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| 1 | A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol显示文摘BACKGROUND: Laparoscopic pancreaticoduodenectomy(LPD)is a safe procedure. Oncological safety of LPD is still a matter for debate. This study aimed to compare the oncological outcomes,in terms of adequacy of resection and recurrence rate following LPD and open pancreaticoduodenectomy(OPD).METHODS: Between November 2005 and April 2009, 12LPDs(9 ampullary and 3 distal common bile duct tumors)were performed. A cohort of 12 OPDs were matched for age,gender, body mass index(BMI) and American Society of Anesthesiologists(ASA) score and tumor site.RESULTS: Mean tumor size LPD vs OPD(19.8 vs 19.2 mm,P=0.870). R0 resection was achieved in 9 LPD vs 8 OPD(P=1.000). The mean number of metastatic lymph nodes and total number resected for LPD vs OPD were 1.1 vs 2.1(P=0.140)and 20.7 vs 18.5(P=0.534) respectively. Clavien complications grade I/II(5 vs 8), III/IV(2 vs 6) and pancreatic leak(2 vs 1)were statistically not significant(LPD vs OPD). The mean high dependency unit(HDU) stay was longer in OPD(3.7 vs 1.4 days,P<0.001). There were 2 recurrences each in LPD and OPD(logrank,P=0.983). Overall mortality for LPD vs OPD was 3 vs 6(log-rank, P=0.283) and recurrence-related mortality was 2 vs 1.There was one death within 30 days in the OPD group secondary to severe sepsis and none in the LPD group.CONCLUSIONS: Compared to open procedure, LPD achieved a similar rate of R0 resection, lymph node harvest and longterm recurrence for tumors less than 2 cm. Though technically challenging, LPD is safe and does not compromise oncological outcome. | Abdul R Hakeem Caroline S Verbeke Alison Cairns Amer Aldouri Andrew M Smith Krishna V Menon | 2014 | Hepatobiliary & Pancreatic Diseases International2014,13,4: | 24 |
| 2 | Advances in endoscopic retrograde cholangiopancreatography for the treatment of cholangiocarcinoma显示文摘Cholangiocarcinoma(CCA) is a malignancy of the bileducts that carries high morbidity and mortality. Patients with CCA typically present with obstructive jaundice, and associated complications of CCA include cholangitis and biliary sepsis. Endoscopic retrograde cholangiopancreatography(ERCP) is a valuable treatment modality for patients with CCA, as it enables internal drainage of blocked bile ducts and hepatic segments by using plastic or metal stents. While there remains debate as to if bilateral(or multi-segmental) hepatic drainage is required and/or superior to unilateral drainage, the underlying tenant of draining any persistently opacified bile ducts is paramount to good ERCP practice and good clinical outcomes. Endoscopic therapy for malignant biliary strictures from CCA has advanced to include ablative therapies via ERCP-directed photodynamic therapy(PDT) or radiofrequency ablation(RFA). While ERCP techniques cannot cure CCA, advancements in the field of ERCP have enabled us to improve upon the quality of life of patients with inoperable and incurable disease. ERCP-directed PDT has been used in lieu of brachytherapy to provide neoadjuvant local tumor control in patients with CCA who are awaiting liver transplantation. Lastly, mounting evidence suggests that palliative ERCP-directed PDT, and probably ERCPdirected RFA as well, offer a survival advantage to patients with this difficult-to-treat malignancy. | Dushant S Uppal Andrew Y Wang | 2015 | World Journal of Gastrointestinal Endoscopy2015,7,7: | 18 |
| 3 | Model for end-stage liver disease score versus Child score in predicting the outcome of surgical procedures in patients with cirrhosis显示文摘AIM:To determine factors affecting the outcome of patients with cirrhosis undergoing surgery and to compare the capacities of the Child-Turcotte-Pugh(CTP) and model for end-stage liver disease(MELD)score to predict that outcome. METHODS:We reviewed the charts of 195 patients with cirrhosis who underwent surgery at two teaching hospitals over a five-year period.The combined endpoint of death or hepatic decompensation was considered to be the primary endpoint. RESULTS:Patients who reached the endpoint had a higher MELD score,a higher CTP score and were more likely to have undergone an urgent procedure.Among patients undergoing elective surgical procedures,no statistically significant difference was noted in the mean MELD(12.8±3.9 vs 12.6±4.7,P=0.9)or in the mean CTP(7.6±1.2 vs 7.7±1.7,P=0.8)between patients who reached the endpoint and those who did not.Both mean scores were higher in the patients reaching the endpoint in the case of urgent procedures(MELD:22.4± 8.7 vs 15.2±6.4,P=0.0007;CTP:9.9±1.8 vs 8.5±1.8, P=0.008).The performances of the MELD and CTP scores in predicting the outcome of urgent surgery were only fair,without a significant difference between them (AUC=0.755±0.066 for MELD vs AUC=0.696±0.070 for CTP,P=0.3). CONCLUSION:The CTP and MELD scores performedequally,but only fairly in predicting the outcome of urgent surgical procedures.Larger studies are needed to better define the factors capable of predicting the outcome of elective surgical procedures in patients with cirrhosis. | Maarouf A Hoteit Amaar H Ghazale Andrew J Bain Eli S Rosenberg Kirk A Easley Frank A Anania Robin E Rutherford | 2008 | World Journal of Gastroenterology2008,14,11: | 16 |
| 4 | Trefoil factors:Tumor progression markers and mitogens via EGFR/MAPK activation in cholangiocarcinoma显示文摘AIM:To investigate trefoil factor(TFF) gene copy number,mRNA and protein expression as potential biomarkers in cholangiocarcinoma(CCA).METHODS:TFF mRNA levels,gene copy number and protein expression were determined respectively by quantitative reverse transcription polymerase chain reaction(PCR),quantitative PCR and immunohistochemistry in bile duct epithelium biopsies collected from individuals with CCA,precancerous bile duct dysplasia and from disease-free controls.The functional impact of recombinant human(rh) TFF2 peptide treatment on proliferation and epidermal growth factor receptor(EGFR) /mitogenactivated protein kinase(MAPK) signaling was assessed in the CCA cell line,KMBC,by viable cell counting and immunoblotting,respectively.RESULTS:TFF1,TFF2 and TFF3 mRNA expression was significantly increased in CCA tissue compared to disease-free controls,and was unrelated to gene copy number.TFF1 immunoreactivity was strongly increased in both dysplasia and CCA,whereas TFF2 immunoreactivity was increased only in CCA compared to diseasefree controls.By contrast,TFF3 immunoreactivity was moderately decreased in dysplasia and further decreased in CCA.Kaplan-Meier analysis found no association of TFF mRNA,protein and copy number with age,gender,histological subtype,and patient survival time.Treatment of KMBC cells with rhTFF2 stimulated proliferation,triggered phosphorylation of EGFR and downstream extracellular signal related kinase(ERK),whereas co-incubation with the EGFR tyrosine kinase inhibitor,PD153035,blocked rhTFF2-dependent proliferation and EGFR/ERK responses.CONCLUSION:TFF mRNA/protein expression is indicative of CCA tumor progression,but not predictive for histological sub-type or survival time.TFF2 is mitogenic in CCA via EGFR/MAPK activation. | Kanuengnuch Kosriwong Trevelyan R Menheniott Andrew S Giraud Patcharee Jearanaikoon Banchob Sripa Temduang Limpaiboon | 2011 | World Journal of Gastroenterology2011,17,12: | 16 |
| 5 | Use of exclusive enteral nutrition in adults with Crohn's disease: A review显示文摘Exclusive enteral nutrition(EEN)is well-established as a first line therapy instead of corticosteroid(CS)therapy to treat active Crohn’s disease(CD)in children.It also has been shown to have benefits over and above induction of disease remission in paediatric populations.However,other than in Japanese populations,this intervention is not routinely utilised in adults.To investigate potential reasons for variation in response between adult studies of EEN and CS therapy.The Ovid database was searched over a 6-mo period.Articles directly comparing EEN and CS therapy in adults were included.Eleven articles were identified.EEN therapy remission rates varied considerably.Poor compliance with EEN therapy due to unpalatable formula was an issue in half of the studies.Remission rates of studies that only included patients with previously untreated/new CD were higher than studies including patients with both existing and new disease.There was limited evidence to determine if disease location,duration of disease or age of diagnosis affected EEN therapy outcomes.There is some evidence to support the use of EEN as a treatment option for a select group of adults,namely those motivated to adhere to an EEN regimen and possibly those newly diagnosed with CD.In addition,the use of more palatable formulas could improve treatment compliance. | Catherine L Wall Andrew S Day Richard B Gearry | 2013 | World Journal of Gastroenterology2013,19,43: | 15 |
| 6 | Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference显示文摘 | Jordi Bruix Morris Sherman Josep M Llovet Michel Beaugrand Riccardo Lencioni Andrew K Burroughs Erik Christensen Luigi Pagliaro Massimo Colombo Juan Rodés | 2001 | Journal of Hepatology2001,,3: | 11 |
| 7 | Endoscopic ultrasound-guided techniques for diagnosing pancreatic mass lesions: Can we do better?显示文摘The diagnostic approach to a possible pancreatic mass lesion relies first upon various non-invasive imaging modalities, including computed tomography, ultrasound, and magnetic resonance imaging techniques. Once a suspect lesion has been identified, tissue acquisition for characterization of the lesion is often paramount in developing an individualized therapeutic approach. Given the high prevalence and mortality associated with pancreatic cancer, an ideal approach to diagnosing pancreatic mass lesions would be safe, highly sensitive, and reproducible across various practice settings. Tools, in addition to radiologic imaging, currently employed in the initial evaluation of a patient with a pancreatic mass lesion include serum tumor markers, endoscopic retrograde cholangiopancreatography, and endoscopic ultrasound-guided fine needle aspiration(EUS-FNA). EUS-FNA has grown to become the gold standard in tissue diagnosis of pancreatic lesions. | Andrew C Storm Linda S Lee | 2016 | World Journal of Gastroenterology2016,22,39: | 10 |
| 8 | 澳大利亚临床共识指南:儿童卒中的诊断和急性期处理显示文摘卒中是导致儿童死亡的十大原因之一,幸存的致残患儿将面临几十年的残疾生活,给患儿及其家庭带来了巨大负担。由于安全性和有效性的证据有限,以及诊断的延误,目前卒中患儿无法接受再灌注治疗。儿童卒中诊断和急性期处理的澳大利亚临床共识指南,旨在最大限度地减少临床诊疗中的不确定性,并记录与成人卒中不同的危险因素、病因和假性卒中情况的最佳证据。临床问题的阐述来自于对2007年至2017年数据库的系统检索,但仅限于英语和儿科研究。该指南应用SIGN方法和国家健康与医学研究委员会系统对证据进行筛选和分类,通过推荐、评估、发展和评价系统(GRADE系统)对推荐进行强弱分级。该指南提供了60多项基于证据的推荐,以帮助参与院前和急症处理的临床医师快速识别儿童卒中,选择最合适的初步检查方案来确定诊断、明确病因,并选择最恰当的干预措施以挽救脑组织、预防复发。同时,指南也提供了颅内压和先天性心脏病管理方面的推荐。该指南的实施需要将院前和急诊系统重组,包括建立区域性卒中网络,建立儿科卒中疾病编码,快速MRI,以及对能够提供再灌注治疗的初级儿科卒中中心进行认证。该指南能够审核治疗的基准时间线,获得急性期的干预措施及预后判断。它还将促进澳大利亚儿童卒中登记的发展,并与国际登记处建立数据联系,以便准确收集卒中发病率、治疗和结果相关的数据。 | Medley TL Miteff C Andrews I Ware T Cheung M Monagle P Mandelstam S Wray A Pridmore C Troedson C Dale RC Fahey M Sinclair A Walsh P Stojanovski S Macka MT 徐佳丽(译) 吴川杰(译) 肖潇(译) 吕俊萱(译) 张博维(译) 吉训明(译) | 2019 | 中国脑血管病杂志2019,16,4: | 9 |
| 9 | 来华医学留学生儿科临床技能学教学模式的改革与发展显示文摘近年来,我国医学教育取得令人瞩目的成绩,越来越多的外国学生选择至我国医学院校接受本科及研究生医学教育。在此过程中,临床技能是医学生由医学理论过渡到临床实践的必学知识,因此我国医学院校对来华医学留学生的临床技能学教育较为重视。本校教务处在国内本科生教学的基础上,通过总结既往留学生临床技能教学的经验教训,成立了专门的课程教学组(课程组),建设了以临床思维培训为导向的临床技能学课程体系,取得较好的效果,现报道如下。 | 徐元敏 刘景仑 BRYAN R S ANDREW T 亢胜男 张丹 | 2019 | 重庆医学2019,48,12: | 8 |
| 10 | Screening and Surveillance for the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline From the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology显示文摘 | Bernard Levin David A. Lieberman Beth McFarland Kimberly S. Andrews Durado Brooks John Bond Chiranjeev Dash Francis M. Giardiello Seth Glick David Johnson C. Daniel Johnson Theodore R. Levin Perry J. Pickhardt Douglas K. Rex Robert A. Smith Alan Thorson S | 2008 | Gastroenterology2008,,5: | 8 |
| 11 | Refining pathological evaluation of neoadjuvant therapy for adenocarcinoma of the esophagus显示文摘AIM:To assess tumour regression grade(TRG)and lymph node downstaging to help define patients who benefit from neoadjuvant chemotherapy.METHODS:Two hundred and eighteen consecutive patients with adenocarcinoma of the esophagus or gastro-esophageal junction treated with surgery alone or neoadjuvant chemotherapy and surgery between 2005and 2011 at a single institution were reviewed.Triplet neoadjuvant chemotherapy consisting of platinum,fluoropyrimidine and anthracycline was considered for operable patients(World Health Organization performance status≤2)with clinical stage T2-4 N0-1.Response to neoadjuvant chemotherapy(NAC)was assessed using TRG,as described by Mandard et al.In addition lymph node downstaging was also assessed.Lymph node downstaging was defined by cN1 at diagnosis:assessed radiologically(computed tomography,positron emission tomography,endoscopic ultrasonography),then pathologically recorded as N0 after surgery;ypN0 if NAC given prior to surgery,or pN0if surgery alone.Patients were followed up for 5 years post surgery.Recurrence was defined radiologically,with or without pathological confirmation.An association was examined between t TRG and lymph node downstaging with disease free survival(DFS)and a comprehensive range of clinicopathological characteristics.RESULTS:Two hundred and eighteen patients underwent esophageal resection during the study interval with a mean follow up of 3 years(median follow up:2.552,95%CI:2.022-3.081).There was a 1.8%(n=4)inpatient mortality rate.One hundred and thirty-six(62.4%)patients received NAC,with 74.3%(n=101)of patients demonstrating some signs of pathological tumour regression(TRG 1-4)and 5.9%(n=8)having a complete pathological response.Forty four point one percent(n=60)had downstaging of their nodal disease(cN1 to ypN0),compared to only 15.9%(n=13)that underwent surgery alone(pre-operatively overstaged:cN1 to pN0),(P<0.0001).Response to NAC was associated with significantly increased DFS(mean DFS;TRG 1-2:5.1years,95%CI:4.6-5.6 vs TRG 3-5:2.8 years,95%CI:2.2-3.3,P<0.0001).Nodal down-staging conferred a significant DFS advantage for those patients with a poor primary tumour response to NAC(median DFS;TRG 3-5 and nodal down-staging:5.533 years,95%CI:3.558-7.531 vs TRG 3-5 and no nodal down-staging:1.114 years,95%CI:0.961-1.267,P<0.0001).CONCLUSION:Response to NAC in the primary tumour and in the lymph nodes are both independently associated with improved DFS. | Fergus Noble Luke Nolan Adrian C Bateman James P Byrne Jamie J Kelly Ian S Bailey Donna M Sharland Charlotte N Rees Timothy J Iveson Tim J Underwood Andrew R Bateman | 2013 | World Journal of Gastroenterology2013,19,48: | 4 |
| 12 | Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial显示文摘 | Wendy S Atkin Rob Edwards Ines Kralj-Hans Kate Wooldrage Andrew R Hart John MA Northover D Max Parkin Jane Wardle Stephen W Duffy Jack Cuzick | 2010 | The Lancet2010,,9726: | 4 |
| 13 | Crohn’s and colitis in children and adolescents显示文摘Crohn's disease and ulcerative colitis can be grouped as the inflammatory bowel diseases(IBD).These conditions have become increasingly common in recent years,including in children and young people.Although much is known about aspects of the pathogenesis of these diseases,the precise aetiology is not yet understood,and there remains no cure.Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life,including in infancy.Pain,diarrhoea and weight loss are typical symptoms of paediatric Crohn's disease whereas bloody diarrhoea is more typical of colitis in children.However,atypical symptoms may occur in both conditions:these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythema nodosum.Growth and nutrition are commonly compromised at diagnosis in both Crohn's disease and colitis.Consideration of possible IBD and completion of appropriate investi-gations are essential to ensure prompt diagnosis,thereby avoiding the consequences of diagnostic delay.Patterns of disease including location and progression of IBD in childhood differ substantially from adultonset disease.Various treatment options are available for children and adolescents with IBD.Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn's disease.Medical and surgical therapies need to considered within the context of a growing and developing child.The overall management of these chronic conditions in children should include multi-disciplinary expertise,with focus upon maintaining control of gut inflammation,optimising nutrition,growth and quality of life,whilst preventing disease or treatment-related complications. | Andrew S Day Oren Ledder Steven T Leach Daniel A Lemberg | 2012 | World Journal of Gastroenterology2012,18,41: | 4 |
| 14 | Update on Cardiovascular Implantable Electronic Device Infections and Their Management: A Scientific Statement From the American Heart Association显示文摘 | Larry M. Baddour Andrew E. Epstein Christopher C. Erickson Bradley P. Knight Matthew E. Levison Peter B. Lockhart Frederick A. Masoudi Eric J. Okum Walter R. Wilson Lee B. Beerman Ann F. Bolger N A. Mark Estes Michael Gewitz Jane W. Newburger Eleanor B. S | 2010 | Circulation2010,,3: | 4 |
| 15 | Campylobacter concisus and inflammatory bowel disease显示文摘Investigation of the possible role of Campylobacter concisus(C. concisus) in inflammatory bowel disease(IBD) is an emerging research area. Despite the association found between C. concisus and IBD, it has been difficult to explain how C. concisus, a bacterium that is commonly present in the human oral cavity, may contribute to the development of enteric diseases. The evidence presented in this review shows that some C. concisus strains in the oral cavity acquired zonula occludens toxin(zot) gene from a virus(prophage) and that C. concisus Zot shares conserved motifs with both Vibrio cholerae Zot receptor binding domain and human zonulin receptor binding domain. Both Vibrio cholerae Zot and human zonulin are known to increase intestinal permeability by affecting the tight junctions. Increased intestinal permeability is a feature of IBD. Based on these data, we propose that a primary barrier function defect caused by C. concisus Zot is a mechanism by which zot-positive C. concisus strains may trigger the onset and relapse of IBD. | Li Zhang Hoyul Lee Michael C Grimm Stephen M Riordan Andrew S Day Daniel A Lemberg | 2014 | World Journal of Gastroenterology2014,20,5: | 4 |
| 16 | Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study显示文摘 | William C Huang Andrew S Levey Angel M Serio Mark Snyder Andrew J Vickers Ganesh V Raj Peter T Scardino Paul Russo | 2006 | Lancet Oncology2006,,9: | 4 |
| 17 | Imaging of liver cancer显示文摘Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality. | Ben Ariff Claire R Lloyd Sameer Khan Mohamed Shariff Andrew V Thillainayagam Devinder S Bansi Shahid A Khan Simon D Taylor-Robinson Adrian KP Lim | 2009 | World Journal of Gastroenterology2009,15,11: | 4 |
| 18 | Are faecal markers good indicators of mucosal healing in inflammatory bowel disease?显示文摘AIM: To review the published literature concerning the accuracy of faecal inflammatory markers for identifying mucosal healing. METHODS: Bibliographical searches were performed in MEDLINE electronic database up to February 2015,using the following terms: 'inflammatory bowel disease','Crohn′s disease','ulcerative colitis','faecal markers','calprotectin','lactoferrin','S100A12','endoscop*','mucosal healing','remission'. In addition,relevant references from these studies were also included. Data were extracted from the published papers including odds ratios with 95%CI,P values and correlation coefficients. Data were grouped together according to each faecal marker,Crohn's disease or ulcerative colitis,and paediatric compared with adult study populations. Studies included in this review assessed mucosal inflammation by endoscopic and/or histological means and compared these findings to faecal marker concentrations in inflammatory bowel diseases(IBD) patient cohorts. Articles had to be published between 1990 and February 2015 and written in English. Papers excluded from the review were those where the faecal biomarker concentration was compared between patients with IBD and controls or other disease groups,those where serum biomarkers were used,those with a heterogeneous study population and those only assessing post-operative disease. RESULTS: The available studies show that faecal markers,such as calprotectin and lactoferrin,are promising non-invasive indicators of mucosal healing. However,due to wide variability in study design,especially with regard to the definition of mucosal healing and evaluation of marker cut offs,the available data do not yet indicate the optimal roles of these markers. Thirty-six studies published between 1990 and 2014 were included. Studies comprised variable numbers of study participants,considered CD(15-164 participants) or UC(12-152 participants) separately or as a combined group(11-252 participants). Eight reports included paediatric patients. Several indices were used to document mucosal inflammation,encompassing elevenendoscopic and eight histologic grading systems. The majority of the available reports focused on faecal calprotectin(33 studies),whilst others assessed faecal lactoferrin(13 studies) and one study assessed S100A12. Across all of the biomarkers,there is a wide range of correlation describing the association between faecal markers and endoscopic disease activity(r values ranging from 0.32 to 0.87,P values ranging from < 0.0001 to 0.7815). Correlation coefficients are described in almost all studies and are used more commonly than outcome measures such as sensitivity,specificity,PPV and/or NPV. Overall,the studies that have evaluated faecal calprotectin and/or faecal lactoferrin and their relationship with endoscopic disease activity show inconsistent results. CONCLUSION: Future studies should report the results of faecal inflammatory markers in the context of mucosal healing with clear validated cut offs. | Gudula JAM Boon Andrew S Day Chris J Mulder Richard B Gearry | 2015 | World Journal of Gastroenterology2015,21,40: | 4 |
| 19 | A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010显示文摘 | Stephen S Lim Theo Vos Abraham D Flaxman Goodarz Danaei Kenji Shibuya Heather Adair-Rohani Mohammad A AlMazroa Markus Amann H Ross Anderson Kathryn G Andrews Martin Aryee Charles Atkinson Loraine J Bacchus Adil N Bahalim Kalpana Balakrishnan John Balmes S | 2012 | 2012 (9859)2012,,9859: | 3 |
| 20 | First performance evaluation of a dual-source CT (DSCT) system显示文摘 | Thomas G. Flohr Cynthia H. McCollough Herbert Bruder Martin Petersilka Klaus Gruber Christoph Sü? Michael Grasruck Karl Stierstorfer Bernhard Krauss Rainer Raupach Andrew N. Primak Axel Küttner Stefan Achenbach Christoph Becker Andreas Kopp Bernd M. Ohnes | 2006 | European Radiology2006,,6: | 3 |