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Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones:Results of a retrospective,single center study between 1996-2002

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World Journal of Gastroenterology 2004年第23期10卷 3495-3499页

作者： Laszlo Lakatos Gabor Mester gyorgy Reti Attila nagy Peter Laszlo Lakatos 1~(st)Department of Medicine Csolnoky FProvince HospitalVeszpremH-8200 Hungary Department of Surgery Csolnoky FProvince HospitalVeszpremH-8200 Hungary 1~(st)Department of Medicine Semmelweis UniversityBudapestH-8200 Hungary

AIM: The optimal treatment for bile duct stones (in terms of cost, complications and accuracy) is unclear. The aim of our study was to determine the predictive factors for preoperative endoscopic retrograde cholangiopancreatography (ERCP).METHODS: Patients undergoing preoperative ERCP (≤90 d before laparoscopic cholecystectomy) were evaluated in this retrospective study from the 1^st of January 1996 to the 31^st of December 2002. The indications for ERCP were elevated serum bilirubin, elevated liver function tests (LFT), dilated bile duct (≥8 mm) and/or stone at US examination, coexisting acute pancreatitis and/or acute pancreatitis or jaundice in patient's history. Suspected prognostic factors and the combination of factors were compared to the result of ERCRRESULTS: Two hundred and six preoperative ERCPs were performed during the observed period. The rate of successful cannulation for ERC was (97.1%). Bile duct stones were detected in 81 patients (39.3%), and successfully removed in 79 (97.5%). The number of prognostic factors correlated with the presence of bile duct stones. The positive predictive value for one prognostic factor was 1.2%, for two 43%,for three 72.5%, for four or more 91.4%.CONCLUSION: Based on our data preoperative ERCP is highly recommended in patients with three or more positive factors (high risk patients). In contrast, ERCP is not indicated in patients with zero or one factor (low risk patients).Preoperative ERCP should be offered to patients with two positive factors (moderate risk patients), however the practice should also be based on the local conditions (*** of the endoscopist, other diagnostic tools).

关键词： Cholangiopancreatography, Endoscopic Retrograde Cholecystectomy, Laparoscopic Patient Selection Bile Ducts Cholelithiasis Female Humans Male Middle Aged Predictive Value of Tests Preoperative Care Retrospective Studies

难治性类风湿关节炎的临床特点:一项国际问卷调查研究

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英国医学杂志中文版 2019年第2期22卷 122-122页

作者： Nadia MT Roodenrijs Maria J H de Hair Marlies C van der Goes Johannes WG Jacobs Paco MJ Welsing Désirée van der Heijde Daniel Aletaha Maxime Dougados Kimme L Hyrich Iain B McInnes Ulf Mueller-Ladner Ladislav Senolt Zoltan Szekanecz Jacob Mvan Laar nagy gyorgy 黄艳荣(译) 张卓莉(审校) 不详北京大学第一医院风湿免疫科

目的尽管按照目前欧洲抗风湿联盟(EULAR)的推荐对类风湿关节炎(rheumatoid arthritis,RA)患者进行治疗,难治性RA患者的临床症状却仍然没有得到完全控制,目前EULAR指南主要关注的是RA的早期治疗和药物治疗。本研究的目的在于分析难治性R... 详细信息

目的尽管按照目前欧洲抗风湿联盟(EULAR)的推荐对类风湿关节炎(rheumatoid arthritis,RA)患者进行治疗,难治性RA患者的临床症状却仍然没有得到完全控制,目前EULAR指南主要关注的是RA的早期治疗和药物治疗。本研究的目的在于分析难治性RA患者的临床特点,以及在患者管理中需要探索然而现有EULAR指南并未涉及的问题。方法对多个国家的风湿科医生进行问卷调查,分析难治性RA的临床特点。问卷包括多选题以及开放性问题,从开放性问题的回答中发现需要进一步阐明的问题以及现有EULAR指南需要增加的内容。结果410名受访者完成了调查问卷,关于难治性RA的特点:50%受访者认为基于28个关节评估的疾病活动评分(disease activity score assessing 28 joints,DAS28)>3.2或存在疾病活动的征象;42%受访者认为疲劳是其特点;48%认为至少两种传统合成改变病情抗风湿药(DMARDs)以及使用至少两种生物制剂或靶向合成DMARDs治疗失败;89%认为糖皮质激素不能减量到5 mg/天或泼尼松不能减量到10 mg/天或同等剂量的其他激素。另外,现有EULAR指南中应增加合并症和关节外表现的干预以及多种药物联合治疗等重要内容。结论目前风湿科医生对难治性RA的定义有很大争议。难治性RA患者的很多重要问题目前EULAR指南中均没有涉及。

关键词：难治性类风湿关节炎临床特点问卷调查改变病情抗风湿药 DMARDs 患者管理糖皮质激素国际

Production of chitinases with Trichoderma harzianum isolates using solid substrate fermentation

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浙江大学学报（农业与生命科学版） 2004年第4期30卷 435-435页

作者： Viviana nagy gyorgy Szakacs Ashok Pandey Technical University of Budapest Department of Agricultural Chemical Technology 1111 Budapest Szent Gellert ter 4. HungaryTechnical University of Budapest Department of Agricultural Chemical Technology 1111 Budapest Szent Gellert ter 4. Hungary Regional. Research Laboratory Biotechnology Division CSIR Trivandrum-695 019 India

关键词：几丁质酶固态基质发酵木霉属真菌

Analysis of risk factors-especially different types of plexitis-for postoperative relapse in Crohn's disease

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World Journal of Gastrointestinal Surgery 2017年第7期9卷 167-173页

作者： Agnes Milassin Anita Sejben László Tiszlavicz Zita Reisz gyorgy Lázár Mónika Szucs Renáta Bor Anita Bálint Mariann Rutka Zoltán Szepes Ferenc nagy Klaudia Farkas Tamás Molnár First Department of Internal Medicine University of Szeged Department of Pathology University of Szeged Department of Surgery University of Szeged Department of Medical Physics and Informatics University of Szeged

AIM To evaluate the presence of submucosal and myenteric plexitis and its role in predicting postoperative *** Data from all patients who underwent Crohn's disease(CD)-related resection at the University of Szeged, Hungary between 2004 and 2014 were analyzed retrospectively. Demographic data, smoking habits, previous resection, treatment before and after surgery, resection margins, neural fiber hyperplasia, submucosal and myenteric plexitis were evaluated as possible predictors of postoperative recurrence. Histological samples were analyzed blinded to the postoperative outcome and the clinical history of the patient. Plexitis was evaluated based on the appearance of the most severely inflamed ganglion or nerve bundle. Patients underwent regular follow-up with colonoscopy after surgery. Postoperativerecurrence was defined on the basis of endoscopic and clinical findings, and/or the need for additional surgical resection. RESULTS One hundred and four patients were enrolled in the study. Ileocecal, colonic, and small bowel resection were performed in 73.1%, 22.1% and 4.8% of the cases, respectively. Mean disease duration at the time of surgery was 6.25 years. Twenty-six patients underwent previous CD-related surgery. Forty-three point two percent of the patients were on 5-aminosalicylate, 20% on corticosteroid, 68.3% on immunomodulant, and 4% on anti-tumor necrosis factor-alpha postoperative treatment. Postoperative recurrence occurred in 61.5% of the patients; of them 39.1% had surgical recurrence. 92.2% of the recurrences developed within the first five years after the index surgery. Mean disease duration for endoscopic relapse was 2.19 years. The severity of submucosal plexitis was a predictor of the need for second surgery(OR = 1.267, 95%CI: 1.000-1.606, P = 0.050). Female gender(OR = 2.21, 95%CI: 0.98-5.00, P = 0.056), stricturing disease behavior(OR = 3.584, 95%CI: 1.344-9.559, P = 0.011), and isolated ileal localization(OR = 2.671, 95%CI: 1.033-6.

关键词： Submucosal plexitis Postoperative recurrence Crohn’s disease Stricturing disease behavior Isolated ileal disease