合并脑转移,PC组患者的客观缓解率都高于单用化疗组,且缓解持续时间有显著延长。合并脑转移的患者中,PC组与单用化疗组的治疗相关不良事件发生率分别为88.2%和82.8%;而无脑转移的患者中,两组治疗相关不良事件的发生率分别为94.5%和90.6%。结论无论是否合并脑转移,与单用化疗相比,帕博利珠单抗联合以铂类为基础的组织学特异性化疗可改善所有PD-L1亚组的临床结局,其中包括PD-L1肿瘤比例评分<1%的患者,并且在晚期NSCLC患者中安全性良好。该方案是晚期NSCLC初治患者的标准方案,并可用于合并稳定性脑转移的患者。 | 周清(翻译校对) Steven F Powell Delvys Rodríguez-Abreu Corey J Langer Ali Tafreshi Luis Paz-Ares Hans-Georg Kopp Jeronimo Rodríguez-Cid Dariusz M Kowalski Ying Cheng Takayasu Kurata Mark M Awad Jinaxin Lin Bin Zhao M Catherine Pietanza Bilal Piperdi Marina C Garassino | 2022 | 中国肺癌杂志2022，25，1： | 6 |
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