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| 1 | BCLC策略:预后预测和治疗推荐2022版更新显示文摘2018版BCLC预后和治疗推荐策略发布后,肝细胞癌(简称HCC)的研究又取得了重大进展。本次更新基于肝癌各领域的研究进展结果。重点关注影响策略的重要研究进展。虽然近年的研究结果成绩斐然,但将其引入为临床医生和研究者提供行动依据的循证模型指南来说证据效力依然不够确切。本文对该问题进行分析,阐述了为HCC患者制定个体化治疗临床决策所需的批判性思维和专业知识。 | Reig M Forner A Rimola J Ferrer-Fabrega J Burrel M Garcia-Criado A Kelley RK Galle PR Mazzaferro V Salem R Sangro B Singal AG Vogel A Fuster J Ayuso C Bruix J 刘永凡(摘译) 崔笑(摘译) 耿小平(审校) | 2022 | 肝胆外科杂志2022，30，5： | 80 |
| 2 | MicroRNA-34a inhibits glioblastoma growth by targeting multiple oncogenes显示文摘 | Li Y Guessous F Zhang Y Dipierro C Kefas B Johnson E Marcinkiewicz L Jiang J Yang Y Schmittgen TD Lopes B Schiff D Purow B Abounader R | 2009 | 中国神经肿瘤杂志2009，7，4： | 56 |
| 3 | 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 |
| 4 | Abnormal activation of the synuclein-gamma gene in hepatocellular carcinomas by epigenetic alteration.显示文摘 | Zhao W Liu H Liu W Wu Y Chen W Jiang B Zhou Y Xue R Luo C Wang L Jiang JD Liu J | 2006 | 中国生物学文摘2006，20，4： | 31 |
| 5 | Chronic hepatitis B infection in pregnancy显示文摘There are no standard guidelines to follow when a patient with chronic hepatitis B infection becomes pregnant or desires pregnancy. Topics to consider include which patients to treat, when to start treatment, what treatment to use and when to stop treatment. Without any prophylaxis or antiviral therapy, a hepatitis B surface antigen and E antigen positive mother has up to a 90% likelihood of vertical transmission of hepatitis B virus(HBV) to child. Standard of care in the United States to prevent perinatal transmission consists of administration of hepatitis B immune globulin and HBV vaccination to the infant. The two strongest risk factors of mother to child transmission(MTCT) of HBV infection despite immunoprophylaxis are high maternal HBV viral load and high activity of viral replication. The goal is to prevent transmission of HBV at birth by decreasing viral load and/or decreasing activity of the virus. Although it is still somewhat controversial, most evidence shows that starting antivirals in the third trimester is effective in decreasing MTCT without affecting fetal development. There is a growing body of literature supporting the safety and efficacy of antiviral therapies to reduce MTCT of hepatitis B. There are no formal recommendations regarding which agent to choose. Tenofovir, lamivudine and telbivudine have all been proven efficacious in decreasing viral load at birth without known birth defects, but final decision of which antiviral medication to use will have to be determined by physician and patient. The antivirals may be discontinued immediately if patient is breastfeeding, or within first four weeks if infant is being formula fed. | Jennifer R Lamberth Sheila C Reddy Jen-Jung Pan Kevin J Dasher | 2015 | World Journal of Hepatology2015，7，9： | 32 |
| 6 | Pediatric functional constipation treatment with Bifi dobacterium-containing yogurt:A crossover,double-blind,controlled trial显示文摘AIM: To evaluate the treatment of pediatric functional chronic intestinal constipation (FCIC) with a probiotic goat yogurt. METHODS: A crossover double-blind formula-controlled trial was carried out on 59 students (age range: 5-15 years) of a public school in Belo Horizonte, MG, Brazil, presenting a FCIC diagnostic, according to Roma Ⅲ criteria. The students were randomized in two groups to receive a goat yogurt supplemented with 109 colony forming unit/mL Bifidobacterium longum (B.longum) (probiotic) daily or only the yogurt for a period of 5 wk (formula). Afterwards, the groups were intercrossed for another 5 wk. Defecation frequency, stool consistency and abdominal and defecation pain were assessed.RESULTS: Both treatment groups demonstrated improvement in defecation frequency compared to baseline. However, the group treated with probiotic showed most signif icant improvement in the f irst phase of the study. An inversion was observed after crossing over, resulting in a reduction in stool frequency when this group was treated by formula. Probiotic and formula improved stool consistency in the f irst phase of treatment, but the improvement obtained with probiotic was significantly higher (P = 0.03). In the second phase of treatment, the group initially treated with probiotic showed worseningstool consistency when using formula. However, the difference was not signif icant. A signif icant improvement in abdominal pain and defecation pain was observed with both probiotic and formula in the first phase of treatment, but again the improvement was more signif icant for the group treated with B. longum during phase I (P < 0.05). When all data of the crossover study were analyzed, significant differences were observed between probiotic yogurt and yogurt only for defecation frequency (P = 0.012), defecation pain (P = 0.046) and abdominal pain (P = 0.015). | Paula VP Guerra Luiza N Lima Tassia C Souza Vanessa Mazochi Francisco J Penna Andreia M Silva Jacques R Nicoli Elizabet V Guimares | 2011 | World Journal of Gastroenterology2011，17，34： | 25 |
| 7 | 炎性肌纤维母细胞肿瘤的分子特性:高频ALK和ROS1基因融合及罕见新型RET基因重排亚型显示文摘约50%的普通型炎性肌纤维母细胞肿瘤( IMTs)伴ALK基因重排和过表达。近年来,已证明其它激酶的基因融合,如ROS1和PDGFRB,与IMT的发病机制有关。然而这些新出现的基因型是否与IMT的临床病理特征有关仍然未知。本文作者对不同临床表现的IMT大样本进行详细的分子遗传学研究,并分析基因型-表型之间的潜在相关性。 | Antonescu C R Suurmeijer A J Zhang L 魏建国 邰艳红 | 2015 | 临床与实验病理学杂志2015，31，7： | 19 |
| 8 | HPV阴性胃型子宫颈原位腺癌:一种具有胃和肠分化的罕见病变谱系显示文摘作者报道9例罕见的具有胃和肠分化且与人类乳头瘤病毒(HPV)感染无关的子宫颈原位腺癌(AIS)。患者年龄25~73岁(平均51岁),所有病例均位于子宫颈鳞一柱交界区(或邻近),其中有3例延伸子宫下段,2例累及子宫内膜。所有病例均大部分保留正常子宫颈腺体结构,其中5例有轻度腺体复杂性增生。腺上皮从几乎为纯胃型(4例)至混合不同比例杯状细胞的胃肠型(5例)。与正常的子宫颈腺体嗜碱性细胞质不同,胃型上皮通常由明显嗜酸性或浅粉色胞质的细胞组成,但在某些病例中胞质呈明显的泡沫状或透明胞质。所有病例均有核非典型性, | Talia K L Stewart C J R Howitt B E 黄爱清(摘译) 余英豪(审校) | 2017 | 临床与实验病理学杂志2017，33，11： | 19 |
| 9 | 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 |
| 10 | 在血压控制不良的高血压患者中使用数字化干预的家庭和在线血压管理:随机对照试验显示文摘HOME BP试验(The home and online management and evaluation of blood pressure)的目的是评估在初级预防中结合自我监测和自我管理的数字化干预在高血压管理中的作用。研究者纳入英国76个治疗中心经过治疗但血压控制不好(>140/90 mm Hg, 1 mm Hg=0.133 kPa)并能上网的患者622例,进行自动确定主要终点的公开随机对照试验。 | McMa-nus RJ Little P Stuart B Morton K Raftery J Kelly J Bradbury K Zhang J Zhu S Murray E May CR Mair FS Michie S Smith P Band R Ogburn E AllenJ Rice C Nut-tall J Williams B Yardley L 陈嘉睿(译) 叶鹏(审校) | 2021 | 中华高血压杂志2021，29，5： | 15 |
| 11 | 我国农村居民的红细胞脂肪酸、血浆脂质与心血管疾病显示文摘对我国49个县的心血管疾病(CVD,包括冠心病、高血压心脏病和脑卒中)死亡率和4900例35~64岁成年男女的膳食进行了调查,并测定了血浆脂质[总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和甘油三酸酯(TG)]的含量,结果指出:1.和西方国家人群比较,我国农民血浆TC、TG、HDL-C和依此计算而得的LDL-C水平较低,而HDL-C/TC比值较高,CVD死亡率也较西方国家的为低。2.在TC、LDL-C与CVD死亡率之间无相关,但在红细胞油酸水平与CVD死亡率间有显著负相关。3.红细胞油酸水平与血浆TC含量间无相关,而与红细胞花生四烯酸水平呈显著负相关。指出油酸对CVD死亡率的影响有可能是通过另一条途径,即减低血小板的聚集作用。4.我国的CVD死亡率呈现明显的地区性分布,即南方低于北方。其分布与红细胞油酸含量,及大米摄取量的地区性分布呈明显的负关系。5.为解释CVD死亡率与红细胞油酸的负关系,本文提出了油酸可能置换了血小板膜磷脂中多不饱和脂肪酸的设想,但对大米保护CVD的作用则尚需有更多的调查和研究数据才能确证之。 | 范文洵 Parker R Parpia B 屈荫生 Cassano P Crawford M Leyton J 田巧珍 黎均耀 陈君石 Campbell C | 1992 | 营养学报1992，14，1： | 15 |
| 12 | The wonders of BMP9:From mesenchymal stem cell differentiation,angiogenesis,neurogenesis,tumorigenesis,and metabolism to regenerative medicine显示文摘Although bone morphogenetic proteins(BMPs)initially showed effective induction of ectopic bone growth in muscle,it has since been determined that these proteins,as members of the TGF-b superfamily,play a diverse and critical array of biological roles.These roles include regulating skeletal and bone formation,angiogenesis,and development and homeostasis of multiple organ systems.Disruptions of the members of the TGF-b/BMP superfamily result in severe skeletal and extra-skeletal irregularities,suggesting high therapeutic potential from understanding this family of BMP proteins.Although it was once one of the least characterized BMPs,BMP9 has revealed itself to have the highest osteogenic potential across numerous experiments both in vitro and in vivo,with recent studies suggesting that the exceptional potency of BMP9 may result from unique signaling pathways that differentiate it from other BMPs.The effectiveness of BMP9 in inducing bone formation was recently revealed in promising experiments that demonstrated efficacy in the repair of critical sized cranial defects as well as compatibility with bone-inducing bio-implants,revealing the great translational promise of BMP9.Furthermore,emerging evidence indicates that,besides its osteogenic activity,BMP9 exerts a broad range of biological functions,including stem cell differentiation,angiogenesis,neurogenesis,tumorigenesis,and metabolism.This review aims to summarize our current understanding of BMP9 across biology and the body. | Sami Mostafa Mikhail Pakvasa Elam Coalson Allen Zhu Alex Alverdy Hector Castillo Jiaming Fan Alex Li Yixiao Feng Di Wu Elliott Bishop Scott Du Mia Spezia Alissa Li Ofir Hagag Alison Deng Winny Liu Mingyang Li Sherwin S·Ho Aravind Athiviraham Michael J·Lee Jennifer Moriatis Wolf Guillermo A·Ameer Hue H·Luu Rex C·Haydon Jason Strelzow Kelly Hynes Tong-Chuan He Russell R·Reid | 2019 | Genes & Diseases2019，6，3： | 15 |
| 13 | 内脏脂肪组织通过产生骨桥蛋白调控成纤维细胞衰老促进心脏衰老显示文摘老化通过增加包括骨桥蛋白(osteopontin,OPN)在内的细胞外基质(extracellular matrix,ECM)蛋白的沉积引起心脏结构和功能改变进而导致进行性间质纤维化。虽然已知OPN参与各种病理状况,但其在心肌衰老中的作用仍不清楚。 | Sawaki D Czibik G Pini M Ternacle J Suffee N Mercedes R Marcelin G Surenaud M Marcos E Gual P Clément K Hue S Adnot S Hatem SN Tsuchimochi I Yoshimitsu T Hénégar C Derumeaux G 刘青 叶鹏 | 2018 | 中华高血压杂志2018，26，3： | 14 |
| 14 | Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome显示文摘BackgroundThere 是在质子泵禁止者(PPI ) 和 clopidogrel 之间的可能的不利相互作用上的大争论。另外, PPI 的使用是否少些影响 ticagrelor 遗体的临床的功效,知道。在经皮的冠的干预(一种总线标准) .MethodsWe 回顾地从 “ 分析了数据以后,我们试图与急性冠的症候群(交流)在病人在临床的结果上决定 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响;真实 world” ;,国际,在 2003 和 2014 之间的多中心登记( n = 15,401 )并且在1年的合成主要端点上估计了 PPI 和 clopidogrel 或 ticagrelor 的伴随物管理的影响(所有原因死亡收到 PPI 的病人更老,更经常女性,并且是更可能的有 comorbidities。没有协会为收到 clopidogrel 的病人在 PPI 使用和主要端点之间被观察(调整 HR:1.036;95% CI:0.903-1.189 ) 或 ticagrelor (调整 HR:2.320;95% CI:0.875-6.151 )(P 相互作用 = 0.2004 ) 。同样, PPI 的使用没与所有原因死亡,重新梗塞,或与交流后面的一种总线标准的为与任何一个 clopidogrel 对待的病人或 ticagrelor.ConclusionsIn 病人的严重流血的减少的风险的增加的风险被联系, PPI 的伴随物使用没在收到 clopidogrel 或 ticagrelor 的病人与不利结果的增加的风险被联系。我们的调查结果显示与 clopidogrel 或 ticagrelor 在联合使用 PPI 是合理的,特别在有胃肠的流血的更高的风险的病人。 | Yan YAN Xiao WANG Jing-Yao FAN Shao-Ping NIE Sergio Raposeiras-Roubin Emad Abu-Assi Jose P Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose R Gonzfilez-Juanatey Stephen B Wilton Wouter J Kikkert Ivlin Nufiez-Gil Albert Ariza-Sole Xian-Tao SONG Dimitrios Alexopoulos Christoph Liebetrau Tetsuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis C Correia Masa-aki Kawashiril Sasko Kedev | 2016 | Journal of Geriatric Cardiology2016，13，3： | 12 |
| 15 | 焦炭特性及其在高炉下部的变化过程显示文摘气化、石墨化和溶解是影响焦炭从高炉软熔带至炉缸间行为的三个主要过程。过去几年在一些专题项目中对这些过程进行了研究。简要叙述并讨论了这些过程的相互作用及其与焦炭特性的关系。对焦炭的气化反应进行了实验室测试研究,用以评价高炉条件下焦炭的特性。用高炉条件下的气化测试装置测试了几种焦炭试样,考查的质量指标包括反应性、结构变化和强度等。用实际尺寸的焦炭块对块状焦炭试样的高温行为进行了评估,将不同种类的焦炭试样加热到2 000℃,以鉴别其在高温下的行为。高温下焦炭将发生石墨化,对高温反应后的强度进行了评定,并作了显微观察,发现了一些现象和组织结构的变化。焦炭与液态渣铁相互作用的研究结果对焦炭在高炉下部的行为有了更好的理解。通过试验研究了焦炭抗液态铁水溶解的性能,对入炉前的焦炭和经高温反应的焦炭分别进行了试验。分析讨论了焦炭的抗气化、抗石墨化和抗铁水溶解性能与其结构、化学成分和强度的关系。 | B van der Velden C J Atkinson T Bakker J R H Stuurwold G J Tijhuis 徐万仁 | 2014 | 世界钢铁2014，，2： | 11 |
| 16 | Transcriptomic landscape regulated by the 14 types of bone morphogenetic proteins(BMPs)in lineage commitment and differentiation of mesenchymal stem cells(MSCs)显示文摘Mesenchymal stem cells(MSCs)are ubiquitously-existing multipotent progenitors that can self-renew and differentiate into multiple lineages including osteocytes,chondrocytes,adipocytes,tenocytes and myocytes.MSCs represent one of the most commonly-used adult progenitors and serve as excellent progenitor cell models for investigating lineagespecific differentiation regulated by various cellular signaling pathways,such as bone morphogenetic proteins(BMPs).As members of TGFb superfamily,BMPs play diverse and important roles in development and adult tissues.At least 14 BMPs have been identified in mammals.Different BMPs exert distinct but overlapping biological functions.Through a comprehensive analysis of 14 BMPs in MSCs,we demonstrated that BMP9 is one of the most potent BMPs in inducing osteogenic differentiation of MSCs.Nonetheless,a global mechanistic view of BMP signaling in regulating the proliferation and differentiation of MSCs remains to be fully elucidated.Here,we conducted a comprehensive transcriptomic profiling in the MSCs stimulated by 14 types of BMPs.Hierarchical clustering analysis classifies 14 BMPs into three subclusters:an osteo/chondrogenic/adipogenic cluster,a tenogenic cluster,and BMP3 cluster.We also demonstrate that six BMPs(e.g.,BMP2,BMP3,BMP4,BMP7,BMP8,and BMP9)can induce ISmads effectively,while BMP2,BMP3,BMP4,BMP7,and BMP11 up-regulate Smad-independent MAP kinase pathway.Furthermore,we show that many BMPs can upregulate the expression of the signal mediators of Wnt,Notch and PI3K/AKT/mTOR pathways.While the reported transcriptomic changes need to be further validated,our expression profiling represents the first-of-its-kind to interrogate a comprehensive transcriptomic landscape regulated by the 14 types of BMPs in MSCs. | Linghuan Zhang Qing Luo Yi Shu Zongyue Zeng Bo Huang Yixiao Feng Bo Zhang Xi Wang Yan Lei Zhenyu Ye Ling Zhao Daigui Cao Lijuan Yang Xian Chen Bin Liu William Wagstaff Russell R*Reid Hue H*Luu Rex C*Haydon Michael J*Lee Jennifer Moriatis Wolf Zhou Fu Tong-Chuan He Quan Kang | 2019 | Genes & Diseases2019，6，3： | 11 |
| 17 | Intentional ingestions of foreign objects among prisoners: A review显示文摘The intentional ingestion of foreign objects(IIFO) is described more commonly in prison populations than in the general population, with an estimated annual incidence of 1 in 1900 inmates in our state correctional facilities. Incidents often involve ingestion of small metal objects(e.g., paperclips, razor blades) or other commonly available items like pens or eating utensils. Despite ingestion of relatively sharp objects, most episodes can be clinically managed with either observation or endoscopy. Surgery should be reserved for those with signs or symptoms of gastrointestinal perforation or obstruction. For those with a history of IIFO, efforts should focus on prevention of recurrenceas subsequent episodes are associated with higher morbidity, significant healthcare and security costs. The pattern of IIFO is often repetitive, with escalation both in frequency of ingestions and in number of items ingested. Little is known about successful prevention strategies, but efforts to monitor patients and provide psychiatric care are potential best-practice strategies. This article aims to provide state-of-the art review on the topic, followed by a set of basic recommendations. | David C Evans Thomas R Wojda Christian D Jones Andrew J Otey Stanislaw P Stawicki | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，3： | 10 |
| 18 | 柑桔黄龙病的鉴定和柯赫氏定理(英文)显示文摘黄龙(梢)病被认为是世界柑橘生产上的毁灭性病害已超过一个世纪,但该病害的病原学至今还没有清晰地建立起来。根据16S rRNA基因序列分析,一组被称为'Candidatus Liberibacter species'的难培养细菌被认为与黄龙病相关。然而,要确定'Ca.Liberibacter spp.'是黄龙病病原的柯赫氏定理并没有真正完成。令我们担忧的是,近年来有些文献频频指出'Ca.Liberibacter spp.'是黄龙病的病原,其实该细菌与柑橘寄主的直接病理反应还没有完全确定。我们建议,在黄龙病病原学清楚之前,文献报道在这方面需要有准确的阐述。 | Chen J Deng X Civerolo E L Lee R F Jones J B Zhou C Hartung J S Manjunath K L Brlansky R H | 2011 | 植物病理学报2011，41，2： | 10 |
| 19 | 常规脂蛋白检测和载脂蛋白在心血管病预测中的比较显示文摘总胆固醇和高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)测量值对于心血管病风险评估至关重要,但对于其他脂质用于风险预测的效用一直存在争议。该研究纳入来自英国生物银行(Biobank)的无基线心血管病、未服用他汀类药物、有相关的脂质指标(n=346 686)的受试者。 | Welsh C Celis-Morales CA Brown R Mackay DF Lewsey J Mark PB Gray SR Ferguson LD Anderson JJ Lyall DM Cleland JG Jhund PS Gill J MR Pell JP Sattar N Welsh P 刘青(译) 叶鹏(摘、审校) | 2019 | 中华高血压杂志2019，27，7： | 10 |
| 20 | Relationship between the exocrine and endocrine pancreas after acute pancreatitis显示文摘AIM:To determine the prevalence and time course of pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.METHODS:Relevant literature cited in three major biomedical journal databases(EMBASE,MEDLINE,and Scopus)was reviewed independently by two authors.There were no language constraints but the search was limited to human studies.Studies included were cohort studies of adult patients who were discharged after an attack of acute pancreatitis.Patients were excluded if they were under 18 years of age or had a previous diagnosis of prediabetes or diabetes mellitus,pancreatic exocrine insufficiency,or chronic pancreatitis.The main outcome measure was the prevalence of concomitant pancreatic exocrine insufficiency in patients who were diagnosed with prediabetes and diabetes mellitus after an attack of acute pancreatitis.Subgroup analysis was conducted for patients who were diagnosed with prediabetes only and those who were diagnosed withdiabetes mellitus only.Subgroup analysis looking at the time course of concomitant pancreatic exocrine and endocrine insufficiency was also conducted.Pooled prevalence and corresponding 95%confidence intervals were calculated for all outcome measures and P-values<0.05 were deemed statistically significant.RESULTS:Eight clinical studies comprising of 234patients met all eligibility criteria.The pooled prevalence of newly diagnosed prediabetes or diabetes in individuals after acute pancreatitis was 43%(95%CI:30%-56%).The pooled prevalence of pancreatic exocrine insufficiency in individuals after acute pancreatitis was 29%(95%CI:19%-39%).The prevalence of concomitant pancreatic exocrine insufficiency in individuals with newly diagnosed prediabetes or diabetes was 40%(95%CI:25%-55%).The prevalence of concomitant pancreatic exocrine insufficiency among individuals with prediabetes alone and diabetes mellitus alone was 41%(95%CI:12%-75%)and 39%(95%CI:28%-51%),respectively.Further analysis showed that the prevalence of concomitant pancreatic exocrine insufficiency in individuals with prediabetes or diabetes decreases over time after an attack of acute pancreatitis.CONCLUSION:Pancreatic exocrine insufficiency occurs in 40%of individuals with newly diagnosed prediabetes or diabetes mellitus after acute pancreatitis.Further studies are needed to investigate the pathogenesis of diabetes in this setting. | Stephanie L M Das James I C Kennedy Rinki Murphy Anthony R J Phillips John A Windsor Maxim S Petrov | 2014 | World Journal of Gastroenterology2014，20，45： | 9 |
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