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在初始应用EUS引导一步术建立入路之后进行胰腺假性囊肿或脓肿的内镜下治疗

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世界核心医学期刊文摘（胃肠病学分册） 2006年第8期2卷 28-29页

作者： Krüger M. Schneider A. S. manns M. p. Meier p.N. 郝筱倩(译) 郑世成(校) Department of Gastroenterology Hepatology and Endocrinology Medizinische Hochschule Hannover CarI-Neuberg-Str. 1 D-30625 Hannover Germany 不详

Background: In this prospective case series, endoscopic management of pancreatic pseudocysts and Abscesses was investigated following an EUS-guided 1- step procedure for initial transmural access. Methods: Endoscopic drainage of pancreatic pseudocysts and Abscesses was performed in 35 patients (mean age, 51 years; range, 21- 81 years) by using interventional echoendoscopes (FG38UX and EG3830UT; pentax-Hitachi, Lü bbecke, Germany). Interventions were performed by using a 1- step device consisting of a needle-wire suitable for cutting current, a 5.5F dilator, and an 8.5F plastic endoprosthesis (Giovannini Needle Wire Oasis, Cook Endoscopy,Winston-Salem, NC). Results: Endoscopic stent placement was successful in 33 of 35 patients (94% ), whereas repeated needle passages were unsuccessful in 2 cases (pancreatic pseudocystwall, 7 mm). No procedure-related complications, such as bleeding, perforation, or pneumoperitoneum, were observed. All subsequent complications, such as ineffective drainage (9% ), stent occlusion (12% ), or cyst infection (12% ), were managed endoscopically. Fourteen patients (43% ) demonstrated sustained clinical improvement and cyst resolutio upon placement of the initial 8.5F transmural drain. Ten patients (30% ) did not reveal a 50% reduction in cyst size on day 3, but cyst resolution was achieved by additional endoscopic cyst irrigation. Nine patients (27% ) with primary or secondary cyst infection underwent endoscopic balloon dilation and prolonged endoscopic drainage procedures to achieve cyst resolution. The overall resolution rate was 88% , with a recurrence rate of 12% , based on a mean follow-up period of 24 months. Conclusion: This 1- step EUS-guided technique with a needle-wire device provides safe transmural access and allows subsequent effective endoscopic management of pancreatic pseudocysts and Abscesses.

关键词：超声内镜(EUS) 胰腺假性囊肿内镜下治疗脓肿入路引导内镜下气囊扩张介入操作支架放置术相关并发症

加拿大Alberta移民中结核病人抗结核药物的耐药性,1982-1994

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国际结核病与肺部疾病杂志 1997年第2期 64-68页

作者： B.J.manns E.A.Fanning R.L.Cowie 屠德华 University of Calgary Foothills HospitalCalgaryAlbertaCanada

背景:加拿大Alberta省结核病机构。目的:估计结核分支杆菌对抗结核药物的耐药率与既往治疗、出生国家、年龄和在加拿大居住时间的关系。设计:1982-1994年间Alberta移民中全部培养阳性诊断的结核病的回顾性图表评价。结果:总共753名培养... 详细信息

背景:加拿大Alberta省结核病机构。目的:估计结核分支杆菌对抗结核药物的耐药率与既往治疗、出生国家、年龄和在加拿大居住时间的关系。设计:1982-1994年间Alberta移民中全部培养阳性诊断的结核病的回顾性图表评价。结果:总共753名培养阳性移民结核病人进行了研究,131名病人(17.4％,95％可信限[CI]14.7,20.1)的菌株对一个或更多一线药物(异烟肼[INH]、利福平[RIF]、乙胺丁醇[EMB]、吡嗪酰胺[pZA]和链霉素[SM]有耐药,初始和继发耐药率分别是16.4％和30.3％,(p=0.003,优势比[OR]2.2,95％CI1.3,3.8),40岁及以下病人的耐药发生率为22.2％,40岁以上病人为13.8％(p=0.005,OR1.8,95％CI 1.2,2.6)。在加拿大生活不到15年的病人20.4％分离出耐药结核分支杆菌,在诊断前移民到加拿大已15年以上的病人是9.0％。(ppZA 1.9％(95％CI0.3,3.5)和SM12.9％(95％CI 10.4,15.4),来自越南、中国和菲律宾移民病人中含耐一个或更多一线药物的病例分别为30.2％,21.8％和15.5％(p=0.04)。结论:在诸如加拿大这样工业化国家中大多数诊断的结核病例是国外出生的,连续的药物耐药性调?

关键词：结核分支杆菌移民药物耐药性异烟肼越南

Successful treatment of cervical esophageal leakage by endoscopic-vacuum assisted closure therapy

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World Journal of Gastrointestinal Endoscopy 2013年第7期5卷 340-345页

作者： Henrike Lenzen Ahmed A Negm Thomas J Erichsen mich.el p manns Jochen Wedemeyer Tim O Lankisch Department of Gastroenterology Hepatology and Endocrinology Hannover Medical School30625 Hannover Germany Department of Internal Medicine Robert Koch Hospital Gehrden30989 Gehrden Germany

AIM: To evaluate the efficacy and safety of endoscopic-vacuum assisted closure (E-VAC) therapy in the treatment of cervical esophageal leakage. METHODS: Between May and November 2012, three male patients who developed post-operative cervical esophageal leakage were treated with E-VAC therapy. One patient had undergone surgical excision of a pharyngo-cervical liposarcoma with partial esophageal resection, and the other two patients had received surgical treatment for symptomatic Zenker's diverticulum. Following endoscopic verification of the leakage, a trimmed polyurethane sponge was fixed to the distal end of a nasogastric silicone tube and endoscopically positioned into the wound cavity, and with decreasing cavity size the sponge was positioned intraluminally to cover the leak. Continuous suction was applied, and the vacuum drainage system was changed twice a ***: The initial E-VAC placement was technically successful for all three patients, and complete closure of the esophageal leak was achieved without any procedure-related complications. In all three patients, the insufficiencies were located either above or slightly below the upper esophageal sphincter. The median duration of the E-VAC drainage was 29 d (range: 19-49 d), with a median of seven sponge exchanges (range: 5-12 sponge exchanges). In addition, the E-VAC therapy reduced inflammatory markers to within normal range for all three patients. Two of the patients were immediately fitted with a percutaneous enteral gastric feeding tube with jejunal extension, and the third patient received parenteral feeding. All three patients showed normal swallow function and no evidence of stricture after completion of the E-VAC therapy. CONCLUSION: E-VAC therapy for cervical esophageal leakage was well tolerated by patients. This safe and effective procedure may significantly reduce morbidity and mortality following cervical esophageal leakage.

关键词： Endoscopic-vacuum assisted closure therapy Vacuum therapy Negative pressure wound therapy Cervical esophageal leakage Anastomotic leakage

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丙型肝炎治疗进展

肝脏 2008年第1期13卷 56-56页

作者： mich.el p. manns 钱燕（译） Medical School of Hannover Germany 不详

急性丙型肝炎未经治疗发展为慢性者的概率高达80％，如及时诊断早期治疗则可防止慢性化，且90％以上患者可治愈。急性丙型肝炎病毒（HCV）感染采用普通干扰素或聚乙二醇化干扰素（pEG-IFN）单药治疗达24周，如12周后患者HCVRNA仍为阳性... 详细信息

急性丙型肝炎未经治疗发展为慢性者的概率高达80％，如及时诊断早期治疗则可防止慢性化，且90％以上患者可治愈。急性丙型肝炎病毒（HCV）感染采用普通干扰素或聚乙二醇化干扰素（pEG-IFN）单药治疗达24周，如12周后患者HCVRNA仍为阳性，则开始采用pEG-IFN联合利巴韦林治疗24周。目前，德国Network of Competence Hep-Net正在全国进行多中心研究比较单药治疗与pEG-IFN联合利巴韦林治疗。

关键词：急性丙型肝炎肝炎治疗聚乙二醇化干扰素丙型肝炎病毒 HCVRNA 单药治疗利巴韦林普通干扰素

TITANIUM SApHIRE LASER TRABECULO- pLASTY IN CATS

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国际眼科杂志 2003年第1期3卷 91-91页

作者： V.Fernadez J.Stoiber p.Lamar E.Hernandez F.manns N.Salas F.Fantes J.M.parel Byophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USAByophisics Center Bascom Palmer Eye Institute University of Miami FL USA

purpose: To assess the safety of a novel Titanium Sapphire laser for trabeculoplasty in an animal model. Methods: The left eye of 6 healthy cats was treated over 180 degrees, while the right eye was used as a control. A Ti:A1203 laser (790nm, four to five 200ns pulses, 7 microseconds pulse train, 200um spot, SOLX, Boston, MA) producing energies of 8 to 84mJ was used.

关键词：猫动物模型激光小梁成形术安全性 SEM 眼内结构

对慢性丙型肝炎无应答患者每日用组合干扰素加利巴韦林治疗:一项随机、开放标记的先导研究

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世界核心医学期刊文摘（胃肠病学分册） 2006年第5期2卷 52-52页

作者： Cornberg M. Hadem J. Herrmann E. M.p. manns 刘丽娜 Department of Gastroenterology Hepatology and Endocrinology Medizinische Hochschule Hannover Carl- Neuberg-Str. 1 D-30625 Hannover Germany

Background/Aims: Therapeutic options for hepatitis C nonresponder patients are limited. Methods: We initiated an open-label pilot study to investigate the efficacy of CIFN plus ribavirin on viral kinetics, sustained virological response (SVR), and histological response in hepatitis C non-responder patients. Seventy-seven patients were enrolled to receive CIFN given daily in combination with 1000/1200 mg ribavirin. An 8 week induction-dosing regimen of 18 μ g CIFN, followed by 9 μ g for 40 weeks was compared to 9 μ g CIFN for 48 weeks. 90% of patients were infected with HCV-genotype 1. Results: Overall, 82% of the patients demonstrated an early virological response, 65% had an end-of-treatment response, and the SVR was 30% . Interferon/ribavirin non-responders demonstrated a SVR of 22% . Induction-dosing resulted in a greater first-phase HCV-RNA decay that, however, did not translate to better SVRs, presumably due to more dose modifications. High ALT, younger age, and second-phase viral kinetics were associated with SVR. Only sustained responders and relapse patients showed an improved liver histology. Conclusions: Daily dosing of CIFN plus ribavirin may be a promising concept for selected non-responder patients before considering therapies which are anti-viral but not curative. However,motivation and compliance are requisites and a CIFN induction is not required.

关键词：慢性丙型肝炎组合干扰素利巴韦林无应答患者治疗持续病毒学应答病毒动力学随机丙型肝炎病毒

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原发性硬化性胆管炎的现代治疗

德国医学 1999年第4期16卷 228-228页

作者： S.Wagner p.N.Meier H.Maschek B.Nashan M.p.manns 张林 Abteilung Gastroenterologie und Hepatologie Medizinische HochschuleCarl-Neuberg-Str.1D-30623 HannoverGermany 同济医科大学附属同济医院

原发性硬化性胆管炎(pSC)是一种不明病因的慢性炎症性肝病,可以导致肝内、外胆管中、大胆管损伤。ERCp在确诊pSC中有重要作用。一般治疗措施针对胆汁淤滞的症状治疗是十分重要的。必须给予脂溶性维生素(A,D,E,K)。脂肪泻可以导致营养... 详细信息

原发性硬化性胆管炎(pSC)是一种不明病因的慢性炎症性肝病,可以导致肝内、外胆管中、大胆管损伤。ERCp在确诊pSC中有重要作用。一般治疗措施针对胆汁淤滞的症状治疗是十分重要的。必须给予脂溶性维生素(A,D,E,K)。脂肪泻可以导致营养不良和中链脂肪酸丢失,建议给予胰酶治疗。瘙痒症的治疗也很重要,可给予消胆胺(4～8g,2～3次/d)。有些病人给予熊去氧胆酸(UDCA)

关键词：肝硬化并发症胆管炎治疗 pSC