|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Study of liver cirrhosis over ten consecutive years in Southern China显示文摘AIM: To investigate the etiology and complications of liver cirrhosis(LC) in Southern China. METHODS: In this retrospective, cross-sectional study, we identified cases of liver cirrhosis admitted between January 2001 to December 2010 and reviewed the medical records. Patient demographics, etiologies and complications were collected, and etiological changes were illustrated by consecutive years and within twotime periods(2001-2005 and 2006-2010). All results were expressed as the mean ± SD or as a percentage. The χ2 test or Student's t-test was used to analyze the differences in age, gender, and etiological distribution, and one-way analysis of variance was applied to estimate the trends in etiological changes. We analyzed the relationship between the etiologies and complications using unconditioned logistic regression, and the risk of upper gastrointestinal bleeding(UGIB) and hepatocellular carcinoma(HCC) in the major etiological groups was evaluated as ORs. A P value less than 0.05 was considered significant. Statistical computation was performed using SPSS 17.0 software.RESULTS: In this study, we identified 6719(83.16%) male patients and 1361(16.84%) female patients. The average age of all of the patients was 50.5 years at the time of diagnosis. The distribution of etiological agents was as follows: viral hepatitis, 80.62% [hepatitis B virus(HBV) 77.22%, hepatitis C virus(HCV) 2.80%,(HBV + HCV) 0.58%]; alcohol, 5.68%; mixed etiology, 4.95%; cryptogenic, 2.93%; and autoimmune hepatitis, 2.03%; whereas the other included etiologies accounted for less than 4% of the total. Infantile hepatitis syndrome LC patients were the youngest(2.5 years of age), followed by the metabolic LC group(27.2 years of age). Viral hepatitis, alcohol, and mixed etiology were more prevalent in the male group, whereas autoimmune diseases, cryptogenic cirrhosis, and metabolic diseases were more prevalent in the female group. When comparing the etiological distribution in 2001-2005 with that in 2006-2010, the proportion of viral hepatitis decreased from 84.7% to 78.3%(P < 0.001), and the proportion of HBV-induced LC also decreased from 81.9% to 74.6%(P < 0.001). The incidence of mixed etiology, cryptogenic cirrhosis, and autoimmune diseases increased by 3.1%(P < 0.001), 0.5%(P = 0.158), and 1.3%(P < 0.001), respectively. Alcohol-induced LC remained relatively steady over the 10-year period. The ORs of the development of UGIB between HBV and other major etiologies were as follows: HCV, 1.07; alcohol, 1.89; autoimmune, 0.90; mixed etiology, 0.83; and cryptogenic, 1.76. The ORs of the occurrence of HCC between HBV and other major etiologies were as follows: HCV, 0.54; alcohol, 0.16; autoimmune, 0.05; mixed etiology, 0.58; and cryptogenic, 0.60.CONCLUSION: The major etiology of liver cirrhosis in Southern China is viral hepatitis. However, the proportions of viral hepatitis and HBV are gradually decreasing. Alcoholic LC patients exhibit a greater risk of experiencing UGIB, and HBV LC patients may have a greater risk of HCC. | Xing Wang Shang-Xiong Lin Jin Tao Xiu-Qing Wei Yuan-Ting Liu Yu-Ming Chen Bin Wu | 2014 | World Journal of Gastroenterology2014，20，37： | 72 |
| 2 | Biliary complications following liver transplantation显示文摘Biliary tract complications are the most common complications after liver transplantation.These complications are encountered more commonly as a result of increased number of liver transplantations and the prolonged survival of transplant patients.Biliary complications remain a major source of morbidity in liver transplant patients,with an incidence of 5%-32%.Post liver transplantation biliary complications include strictures(anastomotic and non-anastomotic),leaks,stones,sphincter of Oddi dysfunction,and recurrence of primary biliary disease such as primary sclerosing cholangitis and primary biliary cirrhosis.The risk of occurrence of a specific biliary complication is related to the type of biliary reconstruction performed at the time of liver transplantation.In this article we seek to review the major biliary complications and their relation to the type of biliary reconstruction performed at the time of liver tranplantation. | Gursimran Kochhar Jose Mari Parungao Ibrahim A Hanouneh Mansour A Parsi | 2013 | World Journal of Gastroenterology2013，19，19： | 41 |
| 3 | Ocular complications of diabetes mellitus显示文摘Diabetes mellitus(DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and isbecoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. | Nihat Sayin Necip Kara G?khan Pekel | 2015 | World Journal of Diabetes2015，6，1： | 38 |
| 4 | Risk factors for complications associated with upper gastrointestinal foreign bodies显示文摘AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract.METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract,confirmed by endoscopy,at two university hospital in South Korea.Patient demographic data,including age,gender,intention to ingestion,symptoms at admission,and comorbidities,were collected.Clinical features of the foreign bodies,such as type,size,sharpness of edges,number,and location,were analyzed.Endoscopic data those were analyzed included duration of foreign body impaction,duration of endoscopic performance,endoscopic device,days of hospitalization,complication rate,30-d mortality rate,and the number of operationsrelated to foreign body removal.RESULTS: The types of upper gastrointestinal foreign bodies included fish bones,drugs,shells,meat,metal,and animal bones.The locations of impacted foreign bodies were the upper esophagus(57.2%),mid esophagus(28.4%),stomach(10.8%),and lower esophagus(3.6%).The median size of the foreign bodies was 26.2 ± 16.7 mm.Among 194 patients,endoscopic removal was achieved in 189,and complications developed in 51 patients(26.9%).Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding(n = 31,16%),ulcer(n = 11,5.7%),perforation(n = 3,1.5%),and abscess(n = 1,0.5%).Four patients underwent operations because of incomplete endoscopic foreign body extraction.In multivariate analyses,risk factors for endoscopic complications and failure were sharpness(HR = 2.48,95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction(HR = 2.42,95%CI: 1.12-5.25,P = 0.025).CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects,rapid endoscopic intervention should be provided in patients with ingested foreign bodies. | Kyong Hee Hong Yoon Jae Kim Jae Hak Kim Song Wook Chun Hee Man Kim Jae Hee Cho | 2015 | World Journal of Gastroenterology2015，21，26： | 35 |
| 5 | Early Enteral Combined with Parenteral Nutrition Treatment for Severe Traumatic Brain Injury:Effects on Immune Function,Nutritional Status and Outcomes显示文摘Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN)with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patientswith severe traumatic brain injury (STBI).Methods A prospective randomized control trial was carried out from January 2009 to May 2012 inNeurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow ComaScale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were administratedEN, PN or EN+PN treatments respectively. The indexes of nutritional status, immune function,complications and clinical outcomes were examined and compared statistically. | Ming-chao Fan Qiao-ling Wang Wei Fang Yun-xia Jiang Lian-di Li Peng Sun Zhi-hong Wang | 2016 | Chinese Medical Sciences Journal2016，31，4： | 37 |
| 6 | 为表面的胃肠的瘤的移动的内视镜的 submucosal 解剖: 技术评论显示文摘 Endoscopic submucosal dissection (ESD) is now the most common endoscopic treatment in Japan for intramucosal gastrointestinal neoplasms (non-metastatic). ESD is an invasive endoscopic surgical procedure, requiring extensive knowledge, skill, and specialized equipment. ESD starts with evaluation of the lesion, as accurate assessment of the depth and margin of the lesion is essential. The devices and strategies used in ESD vary, depending on the nature of the lesion. Prior to the procedure, the operator must be knowledgeable about the treatment strategy(ies), the device(s) to use, the electrocautery machine settings, the substances to inject, and other aspects. In addition, the operator must be able to manage complications, should they arise, including immediate recognition of the complication(s) and its treatment. Finally, in case the ESD treatment is not successful, the operator should be prepared to apply alternative treatments. Thus, adequate knowledge and training are essential to successfully perform ESD. | Noriaki Matsui Kazuya Akahoshi Kazuhiko Nakamura Eikichi Ihara Hiroto Kita | 2012 | World Journal of Gastrointestinal Endoscopy2012，4，4： | 34 |
| 7 | Impact of postoperative complications on long-term survival after radical resection for gastric cancer显示文摘AIM: To investigate the potential impact of complications in gastric cancer patients who survive the initial postoperative period. METHODS: Between January 1, 2005 and December 31, 2006, 432 patients who received curative gastrectomy with D2 lymph node dissection for gastric cancer at our department were studied. Associations between clinicopathological factors [age, sex, American Society of Anesthesiologists grade, body mass index, tumornode-metastases (TNM) stage and tumor grade], including postoperative complications (defined as any deviation from an uneventful postoperative course within 30 d of the operation and survival rates) and treatment-specific factors (blood transfusion, neoadjuvant therapy and duration of surgery). Patients were divided into 2 groups: with (n = 54) or without (n = 378) complications. Survival curves were compared between the groups, and univariate and multivariate models were conducted to identify independent prognostic factors. RESULTS: Among the 432 patients evaluated, 61 com-plications occurred affecting 54 patients (12.50%).Complications included anastomotic leakages, gastric motility disorders, anastomotic block, wound infections, intra-abdominal abscesses, infectious diarrhea, bleeding, bowel obstructions, arrhythmias, angina pectoris, pneumonia, atelectasis, thrombosis, unexplained fever, delirium, ocular fungal infection and multiple organ failure. American Society of Anesthesiologists grade, body mass index, combined organ resection and median duration of operation were associated with higher post-operative complications. The 1-, 3- and 5-year survival rates were 83.3%, 53.2% and 37.5%, respectively. In the univariate analysis, the size of lesions, TNM stage, blood transfusion, lymphovascular invasion, perineural invasion, neoadjuvant chemotherapy, and postoperative complications were significant predictors of overall survival. In the multivariate analysis, only TNM stage and the presence of complications remained significant predictors of reduced survival. CONCLUSION: The occurrence of in-hospital postoperative complications was an independent predictor of worse 5-year overall survival rate after radical resection of gastric cancer. | Qing-Guo Li Ping Li Dong Tang Jie Chen Dao-Rong Wang | 2013 | World Journal of Gastroenterology2013，19，25： | 33 |
| 8 | Clinical observations on the treatment of prolapsing hemorrhoids with tissue selecting therapy显示文摘AIM:To compare the effects and postoperative complications between tissue selecting therapy stapler(TST)and Milligan-Morgan hemorrhoidectomy(M-M).METHODS:Four hundred and eighty patients with severe prolapsing hemorrhoids,who were admitted to the Shenyang Coloproctology Hospital between 2009and 2012,were randomly divided into observation(n=240)and control(n=240)groups.Hemorrhoidectomies were performed with TST in the observation group and with the M-M technique in the control group.The therapeutic effects,operation security,and postoperative complications in the two groups were compared.The immediate and long-term complications were assessed according to corresponding criteria.Pain was assessed on a visual analogue scale.The efficacy was assessed by specialized criteria.The follow-up was conducted one year after the operation.RESULTS:The total effective rates of the observation and control groups were 99.5%(217/218)and 98.6%(218/221)respectively;the difference was not statistically significant(P=0.322).Their were significant differences between observation and control groups in intraoperative blood loss(5.07±1.14 vs 2.45±0.57,P=0.000),pain(12 h after the surgery:5.08±1.62 vs 7.19±2.01,P=0.000;at first dressing change:2.64±0.87 vs 4.34±1.15,P=0.000;first defecation:3.91±1.47 vs 5.63±1.98,P=0.001),urine retention(n=22 vs n=47,P=0.001),anal pendant expansion after the surgery(2.35±0.56 vs 5.16±1.42,P=0.000),operation time(18.3±5.6 min vs 29.5±8.2 min,P=0.000),and the length of hospital stay(5.3±0.6 d vs 11.4±1.8 d,P=0.000).Moreover TST showed significant reductions compared to M-M in the rates of long-term complications such as fecal incontinence(n=3 vs n=16,P=0.003),difficult bowel movement(n=1 vs n=9,P=0.011),intractable pain(n=2 vs n=12,P=0.007),and anal discharge(n=3 vs n=23,P=0.000).CONCLUSION:TST for severe prolapsing hemorrhoids is a satisfactory technique for more rapid recovery,lower complication rates,and higher operation security. | Zhi-Gang Wang Yong Zhang Xian-Dong Zeng Tie-Hui Zhang Qi-Dong Zhu De-Long Liu Yun-Yu Qiao Nan Mu Zhi-Tao Yin | 2015 | World Journal of Gastroenterology2015，21，8： | 33 |
| 9 | Laparoscopic vs open left hepatectomy for hepatolithiasis显示文摘AIM: To explore the feasibility and therapeutic effect of total laparoscopic left hepatectomy (LLH) for hepatolithiasis. METHODS: From June 2006 to October 2009, 61 consecutive patients with hepatolithiasis who met the inclusion criteria for LLH were treated in our institute. Of the 61 patients with hepatolithiasis, 28 underwent LLH (LLH group) and 33 underwent open left hepatectomy (OLH group). Clinical data including operation time, intraoperative blood loss, postoperative complication rate, postoperative hospital stay time, stone clearance and recurrence rate were retrospectively analyzed and compared between the two groups. RESULTS: LLH was successfully performed in 28 patients. The operation time of LLH group was longer than that of OLH group (158 ± 43 min vs 132 ± 39 min, P < 0.05) and the hospital stay time of LLH group was shorter than that of OLH group (6.8 ± 2.8 d vs 10.2 ± 3.4 d, P < 0.01). No difference was found in intraoperative blood loss (180 ± 56 mL vs 184 ± 50 mL), postoperative complication rate (14.2% vs 15.2%), and stone residual rate (intermediate rate 17.9% vs 12.1% and final rate 0% vs 0%) between the twogroups. No perioperative death occurred in either group. Fifty-seven patients (93.4%) were followed up for 2-40 mo (mean 17 mo), including 27 in LLH group and 30 in OLH group. Stone recurrence occurred in 1 patient of each group. CONCLUSION: LLH for hepatolithiasis is feasible and safe in selected patients with an equal therapeutic effect to that of traditional open hepatectomy. | Tu, Jin-Fu Jiang, Fei-Zhao Zhu, Heng-Liang Hu, Ru-Ying Zhang, Wei-Jian Zhou, Zhen-Xu | 2010 | World Journal of Gastroenterology2010，16，22： | 30 |
| 10 | Safe procedure in endoscopic submucosal dissection for colorectal tumors focused on preventing complications显示文摘Endoscopic submucosal dissection (ESD) is efficient for en bloc resection of large colorectal tumors. However, it has several technical difficulties, because the wall of the colon is thin and due to the winding nature of the colon. The main complications of ESD comprise postoperative perforation and hemorrhage, similar to endoscopic mucosal resection (EMR). In particular, the rate of perforation in ESD is higher than that in EMR. Perforation of the colon can cause fatal peritonitis. Endoscopic clipping is reported to be an efficient therapy for perforation. Most cases with perforation are treated conservatively without urgent surgical intervention. However, the rate of postoperative hemorrhage in ESD is similar to that in EMR. Endoscopic therapy including endoscopic clipping is performed and most of the cases are treated conservatively without blood transfusion. In blood examination, some degree of inflammation is detected after ESD. For the standardization of ESD, it is most important to decrease the rate of perforation. Adopting a safe strategy for ESD and a suitable choice of knife are both important waysof preventing perforation. Moreover, appropriate training and increasing experience can improve the endoscopic technique and can decrease the rate of perforation. In this review, we describe safe procedures in ESD to prevent complications, the complications of ESD and their management. | Naohisa Yoshida Nobuaki Yagi Yuji Naito Toshikazu Yoshikawa | 2010 | World Journal of Gastroenterology2010，16，14： | 27 |
| 11 | Efficacy and safety of emergency endoscopic retrograde cholangiopancreatography for acute cholangitis in the elderly显示文摘AIM To investigate the efficacy and safety of emergency endoscopic retrograde cholangiopancreatography(ERCP) in elderly patients with acute cholangitis. METHODS From June 2008 to May 2016, emergency ERCPs were performed in 207 cases of acute cholangitis at our institution. Patients were classified as elderly if they were aged 80 years and older(n = 102); controls were under the age of 80 years(n = 105). The patients' medical records were retrospectively reviewed for comorbidities, laboratory data, etiology of cholangitis(presence of biliary stones, biliary stricture and malignancy), details of the ERCP(therapeutic approaches, technical success rates, procedure duration), ERCP-related complications and mortality. RESULTS The frequency of comorbidities was higher in the elderly group than the control group(91.2% vs 67.6%). Periampullary diverticulum was observed in the elderly group at a higher frequency than the control group(24.5% vs 13.3%). Between the groups, there was no significant difference in the technical success rates(95.1% vs 95.2%) or endoscopicprocedure durations. With regard to the frequency of ERCP-related complications, there was no significant difference between the two groups(6.9% vs 6.7%), except for a lower rate of post-ERCP pancreatitis in the elderly group than in the control group(1.0% vs 3.8%). Neither angiographic nor surgical intervention was required in any of the cases with ERCP-related complications. There was no mortality during the observational periods. CONCLUSION Emergency ERCP for acute cholangitis can be performed safely even in elderly patients aged 80 years and older. | Gen Tohda Masahiro Ohtani Masaki Dochin | 2016 | World Journal of Gastroenterology2016，22，37： | 28 |
| 12 | Clinical effects and complications of TIPS for portal hypertension due to cirrhosis:A single center显示文摘AIM:To determine the clinical effects and complications of transjugular intrahepatic portosystemic shunt(TIPS)for portal hypertension due to cirrhosis.METHODS:Two hundred and eighty patients with portal hypertension due to cirrhosis who underwent TIPS were retrospectively evaluated.Portal trunk pressure was measured before and after surgery.The changes in hemodynamics and the condition of the stent were assessed by ultrasound and the esophageal and fundic veins observed endoscopically.RESULTS:The success rate of TIPS was 99.3%.The portal trunk pressure was 26.8±3.6 cmH2O after surgery and 46.5±3.4 cmH2O before surgery(P<0.01).The velocity of blood flow in the portal vein increased.The internal diameters of the portal and splenic veins were reduced.The short-term hemostasis rate was100%.Esophageal varices disappeared completely in68%of patients and were obviously reduced in 32%.Varices of the stomach fundus disappeared completely in 80%and were obviously reduced in 20%of patients.Ascites disappeared in 62%,were markedly reduced in 24%,but were still apparent in 14%of patients.The total effective rate of ascites reduction was 86%.Hydrothorax completely disappeared in 100%of patients.The incidence of post-operative stent stenosis was 24%at 12 mo and 34%at 24 mo.The incidence of post-operative hepatic encephalopathy was 12%at3 mo,17%at 6 mo and 19%at 12 mo.The incidence of post-operative recurrent hemorrhage was 9%at 12mo,19%at 24 mo and 35%at 36 mo.The cumulative survival rate was 86%at 12 mo,81%at 24 mo,75%at 36 mo,57%at 48 mo and 45%at 60 mo.CONCLUSION:TIPS can effectively lower portal hypertension due to cirrhosis.It is significantly effective for hemorrhage of the digestive tract due to rupture of esophageal and fundic veins and for ascites and hydrothorax caused by portal hypertension. | Jian-Ping Qin Ming-De Jiang Wen Tang Xiao-Ling Wu Xin Yao Wei-Zheng Zeng Hui Xu Qian-Wen He Ming Gu | 2013 | World Journal of Gastroenterology2013，19，44： | 25 |
| 13 | Management of post-hepatectomy complications显示文摘Hepatic resection had an impressive growth over time.It has been widely performed for the treatment of various liver diseases,such as malignant tumors,benign tumors,calculi in the intrahepatic ducts,hydatid disease,and abscesses.Management of hepatic resection is challenging.Despite technical advances and high experience of liver resection of specialized centers,it is still burdened by relatively high rates of postoperative morbidity and mortality.Especially,complex resections are being increasingly performed in high risk and older patient population.Operation on the liver is especially challenging because of its unique anatomic architecture and because of its vital functions.Common posthepatectomy complications include venous catheterrelated infection,pleural effusion,incisional infection,pulmonary atelectasis or infection,ascites,subphrenic infection,urinary tract infection,intraperitoneal hemorrhage,gastrointestinal tract bleeding,biliary tract hemorrhage,coagulation disorders,bile leakage,and liver failure.These problems are closely related to sur-gical manipulations,anesthesia,preoperative evaluation and preparation,and postoperative observation and management.The safety profile of hepatectomy probably can be improved if the surgeons and medical staff involved have comprehensive knowledge of the expected complications and expertise in their management.This review article focuses on the major postoperative issues after hepatic resection and presents the current management. | Shan Jin Quan Fu Gerile Wuyun Tu Wuyun | 2013 | World Journal of Gastroenterology2013，19，44： | 24 |
| 14 | Laparoscopic low anterior resection for rectal carcinoma:Complications and management in 132 consecutive patients显示文摘AIM:To analyze the clinical manifestations and risk fac-tors of complications in laparoscopic low anterior resection(LAR)for rectal cancer patients.METHODS:A series of 132 consecutive patients who received laparoscopic LAR for rectal cancer in our center were included.The etiology,diagnosis,treatment and prevention of rectal cancer were studied among the patients with surgery-related complications using both univariate and multivariate regression analysis.RESULTS:No conversion to open surgery was observed and 5 cases converted to hand-assisted laparoscopic operation.The overall morbidity rate was 20.5%.Complications occurred during the operation in 7 patients(5.3%),within 30 postoperative days in 24 patients(18.2%),and within 3 mo in 2 patients(1.5%).The most significant complications were anastomotic leak-age(9.1%)and anastomotic hemorrhage(5.3%).Sizeand location of tumor,pathological staging and preoperative nutrition were significant factors associated with LAR complications,while gender,age and pathological type showed no relevance.Binary logistics regression showed that the size and location of tumor,and pathological staging were independent factors of laparoscopic LAR.All the complications were treated during their onset of clinical manifestations by interventional or conservative therapy.CONCLUSION:Anastomotic leakage is a major com-plication in laparoscopic LAR.The complications may be associated with tumor size and site,and pathological stage.Interventional therapies are of value in the management of laparoscopic LAR complications. | Qian-Lin Zhu,Bo Feng,Ai-Guo Lu,Ming-Liang Wang,Wei-Guo Hu,Jian-Wen Li,Zhi-Hai Mao,Min-Hua Zheng,Department of General Surgery,Shanghai Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China Shanghai Minimally Invasive Surgery Center,Shanghai 200025,China | 2010 | World Journal of Gastroenterology2010，16，36： | 23 |
| 15 | Plasma levels of tumor necrotic factor-alpha and interleukin-6, -8 during orthotopic liver transplantation and their relations to postoperative pulmonary complications显示文摘BACKGROUND: Pulmonary complications after orthoto- pic liver transplantation (OLT) include high morbidity and mortality. Experimental data have suggested hepatic ische- mia and reperfusion are induced by pro-inflammatory cyto- kines. The high level of inflammatory cytokines might ad- ditionally influence pulmonary cappillary fluid filtration. The objectives of this study were to measure the concentra- tions of tumor necrotic factor-alpha (TNF-α), interleukin- 6 (IL-6) and interleukin-8 (IL-8) during OLT and to in- vestigate the relationship between these cytokines and post- operative pulmonary complications. METHODS: Twenty-two patients undergoing OLT were divided into two groups according to whether they had postoperative pulmonary complications: group A consis- ting of 8 patients with postoperative pulmonary complica- tions , and group B consisting of 14 patients without post- operative pulmonary complications. Enzyme-linked im- munoassay (ELISA) was used to determine serum TNF-α, IL-6 and IL-8. Blood samples were taken at the beginning of operation (T0 ), clamping and cross-clamping of the in- ferior cava and portal vein (T1, T2 ), 90 minutes and 3 hours after reperfusion (T3 , T4 ) and 24 hours after opera- tion (T5). RESULTS: The level of PaO2/FiO2 in group A was lower than that in group B ( P <0. 05 ). The concentrations of TNF-α, IL-6 and IL-8 in the two groups increased rapidly at T2 , peaked at T3 , decreased rapidly after T3 until 24 hours after operation. The concentrations of TNF-α, IL-6 and IL-8 in group A were higher than those in group B at T2, T3, and T4(P<0.05). CONCLUSION: After un-clamping of the inferior cava and portal vein, the serum concentrations of TNF-α, IL-6 and IL-8 increased may be related to pulmonary injury after he- patic ischemic reperfusion. | Xiao-Hong Wen, Hai-Ying Kong, Sheng-Mei Zhu, Jian-Hong Xu, Su-Qin Huang and Qing-Lian Chen Hangzhou, China Department of Anesthesia, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，1： | 21 |
| 16 | Variations and Clinical Significance of Coagulation and Fibrinolysis Parameters in Patients with Diabetes Mellitus显示文摘We observed the changes of parameters of coagulation and fibrinolytic system in order to understand the clinical implication of these variations in type diabetic patients. Subjects consisted of 22 patients with type Ⅱ diabetes mellitus and 25 healthy controls. Compared with the control, activated partial thromboplastin time, prothrombin time were shortened in the patients. The diabetic subjects also displayed higher levels of D-dimer, serum fibrin degradation products,median concentrations of fibrinogen (3.99 vs 2.96 g/L, P<0.01) and yon Willebrand factor (149% vs 87%, P<0.01). Levels of antithrombin Ⅲ activity or antigen were not different from control values. Simple linear regression analysis revealed a negative correlation between antithrombin Ⅲ activity and fast blood glucose. Diabetic patients with vascular complications had significantly higher levels of fibrinogen and D-dimer than those without diabetic angiopathy. Our data demonstrated that patients with type Ⅲ diabetes mellitus had a | 胡俊斌 魏文宁 丁桂芝 袁莉 刘仲萍 | 1998 | Journal of Huazhong University of Science and Technology(Medical Sciences)1998，18，4： | 21 |
| 17 | Colonoscopic perforation:Incidence,risk factors,management and outcome显示文摘This review discusses the incidence,risk factors,management and outcome of colonoscopic perforation(CP).The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic interventions.The perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple comorbidities.Management of CP is mainly based on patients' clinical grounds and their underlying colorectal diseases.Current therapeutic approaches include conservative management(bowel rest plus the administration of broadspectrum antibiotics),endoscopic management,and operative management(open or laparoscopic approach).The applications of each treatment are discussed.Overall outcomes of patients with CP are also addressed. | Varut Lohsiriwat | 2010 | World Journal of Gastroenterology2010，16，4： | 20 |
| 18 | Portosplenomesenteric vein thrombosis in patients with early-stage severe acute pancreatitis显示文摘AIM To investigate the incidence and risk factors of portosplenomesenteric vein thrombosis(PSMVT) in the early stage of severe acute pancreatitis(SAP).METHODS Patients with SAP in a tertiary care setting from January 2014 to December 2016 were retrospectively reviewed. All contrast-enhanced computed tomography(CT) studies were reassessed and reviewed. Clinical outcome measures were compared between SAP patients with and without PSMVT in the early stage of the disease. Univariate and multivariate logistic regression analyses were sequentially performed to assess potential risk factors for the development of PSMVT in SAP patients. A receiver operating characteristic(ROC) curve was generated for the qualifying independent risk factors.RESULTS Twenty-five of the one hundred and forty(17.86%) SAP patients developed PSMVT 6.19 ± 2.43 d after acute pancreatitis(AP) onset. PSMVT was confirmed by contrast-enhanced CT. Multivariate stepwise logistic regression analyses showed that Balthazar's CT severity index(CTSI) scores [odds ratio(OR): 2.742; 95% confidence interval(CI): 1.664-4.519; P = 0.000], hypoalbuminemia(serum albumin level < 25 g/L)(OR: 32.573; 95%CI: 2.711-391.353; P = 0.006) and gastrointestinal wall thickening(OR: 4.367, 95%CI: 1.218-15.658; P = 0.024) were independent risk factors for PSMVT developed in patients with SAP. The area under the ROC curve for Balthazar's CTSI scores was 0.777(P = 0.000), the sensitivity was 52%, and the specificity was 93% at a cut-off value of 5.5.CONCLUSION High Balthazar's CTSI scores, hypoalbuminemia and gastrointestinal wall thickening are independent risk factors for PSMVT developed in the early stage of SAP. | Ling Ding Feng Deng Chen Yu Wen-Hua He Liang Xia Mi Zhou Xin Huang Yu-Peng Lei Xiao-Jiang Zhou Yin Zhu Nong-Hua Lu | 2018 | World Journal of Gastroenterology2018，24，35： | 20 |
| 19 | Risk scoring system and predictor for clinically relevant pancreatic fistula after pancreaticoduodenectomy显示文摘AIM: To establish a scoring system to predict clinicallyrelevant postoperative pancreatic fistula(CR-POPF)after pancreaticoduodenectomy(PD).METHODS: The clinical records of 921 consecutive patients who underwent PD between 2008 and 2013 were reviewed retrospectively. Postoperative pancreatic fistula(POPF) was defined and classified by the international study group of pancreatic fistula(ISGPF).We used a logistic regression model to determine the independent risk factors of CR-POPF and developed a scoring system based on the regression coefficient of the logistic regression model. The optimal cut-off value to divide the risk strata was determined by the Youden index. The patients were divided into two groups(low risk and high risk). The independent sample t test was used to detect differences in the means of drain amylase on postoperative day(POD) 1, 2 and 3. The optimal cut-off level of the drain amylase to distinguish CR-POPF from non-clinical POPF in the two risk strata groups was determined using the receiver operating characteristic(ROC) curves.RESULTS: Grade A POPF occurred in 106(11.5%)patients, grade B occurred in 57(6.2%) patients,and grade C occurred in 32(3.5%) patients. A predictive scoring system for CR-POPF(0-6 points) was constructed using the following four factors: 1 point for each body mass index ≥ 28 [odds ratio(OR) = 3.86;95% confidence interval(CI): 1.92-7.75, P = 0.00],soft gland texture(OR = 4.50; 95%CI, 2.53-7.98, P =0.00), and the difference between the blood loss and transfusion in operation ≥ 800 mL(OR = 3.45; 95%CI,1.92-7.75, P = 0.00); and from 0 points for a 5 mm or greater duct diameter to 3 points for a less than 2 mm duct(OR = 8.97; 95%CI: 3.70-21.77, P = 0.00). The ROC curve showed that the area under the curve of this score was 0.812. A score of 3 points was suggested to be the best cut-off value(Youden index = 0.485). In the low risk group, a drain amylase level ≥ 3600 U/L on POD3 could distinguish CR-POPF from non-clinicalPOPF(the sensitivity and specificity were 75% and85%, respectively). In the high risk group, the best cutoff was a drain amylase level of 1600(the sensitivity and specificity were 77 and 63%, respectively).CONCLUSION: A 6-point scoring system accurately predicted the occurrence of CR-POPF. In addition, a drain amylase level on POD3 might be a predictor of this complication. | Ji-Ye Chen Jian Feng Xian-Qiang Wang Shou-Wang Cai Jia-Hong Dong Yong-Liang Chen | 2015 | World Journal of Gastroenterology2015，21，19： | 20 |
| 20 | Prevention and treatment of hepatic artery thrombosis after liver transplantation显示文摘BACKGROUND: Hepatic artery thrombosis (HAT) which is a serious complication after orthotopic liver transplanta- tion (OLT) remains a significant cause of graft loss. The purpose of this study was to sum up our experiences in the prevention, diagnosis and management of HAT after liver transplantation. METHODS: From April 1993 to September 2003, a total of 198 patients underwent OLT at our hospital. The hepatic artery was anastomosed using 7/0 prolane with running continuous suture in 96 patients (group 1) and with inter- rupted suture in 102 (group 2). Ultrasonography was per- formed every day in two weeks after operation and selec- tively afterwards. RESULTS: HAT occurred in 6 patients (6.3%, 6/96) of group 1, and in 1 (1%, 1/102) of group 2 (x2=4.027, P= 0.045). Six patients received emergency thrombectomy, and 1 conservative therapy but died from tumor recurrence eventually. Biliary complication developed in 3 patients af- ter thrombectomy of whom 2 died of liver failure and one waited for retransplantation. In the other 3 patients after thrombectomy, 1 died of renal failure, and 2 survived. The mortality of patients with HAT was 57.1% (4/7). CONCLUSIONS: The technique of hepatic arterial anasto- mosis is the key factor for the prevention of HAT. Routine ultrasonography is very important in early detection of HAT after OLT. Biliary complication is a severe outcome secondary to HAT. | Shu-Sen Zheng, Zhi-Yong Yu, Ting-Bo Liang, Wei-Lin Wang, Yan Shen, Min Zhang, Xiao Xu and Jian Wu Hangzhou, China Centre of Organ Transplantation and Department o Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital of Medica College, Zhcjiang University, Hangzhou 310003, China | 2004 | Hepatobiliary & Pancreatic Diseases International2004，3，1： | 18 |
您所在的机构暂未开通此部分的功能，请联系管理员