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| 1 | 急性肾损伤诊断与分类专家共识显示文摘近几十来.临床和基础的研究工作者们针对急性肾功能衰竭(ARF)进行了广泛的研究,尽管我们在该疾病的生理和发病机制方面都取得了长足的进步,但如何将这些知识用于临床,改进ARF患者预后方面的工作却做得十分有限。ARF是由多种病因导致、可发生在各种临床情况之下(儿童或成人、门诊或住院、ICU或非ICU患者)的一种复杂的肾功能紊乱,其临床表现既可以是血肌酐水平的轻微升高,也可以是无尿性肾功能衰竭。 | RL Mehta JA Kellum S Shah B Molitoris C Ronco D Warnock A Levin 王欣 | 2006 | 中华肾脏病杂志2006，22，11： | 348 |
| 2 | Portal vein thrombosis, mortality and hepatic decompensation in patients with cirrhosis: A meta-analysis显示文摘AIM: To determine the clinical impact of portal vein thrombosis in terms of both mortality and hepatic decompensations(variceal hemorrhage, ascites, portosystemic encephalopathy) in adult patients with cirrhosis.METHODS: We identified original articles reported through February 2015 in MEDLINE, Scopus, Science Citation Index, AMED, the Cochrane Library, and relevant examples available in the grey literature. Two independent reviewers screened all citations for inclusion criteria and extracted summary data. Random effects odds ratios were calculated to obtain aggregate estimates of effect size across included studies, with 95%CI.RESULTS: A total of 226 citations were identified and reviewed, and 3 studies with 2436 participants were included in the meta-analysis of summary effect. Patients with portal vein thrombosis had an increased risk of mortality(OR = 1.62, 95%CI: 1.11-2.36, P = 0.01). Portal vein thrombosis was associated with an increased risk of ascites(OR = 2.52, 95%CI: 1.63-3.89, P < 0.001). There was insufficient data available to determine the pooled effect on other markers of decompensation including gastroesophageal variceal bleeding or hepatic encephalopathy. CONCLUSION: Portal vein thrombosis appears to increase mortality and ascites, however, the relatively small number of included studies limits more generalizable conclusions. More trials with a direct comparison group are needed. | Jonathan G Stine Puja M Shah Scott L Cornella Sean R Rudnick Marwan S Ghabril George J Stukenborg Patrick G Northup | 2015 | World Journal of Hepatology2015，7，27： | 42 |
| 3 | 页岩气藏流固耦合渗流模型及有限元求解显示文摘页岩气渗流模型是页岩气藏动态分析和数值模拟的基础。将裂缝性页岩气藏视为基质孔隙–裂缝双重介质,同时考虑岩石骨架变形对气体渗流场的影响,建立页岩气藏流固耦合渗流模型。模型假设基质孔隙内作克努森流动,裂缝中作达西渗流,综合考虑页岩气壁面滑脱流动与孔内扩散作用、吸附与脱附、应力敏感性等渗流机制。采用有限元法离散控制方程及全隐式耦合求解方法,编制计算机程序。考虑真实页岩参数取值,利用该模型进行算例分析。结果表明,页岩气藏压力下降速率小于常规裂缝性气藏压力下降速率;裂缝渗透率是影响裂缝渗流压力衰减的主要因素,需考虑页岩裂缝导流能力与基质产气速率的匹配关系;原始地层压力越小,裂缝渗流压力衰减越慢。所建模型可为页岩气藏模拟器开发及动态分析提供理论基础。 | 盛茂 李根生 黄中伟 田守嶒 SHAH S | 2013 | 岩石力学与工程学报2013，32，9： | 17 |
| 4 | Pathogenesis, prevention, diagnosis and treatment of breast cancer显示文摘Breast cancer is the most common cancer affecting women worldwide. Prediction models stratify a woman's risk for developing cancer and can guide screening recommendations based on the presence of known and quantifiable hormonal, environmental, personal, or genetic risk factors. Mammography remains the mainstay breast cancer screening and detection but magnetic resonance imaging and ultrasound have become useful diagnostic adjuncts in select patient populations. The management of breast cancer has seen much refinement with increased specialization and collaboration with multidisciplinary teams that include surgeons, oncologists, radiation oncologists, nurses, geneticist, reconstructive surgeons and patients. Evidence supports a less invasive surgical approach to the staging and management of the axilla in select patients. In the era of patient/tumor specific management, the advent of molecular and genomic profiling is a paradigm shift in the treatment of a biologically heterogenous disease. | Rupen Shah Kelly Rosso S David Nathanson | 2014 | World Journal of Clinical Oncology2014，5，3： | 17 |
| 5 | Bone mineral density and disorders of mineral metabolism in chronic liver disease显示文摘AIM:To estimate the prevalence and identify the risk factors for metabolic bone disease in patients with cirrhosis.METHODS:The study was performed on 72 Indian patients with cirrhosis(63 male, 9 female;aged < 50 years).Etiology of cirrhosis was alcoholism(n = 37), hepatitis B(n = 25) and hepatitis C(n = 10).Twenty-three patients belonged to Child class A, while 39 were in class B and 10 in class C.Secondary causes for metabolic bone disease and osteoporosis were ruled out.Sunlight exposure, physical activity and dietary constituents were calculated.Complete metabolic profiles were derived, and bone mineral density(BMD) was measured using dual energy X ray absorptiometry.Low BMD was defined as a Z score below-2.RESULTS:Low BMD was found in 68% of patients.Lumbar spine was the most frequently and severely affected site.Risk factors for low BMD included low physical activity, decreased sunlight exposure, and low lean body mass.Calcium intake was adequate, with unfavorable calcium:protein ratio and calcium:phosphorus ratio.Vitamin D deficiency was highly prevalent(92%).There was a high incidence of hypogonadism(41%).Serum estradiol level was elevated significantly in patients with normal BMD.Insulin-like growth factor(IGF) 1 and IGF binding protein 3 levels were below the age-related normal range in both groups.IGF-1 was signiflcantly lower in patients with low BMD.Serum osteocalcin level was low(68%) and urinary deoxypyridinoline to creatinine ratio was high(79%), which demonstrated low bone formation with high resorption.CONCLUSION:Patients with cirrhosis have low BMD.Contributory factors are reduced physical activity, low lean body mass, vitamin D def iciency and hypogonadism and low IGF-1 level. | Joe George Hosahithlu K Ganesh Shrikrishna Acharya Tushar R Bandgar Vyankatesh Shivane Anjana Karvat Shobna J Bhatia Samir Shah Padmavathy S Menon Nalini Shah | 2009 | World Journal of Gastroenterology2009，15，28： | 15 |
| 6 | Retinopathy of prematurity: Past, present and future显示文摘Retinopathy of prematurity(ROP) is a vasoproliferative disorder of the retina occurring principally in new born preterm infants. It is an avoidable cause of childhood blindness. With the increase in the survival of preterm babies, ROP has become the leading cause of preventable childhood blindness throughout the world. A simple screening test done within a few weeks after birth by an ophthalmologist can avoid this preventable blindness. Although screening guidelines and protocols are strictly followed in the developed nations, it lacks in developing economies like India and China, which have the highest number of preterm deliveries in the world. The burden of this blindness in these countries is set to increase tremendously in the future, if corrective steps are not taken immediately. ROP first emerged in 1940 s and 1950 s, when it was called retrolental fibroplasia. Several epidemics of this disease were and are still occurring in different regions of the world and since then a lot of research has been done on this disease. However, till date very few comprehensive review articles covering all the aspects of ROP are published. This review highlights the past, present and future strategies in managing this disease. It would help the pediatricians to update their current knowledge on ROP. | Parag K Shah Vishma Prabhu Smita S Karandikar Ratnesh Ranjan Venkatapathy Narendran Narendran Kalpana | 2016 | World Journal of Clinical Pediatrics2016，5，1： | 13 |
| 7 | Retrospective study on mixed neuroendocrine non-neuroendocrine neoplasms from five European centres显示文摘BACKGROUND Mixed neuroendocrine non-neuroendocrine neoplasm(MiNEN)is a rare diagnosis,mainly encountered in the gastro-entero-pancreatic tract.There is limited knowledge of its epidemiology,prognosis and biology,and the best management for affected patients is still to be defined.AIM To investigate clinical-pathological characteristics,treatment modalities and survival outcomes of a retrospective cohort of patients with a diagnosis of MiNEN.METHODS Consecutive patients with a histologically proven diagnosis of MiNEN were identified at 5 European centres.Patient data were retrospectively collected from medical records.Pathological samples were reviewed to ascertain compliance with the 2017 World Health Organisation definition of MiNEN.Tumour responses to systemic treatment were assessed according to the Response Evaluation Criteria in Solid Tumours 1.1.Kaplan-Meier analysis was applied to estimate survival outcomes.Associations between clinical-pathological characteristics and survival outcomes were explored using Log-rank test for equality of survivors functions(univariate)and Cox-regression analysis(multivariable).RESULTS Sixty-nine consecutive patients identified;Median age at diagnosis:64 years.Males:63.8%.Localised disease(curable):53.6%.Commonest sites of origin:colon-rectum(43.5%)and oesophagus/oesophagogastric junction(15.9%).The neuroendocrine component was;predominant in 58.6%,poorly differentiated in 86.3%,and large cell in 81.25%,of cases analysed.Most distant metastases analysed(73.4%)were occupied only by a poorly differentiated neuroendocrine component.Ninety-four percent of patients with localised disease underwent curative surgery;53%also received perioperative treatment,most often in line with protocols for adenocarcinomas from the same sites of origin.Chemotherapy was offered to most patients(68.1%)with advanced disease,and followed protocols for pure neuroendocrine carcinomas or adenocarcinomas in equal proportion.In localised cases,median recurrence free survival(RFS);14.0 months(95%CI:9.2-24.4),and median overall survival(OS):28.6 months(95%CI:18.3-41.1).On univariate analysis,receipt of perioperative treatment(vs surgery alone)did not improve RFS(P=0.375),or OS(P=0.240).In advanced cases,median progression free survival(PFS);5.6 months(95%CI:4.4-7.4),and median OS;9.0 months(95%CI:5.2-13.4).On univariate analysis,receipt of palliative active treatment(vs best supportive care)prolonged PFS and OS(both,P<0.001).CONCLUSION MiNEN is most commonly driven by a poorly differentiated neuroendocrine component,and has poor prognosis.Advances in its biological understanding are needed to identify effective treatments and improve patient outcomes. | Melissa Frizziero Xin Wang Bipasha Chakrabarty Alexa Childs Tu V Luong Thomas Walter Mohid S Khan Meleri Morgan Adam Christian Mona Elshafie Tahir Shah Annamaria Minicozzi Wasat Mansoor Tim Meyer Angela Lamarca Richard A Hubner Juan W Valle Mairéad G McNamara | 2019 | World Journal of Gastroenterology2019，25，39： | 13 |
| 8 | 国际胃袖状切除专家共识:基于>12000手术病例的最佳操作指南显示文摘腹腔镜胃袖状切除术(1aparoscopic sleeve gastrectomy,LSG)系相对较新的减重手术方式。因其操作相对简单、治疗肥胖合并疾病及减重效果明显,逐步得以广泛接受。目前美国代谢与减重手术协会将其推荐为肥胖症治疗的单独标准术式。2011年3月25~26日, | 苏远涛 徐安安 朱江帆 Diaz AA Arvidsson D Baker RS Basso N Bellanger D Boza C El Mourad H France M Gagner M Galvao-Neto M Higa KD Himpens J Hutchinson CM Jacobs M Jorgensen JO Jossart G Lakdawala M Nguyen NT Nocca D Prager G Pomp A Ramos AC Rosenthal RJ Shah S Vix M Wittgrove A Zundel N | 2013 | 中国微创外科杂志2013，13，9： | 12 |
| 9 | 无机水合盐相变陶粒的制备与性能显示文摘采用无机水合盐Ca Cl_2·6H_2O(CCH)作为相变材料,通过真空吸附法制备黏土陶粒负载CCH的相变陶粒,研究了陶粒负载CCH对其液–固相变过冷度的影响以及表面封闭处理对水泥基复合相变材料性能的影响。结果表明,与吸附有机相变材料正癸酸相比,陶粒对CCH的吸附量明显增大,有效减小CCH液–固相变过冷度;采用水泥和聚乙二醇(PEG)对相变陶粒进行包覆,无法实现有效的表面封闭处理:前者在空气中暴露3 d后,表面出现露珠;后者在空气中暴露1个月后,表面出现膨胀性霜状物,使相变陶粒发生破坏。通过进一步吸附正癸酸和油性涂料进行表面处理的相变陶粒,应用于水泥基材料,可有效降低水泥水化放热温升。但采用正癸酸处理时,存在液态正癸酸渗出现象;采用油性涂料处理,则可有效防止液态相变材料渗出。 | 孔德玉 潘罗晟 詹树林 郑晓华 杨芳儿 S P Shah | 2016 | 硅酸盐学报2016，44，7： | 10 |
| 10 | Esophageal tuberculosis presenting with hematemesis显示文摘Esophageal tuberculosis is rare, constituting about 0.3% of gastrointestinal tuberculosis. It presents commonly with dysphagia, cough, chest pain in addition to fever and weight loss. Complications may include hemorrhage from the lesion, development of arterioesophageal fistula, esophagocutaneous fistula or tracheoesophageal fistula. There are very few reports of esophageal tuberculosis presenting with hematemesis due to ulceration. We report a patient with hematemesis that was due to the erosion of tuberculous subcarinal lymph nodes into the esophagus. A 15-year-old boy presented with hemetemesis as his only complaint. Esophagogastroduodenoscopy(EGD) revealed an eccentric ulcerative lesion involving 50% of circumference of the esophagus. Biopsy showed caseating epitheloid granulomas with lymphocytic infiltrates suggestive of tuberculosis. Computerised tomography of the thorax revealed thickening of the mid-esophagus with enlarged mediastinal lymph nodes in the subcarinal region compressing the esophagus along with moderate right sided pleural effusion. Patient was treated with anti-tuberculosis therapy(Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) for 6 mo. Repeat EGD showed scarring and mucosal tags with complete resolution of the esophageal ulcer. | Samit S Jain Piyush O Somani Rajeshkumar C Mahey Dharmesh K Shah Qais Q Contractor Pravin M Rathi | 2013 | World Journal of Gastrointestinal Endoscopy2013，5，11： | 6 |
| 11 | Quality of life assessment in patients with chronic pancreatitis receiving antioxidant therapy显示文摘AIM:To undertake a baseline study comparing quality of life(QoL) in patients with chronic pancreatitis(CP) on Antox to those with CP,matched for disease duration,who were not on this medication.METHODS:CP was defined according to the Zurich classification.Sixty eight consecutive patients with CP who were taking Antox(antioxidants) were compared with 69 consecutive control CP patients not on Antox.European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core questions 30 and Pancreatic Modification(28 questions) were used to assess QoL.Out of a total of 137 patients 28 in each group were matched for disease duration(within 12 mo).Median disease duration was 8(1-22) years in the Antox group and 7(1-23) years in the Non-Antox cohort(P = NS,Mann-Whitney U-test).Other parameters(age,gender,etiology,endocrine and exocrine insufficiency) were similar between groups.RESULTS:Median visual analogue pain score in the Antox group was 3(0-8) compared with 6(0-8) in the Non-Antox group(P < 0.01).Perceptions of cognitive,emotional,social,physical and role function were impaired in the Non-Antox group compared to Antox patients(P < 0.0001,P = 0.0007,P = 0.0032 and P < 0.005 and P < 0.001,respectively).Analgesics and opiate usage was significantly lower in the Antox group(P < 0.01).Overall physical health and global QoL was better in the Antox group(P < 0.0001,95% CI:1.5-3).CONCLUSION:Contemporary quality of life assessments show that after correction for disease duration and cigarette smoking,patients with CP taking antox had better scores than non-antox controls. | Nehal S Shah Alistair J Makin Aali J Sheen Ajith K Siriwardena | 2010 | World Journal of Gastroenterology2010，16，32： | 4 |
| 12 | Steroid resistance in leukemia显示文摘There are several types of leukemia which are characterized by the abnormal growth of cells from the myeloid or lymphoid lineage. Because of their lympholytic actions, glucocorticoids(GCs) are included in many therapeutic regimens for the treatment of various forms of leukemia. Although a significant number of acute lymphoblastic leukemia patients respond well to GC treatment during initial phases; prolonged treatments sometimes results in steroid-resistance. The exact mechanism of this resistance has yet not been completely elucidated, but a correlation between functional GC receptor expression levels and steroidresistance in patients has been found. In recent years, several other mechanisms of action have been reported that could play an important role in the development of such drug resistances in leukemia. Therefore, a better understanding of how leukemic patients develop drug resistance should result in drugs designed appropriately to treat these patients. | Darshan S Shah Raj Kumar | 2013 | World Journal of Experimental Medicine2013，3，2： | 4 |
| 13 | Traumatic brain injury:A case-based review显示文摘BACKGROUND:Traumatic brain injuries are common and costly to hospital systems.Most of the guidelines on management of traumatic brain injuries are taken from the Brain Trauma Foundation Guidelines.This is a review of the current literature discussing the evolving practice of traumatic brain injury.DATA SOURCES:A literature search using multiple databases was performed for articles published through September 2012 with concentration on meta-analyses,systematic reviews,and randomized controlled trials.RESULTS:The focus of care should be to minimize secondary brain injury by surgically decompressing certain hematomas,maintain systolic blood pressure above 90 mmHg,oxygen saturations above 93%,euthermia,intracranial pressures below 20 mmHg,and cerebral perfusion pressure between 60-80 mmHg.CONCLUSION:Much is still unknown about the management of traumatic brain injury.The current practice guidelines have not yet been sufficiently validated,however equipoise is a major issue when conducting randomized control trials among patients with traumatic brain injury. | Liza Victoria S Escobedo Joseph Habboushe Haytham Kaafarani George Velmahos Kaushal Shah Jarone Lee | 2013 | World Journal of Emergency Medicine2013，4，4： | 4 |
| 14 | Apoptosis after intestinal ischemia-reperfusion injury显示文摘 | Shah K A Shndra S Green C J | 1997 | Transplantation1997，64，10： | 3 |
| 15 | Laparoscopic vs open partial colectomy in elderly patients:Insights from the American College of Surgeons- National Surgical Quality Improvement Program database显示文摘AIM: To compare the outcomes between the laparoscopic and open approaches for partial colectomy in elderly patients aged 65 years and over using the American College of Surgeons- National Surgical Quality Improvement Program(ACS NSQIP) database. METHODS: The ACS NSQIP database for the years 2005-2011 was queried for all patients 65 years and above who underwent partial colectomy. 1:1 propensity score matching using the nearest- neighbor method was performed to ensure both groups had similar preoperative comorbidities. Outcomes including postoperative complications, length of stay and mortality were compared between the laparoscopic and open groups. χ2 and Fisher's exact test were used for discrete variables and Student's t-test for continuous variables. P < 0.05 was considered significant and odds ratios with 95%CI were reported when applicable. RESULTS: The total number of patients in the ACS NSQIP database of the years 2005-2011 was 1777035. We identified 27604 elderly patients who underwent partial colectomy with complete data sets. 12009(43%) of the cases were done laparoscopically and15595(57%) were done with open. After propensity score matching, there were 11008 patients each in the laparoscopic(LC) and open colectomy(OC) cohorts. The laparoscopic approach had lower post-operative complications(LC 15.2%, OC 23.8%, P < 0.001), shorter length of stay(LC 6.61 d, OC 9.62 d, P < 0.001) and lower mortality(LC 1.6%, OC 2.9%, P < 0.001). CONCLUSION: Even after propensity score matching, elderly patients in the ACS NSQIP database having a laparoscopic partial colectomy had better outcomes than those having open colectomies. In the absence of specific contraindications, elderly patients requiring a partial colectomy should be offered the laparoscopic approach. | Umashankkar Kannan Vemuru Sunil K Reddy Amar N Mukerji Vellore S Parithivel Ajay K Shah Brian F Gilchrist Daniel T Farkas | 2015 | World Journal of Gastroenterology2015，21，45： | 3 |
| 16 | Response of blood pressure after percutaneous transluminal renal artery angioplasty and stenting显示文摘AIM: To evaluate the short and intermediate term out-come of percutaneous transluminal renal artery angioplasty (PTRA) and stenting particularly on blood pressure (BP) control and renal function and to evaluate predictors of poor BP response after successful PTRA and stenting. METHODS: We conducted a prospective analysis of all patients who underwent PTRA and stenting in our institute between August 2010 to September 2012. A total number of 86 patients were underwent PTRA and renal stenting. Selective angiography was done to confirm at least 70% angiographic stenosis. The predilatation done except few cases with critical stenosis, direct stenting was done in the rest of cases. All patients received aspirin 325 mg orally, and clopidogrel 300 mg orally within 24 h before the procedure. Heparin was used as the procedural anticoagulant agent. Optimal results with TIMI-Ⅲ flow obtained in all cases. Following stent placement, aspirin 150 mg orally once daily was continued for a minimum of 12 mo and clopidogrel 75 mg orally once daily for at least 4 wk. The clinical, radiological, electrocardiography, echocardiography and treatment data of all patients were recorded. The BP measurement, serum creatinine and glomerular filtration rate (GFR) were recorded before the procedure and 1 and 6 mo after PTRA. RESULTS: A total of 86 patients were included in the study. The mean age of study population was 55.87±11.85 years old and 67 (77.9%) of patients were male. There was a significant reduction in both systolic and diastolic BP at 1 mo after the procedure: 170.15±20.10 mmHg vs 146.60±17.32 mmHg and 98.38±10.55 mmHg vs 89.88±9.22 mmHg respectively (P=0.0000). The reduction in BP was constant throughout the follow-up period and was evident 6 mo after the procedure: 144.23±18.19 and 88.26±9.79 mmHg respectively (P=0.0000). However, no improvement in renal function was observed at any time during the follow-up period. After multivariate analysis, we found male sex, low GFR (<60 mL/min) and higher baseline mean BP as a poor predictors of successful outcome on BP response after PTRA and stenting. CONCLUSION: The PTRA and stenting can be considered as an effective therapeutic intervention for improving BP control with minimal effect on renal function. The male sex, higher baseline BP and low GFR are associated with poor BP response after successful PTRA and stenting. | Jayesh S Prajapati Sharad R Jain Hasit Joshi Shaurin Shah Kamal Sharma Sibasis Sahoo Kapil Virparia Ashok Thakkar | 2013 | World Journal of Cardiology2013，5，7： | 3 |
| 17 | Evaluating the accuracy of American Society for Gastrointestinal Endoscopy guidelines in patients with acute gallstone pancreatitis with choledocholithiasis显示文摘BACKGROUND Acute gallstone pancreatitis(AGP) is the most common cause of acute pancreatitis(AP) in the United States. Patients with AGP may also present with choledocholithiasis. In 2010, the American Society for Gastrointestinal Endoscopy(ASGE) suggested a management algorithm based on probability for choledocholithiasis, recommending additional imaging for patients at intermediate risk and endoscopic retrograde cholangiopancreatography(ERCP) for patients at high risk of choledocholithiasis. In 2019, the ASGE guidelines were updated using more specific criteria to categorize individuals at high risk for choledocholithiasis. Neither ASGE guideline has been studied in AGP to determine the probability of having choledocholithiasis.AIM To determine compliance with ASGE guidelines, assess outcomes, and compare 2019 vs 2010 ASGE criteria for suspected choledocholithiasis in AGP.METHODS We conducted a retrospective cohort study of 882 patients admitted with AP to a single tertiary care center from 2008-2018. AP was diagnosed using revised Atlanta criteria and AGP was defined as the presence of gallstones on imaging or with cholestatic pattern of liver injury in the absence of another cause. Patients with chronic pancreatitis and pancreatic malignancy were excluded as were those who went directly to cholecystectomy prior to assessment for choledocholithiasis. Patients were assigned low, intermediate or high risk based on ASGE guidelines. Our primary outcomes of interest were the proportion of patients in the intermediate risk group undergoing magnetic resonance cholangiopancreatography(MRCP) first and the proportion of patients in the high risk group undergoing ERCP directly without preceding imaging. Secondary outcomes of interest included outcome differences based on if guidelines were not adhered to. We then evaluated the diagnostic accuracy of 2019 in comparison to the 2010 ASGE criteria for patients with suspected choledocholithiasis. We performed the t test or Wilcoxon rank sum test, as appropriate, to analyze if there were outcome differences based on if guidelines were not adhered to. Kappa coefficients were calculated to measure the degree of agreement between pairs of variables.RESULTS In this cohort, we identified 235 patients with AGP of which 79 patients were excluded as they went directly to surgery for cholecystectomy without prior MRCP or ERCP. Of the remaining 156 patients, 79 patients were categorized as intermediate risk and 77 patients were high risk for choledocholithiasis according to the 2010 ASGE guidelines. Among 79 intermediate risk patients, 54(68%) underwent MRCP first whereas 25 patients(32%) went directly to ERCP. For the 54 patients with intermediate risk who had MRCP first, 36 patients had no choledocholithiasis while 18 patients had evidence of choledocholithiasis prompting ERCP. Of these patients, ERCP confirmed stone disease in 11 patients. Of the 25 intermediate risk patients who directly underwent ERCP, 18 patients had stone disease. One patient with a normal ERCP developed post ERCP pancreatitis. Patients undergoing MRCP in this group had a significantly longer length of stay(5.0 vs 4.0 d, P = 0.02). In the high risk group, 64 patients(83%) had ERCP without preceding imaging, of which, 53 patients had findings consistent with choledocholithiasis, of which 13 patients(17%) underwent MRCP before ERCP, all of which showed evidence of stone disease. Furthermore, all of these patients ultimately had an ERCP, of which 8 patients had evidence of stones and 5 had normal examination.RESULTS Our cohort also demonstrated that 58% of all 156 patients with AGP had confirmed choledocholithiasis(79% of the high risk group and 37% of the intermediate group when risk was assigned based on the 2010 ASGE guidelines). When the updated 2019 ASGE guidelines were applied instead of the original 2010 guidelines, there was moderate agreement between the 2010 and 2019 guidelines(kappa = 0.46, 95%CI: 0.34-0.58). Forty-two of 77 patients were still deemed to be high risk and 35 patients were downgraded to intermediate risk. Thirty-five patients who were originally assigned high risk were reclassified as intermediate risk. For these 35 patients, 26 patients had ERCP findings consistent with choledocholithiasis and 9 patients had a normal examination. Based on the 2019 criteria, 9/35 patients who were downgraded to intermediate risk had an unnecessary ERCP with normal findings(without a preceding MRCP).CONCLUSION Two-thirds in intermediate risk and 83% in high risk group followed ASGE guidelines for choledocholithiasis. One intermediate-group patient with normal ERCP had post-ERCP AP, highlighting the risk of unnecessary procedures. | Supisara Tintara Ishani Shah William Yakah Awais Ahmed Cristina S Sorrento Cinthana Kandasamy Steven D Freedman Darshan J Kothari Sunil G Sheth | 2022 | World Journal of Gastroenterology2022，28，16： | 3 |
| 18 | Observation on the coalescence behavior of oil droplets and emulsion stability in enhanced oil recovery显示文摘 | Wasan D T Shah S M Andergang N | 1978 | Soc Petrol Engrs J1978，18，6： | 2 |
| 19 | Investigating the installed real power transfer capability of a large scale power system under a proposed multiarea interchange schedule using CPFLOW 显示文摘 | Flueck J Chiang H D Shah K S | 1996 | IEEE Trans on Power Systems1996，11，2： | 2 |
| 20 | Candida esophagitis:Risk factors in non-HIV population in Pakistan显示文摘AIM:Candida esophagitis is a frequent infection in immunocompromised patients. This study was designed to determine its characteristics in non- human immune deficiency virus (HIV) infected patients attending a teaching hospital.METHODS: Clinical records of all patients coded by international classification of diseases 9th revision with clinical modifications'(ICD-9-CM), with candida esophagitis diagnosed by esophagogastroduodenoscopy (EGD) and histopathology over a period of 5 years were studied.RESULTS: Fifty-one patients (27 males, 24 females, range 21-77 years old and mean age 52.9 years) fulfilled the criteria (0.34% of the EGD). The common predisposing factors were carcinoma (OR 3.87, CI 1.00-14.99) and diabetes mellitus (OR 4.39, CI 1.34-14.42). The frequent clinical symptoms were retrosternal discomfort, dysphagia and epigastric abdominal pain with endoscopic appearance of scattered mucosal plaques. Another endoscopic lesion was associated with candida esophagitis in 15% patients.CONCLUSION: Carcinomas, diabetes mellitus, corticosteroid and antibiotic therapy are major risk factors for candida esophagitis in Pakistan. It is an easily managed complication that responds to treatment with nystatin. | Javed Yakoob Wasim Jafri Shahab Abid Nadeem Jafri Muhammad Islam Saeed Hamid Hasnain A Shah Akbar S Hussainy | 2003 | World Journal of Gastroenterology2003，9，10： | 2 |
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