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International expert consensus on laparoscopic pancreaticoduodenectomy

Hepatobiliary Surgery and Nutrition 2020年第4期9卷 464-483页

作者： Renyi Qin Michael L.Kendrick Christopher L.Wolfgang Barish H.Edil Chinnusamy Palanivelu Rowan WParks Yinmo Yang Jin He Taiping Zhang Yiping Mou Xianjun Yu Bing Peng Palanisamy Senthilnathan Ho-Seong Han Jae Hoon Lee Michiaki Unno Steven WMOlde Damink Virinder Kumar Bansal Pierce Chow Tan To Cheung Nim Choi Yu-Wen Tien Chengfeng Wang Manson Fok Xiujun Cai Shengquan Zou Shuyou Peng Yupei Zhao Department of Biliary-Pancreatic Surgery Affiliated Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Mayo clinic RochesterMNUSA Division of Surgical Oncology Department of SurgeryThe John Hopkins University School of MedicineBaltimoreMDUSA Department of Surgery University of OklahomaOklahoma CityOKUSA Department of Surgical gastroenterology and Hepatopancreatobiliary Surgery GEM Hospital and Research CentreCoimbatoreTamil NaduIndia clinical Surgery Royal Infirmary of Edinburgh and University of EdinburghEdinburghUK Department of General Surgery Peking University First HospitalBeijingChina Department of Surgery Johns Hopkins Medical InstitutionsBaltimoreMDUSA Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of gastroenterology and Pancreatic Surgery Zhejiang Provincial People’s HospitalHangzhou Medical CollegeHangzhouChina Department of Pancreatic Surgery Fudan University Shanghai Cancer CenterFudan UniversityShanghaiChina Department of Pancreatic Surgery West China HospitalSichuan UniversityChengduChina Department of Surgery Seoul National University College of MedicineSeoul National University Bundang HospitalSeoulKorea Division of Hepatopancreatobiliary Surgery Department of SurgeryAsan Medical CenterSeoulKorea Department of Surgery Tohoku University Graduate School of MedicineSendaiJapan Department of Surgery NUTRIM School of Nutrition and Translational Research in MetabolismMaastricht University Medical CentreMaastrichtThe Netherlands Department of Surgical Disciplines All India Institute of Medical SciencesNew DelhiIndia Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingaporeSingapore Department of Surgery The University of Hong KongQueen Mary HospitalHong KongChina Department of General Surgery Hospital Conde S.JanuárioMacaoChina Department of Surgery National Ta

Importance:While laparoscopic pancreaticoduodenectomy(LPD)is being adopted with increasing enthusiasm worldwide,it is still challenging for both technical and anatomical ***,there is no consensus on the technical standards for ***:The aim of this consensus statement is to guide the continued safe progression and adoption of *** Review:An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open *** were produced upon reviewing the literature and assessed by the members of the expert *** literature search and its critical appraisal were limited to articles published in English during the period from 1994 to *** Web of Science,Medline,and Cochrane Library and clinical Trials databases were searched,The search strategy included,but was not limited to,the terms'laparoscopic','pancreaticoduodenectomy,'pancreatoduodenectomy','Whipple's operation',and'minimally invasive surgery'.Reference lists from the included articles were manually checked for any additional studies,which were included when *** method was used to establish expert consensus and the AGREE II-GRS Instrument was applied to assess the methodological quality and externally validate the final *** statements were further discussed during a one-day face-to-face meeting at the 1st Summit on Minimally Invasive Pancreatico-Biliary Surgery in Wuhan,***:Twenty-eight international experts from 8 countries constructed the expert *** statements were produced by the members of the expert *** least 80%of responders agreed with the majority(80%)of *** than three randomized controlled trials published to date,most evidences were based on level 3 or 4 studies according to the AGREE II-GRS *** and Relevance:The Wuhan international expert consensus meeting on LPD has produced a set of clinical practice statement

关键词： Consensus pancreaticoduodenectomy laparoscopy Delphi technique

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吗替麦考酚酯在熊脱氧胆酸不敏感的原发性胆汁性肝硬化患者中的治疗作用

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世界核心医学期刊文摘（胃肠病学分册） 2005年第6期1卷 53-54页

作者： Talwalkar J.A. Angulo P. Keach J.C. 王铮 Div. of Gastroenterol. and Hepatol. Mayo Clinic and Foundation 200 First Street SW RochesterMN55905 United States Dr.

Background&Aims: Despite evidence for therapeutic efficacy with ursodeoxycholic acid (UDCA) in primary biliary cirrhosis (PBC), only 30-50%of patients achieve complete biochemical remission within 1 year of therapy. Mycophenolate mofetil (MMF) is an immunosuppressive medication that inhibits T and B lymphocyte proliferation. The aim of this investigation was to determine the safety and estimated efficacy of MMF in patients with PBC. Methods: Twenty-five patients with incomplete responses to UDCA (defined as persistent elevation of serum alkaline phosphatase ≥2 times the upper limit of normal) received MMF 1 g daily to a maximum of 3 g daily with UDCA (13-15 mg/kg per day) for 1 year. Liver biochemistries were determined at 3-month intervals with Mayo Risk Score calculated at baseline and end of therapy. Results: Nineteen (76%) patients completed 1 year of therapy. Despite improvements in serum alkaline phosphatase (920 ±308 vs. 709 ±242 IU/L, P = 0.001) and AST (65 ±31 vs. 51 ±19 IU/L, P = 0.007) levels, these findings were clinically insignificant. Exploratory analysis revealed a strong correlation between advanced PBC defined by higher Mayo Risk Score and reduction in serum alkaline phosphatase levels (r = -0.74, P = 0.006). Six patients (24%) did not complete therapy; adverse drug events were responsible for study withdrawal in 3 individuals. Adverse reactions that resolved spontaneously or by dose reduction occurred in 13 patients. Conclusions: MMF is not associated with important clinical benefits in PBC based on the results of this pilot investigation.

关键词：吗替麦考酚酯治疗作用熊脱氧胆酸正常值上限血清碱性磷酸酶免疫抑制剂中评估生化指标

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Common features between neoplastic and preneoplastic lesions of the biliary tract and the pancreas

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World Journal of gastroenterology 2019年第31期25卷 4343-4359页

作者： Piera Zaccari Vincenzo Cardinale Carola Severi Federica Pedica Guido Carpino Eugenio Gaudio Claudio Doglioni Maria Chiara Petrone Domenico Alvaro Paolo Giorgio Arcidiacono Gabriele Capurso Department of Internal Medicine and Medical Specialties Gastroenterology UnitSapienza University of RomeRome 00161Italy Department of Medico-Surgical Sciences and Biotechnologies Sapienza University of Rome00161 RomeItaly Pathology Department Pancreas Translational and Clinical Research CenterSan Raffaele Scientific Institute IRCCSMilan 20132Italy Department of Movement Human and Health SciencesDivision of Health SciencesUniversity of Rome"Foro Italico"Rome 00161Italy Department of Anatomical HistologicalForensic Medicine and Orthopedics SciencesDivision of Human AnatomySapienza University of RomeRome 00161Italy PancreatoBiliary Endoscopy and EUS Division Pancreas Translational and Clinical Research CenterSan Raffaele Scientific Institute IRCCSMilan 20132Italy Department of Translational and Precision Medicine Sapienza University of RomeRome 00161Italy

the bile duct system and pancreas show many similarities due to their anatomical proximity and common embryological ***,preneoplastic and neoplastic lesions of the bile duct and pancreas share analogies in terms of molecular,histological and pathophysiological *** neoplasms are reported in biliary tract,as biliary intraepithelial neoplasm(BilIN),and in pancreas,as pancreatic intraepithelial neoplasm(PanIN).Both can evolve to invasive carcinomas,respectively cholangiocarcinoma(CCA)and pancreatic ductal adenocarcinoma(PDAC).Intraductal papillary neoplasms arise in biliary tract and *** papillary neoplasm of the biliary tract(IPNB)share common histologic and phenotypic features such as pancreatobiliary,gastric,intestinal and oncocytic types,and biological behavior with the pancreatic counterpart,the intraductal papillary mucinous neoplasm of the pancreas(IPMN).All these neoplastic lesions exhibit similar immunohistochemical phenotypes,suggesting a common carcinogenic ***,CCA and PDAC display similar clinic-pathological features as growth pattern,poor response to conventional chemotherapy and radiotherapy and,as a consequence,an unfavorable *** objective of this review is to discuss similarities and differences between the neoplastic lesions of the pancreas and biliary tract with potential implications on a common origin from similar stem/progenitor cells.

关键词： Biliary Pancreatic Progenitors Preneoplastic Common Tumor

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COVID-19 and liver injury: An ongoing challenge

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World Journal of gastroenterology 2023年第2期29卷 257-271页

作者： Ioanna Papagiouvanni Serafeim-Chrysovalantis Kotoulas Athanasia Pataka Dionisios G Spyratos Konstantinos Porpodis Afroditi K Boutou Georgios Papagiouvannis Ioanna Grigoriou Christos Vettas Ioannis Goulis Fourth Department of Internal Medicine Aristotle University of ThessalonikiThessaloniki 54642ThessalonikiGreece Intensive Care Unit Hippokration General HospitalThessaloniki 54642Greece Department of Respiratory Medicine G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department Aristotle University of ThessalonikiThessaloniki 57001Greece Pulmonary Department G Papanikolaou HospitalResp Failure UnitAristotle University of ThessalonikiThessaloniki 54642Greece Department of Pharmacy School of Health SciencesFrederick UniversityNicosia 1036Cyprus Respiratory Failure clinic Papanikolaou General HospitalThessloniki 57001Greece Fourth Department of Internal Medicine Hippokration General HospitalThessaloniki 54642Greece

The new coronavirus severe acute respiratory syndrome coronavirus 2(SARSCoV-2)was identified in December 2019,in Wuhan,*** virus was rapidly spread worldwide,causing coronavirus disease 2019(COVID-19)*** COVID-19 is presented,usually,with typical respiratory symptoms(i.e.,dyspnea,cough)and fever,extrapulmonary manifestations are also *** injury is a common feature in patients with COVID-19 and ranges from mild and temporary elevation of liver enzymes to severe liver injury and,even,acute liver *** pathogenesis of liver damage is not clearly defined;multiple mechanisms contribute to liver disorder,including direct cytopathic viral effect,cytokine storm and immune-mediated hepatitis,hypoxic injury,and druginduced liver *** with underlying chronic liver disease(i.e.,cirrhosis,non-alcoholic fatty liver disease,alcohol-related liver disease,hepatocellular carcinoma,etc.)may have greater risk to develop both severe COVID-19 and further liver deterioration,and,as a consequence,certain issues should be considered during disease *** aim of this review is to present the prevalence,clinical manifestation and pathophysiological mechanisms of liver injury in patients with SARS-CoV-2 ***,we overview the association between chronic liver disease and SARS-CoV-2 infection and we briefly discuss the management of liver injury during COVID-19.

关键词： COVID-19 Liver injury Cytokine storm Hypoxic hepatitis Drug-induced liver injury Chronic liver disease

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Survival outcomes in older patients with different stages of acute kidney injury defined by the addition of urine output criteria

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Chinese Medical Journal 2023年第9期136卷 1129-1131页

作者： Jiebin Hou Yabin Zhang Jie Zhang Yang Liu Xiaohua Wang Zhen Wu Jiayu Guo Xiaoli Sun Qingli Cheng Qiangguo Ao Department of Nephrology The Second Medical Centre&National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Nephrology National Clinical Research Center for Geriatric DiseasesChinese PLA General HospitalBeijing 100853China Department of Nephrology The Second Medical CentreChinese PLA General HospitalBeijing 100853China Department of gastroenterology The Second Medical CentreChinese PLA General HospitalBeijing 100853China

To the Editor:Globally,acute kidney injury(AKI)is a common life-threatening *** is more prevalent in elderly patients,with increasing mortality *** with younger patients,older patients with AKI have a higher risk of persistent injury and poorer prognoses.[1]Older individuals often have comorbidities,increasing their susceptibility to *** Disease:Improving Global Outcomes(KDIGO)criteria define and stage AKI based on the higher stage of AKI defined by either serum creatinine(SCr)level or urine output(UO).[2]However,the record of UO is difficult to access in clinic,the data on the value of UO combined with SCr for AKI diagnosis or prognosis in elderly patients are ***,the objectives of this study were to investigate whether UO would influence the classification of AKI and improve the accuracy of prediction of the clinical prognosis in elderly patients.

关键词： patients urine Survival

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Overview of dyslipidemia and metabolic syndrome in myeloproliferative neoplasms

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World Journal of clinical Oncology 2024年第6期15卷 717-729页

作者： Mihnea-Alexandru Găman Bahadar Singh Srichawla Yong-Feng Chen Poulami Roy Arkadeep Dhali Ahmed Nahian Muhammad Romail Manan Vincent Kipkorir Richard Christian Suteja Lakshmi Venkata Simhachalam Kutikuppala Amelia Maria Găman Camelia Cristina Diaconu Faculty of Medicine “Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Department of Hematology Center of Hematolog Department of Cellular and Molecular Pathology Stefan S Nicolau Institute of VirologyRomanian AcademyBucharest 030304Romania Department of Neurology University of Massachusetts Chan Medical SchoolWorcesterMA 01655United States Department of Basic Medical Sciences School of Medicine of Taizhou UniversityTaizhou UniversityTaizhou 318000Zhejiang ProvinceChina Department of Medicine North Bengal Medical College and HospitalWest Bengal 734012India Academic Department of gastroenterology Sheffield Teaching Hospitals NHS Foundation TrustSheffield S57AUUnited Kingdom Lecom at Seton Hill GreensburgPA 15601United States Faculty of Medicine Services HospitalLahore 54000Pakistan Department of Human Anatomy and Physiology University of NairobiNairobi 00100Kenya Faculty of Medicine Udayana UniversityDenpasarBali 80361Indonesia Department of General Surgery Dr.NTR University of Health SciencesVijayawada 520008Andhra PradeshIndia Department of Pathophysiology University of Medicine and Pharmacy of CraiovaCraiova 200349Romania clinic of Hematology Filantropia City HospitalCraiova 200143Romania Department of Internal Medicine Faculty of Medicine“Carol Davila”University of Medicine and PharmacyBucharest 050474Romania Internal Medicine clinic Clinical Emergency Hospital of BucharestBucharest 105402Romania

Myeloproliferative neoplasms(MPNs)occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral *** suffering from MPNs display a high burden of cardiovascular risk factors,and thrombotic events are often the cause of death in this population of ***,we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia,metabolic syndrome,and MPNs,with a special focus on cardio-vascular risk,atherosclerosis,and thrombotic ***,we investigate the impact of dyslipidemia and metabolic syndrome on the occurrence and survival of thrombosis in MPN patients,as well as the management of dyslipidemia in MPNs,and the impact of MPN treatment on serum lipid concentrations,particularly as side/adverse effects reported in the context of clinical trials.

关键词： Polycythemia vera Essential thrombocythemia Myelofibrosis Cardiovascular disease Hypercholesterolemia Hypertriglyceridemia Obesity Diabetes Inflammation Oxidative stress

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The SUPER reporting guideline suggested for reporting of surgical technique

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Hepatobiliary Surgery and Nutrition 2023年第4期12卷 534-544,I0024-I0026页

作者： Kaiping Zhang Yanfang Ma Jinlin Wu Qianling Shi Leandro Cardoso Barchi Marco Scarci Rene Horsleben Petersen Calvin S.H.Ng Steven Hochwald Ryuichi Waseda Fabio Davoli Robert Fruscio Giovanni Battista Levi Sandri Michel Gonzalez Benjamin Wei Guillaume Piessen Jianfei Shen Xianzhuo Zhang Panpan Jiao Yulong He Nuria M.Novoa Benedetta Bedetti Sebastien Gilbert Alan D.L.Sihoe Alper Toker Alfonso Fiorelli Marcelo F.Jimenez Toni Lerut Aung Y.Oo Grace S.Li Xueqin Tang Yawen Lu Hussein Elkhayat Tomaz Stupnik Tanel Laisaar Firas Abu Akar Diego Gonzalez-Rivas Zhanhao Su Bin Qiu Stephen D.Wang Yaolong Chen Shugeng Gao Editorial Office AME Publishing CompanyHong KongChina School of Chinese Medicine Hong Kong Baptist UniversityHong KongChina Department of Cardiovascular Surgery Guangdong Provincial People’s HospitalGuangdong Academy of Medical SciencesGuangzhouChina Evidence-based Medicine Center School of Basic Medical SciencesLanzhou UniversityLanzhouChina Lanzhou University Institute of Health Data Science LanzhouChina Digestive Surgery Division Department of GastroenterologyUniversity of Sao Paulo School of MedicineSão PauloBrazil Department of Cardiothoracic Surgery Imperial College Healthcare NHS TrustLondonUK Department of Cardiothoracic Surgery University Hospital of CopenhagenRigshospitaletCopenhagenDenmark The Chinese University of Hong Kong Prince of Wales HospitalShatinNew TerritoriesHong KongChina Department of Surgical Oncology Roswell Park Cancer InstituteBuffaloNYUSA Department of General Thoracic Breast and Pediatric SurgeryFukuoka UniversityFukuokaJapan Department of Thoracic Surgery AUSL RomagnaS.Maria delle Croci Teaching HospitalRavennaItaly clinic of Obstetrics and Gynecology University of Milan-BicoccaSan Gerardo HospitalMonzaItaly Division of General Surgery and Liver Transplantation S.Camillo HospitalRomeItaly Service of Thoracic Surgery Lausanne University Hospital(CHUV)LausanneSwitzerland Division of Cardiothoracic Surgery Department of SurgeryUniversity of Alabama BirminghamBirminghamALUSA University of Lille CNRSInsermCHU LilleUMR9020-U1277-CANTHER-Cancer Heterogeneity Plasticity and Resistance to TherapiesLilleFrance Department of Cardiothoracic Surgery Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityLinhaiChina The First School of clinical Medicine Lanzhou UniversityLanzhouChina Thoracic Surgery Service University Hospital of SalamancaBiomedical Institute of SalamancaSalamancaSpain Department of Thoracic Surgery Helios Clinic Bonn/Rhein SiegBonnGermany Division of Thoracic Surgery Department of SurgeryThe Ottawa

Background:Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical *** Surgical techniqUe rePorting chEcklist and standaRds(SUPER)aims to address this gap by defining reporting standards for surgical *** SUPER guideline intends to apply to articles that encompass surgical technique in any study design,surgical discipline,and stage of surgical ***:Following the EQUATOR(Enhancing the QUAlity and Transparency Of health Research)Network approach,16 surgeons,journal editors,and methodologists reviewed existing reporting guidelines relating to surgical technique,reviewed papers from 15 top journals,and brainstormed to draft initial items for the *** initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and *** final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER ***:The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique *** items are divided into six sections:background,rationale,and objectives(items 1 to 5);preoperative preparations and requirements(items 6 to 9);surgical technique details(items 10 to 15);postoperative considerations and tasks(items 16 to 19);summary and prospect(items 20 and 21);and other information(item 22).Conclusions:The SUPER reporting guideline has the potential to guide detailed,comprehensive,and transparent surgical technique reporting for *** may also assist journal editors,peer reviewers,systematic reviewers,and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique.

关键词： Surgical technique surgical innovation reporting guideline reporting checklist Surgical techniqUe rePorting chEcklist and standaRds(SUPER)

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Resolution of non-alcoholic steatohepatitis by rosuvastatin monotherapy in patients with metabolic syndrome

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World Journal of gastroenterology 2015年第25期21卷 7860-7868页

作者： Konstantinos Kargiotis Vasilios G Athyros Olga Giouleme Niki Katsiki Evangelia Katsiki Panagiotis Anagnostis Chrysoula Boutari Michael Doumas Asterios Karagiannis Dimitri P Mikhailidis 2nd Prop. Department of Internal Medicine Medical School Aristotle University Hippocration Hospital Department of Pathology Hippocration Hospital Department of Endocrinology Hippocration Hospital Department of clinical Biochemistry (Vascular Disease Prevention clinic) Royal Free Campus University College London Medical School University College London Department of Surgery Royal Free Campus University College London Medical School

AIM: To investigate the effect of rosuvastatin monotherapy on non-alcoholic steatohepatitis(NASH). At present there is no effective treatment for non-alcoholic fatty liver disease or its advanced form ***: This prospective study included 20 biopsy proven patients with NASH, metabolic syndrome(Met S) and dyslipidaemia. Biochemical parameters of the blood of the patients and an ultrasonography of the liver were performed at baseline. Then patients receivedlifestyle advice and were treated for a 12 mo period with rosuvastatin(10 mg/d) monotherapy. Patients were re-evaluated during the study at 3 mo intervals, during which biochemical parameters of the blood were measured including liver enzymes. A repeat biopsy and ultrasonography of the liver were performed at the end of the study in all 20 patients. Changes in liver enzymes, fasting plasma glucose, serum creatinine, serum uric acid(SUA), high sensitivity C reactive protein(hs CRP) and lipid profile were assessed every 3 mo. The primary endpoint was the resolution of NASH and the secondary endpoints were the changes in liver enzyme and lipid ***: The repeat liver biopsy and ultrasonography showed complete resolution of NASH in 19 patients, while the 20 th, which had no improvement but no deterioration either, developed arterial hypertension and substantial rise in triglyceride levels during the study, probably due to changes in lifestyle including alcohol abuse. Serum alanine transaminase, aspartate transaminase, and γ-glutamyl transpeptidase were normalised by the 3rd treatment month(ANOVA P < 0.001), while alkaline phosphatase activities by the 6th treatment month(ANOVA, P = 0.01). Fasting plasma glucose and glycated haemoglobin were significantly reduced(P < 0.001). Lipid values were normalised by the 3rd treatment month. No patient had Met S by the 9th treatment month. Body mass index and waist circumference remained unchanged during the study. Thus, changes in liver pathology and function shou

关键词： Non-alcoholic fatty liver disease Non-alcoholicsteatohepatitis Metabolic syndrome Dyslipidaemia Rosuvastatin Fasting blood glucose Serum uric acid

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Predictive Value of Serum pgRNA on HBeAg Clearance in Patients with Chronic Hepatitis B with Low HBeAg Levels Treated with Pegylated Interferon

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Journal of clinical and Nursing Research 2023年第4期7卷 165-169页

作者： Yu Li Yifei Lyu Feng-Yu Xi Ying Gao Department of Infectious Diseases Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of gastroenterology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of clinical Laboratory Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of Hematology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina

Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon ***:Twenty chronic hepatitis B patients with HBeAg positive and quantitativeclinic after *** patients were then divided into groups based on whether their HbeAg turned *** predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive ***:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after ***:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.

关键词： Serum pgRNA Pegylated interferon Low HBeAg level Chronic hepatitis B HBeAg clearance Predictive value

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Perivascular epithelioid cell tumor of the liver coexisting with a gastrointestinal stromal tumor

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World Journal of gastroenterology 2008年第5期14卷 800-802页

作者： Carlos Eduardo Paiva Francisco Alves Moraes Neto Abbas Agaimy Maria Aparecida Custódio Domingues Silvia Regina Rogatto Oncological and Hemato-oncological Center So Paulo State University Botucatu So Paulo 18610-170 Brazil Department of Pathology Amaral Carvalho Hospital Jaú So Paulo Brazil Institute of Pathology Nuremberg Clinic Center Nuremberg Germany Department of Pathology So Paulo State University Botucatu So Paulo 18610-170 Brazil Department of Urology So Paulo State University Botucatu So Paulo 18610-170 Brazil

Approximately 10% of patients with gastrointestinal stromal tumors (GIST) develop other neoplasms, either synchronously or metachronously. In this report we describe coexistence of a gastrointestinal stromal tumor and a hepatic perivascular epithelioid cell tumor (PEComa) in a 51-year-old woman with no evidence of tuberous sclerosis. A subcapsular hepatic nodule (0.8 cm in diameter) was found during surgery for symptomatic gastric neoplasm (15 cm in diameter) arising from the lesser curvature. Both tumors revealed histomorphological and immunohistochemical features confirming a diagnosis of a small incidental hepatic PEComa and a high risky extramural gastric GIST, respectively. The patient remained disease-free 25 mo after surgery with no evidence of tumor recurrence or new neoplasms. To our knowledge, this is the first report of PEComa in a patient with GIST. Hepatic lesions detected synchronously or metachronously in patients with GISTs may represent histogenetically distinct lesions and should be sampled to confirm or exclude metastatic GISTs.

关键词： Gastrointestinal stromal tumors PEComa Coexistence Liver Synchronous

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