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1Epidemiology, demographic characteristics and prognostic predictors of ulcerative colitis显示文摘Ulcerative colitis(UC)is a chronic disease characterized by diffuse inflammation of the mucosa of the colon and rectum.The hallmark clinical symptom of UC is bloody diarrhea.The clinical course is marked by exacerbations and remissions,which may occur spontaneously or in response to treatment changes or intercurrent illnesses.UC is most commonly diagnosed in late adolescence or early adulthood,but it can occur at any age.The incidence of UC has increased worldwide over recent decades,especially in developing nations.In contrast,during this period,therapeutic advances have improved the life expectancy of patients,and there has been a decrease in the mortality rate over time.It is important to emphasize that there is considerable variability in the phenotypic presentation of UC.Within this context,certain clinical and demographic characteristics are useful in identifying patients who tend to have more severe evolution of the disease and a poor prognosis.In this group of patients,better clinical surveillance and more intensive therapy may change the natural course of the disease.The aim of this article was to review the epidemiology and demographic characteristics of UC and the factors that may be associated with its clinical prognosis.Bruno César da Silva Andre Castro Lyra Raquel Rocha Genoile Oliveira Santana 2014World Journal of Gastroenterology2014,20,28:48
2Pediatric 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 Guimares 2011World Journal of Gastroenterology2011,17,34:25
3Feasibility and safety of autologous bone marrow mononuclear cell transplantation in patients with advanced chronic liver disease显示文摘AIM: To evaluate the safety and feasibility of bone marrow cell (BMC) transplantation in patients with chronic liver disease on the waiting list for liver transplantation. METHODS: Ten patients (eight males) with chronic liver disease were enrolled to receive infusion of autologous bone marrow-derived cells. Seven patients were classified as Child-Pugh B and three as Child-Pugh C. Baseline assessment included complete clinical and laboratory evaluation and abdominal MRI. Approximately 50 ml of bone marrow aspirate was prepared by centrifugation in a ficoll-hypaque gradient. At least of 100 millions of mononuclear-enriched BMCs were infused into the hepatic artery using the routine technique for arterial chemoembolization for liver tumors. Patients were followed up for adverse events up to 4 mo. RESULTS: The median age of the patients was 52 years (range 24-70 years). All patients were discharged 48 h after BMC infusion. Two patients complained ofmild pain at the bone marrow needle puncture site. No other complications or specific side effects related to the procedure were observed. Bilirubin levels were lower at 1 (2.19 ± 0.9) and 4 mo (2.10 ± 1.0) after cell transplantation that baseline levels (2.78 ± 1.2). Albumin levels 4 mo after BMC infusion (3.73 ± 0.5) were higher than baseline levels (3.47 ± 0.5). International normalized ratio (INR) decreased from 1.48 (SD = 0.23) to 1.43 (SD = 0.23) one month after cell transplantation. CONCLUSION: BMC infusion into hepatic artery of patients with advanced chronic liver disease is safe and feasible. In addition, a decrease in mean serum bilirubin and INR levels and an increase in albumin levels are observed. Our data warrant further studies in order to evaluate the effect of BMC transplantation in patients with advanced chronic liver disease.Andre Castro lyra Milena Botelho Pereira Soares luiz Flavio Maia da Silva Marcos Fraga Fortes André Goyanna Pinheiro Silva Augusto César de Andrade Mota Sheilla A Oliveira Eduardo lorens Braga Wilson Andrade de Carvalho Bernd Genser Ricardo Ribeiro dos Santos luiz Guilherme Costa lyra 2007World Journal of Gastroenterology2007,13,7:21
4Is autoimmune hepatitis a frequent finding among HCV patients with intense interface hepatitis?显示文摘AIM:To evaluate the overlap of autoimmune hepatitis in hepatitis C virus(HCV)-infected patients with intense interface hepatitis.METHODS:Among 1759 patients with hepatitis C submitted to liver biopsy,92(5.2%) presented intense interface hepatitis.These patients were evaluated regarding the presence of antinuclear antibody(ANA),anti-smooth muscle antibody(SMA) and anti-liver/kidney microsomal antibody(LKM-1),levels of γ-globulin and histological findings related to autoimmune hepatitis(plasma cell infiltrate and presence of rosettes).RESULTS:Among patients with hepatitis C and intense interface hepatitis there was a low prevalence of autoantibodies(ANA=12%,SMA=5%,LKM-1=0%) and the median γ-globulin level was within the normal range.Typical histological findings of autoimmune disease were observed in only two cases(2%).After applying the score for diagnosis of autoimmune hepatitis,only one patient was classified with a definitive diagnosis of autoimmune hepatitis.Since overlap with autoimmune hepatitis was not the explanation for the intense necroinflammatory activity in patients with chronic hepatitis C we sought to identify the variables associated with this finding.The presence of intense interface hepatitis was associated with more advanced age,both at the time of infection and at the time of the biopsy,and higher prevalence of blood transfusion and alcohol abuse.CONCLUSION:Although possible,overlap with autoimmune hepatitis is a very rare association in HCV-infected patients with intense interface hepatitis,an unusual presentation which seems to be related to other host variables.Rosilene G Badiani Vitória Becker Renata M Perez Carla AL Matos Lara B Lemos Valéria P Lanzoni Luis Eduardo C Andrade Alessandra Dellavance Antonio Eduardo B Silva Maria Lucia G Ferraz 2010World Journal of Gastroenterology2010,16,29:7
5Posterior partially edentulous jaws, planning a rehabilitation with dental implants显示文摘AIM: To discuss important characteristics of the useof dental implants in posterior quadrants and the rehabilitation planning. METHODS: An electronic search of English articles was conducted on MEDLINE(PubM ed) from 1990 up to the period of March 2014. The key terms were dental implants and posterior jaws, dental implants/treatment planning and posterior maxilla, and dental implants/treatment planning and posterior mandible. No exclusion criteria were used for the initial search. Clinical trials, randomized and non randomized studies, classical and comparative studies, multicenter studies, in vitro and in vivo studies, case reports, longitudinal studies and reviews of the literature were included in this review. RESULTS: One hundred and fifty-two articles met the inclusion criteria of treatment planning of dental implants in posterior jaw and were read in their entirety. The selected articles were categorized with respect to their context on space for restoration, anatomic considerations(bone quantity and density), radiographic techniques, implant selection(number, position, diameter and surface), tilted and pterygoid implants, short implants, occlusal considerations, and success rates of implants placed in the posterior region. The results derived from the review process were described under several different topic headings to give readers a clear overview of the literature. In general, it was observed that the use of dental implants in posterior region requires a careful treatment plan. It is important that the practitioner has knowledge about the theme to evaluate the treatment parameters. CONCLUSION: The use of implants to restore the posterior arch presents many challenges and requires a detailed treatment planning.Douglas R Monteiro Emily V F Silva Eduardo P Pellizzer Osvaldo Magro Filho Marcelo C Goiato 2015World Journal of Clinical Cases2015,3,1:6
6Endothelial dysfunction as a predictor of cardiovascular disease in type 1 diabetes显示文摘Macro and microvascular disease are the main cause of morbi-mortality in type 1 diabetes(T1DM).Although there is a clear association between endothelial dysfunction and atherosclerosis in type 2 diabetes,a cause-effect relationship is less clear in T1 DM.Although endothelial dysfunction(ED) precedes atherosclerosis,it is not clear weather,in recent onset T1 DM,it may progress to clinical macrovascular disease.Moreover,endothelial dysfunction may either be reversed spontaneously or in response to intensive glycemic control,long-term exercise training and use of statins.Acute,long-term and post-prandial hyperglycemia as well as duration of diabetes and microalbuminuria are all conditions associated with ED in T1 DM.The pathogenesis of endothelial dysfunction is closely related to oxidative-stress.NAD(P)H oxidase over activity induces excessive superoxide production inside the mitochondrial oxidative chain of endothelial cells,thus reducing nitric oxide bioavailability and resulting in peroxynitrite formation,a potent oxidant agent.Moreover,oxidative stress also uncouples endothelial nitric oxide synthase,which becomes dysfunctional,inducing formation of superoxide.Other important mechanisms are the activation of both the polyol and protein kinase C pathways as well as the presence of advanced glycation end-products.Future studies are needed to evaluate the potential clinical applicability of endothelial dysfunction as a marker for early vascular complications in T1 DM.Marcello C Bertoluci Gislaine V Cé Antonio MV da Silva Marco V Wainstein Winston Boff Marcia Punales 2015World Journal of Diabetes2015,6,5:5
7Relationship between Th17 immune response and cancer显示文摘Cancer is the second leading cause of death worldwide and epidemiological projections predict growing cancer mortality rates in the next decades.Cancer has a close relationship with the immune system and,although Th17 cells are known to play roles in the immune response against microorganisms and in autoimmunity,studies have emphasized their roles in cancer pathogenesis.The Th17 immune response profile is involved in several types of cancer including urogenital,respiratory,gastrointestinal,and skin cancers.This type of immune response exerts pro and antitumor functions through several mechanisms,depending on the context of each tumor,including the protumor angiogenesis and exhaustion of T cells and the antitumor recruitment of T cells and neutrophils to the tumor microenvironment.Among other factors,the paradoxical behavior of Th17 cells in this setting has been attributed to its plasticity potential,which makes possible their conversion into other types of T cells such as Th17/Treg and Th17/Th1 cells.Interleukin(IL)-17 stands out among Th17-related cytokines since it modulates pathways and interacts with other cell profiles in the tumor microenvironment,which allow Th17 cells to prevail in tumors.Moreover,the IL-17 is able to mediate pro and antitumor processes that influence the development and progression of various cancers,being associated with variable clinical outcomes.The understanding of the relationship between the Th17 immune response and cancer as well as the singularities of carcinogenic processes in each type of tumor is crucial for the identification of new therapeutic targets.Hanna Santos Marques Breno Bittencourt de Brito Filipe Antônio França da Silva Maria Luísa Cordeiro Santos Júlio César Braga de Souza Thiago Macêdo Lopes Correia Luana Weber Lopes Nayara Silva de Macêdo Neres Rafael Santos Dantas Miranda Dórea Anna Carolina Saúde Dantas Lorena Lôbo Brito Morbeck Iasmin Souza Lima Amanda Alves de Almeida Maiara Raulina de Jesus Dias Fabrício Freire de Melo 2021World Journal of Clinical Oncology2021,12,10:5
8云南咖啡锈菌小种鉴定显示文摘为明确云南咖啡锈菌小种类型,采用国际通用的19个咖啡锈菌生理小种鉴定寄主,利用人工接种鉴定的方法,对采自云南咖啡主产区12县(市)的51份咖啡锈菌进行鉴定,鉴定出9个小种,分别为VIII(v2,3,5)、XXXIII(v5,7 or v5,7,9)、XXXIV(v2,5,7 or v2,5,7,9)、XXXVII(v2,5,6,7,9)、XLI(v2,5,8)、XLII(v2,5,7,8 or v2,5,7,8,9)、New race(v2,5,6,7)、New race(v1,2,5,7 or v1,2,5,7,9)、New race(v1,5,7 or v1,5,7,9),这9个小种均为国内首次鉴定,其中小种XXXIII、XXXIV、New race(v2,5,6,7)、New race(v1,5,7 or v1,5,7,9)、New race(v1,2,5,7 or v1,2,5,7,9)、XLI和XLII均侵染Catimor7963,小种XXXVII侵染CatimorT5175。白学慧 V M P VáRZEA 郭铁英 M C SILVA 张洪波 李锦红 2018热带作物学报2018,39,9:5
9MGMT and MLH1 methylation in Helicobacter pylori-infected children and adults显示文摘AIM:To evaluate the association between Helicobacter pylori(H.pylori) infection and MLH1 and MGMT methylation and its relationship with microsatellite instability(MSI).METHODS:The methylation status of the MLH1 and MGMT promoter region was analysed by methylation specific methylation-polymerase chain reaction(MSPPCR) in gastric biopsy samples from uninfected or H.pylori-infected children(n = 50),from adults with chronic gastritis(n = 97) and from adults with gastric cancer(n = 92).MLH1 and MGMT mRNA expression were measured by real-time PCR and normalised to a constitutive gene(β actin).MSI analysis was performed by screening MSI markers at 4 loci(Bat-25,Bat-26,D17S250 and D2S123) with PCR;PCR products were analysed by single strand conformation polymorphism followed by silver staining.Statistical analyses were performed with either the χ 2 test with Yates continuity correction or Fisher's exact test,and statistical significance for expression analysis was assessed using an unpaired Student's t-test.RESULTS:Methylation was not detected in the promoter regions of MLH1 and MGMT in gastric biopsy samples from children,regardless of H.pylori infection status.The MGMT promoter was methylated in 51% of chronic gastritis adult patients and was associated with H.pylori infection(P < 0.05);this region was methylated in 66% of gastric cancer patients,and the difference in the percentage of methylated samples between these patients and those from H.pylori-infected chronic gastritis patients was statistically significant(P < 0.05).MLH1 methylation frequencies among H.pylori-infected and non-infected chronic gastritis adult patients were 13% and 7%,respectively.We observed methylation of the MLH1 promoter(39%) and increased MSI levels(68%) in samples from gastric cancer patients in comparison to samples from H.pylori-infected adult chronic gastritis patients(P < 0.001 and P < 0.01,respectively).The frequency of promoter methylation for both genes was higher in gastric cancer samples than in H.pylori-positive chronic gastritis samples(P < 0.05).The levels of MLH1 and MGMT mRNA were significantly reduced in chronic gastritis samples that were also hypermethylated(P < 0.01).CONCLUSION:In summary,MGMT and MLH1 methylation did not occur in earlier-stage H.pylori infections and thus might depend on the duration of infection.Marisa C Alvarez Juliana C Santos Nathália Maniezzo Marcelo S Ladeira Artur LC da Silva Isabel CA Scaletsky José Pedrazzoli Jr Marcelo L Ribeiro 2013World Journal of Gastroenterology2013,19,20:5
10Clinical characteristics and outcome of hepatocellular carcinoma in alcohol related and cryptogenic cirrhosis: a prospective study显示文摘BACKGROUND: Non-alcoholic fatty liver disease(NAFLD) is becoming a leading cause of chronic liver disease. Hepatocellular carcinoma(HCC) is one of its complications. Although the pathophysiology is unclear, it is reasonable to expect that cryptogenic cirrhosis related HCC(cryptogenic HCC) behaves differently to other types of HCC. This study prospectively compared patients with cryptogenic HCC and those with HCC related to alcoholic cirrhosis. METHODS: A total of 150 consecutive patients with HCC(89 cryptogenic HCC and 61 alcohol related HCC) referred to our unit over a 23-month period were studied. Their demographic data, liver function, tumor characteristics and outcomes were compared.RESULTS: Alcohol related HCC was seen only in males. Compared with cryptogenic HCC, alcohol related HCC had significantly higher aspartate aminotransferase/alanine aminotransferase(AST/ALT) ratio(1.7 vs 1.4, P=0.002), model for endstage liver disease score(13 vs 11, P=0.018) and Child's score(7 vs 6, P=0.037). No significant difference was seen in platelet counts, serum sodium and AST to platelet ratio index. Single nodular tumors were more common in cryptogenic HCC,while diffuse type tumors and macroscopic vascular invasion were common in alcohol related HCC. In patients who could not be offered any treatment because of advanced tumors or poor liver function, alcohol related HCC had a significantly lower median survival(5.3 months) compared with cryptogenic HCC(9.3 months, P=0.034).CONCLUSIONS: Compared with cryptogenic HCC, alcohol related HCC had worse liver function and aggressive tumor morphology at presentation, and a higher proportion was untreatable. In patients who could not be treated, median survival was lower in patients with alcohol related HCC than in those with cryptogenic HCC.Rohan C Siriwardana Maduni A Niriella Anuradha S Dassanayake Chandika Liyanage Bhagya Gunathilaka Subani Jayathunge Hithanadura J de Silva 2015Hepatobiliary & Pancreatic Diseases International2015,14,4:5
11癌症靶向CTLA-4:是PD-1免疫阻断疗法的理想组合?显示文摘经阻断免疫检查点增强自发而持久抗肿瘤免疫反应的免疫疗法,正在彻底改变恶性肿瘤患者的治疗及预后,其中细胞毒性T淋巴细胞抗原-4(CTLA-4)作为首个免疫检查点靶向分子,单独或与抗程序性细胞死亡蛋白-1(PD-1)抗体联合应用,使临床选择获益匪浅。早在2011年美国FDA就批准伊匹单抗(ipilimumab)作为癌症免疫检查点阻断(ICB)药物,成功治愈了部分转移性黑色素瘤。De Silva P Aiello M Gu-Trantien C 方三高(译) 魏建国(校) 2021诊断病理学杂志2021,28,9:4
12基于定量宏基因组学评估肝硬化患者肠道菌群的变化与慢加急性肝衰竭及预后的关系显示文摘【据Gastroenterology 2020年9月报道】题:基于定量宏基因组学评估肝硬化患者肠道菌群的变化与慢加急性肝衰竭及预后的关系(作者SoléC等)肝硬化与肠道菌群组成的改变有关。慢加急性肝衰竭(ACLF)是肝硬化最严重的临床阶段,但目前仍缺乏使用定量宏基因组学研究ACLF中肠道菌群改变的信息。SOLéC GUILLY S Da SILVA K 邵玥明 温晓玉 2020临床肝胆病杂志2020,36,11:4
13Potential role of Limosilactobacillus fermentum as a probiotic with anti-diabetic properties: A review显示文摘Oxidative stress,inflammation,and gut microbiota impairments have been implicated in the development and maintenance of diabetes mellitus.Strategies capable of recovering the community of commensal gut microbiota and controlling diabetes mellitus have increased in recent years.Some lactobacilli strains have an antioxidant and anti-inflammatory system capable of protecting against oxidative stress,inflammation,and diabetes mellitus.Experimental studies and some clinical trials have demonstrated that Limosilactobacillus fermentum strains can beneficially modulate the host antioxidant and anti-inflammatory system,resulting in the amelioration of glucose homeostasis in diabetic conditions.This review presents and discusses the currently available studies on the identification of Limosilactobacillus fermentum strains with anti-diabetic properties,their sources,range of dosage,and the intervention time in experiments with animals and clinical trials.This review strives to serve as a relevant and well-cataloged reference of Limosilactobacillus fermentum strains capable of inducing anti-diabetic effects and promoting health benefits.Diego Cabral Lacerda Paulo César Trindade da Costa Paula Brielle Pontes Lucas Alves Carneiro dos Santos JoséPatrocínio Ribeiro Cruz Neto Cristiane Cosmo Silva Luis Vanessa Polyana de Sousa Brito JoséLuiz de Brito Alves 2022World Journal of Diabetes2022,13,9:3
14Sex-specific effects of Eugenia punicifolia extract on gastric ulcer healing in rats显示文摘AIM To evaluate the sex-specific effects of a hydroalcoholic extract from Eugenia punicifolia(HEEP) leaves on gastric ulcer healing.METHODS In this rat study involving males, intact(cycling) females, and ovariectomized females, gastric ulcers were induced using acetic acid. A vehicle, lansoprazole, or HEEP was administered for 14 d after ulcer induction. Body weight was monitored throughout the treatment period. At the end of treatment, the rats were euthanized and the following in vivo and in vitro investigations were performed: macroscopic examination of the lesion area and organ weights, biochemical analysis, zymography, and evaluation of protein expression levels. Additionally, the concentration-dependent effect of HEEP was evaluated in terms of subacute toxicity and cytotoxicity.RESULTS Compared to the vehicle, HEEP demonstrated a great healing capacity by substantially reducing the ulcerative lesion area in males(52.44%), intact females(85.22%), and ovariectomized females(65.47%), confirming that HEEP accelerates the healing of acetic acidinduced gastric lesions and suggesting that this effect is modulated by female sex hormones. The antiulcer effect of HEEP was mediated by prostaglandin E2 only in male rats. Overall, the beneficial effect of HEEP was the highest in intact females. Notably, HEEP promoted the expression of vascular endothelial growth factor(intact vs ovariectomized females) and decreased the expression of Caspase-8 and Bcl-2(intact female vs male or ovariectomized female). Additionally, HEEP enhanced fibroblast proliferation and migration into a wounded area in vitro, confirming its healing effect. Finally, no sign of subacute toxicity or cytotoxicity of HEEP was observed.CONCLUSION In gastric ulcers, HEEP-induced healing(modulated by female sex hormones; in males, mediated by prostaglandin) involves extracellular matrix remodeling, with gastric mucosa cell proliferation and migration.Larissa Lucena Périco Vinícius Peixoto Rodrigues Rie Ohara Gabriela Bueno Vania Vasti Alfieri Nunes Raquel Cássia dos Santos Ana Carolina Lima Camargo Luis Antuio Justulin Joior Sérgio Faloni de Andrade Viviane Miranda Bispo Steimbach Luísa Mota da Silva Lúcia Regina Machado da Rocha Wagner Vilegas Catarina dos Santos Clélia Akiko Hiruma-Lima 2018World Journal of Gastroenterology2018,24,38:3
15Acute fatty liver of pregnancy associated with severe acute pancreatitis:A case report显示文摘Acute fatty liver of pregnancy is a rare disease that affects women in the third trimester of pregnancy. Although infrequent, the disease can cause maternal mortality. The diagnosis is not always clear until the pregnancy is terminated, and significant complications, such as acute pancreatitis, can occur. Pancreatic involvement typically only occurs in severe cases after the development of hepatic and renal impairment. To date, little knowledge is available regarding how the disease causes pancreatitis. Treatment involves supportive measures and pregnancy interruption. In this report, we describe a case of a previously healthy 26-year-old woman at a gestational age of 27 wk and 6 d who was admitted with severe abdominal pain and vomiting. This case illustrates the clinical and laboratory overlap between acute fatty liver of pregnancy and pancreatitis, highlighting the difficulties in differentiating each disease. Furthermore, the hypothesis for this overlapping is presented, and the therapeutic options are discussed.Cássio Vieira de Oliveira Alecsro Moreira Julio P Baima Leticia de C Franzoni Talles B Lima Fabio da S Yamashiro Kunie Yabuki Rabelo Coelho Ligia Y Sassaki Carlos Antonio Caramori Ferno G Romeiro Giovanni F Silva 2014World Journal of Hepatology2014,6,7:3
16Diagnostic value of drain amylase for detecting intrathoracic leakage after esophagectomy显示文摘AIM:To investigate the value of elevated drain amylase concentrations for detecting anastomotic leakage(AL) after minimally invasive Ivor-Lewis esophagectomy(MIILE).METHODS:This was a retrospective analysis of prospectively collected data in two hospitals in the Netherlands. Consecutive patients undergoing MI-ILE were included. A Jackson-Pratt drain next to the dorsal side of the anastomosis and bilateral chest drains were placed at the end of the thoracoscopic procedure. Amylase levels in drain fluid were determined in all patients during at least the first four postoperative days. Contrast computed tomography scans and/or endoscopic imaging were performed in cases of a clinically suspected AL. Anastomotic leakage was defined as any sign of leakage of the esophago-gastric anastomosis on endoscopy,re-operation,radiographic investigations,post mortal examination or when gastro-intestinal contents were found in drain fluid. Receiver operator characteristic curves were used to determine the cut-off values. Sensitivity,specificity,positive predictive value,negative predictive value,risk ratio and overall test accuracy were calculated for elevated drain amylase concentrations.RESULTS:A t o t a l o f 8 9 p a t ie n t s w e re in c lu d e d between March 2013 and August 2014. No differences in group characteristics were observed between patients with and without AL,except for age. Patients with AL were older than were patients without AL(P = 0.01). One patient(1.1%) without AL died within 30 d after surgery due to pneumonia and acute respiratory distress syndrome. Anastomotic leakage that required any intervention occurred in 15 patients(16.9%). Patients with proven anastomotic leakage had higher drain amylase levels than patients without anastomotic leakage [median 384 IU/L(IQR 34-6263) vs median 37 IU/L(IQR 26-66),P = 0.003]. Optimal cut-off values on postoperative days 1,2,and 3 were 350 IU/L,200 IU/L and 160 IU/L,respectively. An elevated amylase level was found in 9 of the 15 patients with AL. Five of these 9 patients had early elevations of their amylase levels,with a median of 2 d(IQR 2-5) before signs and symptoms occurred.CONCLUSION:Measurement of drain amylase levels is an inexpensive and easy tool that may be used to screen for anastomotic leakage soon after MI-ILE. However,clinical validation of this marker is necessary.Gijs HK Berkelmans Ewout A Kouwenhoven Boudewijn JJ Smeets Teus J Weijs Luis C Silva Corten Marc J van Det Grard AP Nieuwenhuijzen Misha DP Luyer 2015World Journal of Gastroenterology2015,21,30:3
17Acute pancreatitis complicated with splenic rupture: A case report显示文摘Atraumatic splenic rupture is an uncommon complication of acute pancreatitis. This report describes the case of a 30-year-old man with acute pancreatitis and splenic vein thrombosis complicated by splenic rupture. The patient was admitted to the emergency department with pain in the upper abdomen that had been present for six hours and was associated with vomiting and sweating. He was diagnosed with acute pancreatitis of alcoholic etiology. Upon computed tomography(CT) of the abdomen, the pancreatitis was scored as Balthazar C grade, and a suspicious area of necrosis affecting 30% of the pancreas with splenic vein thrombosis was revealed. Seventytwo hours after admission, the patient had significant improvement in symptoms. However, he showed clinical worsening on the sixth day of hospitalization, with increasing abdominal distension and reduced hemoglobin levels. A CT angiography showed a large amount of free fluid in the abdominal cavity, along with a large splenic hematoma and contrast extravasation along the spleen artery. The patient subsequently underwent laparotomy, which showed hemoperitoneum due to rupture of the splenic parenchyma. A splenectomy was then performed, followed by ultrasound-guided percutaneous drainage.Bruno L Hernani Pedro C Silva Ricardo T Nishio Henrique C Mateus José C Assef Tercio De Campos 2015World Journal of Gastrointestinal Surgery2015,7,9:2
18A multi-agent data mining system for cartel detection in Brazilian government procurement显示文摘Célia Ghedini Ralha Carlos Vinícius Sarmento Silva 2012Expert Systems With Applications2012,,14:2
19Trabecular Bone Score: A Noninvasive Analytical Method Based Upon the DXA Image显示文摘Barbara C Silva William D Leslie Heinrich Resch Olivier Lamy Olga Lesnyak Neil Binkley Eugene V McCloskey John A Kanis John P Bilezikian 2014J Bone Miner Res2014,,3:2
20Hydrotherapy Versus Conventional Land-Based Exercise for the Management of Patients With Osteoarthritis of the Knee: A Randomized Clinical Trial显示文摘Silva Luciana E Valim Valeria Pessanha Ana Paula C Oliveira Leda M Myamoto Samira Jones Anamaria Natour Jamil 2008Physical Therapy2008,,1:2
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