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Consensus on diagnostic criteria for Yin deficiency syndrome in hypertension:a modified Delphi study

Journal of Traditional Chinese medicine 2023年第1期43卷 181-187页

作者： HE Yun HE Jing XU Xiangru LI Haixiao SHI Rongwei LIANG Junya ZHOU Ying ZHU Yao CHEN Xiaohu TANG Shuhua XIAO Min ZHAN Libin PEI Yinghao JIANG Weimin department of General internal medicine Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese MedicineNanjing 210029China department of Hepatology Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese MedicineNanjing 210029China department of Emergency Longhua Hospital affiliated to Shanghai University of Traditional Chinese MedicineShanghai 200032China department of Institute of hypertension Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese MedicineNanjing 210029China department of Cardiology Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese MedicineNanjing 210029China department of Cardiology Dongzhimen Hospital Affiliated to Beijing University of Chinese MedicineBeijing 100700China School of Traditional Chinese medicine&School of Integrated Chinese and Western medicine Nanjing University of Chinese MedicineNanjing 210023China department of Intensive Care Unit Jiangsu Province Hospital of Chinese Medicine Affiliated to Hospital of Nanjing University of Traditional Chinese MedicineNanjing 210029China

OBJECTIVE:To reach consensus on the diagnostic criteria for Yin deficiency syndrome in hypertension(YDSH)patients by a modified Delphi ***:Our study was consistent with T/CACM *** methodology of RAND/UCLA appropriateness was used to develop consensus guidance statements.A nationwide panel of experienced clinical experts from 19 provinces was *** experts were all prominent in Traditional Chinese medicine(TCM)of cardiovascular *** consensus process consisted of two rounds of questionnaires and a final round of consultation to analyze the weight score of each ***,the data extraction process is carried out independently by third-party researchers(LIANG Junya,SUN Yang,and DU Xiaona).When there is disagreement in all three rounds,the expert panel group(odd number)are invited to vote,and the one with more votes *** the questionnaires,participants were asked to rate the appropriateness of each syndrome item using a nine-point Likert *** consensus was defined as a panel median rating 1-3 or 7-9 without *** then the diagnostic criteria of YDSH were formed according to the weight score in the final ***:Twenty-eight experts(84.8%)participated in the first round,and thirty-one(93.9%)finished the second *** two rounds,the consensus of YDSH was reached on 11 items(25.6%),including symptoms,signs,and pulse ***-one experts(63.6%)completed the final round in which they used a grading system for each *** tongue with scanty fur had the highest weighting(22.8%),followed by heat in the palms and soles(20.1%).CONCLUSIONS:The consensus-based diagnostic criteria for YDSH,formed by a modified Delphi method,can be widely incorporated in TCM.A further clinical study will be conducted to analyze the diagnosis value and cut-off score of our YDSH criteria.

关键词： Yin deficiency syndrome hypertension consensus Delphi technique weight score

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Multiparametric ultrasound as a new concept of assessment of liver tissue damage

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World Journal of Gastroenterology 2024年第12期30卷 1663-1669页

作者： Angela Peltec Ioan Sporea department of internal medicine Discipline of GastroenterologyState University of Medicine and Pharmacy"Nicolae Testemitanu"Chishinev 2019Moldova department of Gastroenterology and Hepatology "Victor Babes"University of Medicine and PharmacyTimisoara 300736Romania

Liver disease accounts for approximately 2 million deaths per year *** chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the *** changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue *** methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in *** US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic *** elastography can assess liver stiffness,serving as a surrogate marker for liver *** is important to note that interpreting these values should not rely solely on a histological ***-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver *** evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness *** measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild *** controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly ***-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of *** parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US *** US(MPUS)of the liver introduces a new concept for complete noninvasive *** encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,

关键词： Multiparametric ultrasound Ultrasound-based elastography Liver stiffness Noninvasive diagnostic test for chronic liver disease Liver steatosis assessment Portal hypertension evaluation

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Alcohol and hepatocellular carcinoma:A review and a point of view

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World Journal of Gastroenterology 2014年第43期20卷 15943-15954页

作者： Gianni Testino Silvia Leone Paolo Borro Centro Alcologico Regionale-Regione Liguria Alcoholic UnitDepartment of General Internal and Specialist MedicineIRCCS AOU San Martino-National Institute for Cancer Research-IST department of internal medicine Clinical Pharmacology and Toxicology UnitUniversity of Genoa

It is well recognized that one cause of chronic liver disease and hepatocellular carcinoma(HCC)is alcohol *** in Italy and the United States concludes that the most common cause of HCC(responsible for 32%to 45%of HCC)is *** has recently been shown that a significant relationship between alcohol intake,metabolic changes,and hepatitis virus infection does *** may be a factor in the development of HCC via direct(genotoxic)and indirect mechanisms(cirrhosis).There is only one way of diagnosing HCC,which is early identification through surveillance,when curative treatments become *** stopping alcohol intake the risk of liver cancer decreases by 6%to 7%a year,and an estimated time period of 23 years is also ***,surveillance is also important in former drinkers and,in our opinion,independently from the presence of compensated *** cases of very early stage(VES)and early stage with portal hypertension,liver transplantation is the optimal option;and in cases of associated disease,percutaneous ethanol injections,radiofrequency and microwave ablation are the ideal *** the possibility of detecting microvascular invasion with HR,several studies and some randomized controlled trials revealed that overall survival and DSF rates in patients with VES HCC are much the same after ablation and ***,ablation can be regarded as a firstline choice for patients with VES *** is important to emphasize that the choice of treatment should be weighed carefully in the context of a multidisciplinary cancer team.

关键词： Alcohol Alcoholic liver disease Hepatocellular carcinoma Percutaneous ablation

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Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

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World Journal of Gastroenterology 2013年第29期19卷 4679-4688页

作者： Do Seon Song Si Hyun Bae Myeong Jun Song Sung Won Lee Hee Yeon Kim Young Joon Lee Jung Suk Oh Ho Jong Chun Hae Giu Lee Jong Young Choi Seung Kew Yoon department of internal medicine College of Medicine The Catholic University of Korea Seoul 137-040 South Korea department of Radiology College of Medicine The Catholic University of Korea Seoul 137-040 South Korea

AIM: To evaluate the prognostic factors and efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis. METHODS: Fifty hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) were treated using hepatic arterial infusion chemotherapy (HAIC) via a subcutaneously implanted port. The epirubicin-cisplatin-5-fluorouracil (ECF) chemotherapeutic regimen consisted of 35 mg/m 2 epirubicin on day 1, 60 mg/m 2 cisplatin for 2 h on day 2, and 500 mg/m 2 5-fluorouracil for 5 h on days 1-3. The treatments were repeated every 3 or 4 wk. RESULTS: Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial responses (PR), and 22 (44%) had stable disease (SD).The median survival and time to progression were 7 and 2 mo, respectively. After 2 cycles of HAIC, CR was achieved in 1 patient (2%), PR in 10 patients (20%) and SD in 26 patients (52%). Significant pre-treatment prognostic factors were a tumor volume of < 400 cm 3 (P = 0.01) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-Ⅱ (P = 0.022). After 2 cycles of treatment, disease control (CR + PR + SD) (P = 0.001), PVTT response (P = 0.003) and α-fetoprotein reduction of over 50% (P = 0.02) were independent factors for survival. Objective response (CR + PR), disease control, PVTT response, and combination therapy during the HAIC were also significant prognostic factors. Adverse events were tolerable and successfully managed. CONCLUSION: HAIC may be an effective treatment modality for advanced HCC with PVTT in patients with tumors < 400 cm 3 and good prognostic factors.

关键词： Hepatocellular carcinoma Hepatic arterial infusion chemotherapy Portal vein tumor thrombosis

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hypertension,abnormal blood pressure circadian pattern,and frailty:data from the literature

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Journal of Geriatric Cardiology 2018年第12期15卷 747-750页

作者： Fabio Fabbian Alfredo De Giorgi Rosaria Cappadona Dario Gozzi Mauro Pasin Roberto De Giorgio Roberto Manfredini Faculty of medicine Pharmacy and PreventionUniversity of FerraraFerraraItaly department of internal medicine General Hospital of FerraraFerraraItaly

According to the National Health and Nutrition Examination Survey(NHANES)data,more than 65%of people aged≥60 years are hypertensive.[1]Diabetes mellitus,dyslipidemia,obesity and renal failure are frequently associate... 详细信息

关键词： Blood pressure Frailty The elderly

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Treatment of colonic varices with a superior mesenteric venous stent:a case report describing a unique approach

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Gastroenterology Report 2021年第6期9卷 597-599页

作者： Sandra Naffouj Mustafa Al-Shammari Reena Salgia department of internal medicine Henry Ford HospitalDetroitMIUSA Division of Gastroenterology and Hepatology Department of MedicineHenry Ford HospitalDetroitMIUSA

Introduction Ectopic varices are a rare cause of gastrointestinal(GI)bleeding that may occur in the GI tract outside the esophageal and gastric distribution[1].The majority of these cases are rectal varices in cirrhotic patients with portal *** varices(CV)are less common than rectal,duodenal,and smallbowel varices[2].There are no clear guidelines for managing CV given the rarity of this finding[3].We report a case of massive lower-GI bleeding due to CV in a patient with non-alcoholic steatohepatitis(NASH)without cirrhosis or portal hypertension secondary to porto-mesenteric venous thrombosis that was successfully treated with superior mesenteric venous(SMV)*** the extent of the mesenteric thrombosis,treatment modalities like transjugular intrahepatic portosystemic shunt(TIPS)and balloon-occluded retrograde transvenous obliteration(BRTO)were not possible.

关键词： venous varices balloon

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Trends and risk factors of elderly-onset Crohn’s disease: A nationwide cohort study

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World Journal of Gastroenterology 2020年第4期26卷 404-415页

作者： Jung Min Moon Eun Ae Kang Kyungdo Han Seung Wook Hong Hosim Soh Seona Park Jooyoung Lee Hyun Jung Lee Jong Pil Im Joo Sung Kim department of internal medicine Liver Research InstituteSeoul National University College of MedicineSeoul 03080South Korea department of Biostatistics College of MedicineThe Catholic University of KoreaSeoul 06591South Korea

BACKGROUND The incidence of inflammatory bowel disease(IBD)is increasing in *** risk factors associated with IBD development have been *** To investigate trends and environmental risk factors of Crohn’s disease(CD)diagnosed in persons aged≥40 years in South *** Using the National Health Insurance Service database,a total of 14060821 persons aged>40 years who underwent national health screening in 2009 were followed up until December *** with newly diagnosed CD were enrolled and compared with non-CD *** was identified according to the International Classification of Diseases 10th revision and the rare/intractable disease registration program codes from the National Health Insurance Service *** mean follow-up periods was 7.39 ***,sex,diabetes,hypertension,smoking,alcohol consumption,regular exercise,body mass index,anemia,chronic kidney disease(CKD)and dyslipidemia were adjusted for in the multivariate analysis *** During the follow-up,1337(1.33/100000)patients developed *** in the middle-aged group(40-64 years)had a higher risk than women[adjusted hazard ratio(aHR)1.46,95%confidence interval(CI):1.29-1.66];however,this difference tended to disappear as the age of onset *** the middle-aged group,patients with a history of smoking[(aHR 1.46,95%CI:1.19-1.79)and anemia(aHR 1.85,95%CI:1.55-2.20)]had a significantly higher CD *** the elderly group(age,≥65 years),ex-smoking and anemia also increased the CD risk(aHR 1.68,95%CI:1.22-2.30)and 1.84(95%CI:1.47-2.30,respectively).Especially in the middle-aged group,those with CKD had a statistically elevated CD risk(aHR 1.37,95%CI:1.05-1.79).Alcohol consumption and higher body mass index showed negative association trend with CD incidence in both of the age groups.[Middle-aged:aHR 0.77(95%CI:0.66-0.89)and aHR 0.73(95% CI:0.63-0.84),respectively][Elderly-group:aHR 0.57(95% CI:0.42-0.78)and aHR 0.84(95%CI 0.67-1.04),respectively].For regular p

关键词： Crohn’s disease Aged Environmental Risk factors Epidemiology Nationwide cohort

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Pembrolizumab-induced Guillain-Barrésyndrome in triple-negative breast cancer:A case report

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World Journal of Clinical Oncology 2025年第2期16卷 144-151页

作者： Phani Bhavana Cherukuri Muhammad Tayyeb Sai Rakshith Gaddameedi Doantrang Du Trishala Meghal department of internal medicine Monmouth Medical CenterLong BranchNJ 07740United States department of Hematology Oncology Monmouth Medical CenterLong BranchNJ 07740United States

BACKGROUND The programmed cell death protein 1 inhibitor pembrolizumab has become a key treatment for various cancers,including triple-negative breast ***,it is associated with immune-related adverse events,including rare but serious neurological complications such as Guillain-Barrésyndrome(GBS).GBS is a potentially life-threatening autoimmune disorder characterized by muscle weakness and *** present a unique case of pembrolizumab-induced GBS to highlight the importance of recognizing this complication and managing it promptly in patients receiving immune checkpoint *** SUMMARY A 69-year-old woman with a medical history of hypertension,anxiety,depression,and stage IIIB triple-negative breast cancer treated with pembrolizumab,carboplatin,and paclitaxel,presented to the emergency department with a 1-month history of tingling,lower extremity weakness,and shooting *** progressed to global weakness,ascending paralysis,and double *** examination revealed significant lower extremity weakness and sensory *** resonance imaging of the lumbar spine and cerebrospinal fluid analysis confirmed *** treatment with intravenous immunoglobulin led to relapse,requiring additional intravenous immunoglobulin and high-dose *** patient’s condition improved,pembrolizumab therapy was permanently discontinued,and she was discharged to a rehabilitation *** Pembrolizumab can induce GBS,necessitating early recognition,prompt diagnosis,and multidisciplinary management to prevent serious complications.

关键词： Pembrolizumab Guillain-Barrésyndrome Triple-negative breast cancer Immune-related adverse events Intravenous immunoglobulin therapy High-dose steroids Case report

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Management and control of type 2 diabetes mellitus in Lebanon:Results from the International Diabetes Management Practices Study Wave 6

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World Journal of Diabetes 2019年第4期10卷 249-259页

作者： Hala Ahmadieh Marie-Therese Sawaya Sami T Azar department of medicine Beirut Arab University Medical Affairs department Sanofi-aventis Lebanon department of internal medicine Division of Endocrinology American University of Beirut-Medical Center

BACKGROUND Diabetes mellitus is a worldwide public health problem associated with significant complications. There is lack of data on the quality of care of patients with diabetes, specifically among the non-Western countries. Efforts have been made in Lebanon to better study the characteristics of patients with diabetes mellitus in order to improve glycemic control and prevent late-term *** To investigate control and therapeutic management of patients with diabetes mellitus in the current medical practice in *** Wave 6 of the International Diabetes Management Practice Study in Lebanon is an international and multicenter study involving selected *** Only 1 patient with type 1 diabetes and 595 patients with type 2 diabetes were included in Wave 6. Average age was around 60 years, with a mean body mass index of 30. The mean fasting serum glucose was 159.42 mg/dL, and the mean glycosylated hemoglobin(HbA1 c) level was 7.98 with around 30% achieving an HbA1 c target of hypertension and dyslipidemia, the majority ofwhom were treated but only a small percentage were *** Diabetes, with its associated dyslipidemia and hypertension, is still not very well controlled. Screening for diabetes complications has improved over the *** need to have more proper care, and physicians need to follow diabetes guidelines, and to have a larger number of patients who have appropriate treatment of diabetes, hypertension and lipids.

关键词： Diabetes complications Dyslipidemia hypertension Blood pressure control Glycemic control

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Review article: Update on current and emergent data on hepatopulmonary syndrome

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World Journal of Gastroenterology 2018年第12期24卷 1285-1298页

作者： Stergios Soulaidopoulos Evangelos Cholongitas George Giannakoulas Maria Vlachou Ioannis Goulis Fourth department of internal medicine Hippokration General Hospital Medical School of Aristotle University of Thessaloniki First department of internal medicine Laiko General Hospital Medical School of National and Kapodistrian University of Athens department of Cardiology AHEPA University Hospital Medical School of Aristotle University of Thessaloniki

Hepatopulmonary syndrome(HPS) is a frequent pulmonary complication of end-stage liver disease, characterized by impaired arterial oxygenation induced by intrapulmonary vascular dilatation. Its prevalence ranges from 4% to 47% in patients with cirrhosis due to the different diagnostic criteria applied among different studies. Nitric oxide overproduction and angiogenesis seem to be the hallmarks of a complicated pathogenetic mechanism, leading to intrapulmonary shunting and ventilation-perfusion mismatch. A classification of HPS according to the severity of hypoxemia has been suggested. Contrast-enhanced echocardiography represents the gold standard method for the detection of intrapulmonary vascular dilatations which is required, in combination with an elevated alveolar arterial gradient to set the diagnosis. The only effective treatment which can modify the syndrome's natural history is liver transplantation. Although it is usually asymptomatic, HPS imparts a high risk of pretransplantation mortality, independently of the severity of liver disease, while there is variable data concerning survival rates after liver transplantation. The potential of myocardial involvement in the setting of HPS has also gained increasing interest in recent research. The aim of this review is to critically approach the existing literature of HPS and emphasizeunclear points that remain to be unraveled by future research.

关键词： Hepatopulmonary syndrome Liver cirrhosis Liver transplantation Portal hypertension Contrast echocardiography

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