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| 1 | AGNP精神科治疗药物监测共识指南:2011显示文摘治疗药物监测(Therapeutic drug monitoring,TDM),如通过定量测定血清或血浆药物浓度指导用药剂量优化,已经成为对患者进行精神药物治疗的很有价值的工具。在患者用药依从性难以判断、药物耐受性不佳、治疗剂量下无效以及可能存在药代动力学药物-药物相互作用等情况下,测定药物浓度是很有用的。在精神科,有可能明显获益于TDM的主要患者群体包括儿童、孕妇、老年患者、智力障碍患者、涉及司法的患者、已知或怀疑携带药代动力学相关基因变异的患者,以及合并躯体疾病影响药代动力学的患者。然而,只有将TDM充分整合到临床治疗过程中去,才能发挥其优化药物治疗的潜在优势。为了促进TDM的合理应用,神经精神药理学与药物精神病学协会(Arbeitsgemeinschaft für Neuropsychopharmakologie und Pharmakopsychiatrie,AGNP)的TDM专家组在2004年发表了精神药物治疗药物监测指南。之后,随着知识不断更新,又有许多可能需要进行TDM的新药上市。因此,本次更新将神经精神药物的种类扩展到了128种,并将其TDM必要性划分为从'强烈推荐'到'可能有用'的四个等级。经过大量细致且全面的文献检索与分门别类的汇总整理,将基于循证医学理念的'治疗参考浓度范围'和'剂量相关参考浓度范围'呈现给大家。本共识指南引入了'实验室警戒浓度'的新概念,即实验室需要马上告知治疗医生的药物浓度上限。本共识指南还给出了诸如药物作为细胞色素P450酶的底物和抑制剂的性质,代谢物与母药浓度比值的常见范围,以及与结果解释相关的内容,还提供了何时将TDM与遗传药理学检测相结合的建议。遵循本指南,有助于改善许多患者精神药物治疗的效果,特别是那些存在药代动力学异常的患者。TDM是一门交叉学科,有时针对看起来不一致的数据,需要多学科坦诚地讨论,只有这样,患者才能从这种合作中获益。 | Hiemke C Baumann P Bergemann N Conca A Dietmaier O Egberts K Fric M Gerlach M Greiner C Gründer G Haen E Havemann-Reinecke U Jaquenoud Sirot E Kirchherr H Laux G Lutz UC Messer T Müller MJ Pfuhlmann B Rambeck B Riederer P Schoppek B Stingl J Uhr M Ulrich S Waschgler R Zernig G 李文标(译) 果伟(译) 阮灿军(译) 贺静(译) 汤宜朗(审校) 王传跃(审校) | 2016 | 实用药物与临床2016，19，10： | 37 |
| 2 | 尿钠排泄、血压、心血管病与死亡率的关系:社区前瞻性流行病学队列研究显示文摘WHO建议人群钠摄人<2 g/d作为预防心血管病的措施之一,但这一目标在任何国家都没有实现。该建议主要基于短期血压试验的个体水平数据,没有来自随机试验或观察性研究的关于低钠摄入与降低心血管事件的数据。前瞻性城市农村流行病学研究目前正在21个国家进行。该文对其中18个国家的数据进行分析,其中包含了临床结果数据。 | Mente A O'Donnell M Rangarajan S McQueen M Dagenais G Wielgosz A Lear S Ah STL Wei L Diaz R Avezum A Lopez-Jaramillo P Lanas F Mony P Szuba A Iqbal R Yusuf R Mohammadifard N Khatib R Yusoff K Ismail N Gulec S Rosengren A Yusufali A Kruger L Tsolekile LP Chifamba J Dans A Alhabib KF Yeates K Teo K Yusuf S 刘莉 叶鹏 | 2018 | 中华高血压杂志2018，26，12： | 29 |
| 3 | Achalasia: A review of clinical diagnosis, epidemiology,treatment and outcomes显示文摘Achalasia is a neurodegenerative motility disorder of the oesophagus resulting in deranged oesophageal peristalsis and loss of lower oesophageal sphincter function.Historically,annual achalasia incidence rates were believed to be low,approximately 0.5-1.2 per 100000.More recent reports suggest that annual incidence rates have risen to 1.6 per 100000 in some populations.The aetiology of achalasia is still unclear but is likely to be multi-factorial.Suggested causes include environmental or viral exposures resulting in inflammation of the oesophageal myenteric plexus,which elicits an autoimmune response.Risk of achalasia may be elevated in a sub-group of genetically susceptible people.Improvement in the diagnosis of achalasia,through the introduction of high resolution manometry with pressure topography plotting,has resulted in the development of a novel classification system for achalasia.This classification system can evaluate patient prognosis and predict responsiveness to treatment.There is currently much debate over whether pneumatic dilatation is a superior method compared to the Heller’s myotomy procedure in the treatment of achalasia.A recent com-parative study found equal efficacy,suggesting that patient preference and local expertise should guide the choice.Although achalasia is a relatively rare condition,it carries a risk of complications,including aspiration pneumonia and oesophageal cancer.The risk of both squamous cell carcinoma and adenocarcinoma of the oesophagus is believed to be significantly increased in patients with achalasia,however the absolute excess risk is small.Therefore,it is currently unknown whether a surveillance programme in achalasia patients would be effective or cost-effective. | Orla M O'Neill Brian T Johnston Helen G Coleman | 2013 | World Journal of Gastroenterology2013，19，35： | 26 |
| 4 | Depression in patients with irritable bowel syndrome in Jos,Nigeria显示文摘AIM: To study the brain-gut interaction and the effect of behavioral or psychiatric conditions on irritable bowel syndrome (IBS) in an African population. METHODS: IBS was diagnosed using the Rome Ⅱ diagnostic criteria. The entry of each patient was confirmed following detailed explanations of the questions. Four hundred and eighteen patients were studied. Subjects satisfying the Rome Ⅱ criteria for IBS were physically examined and stool microscopy was done to identify the presence of “alarm factors”. Depression was diagnosed using the symptom-check list adapted from the Research Diagnostic Criteria (DSM-Ⅳ) of the American Psychiatric Association. RESULTS: Seventy-five (56.8%) of the 132 IBS patients were depressed whereas only 54 (20.1%) of the 268 non-IBS patients were depressed. There was a significant relationship between IBS and depression (χ2 = 54.29, Odds ratio = 5.21, 56.8 ± 8.4 vs 20.1 ± 5.2, P = 0.001). Even though constipation predominant IBS patients were more likely to be depressed, no significant relationship was found between the subtype of IBS and depression (χ2 = 0.02, OR = 0.95, P = 0.68). CONCLUSION: IBS is significantly associated with major depression but not gender and bowel subtypes of the patients. Patients with IBS need to be evaluated for depression due to the highly significant relationship between the two conditions. | Nimzing G Ladep Taiwo J Obindo Moses D Audu Edith N Okeke Abraham O Malu | 2006 | World Journal of Gastroenterology2006，12，48： | 22 |
| 5 | 高光谱遥感在农作物长势监测中的应用显示文摘该研究是加拿大Saskatchewan Scott农作物轮作系统(ACS)研究的一部分。研究始于1994年,历时18a,评价9个可耕种农作物产量系统的可靠性。由3种处理水平(organic,reduced,high)和3种作物多样性水平(low,diversified annual grains,diversified annual perennials)结合而产生的9个农作物产量系统,被用于监测和评价加拿大牧场不同处理和不同作物种植轮作下可耕种农作物的产量。在2003年生长季共收集了3次叶面积指数和光谱反射率的数据:生长季前期(6月)、生长季旺盛期(7月)、生长季后期(8月)。叶面积指数是由LAI-2000植物冠层分析仪监测的,光谱测量是由覆盖了350-2500 nm波长范围共2215个波段的ADS便携式高光谱仪完成的。结果显示,光学测量可以用于监测农作物生长状况的差异。从生长季的早期到中期,光谱和叶面积指数在不同处理下有显著差异。7月中期是用遥感资料监测农作物长势的最佳季节;红光波段与近红外波段反射率的比值和基于这两个波段构造的归一化植被指数,是检测农作物长势的最佳植被指数。 | 郑有飞 Guo X Olfert O Brandt S Thomas G Weiss R Sproule L | 2007 | 气象与环境科学2007，30，1： | 22 |
| 6 | 血管性认知障碍的诊断标准:国际血管性行为与认知障碍学会的申明显示文摘长期以来,脑血管病(CVD)就被认为是认知损害的一个重要原因,但是有关脑血管病后认知障碍的概念化却有着一段多变的历史。'动脉变硬'或脑的动脉粥样硬化是'老化'的原因,是存在已久的观点,在20世纪60年代受到了来自英格兰纽卡斯尔的神经病理学研究的质疑。这些研究表明,血管性痴呆(vascular dementia,Va D)与超过一定程度的多发性脑梗死有关。 | 徐岩 郭起浩 Sachdev P Kalaria R O'Brien J Skoog I Alladi S Black SE Blacker D Blazer DG Chen C Chui H Ganguli M Jellinger K Jeste DV Pasquier F Paulsen J Prins N Rockwood K Roman G Scheltens P | 2014 | 神经病学与神经康复学杂志2014，11，3： | 19 |
| 7 | Therapeutic temperature modulation is associated with pulmonary complications in patients with severe traumatic brain injury显示文摘AIM: To examine complications associated with the use of therapeutic temperature modulation(mild hypothermia and normothermia) in patients with severe traumatic brain injury(TBI). METHODS: One hundred and fourteen charts were reviewed. Inclusion criteria were: severe TBI with Glasgow Coma Scale(GCS) < 9, intensive care unit(ICU) stay > 24 h and non-penetrating TBI. Patients were divided into two cohorts: the treatment group received therapeutic temperature modulation(TTM) with continuous surface cooling and indwelling bladder temperature probes. The control group received standard treatment with intermittent acetaminophen for fever. Information regarding complications during the time in the ICU was collected as follows: Pneumonia was identified using a combination of clinical and laboratory data. Pulmonary embolism, pneumothorax and deep venous thrombosis were identified based onimaging results. Cardiac arrhythmias and renal failure were extracted from the clinical documentation. acute respiratory distress syndrome and acute lung injury were determined based on chest imaging and arterial blood gas results. A logistic regression was conducted to predict hospital mortality and a multiple regression was used to assess number and type of clinical complications. RESULTS: One hundred and fourteen patients were included in the analysis(mean age = 41.4, SD = 19.1, 93 males), admitted to the Jackson Memorial Hospital Neuroscience ICU and Ryder Trauma Center(mean GCS = 4.67, range 3-9), were identified and included in the analysis. Method of injury included motor vehicle accident(n = 29), motor cycle crash(n = 220), blunt head trauma(n = 212), fall(n = 229), pedestrian hit by car(n = 216), and gunshot wound to the head(n = 27). Ethnicity was primarily Caucasian(n = 260), as well as Hispanic(n = 227) and African American(n = 223); four patients had unknown ethnicity. Patients received either TTM(43) or standard therapy(71). Within the TTM group eight patients were treated with normothermia after TBI and 35 patients were treated with hypothermia. A logistic regression predicting in hospital mortality with age, GCS, and TM demonstrated that GCS(Beta = 0.572, P < 0.01) and age(Beta =-0.029) but not temperature modulation(Beta = 0.797, ns) were significant predictors of in-hospital mortality [χ2(3) = 22.27, P < 0.01] A multiple regression predicting number of complications demonstrated that receiving TTM was the main contributor and was associated with a higher number of pulmonary complications(t =-3.425, P = 0.001). CONCLUSION: Exposure to TTM is associated with an increase in pulmonary complications. These findings support more attention to these complications in studies of TTM in TBI patients. | Kristine H O’Phelan Amedeo Merenda Katherine G Denny Kassandra E Zaila Cynthia Gonzalez | 2015 | World Journal of Critical Care Medicine2015，4，4： | 18 |
| 8 | 欧洲新生儿呼吸窘迫综合征防治共识显示文摘呼吸窘迫综合征(RDS)是由于肺表面活性物质(PS)缺乏及肺结构发育不成熟所致,多见于早产儿,自然病程为出生当时或生后很快发病,并在生后2d内进行性恶化,如不及时治疗,因进行性缺氧和呼吸衰竭而死亡。存活者出生后2—4d病情开始改善。RDS临床表现早期出现呼吸窘迫如紫绀、呻吟、吸凹和呼吸急促,然后进一步发展为呼吸衰竭,血气分析结果可提示呼吸衰竭的严重性。胸部X线典型的毛玻璃样改变和支气管充气征可以确诊。Vermont Oxford新生儿协作网对RDS的定义为: | Sweet D Bevilacqua G Carnielli V Greisen G Plavka R Didrik Saugstad O Simeoni U Speer CP Valls-I-Soler A Halliday H 袁琳(译) 陈超(译) 杜立中(校) | 2008 | 中华儿科杂志2008，46，1： | 17 |
| 9 | 局部和全身给药后泼尼松龙在外淋巴液中的浓度分析显示文摘目的 :比较局部和全身给药后 2 1 氢化琥珀酸 泼尼松龙在外淋巴液中的药物动力学。方法 :将实验豚鼠分组 ,局部用药 (局部组 ) :将 0 .5 %的 2 1 氢化琥珀酸 泼尼松龙液在直视下置于圆窗龛 ;全身用药 (全身组 ) :按 6 0mg/kg腹腔内注药 ;两组均以生理盐水作为对照。分别于给药后不同时间段采集外淋巴液标本 ,采用高压液相色谱法 (HPLC)测定药物浓度。结果 :局部组药物最高浓度出现在给药后 180min ,为 (95 2 .3± 382 .7)mg/L ,并在 96 0min后维持在 (18.72± 16 .97)mg/L。全身组药物最高峰时间在给药后 15 0min ,为 (14 .71± 7.0 5 )mg/L。结论 :局部给予 2 1 氢化琥珀酸 泼尼松龙 ,可以获得长时间、高浓度的药物水平。 | 苏纪平 Bachmann G 唐安洲 Zumegen C Michel O Wittekindt C | 2003 | 临床耳鼻咽喉科杂志2003，17，10： | 16 |
| 10 | Clostridium difficile causing acute renal failure: Case presentation and review显示文摘AIM: Clostridium difficile infection is primarily a nosocomial infection but asymptomatic carriers of Clostridium difficile can be found in up to 5% of the general population.Ampicillin, cephalosporins and clindamycin are the antibiotics that are most frequently associated with Clostridium difficile-associated diarrhea or colitis. Little is known about acute renal failure as a consequence of Clostridium difficile-associated diarrhea.METHODS: In this case report, we describe the course of Clostridium difficile-associated diarrhea in an 82-yearold patient developing acute renal failure. Stopping the offending agent and symptomatic therapy brought a rapid improvement of diarrhea and acute renal failure, full recovery was gained 18 d after admission. In a systematic review we looked for links between the two conditions.RESULTS: The link between Clostridium difficilr-associated diarrhea and acute renal failure in our patient was most likely volume depletion. However, in experimental studies a direct influence of Clostridium difficile toxins on renal duct cells could be shown.CONCLUSION: Rapid diagnosis, nonspecific supportive treatment and specific antibiotic treatment, especially in the elderly, may lower excess mortality Clostridium difficile-associated diarrhea and renal failure being possible complications. | Jasmin Arrich Gottfried H.Sodeck Gürkan Seng(o|¨)lge Christoforos Konnaris Marcus Müllner Anton N.Laggner Hans Domanovits | 2005 | World Journal of Gastroenterology2005，11，8： | 15 |
| 11 | 小麦干物质、果聚糖和氮的积累分配及其与籽粒产量和品质的关系显示文摘 在200kg/hm2施N条件下,对17个澳大利亚小麦品种的干物质、果聚糖、氮的积累分配及其与籽粒产量(GY)、籽粒氮产量(GNY)及籽粒氮含量(GNC)的关系进行了研究。结果表明,干物质、果聚糖和氮积累的模式相似,在叶片、茎秆和植株中分别于开花期、乳熟期和成熟期积累到最大值。在开花前,茎秆是贮存果聚糖的主要器官,叶片是氮的主要贮存器官,而在花期后,籽粒成为贮存果聚糖和氮最多的器官,其次为茎秆。从乳熟期至成熟期,随着干物质、果聚糖和氮在营养器官中积累的降低,GY、GNY和籽粒果聚糖积累快速增加。在多数取样期,植株干物质积累和果聚糖积累与GY和GNY呈极显著正相关,与GNC呈负相关;成熟期植株氮积累与GY呈显著负相关,与GNC显著正相关;在花期后,叶片和茎秆氮积累与GY和GNY呈显著负相关。 | 赵万春 高翔 董剑 Bonnett D G O'Brien L | 2005 | 西北农林科技大学学报(自然科学版)2005，33，3： | 14 |
| 12 | Efficacy of neoadjuvant therapy and surgical rescue for locally advanced hepatoblastomas:10 year single-center experience and literature review显示文摘AIM:To report our experience with long-term outcomes after multimodal management therapy.METHODS:An observational retrospective study was performed containing seven patients with hepatoblastoma(Hbl)treated in our institution,a tertiary referral center,from 2003 to 2011.Demographic,preoperative,surgical,and outcome variables were collected.A survival analysis and a review of the current literature related to combination neoadjuvant chemotherapy and surgical resection on Hbl were performed.RESULTS:The median age at surgery was 14.4 mo,with a male to female ratio of 4:3.Pretext staging at diagnosis was as follows:stageⅠ,4 cases;stageⅡ,2 patients;and stageⅢ,1 case.Mean pretreatment tumor volume was 735 cm3.Five out of seven patients received neoadjuvant chemotherapy according to SIOPEL-3 or SIOPEL-6 protocols.Tumor volume and alphafetoprotein levels significantly dropped after neoadjuvant therapy.Surgical procedures performed included hemihepatectomies,segmentectomies and atypical resection.All patients received chemotherapy after surgery.Median postoperative hospital stay was 8 d.All patients were alive and disease-free after a median follow-up period of 23 mo.With regards to the literature review,seventeen articles were found that were related to our search.CONCLUSION:Our series shows how multimodal management of Hbl,exhaustive control and a meticulous surgical approach leads to almost 100%complete resection with optimal postoperative results. | Dolores Ayllon Teran Oscar Gómez Beltran Rubén Ciria Bru Elena Mateos González María José Pea Rosa Antonio Luque Molina Pedro López Cillero Javier Briceo Delgado | 2014 | World Journal of Gastroenterology2014，20，29： | 12 |
| 13 | An epigenomic approach to therapy for tamoxifen-resistant breast cancer显示文摘Tamoxifen 是为雌激素受体 alpha 的前线治疗(ERα) 在绝经前的女人的积极的胸肿瘤。然而,到 tamoxifen 的抵抗发生在许多病人。嗯仍然与获得的 tamoxifen 抵抗在乳癌房间的生长起一个关键作用,建议那 ERα为治疗仍然是一个有效目标 tamoxifen 抵抗(Tam-R ) 乳癌。以识别 ERα 的新奇管理者;发信号,通过对 histone 甲基修饰词的一幅小规模的 siRNA 屏幕,我们发现了 WHSC1, histone H3K36 methyltransferase, ERα 的一个积极管理者;在乳癌房间发信号。我们证明 WHSC1 被招募到 ERα由 BET 蛋白质 BRD3/4 的基因,并且便于 ERα基因表示。小分子的赌注蛋白质禁止者 JQ1 potently 压制了经典 ERα发信号的小径和在文化的 Tam-R 乳癌房间的生长。用一个 Tam-R 乳癌异种皮移植老鼠模型,我们与 JQ1 和 ER degrader fulvestrant 由 JQ1 和联合治疗的强壮的长持续的效果在 vivo 反胸癌症活动示威了。一起拿,我们提供 epigenomic 蛋白质 BRD3/4 和 WHSC1 是雌激素受体发信号的必要管理者并且是为 Tam-R 乳癌的治疗的新奇治疗学的目标的证据。 | Qin Feng Zheng Zhang Martin J Shea Chad J Creighton Cristian Coarfa Susan G Hilsenbeck Rainer Lanz Bin He Lei Wang Xiaoyong Fu Agostina Nardone Yongcheng Song James Bradner Nicholas Mitsiades Constantine S Mitsiades C Kent Osborne Rachel Schiff Bert W O'Malley | 2014 | Cell Research2014，24，7： | 10 |
| 14 | Imaging of bone metastasis: An update显示文摘Early detection of skeletal metastasis is critical for accurate staging and optimal treatment. This paper briefly reviews our current understanding of the biological mechanisms through which tumours metastasise to bone and describes the available imaging methods to diagnose bone metastasis and monitor response to treatment. Among the various imaging modalities currently available for imaging skeletal metastasis, hybrid techniques whichfuse morphological and functional data are the most sensitive and specific, and positron emission tomography(PET)/computed tomography and PET/magnetic resonance imaging will almost certainly continue to evolve and become increasingly important in this regard. | Gerard J O'Sullivan Fiona L Carty Carmel G Cronin | 2015 | World Journal of Radiology2015，7，8： | 10 |
| 15 | 胰腺导管内管状乳头状肿瘤:33例临床病理和免疫组化分析显示文摘胰腺导管内管状乳头状肿瘤属于胰腺导管内肿瘤家族成员。因此,有关其组织学特征和免疫表型、临床生物学行为以及与其它胰腺肿瘤异同点的文献报道较少。本组33例胰腺导管内管状乳头状肿瘤是迄今为止报道例数最多。免疫组化标记包括细胞角蛋白、糖蛋白、胰腺酶、肠道和神经内分泌分化的标志物, | Basturk O Adsay V Askan G 解建军 张仁亚 | 2017 | 临床与实验病理学杂志2017，33，7： | 9 |
| 16 | Role of CARD15,DLG5 and OCTN genes polymorphisms in children with inflammatory bowel diseases显示文摘AIM: To investigate the contribution of variants of CARD15, OCTN1/2 and DLG5 genes in disease predispo- sition and phenotypes in a large Italian cohort of pediatric patients with inflammatory bowel diseases (IBD). METHODS: Two hundred patients with Crohn’s disease (CD), 186 ulcerative colitis (UC) patients, 434 par- ents (217 trios), and 347 healthy controls (HC) were studied. Polymorphisms of the three major variants of CARD15, 1672C/T and -207G/C SNPs for OCTN genes, IGR2096a_1 and IGR2198a_1 SNPs for the IBD5 locus, and 113G/A variant of the DLG5 gene were evaluated. Potential correlations with clinical sub-phenotypes were investigated. RESULTS: Polymorphisms of CARD15 were significantly associated with CD, and at least one variant was found in 38% of patients (15% in HC, OR = 2.7, P < 0.001). Homozygosis for both OCTN1/2 variants was more com- mon in CD patients (1672TT 24%, -207CC 29%) than in HC (16% and 21%, respectively; P = 0.03), with an in- creased frequency of the TC haplotype (44.8% vs 38.3% in HC, P = 0.04). No association with the DLG5 variant was found. CD carriers of OCTN1/2 and DLG5 variants more frequently had penetrating disease (P = 0.04 and P = 0.01), while carriers of CARD15 more frequently had ileal localization (P = 0.03). No gene-gene interaction was found. In UC patients, the TC haplotype was morefrequent (45.4%, P = 0.03), but no genotype/phenotype correlation was observed. CONCLUSION: Polymorphisms of CARD15 and OCTN genes, but not DLG5 are associated with pediatric on- set of CD. Polymorphisms of CARD15, OCTN, and DLG5 genes exert a weak influence on CD phenotype. | S Cucchiara A Latiano O Palmieri AM Staiano R D'Incà G Guariso G Vieni V Rutigliano O Borrelli MR Valvano V Annese | 2007 | World Journal of Gastroenterology2007，13，8： | 9 |
| 17 | 在结肠和直肠的癌症的淋巴节点收获: 当前的考虑显示文摘 The prognostic significance of identifying lymph node(LN) metastases following surgical resection for colon and rectal cancer is well recognized and is reflected in accurate staging of the disease.An established body of evidence exists,demonstrating an association between a higher total LN count and improved survival,particularly for node negative colon cancer.In node positive disease,however,the lymph node ratios may represent a better prognostic indicator,although the impact of this on clinical treatment has yet to be universally established.By extension,strategies to increase surgical node harvest and/or laboratory methods to increase LN yield seem logical and might improve cancer staging.However,debate prevails as to whether or not these extrapolations are clinically relevant,particularly when very high LN counts are sought.Current guidelines recommend a minimum of 12 nodes harvested as the standard of care,yet the evidence for such is questionable as it is unclear whether an increasing the LN count results in improved survival.Findings from modern treatments,including down-staging in rectal cancer using pre-operative chemoradiotherapy,paradoxically suggest that lower LN count,or indeed complete absence of LNs,are associated with improved survival;implying that using a specific number of LNs harvested as a measure of surgical quality is not always appropriate.The pursuit of a sufficient LN harvest represents good clinical practice;however,recent evidence shows that the exhaustive searching for very high LN yields may be unnecessary and has little in? uence on modern approaches to treatment. | James R McDonald Andrew G Renehan Sarah T O’Dwyer Najib Y Haboubi | 2012 | World Journal of Gastrointestinal Surgery2012，4，1： | 8 |
| 18 | IL28B polymorphism and cytomegalovirus predict response to treatment in Egyptian HCV type 4 patients显示文摘AIM:To test whether the status of positive cytomegalovirus(CMV) DNA detection adds to the predictive value of IL28B and to further categorize C/T allele carriers.METHODS:This study included 166 chronic hepatitis C(CHC) patients who received combined interferon and ribavirin therapy for 48 wk,84 spontaneous hepatitis C virus(HCV) resolvers who were positive for IgG anti-HCV antibody and negative for HCV RNA,and 100 healthy subjects who were negative for both HCV antibodies and RNA as controls.Genomic DNA from peripheral blood was used for IL28B rs.12979860 single nucleotide polymorphism(SNP) and CMV DNA detection.A 139 bp fragment containing IL28B SNP was amplified in all subjects by polymerase chain reaction using a specifically designed primer.Then the IL28B rs.12979860 SNP was detected by restriction fragment length polymorphism(RFLP) genotyping.The presence of CMV DNA was tested by amplification of the gB1 gene using nested polymerase chain reaction.The role of CMV and IL28B rs.12979860 SNP genotypes in determining the response rate to combined interferon therapy and clinical status of patients were statistically analyzed.RESULTS:Current data showed that 67% of patients carrying the IL28B 12979860 C/C allele had a sustained viral response(SVR) while the genotypes C/T and TT were associated with lower SVR rates,50% and 48%,respectively.SVR rates for the C/C allele were lower than other HCV genotypes and/or other populations.Genotype CC was associated with the response to interferon(P = 0.025).Genotype C/C was reduced from 48% in controls to 14% in CHC patients suggesting its protective role against progression to chronicity.The majority of spontaneously cleared subjects(86%) were C/C,confirming its protective role.The C/T allele was present in 71% of CHC patients compared with 38% of controls,so the use of IL28B SNP genotyping only in these patients may be of little value as a predictor of response.CMV reactivation occurred in 40% of CHC patients.Co-infection with CMV seriously diminished the response to interferon(IFN) therapy,with SVR rates in C/C genotypes 87.5% in CMV-negative patients and 12.5% in CMV-positive patients(P < 0.0001).SVR rates among C/T carriers were reduced to < 50% in patients with positive CMV DNA while the non-response rate doubled.These data indicate that a supplemental assay for CMV viremia adds to the prognostic value of IL28B genotyping.CONCLUSION:The results suggest that both genetic(i.e.,spontaneous) and therapeutic(IFN-based therapy) arms are complementary in the battle against HCV.CMV DNA testing may be of value to better predict the response to IFN,particularly in IL28B C/T carriers. | Mostafa K El Awady Noha G Bader El Din Ashraf Tabll Yaser El Hosary Ashraf O Abdel Aziz Hesham El Khayat Mohsen Salama Tawfeek H Abdelhafez | 2013 | World Journal of Gastroenterology2013，19，2： | 8 |
| 19 | Pain sensation in pancreatic diseases is not uniform: The different facets of pancreatic pain显示文摘AIM: To systematically characterize specific pain patterns in the most frequent pancreatic diseases.METHODS: Pain in patients with chronic pancreatitis(n = 314), pancreatic cancer(n = 469), and other pancreatic tumors(n = 249) including mucinous(n = 20) and serous cystadenoma(n = 31), invasive(n = 37) and non-invasive intraductal papillary mucinous neoplasia(IPMN; n = 48), low stage(n = 18) and high stage neuroendocrine neoplasia(n = 44), and ampullary cancer(n = 51) was registered and correlated with clinicopathological data. Survival times were estimated by the Kaplan-Meier method. Patients alive at the follow-up time were censored. Survival curves were compared statistically using the log-rank test.RESULTS: Forty-nine point one percent of pancreatic cancer patients revealed no pain, whereas in chronic pancreatitis only 18.3% were pain free. In contrary, moderate/severe pain was registered in 15.1% in pancreatic cancer patients that was increased in chronic pancreatitis with up to 34.2%. Serous cystadenoma was asymptomatic in most cases(58.1%), whereas 78.9% of all mucinous cystadenoma patients suffered pain. In neuroendocrine neoplasia pain was not a key clinical symptom since 64% of low stage neuroendocrine neoplasia and 59% of high stage neuroendocrine neoplasia patients were pain free. Cancer localization in the pancreatic body and patients with malignant pancreatic neoplasms were associated with more severe pain. Tumor grading and stage did not show any impact on pain. Only in pancreatic cancer, pain was directly associated with impaired survival.CONCLUSION: Pancreatic pain depicts different patterns of abdominal pain sensation according to the respective pancreatic disorder and does not allow a unification of the term pancreatic pain. | Jan G D'Haese Mark Hartel Ihsan Ekin Demir Ulf Hinz Frank Bergmann Markus W Büchler Helmut Friess Güralp O Ceyhan | 2014 | World Journal of Gastroenterology2014，20，27： | 8 |
| 20 | Oxidative stress and lipid peroxidation products:effect of pinealectomy or exogenous melatonin injections on biomarkers of tissue damage during acute pancreatitis显示文摘BACKGROUND:Melatonin (N-acetyl-5-methoxytripta-mine) is a free radical scavenger and a strong antioxidant,secreted by the pineal gland.In this study,we evaluated the effects of decreasing and increasing serum melatonin levels on malonyldialdehyde (MDA),superoxide dismutase (SOD),and reduced glutathione (GSH) levels in pancreatic tissue from rats with experimental acute pancreatitis.METHODS:Experimental acute pancreatitis was induced in three groups of Wistar albino rats (10 animals per group) by pancreatic ductal ligation.The first group had only acute pancreatitis and served as the control.Surgical pinealectomy was added to acute pancreatitis in the second group,removing the source of endogenous melatonin (low melatonin levels group).The third group was given 0.1 ml daily intraperitoneal injections of 20 mg/ml melatonin solution for one week (high melatonin levels group).The effects of melatonin levels were evaluated by comparison of the levels of MDA,SOD,and GS in pancreatic tissue.RESULT:We found that intraperitoneal melatonin injections decreased the levels of MDA and increased the levels of SOD and GSH in pancreatic tissue.CONCLUSION:Exogenous melatonin has a preventive effect on lipid peroxidation and oxidative damage in acute pancreatitis. | Cavit l Kahraman Dinler O■uz Hasdemir Oktay Büyüka■ik Güler Bu■dayci | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，1： | 7 |
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