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| 1 | Meta分析方法系统性分析腹腔镜疝修补术的选择——TEP与TAPP显示文摘腹股沟疝修补术是最常见的手术之一。一个好的疝修补术应该是操作简单、手术时间短、安全。手术结果必须是创伤小、疼痛轻以及复发率低口j。腹腔镜疝修补术和传统的开放式疝修补术(openherniarepair,OHR)相比,术后疼痛轻、对患者限制少。目前,在临床上使用最多的腹腔镜疝修补术方法分别是:经腹腔腹膜前疝修补(transabdominalpreperitoneal,TAPP)和完全腹膜外疝修补(totallyextraperitonealherniarepair,TEP)。本文运用随机对照法研究资料,分析TEP与TAPP孰优孰劣。 | Bracale U Melillo P Pignata G Di Salvo E Rovani M Merola G Pecchia L Surg Endosc 陈大伟 | 2013 | 中华疝和腹壁外科杂志(电子版)2013，7，4： | 15 |
| 2 | Chronic constipation in hemiplegic patients显示文摘AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy. METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients’ mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors, calcium antagonists, anticoagulants, antithrombotics, antidepressants, anti-epileptics. RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident. Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13), sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury. CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients. Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere, and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation. | F Bracci D Badiali P Pezzotti G Scivoletto U Fuoco L Di Lucente A Petrelli E Corazziari | 2007 | World Journal of Gastroenterology2007，13，29： | 15 |
| 3 | 酒精摄入、心脏生物标志物和心房颤动风险与不良结局显示文摘酒精摄入和新发心房颤动相关性证据不一,尤其是在低剂量下。该研究评估欧洲队列在整个饮酒范围内酒精摄入、生物标志物和新发心房颤动的关系。方法和结果:在一个以社区为基础的汇集队列中,研究者随访107845人,以评估酒精摄入(酒精种类和饮酒方式)与新发心房颤动的关系。研究者收集经典心血管病危险因素和新发心力衰竭的信息,并检测生物标记物氨基末端脑钠肽前体和高敏肌钙蛋白I。 | 陈嘉睿(译) 练桂丽((审校) Csengeri D Sprünker NA Di Castelnuovo A Niiranen T Vishram-Nielsen JK Costanzo S S derberg S Jensen SM Vartiainen E Donati MB Magnussen C Camen S Gianfagna F L chen ML Kee F Kontto J Mathiesen EB Koenig W Stefan B de Gaetano G J rgensen T Kuulasmaa K Zeller T Salomaa V Iacoviello L Schnabel RB | 2021 | 中华高血压杂志2021，29，2： | 9 |
| 4 | Breath test for differential diagnosis between small intestinal bacterial overgrowth and irritable bowel disease:An observation on non-absorbable antibiotics显示文摘AIM: To estimate the prevalence of small intestine bacterial overgrowth (SIBO) among patients with an earlier diagnosis of irritable bowel disease (IBS) in our geographical area, and to collect information on the use of locally acting non-absorbable antibiotics in the management of SIBO. METHODS: A non-interventional study was conducted in 73 consecutive patients with a symptom-based diagnosis.. RESULTS: When the patients underwent a 'breath test', 33 (45.2%) showed the presence of a SIBO. After treatment with rifaximin 1200 mg/d for seven days in 32 patients, 19 (59.4%) showed a negative 'breath test' one week later as well as a significant reduction of symptoms, thus confirming the relationship between SIBO and many of the symptoms claimed by patients. In the other 13 patients, 'breath test' remained positive, and a further cycle of treatment with ciprofloxacin 500 mg/d was given for 7 additional days, resulting in a negative 'breath test' in one patient only. CONCLUSION: (1) about half of the patients with a symptomatic diagnosis of IBS have actually SIBO, which is responsible for most of the symptoms attributed to IBS; (2) only a 'breath test' with lactulose (or with glucose in subjects with an intolerance to lactose) can provide a differential diagnosis between IBS and SIBO, with almost identical symptoms; and (3) the use of non-absorbable antibiotics may be useful to reduce the degree of SIBO and related symptoms; it must be accompanied, however, by the correction of the wrong alimentary habits underlying SIBO. | I Esposito A de Leone G Di Gregorio S Giaquinto L de Magistris A Ferrieri G Riegler | 2007 | World Journal of Gastroenterology2007，13，45： | 8 |
| 5 | ConservativeapproachinPeutz-JeghersSyndrome:Single-balloon enteroscopyandsmallbowelpolypectomy显示文摘AIM: To assess the usefulness of the balloon assisted enteroscopy in preventing surgical intervention in pa-tients with Peutz-Jeghers syndrome (PJS) having a small bowel large polyps. METHODS: Seven consecutive asymptomatic pts(age 15-38 years) with PJS have been collected; six under-went polypectomy using single balloon enteroscopy(Olympus SIF Q180) with antegrade approach using push and pull technique. SBE system consists of the SIF-Q180 enteroscope, an overtube balloon control unit(OBCU Olympus Balloon Control Unit) and a dispos-able silicone splinting tube with balloon(ST-SB1). All procedures were performed under general anesthesia. Previously all pts received wireless capsule endos-copy(WCE). Prophylactic polypectomy was reservedmainly in pts who had polyps > 15 mm in diameter. The balloon is inflated and deflated by a balloon control unit with a safety pressure setting range from-6.0 kPa to +5.4 kPa. Informed consent has been obtained from pts or parents for each procedure.RESULTS: Six pts underwent polypectomy of small bowel polyps; in 5 pts a large polyp > 15 mm(range 20-50 mm in diameter) was resected; in 1 patient with WCE negative, SBE was performed for previous surgi-cal resection of gastrointestinal stromal tumors. In 2 pts endoscopic clips were placed due to a polypectomy. No surgical complication have been reported. SBE with resection of small bowel large polyps in PJS pts was useful to avoid gastrointestinal bleeding and emergency laparotomy due to intestinal intussuscep-tions. No gastrointestinal tumors were found in sub-sequent enteroscopic surveillance in all seven pts. In order surveillance, all pts received WCE, upper en-doscopy, ileocolonoscopy every 2 years. No pts had extraintestinal malignant lesions. SBE was performed when WCE was positive for significant polyps(> 15 mm).CONCLUSION: The effective of prophylactic polyp-ectomy of small bowel large polyps(> 15 mm) could be the first line treatment for conservative approach in management of PJS patients. | Torroni F Romeo E Rea F De Angelis P Foschia F Faraci S Federici di Abriola G Contini AC Caldaro T Dall’Oglio L | 2014 | World Journal of Gastrointestinal Endoscopy2014，6，7： | 7 |
| 6 | Alleviated mucosal and neuronal damage in a rat model of Crohn's disease显示文摘AIM:To establish a rat model suitable to investigate the repetitive relapsing inflammations(RRI)characteristic to Crohn’s disease.METHODS:Colitis was induced by 2,4,6-trinitrobenzenesulfonic acid(TNBS).RRI were mimicked by repeating administrations of TNBS.Tissue samples were taken from control,once,twice and three times treated rats from the inflamed and adjacent non-inflamed colonic segments at different timepoints during the acute intestinal inflammation.The means of the ulcerated area were measured to evaluate the macroscopic mu-cosal damage.The density of myenteric neurons was determined on whole mounts by Hu C/Hu D immunohistochemistry.Heme oxygenase-1(HO-1)expression was evaluated by molecular biological techniques.RESULTS:TNBS-treated rats displayed severe colitis,but the mortality was negligible,and an increase of body weight was characteristic throughout the experimental period.The widespread loss of myenteric neurons,and marked but transient HO-1 up-regulation were demonstrated after the first TNBS administration.After repeated doses the length of the recovery time and extent of the ulcerous colonic segments were markedly decreased,and the neuronal loss was on a smaller scale and was limited to the inflamed area.HO-1 m RNA level was notably greater than after a single dose and overexpression was sustained throughout the timepoints examined.Nevertheless,the HO-1protein up-regulation after the second TNBS treatment proved to be transient.Following the third treatment HO-1 protein expression could not be detected.CONCLUSION:Experimentally provoked RRI may exert a protective preconditioning effect against the mucosal and neuronal damage.The persistent up-regulation of HO-1 m RNA expression may correlate with this. | Petra Talapka Lajos István Nagy Alexandra Pál Marietta Zita Poles Anikó Berkó Mária Bagyánszki László Géza Puskás éva Fekete Nikolett Bódi | 2014 | World Journal of Gastroenterology2014，20，44： | 3 |
| 7 | Structural and molecular features of intestinal strictures in rats with Crohn's-like disease显示文摘AIM: To develop a new rat model we wanted to gain a better understanding of stricture formation in Crohn's disease(CD).METHODS: Chronic colitis was induced locally by the administration of 2,4,6-trinitrobenzenesulfonic acid(TNBS). The relapsing inflammation characteristic to CD was mimicked by repeated TNBS treatments. Animals were randomly divided into control, once, twice and three times TNBS-treated groups. Control animals received an enema of saline. Tissue samples were taken from the strictured colonic segments and also adjacent proximally and distally to its 60, 90 or 120 d after the last TNBS or saline administrations. The frequency and macroscopic extent of the strictures were measured on digital photographs. The structural features of strictured gut wall were studied by light- and electron microscopy. Inflammation related alterations in TGF-beta 2 and 3, matrix metalloproteinases 9(MMP9) and TIMP1 m RNA and protein expression were determined by quantitative real-time PCR and western blot analysis. The quantitative distribution of caspase 9 was determined by post-embedding immunohistochemistry.RESULTS: Intestinal strictures first appeared 60 d after TNBS treatments and the frequency of them increased up to day 120. From day 90 an intact lamina epithelialis, reversible thickening of lamina muscularis mucosae and irreversible thickening of the muscularis externa were demonstrated in the strictured colonic segments. Nevertheless the morphological signs of apoptosis were frequently seen and excess extracellular matrix deposition was recorded between smooth muscle cells(SMCs). Enhanced caspase 9 expression on day 90 in the SMCs and on day 120 also in myenteric neurons indicated the induction of apoptosis. The m RNA expression profile of TGF-betas after repeated TNBS doses was characteristic to CD, TGF-beta 2, but not TGF-beta 3 was up-regulated. Overexpression of MMP9 and down-regulation of TIMP1 were demonstrated. The progressive increase in the amount of MMP9 protein in the strictures was also obvious between days 90 and 120 but TIMP1 protein was practically undetectable at this time.CONCLUSION: These findings indicate that aligned structural and molecular changes in the gut wall rather than neuronal cell death play the primary role in stricture formation. | Petra Talapka Anikó Berkó Lajos István Nagy Lalitha Chandrakumar Mária Bagyánszki László Géza Puskás éva Fekete Nikolett Bódi | 2016 | World Journal of Gastroenterology2016，22，22： | 3 |
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