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Partial hepatectomy versus interventional treatment in patients with hepatitis B virus-related hepatocellular carcinoma and clinically significant portal hypertension: a randomized comparative clinical trial

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cancer Communications 2024年第11期44卷 1337-1349页

作者： Yichuan Yuan Hong Peng Wei He Yun Zheng Jiliang Qiu Bin Chen Ruhai Zou Chenwei Wang Wan Yee Lau Binkui Li Yunfei Yuan State Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Department of liver Surgery Sun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China The center of Hepatocellular-pancreatobiliary Surgery The First Affiliated HospitalSun Yat-sen universityGuangzhouGuangdongP.R.China Department of Ultrasound Sun Yat-sen University Cancer CenterGuangzhouGuangdongP.R.China Faculty of Medicine The Chinese University of Hong KongHong KongSARP.R.China

Background:The widely accepted view that portal hypertension(PHT)is a con-traindication to hepatectomy for patients with hepatocellular carcinoma(HCC)is being increasingly *** long-term survival outcomes and safety of partial hepatectomy versus interventional treatment using ablation with or without pre-ablation transarterial chemoembolization(TACE)in patients with HBV-related HCC within the Milan criteria and with clinically significant PHT were compared in this ***:This open-label randomized clinical trial was conducted on consecu-tive patients with clinically PHT and hepatitis B virus(HBV)-related HCC with tumors which were within the Milan *** patients were randomized 1:1 to receive either partial hepatectomy or interventional treatment between December 2012 and June *** primary endpoint was overall survival(OS);secondary endpoints included recurrence-free survival(RFS)and therapeutic ***:Each of the 2 groups had 80 *** 1-,3-and 5-year OS rates in the partial hepatectomy group and the interventional treatment group were 95.0%,86.2%,69.5%versus 93.8%,77.5%,64.9%,respectively(P=0.325).The corresponding RFS rates were 78.8%,55.0%,46.2%versus 71.3%,52.5%,45.0%,respectively(P=0.783).The partial hepatectomy group had a higher compli-cation rate compared to the interventional group(67.5%vs.20%,P0.05).Conclusions:This study shows that partial hepatectomy treatment did not meet prespecified significance for improved OS and RFS compared to interventional treatment for patients with HBV-related HCC within the Milan criteria and with clinically significant ***,partial hepatectomy is still a safe procedure and should be considered as a treatment option rather than a contraindication.

关键词： hepatocellular carcinoma portal hypertension partial hepatectomy interventional treatment

Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multiinstitutional analysis (KROG 19-04)

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cancer Biology & Medicine 2022年第6期19卷 931-944页

作者： Sung Uk Lee Jinsil Seong Tae Hyun Kim Jung Ho Im Woo Chul Kim Kyubo Kim Hae Jin Park Tae Gyu Kim Youngkyong Kim Bae Kwon Jeong Jin Hee Kim Byoung Hyuck Kim Taek-Keun Nam center for proton therapy and center for liver and pancreatobiliary cancer National Cancer CenterGoyang 10408Korea Department of Radiation Oncology Yonsei Cancer CenterYonsei University College of MedicineSeoul 03722Korea Department of Radiation Oncology CHA Bundang Medical CenterCHA University School of MedicineSeongnam 13497Korea Department of Radiation Oncology Inha University HospitalInha University School of MedicineIncheon 22332Korea Department of Radiation Oncology Ewha Womans University Mokdong HospitalEwha Womans University College of MedicineSeoul 07985Korea Department of Radiation Oncology Hanyang University Medical CenterHanyang University College of MedicineSeoul 04763Korea Department of Radiation Oncology Samsung Changwon HospitalSungkyunkwan University School of MedicineChangwon 51353Korea Department of Radiation Oncology Kyung Hee University HospitalKyung Hee University College of MedicineSeoul 02447Korea Department of Radiation Oncology Gyeongsang National University HospitalGyeongsang National University College of MedicineJinju 52727Korea Department of Radiation Oncology Dongsan Medical CenterKeimyung University School of MedicineDaegu 41931Korea Department of Radiation Oncology Seoul Metropolitan Government Seoul National University Boramae Medical CenterSeoul 07061Korea Department of Radiation Oncology Chonnam National University Hwasun HospitalChonnam National University College of MedicineHwasun 58128Korea

Objective:The effectiveness of adjuvant treatments for resected gallbladder carcinoma(GBC)has remained unclear due to lack of randomized controlled trials;thus,the aim of present study was to evaluate the role of adjuvant treatments,including chemoradiotherapy(CRT)and/or chemotherapy(CTx),in patients with resected ***:A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional *** 733 patients,372(50.8%)did not receive adjuvant treatment,whereas 215(29.3%)and 146(19.9%)received adjuvant CTx and CRT,*** locoregional recurrence-free survival(LRFS),recurrence-free survival(RFS),and overall survival(OS)of the adjuvant treatment groups were compared according to tumor stage(stage II *** III–IV).Results:In stage II disease(n=381),the 5-year LRFS,RFS,and OS were not significantly different among the no-adjuvant therapy,CTx,and CRT groups,and positive resection margin,presence of perineural invasion,and Nx classification were consistently associated with worse LRFS,RFS,and OS in the multivariate analysis(Ptherapy and CTx groups(67.8%,45.2%,and 56.9%;37.9%,28.8%,and 35.4%;and 45.0%,30.0%,and 45.7%,respectively)(P<0.05).Conclusions:CRT has value as adjuvant treatment for resected GBC with stage III–IV *** study is needed for stage II disease with high-risk features.

关键词： Gallbladder cancer adjuvant treatment chemoradiotherapy locoregional recurrence-free survival overall survival

Differential risk of 23 site-specific incident cancers and cancer-related mortality among patients withmetabolic dysfunction-associated fatty liver disease:a population-based cohort study with 9.7 million Korean subjects

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cancer Communications 2023年第8期43卷 863-876页

作者： Goh Eun Chung Su Jong Yu Jeong-Ju Yoo Yuri Cho Kyu-na Lee Dong Wook Shin Yoon Jun Kim Jung-Hwan Yoon Kyungdo Han Eun Ju Cho Department of Internal Medicine and Healthcare Research Institute Seoul National University Hospital Healthcare System Gangnam CenterSeoulRepublic of Korea Department of Internal Medicine and liver Research Institute Seoul National University College of MedicineSeoulRepublic of Korea Department of Gastroenterology and Hepatology Soonchunhyang University Bucheon HospitalBucheonGyeonggi-doRepublic of Korea center for liver and pancreatobiliary cancer National Cancer CenterGoyangGyeonggi-doRepublic of Korea Department of Biomedicine&Health Science Catholic University of KoreaSeoulRepublic of Korea Department of Family Medicine/Supportive care center Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea Department of Clinical Research Design and Evaluation/Department of Digital Health Samsung Advanced Institute for Health ScienceSeoulRepublic of Korea Department of Statistics and Actuarial Science Soongsil UniversitySeoulRepublic of Korea

Introduction:Although an association between metabolic dysfunctionassociated fatty liver disease(MAFLD)and cardiovascular disease or overall mortality has been reported,it is unclearwhether there is an association between MAFLD and cancer incidence or *** aimed to investigate the differential risk of all-and site-specific cancer incidence and mortality according to MAFLD subgroups categorized by additional etiologies of liver ***:Using the Korean National Health Insurance Service database,we stratified the participants into three groups:(1)single-etiology MAFLD(SMAFLD)or MAFLD of pure metabolic origin;(2)mixed-etiology MAFLD(M-MAFLD)or MAFLD with additional etiological factor(s)(i.e.,concomitant liver diseases and/or heavy alcohol consumption);and(3)*** steatosis and fibrosiswere defined using the fatty liver index and the BARDscore,*** proportional hazards regression was performed to estimate the risk of cancer ***:Among the 9,718,182 participants,the prevalence of S-MAFLD and M-MAFLD was 29.2%and 6.7%,*** the median 8.3 years of follow-up,510,330(5.3%)individuals were newly diagnosed with cancer,and 122,774(1.3%)cancer-related deaths occurred among the entire *** with the non-MAFLD group,the risk of all-cancer incidence and mortality was slightly higher among patients in the S-MAFLD group(incidence,adjusted hazard ratio[aHR]=1.03;95%confidence interval[CI]:1.02−1.04;mortality,aHR=1.06;95%CI:1.04−1.08)and highest among patients with M-MAFLD group(incidence,aHR=1.31;95%CI:1.29−1.32;mortality,aHR=1.45;95%CI:1.42−1.48,respectively).The M-MAFLD with fibrosis group(BARD score≥2)showed the highest relative risk of all-cancer incidence(aHR=1.38,95%CI=1.36–1.39),followed by the M-MAFLD without fibrosis group(aHR=1.09,95%CI=1.06–1.11).Similar trends were observed for cancer-related ***:MAFLD classification,by applying additional etiologies other than pure metabolic origi

关键词： cancer etiology metabolic mortality steatosis

Plant-derived nanovesicles: Further exploration of biomedical function and application potential

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Acta Pharmaceutica Sinica B 2023年第8期13卷 3300-3320页

作者： Aixue Li Dan Li Yongwei Gu Rongmei Liu Xiaomeng Tang Yunan Zhao Fu Qi Jifu Wei Jiyong Liu College of Pharmacy Shandong University of Traditional Chinese MedicineJinan 250355China Department of Pharmacy Fudan University Shanghai Cancer CenterShanghai 200032China Department of Oncology Shanghai Medical CollegeFudan UniversityShanghai 200032China Department of Pharmacy Jiangsu Cancer HospitalNanjing 210009China Jiangsu Institute of cancer Research Nanjing 210009China The Affiliated cancer Hospital of Nanjing Medical University Nanjing 210009China Department of Pharmacy Shanghai Proton and Heavy Ion CenterShanghai 201315China

Extracellular vesicles(EVs)are phospholipid bilayer vesicles actively secreted by cells,that contain a variety of functional nucleic acids,proteins,and lipids,and are important mediums of intercellular *** on their natural properties,EVs can not only retain the pharmacological effects of their source cells but also serve as natural delivery *** them,plant-derived nanovesicles(PNVs)are characterized as natural disease therapeutics with many advantages such as simplicity,safety,eco-friendliness,low cost,and low toxicity due to their abundant resources,large yield,and low risk of immunogenicity in *** review systematically introduces the biogenesis,isolation methods,physical characterization,and components of PNVs,and describes their administration and cellular uptake as therapeutic *** highlight the therapeutic potential of PNVs as therapeutic agents and drug delivery carriers,including anti-inflammatory,anticancer,wound healing,regeneration,and antiaging properties as well as their potential use in the treatment of liver disease and ***,the toxicity and immunogenicity,the current clinical application,and the possible challenges in the future development of PNVs were *** expect the functions of PNVs to be further explored to promote clinical translation,thereby facilitating the development of a new framework for the treatment of human diseases.

关键词： Plant-derived nanovesicles Extracellular vesicles Therapeutic agents Drugdelivery systems Clinical application

Prevalence of nonalcoholic fatty liver disease in pediatrics and adolescents:a systematic review and meta-analysis

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World Journal of Pediatrics 2024年第6期20卷 569-580页

作者： Eun Joo Lee Miyoung Choi Sang Bong Ahn Jeong-Ju Yoo Seong Hee Kang Yuri Cho Do Seon Song Hong Koh Dae Won Jeon Hye Won Lee Department of Pediatrics Yonsei University College of MedicineSeoulKorea Clinical Evidence Research National Evidence-Based Healthcare Collaborating Agency(NECA)SeoulKorea Department of Internal Medicine Nowon Eulji Medical CenterEulji University College of MedicineSeoulKorea Department of Internal Medicine Soonchunhyang University Bucheon HospitalBucheonKorea Department of Internal Medicine Sangkye Paek HospitalInje University College of MedicineSeoulKorea center for liver and pancreatobiliary cancer National Cancer CenterGoyangKorea Department of Internal Medicine College of MedicineSt.Vincent's HospitalThe Catholic University of KoreaSuwonKorea Department of Internal Medicine Hanyang University College of MedicineSeoulKorea Department of Internal Medicine Yonsei University College of MedicineSeoulKorea

Background As childhood obesity escalates worldwide,the prevalence of nonalcoholic fatty liver disease(NAFLD)in pediatric and adolescent populations is also ***,systematic studies and meta-analyses evaluating the prevalence of pediatric NAFLD remain *** The MEDLINE,Korean Medical Database(KMBASE),Embase,Global Health,and Cochrane Library databases were searched from January 1997 to April *** terms included NAFLD or steatosis;nonalcoholic or steatohepatitis;child(ren),adolescent,or teenager;and prevalence,incidence,or epidemiology.A random-effects meta-analysis model was used to estimate the prevalence of pediatric *** A total of 2116 publications were found,of which 62 were included in the *** them,27 reported the prevalence in the general population and 39 in the obese *** worldwide pooled prevalence of pediatric NAFLD was 13%[95%confidence interval(CI)9-18%]in the general population and 47%(95%CI 41%–53%)in the obese *** 16 studies in the general population and 18 in the obese population,NAFLD prevalence varied by *** the general population,the prevalence of NAFLD was 15%(95%CI 8%–23%)in males and 10%(95%CI 6%–15%)in *** the obese population,it was 54%(95%CI 46%–61%)in males and 39%(95%CI 30%–49%)in *** The global prevalence of pediatric NAFLD is rising in both the general and obese *** the increasing rates of childhood obesity,epidemiological studies on the prevalence and incidence of NAFLD are needed.

关键词： Meta-analysis Nonalcoholic fatty liver disease Pediatric Prevalence

Clostridium difficile infection in the community:Are proton pump inhibitors to blame?

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World Journal of Gastroenterology 2013年第40期19卷 6710-6713页

作者： Daniel E Freedberg Julian A Abrams Division of Digestive and liver Diseases Columbia University Medical CenterNew YorkNY 10032United States

Once a nosocomial disease,Clostridium difficile infection(CDI)now appears frequently in the community in the absence of exposure to *** studies have shown that patients with community-acquired CDI are younger,more likely to be female,and have fewer comorbidities compared to patients with hospital-associated *** most studies of CDI are hospitalbased,comparatively little is known about communityacquired *** recent study by Chitnis has received widespread attention because it used active surveillance to capture all cases of community-acquired CDI within a large population and assessed key risk *** authors found that low-level healthcare exposure and proton pump inhibitor use were common among those with non-antibiotics associated,community-acquired *** this commentary,we discuss the changing epidemiology of community-acquired CDI and the evidence basis for the controversial association between proton pump inhibitors and community-acquired CDI.

关键词： Clostridium difficile Pseudomembranous enterocolitis proton pump inhibitors Anti-bacterial agents Pharmacoepidemiology Public health Disease outbreaks Epidemics

Gastrinoma and Zollinger Ellison syndrome:A roadmap for the management between new and old therapies

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World Journal of Gastroenterology 2021年第35期27卷 5890-5907页

作者： Roberta Elisa Rossi Alessandra Elvevi Davide Citterio Jorgelina Coppa Pietro Invernizzi Vincenzo Mazzaferro Sara Massironi HPB Surgery Hepatology and Liver TransplantationENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale Tumori(INTNational Cancer Institute)Milan 20133Italy Department of Pathophysiology and Transplantation University of MilanMilan 20122Italy Division of Gastroenterology and center for Autoimmune liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaMonza 20900Italy European Reference Network on Hepatological Diseases(ERN RARE-liver) San Gerardo HospitalMonza 20033Italy Department of Oncology and Hemato-Oncology University of MilanMilan 20122Italy

Zollinger-Ellison syndrome(ZES)associated with pancreatic or duodenal gastrinoma is characterized by gastric acid hypersecretion,which typically leads to gastroesophageal reflux disease,recurrent peptic ulcers,and chronic *** symptoms of ZES are nonspecific and overlap with other gastrointestinal disorders,the diagnosis is often delayed with an average time between the onset of symptoms and final diagnosis longer than 5 *** critical step for the diagnosis of ZES is represented by the initial clinical *** is the hallmark of ZES;however,hypergastrinemia might recognize several causes,which should be ruled out in order to make a final *** levels>1000 pg/mL and a gastric pH below 2 are considered to be diagnostic for gastrinoma;some specific tests,including esophageal pH-recording and secretin test,might be useful in selected cases,although they are not widely *** ultrasound is very useful for the diagnosis and the local staging of the primary tumor in patients with ZES,particularly in the setting of multiple endocrine neoplasia type *** controversies about the management of these tumors also *** the localized stage,the combination of proton pump inhibitory therapy,which usually resolves symptoms,and surgery,whenever feasible,with curative intent represents the hallmark of gastrinoma *** high expression of somatostatin receptors in gastrinomas makes them highly responsive to somatostatin analogs,supporting their use as anti-proliferative agents in patients not amenable to surgical *** medical options for advanced disease are super-imposable to other neuroendocrine neoplasms,and studies specifically focused on gastrinomas only are scant and often limited to case reports or small retrospective *** multidisciplinary approach remains the cornerstone for the proper management of this composite ***,we reviewed available literature about gastrinoma-associated ZES wit

关键词： Gastrinoma Zollinger-Ellison syndrome Neuroendocrine neoplasms Pancreatic neuroendocrine neoplasm Duodenal neuroendocrine neoplasm Diagnosis therapy

Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy: applicability to Eastern cohorts?

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Hepatobiliary Surgery and Nutrition 2019年第3期8卷 211-218页

作者： Jae Seung Kang Taesung Park Youngmin Han Seungyeon Lee Jae Ri Kim Hongbeom Kim Wooil Kwon Sun-Whe Kim Jin Seok Heo Seong Ho Choi Dong Wook Choi Song Cheol Kim Tae Ho Hong Dong Sup Yoon Joon Seong Park Sang Jae Park Sung-Sik Han Sae-Byeol Choi Joo Seop Kim Chang-Sup Lim Jin-Young Jang Department of Surgery and cancer Research Institute Seoul National University College of MedicineSeoulRepublic of Korea Department of Statistics and Interdisciplinary Program in Biostatistics Seoul National UniversitySeoulRepublic of Korea Department of Mathematics and Statistics Sejung UniversitySeoulRepublic of Korea Department of Surgery Samsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea Division of Hepatobiliary and Pancreatic Surgery Department of SurgeryUlsan University College of Medicine and Asan Medical CenterSeoulRepublic of Korea Department of Surgery Seoul St.Mary’s HospitalThe Catholic University of KoreaCollege of MedicineSeoulRepublic of Korea pancreatobiliary cancer Clinic Department of SurgeryGangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea center for liver cancer National Cancer CenterGyeonggidoRepublic of Korea Department of Surgery Korea University Guro HospitalKorea University College of MedicineSeoulRepublic of Korea Department of Surgery Kangdong Sacred Heart HospitalHallym University College of MedicineSeoulRepublic of Korea Department of Surgery Seoul Metropolitan Government-Seoul National University Boramae Medical CenterSeoul National University College of MedicineSeoulRepublic of Korea

Background:Although several prediction models for the occurrence of postoperative pancreatic fistula(POPF)after pancreatoduodenectomy(PD)exist,all were established using Western ***-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index(BMI)are *** purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean ***:Nine tertiary university hospitals in the Republic of Korea ***'preoperative characteristics,intraoperative factors,and pathologic findings were *** grades were determined according to the 2016 International Study Group on Pancreatic Surgery *** POPF risk models(Callery,Roberts,and Mungroop)were selected for external ***:A total of 1,898 PD patients were enrolled.A non-pancreatic disease diagnosis[hazard ratio(HR),1.856;95%confidence interval(CI),1.223–2.817;P=0.004),higher preoperative BMI(HR,1.069;95%CI,1.019–1.121;P=0.006),and soft pancreatic texture(HR,1.859;95%CI,1.264–2.735;P=0.002)were independent risk factors for clinically relevant POPF(CR-POPF).The area under the receiver operating characteristic curve(AUC)values were 0.61,0.64,and 0.63 on the Callery,Roberts,and Mungroop models,respectively;all were lower than those published in each external validation ***:Western POPF prediction models performed less well when applied to Korean ***,a large-scale Eastern-specific and externally validated POPF prediction model is needed.

关键词： Pancreatic fistula pancreatoduodenectomy(PD) predictive score

Endoscopic foregut surgery and interventions:The future is *** state-of-the-art and my personal journey

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World Journal of Gastroenterology 2019年第1期25卷 1-41页

作者： Kenneth J Chang H.H.Chao Comprehensive Digestive Disease center University of CaliforniaIrvine Medical CenterOrangeCA 92868United States

In this paper, I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically. Within each topic,the content will progress as follows: "lessons learned", "technical considerations"and "future opportunities". Lessons learned will provide a brief background and update on the most current literature. Technical considerations will include my personal experience, including tips and tricks that I have learned over the ***, future opportunities will address current unmet needs and potential new areas of development. The foregut is defined as "the upper part of the embryonic alimentary canal from which the pharynx, esophagus, lung, stomach, liver,pancreas, and part of the duodenum develop". Foregut surgery is well established in treating conditions such as gastroesophageal reflux disease(GERD), achalasia, esophageal diverticula, Barrett's esophagus(BE) and esophageal cancer, stomach cancer, gastric-outlet obstruction, and obesity. Over the past decade, remarkable progress in interventional endoscopy has culminated in the conceptualization and practice of endoscopic foregut surgery for various clinical conditions summarized in this paper. Regarding GERD, there are now several technologies available to effectively treat it and potentially eliminate symptoms, and the need for long-term treatment with proton pump *** the first time, fundoplication can be performed without the need for open or laparoscopic surgery. Long-term data going out 5-10 years are now emerging showing extended durability. In respect to achalasia, per-oral endoscopic myotomy(POEM) which was developed in Japan, has become an alternative to the traditional Heller's myotomy. Recent meta-analysis show that POEM may have better results than Heller, but the issue of post-POEM GERD still needs to be addressed. There is now a resurgence of endoscopic tre

关键词： Endoscopy Foregut diseases Gastroesophageal reflux disease Endoscopic sleeve gastroplasty Endoscopic submucosal dissection Per-oral endoscopic myotomy Endo-hepatology