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Long-term outcomes after stenting as a"bridge to surgery"for the management of acute obstruction secondary tocolorectal cancer

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World Journal of Gastrointestinal Oncology 2016年第1期8卷 105-112页

作者： javier suárez javier jimenez-pérez department of general surgery coloproctology unitcomplejo hospitalario de navarra31008 PamplonaSpain department of gastroenterology endoscopy unithospital de la ribera46600 AlziraSpain

Obstructive symptoms are present in 8% of cases at the time of initial diagnosis in cases of colorectal cancer. Emergency surgery has been classically considered the treatment of choice in these patients. However, in the majority of studies, emergency colorectal surgery is burdened with higher morbidity and mortality rates than elective surgery, and many patients require temporal colostomy which deteriorates their quality of life and becomes permanent in 10%-40% of cases. The aim of stenting by-pass to surgery is to transform emergency surgery into elective surgery in order to improve surgical results, obtain an accurate tumoral staging and detection of synchronous lesions, stabilization of comorbidities and performance of laparoscopic surgery. Immediate results were more favourable in patients who were stented concerning primary anastomosis, permanent stoma, wound infection and overall morbidity, having the higher surgical risk patients the greater benefit. However, some findings laid out the possible implication of stenting in long-term results of oncologic treatment. Perforation after stenting is related to tumoral recurrence. In studies with perforation rates above 8%, higher recurrences rates in young patients and lower disease free survival have been shown. On the other hand, after stenting the number of removed lymph nodes in the surgical specimen is larger, patients can receive adjuvant chemotherapy earlier and in a greater percentage and the number of patients who can be surgically treated with laparoscopic surgery is larger. Finally, there are no consistent studies able to demonstrate that one strategy is superior to the other in terms of oncologic benefits. At present, it would seem wise to assume a higher initial complication rate in young patients without relevant comorbidities and to accept the risk of local recurrence in old patients(> 70 years) or with high surgical risk(ASA Ⅲ/Ⅳ).

关键词： Self-expanding metallic stent Colorectalcancer Obstructive colorectal cancer Colorectal cancerchemotherapy Colorectal cancer surgery

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Continuous Gas Outflow Is More Effective Than Carbon Filters to Evacuate Smoke in Laparoscopic Colorectal Resections: A Comparative Study

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surgical Science 2017年第2期8卷 86-93页

作者： Enrique M. Balén javier suárez Begoñ a Oronoz José M. Lera Dept of surgery Complejo Hospitalario de Navarra Pamplona Spain

Background: Carbon filters and expensive evacuation machines are available to evacuate surgical smoke in long-lasting laparoscopic operations and achieve good visibility and patient’s safety. Methods: This study was aimed to determine which of two methods for laparoscopic smoke evacuation is most effective getting the best visibility. 20 patients submitted to elective laparoscopic colorectal resections were allocated to be operated using, either a carbon filter (Group A) or a home-made tubing with a continuous suction (Group B) connected through one of the ports to the hospital vacuum system: both methods were regulated with a roller clamp to increase smoke evacuation in order to obtain good visibility. A mono-polar hook and the LigasureV 5-mm vessel-sealing device were used. Groups were comparable for demographic characteristics, surgical techniques, and malignancy. Mann-Whitney and Fisher’s exact test were used for statistics. Results: Morbidity was 10%. There was no mortality, and there was no difference between Group A and B according to complications (p = 1.00), hospital stay (p = 0.23), duration of the operation (p = 0.79) and total consumption of CO2 (p = 0.36). However, the number of times that the clamp had to be released (Group A: 3.4 + 1 vs Group B: 1.5 + 1) (p = 0.006) and that a port had to be opened freely to quickly evacuate dense smoke (Group A: 0.9 + 0.7 vs Group B: 0) (p = 0.002) was very significantly increased in Group A as compared to Group B. Mean follow-up was 60 months and no port site metastases that could be a consequence of “chimney effect” or wound recurrence have been detected. Conclusions: The surgeon’s subjective impression that carbon filters are less effective for smoke evacuation than continuous outflow of gas through a port connected to the hospital vacuum source was confirmed. This simple method is advised for long-lasting laparoscopic procedures to improve visibility throughout the procedure.

关键词： Advanced Laparoscopy surgical Smoke Evacuation Visibility Advanced Laparoscopy Visibility

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Astrocytes, reactive astrogliosis, and glial scar formation in traumatic brain injury

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Neural Regeneration Research 2025年第4期20卷 973-989页

作者： María Belén Cieri Alberto javier Ramos Laboratorio de Neuropatología Molecular IBCN UBA-CONICETFacultad de MedicinaUniversidad de Buenos AiresBuenos AiresArgentina

Traumatic brain injury is a global health crisis,causing significant death and disability *** that follows traumatic brain injury has serious consequences for neuronal survival and cognitive impairments,with astrocytes involved in this *** traumatic brain injury,astrocytes rapidly become reactive,and astrogliosis propagates from the injury core to distant brain *** astroglial proteins are downregulated near the traumatic brain injury core,while pro-inflammatory astroglial genes are *** altered gene expression is considered a pathological remodeling of astrocytes that produces serious consequences for neuronal survival and cognitive *** addition,glial scar formed by reactive astrocytes is initially necessary to limit immune cell infiltration,but in the long term impedes axonal reconnection and functional *** therapeutic strategies for traumatic brain injury are focused on preventing acute ***,cannabinoids,progesterone,beta-blockers,and cerebrolysin demonstrate neuroprotective benefits but most of them have not been studied in the context of *** this review,we discuss the cell signaling pathways activated in reactive astrocytes following traumatic brain injury and we discuss some of the potential new strategies aimed to modulate astroglial responses in traumatic brain injury,especially using cell-targeted strategies with miRNAs or lncRNA,viral vectors,and repurposed drugs.

关键词： astrocyte glial scar innate immunity neuroinflammation stab injury Toll-like receptors

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Differential response of injured and healthy retinas to syngeneic and allogeneic transplantation of a clonal cell line of immortalized olfactory ensheathing glia:a double-edged sword

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Neural Regeneration Research 2025年第8期20卷 2395-2407页

作者： María Norte-Muñoz María Portela-Lomba Paloma Sobrado-Calvo Diana Simón Johnny Di Pierdomenico Alejandro Gallego-Ortega Mar Pérez JoséMCabrera-Maqueda javier Sierra Manuel Vidal-Sanz María Teresa Moreno-Flores Marta Agudo-Barriuso Grupo de Investigación Oftalmología Experimental Departamento de OftalmologíaOptometríaOtorrinolaringología y Anatomía PatológicaFacultad de MedicinaUniversidad de MurciaInstituto Murciano de Investigación Biosanitaria(IMIB)Campus de Ciencias de la SaludMurciaSpain Experimental Sciences Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain Anatomy Histology and Neuroscience DepartmentMedicine FacultyUniversidad Autónoma de MadridMadridSpain Center of Neuroimmunology Service of NeurologyLaboratory of Advanced Imaging in Neuroimmunological DiseasesHospital Clínic of BarcelonaInstitut d’Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS)and Universitat de BarcelonaBarcelonaSpain Medicine Faculty Universidad Francisco de VitoriaPozuelo de AlarcónMadridSpain

Olfactory ensheathing glia promote axonal regeneration in the mammalian central nervous system,including retinal ganglion cell axonal growth through the injured optic ***,it is unknown whether olfactory ensheathing glia also have neuroprotective *** ensheathing glia express brain-derived neurotrophic factor,one of the best neuroprotectants for axotomized retinal ganglion ***,we aimed to investigate the neuroprotective capacity of olfactory ensheating glia after optic nerve *** ensheathing glia cells from an established rat immortalized clonal cell line,TEG3,were intravitreally injected in intact and axotomized retinas in syngeneic and allogeneic mode with or without microglial inhibition or immunosuppressive *** and gene expression analyses were *** bulb-derived primary olfactory ensheathing glia and TEG3 express major histocompatibility complex classⅡ*** and syngenically transplanted TEG3 cells survived in the vitreous for up to 21 days,forming an *** axotomized retinas,only the allogeneic TEG3 transplant rescued retinal ganglion cells at 7 days but not at 21 *** these retinas,microglial anatomical activation was higher than after optic nerve crush *** intact retinas,both transplants activated microglial cells and caused retinal ganglion cell death at 21 days,a loss that was higher after allotransplantation,triggered by pyroptosis and partially rescued by microglial inhibition or ***,neuroprotection of axotomized retinal ganglion cells did not improve with these *** different neuroprotective properties,different toxic effects,and different responses to microglial inhibitory treatments of olfactory ensheathing glia in the retina depending on the type of transplant highlight the importance of thorough preclinical studies to explore these variables.

关键词： cell therapy immune recognition major histocompatibility complex class II(MHCII) neuroprotection olfactory ensheathing glia retinal ganglion cells

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Beyond neurodegeneration:engineering amyloids for biocatalysis

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Neural Regeneration Research 2025年第10期20卷 2915-2916页

作者： Andrea Bartolomé-Nafría javier García-Pardo Salvador Ventura Institut de Biotecnologia i de Biomedicina(IBB)and Departament de Bioquímica i Biologia Molecular Universitat Autònoma de BarcelonaBellaterraBarcelonaSpain Hospital Universitari Parc Taulí Institut d’Investigaciói InnovacióParc Taulí(I3PT-CERCA)Universitat Autònoma de BarcelonaSabadellSpain

Amyloid fibrils are highly organized protein or peptide aggregates,often characterized by a distinctive supramolecular cross-β-sheet *** formation and accumulation of these structures have been traditionally associated with neural or systemic human diseases,such as Alzheimer’s disease,Parkinson’s disease,type-2 diabetes,or amyotrophic lateral sclerosis(Wei et al.,2017;Wittung-Stafshede,2023).

关键词： structure amyloid

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Hepatobiliary manifestations in inflammatory bowel disease: The gut,the drugs and the liver

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World Journal of Gastroenterology 2013年第42期19卷 7327-7340页

作者： María Rojas-Feria Manuel Castro Emilio suárez javier Ampuero Manuel Romero-Gómez Unit for Medical and surgical Management of Digestive Diseases and CIBERehd Valme University HospitalUniversity of SevilleE-41014 SevillaSpain

Abnormal liver biochemical tests are present in up to30%of patients with inflammatory bowel disease(IBD),and therefore become a diagnostic *** and biliary tract diseases are common extraintestinal manifestations for both Crohn’s disease and ulcerative colitis(UC),and typically do not correlate with intestinal *** sclerosing cholangitis(PSC)is the most common hepatobiliary manifestation of IBD,and is more prevalent in *** 5%of patients with UC develop PSC,with the prevalence reaching up to 90%.Cholangiocarcinoma and colon cancer risks are increased in these *** common disorders include autoimmune hepatitis/PSC overlap syndrome,IgG4-associated cholangiopathy,primary biliary cirrhosis,hepatic amyloidosis,granulomatous hepatitis,cholelithiasis,portal vein thrombosis,liver abscess,and non-alcoholic fatty liver *** B reactivation during immunosuppressive therapy is a major concern,with screening and vaccination being recommended in serologically negative cases for patients with *** prophylaxis with entecavir or tenofovir for 6to 12 mo after the end of immunosuppressive therapy is mandatory in patients showing as hepatitis B surface antigen(HBsAg)positive,independently from viral *** negative and anti-HBc positive patients,with or without anti-HBs,should be closely monitored,measuring alanine aminotransferase and hepatitis B virus DNA within 12 mo after the end of therapy,and should be treated if the viral load *** the other hand,immunosuppressive therapy does not seem to promote reactivation of hepatitis C,and hepatitis C antiviral treatment does not influence IBD natural history *** of the drugs used for IBD treatment may induce hepatotoxicity,although the incidence of serious adverse events is *** in liver biochemical tests associated with aminosalicylates are uncommon and are usually not clinically *** hepatotoxicity has been describ

关键词： Inflammatory bowel disease Hepatobiliary disorders Extraintestinal manifestations Primary sclerosing cholangitis Drug-induced liver injury Hepatotoxicity Hepatitis B Hepatitis C

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Anthropomorphism Indexes of the Kinematic Chain for Artificial Hands

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Journal of Bionic Engineering 2020年第3期17卷 501-511页

作者： Immaculada Llop-Harillo Antonio Pérez-González javier Andrés-Esperanza Grupo de Biomecdnicay Ergonomia Departamento de Ingenieria Mecdnicay Construccidny Universitat Jaume I(UJI)Castelldn 12071Spain

Anthropomorphic hands have received increasing research interest in the fields of robotics and *** it is not yet clear how to evaluate their *** in the kinematic chain is essential to achieve both functionality and cosmesis.A few previous works have addressed the definition of anthropomorphism indexes,although they have some limitations in its *** this study,three different anthropomorphism indexes have been defined to compare the kinematic chain of artificial hands with that of the human *** indexes are based on the comparison of:(I)the parameters of the kinematic chain(dimensions,type of joints,orientations and ranges of motion),(2)the reachable workspace,and(3)common grasping *** artificial hands with different degrees of anthropomorphism have been compared using the three Anthropomorphism Indexes of the Kinematic Chain(AIKC).The results show a high correlation between the first and third AIKC for the hands *** second AIKC presents much lower values than the other two,although they are higher for hands that combine abduction/adduction and flexion/extension movements in the kinematic chain of each *** indexes can be useful during the initial stage of designing artificial hands or evaluating their anthropomorphism.

关键词： anthropomorphism grasping indexes kinematics multifingered hands

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Role of microRNAs in alcohol-induced liver disorders and non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2018年第36期24卷 4104-4118页

作者： Jorge-Luis Torres Ignacio Novo-Veleiro Laura Manzanedo Lucía Alvela-suárez Ronald Macías Francisco-javier Laso Miguel Marcos Department of Internal Medicine University Hospital of SalamancaInstitute of Biomedical Research of Salamanca-IBSAL Spanish Working Group on Alcohol and Alcoholism Spanish Society of Internal Medicine Department of Internal Medicine University Hospital of Santiago de Compostela Department of Internal Medicine HM Rosaleda HospitalSantiago de Compostela Department of Medicine Faculty of MedicineUniversity of Salamanca

MicroRNAs(miRNAs) are small non-coding RNAs that regulate multiple physiological and pathological functions through the modulation of gene expression at the post-transcriptional level. Accumulating evidence has established a role for miRNAs in the development and pathogenesis of liver disease. Specifically, a large number of studies have assessed the role of miRNAsin alcoholic liver disease(ALD) and non-alcoholic fatty liver disease(NAFLD), two diseases that share common underlying mechanisms and pathological characteristics. The purpose of the current review is to summarize and update the body of literature investigating the role of miRNAs in liver disease. In addition, the potential use of miRNAs as biomarkers and/or therapeutic targets is discussed. Among all miRNAs analyzed, miR-34 a, miR-122 and miR-155 are most involved in the pathogenesis of NAFLD. Of note, these three miRNAs have also been implicated in ALD, reinforcing a common disease mechanism between these two entities and the pleiotropic effects of specific miRNAs. Currently, no single miRNA or panel of miRNAs has been identified for the detection of, or staging of ALD or NAFLD. While promising results have been shown in murine models, no therapeutic based-miRNA agents have been developed for use in humans with liver disease.

关键词： Alcohol use disorder Alcoholic liver disease Non-alcoholic fatty liver disease Steatosis Obesity miRNA Biomarkers

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Colorectal cancer screening and surveillance in patients with inflammatory bowel disease in 2021

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World Journal of Gastroenterology 2022年第5期28卷 502-516页

作者： Jose Maria Huguet Luis Ferrer-Barceló Patrícia suárez Eva Sanchez Jose David Prieto Victor Garcia javier Sempere Department of Digestive Disease General University Hospital of ValenciaValencia 46014Spain

The detection of dysplasia in patients with inflammatory bowel disease(IBD)continues to be important given the increased risk of colorectal cancer in this ***,in 2017,we performed a review and update of the recommendations for the management and follow-up of patients with IBD based on the clinical practice guidelines of various scientific *** present manuscript focuses on new aspects of the detection,follow-up,and management of dysplasia according to the latest studies and *** chromoendoscopy with targeted biopsy continues to be the technique of choice for the screening and detection of dysplasia in IBD,the associated difficulties mean that it is now being compared with other techniques(virtual chromoendoscopy),which yield similar results with less technical ***,the emergence of new endoscopy techniques that are still being researched but seem promising(e.g.,confocal laser endomicroscopy and full-spectrum endoscopy),together with the development of devices that improve endoscopic visualization(e.g.,Endocuff Vision),lead us to believe that these approaches can revolutionize the screening and follow-up of dysplasia in patients with ***,further studies are warranted to define the optimal follow-up strategy in this patient population.

关键词： Colitis surveillance Colitis screening Chromoendoscopy Colorectal cancer Inflammatory bowel disease Ulcerative colitis

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Factors associated with early virological response to peginterferon-α-2a/ribavirin in chronic hepatitis C

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World Journal of Gastroenterology 2013年第12期19卷 1943-1952页

作者： javier García-Samaniego Miriam Romero Rafael Granados Remedios Alemán Miguel Jorge Juan Dolores suárez Ramón Pérez Gregorio Castellano Carlos González-Portela Liver Unit Hospital Carlos Ⅲ Centro de Investigación Biómedica en Red de Enfermedades Hepáticas y Digestivas Department of Gastroenterology Hospital Universitario de Gran Canaria Gastroenterology Service Hospital Universitario de Canarias Department of Gastroenterology Hospital Universitario Insular de Gran Canaria Internal Medicine Service Hospital Arquitecto Marcide Gastroenterology Service Hospital Central de Asturias Gastroenterology Service Hospital 12 de Octubre Gastroenterology Service Hospital Policlínico de Vigo

AIM: To evaluate the impact of sociodemographic/clinical factors on early virological response (EVR) to pegin-terferon/ribavirin for chronic hepatitis C (CHC) in clinical practice. METHODS: We conducted a multicenter, cross-sectional, observational study in Hepatology Units of 91 Spanish hospitals. CHC patients treated with peginterferon α-2a plus ribavirin were included. EVR was defined as undetectable hepatitis C virus (HCV)-ribonucleic acid (RNA) or ≥ 2 log HCV-RNA decrease after 12 wk of treatment. A bivariate analysis of sociodemographic and clinical variables associated with EVR was carried out. Independent factors associated with an EVR were analyzed using a multiple regression analysis that included the following baseline demographic and clinical variables: age (≤ 40 years vs > 40 years), gender, race, educational level, marital status and family status, weight, alcohol and tobacco consumption, source of HCV infection, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and gamma glutamyl transpeptidase (GGT) (≤ 85 IU/mL vs > 85 IU/mL), serum ferritin, serum HCV-RNA concentration (suLTS: A total of 1014 patients were included in the study. Mean age of the patients was 44.3 ± 9.8 years, 70% were male, and 97% were Caucasian. The main sources of HCV infection were intravenous drug abuse (25%) and blood transfusion (23%). Seventyeight percent were infected with HCV genotype 1/4 (68% had genotype 1) and 22% with genotypes 2/3. The HCV-RNA level was > 400 000 IU/mL in 74% of patients. The mean ALT and AST levels were 88.4 ± 69.7 IU/mL and 73.9 ± 64.4 IU/mL, respectively, and mean GGT level was 82 ± 91.6 IU/mL. The mean ferritin level was 266 ± 284.8 μg/L. Only 6.2% of patients presented with cirrhosis. All patients received 180 mg of peginterferon α-2a. The most frequently used ribavirin doses were 1000 mg/d (41%) and 1200 mg/d (41%).

关键词： Antiviral therapy Baseline factors Early virological response Peginterferon α-2a Ribavirin

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