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Impact of pain on health-related quality of life in patients with inflammatory bowel disease

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World Journal of Gastroenterology 2010年第25期16卷 3168-3177页

作者： Anja Schirbel Anne Reichert Stephanie Roll Daniel C Baumgart Carsten Büning Bianca Wittig Bertram Wiedenmann Axel Dignass Andreas Sturm Division of Gastroenterology and Hepatology Department of Medicine Charité-Campus Virchow Clinic Universittsmedizin Berlin 13353 Berlin Germany Institute for Social Medicine Epidemiology and Health Economics Campus Mitte Charité-Universittsmedizin Berlin 10117 Berlin Germany Division of Gastroenterology Hepatology and Endocrinology Campus Mitte Charité-Universittsmedizin Berlin 10117 Berlin Germany Division of Gastroenterology Infectiology and Rheumatology Department of Medicine Charité-Campus Benjamin Franklin Universittsmedizin Berlin 12203 Berlin Germany Department of Medicine I Markus-Hospital Wilhelm-Epstein-Str. 4. 60431 Frankfurt/Main Germany

AIM: To evaluate intensity, localization and cofactors of pain in Crohn’s disease and ulcerative colitis patients in connection with health-related quality of life (HRQOL) and disease activity. METHODS: We reviewed and analyzed the responses of 334 patients to a specifically designed questionnairebased on the short inflammatory bowel disease questionnaire (SIBDQ) and the German pain questionnaire. Pain intensity, HRQOL, Crohn’s disease activity index (CDAI) and colitis activity index (CAI) were correlated and verified on a visual analog scale (VAS). RESULTS: 87.9% of patients reported pain. Females and males reported comparable pain intensities and HRQOL. Surgery reduced pain in both genders (P = 0.023), whereas HRQOL only improved in females. Interestingly, patients on analgesics reported more pain (P = 0.003) and lower HRQOL (P = 0.039) than patients not on analgesics. A significant correlation was found in UC patients between pain intensity and HRQOL (P = 0.023) and CAI (P = 0.027), and in CD patients between HRQOL and CDAI (P = 0.0001), but not between pain intensity and CDAI (P = 0.35). No correlation was found between patients with low CDAI scores and pain intensity. CONCLUSION: Most IBD patients suffer from pain and have decreased HRQOL. Our study reinforces the need for effective individualized pain therapy in IBD patients.

关键词： Disease activity index Health-related quality of life Inflammatory bowel disease Pain

Composite tissue allotransplantation: opportunities and challenges

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Cellular & Molecular Immunology 2019年第4期16卷 343-349页

作者： Jasper Iske Yeqi Nian Ryoichi Maenosono Max Maurer Igor M.Sauer Stefan G.Tullius Division of Transplant Surgery Department of SurgeryBrigham and Women’s HospitalHarvard Medical SchoolBostonMAUSA Institute of Transplant Immunology Integrated Research and Treatment Center TransplantationHannover Medical SchoolHannoverLower SaxonyGermany Department of Surgery Charité-Universitätsmedizin BerlinCampus CharitéMitte and Virchow-KlinikumBerlinGermany Einstein-BIH Visiting Fellow Department of SurgeryCharité-Universitätsmedizin BerlinCampus CharitéMitte and Virchow-KlinikumcBerlinGermany

Vascularized composite allotransplants(VCAs)have unique properties because of diverse tissue components transplanted en mass as a single *** addition to surgery,this type of transplant also faces enormous immunological challenges that demand a detailed analysis of all aspects of alloimmune responses,organ preservation,and injury,as well as the immunogenicity of various tissues within the VCA grafts to further improve graft and patient ***,the side effects of long-term immunosuppression for VCA patients need to be carefully balanced with the potential benefit of a non-life-saving *** this review article,we provide a comprehensive update on limb and face transplantation,with a specific emphasis on the alloimmune responses to VCA,established and novel immunosuppressive treatments,and patient outcomes.

关键词： surgery challenges graft

Validation of the Enhanced Recovery after Surgery (ERAS) society recommendations for liver surgery: a prospective, observational study

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Hepatobiliary Surgery and Nutrition 2023年第1期12卷 20-36,I0003-I0006页

作者： Moritz Schmelzle Felix Krenzien Paul Dahlke Alina Krombholz Nora Nevermann Linda Feldbrügge Axel Winter Wenzel Schoning Christian Benzing Johann Pratschke Jens Neudecker Department of Surgery Campus Charite Mitte and Campus Virchow-KlinikumCharite-Universitatsmedizincorporate member of Freie Universität BerlinHumboldt-Universitat zu BerlinBerlinGermany Berlin Institute of Health(BIH) BerlinGermany

Twenty-three recommendations were summarized by the Enhanced Recovery After Surgery(ERAS)society for liver *** aim was to validate the protocol especially with regard to adherence and the impact on ***:Using the ERAS Interactive Audit System(EIAS),ERAS items were evaluated in patients undergoing liver *** a period of 26 months,304 patients were prospectively enrolled in an observational study(DRKS00017229).Of those,51 patients(non-ERAS)were enrolled before and 253 patients(ERAS)after the implementation of the ERAS *** adherence and complications were compared between the two ***:Overall adherence increased from 45.2%in the non-ERAS group to 62.7%in the ERAS group(P0.05).Overall complications decreased from 41.2%(n=21)in the non-ERAS group to 26.5%(n=67)in the ERAS group(P=0.0423),which was mainly due to the reduction of grade 1-2 complications from 17.6%(n=9)to 7.6%(n=19)(P=0.0322).As for patients undergoing open surgery,implementation of ERAS lead to a reduction of overall complications in patients scheduled for minimally invasive liver surgery(MILS)(P=0.036).Conclusions:Implementation of the ERAS protocol for liver surgery according to the ERAS guidelines of the ERAS Society reduced Clavien-Dindo grade 1-2 complications particularly in patients who underwent *** ERAS guidelines are beneficial for the outcome,while adherence to the various items has not yet been satisfactorily defined.

关键词： Enhanced Recovery After Surgery(ERAS) prehabilitation liver surger

Conventional therapy for Crohn's disease

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World Journal of Gastroenterology 2006年第30期12卷 4794-4806页

作者： Carsten Büning Herbert Lochs Department of Gastroenterology Hepatology & Endocrinology Charité Campus Mitte Universittsmedizin Berlin Berlin Germany

Crohn 的疾病(CD ) 是未知原因的多因素的混乱。关于 CD 的病理生理学的突出的进步导致了创新治疗学的概念的开发。众多的控制试用在最后年在 CD 被执行了。然而，许多药没被规章的当局由于功效或严重副作用的缺乏同意了。因此，包括象 ... 详细信息

Crohn 的疾病(CD ) 是未知原因的多因素的混乱。关于 CD 的病理生理学的突出的进步导致了创新治疗学的概念的开发。众多的控制试用在最后年在 CD 被执行了。然而，许多药没被规章的当局由于功效或严重副作用的缺乏同意了。因此，包括象 azathioprine 那样的 5-ASA，全身或热门的 corticosteroids，和抑制免疫力的药，著名的药仍然是 CD 治疗的支柱。重要地，象 infliximab 那样的生物制品出现了在象 fistulizing 或类固醇依赖者 CD 那样的有问题的背景有效。这评论被打算为 CD 的常规处理把实际指南给临床医生。当可得到时，我们专注于使随机化的、控制安慰剂的审判和元分析的结果，提供证据的最高的度。我们提供基于证据的处理算法每当时可能。然而，许多临床的状况没被控制临床的审判回答了，通过专家意见充满这些差距是重要的。我们希望这评论在 CD 的挑战性的处理为临床医生提供一个有用工具。

关键词：常规治疗结肠疾病临床病理机制

Malnutrition affects quality of life in gastroenterology patients

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World Journal of Gastroenterology 2006年第21期12卷 3380-3385页

作者： Kristina Norman Henriette Kirchner Herbert Lochs Matthias Pirlich Klinik mil Schwerpunkt Gastroenterologie Hepatologie und Endokrinologie Charité-Universit(a|¨)tsmedizin Berlin Campus MitteGermany

瞄准：与良性的胃肠的疾病调查在在病人的生命的营养不良和质量之间的协会。方法：200 个病人(养育的 104 井并且 96 营养不良) 根据主观全球评价，人体测量的大小和简历被估计电的阻抗分析。生命的质量与短形式的一般健康调查的验证医... 详细信息

瞄准：与良性的胃肠的疾病调查在在病人的生命的营养不良和质量之间的协会。方法：200 个病人(养育的 104 井并且 96 营养不良) 根据主观全球评价，人体测量的大小和简历被估计电的阻抗分析。生命的质量与短形式的一般健康调查的验证医药结果学习 36 条款(SF 36 ) 被决定。肌肉功能手工被估计掌握力量和山峰流动。结果：身体集体索引，身体细胞群，手臂肌肉区域和手握力法力量在营养不良的病人是显著地更低的。当时，生命的质量通常更低与标准价值相比。七从生活规模的八质量(排除身体疼痛) 显著地在营养不良的病人被减少。把病人与肝肝硬化和煽动性的肠疾病(IBD ) 作比较，有经历的 IBD 的病人显著地在感觉降低价值身体疼痛，社会工作和心理健康。营养不良的肝 cirrhotics 在更多的规模承受了减小(六从八) 比营养不良的 IBD，病人们做了(四从八) 。结论：生命的质量在良性的胃肠的疾病通常是低的并且进一步在作为营养不良被分类的病人被减少。看来，肝肝硬化病人比 IBD 病人做经历生命的高质量，但是营养不良的影响似乎比在 IBD 在肝肝硬化更大。

关键词：营养不良生存质量胃肠疾病肝硬化

Effective treatment of gastrointestinal bleeding with thalidomide- Chances and limitations

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World Journal of Gastroenterology 2016年第11期22卷 3158-3164页

作者： Juergen Bauditz Department of Internal Medicine Helios Klinik Anhalt/Zerbst Department of Gastroenterology Hepatology and InfectiologyCharité Campus MitteCharité University Hospital

For more than 50 years bleeding from gastrointestinal angiodysplasias has been treated by hormonal therapy with estrogens and progesterons. After a randomized study finally demonstrated that hormones have no effect on bleeding events and transfusion requirements, therapy has switched to endoscopic coagulation. However, angiodysplasias tend to recur over months to years and endoscopy often has to be repeated for long time periods. Thalidomide, which caused severe deformities in newborn children in the 1960 s, is now increasingly used after it was shown to suppress tumor necrosis factor alpha, inhibi t angiogenesis and to be also effective for treatment of multiple myeloma. In 2011 thalidomide was proven to be highly effective for treatment of bleeding from gastrointestinal angiodysplasias in a randomized study. Further evidence by uncontrolled studies exists that thalidomide is also useful for treatment of bleeding in hereditary hemorrhagic telangiectasia. In spite of this data, endoscopic therapy remains the treatment of choice in many hospitals, as thalidomide is still notorious for its teratogenicity. However, patients with gastrointestinal bleeding related to angiodysplasias are generally at an age in which women have no child-bearing potential. Teratogenicity is therefore no issue for these elderly patients. Other side-effects of thalidomide like neurotoxicity may limit treatment options but can be monitored safely.

关键词： Thalidomide Angiodysplasia Vascular malformation Gastrointestine Bleeding Therapy Angiogenesis Vascu

Hepatocellular carcinoma: Therapeutic advances in signaling,epigenetic and immune targets

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World Journal of Gastroenterology 2019年第25期25卷 3136-3150页

作者： Daniel Neureiter Sebastian Stintzing Tobias Kiesslich Matthias Ocker Institute of Pathology Cancer Cluster SalzburgParacelsus Medical University/Salzburger Landeskliniken(SALK)Salzburg 5020Austria Medical Department Division of Oncology and HematologyCampus CharitéMitteCharitéUniversity Medicine BerlinBerlin 10117Germany Department of Internal Medicine I Paracelsus Medical University/Salzburger Landeskliniken(SALK)and Institute of Physiology and PathophysiologyParacelsus Medical UniversitySalzburg 5020Austria Translational Medicine Oncology Bayer AGBerlin 13353Germany charitéUniversity Medicine Berlin Berlin 10117Germany

Hepatocellular carcinoma(HCC)remains a global medical burden with rising incidence due to chronic viral hepatitis and non-alcoholic fatty liver *** of advanced disease stages is still *** first and second generation tyrosine kinase inhibitors,immune checkpoint inhibitors have become central for the treatment of *** modalities like epigenetic therapy using histone deacetylase inhibitors(HDACi)and cell therapy approaches with chimeric antigen receptor T cells(CAR-T cells)are currently under investigation in clinical *** of such novel drugs is closely linked to the availability and improvement of novel preclinical and animal models and the identification of predictive *** current status of treatment options for advanced HCC,emerging novel therapeutic approaches and different preclinical models for HCC drug discovery and development are reviewed here.

关键词： Liver cancer Immunotherapy Checkpoint inhibitors Targeted therapy Mouse model Biomarker Next-generation sequencing Non-alcoholic steatohepatitis Fibrosis Clinical trial

Uptake of citrate-coated iron oxide nanoparticles into atherosclerotic lesions in mice occurs via accelerated transcytosis through plaque endothelial cells

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Nano Research 2016年第11期9卷 3437-3452页

作者： Wolfram C. Poller Evelyn Ramberger Philipp Boehm-Sturm Susanne Mueller Konstantin Moller Norbert Lowa Frank Wiekhorst Susanne Wagner Matthias Taupitz Eyk Schellenberger Gert Baumann Karl Stangl Verena Stangl Antje Ludwig Medizinische Klinik mit Schwerpunkt Kardiologie und Angiologie Charite-Universitatsmedizin Berlin Campus Mitte Chariteplatz 1 10117 Berlin Germany Abteilung fur Experimentelle Neurologie Center for Stroke Research Charite-Universitatsmedizin Berlin Chariteplatz 1 10117 Berlin Germany charite Core Facility '7 T experimental MRIs' Charite-Universitatsmedizin Berlin Chariteplatz 1 10117 Berlin Germany Physikalisch-Technische Bundesanstalt Abbestr. 2-12 10587Berlin Germany Institut fur Radiologie Charite-Universitatsmedizin Berlin Campus Mitte Charit@platz 1 10117 Berlin Germany DZHK (German Centre for Cardiovascular Research) partner site Berlin 10115 Berlin Germany Berlin Institute of Health (BIH) 10117 Berlin Germany

Very small superparamagnetic iron oxide nanoparticles （VSOPs） rapidly accumulate in atherosclerotic lesions, thereby enabling plaque visualization by magnetic resonance imaging （MRI）. This study was performed to identify the uptake mechanisms of VSOPs into atherosclerotic plaques. Low-density lipoprotein receptor-deficient （LDLR^-/-） mice with advanced atherosclerosis were analyzed using MRI and transmission electron microscopy （TEM） at various time points after intravenous administration of VSOPs. Post-mortem MRI detected VSOP labeling of atherosclerotic plaques 10 min after injection, and the signal increased over the first 3 h. TEM revealed that the intensive plaque labeling was mediated by accelerated transcytosis of VSOPs through endothelial cells overlaying atherosclerotic lesions. Experiments with endocytosis inhibitors and small interfering RNA （siRNA） revealed a dynamin-dependent mechanism involving both clathrin- and caveolin-mediated processes. In cell culture experiments, endothelial VSOP uptake was enhanced under proatherogenic flow and TNFα stimulation, conditions that are both present in plaque areas. Our study demonstrates that VSOPs enable non-invasive MRI assessment of accelerated endothelial transcytosis, an important pathomechanism in atherosclerotic plaque formation.

关键词： atherosclerosis,unstable plaques,magnetic resonanceimaging decreased endothelial barrier function,superparamagnetic ironoxide nanoparticles

3T腓动脉非增强MR血管成像:个体间比较3D血流依赖减影MRA和2D非血流依赖非减影MRA

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国际医学放射学杂志 2017年第1期 116-117页

作者： G.Knobloch M.T.Lauff S.Hirsch C.Schwenke B.Hamm M.Wagner 屈瑾 Department of Radiology Charité-Universit?tsmedizin BerlinCharité Campus Mitte

摘要目的比较3 T 3D血流依赖减影MRA和2D非血流依赖非减影MRA对腓动脉的评估。方法 42例外周动脉闭塞病人,行腓动脉非增强MRA,采用3 T MRA(快速自旋

关键词： MRA 流依赖腓动脉 MR 减影