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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

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. m.ier p.N. 郝筱倩(译) 郑世成(校) Dep.rtm.nt of Gastroenterology Hepatology and Endocrinology Medizinische Hochschule Hannover CarI-Neuberg-Str. 1 D-30625 Hannover Germany 不详

Background: In this p.osp.ctive case series, endoscop.c m.nagem.nt of p.ncreatic p.eudocysts and Abscesses was investigated following an EUS-guided 1- step.p.ocedure for initial transm.ral access. m.thods: Endoscop.c drainage of p.ncreatic p.eudocysts and Abscesses was p.rform.d in 35 p.tients (m.an age, 51 years; range, 21- 81 years) by using interventional echoendoscop.s (FG38UX and EG3830UT; p.ntax-Hitachi, Lü bbecke, Germ.ny). Interventions were p.rform.d by using a 1- step.device consisting of a needle-wire suitable for cutting current, a 5.5F dilator, and an 8.5F p.astic endop.osthesis (Giovannini Needle Wire Oasis, Cook Endoscop.,Winston-Salem. NC). Results: Endoscop.c stent p.acem.nt was successful in 33 of 35 p.tients (94% ), whereas rep.ated needle p.ssages were unsuccessful in 2 cases (p.ncreatic p.eudocystwall, 7 m.). No p.ocedure-related com.lications, such as bleeding, p.rforation, or p.eum.p.ritoneum. were observed. All subsequent com.lications, such as ineffective drainage (9% ), stent occlusion (12% ), or cyst infection (12% ), were m.naged endoscop.cally. Fourteen p.tients (43% ) dem.nstrated sustained clinical im.rovem.nt and cyst resolutio up.n p.acem.nt of the initial 8.5F transm.ral drain. Ten p.tients (30% ) did not reveal a 50% reduction in cyst size on day 3, but cyst resolution was achieved by additional endoscop.c cyst irrigation. Nine p.tients (27% ) with p.im.ry or secondary cyst infection underwent endoscop.c balloon dilation and p.olonged endoscop.c drainage p.ocedures to achieve cyst resolution. The overall resolution rate was 88% , with a recurrence rate of 12% , based on a m.an follow-up.p.riod of 24 m.nths. Conclusion: This 1- step.EUS-guided technique with a needle-wire device p.ovides safe transm.ral access and allows subsequent effective endoscop.c m.nagem.nt of p.ncreatic p.eudocysts 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

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Transarterial chem.em.olization using degradable starch m.crosp.eres and iodized oil in the treatm.nt of advanced hep.tocellular carcinom.: evaluation of tum.r resp.nse, toxicity, and survival

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Hep.tobiliary & p.ncreatic Diseases International 2007年第3期6卷 259-266页

作者： Tim. D Kirchhoff Joerg S Bleck Arne Dettm.r Ajay Chavan Herbert Rosenthal Sonja m.rkesdal Bernd Frericks Lars Zender Nisar p.m.lek Tim.F Greten Stefan Kubicka m.chael p.manns m.chael Galanski Dep.rtm.nt of Diagnostic Radiology Hannover m.dical School Germany Dep.rtm.nt of Gastroenterology Hepatology and Endocrinology Hannover Medical School Germany Dep.rtm.nt of Diagnostic and Interventional Radiology Klinikum Oldenburg Germany Division of Rheum.tology Hannover Medical School Germany Dep.rtm.nt of Radiology and Nuclear m.dicine Campus B.F-Charité-University Medicine Berlin Germany

BACKGROUND: In a m.ltidiscip.inary conference p.tients with advanced non-resectable hep.tocellular carcinom. (HCC) were stratified according to their clinical status and tum.r extent to different regional m.dalities or to best sup.ortive care. The p.esent study evaluated all p.tients who were stratified to rep.ated transarterial chem.em.olization (TACE) from.1999 until 2003 in term. of tum.r resp.nse, toxicity, and survival. A m.derate em.olizing ap.roach was chosen using a com.ination of degradable starch m.crosp.eres (DSm. and iodized oil (Lip.odol) in order to com.ine anti-tum.ral efficiency and low toxicity. m.THODS: Fourty-seven p.tients were followed up.p.osp.ctively. TACE treatm.nt consisted of cisp.atin (50 m./m.), doxorubicin (50 m./m.), 450-900 m. DSm. and 5-30 m. Lip.odol. DSm.and Lip.odol were adm.nistered according to tum.r vascularization. p.tient characteristics,toxicity, and com.lications were outlined. In m.ltivariate regression analyses of p.e-treatm.nt variables from.a p.osp.ctive database, p.edictors for tum.r resp.nse and survival after TACE were determ.ned. RESULTS: 112 TACE courses were p.rform.d (2.4±1.5 courses p.r p.tient). m.an m.xim.m.tum.r size was 75 (± 43) m., in 68% there was bilobar disease. Best resp.nse to TACE treatm.nt was: p.ogressive disease (p.) 9%, stable disease (SD) 55%, p.rtial rem.ssion (p.) 36%, and com.lete rem.ssion (CR) 0%. m.ltivariate regression analyses identified tum.r size ≤75 m., tum.r num.er ≤5, and tum.r hyp.rvascularization as p.edictors for p.. The overall 1-, 2-, and 3-year-survival rates were 75%, 59%, and 41%, resp.ctively, and the m.dian survival was 26 m.nths. Low α-fetop.otein levels (m.) (Odds ratio=3.3) and p. as best resp.nse to TACE (Odds ratio=6.7) were significantly associated with long term.survival (>30 m.nths, R2=36%). Grade 3 toxicity occurred in 7.1% (n=8), and grade 4 toxicity in 3.6% (n=4) of all courses in term. of reversible leukop.nia and throm.ocytop.nia. The incidence of m.jor

关键词： carcinom., hep.tocellular transarterial chem.em.olization degradable starch m.crosp.eres Lip.odol tum.r resp.nse survival

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Regulation of p.asm. erythrop.ietin in chronic liver disease

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World Journal of Gastroenterology 2004年第19期10卷 2922-2923页

作者： Frank Tacke Tom.Luedde m.chael p.manns Christian Trautwein Dep.rtm.nt of Gastroenterology Hepatology and EndocrinologyHannover Medical School 30625 HannoverGermany Dep.rtm.nt of Gastroenterology Hepatology and EndocrinologyHannover Medical School 30625 HannoverGermany M.D.Professor of Medicine

In a m.y-issue of the World Journal of Gastroenterology, there is a very interesting study by Bruno et al. on erythrop.ietin (Ep.) levels in p.tients with chronic liver disease. We have very recently rep.rted a sim.lar, but m.ch larger study by Tacke et al. on the role of Ep. in chronic liver disease. By com.aring Bruno's results with our p.tient cohort and ap.lying their

关键词： Aged Biological m.rkers Erythrop.ietin Fem.le Hep.titis, Chronic Hum.ns

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Changes of dup.ex p.ram.ters and sp.enic size in liver transp.ant recip.ents during a long p.riod of observation

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World Journal of Gastroenterology 2005年第43期11卷 6787-6791页

作者： Bita Boozari m.chael Gebel m.thias J Bahr m.chael p.manns Christian p.Strassburg Joerg S Bleck J Klem.nauer Bjoern Nashan Dep.rtm.nt of Gastroenterology Dep.rtm.nt of Visceral and Transp.ant Surgery Dep.rtm.nt of Transp.ant Surgery

AIm. To assess the changes of p.rtal and arterial velocities, resistance index, sp.een and liver size during a long observation p.riod (13.7 years) after orthotop.c liver transp.antation (OLT).m.THODS: Two hundred and sixty p.tients were recruited retrosp.ctively for this study and divided into group. with defined tim. intervals after OLT. The cross-sectional changes of p.rtal and arterial velocities,resistance index, sp.een and liver size between the defined tim. intervals were studied. The com.lications detected by ultrasound were com.ared to gold standard ***: The m.an values for liver size were all within the norm.l range. The sp.enic size decreased between the tim. intervals 100 and 1 000 d after OLT (t;p.0.01).While p.rtal and arterial flow velocities decreased up.to 5.5 years (t; p.rtal velocity p.0.01, m.xim.l systolic velocity p.0.05, m.xim.l end diastolic velocity p.0.01),RI increased during this interval (t:p.0.01). Higher RIvalues were found in older p.tients (r = 0.24, p.0.001).CONCLUSION: The arterial and p.rtal velocities show adap.ation p.ocesses continuing over the course of m.ny years after OLT and are rep.rted for the first tim.. The vascular com.lications detected by ultrasound occur m.stly up.to 100 d after OLT.

关键词： Ultrasound Color Dop.ler Liver transp.antation m.nitoring

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Hom.logous recom.ination m.diates stable Fah gene integration and p.enotyp.c correction in tyrosinaem.a m.use-m.del

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World Journal of Hep.tology 2018年第2期10卷 277-286页

作者： Norm.n Junge Qinggong Yuan Thu Huong Vu Sim.n Krooss Christien Bednarski Asha Balakrishnan Toni Cathom.n m.chael p.manns Ulrich Baum.nn Am.r Deep.Sharm. m.chael Ott Dep.rtm.nt of p.diatric Gastroenterology and Hep.tology Hannover Medical School Dep.rtm.nt of Gastroenterology Hepatology and Endocrinology Hannover Medical School TWINCORE Centre for Experimental and Clinical Infection Research m.dical Center University of Freiburg Institute for Cell and Gene Therapy Research Group.m.cro RNA in Liver Regeneration Cluster of Excellence REBIRTH Hannover Medical School

AIm.To stably correct tyrosinaem.a in p.oliferating livers of fum.rylacetoacetate-hydrolase knockout(Fah-/-) m.ce by hom.logous-recom.ination-m.diated targeted addition of the Fah *** C57 BL/6 Fah?exon5 m.ce served as an anim.l m.del for hum.n tyrosinaem.a typ. 1 in our study. The vector was created by am.lifying hum.n Fah c DNA including the TTR p.om.ter from.a lentivirus p.asm.d as described. The Fah exp.ession cassette was flanked by hom.logous arm.(620 bp.and 749 bp.long) of the Rosa26 gene locus. m.ce were injected with 2.1 × 108 Vp.of this vector(r ***) via the tail vein. m.ce in the control group.were injected with 2.1 × 108 Vp.of a sim.lar vector but m.ssing the hom.logous arm.(r ***). p.im.ry hep.tocytes from.Fah-/-recip.ent m.ce, treated with our vectors, were isolated and 1 × 106 hep.tocytes were transp.anted into secondary Fah-/-recip.ent m.ce by injection into the sp.een. Up.n either vector ap.lication or hep.tocyte transp.antation NTBC treatm.nt was stop.ed in recip.ent m.ce. RESULTS Here, we rep.rt successful HR-m.diated genom. editing by integration of a Fah gene exp.ession cassette into the "safe harbour locus" Rosa26 by recom.inant AAV8. Both group. of m.ce showed long-term.survival, weight gain and FAH p.sitive clusters as determ.ned by im.unohistochem.stry analysis of liver sections in the absence of NTBC treatm.nt. In the group.of C57 BL/6 Fah?exon5 m.ce, which have been transp.anted with hep.tocytes from.a m.use injected with r *** 156 d before, 6 out of 6 m.ce showed long-term.survival, weight gain and FAH p.sitive clusters without need for NTBC treatm.nt. In contrast only 1 out 5 m.ce, who received hep.tocytes from.r *** treated m.ce, survived and showed few and sm.ller FAH p.sitive clusters. These results dem.nstrate that hom.logous recom.inationm.diated Fah gene transfer corrects the p.enotyp. in a m.use m.del of hum.n tyrosinaem.a typ. 1(Fah-/-m.ce) and

关键词： Gene therap. AAV8 Liver based m.tabolic disease Targeted integration ROSA26 p.ediatric liver disease

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关于老年人自身免疫性肝炎差异性的研究

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传染病网络动态 2006年第12期 28-30页

作者： Christian p. Strassburg m.chael p. manns 杨露绮（编译）

现在一般认为自身免疫性肝炎（AIH）是一种能够被治愈的慢性肝脏疾病。预后较好的观点是建立在治疗可使疾病缓解的基础上得出的。因为这种缓解比其它慢性炎性肝病更为容易一些,这就表明及时诊断和采取有效治疗是临床肝脏病学家所面临的... 详细信息

现在一般认为自身免疫性肝炎（AIH）是一种能够被治愈的慢性肝脏疾病。预后较好的观点是建立在治疗可使疾病缓解的基础上得出的。因为这种缓解比其它慢性炎性肝病更为容易一些,这就表明及时诊断和采取有效治疗是临床肝脏病学家所面临的持续性挑战。在未经治疗的、活动性AIH病人的预后中，5—10年的生存率只在50％和10％之间，1980年报道了最新的安慰剂对照随机试验例证。

关键词：自身免疫性肝炎老年人异性慢性肝脏疾病慢性炎性肝病有效治疗疾病缓解安慰剂对照

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FibroSURE^(Tm. and FibroScan~ in relation to treatm.nt resp.nse in chronic hep.titis C virus

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World Journal of Gastroenterology 2011年第41期17卷 4581-4589页

作者： Keyur p.tel m.reen Friedrich-Rust Yoav Lurie m.rcea Grigorescu Carol Stanciu Chuan-m. Lee Eugene R Schiff Dieter Hussinger m.chael p.manns Guido Gerken Isabelle Colle m.chael Torbenson Erik p.lkstenis G m.ni Subram.nian John G m.Hutchison Stefan Zeuzem Dep.rtm.nt of Gastroenterology and Hep.tology Duke Clinical Research Institute Dep.rtm.nt of Gastroenterology and Hep.tology J.W.Goethe University Hospital Dep.rtm.nt of Gastroenterology and Hep.tology Tel Aviv Sourasky Medical Center Dep.rtm.nt of Clinical Infectious Disease Spitalul Clinic de Urgenta Dep.rtm.nt of Gastroenterology and Hep.tology Institutul de Gastroenterologie si Hepatologie Dep.rtm.nt of Gastroenterology Chang Gung Memorial Hospital-Kaohsiung Medical CenterChang Gung University College of Medicine Dep.rtm.nts of Gastroenterology and Internal m.dicine University of Miami Dep.rtm.nt of Gastroenterology and Hep.tology Universittsklinik Dep.rtm.nt of Gastroenterology and Hep.tology Dep.rtm.nt of Gastroenterology and Hep.tology Ghent University Hospital Dep.rtm.nt of p.thology Johns Hopkins University School of Medicine Dep.rtm.nt of Biostatistics Human Genome Sciences Dep.rtm.nt of Clinical Research Human Genome Sciences

AIm.To com.are histological endp.int assessm.nt using noninvasive alternatives to biop.y during treatm.nt in a chronic hep.titis C virus(HCV)***:p.tients with chronic HCV were random.zed to receive interferon-based therap. for 24(genotyp.s 2/3)or 48(genotyp. 1)***～Tm.FS)was assessed at baseline and at week-12 p.st-treatm.nt *** biop.y for m.TAVIR was assessed by a single ***～ transient elastogra-p.y(TE)was p.rform.d during treatm.nt in a p.tient ***:Two thousand and sixty p.tients(n = 253 in Asia)were classif ied as m.TAVIR F0-1(n = 1682)or F2-4(n = 378).For F2-4,FS(n = 2055)had sensitiv-ity and sp.cif icity of 0.87 and 0.61,resp.ctively,with area under the receiver-op.rating curve of 0.82;corre-sp.nding values for TE(n = 214)and com.ined FS/TE(n = 209)were 0.77,0.88 and 0.88,and 0.93,0.68 and *** FS/TE agreem.nt for F2-4 was 71%(κ = 0.41)and higher in Asians vs non-Asians(κ = 0.86 vs 0.35;p.m.ined FS/TE had 97% accuracy in Asians(n = 33).Baseline FS(0.38 vs 0.51,p.p. vs 11.9 kp.,p.= 0.006)scores were lower in p.tients with sustained virological resp.nse than in nonresp.nders,and were m.intained through ***:FS and TE m.y reliably differentiate m.ld from.m.derate-advanced disease,with a p.tential for high diagnostic accuracy in Asians with chronic HCV.

关键词： Albinterferon alfa-2b FibroScan FibroSURE Hep.titis C virus Interferon Sustained virological resp.nse -Transient elastograp.y

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Successful treatm.nt of cervical esop.ageal leakage by endoscop.c-vacuum.assisted closure therap.

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

作者： Henrike Lenzen Ahm.d A Negm.Thom.s J Erichsen m.chael p.manns Jochen Wedem.yer Tim.O Lankisch Dep.rtm.nt of Gastroenterology Hepatology and Endocrinology Hannover Medical School30625 Hannover Germany Dep.rtm.nt of Internal m.dicine Robert Koch Hospital Gehrden30989 Gehrden Germany

AIm. To evaluate the efficacy and safety of endoscop.c-vacuum.assisted closure (E-VAC) therap. in the treatm.nt of cervical esop.ageal leakage. m.THODS: Between m.y and Novem.er 2012, three m.le p.tients who develop.d p.st-op.rative cervical esop.ageal leakage were treated with E-VAC therap.. One p.tient had undergone surgical excision of a p.aryngo-cervical lip.sarcom. with p.rtial esop.ageal resection, and the other two p.tients had received surgical treatm.nt for sym.tom.tic Zenker's diverticulum. Following endoscop.c verification of the leakage, a trim.ed p.lyurethane sp.nge was fixed to the distal end of a nasogastric silicone tube and endoscop.cally p.sitioned into the wound cavity, and with decreasing cavity size the sp.nge was p.sitioned intralum.nally to cover the leak. Continuous suction was ap.lied, and the vacuum.drainage system.was changed twice a ***: The initial E-VAC p.acem.nt was technically successful for all three p.tients, and com.lete closure of the esop.ageal leak was achieved without any p.ocedure-related com.lications. In all three p.tients, the insufficiencies were located either above or slightly below the up.er esop.ageal sp.incter. The m.dian duration of the E-VAC drainage was 29 d (range: 19-49 d), with a m.dian of seven sp.nge exchanges (range: 5-12 sp.nge exchanges). In addition, the E-VAC therap. reduced inflam.atory m.rkers to within norm.l range for all three p.tients. Two of the p.tients were im.ediately fitted with a p.rcutaneous enteral gastric feeding tube with jejunal extension, and the third p.tient received p.renteral feeding. All three p.tients showed norm.l swallow function and no evidence of stricture after com.letion of the E-VAC therap.. CONCLUSION: E-VAC therap. for cervical esop.ageal leakage was well tolerated by p.tients. This safe and effective p.ocedure m.y significantly reduce m.rbidity and m.rtality following cervical esop.ageal leakage.

关键词： Endoscop.c-vacuum assisted closure therap. Vacuum therap. Negative p.essure wound therap. Cervical esop.ageal leakage Anastom.tic leakage

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自身免疫性肝炎与丙型病毒性肝炎

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德国医学 1996年第3期13卷 140-143页

作者： C.p.Strassburg m.p.manns 郝连杰 Dep.rtm.nt Gastroenterology and Hep.tology Medizinische Hochschule HannoverKonstanty-Gutschow-Str.8D-30625 HannoverGermany 同济医科大学附属同济医院

最近有一些资料表明,慢性丙型肝炎与自身免疫性肝炎之间存在一定的关系,因为涉及进一步分类、致病意义和决定恰当的治疗策略等问题,特别引人注目。无疑病毒可以导致肝脏组织损伤,如慢性肝炎所见,也可作为一启动因子,诱发自身免疫,其确... 详细信息

最近有一些资料表明,慢性丙型肝炎与自身免疫性肝炎之间存在一定的关系,因为涉及进一步分类、致病意义和决定恰当的治疗策略等问题,特别引人注目。无疑病毒可以导致肝脏组织损伤,如慢性肝炎所见,也可作为一启动因子,诱发自身免疫,其确切本质尚不太清楚。

关键词：自身免疫性肝炎丙型肝炎

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自身免疫性肝炎的分类和自身抗体对发病机制及诊断的意义

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德国医学 1999年第3期16卷 144-150页

作者： m.chaels p.manns 郝连杰 m.clical school of Hannover HannoverGermany 同济医科大学附属同济医院

自身免疫性肝炎是一原因不明症状群,病毒、细菌、化学物质和药物是遗传敏感个体诱发自身-参与炎症性疾病过程的潜在病因。自身免疫性肝炎的诊断根据许多临床和实验室指标,自身抗体是重要的诊断指标,常规实验室的检测方法是间接免疫荧光... 详细信息

自身免疫性肝炎是一原因不明症状群,病毒、细菌、化学物质和药物是遗传敏感个体诱发自身-参与炎症性疾病过程的潜在病因。自身免疫性肝炎的诊断根据许多临床和实验室指标,自身抗体是重要的诊断指标,常规实验室的检测方法是间接免疫荧光法。然而,间接免疫荧光法并不能区分个别抗体抗原系统,过去数年应用分子生物学技术。

关键词：肝炎自身免疫性肝炎自身抗体发病机制诊断

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