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1初级保健中原发性醛固酮增多症的患病率和临床表现显示文摘原发性醛固酮增多症(primaryaldosteronism,PA)是一种异质性疾病,以高血压和相对自主于肾素血管紧张素系统产生过量醛固酮为特征。与心血管病风险相似的原发性高血压患者相比,PA患者发生心脑血管并发症的风险以及代谢综合征患病率增加,提示正确诊断PA的重要性。Monticone S Burrello J Tizzani D Bertello C Viola A Buffolo F Gabetti L Mengozzi G Williams TA Rabbia F Veglio F Mulatero P 练桂丽 叶鹏 2017中华高血压杂志2017,25,5:58
2Canopy Temperature Depression as a Potential Selection Criterion for Drought Resistance in Wheat显示文摘Field studies were conducted at Bushland, Texas, USA, in 2004 to examine usefulness of canopy temperature depression(CTD), the difference of air-canopy temperature, in screening wheat (Triticum aestivum L.) genotypes for yield underdryland and irrigated. Forty winter wheat genotypes were grown under irrigation and dryland. CTDs were recorded afterheading between 1 330 and 1 530 h on 6 clear days for dryland and 9 days for irrigation. Drought susceptible index (DSI)for each genotype was calculated using mean yield under dryland and irrigated conditions. Genotypes exhibited greatdifferences in CTD under each environment. The dryland CTDs averaged 1.33°C ranging from -0.67 to 2.57°C, and theaverage irrigation CTD were 4.59°C ranging from 3.21 to 5.62°C. A low yield reduction was observed under drylandconditions relative to irrigated conditions for high-CTD genotypes. CTD values were highly negatively correlated withDSI under dryland, and genotypes of CTDs = 1.3°C in dryland condition were identified as drought resistant. For 21genotypes classified as drought resistant by DSI, their CTDs were 1.68°C for dryland and 4.35°C for irrigation on average;for 19 genotypes classified as drought susceptible by DSI, average CTD was 0.94°C in dryland and 4.85°C in irrigation.The high-yield genotypes consistently had high CTD values, and the low-yield ones had low CTD values for allmeasurements in dryland. After heading, genotypes maintained consistent ranking for CTD. Regression results for CTDand yield suggested that the best time for taking CTD measurement was 3-4 weeks after heading in irrigation but any timebefore senescence in dryland. Crop water stress index (CWSI) calculated from CTD data was highly correlated with CWSIcalculated from yield, which suggesting traditional costly CWSI measurement may be improved by using portable infraredthermometers. Most importantly, grain yield was highly correlated with CTD under dryland (R2 = 0.79-0.86) and irrigation(R2 = 0.46-0.58) conditions. These results clearly indicated grain yield and water stress can be predicted by taking CTDvalues in field, which can be used by breeding programs as a potential selection criterion for grain yield and droughtresistance in wheat, but a second study year is needed to confirm further.FAN Ting-lu Maria Balta Jackie Rudd William A Payne 2005Agricultural Sciences in China2005,4,10:35
3冠状动脉内影像学临床应用专家共识(第一部分):对冠状动脉介入治疗的指导与优化显示文摘欧洲心血管介入协会(EAPCI)专家组系统总结了血管内超声(IVUS)和光学相干断层成像(OCT)这两种血管内影像学检查临床应用指征的现有证据,提供了关于IVUS和OCT指导经皮冠状动脉介入治疗(PCI)的应用价值,并明确了最可能从腔内影像学指导的介入治疗中获得临床收益的患者或病变类型,同时详细论述了PCI前如何使用IVUS或OCT优化支架尺寸(支架长度和直径)和手术策略的选择。此外,专家推荐对支架失败(支架内再狭窄或支架内血栓形成)的患者应常规进行冠状动脉内影像学检查,并首选OCT。最后,重点论述了IVUS和OCT在指导PCI和评估支架失败两个方面的优势和局限性,并对未来需要深入研究的领域进行了展望。Lorenz Raber Gary S Mintz Konstantinos C Koskinas Thomas W Johnson Niels R Holm Yoshinubo Onuma Maria D Radu Michael Joner Bo Yu Haibo Jia Nicolas Meneveau Jose M.de la Torre Hemandez Javier Escaned Jonathan Hill Francesco Prati Antonio Colombo Carlo di Mario Evelyn Regar Davide Capodanno William Wijns Robert A Byme Giulio Guagliumi 2019中华心血管病杂志2019,47,1:17
4Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage显示文摘证据正在增加精子 DNA 的正直可能也与培植失败和周期性的流产(RM ) 有关。调查这,在有在 vitro 授精,与 RM 诊断的 16 个女人和七位最近的父亲(控制) 列在后面的周期性的培植失败(RIF ) 的 35 个女人的搭挡的精子 DNA 破碎被检验。精子由测试和终端 deoxynucleotidyl transferase dUTP 刻痕结束标记的精子染色质分散(SCD )(TUNEL ) 是检验密度前和密度以后的 centrifugation 试金。在在三之间的搭挡或精子集中,活动性或形态学组织的任何一个的年龄没有重要差别。而且,在 DNA 破碎由也测量了的精子没有明显的差别测试。不管多么虽然平均在所有的精子 DNA 破碎组织当由 SCD 测试测量了时,在准备精子是统计上更低的,这没从 TUNEL 试金与结果被看见。这些结果不支持精子 DNA 破碎是 RIF 或 RM 的一个重要原因的假设,否则测试的那精子 DNA 正直在如此的病人有价值。它也在从精子 DNA 破碎测试解释数据加亮测试方法论和精子准备方法之间的重要差别。Carol Coughlan Helen Clarke Rachel Cutting Jane Saxton Sarah Waite William Ledger Tinchiu Li Allan A Pacey 2015Asian Journal of Andrology2015,17,4:17
5Choledochal cysts: Similarities and differences between Asian and Western countries显示文摘Choledochal cysts(CCs)are rare bile duct dilatations,intra-and/or extrahepatic,and have higher prevalence in the Asian population compared to Western populations.Most of the current literature on CC disease originates from Asia where these entities are most prevalent.They are thought to arise from an anomalous pancreaticobiliary junction,which are congenital anomalies between pancreatic and bile ducts.Some similarities in presentation between Eastern and Western patients exist such as female predominance,however,contemporary studies suggest that Asian patients may be more symptomatic on presentation.Even though CC disease presents with an increased malignant risk reported to be more than 10%after the second decade of life in Asian patients,this risk may be overstated in Western populations.Despite this difference in cancer risk,management guidelines for all patients with CC are based predominantly on observations reported from Asia where it is recommended that all CCs should be excised out of concern for the presence or development of biliary tract cancer.George N Baison Morgan M Bonds William S Helton Richard A Kozarek 2019World Journal of Gastroenterology2019,25,26:16
6Design of 16S rRNA gene primers for 454 pyrosequencing of the human foregut microbiome显示文摘AIM:To design and validate broad-range 16S rRNA primers for use in high throughput sequencing to classify bacteria isolated from the human foregut microbiome.METHODS:A foregut microbiome dataset was constructed using 16S rRNA gene sequences obtained from oral,esophageal,and gastric microbiomes produced by Sanger sequencing in previous studies represented by 219 bacterial species.Candidate primers evaluated were from the European rRNA database.To assess the effect of sequence length on accuracy of classification,16S rRNA genes of various lengths were created by trimming the full length sequences.Sequences spanning various hypervariable regions were selected to simulate the amplicons that would be obtained using possible primer pairs.The sequences were compared with full length 16S rRNA genes for accuracy in taxonomic classification using online software at the Ribosomal Database Project (RDP).The universality of the primer set was evaluated using the RDP 16S rRNA database which is comprised of 433 306 16S rRNA genes,represented by 36 phyla.RESULTS:Truncation to 100 nucleotides(nt)downstream from the position corresponding to base 28 in the Escherichia coli 16S rRNA gene caused misclassification of 87(39.7%)of the 219 sequences,compared with misclassification of only 29(13.2%)sequences with truncation to 350 nt.Among 350-nt sequence reads within various regions of the 16S rRNA gene,the reverse read of an amplicon generated using the 343F/798R primers had the least(8.2%)effect on classification.In comparison,truncation to 900 nt mimicking single pass Sanger reads misclassified 5.0%of the 219 sequences.The 343F/798R amplicon accurately assigned 91.8%of the 219 sequences at the species level.Weighted by abundance of the species in the esophageal dataset,the 343F/798R amplicon yielded similar classification accuracy without a significant loss in species coverage(92%).Modification of the 343F/798R primers to 347F/803R increased their universality among foregut species.Assuming that a typicalpolymerase chain reaction can tolerate 2 mismatches between a primer and a template,the modified 347F and 803R primers should be able to anneal 98%and 99.6%of all 16S rRNA genes in the RDP database.CONCLUSION:347F/803R is the most suitable pair of primers for classification of foregut 16S rRNA genes but also possess universality suitable for analyses of other complex microbiomes.Carlos W Nossa William E Oberdorf Jφrn A Aas Bruce J Paster Todd Z DeSantis Eoin L Brodie Daniel Malamud Michael A Poles Zhiheng Pei 2010World Journal of Gastroenterology2010,16,33:16
7Computed tomography overestimation of esophageal tumor length: Implications for radiotherapy planning显示文摘AIM:To assess the relationship between preoperative computed tomography(CT)and postoperative pathological measurements of esophageal tumor length and the prognostic significance of CT tumor length data.METHODS:A retrospective study was carried out in 56 patients who underwent curative esophagogastrectomy.Tumor lengths were measured on the immediate preoperative CT and on the post-operative resection specimens.Inter-and intra-observer variations in CT measurements were assessed.Survival data were collected.RESULTS:There was a weak correlation between CT and pathological tumor length(r=0.30,P=0.025).CT lengths were longer than pathological lengths in 68%(38/56)of patients with a mean difference of 1.67 cm(95%CI:1.18-2.97).The mean difference in measurements by two radiologists was 0.39 cm(95% CI:-0.59-1.44).The mean difference between repeat CT measured tumor length(intra-observer variation) were 0.04 cm(95%CI:-0.59-0.66)and 0.47 cm (95%CI:-0.53-1.47).When stratified,patients not receiving neoadjuvant chemotherapy showed a strong correlation between CT and pathological tumor length(r =0.69,P=0.0014,n=37)than patients that did(r= 0.13,P=0.43,n=19).Median survival with CT tumor length>5.6 cm was poorer than with smaller tumors,but the difference was not statistically significant.CONCLUSION:Esophageal tumor length assessed using CT does not reflect pathological tumor extent and should not be the only modality used for management decisions,particularly for planning radiotherapy.Karim Sillah Luke R Williams Hans-Ulrich Laasch Azeem Saleem Gillian Watkins Susan A Pritchard Patricia M Price Catharine M West Ian M Welch 2010World Journal of Gastrointestinal Oncology2010,2,4:10
8New advances in molecular mechanisms and emerging therapeutic targets in alcoholic liver diseases显示文摘Alcoholic liver disease is a major health problem in the United States and worldwide. Chronic alcohol consumption can cause steatosis, inflammation, fibrosis, cirrhosis and even liver cancer. Significant progress has been made to understand key events and molecular players for the onset and progression of alcoholic liver disease from both experimental and clinical alcohol studies. No successful treatments are currently available for treating alcoholic liver disease; therefore, development of novel pathophysiological-targeted therapies is urgently needed. This review summarizes the recent progress on animal models used to study alcoholic liver disease and the detrimental factors that contribute to alcoholic liver disease pathogenesis including miRNAs, S-adenosylmethionine, Zinc deficiency, cytosolic lipin-1β, IRF3-mediated apoptosis, RIP3-mediated necrosis and hepcidin. In addition, we summarize emerging adaptive protective effects induced by alcohol to attenuate alcohol-induced liver pathogenesis including FoxO3, IL-22, autophagy and nuclear lipin-1α.Jessica A Williams Sharon Manley Wen-Xing Ding 2014World Journal of Gastroenterology2014,20,36:10
9Mycophenolate mofetil for drug-induced vanishing bile duct syndrome显示文摘Amoxicillin/clavulanate is associated with liver injury, mostly of a cholestatic pattern. While outcomes are usually benign, progression to cirrhosis and death has been reported. The role of immunosuppressive therapy for patients with a protracted course is unclear. We report the case of an elderly patient who developed prolonged cholestasis secondary to amoxicillin/clavulanate. Vanishing bile duct syndrome was confirmed by sequential liver biopsies. The patient responded to prednisone treatment, but could not be weaned off corticosteroids, even when azathioprine was added. Complete withdrawal of both prednisone and azathioprine was possible by using mycophenolate mofetil, an inosine monophosphate dehydrogenase inhibitor. Sustained remission has been maintained for more than 3 years with low-dose mycophenolate mofetil.S Simona Jakab A Brian West Dennis M Meighan Robert S Brown Jr William B Hale 2007World Journal of Gastroenterology2007,13,45:8
10Method for rapid on-site identification of VOCs显示文摘Rapid on-site identification of volatile organic compounds (VOCs) in ambient air is an important first step in remediation efforts. This study describes modification of a commercially available, portable GC/MS system and development of an analysis protocol for rapid (< 3 min) sampling and identification of VOCs typically found at contaminated sites at the low ppbv level.Justin D Fair William F Bailey Robert A Felty Amy E Gifford Benjamin Shultes Leslie H Volles 2009Journal of Environmental Sciences2009,21,7:8
11Progress in structural materials for aerospace systems 1 1 The Golden Jubilee Issue—Selected topics in Materials Science and Engineering: Past, Present and Future, edited by S. Suresh.显示文摘James C Williams Edgar A Starke 2003Acta Materialia2003,,19:7
12艾滋病的治疗与控制显示文摘感染人类免疫缺陷病毒(HIV)会造成免疫系统致命的进行性的破坏,导致各种被定义为获得性免疫缺陷综合征的机会性感染的发生.HIV感染有CD4表达的细胞,这是主要的病毒受体,见于辅助T淋巴细胞和单核/巨噬细胞.HIV原发感染常引起急性的病毒综合征,表现为发热、皮疹、腹泻和不适,伴有极高水平的血循环病毒水平,在淋巴结、脑和其它储存单位中发生感染.急性期的终结以特异性的HIV免疫应答为标志,包括HIV抗体的出现,对抗体的检测被用于诊断试验.随后的慢性而隐匿的病变期通常没有症状.病毒血症低下但始终存在,在数年的病程中CD4-;T细胞逐渐耗竭.随着病变的加重,CD4-;T细胞会加速丢失,并伴有循环病毒的增多,后者可用血浆HIV RNA检测加以量化(病毒载量).CD4+;T细胞降低至200个/mm3以下时可伴有各种机会性感染的出现.即使没有可确诊为AIDS的疾病出现,CD;T细胞计数低于200个/mm3也可考虑诊断为AIDS.William A O’Brien 2001中国性病艾滋病防治2001,7,1:7
13Pancreatic endometrial cyst mimics mucinous cystic neoplasm of the pancreas显示文摘Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis. With concern for a possible pre-malignant lesion, the patient underwent a laparoscopic distal pancreatectomy with splenectomy, which revealed a 16cm×12cm×4cm lesion. Final histopathology was consistent with an intra-pancreatic endometrial cyst. Here we discuss the overlapping imaging and laboratory features of pancreatic endometrial cysts and mucinous cystic neoplasms of the pancreas.Michael A Mederos Nicole Villafane Sadhna Dhingra Carlos Farinas Amy Mc Elhany William E Fisher George Van Buren II 2017World Journal of Gastroenterology2017,23,6:7
14Immunohistochemical expression of SP-NK-1R-EGFR pathway and VDR in colonic inflammation and neoplasia显示文摘AIM:To determine the expression of neurokinin-1receptor(NK-1R),phosphorylated epidermal growth factor receptor(p EGFR),cyclooxygenase-2(Cox-2),and vitamin D receptor(VDR)in normal,inflammatory bowel disease(IBD),and colorectal neoplasia tissues from Puerto Ricans.METHODS:Tissues from patients with IBD,colitisassociated colorectal cancer(CAC),sporadic dysplasia,and sporadic colorectal cancer(CRC),as well as normal controls,were identified at several centers in Puerto Rico.Archival formalin-fixed,paraffin-embedded tissues were de-identified and processed by immunohistochemistry for NK-1R,p EGFR,Cox-2,and VDR.Pictures of representative areas of each tissues diagnosis were taken and scored by three observers using a4-point scale that assessed intensity of staining.Tissues with CAC were further analyzed by photographing representative areas of IBD and the different grades of dysplasia,in addition to the areas of cancer,within each tissue.Differences in the average age between the five patient groups were assessed with one-way analysis of variance and Tukey-Kramer multiple comparisons test.The mean scores for normal tissues and tissues with IBD,dysplasia,CRC,and CAC were calculatedand statistically compared using one-way analysis of variance and Dunnett’s multiple comparisons test.Correlations between protein expression patterns were analyzed with the Pearson’s product-moment correlation coefficient.Data are presented as mean±SE.RESULTS:On average,patients with IBD were younger(34.60±5.81)than normal(63.20±6.13,P<0.01),sporadic dysplasia(68.80±4.42,P<0.01),sporadic cancer(74.80±4.91,P<0.001),and CAC(57.50±5.11,P<0.05)patients.NK-1R in cancer tissue(sporadic CRC,1.73±0.34;CAC,1.57±0.53)and sporadic dysplasia(2.00±0.45)were higher than in normal tissues(0.73±0.19).p EGFR was significantly increased in sporadic CRC(1.53±0.43)and CAC(2.25±0.47)when compared to normal tissue(0.07±0.25,P<0.05,P<0.001,respectively).Cox-2 was significantly increased in sporadic colorectal cancer(2.20±0.23 vs 0.80±0.37 for normal tissues,P<0.05).In comparison to normal(2.80±0.13)and CAC(2.50±0.33)tissues,VDR was significantly decreased in sporadic dysplasia(0.00±0.00,P<0.001 vs normal,P<0.001 vs CAC)and sporadic CRC(0.47±0.23,P<0.001 vs normal,P<0.001 vs CAC).VDR levels negatively correlated with NK-1R(r=-0.48)and p EGFR(r=-0.56)in normal,IBD,sporadic dysplasia and sporadic CRC tissue,but not in CAC.CONCLUSION:Immunohistochemical NK-1R and p EGFR positivity with VDR negativity can be used to identify areas of sporadic colorectal neoplasia.VDR immunoreactivity can distinguish CAC from sporadic cancer.Raymond A Isidro Myrella L Cruz Angel A Isidro Axel Baez Axel Arroyo William A González-Marqués Carmen González-Keelan Esther A Torres Caroline B Appleyard 2015World Journal of Gastroenterology2015,21,6:7
15Role of functional imaging in the development and refinement of invasive neuromodulation for psychiatric disorders显示文摘Deep brain stimulation(DBS) is emerging as a pow-erful tool for the alleviation of targeted symptoms in treatment-resistant neuropsychiatric disorders. Despite the expanding use of neuropsychiatric DBS, the mecha-nisms responsible for its effects are only starting to be elucidated. Several modalities such as quantitative elec-troencephalography as well a intraoperative recordings have been utilized to attempt to understand the under-pinnings of this new treatment modality, but functional imaging appears to offer several unique advantages. Functional imaging techniques like positron emission tomography, single photon emission computed tomog-raphy and functional magnetic resonance imaging have been used to examine the effects of focal DBS on activ-ity in a distributed neural network. These investigations are critical for advancing the field of invasive neuro-modulation in a safe and effective manner, particularly in terms of defining the neuroanatomical targets and refining the stimulation protocols. The purpose of this review is to summarize the current functional neuroim-aging findings from neuropsychiatric DBS implantation for three disorders: treatment-resistant depression, obsessive-compulsive disorder, and Tourette syndrome. All of the major targets will be discussed(Nucleus ac-cumbens, anterior limb of internal capsule, subcallosal cingulate, Subthalamic nucleus, Centromedial nucleus of the thalamus-Parafasicular complex, frontal pole, and dorsolateral prefrontal cortex). We will also address some apparent inconsistencies within this literature, and suggest potential future directions for this promis-ing area.Nolan R Williams Joseph J Taylor Kayla Lamb Colleen A Hanlon E Baron Short Mark S George 2014World Journal of Radiology2014,6,10:6
162型糖尿病患者采用血管紧张素转换酶抑制剂治疗后血清肌酐急性升高及其继续治疗对主要临床结局的影响显示文摘血管紧张素转换酶抑制剂开始治疗后血清肌酐急性升高≥30%时推荐停药。但血清肌酐升高后继续服药或停药对主要临床结局的长期影响仍不明确。在ADVANCE(糖尿病与血管疾病行动:培哚普利-吲达帕胺与达美康缓释片对照评估)试验中,11 140例糖尿病患者在6周活性导入期后随机采用培哚普利-吲达帕胺或安慰剂治疗。Ohkuma T Jun M Rodgers A Cooper ME Glasziou P Hamet P Harrap S Mancia G Marre M Neal B Perkovic V Poulter N Williams B Zoungas S Chalmers J Woodward M 赵狄 练桂丽 2019中华高血压杂志2019,27,1:6
17Importance of sperm morphology during sperm transport and fertilization in mammals显示文摘在自然或人工的授精以后,精子从免职的地点开始一次旅行到授精的地方。然而,仅仅扔的精子的一个小子集达到他们的目标:到达并且使肥沃卵。涉及控制精子运输和授精的因素包括女繁殖的道环境,房间房间相互作用,基因表示,和 phenotypic 精子特点。一些授精的重要决定因素被知道(即,活动性或 DNA 地位) ,但是许多精子特点仍然是难懂的。一个例子在在向卵母细胞的女生殖道以内的运输之上是精子尺寸和形状的影响。在精子尺寸和活动性之间的生物物理的协会可以通过女繁殖的道影响精子的前进,但是无常有关精子形态学怎么,并且是否仅仅影响授精过程留下精子尺寸本身被包含。而且,如此的解释不允许女道能够,根据他们的形态学区分肥沃的精子的可能性似乎是有生物化学、分子、基因的性质的盒子。这评论在使肥沃的子宫和能力以内在精子运输和选择在进化和他们的通常认为的角色集中于精子尺寸和形状的影响卵母细胞。Francisco A Garcia-Vazquez Joaquin Gadea Carmen Matas William V Holt 2016Asian Journal of Andrology2016,18,6:6
18CIMMYT小麦puroindoline基因型的进一步鉴定与分析显示文摘目的籽粒硬度是小麦市场分级和定价的重要依据,影响磨粉和食品加工品质。CIMMYT是我国最重要小麦引种地之一,研究其硬度基因型对我国小麦引种具有重要的应用价值。方法以CIMMYT常用的236份小麦亲本和高代品系为材料,采用改进的颗粒指数法、特异引物的PCR扩增和改进的SDS-PAGE凝胶电泳对其SKCS硬度及其puroindoine基因型进行鉴定和分析。结果202份硬质麦中,165份为PINA蛋白缺失类型;37份为Pinb-D1b类型,其中19份为非CIMMYT材料,18份亲本中均含有非CIMMYT材料。在34份软质麦中,有野生型、Pina-D1a/Pinb-D1i、Pina-D1c/Pinb-D1h、Pina-D1j/Pinb-D1i和Pina-D1a/Pinb-D1j共5种基因型。两种硬质类型中,Pina-D1b类型胚乳硬质程度明显高于(PSI硬度显著低于)Pinb-D1b类型;4种软质类型中,Pina-D1c/Pinb-D1h和Pina-D1a/Pinb-D1i类型胚乳硬质程度显著高于(PSI硬度显著低于)Pina-D1j/Pinb-D1i和Pina-D1a/Pinb-D1a类型。通过分析各类型的puroindoline基因序列发现,Pinb-D1h和Pinb-D1i编码同一种氨基酸,突变后仍表现为软质是因为第28位精氨酸变成色氨酸,其余软质变异类型色氨酸丰富区附近均未发生变化,这可能是导致其胚乳质地仍未变硬的主要原因。结论在先前研究基础上,本试验对CIMMYT小麦基因型作了进一步分析,发现系谱中没有外源材料的所有CIMMYT硬质麦均为Pina-D1b类型。从山羊草引进的软质突变类型之间存在一定硬度差异。陈锋 夏先春 Manila William Morten Lillemo Richard Trethowan Roberto J Peňa 何中虎 2006中国农业科学2006,39,8:6
19Short and long term outcomes of 200 patients supported by continuous-flow left ventricular assist devices显示文摘AIM: To study the institutional experience over 8 years with 200 continuous-flow(CF)- left ventricular assist devices(LVAD).METHODS: We evaluated our institution's LVAD database and analyzed all patients who received a CF LVAD as a bridge to transplant(BTT) or destination therapy from March 2006 until June 2014. We identified 200 patients, of which 179 were implanted with a Heart Mate II device(Thoratec Corp., Pleasanton, CA) and 21 received a Heartware HVAD(Heart Ware Inc., Framingham, MA).RESULTS: The mean age of our LVAD recipients was 59.3 years(range 17-81), 76%(152/200) were males, and 49% were implanted for the indication of BTT. The survival rate for our LVAD patients at 30 d, 6 mo, 12 mo, 2 years, 3 years, and 4 years was 94%, 86%, 78%, 71%, 62% and 45% respectively. The mean duration of LVAD support was 581 d(range 2-2595 d). Gastrointestinal bleeding(was the most common adverse event(43/200, 21%), followed by right ventricular failure(38/200, 19%), stroke(31/200, 15%), re exploration for bleeding(31/200, 15%),ventilator dependent respiratory failure(19/200, 9%) and pneumonia(15/200, 7%). Our driveline infection rate was 7%. Pump thrombosis occurred in 6% of patients. Device exchanged was needed in 6% of patients. On multivariate analysis, preoperative liver dysfunction, ventilator dependent respiratory failure, tracheostomy and right ventricular failure requiring right ventricular assist device support were significant predictors of post LVAD survival.CONCLUSION: Short and long term survival for patients on LVAD support are excellent, although outcomes still remain inferior compared to heart transplantation. The incidence of driveline infections, pump thrombosis and pump exchange have declined significantly in recent years.Athanasios Tsiouris Gaetano Paone Hassan W Nemeh Jamil Borgi Celeste T Williams David E Lanfear Jeffrey A Morgan 2015World Journal of Cardiology2015,7,11:5
20Model combining pre-transplant tumor biomarkers and tumor size shows more utility in predicting hepatocellular carcinoma recurrence and survival than the BALAD models显示文摘AIM To assess the performance of BALAD, BALAD-2 and their component biomarkers in predicting outcome of hepatocellular carcinoma(HCC) patients after liver transplant.METHODS BALAD score and BALAD-2 class are derived from bilirubin, albumin, alpha-fetoprotein(AFP), Lens culinaris agglutinin-reactive AFP(AFP-L3), and des-gammacarboxyprothrombin(DCP). Pre-transplant AFP, AFP-L3 and DCP were measured in 113 patients transplanted for HCC from 2000 to 2008. Hazard ratios(HR) for recurrence and death were calculated. Univariate and multivariate regression analyses were conducted. C-statistics were used to compare biomarker-based to predictive models. RESULTS During a median follow-up of 12.2 years, 38 patients recurred and 87 died. The HRs for recurrence in patients with elevated AFP, AFP-L3, and DCP defined by BALAD cut-off values were 2.42(1.18-5.00), 1.86(0.98-3.52), and 2.83(1.42-5.61), respectively. For BALAD, the HRs for recurrence and death per unit increased score were 1.48(1.15-1.91) and 1.59(1.28-1.97). For BALAD-2, the HRs for recurrence and death per unit increased class were 1.45(1.06-1.98) and 1.38(1.09-1.76). For recurrence prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs. 0.64, 0.61, 0.53, and 0.53 for BALAD, BALAD-2, Milan, and UCSF, respectively. Similarly, for death prediction, the combination of three biomarkers had the highest c-statistic of 0.66 vs 0.65,0.61, 0.52, and 0.50 for BALAD, BALAD-2, Milan, and UCSF. A new model combining biomarkers with tumor size at the time of transplant(S-LAD) demonstrated the highest predictive capability with c-statistics of 0.71 and 0.69 for recurrence and death. CONCLUSION BALAD and BALAD-2 are valid in transplant HCC patients, but less predictive than the three biomarkers in combination or the three biomarkers in combination with maximal tumor diameter(S-LAD).Nicha Wongjarupong Gabriela M Negron-Ocasio Roongruedee Chaiteerakij Benyam D Addissie Essa A Mohamed Kristin C Mara William S Harmsen J Paul Theobald Brian E Peters Joseph G Balsanek Melissa M Ward Nasra H Giama Sudhakar K Venkatesh Denise M Harnois Michael R Charlton Hiroyuki Yamada Alicia Algeciras-Schimnich Melissa R Snyder Terry M Therneau Lewis R Roberts 2018World Journal of Gastroenterology2018,24,12:5
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