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The quest for optimal and reliable guidelines based on robust evidence for the treatment of cholangiocarcinoma

Hepatobiliary Surgery and Nutrition 2021年第6期10卷 913-915页

作者： Daniel Azoulay david bomze Tomer Meirson Centre Hépato-Biliaire Assistance Publique-Hôpitaux de ParisHôpital Universitaire Paul BrousseInstitut National de la Santéet de la Recherche Médicale(INSERM)Unité935and UniversitéParis-SaclayVillejuifFrance Sackler Faculty of Medicine Tel Aviv UniversityTel AvivIsrael Ella Lemelbaum Institute for Immuno-oncology Sheba Medical CenterRamat-GanIsrael The Azrieli Faculty of Medicine Bar-Ilan UniversitySafedIsrael

In 1991,Gordon *** described the evidence-based medicine(EBM)as“a focus on educating front-line clinicians in assessing the credibility of research evidence,understanding the results of clinical studies,and determining how best to apply the results to their everyday practice”(1).In 2010,Graham et *** clinical guidelines as“statements that include recommendations intended to optimize patient care that are informed by a systematic review of the evidence and an assessment of the benefits and harms of alternative care options”(2).Since 2010,the number of clinical guidelines increased exponentially,and the query on PubMed with the term“new guidelines”produces 59,773 results.

关键词： Graham clinical treatment

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Systemic review of the robustness of randomized controlled trials for the treatment of cholangiocarcinoma in three domains: survival-inferred fragility index, restricted mean survival time, and the spin effect

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Hepatobiliary Surgery and Nutrition 2022年第6期11卷 861-869,I0016页

作者： Nir Horesh david bomze Chetana Lim Gal Markel Tomer Meirson Daniel Azoulay Unit of Hepatobiliary and Pancreatic Surgery and Transplantation Sheba Medical CenterFaculty of Medicine Tel Aviv UniversityTel AvivIsrael Sackler Faculty of Medicine Tel Aviv UniversityTel AvivIsrael Centre Hépato-Biliaire Department of Hepatobiliary and Pancreatic Surgery and TransplantationPitiéSalpetriere HospitalAssistance Publique-Hôpitaux de ParisParisFrance davidoff Cancer Center Rabin Medical Center-Beilinson HospitalPetah TikvaIsrael Shamir Medical Center(Assaf Harofeh) Rishon LezionIsrael The Azrieli Faculty of Medicine Bar-Ilan UniversitySafedIsrael Centre Hépato-Biliaire Department of Hepatobiliary and Pancreatic Surgery and TransplantationPaul Brousse HospitalAssistance Publique-Hôpitaux de ParisUniversitéSaclayVillejuifFrance

Background:The vast majority of patients with cholangiocarcinoma(CC)have advanced disease at diagnosis and are candidates for palliative treatment *** robustness of the randomized controlled trials regarding the treatment of CC are ***:A systematic review of all randomized control trials(RCT)of treatments for both intra-and extrahepatic CC between 2010 and 2020 was *** survival-inferred fragility index(SIFI;the minimum number of reassignments of the best survivors between arms that would overturn the statistical outcomes)was *** addition,the gain,or loss,in survival in RCTs was evaluated by the restricted mean survival time(RMST)***,the level of spin i.e.,misrepresentation of study outcomes,was measured in inconclusive studies to assess distorted reporting ***:Out of 6,167 studies retrieved,11 could be retained for full text revision(7 with both intra-and extrahepatic CC,3 with peri-hilar CC,and 1 with peri-hilar or distal CC).Only 3 studies included resected patients(2 with both intra-and extrahepatic CC and 1 with peri-hilar or distal CC).Nine studies investigated systemic chemotherapy(including 3 after surgical resection),one study evaluated photodynamic therapy,and another investigated the use of an endoscopically inserted stent in the biliary *** median SIFI was−2[interquartile range(IQR):−6.25,−0.25]across all ***,the median RMST difference was 0.56 months(IQR:0.10,0.95).Finally,for inconclusive studies,the level of spin was high,moderate,and low in respectively 12.5%,25%,and 62.5% of the ***:RCTs of CC showed a low degree of robustness with a frequent proportion of associated spin.

关键词： Cholangiocarcinoma(CC) randomized controlled trials robustness of evidence survival-inferred fragility index(SIFI) restricted mean survival time(RMST) spin effect

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Nat Cell Biol:研究发现人肝细胞抵抗HCV感染的代谢过程

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现代生物医学进展 2016年第35期16卷 I0001-I0002页

作者： Gahl Levy, Naomi Habib, Maria Angela Guzzardi, Daniel Kitsberg, david bomze, Elishai Ezra, Merav Cohen, Nir Friedman Yaakov Nahmias Gahl Levy, Daniel Kitsberg, david bomze, Merav Cohen, Nir Friedman Yaakov Nahmias Naomi Habib Maria Angela Guzzardi Elishai Ezra Basak E Uygun Korkut Uygun Martin Trippler Joerg F Schlaak Oren Shibolet Ella H Sklan Joerg Timm Grass Center for Bioengineering Benin School of Computer Science and Engineering The Hebrew University of Jerusalem Jerusalem Israel. Silberman Institute of Life Sciences The Hebrew University of Jerusalem Jerusalem Israel. Klarman Cell Observatory Broad Institute of Harvard and MIT Cambridge Massachusetts USA. Institute of Clinical Physiology National Research Council (CNR) Pisa Italy. Faculty of Engineering Jerusalem College of Technology Jerusalem Israel. Center for Engineering in Medicine Massachusetts General Hospital Boston Massachusetts USA. Department of Gastroenterology and Hepatology University Hospital University Duisburg-Essen Essen Germany. Liver Unit Department of Gastroenterology Tel-Aviv Medical Center and Sackler Faculty of Medicine Tel Aviv Israel. Department of Clinical Microbiology and Immunology Sackler School of Medicine Tel Aviv University Tel Aviv Israel. Institute for Virology Medical Faculty University of D&#x000FC sseldorf D&#x000FC sseldorf Germany.

病毒感染是二十一世纪面临的主要医学挑战之一，从影响全球3％人口的丙肝病毒（HCV）流行病到最近爆发的西尼罗河病毒、寨卡病毒和埃博拉病毒感染。病毒缺乏进行自我复制所需的基础代谢机制。为了解决这个问题，它们劫持它们的宿主的代... 详细信息

病毒感染是二十一世纪面临的主要医学挑战之一，从影响全球3％人口的丙肝病毒（HCV）流行病到最近爆发的西尼罗河病毒、寨卡病毒和埃博拉病毒感染。病毒缺乏进行自我复制所需的基础代谢机制。为了解决这个问题，它们劫持它们的宿主的代谢机制以便完成它们的生命周期和进行增殖。然而，科学家们仍然并没有很好地理解病毒与它们感染的有机体之间在代谢上的相互作用。这主要是因为人基因与代谢过程之间存在复杂的相互作用。

关键词：病毒感染代谢过程 Cell 人肝细胞 Nat HCV 西尼罗河病毒代谢机制

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