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World Journal of Gastrointestinal Surgery 2016年第6期8卷 444-451页

作者： Ehab El Hanafy Ayman El Nakeeb Helmy Ezzat emad Hamdy Ehab Atif Tharwat Kandil Amgad Fouad Mohamed Abdel Wahab Ahmed Monier Gastroenterology Surgical Center Mansoura University

AIM:To investigate the clinicopathological features and the significance of different prognostic factors which predict surgical overall survival in patients with gastric ***:This retrospective study includes 80 patients diagnosed and treated at gastroenterology surgical center,Mansoura University,Egypt between February 2009 to February *** factors were assessed by cox proportional hazard ***:There were 57 male and 23 *** median age was 57 years(24-83).One,3 and 5 years survival rates were 71%,69% and 46% *** median survival was 69.96 *** the follow-up period,13 patients died(16%).Hospital morbidity was reported in 10 patients(12.5%).The median number of lymph nodes removed was 22(4-41).Lymph node(LN) involvement was found in 91% of *** R0 resection,depth of wall invasion,LN involvement and the number(> 15) of retrieved LN,LN ratio and tumor differentiation predict *** multivariable analysis,tumor differentiation,curability of resection and a number of resected LN superior to 15 were found to beindependent prognostic ***:Surgery remains the cornerstone of *** differentiation,curability of resection and a number of resected LN superior to 15 were found to be independent prognostic *** LN dissection does not increase the morbidity or mortality rate but markedly improves long term survival.

关键词： Cancer stomach Prognostic factors Lymph node metastasis Recurrence after gastrectomy Lymph node ratio

Ankylosing spondylitis: A state of the art factual backbone

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World Journal of Radiology 2015年第9期7卷 236-252页

作者： Mohammad Ghasemi-rad Hosam Attaya Emal Lesha Andrea Vegh Tooraj Maleki-Miandoab emad Nosair Nariman Sepehrvand Ali Davarian Hamid Rajebi Abdolghader Pakniat Seyed Amirhossein Fazeli Afshin Mohammadi Division of Inter-ventional Radiology Massachusetts General Hospital Harvard Medical School Harvard--MIT Division of Health Sciences and Technology Mass-achusetts Institute of Technology College of Science and Mathematics University of Massachusetts Boston Department of Materials Science and Engineering Faculty of Applied Science and Engineering University of Toronto Department of Radiology Urmia University of Medical Sciences Anatomical Sciences Basic Medical Sciences Department College of Medicine Sharjah University Department of Medicine University of Alberta Ischemic Disorders Research Center Golestan University of Medical Sciences Radiology Department SUNY Upstate Medical University Department of Emergency Medicine Arak University of Medical Science Department of Medicine Zahedan University of Medical Sciences Solid Tumor Research Center Imam Khomaini Hospital University of Medical Sciences

Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.

关键词： Ankylosing spondylitis Magnetic resonance imaging

非微电极导向的立体定向苍白球切开术:手术技术和2年回顾

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中国微侵袭神经外科杂志 2000年第4期 226-226页

作者：景猛,董长珲,emad N.E ,Leslie A ,John B P ,JR.Stereotactic

Place of upper endoscopy before and after bariatric surgery: A multicenter experience with 3219 patients

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World Journal of Gastrointestinal Endoscopy 2016年第10期8卷 409-417页

作者： Mohamed E Abd Ellatif Haitham Alfalah Walid A Asker Ayman E El Nakeeb Alaa Magdy Waleed Thabet Mohamed A Ghaith emad Abdallah Rania Shahin Asharf Shoma Ibraheim E Dawoud Ashraf Abbas Asaad F Salama Maged Ali Gamal Department of Surgery Mansoura University Hospital Consultant of Bariatric Surgery King Saud Medial City (KSMS) Gastroenterology Surgical Center Mansoura University Department of Anesthesia Mansoura University Hospital Department of Clinical Pathology Benha University Hospital Department of Surgery Jahra Hospital

AIM: To study the preoperative and postoperative role of upper esophagogastroduodenoscopy(EGD) in morbidly obese patients. METHODS: This is a multicenter retrospective study by reviewing the database of patients who underwent bariatric surgery(laparoscopic sleeve gastrectomy, laparoscopic Roux en Y gastric bypass, or laparoscopic minigastric bypass) in the period between 2001 June and 2015 August(Jahra Hospital-Kuwait, Hafr Elbatin Hospital and King Saud Medical City-KSA, and Mansoura University Hospital- Egypt). Patients with age 18-65 years, body mass index(BMI) > 40, or > 35 with comorbidities after failure of many dietetic regimen and acceptable levels of surgical risk were included in the study after having an informed signed consent. We retrospectively reviewed the medical charts of all morbidly obese patients. The patients' preoperative data included clinical history including upper digestive symptoms and preoperative full workup including EGD. Only patients whose charts revealed weather they were symptomatic or not were studied. We categorized patients accordingly into two groups; with(group A) or without(group B) upper digestive symptoms. The endoscopic findings were categorized into 4 groups based on predetermined criteria. The medical record of patients who developed stricture, leak or bleeding after bariatric surgery was reviewed. Logestic regression analysis was used to identify preoperative predictors that might be associated with abnormal endoscopic findings. RESULTS: Three thousand, two hundred and nineteen patients in the study period underwent bariatric surgery(75% LSG, 10% LRYDB, and 15% MGB). Mean BMI was 43 ± 13, mean age 37 ± 9 years, 79% were female. Twenty eight percent had presented with upper digestive symptoms(group A). EGD was considered normal in 2414(75%) patients(9% group A vs 66% group B, P = 0.001). The abnormal endoscopic findings were found high in those patients with upper digestive symptoms. Abnormal findings(one or more) were fo

关键词： Morbid obesity Obesity surgery Endoscopy Complications Dilation Stenting

联合应用氯吡格雷和质子泵抑制剂对急性冠状动脉综合征患者经皮冠状动脉介入术后预后的影响

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中国医药 2017年第2期12卷 161-166页

作者：严研王晓范婧尧聂绍平 Sergio Raposeiras-Roubin emad Abu-Assi Jose Paulo Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose Ramon Gonzalez-Juanatey Stephen B. Wilton Wouter J. Kikkert Ivan Nunez-Gil Albert Ariza-Sole Dimitrios Alexopoulos Christoph Liebetrau Testuma Kawaji Claudio Moretti Zenon Huczek Toshiharu Fujii Luis Claudio Correia Masa-aki Kawashiri Sasko Kedev 首都医科大学附属北京安贞医院急诊危重症中心 000029 西班牙比戈市阿尔瓦罗康克雷诺医院心内科 36312 荷兰阿姆斯特丹大学学术医学中心心内科 1105 意大利都灵市圣乔瓦尼巴蒂斯塔医院心内科 10126 美国芝加哥市北岸大学医院心内科 60201 西班牙圣地亚哥·德·孔波斯特拉大学临床医院心内科 15706 加拿大卡尔加里市阿尔伯塔利宾心血管研究所心脏科学医学科 T2N4N1 西班牙马德里市圣卡洛斯医院心内科 28040 西班牙巴塞罗纳市贝尔维尔医院心内科 08907 希腊雅典市佩特雷大学医院心内科 26504 德国法兰克福市基尔霍夫胸腔心脏中心心内科 61231 日本京都大学医学研究生院心内科 606-8507 波兰华沙市临床医院心内科 02-091 日本东京市东海大学医学院心内科 259-1193 巴西萨尔瓦多市圣拉斐尔医院 41253-190 日本金泽大学医学研究生院心内科 920-0942 马其顿斯科普里市临床心脏病诊所心内科 1000

目的探讨联合应用氯吡格雷和质子泵抑制剂（PPI）对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入（PCI）术后预后的影响。方法回顾性分析2003年至2014年来自10个国家（加拿大，巴西，德国，波兰，荷兰，西班牙，意大利，希腊，中国... 详细信息

目的探讨联合应用氯吡格雷和质子泵抑制剂（PPI）对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入（PCI）术后预后的影响。方法回顾性分析2003年至2014年来自10个国家（加拿大，巴西，德国，波兰，荷兰，西班牙，意大利，希腊，中国，日本）15个临床中心的ACS合并PCI术后18077例患者的临床资料。研究氯吡格雷、PPI与ACS患者PCI术后预后的关系。比较患者的基本临床特征、既往病史、生化指标、药物应用，以及终点事件的发生率情况。通过Cox回归模型进行分析及倾向性评分调整其他可能影响患者的预后因素包括人口学信息（年龄、性别）和临床指标，计算PPI这一干预因素的风险比并评价其是否能够明显影响患者的预后。结果基于国际多中心Blee MACs注册登记研究分析，排除关键数据缺失过多患者2676例。根据纳入与排除标准及倾向性评分调整整理后，再排除患者6461例，最终列队患者8940例。根据患者用药不同，将患者分为氯吡格雷＋PPI组（4814例）和氯吡格雷组（4126例）。氯吡格雷＋PPI组患者女性、高血压病史、高脂血症病史、糖尿病史、外周血管疾病史、既往急性心肌梗死史、慢性肾功能不全病史、消化道溃疡病史、冠状动脉旁路移植术病史、既往出血病史、恶性肿瘤病史、不稳定型心绞痛、非sT段抬高型心肌梗死、心功能Killip分级≥2级、经皮腔内冠状动脉成形术、出院后血管紧张素转换酶抑制剂／血管紧张素Ⅱ受体拮抗剂应用比例、年龄和入院时血肌酐水平明显高于氯吡格雷组[25．4％（1225／4814）比21．0％（865／4126）、59．9％（2882／4814）比49．2％（2032／4126）、48．3％（2327／4814）比42．7％（1762／4126）、26．4％（1272／4814）比22．1％（910／4126）、8．0％（386／4814）比5．6％（231／4126）、12．3％（593／4814）比10．6％（436／4126）、2．0％（98／4814）比0．7％（30／4126）、2．3％（112／4814）比1．0％（42／4126）、3．6％（172／4814）比2．2％（92／4126）、4．5％（219／4814）比3．0％（123／4126）、8．0％（387／4814）比4．7％（193／4126）、13．4％（644／4814）比9．1％（374／4126）、29．1％（1400／4814）比15．9％（656／4126）、14．5％（699／4814）比11．2％（462／4126）、56．0％（2697／4814）比55．7％（2300／4126）、75．5％（3633／4814）比68．6％（2829／4126）、（66±12）岁比（61±13）岁、（10±6）mg／L比（9±4）mg／L]；且入院时血红蛋白水平和出院后β受体阻滞剂应用比例明显低于氯吡格雷组[（138±19）g／L比（141±16）g／L、80．6％（3880／4814）比83．1％（3428／4126）]，差异均有统计学意义（均P〈0．05）。调整前，氯吡格雷＋PPI组主要终点事件（全因死亡／再发心肌梗死／出血）发生率明显高于氯吡格雷组，差异有统计学意义（风险比为1．331，95％置信区间为1．161-1．524）。调整后，氯吡格雷＋PPI组主要终点事件（全因死亡／再发心肌梗死／出血）发生率与氯吡格雷组比较，差异无统计学意义（风险比为1．036，95％置信区间为0．903-1．189）。结论ACS患者PCI术后联合应用PPI与氯吡格雷是合理的，尤其在胃肠道出血高危患者中。

关键词：急性冠状动脉综合征氯吡格雷质子泵抑制剂预后

Renal function assessment in atrial fibrillation:Usefulness of chronic kidney disease epidemiology collaboration vs reexpressed 4 variable modification of diet in renal disease

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World Journal of Cardiology 2015年第10期7卷 685-694页

作者： Rami Riziq-Yousef Abumuaileq emad Abu-Assi Andrea López-López Sergio Raposeiras-Roubin Moisés Rodríguez-Manero Luis Martínez-Sande Francisco Javier García-Seara Xesus Alberte Fernandez-López Jose Ramón González-Juanatey Cardiology Department University Clinical Hospital of Santiago de Compostela

AIM: To compare the performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial ***: We studied 911 consecutive patients with non-valvular atrial fibrillation on vitamin-K antagonist. The performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation with respect to either a composite endpoint of major bleeding, thromboembolic events and all-cause mortality or each individual component of the composite endpoint was assessed using continuous and categorical ≥ 60, 59-30, and < 30 m L/min per 1.73 m2 estimated glomerular filtration ***: During 10 ± 3 mo, the composite endpoint occurred in 98(10.8%) patients: 30 patients developed major bleeding, 18 had thromboembolic events, and 60 died. The new equation provided lower prevalence of renal dysfunction < 60 m L/min per 1.73 m2(32.9%),compared with the re-expressed equation(34.1%). Estimated glomerular filtration rate from both equations was independent predictor of composite endpoint(HR = 0.98 and 0.97 for the re-expressed and the new equation, respectively; P < 0.0001) and all-cause mortality(HR = 0.98 for both equations, P < 0.01). Strong association with thromboembolic events was observed only when estimated glomerular filtration rate was < 30 m L/min per 1.73 m2: HR is 5.1 for the re-expressed equation, and HR = 5.0 for the new equation. No significant association with major bleeding was observed for both ***: The new equation reduced the prevalence of renal dysfunction. Both equations performed similarly in predicting major adverse outcomes.

关键词： Atrial fibrillation Anticoagulants Follow-up studies Kidney Prognosis

急性冠状动脉综合征患者经皮冠状动脉介入术后出血情况分析

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中国医药 2017年第6期12卷 801-805页

作者：严研王晓范婧尧聂绍平宋现涛 Sergio Raposeiras-Roubin emad Abu-Assi Jose Paulo Simao Henriques Fabrizio D'Ascenzo Jorge Saucedo Jose Ramon Gonza1ez-Juanatey Stephen B. Wilton Ivan Nufiez-Gil Albert Ariza-Sole Dimitrios Alexopoulos [ Christoph Liebetrau Testuma Kawaji Zenon Huczek Toshiharu Fujii Luis Claudio Correia Masa-aki Kawashiri Sasko Kedev 首都医科大学附属北京安贞医院急诊危重症中心 100029 首都医科大学附属北京安贞医院心内科 100029 西班牙比戈市阿尔瓦罗康克雷诺医院心内科 36312 荷兰阿姆斯特丹大学学术医学中心心内科 1105 意大利都灵市圣乔瓦尼巴蒂斯塔医院心内科 10126 美国芝加哥市北岸大学医院心内科 60201 西班牙圣地亚哥·德·孔波斯特拉大学临床医院心内科 15706 加拿大卡尔加里市阿尔伯塔省利宾心血管研究所心脏科学医学科 T2N4N1 西班牙马德里市圣卡洛斯医院心内科 28040 西班牙巴塞罗纳市贝尔维尔医院心内科 08907 希腊雅典市佩特雷大学医院心内科 26504 德国法兰克福市基尔霍夫胸腔心脏中心心内科 61231 日本京都大学医学研究生院心内科 606-8507 日本东京市东海大学医学院心内科 259-1193 巴西萨尔瓦多市圣拉斐尔医院心内科 41253-190 日本金泽大学医学研究生院心内科 920-0942 马其顿斯科普里市临床心脏病诊所心内科 1000

目的分析急性冠状动脉综合征（ACS）经皮冠状动脉介入（PCI）术后出血情况。方法回顾性分析2003年1月至2014年12月来自11个国家16个临床中心的18077例行PCI的ACS患者的临床资料。根据是否出现出血事件，将患者分为出血组（558例）和非... 详细信息

目的分析急性冠状动脉综合征（ACS）经皮冠状动脉介入（PCI）术后出血情况。方法回顾性分析2003年1月至2014年12月来自11个国家16个临床中心的18077例行PCI的ACS患者的临床资料。根据是否出现出血事件，将患者分为出血组（558例）和非出血组（17519例），比较2组患者的基本临床特征、手术情况及生化指标。分析ACS患者PCI术后出血相关情况。结果马其顿中心数据因关键变量缺失过多而被排除患者2676例，故最终纳入10个国家15个中心15401例ACS患者。排除缺失数据，本研究共有12910例患者收集到出血部位的数据，409例患者存在出血事件。胃肠道是最常见出血部位，占48．7％（199／409），颅内出血占7．6％（31／409）。Logistic逐步回归方法多因素分析显示，既往出血病史、高血压病史是术后1年内消化道出血的危险因素。排除马其顿中心数据（2676例）与Cox回归模型和倾向性评分调整再排除5972例，剩余9429例作分层分析。根据是否联用质子泵抑制剂（PPI），将出院应用氯吡格雷生存患者8942例分为氯吡格雷联合应用PPI组（4814例）和氯吡格雷未联合应用PPI组（4126例）；将出院应用替格瑞洛生存患者489例分为替格瑞洛联合应用PPI组（351例）和替格瑞洛未联合应用PPI组（138例）。Kaplan-Meier法分析显示氯吡格雷联合应用PPI组1年出血事件发生率明显高于氯吡格雷未联合应用PPI组，差异有统计学意义（P=0．004）；替格瑞洛联合应用PPI组1年出血事件发生率与替格瑞洛未联合应用PPI组比较，差异无统计学意义（P=0．573）。结论ACS患者PCI术后最常见的出血部位为消化道，PPI与替格瑞洛联合应用在胃肠道出血风险较高患者中适用。

关键词：急性冠状动脉综合征出血质子泵抑制剂氯吡格雷替格瑞洛