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Being accompanied to liver discharge clinic: An easy measure to identify potential liver transplant candidates among those previously considered ineligible

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World Journal of Hepatology 2019年第4期11卷 370-378页

作者： Jordan Sack Nilofar Najafian Angela DeLisle Simona Jakab Department of Internal Medicine Yale University School of Medicine Northeast Medical Group Yale New Haven Health Section of Digestive Diseases Yale University School of Medicine

BACKGROUND Patients with cirrhosis deemed ineligible for liver transplantation are usually followed in general hepatology or gastroenterology clinics, with the hope of reevaluation once they meet the appropriate criteria. Specific strategies to achieve liver transplant eligibility for these patients have not been *** To assess clinical and sociodemographic factors associated with future liver transplant eligibility among patients initially considered *** This is a retrospective study of patients with cirrhosis considered non-transplant eligible, but without absolute contraindications, who were scheduled in our transitional care liver clinic(TCLC) after discharge from an inpatient liver *** candidacy was assessed 1 year after the first scheduled TCLC *** on clinical and sociodemographic factors were *** Sixty-nine patients were identified and the vast majority were Caucasian men with alcoholic cirrhosis. 46 patients(67%) presented to the first TCLC visit. Seven of 46 patients that showed to the first TCLC visit became transplant candidates,while 0 of 23 patients that no-showed did(15.2% vs 0%, P = 0.08). Six of 7 patients who showed and became transplant eligible were accompanied by family orfriends at the first TCLC appointment, compared to 13 of 39 patients who showed and did not become transplant eligible(85.7% vs 33.3%, P = 0.01).CONCLUSION Patients who attended the first post-discharge TCLC appointment had a trend for higher liver transplant eligibility at 1 year. Being accompanied by family or friends during the first TCLC visit correlated with higher liver transplant eligibility at 1 year(attendance by family or friends was not requested). Patient and family engagement in the immediate post-hospitalization period may predict future liver transplant eligibility for patients previously declined.

关键词： Cirrhosis Transitional clinic Transplant listing Support Family

Future Strategies on Glioma Research:From Big Data to the clinic

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Genomics, Proteomics & Bioinformatics 2017年第4期15卷 263-265页

作者： Hang Cao Feiyifan Wang Xue-Jun Li Department of Neurosurgery Xiangya HospitalCentral South UniversityChangsha 410008China

Glioma, as the most common and aggressive malignant central nervous system （CNS） tumor with generally poor prognosis, has been attracting much attention in the last decade [1]. Temozolomide was firstly available in the United States in 1999 as a chemotherapy drug for treating brain cancers and remains as the first-line treatment for glioma. The World Health Organization （WHO） classified glioma into four main grades according to the degree of malignancy in 2007, which were updated in 2016 with the introduction of significant molecular alternations. Also in 2016, the Chinese Glioma Cooperative Group （CGCG） published the first guideline for adult diffuse gliomas [2], representing the only national consensus for the diagnosis and treatment of adult gliomas up till nOW.

关键词： From Big Data to the clinic Future Strategies on Glioma Research GBM IDH

The JAK/STAT signaling pathway:from bench to clinic

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Signal Transduction and Targeted Therapy 2021年第12期6卷 3603-3635页

作者： Xiaoyi Hu Jing li Maorong Fu Xia Zhao Wei Wang State Key Laboratory of Biotherapy and Cancer Center West China HospitalSichuan Universityand Collaborative Innovation Center for Biotherapy Chengdu610041 SichuanP.R.China Department of Gynecology and Obstetrics Development and Related Disease of Women and Children Key Laboratory of Sichuan ProvinceKey Laboratory of Birth Defects and Related Diseases of Women and ChildrenMinistry of EducationWest China Second HospitalSichuan University610041 ChengduP.R.China

The Janus kinase/signal transducer and activator of transcription(JAK/STAT)signaling pathway was discovered more than a quarter-century *** a fulcrum of many vital cellular processes,the JAK/STAT pathway constitutes a rapid membrane-to-nucleus signaling module and induces the expression of various critical mediators of cancer and *** evidence suggests that dysregulation of the JAK/STAT pathway is associated with various cancers and autoimmune *** this review,we discuss the current knowledge about the composition,activation,and regulation of the JAK/STAT ***,we highlight the role of the JAK/STAT pathway and its inhibitors in various diseases.

关键词： JAK/STAT constitute quarter

Evaluation of clinical outcomes in an interdisciplinary abdominal pain clinic: A retrospective, exploratory review

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World Journal of Gastroenterology 2019年第24期25卷 3079-3090页

作者： Amanda D Deacy Craig A Friesen Vincent S Staggs Jennifer V Schurman Division of Gastroenterology Children’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States Division of Developmental and Behavioral Sciences Children’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States Biostatistics and Epidemiology Health Services and Outcomes ResearchChildren’s Mercy Kansas CityUMKC School of MedicineKansas CityMO 64108United States

BACKGROUND Pediatric functional gastrointestinal disorders(FGIDs)are common and wellaccepted to be etiologically complex in terms of the contribution of biological,psychological,and social factors to symptom ***,despite its documented benefits,interdisciplinary treatment,designed to address all of these factors,for pediatric FGIDs remains *** current study hypothesized that the majority of pediatric patients seen in an interdisciplinary abdominal pain clinic(APC)would demonstrate clinical resolution of symptoms during the study period and that specific psychosocial variables would be significantly predictive of GI symptom *** To evaluate outcomes with interdisciplinary treatment in pediatric patients with pain-related FGIDs and identify patient characteristics that predicted clinical *** Participants were 392 children,ages 8-18[M=13.8;standard deviation(SD)=2.7],seen between August 1,2013 and June 15,2016 in an interdisciplinary APC housed within the Division of Gastroenterology in a medium-sized Midwestern children's *** be eligible,patients had to be 8 years of age or older and have had abdominal pain for≥8 wk at the time of initial *** and psychosocial data collected as part of standard of care were retrospectively reviewed and analyzed in the context of the observational *** regression was used to model odds of reporting vs never reporting improvement,as well as to differentiate rapid from slower *** Nearly 70%of patients followed during the study period achieved resolution on at least one of the employed outcome *** those who achieved resolution during follow up,43%to 49%did so by the first follow up(i.e.,within roughly 2 mo after initial evaluation and initiation of interdisciplinary treatment).Patient age,sleep,ease of relaxation,and depression all significantly predicted the likelihood of *** specifically,the odds of clinical resolution w

关键词： Pediatric functional gastrointestinal disorders Integrated care Behavioral health consultation Treatment outcomes Abdominal pain clinic

Spinal intradural electrodes: opportunities, challenges and translation to the clinic

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Neural Regeneration Research 2024年第3期19卷 503-504页

作者： Bruce Harland Chien Yew Kow Darren Svirskis School of Pharmacy University of AucklandAucklandNew Zealand Department of Neurosurgery Auckland City HospitalAucklandNew Zealand

Damage to the spinal cord disrupts the electrically active nerve cells which normally transmit afferent and efferent signals,resulting in loss of motor,sensory,and autonomic *** treatments for spinal cord injury utilizing implanted spinal electrodes can be broadly classified into three different *** first of these approaches is“spinal stimulation”where electrodes,usually positioned above the level of injury,provide electrical stimulation to target and disrupt pain signals before they reach the *** second approach uses“activity-dependent neuro-technologies”,in which electrodes positioned below the level of injury initiate a complex spatiotemporal pattern of stimulation at the lumbar spinal cord to generate a walking gait in the limbs(Minev et al.,2015;Wagner et al.,2018).

关键词： stimulation electrodes utilizing

Satiety testing: Ready for the clinic?

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World Journal of Gastroenterology 2008年第35期14卷 5371-5376页

作者： Michael P Jones Division of Gastroenterology Northwestern UniversityChicagoIL 60611United States

Drink tests are advocated as an inexpensive, nonivasive technique to assess gastric function in patients with a variety of upper digestive symptoms. Many patients with dyspeptic complaints will achieve satiation or develop symptoms at ingested volumes below those typically required to achieve these endpoints in controls. Substantial variation in test performance exists and a greater degree of standardization is required. Additionally, it remains unclear exactly what drink tests measure as correlations with measures of gastric sensation, accomodation and emptying are modest at best. Finally, results of drink tests do not guide therpay. At present, these tests are best reserved for research studies and are not advocated for use in clinical practice.

关键词： Drink test Dyspepsia Gastroparesis

Refractory lipoatrophy treated with autologous whole blood injection:A case report

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World Journal of clinical Cases 2025年第2期13卷 33-38页

作者： Wonnam Kim Jun Su Park En Hyung Kim Department of Pharmacology School of Korean MedicinePusan National UniversityYangsan 50612GyeongnamSouth Korea Department of Dermatology College of MedicineChungbuk National UniversityCheongju 28644ChungbukSouth Korea Department of Dermatology Chungbuk National University HospitalCheongju 28644ChungbukSouth Korea

BACKGROUND Intramuscular corticosteroid injection may cause adverse effects such as dermal and/or subcutaneous atrophy,alopecia,hypopigmentation,and *** cutaneous atrophy can spontaneously resolve,several treatment options have been suggested for this *** SUMMARY In this paper,we report a case of corticosteroid injection induced lipoatrophy treated with autologous whole blood(AWB)injection,as the condition had been unresponsive to fractional laser therapy.A 29-year-old female patient visited the dermatology clinic complaining of skin depression on her right buttock area,which had appeared six months *** had been only subtle improvement at the margins after fractional CO_(2) laser treatment;therefore,after obtaining informed consent from the patient,AWB treatment was *** month after the first AWB injection,the size and depth of the lesion had noticeably improved,and a slight improvement was also observed in *** Close observation is the initial treatment of choice for steroid induced skin atrophy;however,for patients in need of immediate cosmetic improvement,AWB injection may be a safe and cost-effective alternative.

关键词： Atrophy Corticosteroid Subcutaneous fat Autologous whole blood injection Laser therapy Case report

Hepatocellular carcinoma:Surgical perspectives beyond the barcelona clinic liver cancer recommendations

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World Journal of Gastroenterology 2014年第24期20卷 7525-7533页

作者： Alfredo Guglielmi rea Ruzzenente Simone Conci Alessro Valdegamberi Marco Vitali Francesca Bertuzzo Michela De Angelis Guido Mantovani Calogero Iacono Department of Surgery Division of General Surgery AUnit of Hepato-Pancreatico-Biliary surgeryUniversity of Verona Medical School37134 VeronaItaly

The barcelona clinic liver cancer(BCLC)staging system has been approved as guidance for hepatocellular carcinoma(HCC)treatment guidelines by the main Western clinical liver *** to the BCLC classification,only patients with a small single HCC nodule without signs of portal hypertension or hyperbilirubinemia should undergo liver *** contrast,patients with intermediate-advanced HCC should be scheduled for palliative therapies,even if the lesion is *** studies report good short-term and long-term outcomes in patients with intermediate-advanced HCC treated by liver ***,this classification has been criticised because it excludes many patients who could benefit from curative *** aim of this review was to evaluate the role of surgery beyond the BCLC *** liver resection can be performed in patients with portal hypertension and well-compensated liver function with a 5-year survival rate of 50%.Surgery also offers good long-term result in selected patients with multiple or large HCCs with a reported 5-year survival rate of over 50%and 40%,*** macrovascular invasion is associated with a poor prognosis,liver resection provides better long-term results than palliative therapies or best supportive ***,researchers have identified several genes whose altered expression influences the prognosis of patients with *** genes may be useful for classifying the biological behaviour of different tumours.A revision of the BCLC classification should be introduced to provide the best treatment strategy and to ensure the best prognosis in patients with HCC.

关键词： Hepatocellular carcinoma Liver resection Hepatectomy Barcelona clinic liver cancer Surgical therapy

Systematic review of the outcomes of surgical resection for intermediate and advanced Barcelona clinic Liver Cancer stage hepatocellular carcinoma:A critical appraisal of the evidence

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World Journal of Hepatology 2018年第6期10卷 433-447页

作者： Ye Xin Koh Hwee Leong Tan Weng Kit Lye Juinn Huar Kam Adrian Kah Heng Chiow Siong San Tan Su Pin Choo Alexander Yaw Fui Chung Brian Kim Poh Goh Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore 169608Singapore Center for Quantitative Medicine Duke-NUS Graduate Medical SchoolSingapore 169857Singapore Department of General Surgery Hepatopancreatobiliary ServiceChangi General HospitalSingapore 529889Singapore Department of Medical Oncology National Cancer Centre SingaporeSingapore 169610Singapore Duke-NUS Graduate Medical School Singapore 169857Singapore

AIM To perform a systematic review to determine the survival outcomes after curative resection of intermediate and advanced hepatocellular carcinomas(HCC).METHODS A systematic review of the published literature was performed using the PubM ed database from 1 st January 1999 to 31 st Dec 2014 to identify studies that reported outcomes of liver resection as the primary curative treatment for Barcelona clinic Liver Cancer(BCLC) stage B or C HCC. The primary end point was to determine the overall survival(OS) and disease free survival(DFS) of liver resection of HCC in BCLC stage B or C in patients with adequate liver reserve(i.e., Child's A or B status). The secondary end points were to assess the morbidity and mortality of liver resection in large HCC(defined as lesions larger than 10 cm in diameter) and to compare the OS and DFS after surgical resection of solitary vs multifocal *** We identified 74 articles which met the inclusion criteria and were analyzed in this systematic review. Analysis of the resection outcomes of the included studies were grouped according to(1) BCLC stage B or C HCC,(2) Size of HCC and(3) multifocal tumors. The median 5-year OS of BCLC stage B was 38.7%(range 10.0-57.0); while the median 5-year OS of BCLC stage C was 20.0%(range 0.0-42.0). The collective median 5-year OS of both stages was 27.9%(0.0-57.0). In examining the morbidity and mortality following liver resection in large HCC, the pooled RR for morbidity [RR(95%CI) = 1.00(0.76-1.31)] and mortality [RR(95%CI) = 1.15(0.73-1.80)] were not significant. Within the spectrum of BCLC B and C lesions, tumors greater than 10 cm were reported to have median 5-year OS of 33.0% and multifocal lesions 54.0%.CONCLUSION Indication for surgical resection should be extended to BCLC stage B lesions in selected patients. Further studies are needed to stratify stage C lesions for resection.

关键词： Barcelona clinic Liver Cancer Hepatocellular carcinoma Hepatectomy Milan criteria