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Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography:A single-blind,multicenter,randomized controlled trial

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Chinese Medical Journal 2024年第12期137卷 1437-1446页

作者： Wenbo Meng Joseph W.Leung Zhenyu Wang Qiyong Li Leida Zhang Kai Zhang Xuefeng Wang Meng Wang Qi Wang Yingmei Shao Jijun Zhang Ping Yue Lei Zhang Kexiang Zhu Xiaoliang Zhu Hui Zhang Senlin Hou Kailin Cai Hao Sun Ping Xue Wei Liu Haiping Wang Li Zhang Songming Ding Zhiqing Yang Ming Zhang Hao Weng QingyuanWu Bendong Chen Tiemin Jiang Yingkai Wang Lichao Zhang Ke Wu Xue Yang Zilong Wen Chun Liu LongMiao Zhengfeng Wang Jiajia Li Xiaowen Yan Fangzhao Wang Lingen Zhang Mingzhen Bai Ningning Mi XianzhuoZhang Wence Zhou Jinqiu Yuan Azumi Suzuki Kiyohito Tanaka Jiankang Liu Ula Nur Elisabete Weiderpass Xun Li department of General Surgery The First Hospital of Lanzhou UniversityLanzhouGansu 730000China Key Laboratory of Biological Therapy and Regenerative Medicine Transformation Gansu Province LanzhouGansu 730000China Division of Gastroenterology and Hepatology UC Davis Medical CenterSacramentoCA 95816USA department of Minimally Invasive Surgery Tianjin Nankai HospitalTianjin 300100China Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryShulan(Hangzhou)Hospital Affiliated to Zhejiang Shuren UniversityHangzhouZhejiang 310000China department of Hepatobiliary Surgery Southwest HospitalArmy Medical UniversityChongqing 400000China Hepatobiliary Surgery department Shandong Provincial Third HospitalJinanShandong 250000China department of General Surgery Xinhua HospitalAffiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Laboratory of Biliary Tract Disease ResearchShanghai 200000China department of Hepatobiliary and Pancreatic Surgery The First Hospital of Jilin UniversityChangchunJilin 130000China department of Hepatobiliary Surgery The General Hospital of Ningxia Medical UniversityYinchuanNingxia 750000China department of Hepatobiliary&Hydatid Digestive and Vascular Surgery CenterXinjiang Key Laboratory of Echinococcosis and Liver Surgery ResearchThe First Affiliated Hospital of Xinjiang Medical UniversityUrumqiXinjiang 830000China department of Hepatobiliary and Pancreatic Surgery The First Hospital of Shanxi Medical UniversityTaiyuanShanxi 030000China department of General Surgery The Second Hospital of Lanzhou UniversityLanzhouGansu 730000China department of Biliopancreatic Endoscopic Surgery The Second Hospital of Hebei Medical UniversityShijiazhuangHebei 050000China Gastrointestinal Surgery department Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430000China department of Hepatobiliary Surgery The First Affiliated Hospital of Xi’an Jiaotong UniversityXi’anShaanxi 710000China Depart

Background:Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography(ERCP),the benefits and safety of high-carbohydrate fluid diet(CFD)intake 2 h before ERCP remain *** study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’***:This prospective,multicenter,randomized controlled trial involved 15 tertiary ERCP centers.A total of 1330 patients were randomized into CFD group(n=665)and fasting group(n=665).The CFD group received 400 mL of maltodextrin orally 2 h before ERCP,while the control group abstained from food/water overnight(>6 h)before *** ERCP procedures were performed using deep sedation with intravenous *** investigators were blinded but not the *** primary outcomes included postoperative fatigue and abdominal pain score,and the secondary outcomes included complications and changes in metabolic *** outcomes were analyzed according to a modified intention-to-treat ***:The post-ERCP fatigue scores were significantly lower at 4 h(4.1±2.6 vs.4.8±2.8,t=4.23,Pnd 20 h(2.4±2.1 vs.3.4±2.4,t=7.94,P26-0.71,Pnd 0.76(95%CI:0.57-0.95,P2.1±1.7 vs.2.2±1.7,t=2.60,P=0.009,with a least-squares mean difference of 0.21[95%CI:0.05-0.37])and positive urine ketone levels(7.7%[39/509]vs.15.4%[82/533],χ^(2)=15.13,P2.1%[13/634]vs.4.0%[26/658],χ^(2)=3.99,P=0.046)but not pancreatitis(5.5%[35/634]vs.6.5%[43/658],χ^(2)=0.59,P=0.444).Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla(odds ratio[OR]:0.61,95%CI:0.39-0.95,P=0.028)in the multivariable ***:Ingesting 400 mL of CFD 2 h before ERCP is safe,with a reduction in post-ERCP fatigue,

关键词： Endoscopic retrograde cholangiopancreatography ERCP Carbohydrate Fasting Safety Complications Enhanced recovery after surgery Randomized controlled trial

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Predictors of common bile duct lithiasis in laparoscopic era

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World Journal of Gastroenterology 2005年第21期11卷 3267-3272页

作者： George Sgourakis Georgia Dedemadi Athanasios Stamatelopoulos Emmanuel Leandros Dionysius Voros Konstantinos Karaliotas 2nd surgical department of korgialenio-mpenakio red cross hospital athens Greece surgical department of Hippocration University Hospital of AthensGreece surgical department of Areteion University Hospital of Athens Greece

AIM: To analyze retrospectively the records of 294 conse-cutive patients operated upon for gallbladder stones, to determine the predictive factors of synchronous common bile duct (CBD) stones and validate prospectively the generated model. METHODS: The prognostic estimation of a biochemical test and ultrasonography alone to differentiate between the absence and presence of choledocholithiasis was assessed using receiver operating characteristics curve analysis. Multivariate analysis was employed using discriminant analysis for establishment of a best model. Prospective validation of the model was ***: Discriminant forward stepwise analysis disclosed that high values (≥ 2×normal) of SGOT, ALP, conjugated bilirubin and CBD diameter on ultrasound ≥ 10 mm were all prognostic factors of CBD lithiasis in univariate and multivariate analysis, P＜0.01. History was not included in the model. Prospective validation of the model was performed by multivariate analysis using Visual General Stepwise Regression. Positive predictive value,when considering all these predictors, was 93.3%, while the negative predictive value was 88.8%. Sensitivity of the model was 96.5% and specificity 80%.CONCLUSION: The above model can be objectively applied to predict the presence of CBD stones.

关键词：胆管结石症病理机制胆红素

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nd:YAG water mist laser treatment for giant gestational gingival tumor: A case report

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World Journal of Clinical Cases 2024年第11期12卷 1974-1979页

作者： Hong-Yu Chen Jun-Ji Xu Xiu-Lin Chang Pei Wu department of Stomatology Women and Children's Hospital Affiliated to Ningbo UniversityNingbo 315012Zhejiang ProvinceChina

BACKGROUnd This case of gestational gingival tumor is huge and extremely rare in clinical *** the growth location of this gingival tumor is in the upper anterior tooth area,it seriously affects the pregnant woman's speech and food,causing great pain to the *** use of nd:YGA water mist laser to remove the gingival tumor resulted in minimal intraoperative bleeding,minimal adverse reactions,and good postoperative healing,which is worthy of clinical promotion and *** SUMMARY The patient,a pregnant woman,reported a large lump in her mouth on the first day of postpartum *** on medical history and clinical examination,the diagnosis was diagnosed as gestational gingival *** pathological biopsy also confirmed this *** use of nd:YAG water mist laser to remove the tumor resulted in minimal intraoperative bleeding,clear surgical field of view,short surgical time,and good postoperative *** In comparison to traditional surgery,nd:YAG water mist laser surgery is minimally invasive,minimizes cell damage,reduces bleeding,ensures a clear field of vision,and virtually eliminates postoperative edema,carbonization,and the risk of cross *** has unique advantages in oral soft tissue surgery for pregnant ***,the clinical application of nd:YAG water mist laser for the treatment of gestational gingival tumors is an ideal choice.

关键词： Gestational gingival tumor nd:YAG water mist laser Granulomatous gingival tumor Minimally invasive dentistry Pregnancy related diseases Oral soft tissue surgery Case report

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Severe monobacterial necrotizing soft tissue infection by group A Streptococcus:A surgical emergency

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Asian Pacific Journal of Tropical Biomedicine 2012年第3期2卷 250-252页

作者： Sophocles Lanitis Khan MAA Sgourakis G Kontovounisios C Papaconstandinou T Karaliotas C Second surgical department and Unit of surgical Oncology "korgialenio-Benakio" Red Cross Athens General Hospital Specialist Registrar Department of Plastic and Reconstructive SurgeryCastle Hill Hospital

Eight percent of necrotizing soft tissue infections(NSTI) are attributable to group A Streptococci(GAS),and among these,50%develop streptococcal toxic shock *** reported mortality associated with NSTI reaches 32%.We present cases of two healthy individuals with minor GAS skin infection which developed to a rapidly progressed NSTI and sepsis despite of the antibiotic treatment,aiming to discuss the lessons learned from the course and management of these patients.

关键词： Necrotizing soft tissue infection Group A Streptococci Fulminant skin necrosis

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Identification of telomere maintenance gene variations related to lung adenocarcinoma risk by genome-wide association and whole genome sequencing analyses

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Cancer Communications 2024年第2期44卷 287-293页

作者： Kouya Shiraishi Atsushi Takahashi Yukihide Momozawa Yataro Daigo Syuzo Kaneko Takahisa Kawaguchi Hideo Kunitoh Shingo Matsumoto Hidehito Horinouchi Akiteru Goto Takayuki Honda Kimihiro Shimizu Masahiro Torasawa Daisuke Takayanagi Motonobu Saito Akira Saito Yuichiro Ohe Shun-ichi Watanabe Koichi Goto Masahiro Tsuboi Katsuya Tsuchihara Sadaaki Takata Tomomi Aoi Atsushi Takano Masashi Kobayashi Yohei Miyagi Kazumi Tanaka Hiroyuki Suzuki Daichi Maeda Takumi Yamaura Maiko Matsuda Yoko Shimada Takaaki Mizuno Hiromi Sakamoto Teruhiko Yoshida Yasushi Goto Tatsuya Yoshida Taiki Yamaji Makoto Sonobe Shinichi Toyooka Kazue Yoneda Katsuhiro Masago Fumihiro Tanaka Megumi Hara Nobuo Fuse Satoshi S.Nishizuka Noriko Motoi Norie Sawada Yuichiro Nishida Kazuki Kumada Kenji Takeuchi Kozo Tanno Yasushi Yatabe Kuniko Sunami Tomoyuki Hishida Yasunari Miyazaki Hidemi Ito Mitsuhiro Amemiya Hirohiko Totsuka Haruhiko Nakayama Tomoyuki Yokose Kazuyoshi Ishigaki Toshiteru Nagashima Yoichi Ohtaki Kazuhiro Imai Ken Takasawa Yoshihiro Minamiya Kazuma Kobayashi Kenichi Okubo Kenji Wakai Atsushi Shimizu Masayuki Yamamoto Motoki Iwasaki Koichi Matsuda Johji Inazawa Yuichi Shiraishi Hiroyoshi Nishikawa Yoshinori Murakami Michiaki Kubo Fumihiko Matsuda Yoichiro Kamatani Ryuji Hamamoto Keitaro Matsuo Takashi Kohno Division of Genome Biology National Cancer Center Research InstituteTokyoJapan department of Clinical Genomics National Cancer Center Research InstituteTokyoJapan Laboratory for Statistical Analysis Center for Integrative Medical SciencesRIKENYokohamaJapan department of Genomic Medicine Research InstituteNational Cerebral and Cardiovascular CenterOsakaJapan Laboratory for Genotyping Development Center for Integrative Medical SciencesRIKENYokohamaJapan Center for Antibody and Vaccine Therapy Research HospitalInstitute of Medical ScienceThe University of TokyoTokyoJapan department of Medical Oncology and Cancer Center and Center for Advanced Medicine against CancerShiga University of Medical ScienceOtsuJapan Division of Medical AI Research and Development National Cancer Center Research InstituteTokyoJapan Center for Genomic Medicine Graduate School of MedicineKyoto UniversityKyotoJapan department of Medical Oncology Japanese Red Cross Medical CenterTokyoJapan department of Thoracic Oncology National Cancer Center Hospital EastJapan department of Thoracic Oncology National Cancer Center HospitalTokyoJapan department of Cellular and Organ Pathology Graduate School of MedicineAkita UniversityAkitaJapan department of Respiratory Medicine Tokyo Medical and Dental UniversityBunkyo-kuTokyoJapan Division of General Thoracic Surgery Department of SurgeryShinshu University School of MedicineMatsumotoNaganoJapan department of General surgical Science Division of General Thoracic SurgeryGunma University Graduate School of MedicineIntegrative Center of General SurgeryGunma University HospitalGunmaJapan department of Gastrointestinal Tract Surgery Fukushima Medical University School of MedicineFukushimaJapan StaGen Co. LtdTokyoJapan Division of Thoracic Surgery National Cancer Center HospitalTokyoJapan department of Thoracic Surgery National Cancer Center Hospital EastChibaJapan Division of Translational Informatics Exploratory Oncology Research and Clinical Trial Center(EPOC

Dear editor,Lung carcinoma is responsible for the highest fatal-ity rate among cancer-related deaths globally,with lung adenocarcinoma(LADC)emerging as the prevailing sub-type.

关键词： adenocarcinoma lung Lung

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Factors other than fibrosis that increase measured shear wave velocity

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World Journal of Gastroenterology 2022年第46期28卷 6512-6521页

作者： Hiroko Naganuma Hideaki Ishida department of Gastroenterology Yokote Municipal HospitalYokote 013-8602Japan department of Gastroenterology Akita Red Cross HospitalAkita 010-1495Japan

Shear wave elastography(SWE)is now becoming an indispensable diagnostic tool in the routine examination of liver *** particular,accuracy is required for shear wave propagation velocity measurement,which is directly related to diagnostic *** is generally accepted that the liver shear wave propagation velocity reflects the degree of fibrosis,but there are still few reports on other factors that increase the shear wave propagation *** this study,we reviewed such factors in the literature and examined their *** SWE measures propagation velocity based on the assumption that the medium has a homogeneous structure,uniform density,and is purely ***,the measurement is subject to *** other(confounding)factors that we routinely experience are primarily:(1)Conditions that appear to increase the viscous component;and(2)Conditions that appear to increase tissue ***,the former includes acute hepatitis,congested liver,biliary obstruction,etc,and the latter includes diffuse infiltration of malignant cells,various storage diseases,tissue necrosis,*** any case,it is important to evaluate SWE in the context of the entire clinical picture.

关键词： Liver Shear wave elastography Propagation velocity Viscoelasticity Artifact Ultrasound

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Endoscopic and surgical resection of T1a/T1b esophageal neoplasms: A systematic review

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World Journal of Gastroenterology 2013年第9期19卷 1424-1437页

作者： George Sgourakis Ines Gockel Hauke Lang department of General and Abdominal Surgery Johannes Gutenberg University Hospital of Mainz 2nd surgical department and surgical Oncology Unit of "korgialenio-Benakio" Red Cross Hospital of Athens

AIM: To investigate potential therapeutic recommendations for endoscopic and surgical resection of T1a/ T1b esophageal neoplasms. METHODS: A thorough search of electronic databases MEDLINE, Embase, Pubmed and Cochrane Library, from 1997 up to January 2011 was performed. An analysis was carried out, pooling the effects of outcomes of 4241 patients enrolled in 80 retrospective studies. For comparisons across studies, each reporting on only one endoscopic method, we used a random effects meta-regression of the log-odds of the outcome of treatment in each study. "Neural networks" as a data mining technique was employed in order to establish a prediction model of lymph node status in superficial submucosal esophageal carcinoma. Another data mining technique, the "feature selection and root cause analysis", was used to identify the most impor-tant predictors of local recurrence and metachronous cancer development in endoscopically resected patients, and lymph node positivity in squamous carcinoma (SCC) and adenocarcinoma (ADC) separately in surgically resected patients. RESULTS: Endoscopically resected patients: Low grade dysplasia was observed in 4% of patients, high grade dysplasia in 14.6%, carcinoma in situ in 19%, mucosal cancer in 54%, and submucosal cancer in 16% of patients. There were no significant differences between endoscopic mucosal resection and endoscopic submucosal dissection (ESD) for the following parameters: complications, patients submitted to surgery, positive margins, lymph node positivity, local recurrence and metachronous cancer. With regard to piecemeal resection, ESD performed better since the number of cases was significantly less [coefficient: -7.709438, 95%CI: (-11.03803, -4.380844), P 28, 95%CI: (-6.151498, -1.915559),P 22266, 95%CI: (3.810146, 10.83439), P < 0.001]. A

关键词： Superficial esophageal cancer Endoscopic resection Mucosal infiltration Submucosal involvement Recurrent tumor Controversies in treatment Squamous cell carcinoma Adenocarcinoma Lymphatic invasion Vascular invasion Submucosal layer Superficial submucosal layer Middle third submucosal layer Deep third submucosal layer Esophageal cancer Endoscopic gastrointestinal surgical procedures Endoscopic gastrointestinal surgery Lymph node dissection Dysplasia

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Frontal Sinus Fractures: Management at the Yalgado Ouedraogo University hospital Centre (Burkina Faso)

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Open Journal of Stomatology 2024年第1期14卷 42-54页

作者： Arsène Coulibaly Patrik Gane-Bang Joseph Wend-Toin Biogo Ibraïma Traoré Tarcissus Konsem department of Maxillofacial Surgery Regional University Hospital Centre of Ouahigouya Ouahigouya Burkina Faso department of Stomatology and Maxillofacial Surgery Regional Hospital Centre of Banfora Banfora Burkina Faso department of Neurosurgery Regional University Hospital Centre of Ouahigouya Ouahigouya Burkina Faso department of Stomatology and Maxillofacial Surgery Souro SANOU University Hospital Centre Bobo Dioulasso Burkina Faso department of Stomatology and Maxillofacial Surgery Yalgado OUEDRAOGO University Hospital Centre Ouagadougou Burkina Faso

Introduction: Frontal sinus fractures are potentially serious. They are defined as a solution of continuity, open or closed, of one or both bone tables of the frontal sinus. This study aims to report on the management of them at the Yalgado OUEDRAOGO University hospital Centre. Methodology: It is a descriptive cross-sectional study with retrospective collection from January 01, 2016 to December 31, 2018. Patients with frontal sinus fractures were managed at the Yalgado OUEDRAOGO University hospital Centre through CT-scan proof. Results: Over three years, a total of 102 cases of frontal sinus fractures were collected with 29.9 years as average age. There were 96 men. Workers in the informal sector and pupils/students represented 58.90% of patients. The residence of the patients was urban in 68.80% of cases and rural in 31.40%. Road traffic accidents (RTAs) happened in 90.20%, and involved 2-wheelers in 98.20%. None of these drivers was wearing a helmet. The type III frontal fracture of Ioannides et al. represented 51.9% of cases. In 89.21% of cases, other facial and/or cranioencephalic injuries were compounded to frontal sinus fractures. No surgical management was observed in 82 (80.39%) patients and surgical management in 20 (19.61%) patients. The outcome was favourable, but sequelae and/or complications were noted in 10 patients who had surgery and 30 patients who did not. Conclusion: These results enforce helmet wearing for all riders of two-wheeled machines. In addition, vaccinations to prevent meningitis in frontal sinus fractures with dural breach should be systematic.

关键词： Management Frontal Sinus Fracture Burkina Faso

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Corticosteroid-free immunosuppression in liver transplantation: An evidence-based review

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World Journal of Gastroenterology 2014年第31期20卷 10703-10714页

作者： George Sgourakis Georgia Dedemadi 2~(nd) surgical department and surgical Oncology Unit "Korgialenio-Benakio" Red Cross Hospital surgical department of "Amalia Fleming" General hospital

Thirty-six randomized controlled trials and two metaanalyses were reviewed. With respect to adult patients undergoing first orthotopic liver transplantation(OLT), steroid replacement resulted in fewer cases of overall acute rejection in the corticosteroid free-immunosuppression arm. Initial steroid administration for two weeks and early tacrolimus monotherapy is a feasible immunosuppression regimen without steroid replacement, although further investigations are needed in view of chronic rejections. No significant differences were noted between the treatment groups in terms of patient and graft survival independently of steroid replacement. Renal insufficiency, de novo hypertension, neurological disorders and infectious complications did not differ significantly among steroid and steroidfree groups. Diabetes mellitus, cholesterol levels and cytomegalovirus infection are more frequent in patients within the steroid group. With respect to diabetes mellitus and hypercholesterolemia, the difference was independent of steroid replacement. In relation to transplanted hepatitis C virus patients, mycophenolate mofetil does not appear to have a significant antiviral effect despite early reports. Male gender of donors and recipients, living donors, cold ischemia times, acute rejection, and early histological recurrence were related to the development of advanced hepatitis. There is sufficient scientific clinical evidence advocating avoidance of the ab initio use of steroids in OLT.

关键词： Meta-analysis Evidence based Hepatitis C virus rec

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Endothelial progenitor cells mobilization after maximal exercise according to heart failure severity

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World Journal of Cardiology 2020年第11期12卷 526-539页

作者： Christos Kourek Eleftherios Karatzanos Katherina Psarra Georgios Georgiopoulos Dimitrios Delis Vasiliki Linardatou Gerasimos Gavrielatos Costas Papadopoulos Serafim Nanas Stavros Dimopoulos department of Clinical Ergospirometry Exercise&Rehabilitation LaboratoryEvaggelismos HospitalAthens 10676Greece Immunology and Histocompatibility department Evaggelismos HospitalAthens 10676Greece department of Clinical Therapeutics Alexandra HospitalAthens 11528Greece department of Cardiology Tzaneio General Hospital of PiraeusPiraeus 18536Greece 2nd Cardiology department Korgialenio-Benakio Red Cross HospitalAthens 11526Greece Cardiac Surgery Intensive Care Unit Onassis Cardiac Surgery CenterAthens 17674Greece

BACKGROUnd Vascular endothelial dysfunction is an underlying pathophysiological feature of chronic heart failure(CHF).Patients with CHF are characterized by impaired vasodilation and inflammation of the vascular *** also have low levels of endothelial progenitor cells(EPCs).EPCs are bone marrow derived cells involved in endothelium regeneration,homeostasis,and *** has been shown to improve vasodilation and stimulate the mobilization of EPCs in healthy people and patients with cardiovascular ***,the effects of exercise on EPCs in different stages of CHF remain under *** To evaluate the effect of a symptom-limited maximal cardiopulmonary exercise testing(CPET)on EPCs in CHF patients of different *** Forty-nine consecutive patients(41 males)with stable CHF[mean age(years):56±10,ejection fraction(EF,%):32±8,peak oxygen uptake(VO2,mL/kg/min):18.1±4.4]underwent a CPET on a cycle *** blood was sampled before and after *** circulating endothelial populations were quantified by flow cytometry:Three subgroups of EPCs[CD34+/CD45-/CD133+,CD34+/CD45-/CD133+/VEGFR2 and CD34+/CD133+/vascular endothelial growth factor receptor 2(VEGFR2)]and two subgroups of circulating endothelial cells(CD34+/CD45-/CD133-and CD34+/CD45-/CD133-/VEGFR2).Patients were divided in two groups of severity according to the median value of peak VO2(18.0 mL/kg/min),predicted peak VO2(65.5%),ventilation/carbon dioxide output slope(32.5)and EF(reduced and mid-ranged EF).EPCs values are expressed as median(25th-75th percentiles)in cells/106 enucleated *** Patients with lower peak VO2 increased the mobilization of CD34+/CD45-/CD133+[pre CPET:60(25-76)vs post CPET:90(70-103)cells/106 enucleated cells,P2[pre CPET:1(1-4)vs post CPET:5(3-8)cells/106 enucleated cells,P247-658)cells/106 enucleated cells,P<0.001]an

关键词： Chronic heart failure Endothelial progenitor cells Circulating endothelial cells Maximal exercise Cardiopulmonary exercise testing Severity

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