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| 1 | Recent advances in the diagnosis and treatment of acute myocardial infarction显示文摘The Third Universal Definition of Myocardial Infarction(MI) requires cardiac myocyte necrosis with an increase and/or a decrease in a patient's plasma of cardiac troponin(cT n) with at least one cT n measurement greater than the 99 th percentile of the upper normal reference limit during:(1) symptoms of myocardialischemia;(2) new significant electrocardiogram(ECG) ST-segment/T-wave changes or left bundle branch block;(3) the development of pathological ECG Q waves;(4) new loss of viable myocardium or regional wall motion abnormality identified by an imaging procedure; or(5) identification of intracoronary thrombus by angiography or autopsy.Myocardial infarction,when diagnosed,is now classified into five types.Detection of a rise and a fall of troponin are essential to the diagnosis of acute MI.However,high sensitivity troponin assays can increase the sensitivity but decrease the specificity of MI diagnosis.The ECG remains a cornerstone in the diagnosis of MI and should be frequently repeated,especially if the initial ECG is not diagnostic of MI.There have been significant advances in adjunctive pharmacotherapy,procedural techniques and stent technology in the treatment of patients with MIs.The routine use of antiplatelet agents such as clopidogrel,prasugrel or ticagrelor,in addition to aspirin,reduces patient morbidity and mortality.Percutaneous coronary intervention(PCI) in a timely manner is the primary treatment of patients with acute ST segment elevation MI.Drug eluting coronary stents are safe and beneficial with primary coronary intervention.Treatment with direct thrombin inhibitors during PCI is non-inferior to unfractionated heparin and glycoprotein Ⅱb/Ⅲa receptor antagonists and is associated with a significant reduction in bleeding.The intra-coronary use of a glycoprotein Ⅱb/Ⅲa antagonist can reduce infarct size.Pre- and post-conditioning techniques can provide additional cardioprotection.However,the incidence and mortality due to MI continues to be high despite all these recent advances.The initial ten year experience with autologous human bone marrow mononuclear cells(BMCs) in patients with MI showed modest but significant increases in left ventricular(LV) ejection fraction,decreases in LV endsystolic volume and reductions in MI size.These studies established that the intramyocardial or intracoronary administration of stem cells is safe.However,many of these studies consisted of small numbers of patients who were not randomized to BMCs or placebo.The recent LateT ime,Time,and Swiss Multicenter Trials in patientswith MI did not demonstrate significant improvement in patient LV ejection fraction with BMCs in comparison with placebo.Possible explanations include the early use of PCI in these patients,heterogeneous BMC populations which died prematurely from patients with chronic ischemic disease,red blood cell contamination which decreases BMC renewal,and heparin which decreases BMC migration.In contrast,cardiac stem cells from the right atrial appendage and ventricular septum and apex in the SCIPIO and CADUCEUS Trials appear to reduce patient MI size and increase viable myocardium.Additional clinical studies with cardiac stem cells are in progress. | Koushik Reddy Asma Khaliq Robert J Henning | 2015 | World Journal of Cardiology2015，7，5： | 107 |
| 2 | 艾滋病感染者和病人随访干预效果分析显示文摘目的 了解艾滋病感染者和病人艾滋病知识知晓情况及与配偶/固定性伴性行为情况等,初步分析随访干预效果.方法 对艾滋病感染者和病人进行基线调查,收集艾滋病相关知识、性行为等信息,并进行健康教育、安全套推广、转介治疗等随访干预,6个月后进行1次随访调查.结果 调查对象的艾滋病知识和相关服务知晓率在基线调查时约为70.0%~ 80.0%,随访时达100.0%;基线中最近6个月与配偶/固定性伴发生性行为时50.0%未每次使用安全套;3.2%有商业性行为,1.5%有临时性行为.随访调查时与配偶/固定性伴发生性行为,仅1人从未使用安全套,而且最近6个月均没有发生过商业性行为和临时性行为.结论 加强对艾滋病感染者和病人随访管理,强化干预措施,对提高他们的艾滋病防治知识知晓率、减低危险行为从而减少传播风险起到积极的促进作用. | 朱秋映 朱金辉 刘伟 郑文彬 | 2014 | 中华疾病控制杂志2014，18，1： | 36 |
| 3 | Metastatic human hepatocellular carcinoma models in nude mice and cell line with metastatic potential显示文摘Metastatic human HCC model is needed for the studies on mechanism and intervention of metastatic recurrence. By using orthotopic implantation of histologically intact tissues of 30 surgical specimens, a patient like metastatic model of human HCC in nude mice (LCI-D20)and a Iow metastatic model of human HCC in nude mice LCI-D35 ) have been established. All mice with transplanted LCI-D20 tumors exhibited extremely high metastatic ability including spontaneous metastasis to liver, lungs, lymph nodes and peritoneal seeding.Remarkable difference was also found in expression of some of the invasiveness related genes and growth factors between the LCI-D20 and LCI-D35 tumors. PAI-Iincreased gradually following tumor progression in LCID20 model, and correlated with tumor size and AFP level,Phasic expression of tissue intercellular adhesion molecule-I in this model was also observed. Using corneal micropocket model, it was demonstrated that the vascular response induced by LCI-D20 tumor was stronger than that induced by LCI-D35 tumor. Similar report on metastatic human HCC model in nude mice and human HCC cell line with metastatic potential was rarely found in the literature. This LCI-D20 model has been widely used for the studies on intervention of metastasis, including antiangiogenesis, antisense approach, metalloproteinase inhibitor, differentiation inducer, etc. It is concluded that the establishment of metastatic human HCC model in nude mice and human HCC cell line with metastatic potential will provide important models for the in vivo and in vitro study of HCC invasiveness, angiogenesis as well as intervention of HCC recurrence. | Zhao-You Tang Fan-Xian Sun Jian Tian Sheng-Long Ye Yin-Kun Liu Kang-Da Liu Qiong Xue Jie Chen Jing-Lin Xia Lun-Xiu Qin Hui-Chuan Sun Lu Wang Jian Zhou Yan Li Zeng-Chen Ma Xin-Da Zhou Zhi-Quan Wu Zhi-Ying Lin Bing-Hui Yang Liver Cancer Institute of Fudan University and Zhongshan Hospital,Shanghai 200032,China | 2001 | World Journal of Gastroenterology2001，7，5： | 34 |
| 4 | Delayed hepatocarcinogenesis through antiangiogenic intervention in the nuclear factor-kappa B activation pathway in rats显示文摘BACKGROUND:The active form of nuclear factor-kappa B(NF- κB)is involved in the initiation,generation,and development of hepatocellular carcinoma(HCC),and is up-regulated in inflammation-associated malignancies.We investigated the dynamic expression of NF-κB and its influences on the occurrence of HCC through antiangiogenic(thalidomide) intervention in NF-κB activation. METHODS:Hepatoma models were induced with 2-fluorenyl- acetamide(2-FAA,0.05%)in male Sprague-Dawley rats,and thalidomide(100 mg/kg body weight)was administered intragastrically to intervene in NF-κB activation.The pathological changes in the liver of sacrificed rats were assessed after hematoxylin and eosin staining.NF-κB mRNA was amplified by RT-nested PCR.The alterations of NF-κB and vascular endothelial growth factor(VEGF)expression were analyzed by enzyme-linked immunosorbent assay,immunohistochemistry,and Western blotting. RESULTS:Rat hepatocytes showed denatured,precancerous,and cancerous stages in hepatocarcinogenesis,with an increasing tendency of hepatic NF-κB,NF-κB mRNA,and VEGF expression,and their values in the HCC group were higher than those in controls(P<0.001).In the thalidomide- treated group,the morphologic changes generated only punctiform denaturation and necrosis at the early or middle stages,and nodular hyperplasia or a little atypical hyperplasia at the final stages,with the expression of NF-κB (χ2=9.93,P<0.001)and VEGF(χ2=8.024,P<0.001)lower than that in the 2-FAA group. CONCLUSION:NF-κB is overexpressed in hepatocarcinogenesis and antiangiogenic treatment down-regulates the expression of NF-κB and VEGF,and delays the occurrence of HCC. | Dong, Zhi-Zhen Yao, Deng-Fu Wu, Wei Yao, Min Yu, Hong-Bo Shen, Jun-Jun Qiu, Li-Wei Yao, Ning-Hua Sai, Wen-Li Yang, Jun-Ling | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，2： | 31 |
| 5 | Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI显示文摘BACKGROUND:This study investigated the effects of the intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).METHODS:Seventy-eight STEMI patients with age>65 years who underwent emergency PCI were consecutively enrolled.These patients received conventional PCI and were randomly divided into a control group and a treatment group(n=39 per group).The control group received an intracoronary injection of tirofiban followed by a maintenance infusion for 36 hours after surgery.The treatment group received intracoronary injection of tirofiban and nicorandil,and then intravenous infusion of tirofiban and nicorandil 36 hours after surgery.The following parameters were measured:TIMI grade,corrected TIMI frame count(c TFC),TIMI myocardial perfusion grade(TMPG),STsegment resolution(STR)rate 2 hours post-operatively,resolution of ST-segment elevation(STR)at 2 hours postoperatively,peak level of serum CK-MB,left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)at 7–10 days postoperatively,and major adverse cardiac events(MACEs)in-hospital and within 30 days post-operatively.RESULTS:Compared with the control group,more patients in the treatment group had TIMI 3 and TMPG 3,and STR after PCI was significantly higher.The treatment group also had significantly lower c TFC,lower infarction relative artery(IRA),lower peak CK-MB,and no reflow ratio after PCI.The treatment group had significantly higher LVEDD and LVEF but lower incidence of MACEs than the control group.CONCLUSION:The intracoronary injection of nicorandil combined with tirofiban can effectively improve myocardial reperfusion in elderly STEMI patients after emergency PCI and improve shortterm prognoses. | Guo-xiong Chen Hong-na Wang Jin-lin Zou Xiao-xu Yuan | 2020 | World Journal of Emergency Medicine2020，11，3： | 27 |
| 6 | 心理护理干预对艾滋病患者高效联合抗反转录病毒治疗依从性的影响显示文摘综述了艾滋病患者HAART治疗服药依从性的重要性、现状及其心理影响因素,提出患者服药依从性较差,与多种影响因素相关,尤其是心理因素有关,给予其心理护理干预可提高服药依从性,从而提高患者生活质量及延长生命。 | 徐艳 柏春琴 范春红 | 2010 | 湖南中医药大学学报2010，30，10： | 22 |
| 7 | Chronic obstructive pulmonary disease as a risk factor for lung cancer显示文摘The association between chronic obstructive pulmonary disease(COPD) and lung cancer has long been a subject of intense debate. The high prevalence of COPD in elderly smokers inevitably strengthens their coincidence. In addition to this contingent coincidence, recent studies have revealed a close association between the two diseases that is independent of the smoking history; that is, the existence of COPD is an independent risk factor for the development of lung cancer. Molecular-based evidence has been accumulating as a result of the efforts to explain the underlying mechanisms of this association. These mechanisms may include the following: the retention of airborne carcinogens followed by the activation of oncogenes and the suppression of tumor suppressor genes; the complex molecular mechanism associated with chronic inflammation in the distal airways of patients with COPD; the possible in-volvement of putative distal airway stem cells; and gel netic factors that are common to both COPD and lung cancer. The existence of COPD in patients with lung l cancer may potentially affect the process of diagnosis, surgical resection, radiotherapy, chemotherapy, and end-of-life care. The comprehensive management of COPD is extremely important for the appropriate treatment of lung cancer. Surgical resections with the aid of early interventions for COPD are often possible, even for patients with mild-to-moderate COPD. New challenges, such as lung cancer CT screening for individuals t at high risk, are now in the process of being implemented. Evaluating the risk of lung cancer in patients with COPD may be warranted in community-based lung cancer screening. | Yuichi Takiguchi Ikuo Sekine Shunichiro Iwasawa Ryota Kurimoto Koichiro Tatsumi | 2014 | World Journal of Clinical Oncology2014，5，4： | 21 |
| 8 | A risk score model for predicting cardiac rupture after acute myocardial infarction显示文摘Background:Cardiac rupture (CR) is a major lethal complication of acute myocardial infarction (AMI).However,no valid risk score model was found to predict CR after AMI in previous researches.This study aimed to establish a simple model to assess risk of CR after AMI,which could be easily used in a clinical environment.Methods:This was a retrospective case-control study that included 53 consecutive patients with CR after AMI during a period from January 1,2010 to December 31,2017.The controls included 524 patients who were selected randomly from 7932 AMI patients without CR at a 1:10 ratio.Risk factors for CR were identified using univariate analysis and multivariate logistic regression.Risk score model was developed based on multiple regression coefficients.Performance of risk model was evaluated using receiveroperating characteristic (ROC) curves and internal validity was explored using bootstrap analysis.Results:Among all 7985 AMI patients,53 (0.67%) had CR (free wall rupture,n=39;ventricular septal rupture,n=14).Hospital mortalities were 92.5% and 4.01% in patients with and without CR (P<0.001).Independent variables associated with CR included:older age,female gender,higher heart rate at admission,body mass index (BMI)<25 kg/m^2,lower left ventricular ejection fraction (LVEF) and no primary percutaneous coronary intervention (pPCI) treatment.In ROC analysis,our CR risk assess model demonstrated a very good discriminate power (area under the curve [AUC]= 0.895,95% confidence interval:0.845–0.944,optimism-corrected AUC= 0.821,P<0.001).Conclusion:This study developed a novel risk score model to help predict CR after AMI,which had high accuracy and was very simple to use. | Yuan Fu Kui-Bao Li Xin-Chun Yang | 2019 | Chinese Medical Journal2019，，9： | 19 |
| 9 | Strategies to prevent hypertrophic scar formation:a review of therapeutic interventions based on molecular evidence显示文摘Once scar tissues mature,it is impossible for the surrounding tissue to regenerate normal dermal tissue.Therefore,it is essential to understand the fundamental mechanisms and establish effective strategies to inhibit aberrant scar formation.Hypertrophic scar formation is considered a result of the imbalance between extracellular matrix synthesis and degradation during wound healing.However,the underlying mechanisms of hypertrophic scar development are poorly understood.The purpose of this review was to outline the management in the early stage after wound healing to prevent hypertrophic scar formation,focusing on strategies excluding therapeutic agents of internal use.Treatment aimed at molecular targets,including cytokines,will be future options to prevent and treat hypertrophic scars.More basic studies and clinical trials,including combination therapy,are required to investigate the mechanisms and prevent hypertrophic scar formation. | Eri Shirakami Sho Yamakawa Kenji Hayashida | 2020 | Burns & Trauma2020，8，1： | 18 |
| 10 | Imaging and interventions in hilar cholangiocarcinoma: A review显示文摘Hilar cholangiocarcinoma is a common malignant tumor of the biliary tree. It has poor prognosis with very low 5-year survival rates. Various imaging modalities are available for detection and staging of the hilar cholangiocarcinoma. Although ultrasonography is the initial investigation of choice, imaging with contrast enhanced computed tomography scan or magnetic resonance imaging is needed prior to management. Surgery is curative wherever possible. Radiological interventions play a role in operable patients in theform of biliary drainage and/or portal vein embolization. In inoperable cases, palliative interventions include biliary drainage, biliary stenting and intra-biliary palliative treatment techniques. Complete knowledge of application of various imaging modalities available and about the possible radiological interventions is important for a radiologist to play a critical role in appropriate management of such patients.We review the various imaging techniques and appearances of hilar cholangiocarcinoma and the possible radiological interventions. | Kumble Seetharama Madhusudhan Shivanand Gamanagatti Arun Kumar Gupta | 2015 | World Journal of Radiology2015，7，2： | 18 |
| 11 | Surgical treatment of Budd-Chiari syndrome:analysis of 221 cases显示文摘BACKGROUND:Budd-Chiari syndrome (B-CS) refers to post-hepatic portal hypertension and/or inferior vena cava hypertension caused by obstruction of blood flow at the portal cardinal hepatic vein.The treatments of B-CS include operations on pathological membrane lesions,shunting and combined operations.Studies have shown that China,Japan,India and South Africa have a high incidence of B-CS.In China,the Yellow River Basin in Henan,Shandong,Jiangsu and Anhui Provinces also have a high incidence,around 10 per 100 000.METHODS:The clinical data of 221 B-CS patients were analyzed retrospectively.We focused on pathological types,surgical methods,effectiveness and complications of treatment,and follow-up.RESULTS:Based on imaging findings such as color ultrasonography,angiography or magnetic resonance angiography,the 221 patients were divided into 3 types (five subtypes):type Ia (72 patients),type Ib (20),type II (72),type IIIa (33),and type IIIb (24).Surgical procedures included balloon membranotomy with or without stent (65 patients),improved splenopneumopexy (18),radical resection of membrane and thrombus (17),inferior vena cava bypass [29,with cavocaval transflow (13) and cavoatrial transflow (16)],mesocaval shunt (41),splenocaval shunt (25),splenoatrial shunt (12),splenojugular shunt (6),and combined methods (8).The complication rate was 9.05% (20/221) and the perioperative death rate was 2.26% (5/221).All of the patients were followed up from 6 months to 5 years.The success rate was 84.6% (187/221),and the recurrence rate was 8.9% (9/101) and 13.5% (13/96) after 1-and 5-year follow-up,respectively.CONCLUSION:The rational choice of surgical treatment based on B-CS pathological typing may increase the success rate and decrease the recurrence. | Xiao-Wei Dang,Pei-Qin Xu,Xiu-Xian Ma,Da-Qian Xu,Yan-Ju Zhu and Yong-Shuai Zhang Division of Hepatobiliary and Pancreatic Surgery,First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，4： | 17 |
| 12 | Controversial role of toll-like receptors in acute pancreatitis显示文摘Acute pancreatitis(AP)is a common clinical condition with an incidence of about 300 or more patients per million annually.About 10%-15%of patients will develop severe acute pancreatitis(SAP)and of those, 10%-30%may die due to SAP-associated complications.Despite the improvements done in the diagnosis and management of AP,the mortality rate has not significantly declined during the last decades.Toll-like receptors(TLRs)are pattern-recognition receptors that seem to play a major role in the development of numerous diseases,which make these molecules attractive as potential therapeutic targets.TLRs are involved in the development of the systemic inflammatory response syndrome,a potentially lethal complication in SAP.In the present review,we explore the current knowledge about the role of different TLRs that have been described associated with AP.The main candidate for targeting seems to be TLR4,which recognizes numerous damage-associated molecular patterns related to AP.TLR2 has also been linked with AP,but there are only limited studies that exclusively studied its role in AP.There is also data suggesting that TLR9 may play a role in AP. | Juan Vaz Hamid Akbarshahi Roland Andersson | 2013 | World Journal of Gastroenterology2013，19，5： | 16 |
| 13 | Disclosure of government financial information and the cost of local government's debt financing——Empirical evidence from provincial investment bonds for urban construction显示文摘China's slowing economic growth and rapid urbanization have made local government debt financing a significant issue.This study uses a sample of China's provincial government data for the 2006–2012 period to examine the effect of the disclosure of financial information by local governments on their debt financing costs.The results show that financial information disclosure is conducive to public supervision and enhances government credibility,leading to a decrease in the cost of debt financing.Furthermore,increased government economic intervention increases the strength of the association between financial information disclosure and the cost of debt financing.Increased government audit prevention function weakens the strength of the association between financial information disclosure and the cost of debt financing. | Zhibin Chen Jun Pan Liangliang Wang Xiaofeng Shen | 2016 | China Journal of Accounting Research2016，，3： | 15 |
| 14 | Relationship between serum homocysteine levels and long-term outcomes in patients with ST-segment elevation myocardial infarction显示文摘Background:The mortality of cardiovascular disease is constantly rising,and novel biomarkers help us predict residual risk.This study aimed to evaluate the predictive value of serum homocysteine (HCY) levels on prognosis in patients with ST-segment elevation myocardial infarction (STEMI).Methods:The 419 consecutive patients with STEMI,treated at one medical center,from March 2010 to December 2015 were retrospectively investigated.Peripheral blood samples were obtained within 24 h of admission and HCY concentrations were measured using an enzymatic cycling assay.The patients were divided into high HCY level (H-HCY) and low HCY level (L-HCY) groups.Short- and long-term outcomes were compared,as were age-based subgroups (patients aged 60 years and younger vs.those older than 60 years).Statistical analyses were mainly conducted by Student t-test,Chi-squared test,logistic regression,and Cox proportional-hazards regression.Results:The H-HCY group had more males (84.6% vs.75.4%,P=0.018),and a lower prevalence of diabetes (20.2% vs.35.5%,P<0.001),compared with the L-HCY group.During hospitalization,there were seven mortalities in the L-HCY group and 10 in the H-HCY group (3.3% vs.4.8%,P= 0.440).During the median follow-up period of 35.8 (26.9–46.1) months,33 (16.2%) patients in the L-HCY group and 48 (24.2%) in the H-HCY group experienced major adverse cardiovascular and cerebrovascular events (MACCE)(P=0.120).History of hypertension (hazard ratio [HR]:1.881,95% confidence interval [CI]:1.178–3.005,P=0.008) and higher Killip class (HR:1.923,95% CI:1.419–2.607,P<0.001),but not HCY levels (HR:1.007,95% CI:0.987–1.027,P=0.507),were significantly associated with long-term outcomes.However,the subgroup analysis indicated that in older patients,HCY levels were significantly associated with long-term outcomes (HR:1.036,95% CI:1.011–1.062,P=0.005).Conclusion:Serum HCY levels did not independently predict in-hospital or long-term outcomes in patients with STEMI;however,among elderly patients with STEMI,this study revealed a risk profile for late outcomes that incorporated HCY level. | Jin Si Xue-Wen Li Yang Wang Ying-Hua Zhang Qing-Qing Wu Lei-Min Zhang Xue-Bing Zuo Jing Gao Jing Li | 2019 | Chinese Medical Journal2019，，9： | 15 |
| 15 | Clinical effects of psychological intervention and drug therapy against peptic ulcer显示文摘Objective:To evaluate the clinical effects of psychological interventions and drug therapy against peptic ulcer.Methods:96 patients with peptic ulcer were divided into control group with Tagamet 800 mg per evening p.o.and trial group with psychological intervention on the basis of drug treatment.Results:There were significant differences between the two groups(P<0.05), the trial group showed that the anxiety and depression cases declined obviously and effective rate of ulcer therapy was much higlier than control group.Conclusions:In sum,psychological intervention combined with drug therapy provides an effective method for ulcer treatment. | Duo-Yu Wu Min Guo Yun-Suo Gao Yan-Hai Kang Jun-Cheng Guo Xiang-Ling Jiang Feng Chen Tao Liu Min Li | 2012 | Asian Pacific Journal of Tropical Medicine2012，5，10： | 14 |
| 16 | Myocardial ischemia is a key factor in the management of stable coronary artery disease显示文摘Previous studies demonstrated that coronary revascularization,especially percutaneous coronary intervention(PCI),does not significantly decrease the incidence of cardiac death or myocardial infarction in patients with stable coronary artery disease.Many studies using myocardial perfusion imaging(MPI) showed that,for patients with moderate to severe ischemia,revascularization is the preferred therapy for survival benefit,whereas for patients with no to mild ischemia,medical therapy is the main choice,and revascularization is associated with increased mortality.There is some evidence that revascularization in patients with no or mild ischemia is likely to result in worsened ischemia,which is associated with increased mortality.Studies using fractional flow reserve(FFR) demonstrate that ischemia-guided PCI is superior to angiography-guided PCI,and the presence of ischemia is the key to decisionmaking for PCI.Complementary use of noninvasive MPI and invasive FFR would be important to compensate for each method's limitations.Recent studies of appropriateness criteria showed that,although PCI in the acute setting and coronary bypass surgery are properly performed in most patients,PCI in the non-acute set-ting is often inappropriate,and stress testing to identify myocardial ischemia is performed in less than half of patients.Also,some studies suggested that revascularization in an inappropriate setting is not associated with improved prognosis.Taken together,the presence and the extent of myocardial ischemia is a key factor in the management of patients with stable coronary artery disease,and coronary revascularization in the absence of myocardial ischemia is associated with worsened prognosis. | Kohichiro Iwasaki | 2014 | World Journal of Cardiology2014，6，4： | 13 |
| 17 | Neonatal gastric perforation: A single center experience显示文摘AIM: To determine the etiology and prognostic factors for neonatal gastric perforation(NGP), a rare but life-threatening disease.METHODS: Between 1980 and 2011, nine patients un-derwent surgical intervention for NGP at Seoul National University Children's Hospital. The characteristics and prognosis of the patients were retrospectively analyzed.RESULTS: Among the nine patients, three(33.3%) were preterm babies and five(55.5%) had associated anomalies, which included diaphragmatic eventration(n = 2), congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, and antral web. Three(33.3%) patients were born before 1990 and three(33.3%) had a birth weight < 2500 g. Pneumo-peritoneum was found on preoperative images in six(66.7%) patients, and incidentally in the other three(33.3%) patients. Surgery was performed within 24 h after the onset of symptoms in seven(77.8%) patients. The overall mortality rate was 22.2%(2/9). The time between symptoms and surgical intervention was the only prognostic factor for survival, whereas premature birth and birth weight were not.CONCLUSION: Early detection and advances in neo-natal intensive care may improve the prognosis of NGP. | Jeik Byun Hyun Young Kim Seung Yeon Noh Soo Hong Kim Sung Eun Jung Seong Cheol Lee Kwi Won Park | 2014 | World Journal of Gastrointestinal Surgery2014，6，8： | 13 |
| 18 | Clinical features and outcomes of patients with severe acute pancreatitis complicated with gangrenous cholecystitis显示文摘BACKGROUND: The effects of gangrenous cholecystitis (GC) and consequent surgical interventions on the clinical outcomes and prognosis of patients with severe acute pancreatitis are not clear. The present study was to characterize the clinical outcomes of patients with severe acute pancreatitis complicated with GC. METHODS: We retrospectively analyzed 253 consecutive patients hospitalized for acute pancreatitis in intensive care unit. Among them, 68 were diagnosed as having severe acute pancreatitis; 10 out of the 68 patients had GC. We compared these 10 patients with GC and 58 patients without GC. The indices analyzed included sepsis/septic shock, pancreatic encephalopathy, acute respiratory distress syndrome, acute renal failure, multiple organ dysfunction syndrome, and death. RESULTS: Specific CT images of GC in patients with severe acute pancreatitis included enlarged and high-tensioned gallbladder, wall thickening, lumenal emphysema, discontinuous and/or irregular enhancement of mucosa, and pericholecystic effusion. The rates of severe sepsis/septic shock (70.0% vs 24.1%, P<0.01), pancreatic encephalopathy (50.0% vs 17.2%, P<0.05), acute respiratory distress syndrome (90.0% vs 41.4%, P<0.01), multiple organ dysfunction syndrome (70.0% vs 24.1%, P<0.01), acute renal failure (40.0% vs 27.6%, P<0.05), and death (40.0% vs 13.8%, P<0.05) were significantly higher in patients with GC than in those without GC.CONCLUSION: CT scans can help to identify early GC in patients with severe acute pancreatitis; early diagnosis and intervention for patients with GC can reduce morbidity and mortality. | Er-Zhen Chen Jie Huang Zhi-Wei Xu Jian Fei En-Qiang Mao Sheng-Dao Zhang | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，3： | 13 |
| 19 | Safety and efficacy of early administration of tirofiban in patientswith acute ST-segment elevation myocardial infarction undergoingprimary percutaneous coronary intervention: a meta-analysis显示文摘Background Tirofiban has been widely used as an adjunctive pharmacologic agent for revascularization in patientsundergoing percutaneous coronary intervention, and the outcomes appear attractive. However, the potential benefits fromearly administration of tirofiban in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoingpdmarv percutaneous coronary intervention (PPCI) remain unclear. | | 2014 | Chinese Medical Journal2014，，6： | 12 |
| 20 | Intracoronary pressure gradient measurement in acute myocardial infarction patients with the no-reflow phenomenon during primary percutaneous coronary intervention显示文摘Background:Various experimental and clinical studies have reported on coronary microcirculatory dysfunction('no-reflow'phenomenon).Nevertheless,pathogenesis and effective treatment are yet to be fully elucidated.This study aimed to measure the intracoronary pressure gradient in the no-reflow artery during emergent percutaneous coronary intervention and explore the potential mechanism of no-reflow.Methods:From September 1st,2018 to June 30th,2019,intracoronary pressure in acute myocardial infarction patient was continuously measured by aspiration catheter from distal to proximal segment in the Department of Coronary Care Unit,Tianjin Chest Hospital,respectively in no-reflow arteries(no-reflow group)and arteries with thrombolysis in myocardial infarction-3 flow(control group).At least 12 cardiac cycles were consecutively recorded when the catheter was pulled back.The forward systolic pressure gradient was calculated as proximal systolic pressure minus distal systolic pressure.Comparison between groups was made using the Student t test,Mann-Whitney U-test or Chi-square test,as appropriate.Results:Intracoronary pressure in 33 no-reflow group and 26 in control group were measured.The intracoronary forward systolic pressure gradient was-1.3(-4.8,0.7)and 3.8(0.8,8.8)mmHg in no-reflow group and control group(Z=-3.989,P<0.001),respectively,while the forward diastolic pressure gradient was-1.0(-3.2,0)and 4.6(0,16.5)mmHg in respective groups(Z=-3.851,P<0.001).Moreover,the intracoronary forward pressure gradient showed significant difference between that before and after nicorandil medication(Z=-3.668,P<0.001 in systolic pressure gradient and Z=-3.530,P<0.001 in diastolic pressure gradient).Conclusions:No reflow during emergent coronary revascularization is significantly associated with local hemodynamic abnormalities in the coronary arteries.Intracoronary nicorandil administration at the distal segment of a coronary artery with an aspiration catheter could improve the microcirculatory dysfunction and resume normal coronary pressure gradient.Clinical trial registration:www.ClinicalTrials.gov(No.NCT 03600259). | Ming-Dong Gao En-Yuan Zhang Yuan-Ying Liu Xiao-Wei Li Jian-Yong Xiao Gen-Yi Sun Yin Liu | 2020 | Chinese Medical Journal2020，，7： | 12 |
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