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Body-mass index correlates with severity and mortality in acute pancreatitis: A meta-analysis

World Journal of Gastroenterology 2019年第6期25卷 729-743页

作者： Dalma Dobszai Péter Mátrai Zoltan Gyongyi Dezso Csupor Judit Bajor Balint Eross Alexandra Mikó Lajos Szakó Agnes Meczker Roland Hágendorn Katalin Márta Andrea Szentesi Péter Hegyi on behalf of the hungarian pancreatic study group Institute for Translational Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Clinical Medicine Doctoral School University of SzegedSzeged 6720Hungary Institute for Bioanalysis Medical SchoolUniversity of PécsPécs 7624Hungary Department of Public Health Medicine Medical SchoolUniversity of PécsPécs 7624Hungary Department of Pharmacognosy University of SzegedSzeged 6720Hungary Division of Gastroenterology First Department of MedicineUniversity of PécsMedical SchoolPécs 7624Hungary János Szentágothai Research Center University of PécsPécs 7624 Hungary MTA-SZTE Momentum Translational Gastroenterology Research group University of SzegedSzeged 6720Hungary 不详

BACKGROUND Obesity rates have increased sharply in recent decades. As there is a growing number of cases in which acute pancreatitis(AP) is accompanied by obesity, we found it clinically relevant to investigate how body-mass index(BMI) affects the outcome of the *** To quantify the association between subgroups of BMI and the severity and mortality of *** A meta-analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA) Protocols. Three databases(PubMed, EMBASE and the Cochrane Library) were searched for articles containing data on BMI, disease severity and mortality rate for AP. Englishlanguage studies from inception to 19 June 2017 were checked against our predetermined eligibility criteria. The included articles reported all AP cases with no restriction on the etiology of the disease. Only studies that classified AP cases according to the Atlanta Criteria were involved in the severity analyses. Odds ratios(OR) and mean differences(MD) were pooled using the random effects model with the DerSimonian-Laird estimation and displayed on forest plots. The meta-analysis was registered in PROSPERO under number *** A total of 19 articles were included in our meta-analysis containing data on 9997 patients. As regards severity, a subgroup analysis showed a direct association between AP severity and BMI. BMI 25 had an almost three-fold increased risk for severe AP in comparison to normal BMI(OR = 2.87, 95%CI: 1.90-4.35, P group(MD = 1.79, 95%CI: 0.89-2.70, P groups. A BMI < 18.5 carries an almost two-fold increase in risk of mortality compared to normal BMI(OR = 1.82, 95%CI: 1.32-2.50, P < 0.001). However, the chance of mortality

关键词： Acute pancreatitis Body-mass index Obesity Severity Mortality Prognostic Meta-analysis

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Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma:A large multicenter sample analysis

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Chinese Journal of Cancer Research 2021年第4期33卷 433-446页

作者： Qiyue Chen Zhongliang Ning Zhiyu Liu Yanbing Zhou Qingliang He Yantao Tian Hankun Hao Wei Lin Lixin Jiang Gang Zhao Ping Li Chaohui Zheng Changming Huang on behalf of the study group for Gastric Neuroendocrine Tumors Department of Gastric Surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China Key Laboratory of Ministry of Education of Gastrointestinal Cancer Fujian Medical UniversityFuzhou 350004China Fujian Key Laboratory of Tumor Microbiology Fujian Medical UniversityFuzhou 350004China Department of Gastrointestinal Surgery West District of the First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Department of Gastrointestinal Surgery Affiliated Hospital of Qingdao UniversityQingdao 266000China Department of Gastrointestinal Surgery the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005China Department of pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of General Surgery Huashan HospitalFudan UniversityShanghai 200040China Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute the Affiliated Hospital of Putian UniversityPutian 351106China Department of Gastrointestinal Surgery Yantai Yuhuangding HospitalYantai 264099China Department of Gastrointestinal Surgery Renji HospitalShanghai Jiaotong UniversityShanghai 200127China 不详

Objective:Quality assurance is crucial for oncological surgical treatment *** rare diseases,singlequality indicators are not *** aim to develop a comprehensive and reproducible measurement,called the"Textbook Outcome"(TO),to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma(G-NEC)***:Data from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were *** included receiving a curative resection,≥15 lymph nodes examined,no severe postoperative complications,hospital stay≤21 d,and no hospital readmission≤30 d after *** variation in TO was analyzed using a case mix-adjusted funnel *** factors of survival and risk factors for non-Textbook Outcome(non-TO)were analyzed using Cox and logistic models,***:TO was achieved in 56.6%of 860 G-NEC *** patients had better overall survival(OS),disease-free survival(DFS),and recurrence-free survival(RFS)than non-TO patients(P200 mL blood loss were independent risk factors for non-TO patients(P<0.05).Conclusions:TO is strongly associated with multicenter surgical quality and prognosis for G-NEC *** predicting non-TO are identified,which may help guide strategies to optimize G-NEC outcomes.

关键词： Textbook Outcome gastric neuroendocrine carcinoma surgical quality prognosis risk factor

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Exocrine pancreatic insufficiency in adults:A shared position statement of the Italian association for the study of the pancreas

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World Journal of Gastroenterology 2013年第44期19卷 7930-7946页

作者： Raffaele Pezzilli Angelo Andriulli Claudio Bassi Gianpaolo Balzano Maurizio Cantore Gianfranco Delle Fave Massimo Falconi Luca Frulloni the Exocrine pancreatic Insufficiency collaborative(EPIc) group Department of Digestive Diseases Internal Medicine Sant’Orsola-Malpighi Hospital 40138 Bologna Italy

This is a medical position statement developed by the Exocrine pancreatic Insufficiency collaborative group which is a part of the Italian Association for the study of the Pancreas(AISP).We covered the main diseases associated with exocrine pancreatic insufficiency(EPI)which are of common interest to internists/gastroenterologists,oncologists and surgeons,fully aware that EPI may also occur together with many other diseases,but less frequently.A preliminary manuscript based on an extended literature search(Medline/PubMed,Cochrane Library and Google Scholar)of published reports was prepared,and key recommendations were *** evidence was discussed at a dedicated meeting in Bologna during the National Meeting of the Association in October *** of the proposed recommendations and algorithms was discussed and an initial consensus was *** final draft of the manuscript was then sent to the AISP Council for approval and/or *** concerned parties approved the final version of the manuscript in June 2013.

关键词： Exocrine pancreatic insufficiency Chronic pancreatitis Gastric surgery pancreatic surgery pancreatic neoplasms Risk factors Clinical studies

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Toll-like receptor 4 and NOD2/CARD15 mutations in hungarian patients with Crohn's disease: Phenotype-genotype correlations

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World Journal of Gastroenterology 2005年第10期11卷 1489-1495页

作者： Peter Laszlo Lakatos Laszlo Lakatos Ferenc Szalay Claudia Willheim-Polli Christoph (O|¨)sterreicher Zsolt Tulassay Tamas Molnar Walter Reinisch Janos Papp Gyula Mozsik hungarian IBD study group Peter Ferenci 1st Department of Medicine Laszlo Lakatos Department of Internal Medicine 4 2nd Department of Medicine Semmelweis University 2nd Department of MedicineSemmelweis UniversityBudapest:Laszlo PronaiAnnamaria NemethPal Miheller Erzsebet Hospital 1st Department of MedicineBudapest: Agota KovacsLaszlo Bene Szent Janos Hospital 1st Department of Medicine:Gyorgy Szekely University of Pecs 1st Department of MedicinePecs:Beata Gasztonyi University of Szeged 1st Department of MedicineSzeged:Ferenc NagyJanos Lonovics Semmelweis Hospital 1st Department of MedicineMiskolc:Laszlo Ujszaszy University of Debrecen 2nd Department of MedicineDebrecen:Istvan AltorjaiKaroly Palatka Kenezi Gy. County Hospital 2nd Department of MedicineDebrecen: Gyula G. Kiss County Hospital 2nd Department of MedicineZalaegerszeg Ferenc Tarnok Markusovszky Hospital2nd Department of MedicineSzombathely:Zoltan Dobronte Csolnoky F. County Hospital 1st Department of MedicineVeszprem:Zsuzsanna ErdelyiTunde PandurGabor Mester

AIM: To determine common NOD2/CARD15 mutations and TLR4 D299G polymorphism in hungarian patients with CD. METHODS: A total of 527 unrelated patients with CD (male/female: 265/262, age: 37.1 (SD 7.6) years) and 200 healthy subjects were included. DNA was screened for possible NOD2/CARD15 mutations by denaturing high-performance liquid chromatography (confirmed by direct sequencing). TLR4 D299G was tested by PCR-RFLP. RESULTS: NOD2/CARD15 mutations were found in 185 patients (35.1%) and in 33 controls (16.5%,Phungarian CD patients. In contrast, although the frequency of TLR4 D299G polymorphism was not different from controls, NOD2/TLR4 mutation carriers tended to present at earlier age.

关键词： Crohn's disease NOD2 CARD15 TLR4 Extraintestinal manifestation Phenotype

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胰腺神经内分泌肿瘤诊治专家共识

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中华肿瘤杂志 2014年第9期36卷 717-720页

作者：王成峰中国医学科学院 100021 北京协和医学院肿瘤医院腹部外科 100021

胰腺神经内分泌肿瘤（pancreatic neuroendocrine tumor，PNET）是一类起源于肽能神经元和神经内分泌细胞的异质性肿瘤，发病率逐年升高，达0．32／10万。恶性PNET约占胰腺恶性肿瘤的1％，发病高峰年龄为40-69岁，男女之比为1．33：1。

关键词：胰腺神经内分泌肿瘤诊断治疗专家共识

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Chinese Medical Association consensus for standardized diagnosis and treatment of pancreatic neuroendocrine neoplasms

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Chinese Medical Journal 2023年第20期136卷 2397-2411页

作者： Feng Jiao Jiujie Cui Deliang Fu Qi Li Zheng Wu Zan Teng Hongmei Zhang Jun Zhou Zhihong Zhang Xiaobing Chen Yuhong Zhou Yixiong Li Yiping Mou Renyi Qin Yongwei Sun Gang Jin Yuejuan Cheng Jian Wang Gang Ren Jiang Yue Guangxin Jin Xiuying Xiao Liwei Wang on behalf of pancreatic Tumor group,Society of Oncology,Chinese Medical Association Department of Oncology State Key Laboratory of Systems Medicine for CancerShanghai Cancer InstituteRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of pancreatic Surgery Huashan HospitalFudan UniversityShanghai 200040China Department of Oncology Shanghai General HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200080China Department of Hepatobiliary Surgery The First Affiliated Hospital of Xi’an Jiao Tong UniversityXi’anShaanxi 710061China Department of Oncology The First Hospital of China Medical UniversityShenyangLiaoning 110801China Department of Medical Oncology The First Affiliated Hospital of Air Force Medical UniversityXi’anShaanxi 710032China Department of Gastrointestinal Oncology Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing)Peking University Cancer Hospital and InstituteBeijing 100142China Department of Pathology The First Affiliated Hospital of Nanjing Medical UniversityNanjingJiangsu 210029China Department of Oncology The Affiliated Cancer Hospital of Zhengzhou UniversityHenan Cancer HospitalZhengzhouHenan 450003China Department of Medical Oncology Zhongshan HospitalFudan UniversityShanghai 200032China Department of General Surgery Xiangya HospitalCentral South UniversityChangshaHunan 410008China Department of Gastrointestinal and pancreatic Surgery Zhejiang Provincial People’s HospitalAffiliated People’s HospitalHangzhou Medical CollegeHangzhouZhejiang 310014China Department of Biliary-pancreatic Surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China Department of Biliary-pancreatic Surgery Renji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of Hepatobiliary pancreatic Surgery Changhai HospitalNaval Medical UniversityShanghai 200433China Department of Medical Oncology Peking Union Medical College HospitalChinese Academy of Medical Sci

pancreatic neuroendocrine neoplasms(pNENs)are rare and highly heterogeneous tumors originating from pluripotent stem cells with neuroendocrine differentiation in the pancreas,constituting approximately 3%of all pancreatic tumors.^([1])The global incidence of pNENs has been increasing recently,and most cases are sporadic and more common in women.^([1,2])pNENs are clinically divided into functioning and nonfunctioning tumors depending on whether the tumors are accompanied by a clinical syndrome related to specific hormone overproduction.

关键词： neoplasms neuroendocrine diagnosis

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胰腺神经内分泌肿瘤治疗指南（2014版）

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中华消化外科杂志 2014年第12期13卷 919-922页

作者：楼文晖吴文铭中华医学会外科学分会胰腺外科学组

1 前言胰腺神经内分泌肿瘤（pancreatic neuroendocrine neoplasms，pNENs），原称为胰岛细胞瘤，约占原发性胰腺肿瘤的3％。依据激素的分泌状态和患者的临床表现，分为功能性和无功能性pNENs。无功能性pNENs占75％～85％。功能性pNEN... 详细信息

1 前言胰腺神经内分泌肿瘤（pancreatic neuroendocrine neoplasms，pNENs），原称为胰岛细胞瘤，约占原发性胰腺肿瘤的3％。依据激素的分泌状态和患者的临床表现，分为功能性和无功能性pNENs。无功能性pNENs占75％～85％。功能性pNENs约占pNENs的20％。常见的功能性pNENs有胰岛素瘤和胃泌素瘤。胰岛素瘤一般位于胰腺，而胃泌素瘤多见于十二指肠或胰腺；其余的功能性pNENs均少见，统称为罕见功能性胰腺神经内分泌肿瘤（rare function-al pancreatic neuroendocrine tumors，RFrs），包括生长抑素瘤、胰高血糖素瘤、生长激素瘤等。

关键词：神经内分泌肿瘤胰腺治疗

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胰腺常规手术后胰瘘的预防及引流管理

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中华消化外科杂志 2018年第1期17卷 55-59页

作者：中华消化外科菁英荟胰腺外科学组中华消化外科菁英荟胰腺外科学组

胰瘘是胰腺术后常见并发症之一，可能导致腹腔内感染、出血及脓毒血症等并发症，是术后患者死亡的重要原因。关于胰瘘的防治及引流管理问题．学术界一直存在广泛争议。胰腺手术的方式多种多样，患者的基础条件千差万别，其胰瘘的管理不... 详细信息

胰瘘是胰腺术后常见并发症之一，可能导致腹腔内感染、出血及脓毒血症等并发症，是术后患者死亡的重要原因。关于胰瘘的防治及引流管理问题．学术界一直存在广泛争议。胰腺手术的方式多种多样，患者的基础条件千差万别，其胰瘘的管理不能一概而论，也不应一种模式。针对两种常规手术方式：胰十二指肠切除术和远端胰腺切除术,本文按照危险因素识别、术中预防胰瘘和术后引流管理3个方面分别进行探讨。

关键词：胰腺疾病胰瘘胰十二指肠切除术远端胰腺切除术危险因素引流管理

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重症儿童血清淀粉酶或脂肪酶升高与胰腺损伤的关系

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中华儿科杂志 2016年第9期54卷 658-664页

作者：全国重症儿童继发胰腺损伤研究协助组全国重症儿童继发胰腺损伤研究协助组

目的观察血清淀粉酶和脂肪酶升高在重症儿童中的发生率及其与胰腺损伤关系.方法按照协助组制定的纳入和排除标准前瞻性收集2012年1月至2014年3月来自全国17所三级甲等医院儿科重症监护病房的患儿临床资料.根据血清淀粉酶或脂肪酶水平... 详细信息

目的观察血清淀粉酶和脂肪酶升高在重症儿童中的发生率及其与胰腺损伤关系.方法按照协助组制定的纳入和排除标准前瞻性收集2012年1月至2014年3月来自全国17所三级甲等医院儿科重症监护病房的患儿临床资料.根据血清淀粉酶或脂肪酶水平,将患儿分为正常组（血清淀粉酶和脂肪酶正常）,轻度升高组（1倍＜血清淀粉酶或脂肪酶升高＜3倍）,显著升高组（血清淀粉酶或脂肪酶升高≥3倍）,采用t检验、方差分析、x2检验或非参数检验比较各组间临床表现、胰腺彩色超声、生化指标、器官损伤及衰竭情况、机械通气、脓毒症严重程度、病死率并进行生存分析.对影响淀粉酶或脂肪酶升高的危险因素进行多因素Logistic回归分析.结果（1）共纳入3 380例患儿（男2 140例、女1 240例）,其中正常组2 607例,轻度升高组569例,显著升高组204例.淀粉酶或脂肪酶升高在重症儿童中的发生率为22.87％（773/3 380）.（2）3组间低血压、呕吐、腹部压痛、腹肌紧张、腹膜刺激征阳性、肠鸣音减弱、肝脏增大、抽搐及意识障碍发生率差异均具有统计学意义（χ^2=32.264、12.071、13.959、7.979、13.774、12.459、9.443、40.805、99.183,P均＜0.05）.（3）正常组、轻度升高组、显著升高组胰腺彩色超声异常比例分别为0.90％（4/443）、14.06％（9/64）、20.83％（5/24）,差异有统计学意义（χ^2=52.925,P=0.000）.（4）3组间碱剩余、白细胞计数、降钙素原、血钙、丙氨酸转氨酶、天冬氨酸转氨酶、肌酐、尿素氮、乳酸脱氢酶、肌酸激酶同工酶异常发生率差异均有统计学意义（x2=59.485、27.634、125.564、102.258、10.175、27.338、80.616、140.521、72.830、72.136,P均＜0.05）.（5）3组间心肌损伤、肝脏损伤、肾损伤、急性呼吸窘迫综合征、颅高压综合征、应激性溃疡、凝血功能障碍、循环功能障碍、严重脓毒症、多器官功能障碍（MODS）、有创机械通气比例及病死率差异均具有统计学意义（χ^2=8.826、17.864、49.061、96.221、106.918、80.559、30.355、99.183、196.412、133.887、154.239、9.206,P均＜0.01）.（6）淀粉酶和脂肪酶正常患儿生存表中位数为75 d,淀粉酶或脂肪酶升高患儿生存表中位数为24d.（7）年龄、抽搐、意识障碍、碱剩余、降钙素原、血钙、机械通气、严重脓毒症及MODS是患儿淀粉酶或脂肪酶升高的危险因素（OR=1.155、1.491、2.237、0.949、0.604、1.008、0.660、1.907、0.836,P均＜0.05）.结论高淀粉酶血症或高脂肪酶血症在儿童危重症发生率不如成人,胰酶升高是危重症病情发展过程中的伴随表现,可能由于胰腺损伤所致,胰酶越高病情越危重,预后越差.

关键词：淀粉酶类脂肪酶胰腺重症监护儿童

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A Chinese consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency after pancreatic surgery(2018)

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Journal of Pancreatology 2018年第1期1卷 30-34页

作者： Taiping Zhang Zhe Cao Rufu Chen Yiqi Du Defei Hong Kuirong Jiang Gang Jin Fei Li Weiqin Li Zhaoshen Li Tingbo Liang Quan Liao Wenhui Lou Yi Miao Jiaming Qian Renyi Qin Bei Sun Zhaohui Tang Chunyou Wang Weilin Wang Wenming Wu Yinmo Yang Gang Zhao Yupei Zhao study group of pancreatic Surgery in Chinese Society of Surgery of Chinese Medical Association pancreatic Disease Committee of Chinese Research Hospital Association Department of General Surgery Peking Union Medical College HospitalBeijing Department of Hepatobiliary Surgery Sun Yat-sen Memorial HospitalGuangzhou Department of Gastroenterology Changhai HospitalSecond Military Medical UniversityShanghai Department of General Surgery Sir Run Run Shaw HospitalThe Medicine School of Zhejiang UniversityHangzhou Department of General Surgery Pancreas CentreThe First Affiliated Hospital of Nanjing Medical UniversityNanjing Department of Hepatobiliary pancreatic Surgery Changhai HospitalSecond Military Medical UniversityShanghai Department of General Surgery Xuanwu HospitalCapital Medical UniversityBeijing Surgical Intensive Care Unit(SICU) Department of General SurgeryJinling HospitalMedical School of Nanjing UniversityNanjing Department of Hepatobiliary and pancreatic Surgery The Second Affiliated HospitalZhejiang University School of MedicineHangzhou Department of pancreatic Surgery Zhongshan HospitalFudan UniversityShanghai Department of Biliary-pancreatic Surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan Department of pancreatic and Biliary Surgery The First Affiliated Hospital of Harbin Medical UniversityHarbin Department of General Surgery Xinhua Hospital Shanghai Jiaotong UniversityShanghai Department of pancreatic Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan Division of Hepatobiliary and pancreatic Surgery The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou Department of General Surgery Peking University First HospitalBeijing 不详

A consensus statement on the diagnosis and treatment of pancreatic exocrine insufficiency(PEI)after pancreatic surgery was developed based on the latest references,combined with China’s actual *** than 20 Chinese excellent experts participated in this work and contributed many thorough *** consensus discusses the definition,epidemiology,diagnosis,treatment,and follow-up of PEI after pancreatic *** authors hope this consensus will promote the standard procedure of diagnosis and treatment of PEI in China.

关键词： Expert consensus pancreatic exocrine insufficiency Postoperative complications

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