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World Journal of Gastroenterology 2014年第30期20卷 10620-10627页

作者： John M Rivas Alejro Perez Marlow Hernez Alison Schneider Ferno J Castro Digestive Disease Center Cleveland Clinic FloridaWestonFL 33331United States Department of Gastroenterology University of Medicine and Dentistry of New JerseyStratfordNJ 08084United States Department of Internal Medicine Cleveland Clinic FloridaWestonFL 33331United States

AIM: To compare the bowel cleansing efficacy of same day ingestion of 4-L sulfa-free polyethylene glycol (4-L SF-PEG) vs 2-L polyethylene glycol solution with ascorbic acid (2-L PEG + Asc) in patients undergoing after... 详细信息

关键词： Bowel preparation Colonoscopy Screening colonoscopy Colon cancer screening

Continuous positive airway pressure to improve insulin resistance and glucose homeostasis in sleep apnea

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World Journal of diabetes 2011年第1期2卷 16-18页

作者： Paschalis Steiropoulos Nikolaos Papanas Sleep Unit Department of PneumonologyDemocritus University of Thrace outpatient clinic of Obesity Diabetes and MetabolismSecond Department of Internal MedicineDemocritus University of Thrace

Obstructive sleep apnea syndrome(OSAS)is a relatively common disorder in the adult *** is associated with alterations in glucose metabolism and increases the risk for diabetes *** positive airway pressure(CPAP)is the treatment of choice for *** may also have a favorable effect on insulin resistance and glucose metabolism,although relevant data is *** research is still needed to fully establish the effect of CPAP on glucose *** should ascertain which patients may benefit most and how long treatment takes to induce favorable ***,patient compliance is being appreciated as a major factor influencing therapeutic outcomes,and this needs to be further examined.

关键词： Continuous positive airway pressure diabetes mellitus Glucose homeostasis Obstructive sleep apnea syndrome

Axillary Sentinel Lymph Node Biopsy for Breast Cancer and Melanoma Patients after Previous Axillary Surgery: A Systematic Review

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Journal of Cancer Therapy 2013年第9期4卷 1395-1402页

作者： Maurice Matter Sebastien Romy Ariane Boubaker Olivier Michielin Nicolas Demartines Department of Nuclear Medicine Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland Department of Oncology Melanoma Outpatient Clinic Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland Department of Visceral Surgery Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland

Objective: Sentinel lymph node biopsy (SLNB) is a validated staging technique for breast carcinoma. Some women are exposed to have a second SLNB due to breast cancer recurrence or a second neoplasia (breast or other). Due to modified anatomy, it has been claimed that previous axillary surgery represents a contra-indication to SLNB. Our objective was to analyse the literature to assess if a second SLNB is to be recommended or not. Methods: For the present study, we performed a review of all published data during the last 10 years on patients with previous axilla surgery and second SLNB. Results: Our analysis shows that second SLNB is feasible in 70%. Extra-axillary SNs rate (31%) was higher after radical lymph node dissection (ALND) (60% - 84%) than after SLNB alone (14% - 65%). Follow-up and complementary ALND following negative and positive second SLNB shows that it is a reliable procedure. Conclusion: The review of literature confirms that SLNB is feasible after previous axillary dissection. Triple technique for SN mapping is the best examination to highlight modified lymphatic anatomy and shows definitively where SLNB must be performed. Surgery may be more demanding as patients may have more frequently extra-axillary SN only, like internal mammary nodes. ALND can be avoided when second SLNB harvests negative SNs. These conclusions should however be taken with caution because of the heterogeneity of publications regarding SLNB and surgical technique.

关键词： Breast Neoplasms Melanoma Sentinel Lymph Node Biopsy Dissection Lymphatic Vessels Surgery Lymphatic Anatomy

Risk stratification and geographical mapping of Brazilian inflammatory bowel disease patients during the COVID-19 outbreak:Results from a nationwide survey

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World Journal of Gastroenterology 2021年第12期27卷 1226-1239页

作者： Natália Sousa Freitas Queiroz Fábio Vieira Teixeira Marina Pamponet Motta Liliana Andrade Chebli Adriano Akira Ferreira Hino Camilla de Almeida Martins Abel Botelho Quaresma Alexandre Augusto de Paula da Silva Adérson Omar Mourão Cintra Damião Rogerio Saad-Hossne Paulo Gustavo Kotze Department of Gastroenterology University of São Paulo School of MedicineSão Paulo 05403-000SPBrazil IBD Unit Gastroenterology DepartmentGastrosaúde ClinicMarilia 17509190SPBrazil School of Medicine Federal University of BahiaSalvador 40020-025BHBrazil IBD outpatient clinics Universidade Federal de Juiz de ForaJuiz de Fora 36010-010MGBrazil Health Sciences Postgraduate Program Pontifícia Universidade Católica do Paraná(PUCPR)Curitiba 80440-220PRBrazil Departamento de Ciências da Saúde Universidade do Oeste de Santa Catarina(UNOESC)Joaçaba 89600-000SCBrazil Botucatu Medical School Paulista State University(UNESP)Botucatu 18600-050SPBrazil IBD outpatient clinics Pontificia Universidade Católica do Paraná(PUCPR)Curitiba 80440-220PRBrazil

BACKGROUND Coronavirus disease 2019(COVID-19)pandemic is still evolving globally,and Brazil is currently one of the most affected *** is still debated whether patients with inflammatory bowel disease(IBD)are at a higher risk for developing COVID-19 or its *** To assess geographical distribution of IBD patients at the highest risk and correlate these data with COVID-19 mortality rates in *** The Brazilian IBD Study Group(Grupo de Estudos da Doença Inflamatória Intestinal do Brasil)developed a web-based survey adapted from the British Society of Gastroenterology *** included categories were demographic data and inquiries related to risk factors for complications from *** were categorized as highest,moderate or lowest individual *** Spearman correlation test was used to identify any association between highest risk and mortality rates for each state of the *** A total of 3568 patients(65.3%females)were *** participants were from the southeastern and southern regions of Brazil,and 84.1%were using immunomodulators and/or *** patients(55.1%)were at moderate risk,23.4%were at highest risk and 21.5%were at lowest risk of COVID-19 *** association between the proportion of IBD patients at highest risk for COVID-19 complications and higher mortality rates was identified in different Brazilian states(r=0.146,P=0.467).CONCLUSION This study indicates a distinct geographical distribution of IBD patients at highest risk for COVID-19 complications in different states of the country,which may reflect contrasting socioeconomic,educational and healthcare *** association between high risk of IBD and COVID-related mortality rates was identified.

关键词： Crohn’s disease Colitis,Ulcerative COVID-19 Inflammatory bowel disease Brazil

Epidemiological study of hypertensive retinopathy in the primary care setting: Retrospective cross-sectional review of retinal photographs

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Family Medicine and Community Health 2016年第4期4卷 13-21页

作者： Lap-kin Chiang Michael K.C.Yau Cheuk-wai Kam Lorna V.Ng Benny C.Y.Zee Family Medicine and General outpatient Department Kwong Wah HospitalHospital AuthorityHong KongChina The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong KongChina

Objective:The objective is to estimate the prevalence and grading of hypertensive retinopa-thy in the primary care setting;examine the patient characteristics associated with hypertensive retinopathy;and examine the association of hypertensive retinopathy and other hypertension ***:This is a retrospective cross-sectional *** included adult hypertensive patients with available and gradable retinal ***:Two hundred fifty-six male hypertensive patients(34.3%)and 491 female hyper-tensive patients(65.7%)were *** average duration of hypertension was 7.2 years,and 49.8%and 41.2%of patients were taking one or two antihypertensive medications *** 1491 qualified retinal photographs(744 right eye and 747 left eye),24.9%,62.6%,and 12.5%were classified as showing normal,mild,and moderate hypertensive retinopathy *** three commonest retinal signs were generalized or focal arteriolar narrowing(650 cases,43.6%),hard exudates(168 cases,11.3%),and opacity(copper or silver wiring)of the arteriolar wall(166 cases,11.1%).Patients older than 61 years,having hypertension for more than 15 years,or taking three or more antihypertensive medications were significantly associated with hyperten-sive retinopathy(Pclinic in Hong Kong,77.1%of hypertensive patients had hypertensive *** hypertensive retinopathy was the commonest target organ damage for hypertensive patients in a primary care clinic.

关键词： Hypertensive retinopathy retinal photograph primary care

Berberine and Metformin in the Treatment of Type 2 diabetes Mellitus: A Systemic Review and Meta-Analysis of Randomized clinical Trials

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Health 2021年第11期13卷 1314-1329页

作者： Li Wang Donglan Liu Guohong Wei Hui Ge Department of Healthcare The First Affiliated Hospital Sun Yat-sen University Guangzhou China outpatient clinic of Internal Medicine Department The First Affiliated Hospital Sun Yat-sen University Guangzhou China Department of Endocrinology The First Affiliated Hospital Sun Yat-sen University Guangzhou China

Objective: To assess the effects of berberine and metformin on glucose in patients with type 2 diabets mellitus (T2DM) with a systematic review and meta-analysis. Methods: The databases including PubMed, Excerpta Medica Database (EMBase), Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI), WanFang, the Chinese Scientific and Technical Journals database (VIP), China Doctor Dissertation Full-text Database (CDFD) and China Master Dissertation Full-text Database (CMFD) from the inception to April 2021 in Chinese or English language were searched. Randomized controlled trials (RCTs) of berberine only or combined with metformin versus metformin were included. Data extraction and paper quality assessment were conducted according to the Cochrane Handbook. RevMan 5.4 was used for the meta-analysis. Results: A total of thirteen studies were included, covering 1173 participants. The clinical heterogeneity of the included trials was relatively high. The methodological quality of most trials was generally low with bias in terms of random sequence generation, allocation concealment, blinding method, outcome data and selective reporting. Interventions were divided into two subgroups for analysis. Meta-analysis suggested that there was no statistical significance in the hypoglycemic effect between berberine and metformin for T2DM. However, berberine combined with metformin could reduce fasting plasma glucose (FPG) [MD = −1.49, 95% CI (−2.22, −0.76), P MD = −1.89, 95% CI (−2.94, −0.84), P = 0.0004], glycosylated hemoglobin A1c (HbA1c) [MD

关键词： Berberine Metformin Type 2 diabetes Mellitus Efficacy Safety Meta-Analysis

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长期存活肿瘤患儿不良预后的医学评估

美国医学会杂志（中文版） 2008年第3期27卷 137-147页

作者： Maud M. Geenen, MD Mathilde C. Cardous-Ubbink, MSc Leontien C. M. Kremer, MD, PhD Cor van den Bos, MD, PhD Helena J. H. van der Pal, MD Richard C. Heinen, MSc Monique. M. Jaspers, PhD, MSc Caro C. E. Koning, MD, PhD Foppe Oldenburger, MD Nelia E. Langeveld, PhD, RN Augustinus A. M. Hart, MSc Piet J. M. Bakker, MD, PhD Huib N. Caron, MD, PhD Flora E. van Leeuwen, PhD, MSc 张成海(译) 武爱文(译) 徐光炜(校) Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Emma Children's Hospital/Academic Medical Center: Departments of Medical Oneology Department of Pediatric Oncology Academic Medical Center:and Departments of Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Department of Pediatric Oncology Epidemiology Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Medical Informatics Netherlands Cancer Institute Amsterdamthe Netherlands Late Effects Study Group and outpatient clinic/Polikliniek Late Effecten Kindertumoren(PLEK) Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands Radiotherapy Netherlands Cancer Institute Amsterdamthe Netherlands

背景：癌症患儿存活改善与多种治疗相关并发症相伴。然而，绝大多数有关癌症儿童生存率的研究仅局限于单一的远期效应。目的：在一个有完整的长期随访资料的大型儿童癌症生存队列中对癌症长期存活的不良预后（临床或亚临床病症）的总负... 详细信息

背景：癌症患儿存活改善与多种治疗相关并发症相伴。然而，绝大多数有关癌症儿童生存率的研究仅局限于单一的远期效应。目的：在一个有完整的长期随访资料的大型儿童癌症生存队列中对癌症长期存活的不良预后（临床或亚临床病症）的总负荷进行评估。设计、地点及人群：于1362例已生存5年的儿童癌症患者中进行回顾性队列研究。患儿1966至1996年在荷兰一家医疗机构接受治疗。所有生存者均被邀请到晚期效应诊所进行不良事件医学评估。2004年1月以前发生的不良事件依据标准方式进行严重度分级。主要观测指标：随访结束时治疗别不良事件（依据严重性）的发生率以及各种治疗相关疾病高度或严重负荷（危险度92或危及生命或致残的不良事件≥1个）的相对危险度。结果：94．3％的生存者完成了随访（中位随访时间17年）。随访结束时中位年龄为24、4岁。大约75％的生存者有1个或更多不良事件，24．6％发生5个或以上不良事件。而且，40％的生存者至少有1个严重、危及生命或致残的不良事件。在接受单纯放疗的生存者中，55％的患者观察到高度或严重不良事件负荷。接受单纯化疗的生存者发生率为15％，而单纯手术治疗的存活者相应发生率则为25％（校正后相对危险分别为2．18[95％可信区间，1．62—2．95]和0．65[95％可信区间，0．46—0．90]）。不良事件高度或严重负荷最常见于骨肿瘤生存者（64％），较少见于白血病或Wilms瘤生存者（12％）。结论：在成年时，很大一部分儿童癌症生存者都存在高度或严重疾病负荷，尤其是在放疗后。这强调了对儿童癌症生存者根据危险分层进行终生医学监视的必要性。

关键词：医学评估肿瘤患儿长期存活不良预后单纯手术治疗癌症生存者相对危险度不良事件

Turner Syndrome and Inflammatory Bowel Disease： Case Report

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Journal of Pharmacy and Pharmacology 2018年第2期6卷 136-139页

作者： Priscilla Pereira dos Reis Ricardo Fortes Monteiro de Castro Rafaela Costa Vieira Carolina de Paula Guimaraes Baia Department of Gastroenterology and Hepatology Felicio Rocho Hospital Minas Gerais 30110-017 Brazil Specialization in Gastroenterology and Hepatology Felicio Rocho Hospital Minas Gerais 30110-017 Brazil Department of Gastroenterology and Hepatology Inflammatory Bowel Disease outpatient clinic Felicio Rocho Hospital Minas Gerais 30110-017 Brazil

Summary： TS （Turner syndrome） is a genetic disease which affects women caused by complete or partial absence of one of the X chromosomes. This condition is related to an increase in autoimmune diseases incidence like, IBD （inflammatory bowel disease）. Material and Methods： a case report of a 31 years old woman with T S hospitalized with two months of prostration, fever, rashes, nausea, vomit and diarrhea. Investigations have shown colonic mucosa inflammation, besides chronic colitis with cryptic microabscess in the anatomopathological evaluation, suggesting IBD as etiology. Treatment with mesalazine was effective in symptoms improvement. Conclusions： TS is a condition frequently associated with autoimmune diseases, including diseases of the gastrointestinal tract, such as IBDs. Recognition and early treatment of this condition leads to an improvement in the quality of life of these patients and reduces the chances of future complications.

关键词： TS inflammatory bowel diseases colitis (ulcerative).

Aggressive treatment of acute anal fissure with 0.5% nifedipine ointment prevents its evolution to chronicity

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World Journal of Gastroenterology 2006年第38期12卷 6203-6206页

作者： Panagiotis Katsinelos Jannis Kountouras George Paroutoglou Athanasios Beltsis Grigoris Chatzimavroudis Christos Zavos Taxiarchis Katsinelos Basilis Papaziogas Department of Endoscopy and Motility Unit Central Hospital Thessaloniki Greece Department of Gastroenter- ology Second Medical Clinic Aristotle University of Thessaloniki Ippokration Hospital Thessaloniki Greece

AIM： To investigate the efficacy of topical application of 0.5% nifedipine ointment in healing acute anal tissue and preventing its progress to chronicity. METHODS： Thirty-one patients （10 males, 21 females） with acute anal fissure from September 1999 to January 2005 were treated topically with 0.5% nifedipine ointment （t.i.d.） for 8 wk. The patients were encouraged to follow a high-fiber diet and assessed at 2, 4 and 8 wk post-treatment. The healing of fissure and any side effects were recorded. The patients were subsequently followed up in the outpatient clinic for one year and contacted by phone every three months thereafter, while they were encouraged to come back if symptoms recurred. RESULTS： Twenty-seven of the 31 patients completed the 8-wk treatment course, of them 23 （85.2%） achieved a complete remission indicated by resolution of symptoms and healing of fissure. Of the remaining four unhealed patients （14.8%）, 2 opted to undergo lateral sphincterotomy and the other 2 to continue therapy for four additional weeks, resulting in healing of fissure. All the 25 patients with complete remission had a mean follow-up of 22.9 ± 14 （range 6-52） too. Recurrence of symptoms occurred in four of these 25 patients （16%） who were successfully treated with an additional 4-wk course of 0.5% nifedipine ointment. Two of the 27 （7.4%） patients who completed the 8-wk treatment presented with moderate headache as a side effect of nifedipine. CONCLUSION： Topical 0.5% nifedipine ointment, used as an agent in chemical sphincterotomy, appears to offer a significant healing rate for acute anal fissure and might prevent its evolution to chronicity.

关键词： Acute anal fissure Nifedipine Calcium channel blockers Topical treatment

A foot structure study of new arch flexibility grading system based on threedimensional arch volume

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Chinese Journal of Traumatology 2023年第6期26卷 329-333页

作者： Jun Liu Miao Deng Wei Wang Xiang-Dong Liu Lun Tao Hong-Yi Xiang Yan Xiong Department of Orthopedics Daping HospitalArmy Medical UniversityChongqing400042China The 5th outpatient clinic Western Theater General HospitalChengdu610000China Department of Orthopedics Armed Police Hospital of ChongqingChongqing400042China Institute for Traffic Medicine Daping HospitalArmy Medical UniversityChongqing400042China

Purpose:Different arch structures may cause different foot function *** the past,the arch structure and flexibility of the foot were often defined by the height of the arch,and there was no three-dimensional(3D)structure classification *** order to form a more complete 3D description,we propose a new classification system of arch volume flexibility(AVF),and then use this new classification system to investigate the relationship between the AVF and arch index(AI),and the arch height flexibility(AHF)and AI,***:It is proposed to recruit 180 young male adults for the *** obtained arch volume and AI through 3D scanning and obtained the navicular height through manual *** on these data,we calculated the AHF and the *** the quintile method,these arches are divided into very stiff,stiff,neutral,flexible,and very *** to AI value,all arches were divided into cavus,rectus,and *** distribution of AVF was compared usingχ^(2)goodness of fit *** spearman correlation test was used to compare the AHF and AVF.A p<0.05 indicates that the difference is statistically ***:All participants'plantar data was obtained through 3D scanning,but only 159 of them were complete,so only 318 feet had valid *** left AHF is(21.23±12.91)mm/kN,and the right AHF is(21.71±12.69)mm/*** AVF of the left foot arch is(207.35±118.28)mm^(3)/kg,while the right one is(203.00±117.92)mm^(3)/kg,and the total AVF of the arch was(205.17±117.94)mm^(3)/*** was no statistical difference in the AVF between the left and right feet for the same participant(n=159,p=0.654).In cavus,the percentage of arch with AVF is 21.4%(very stiff),21.4%(stiff),14.3%(neutral),7.1%(flexible),and 35.7%(very flexible).In rectus,the percentage of arch with AVF is 23.9%(very stiff),19.6%(stiff),14.7%(neutral),24.5%(flexible),and 17.2%(very flexible).In planus,the percentage of arch with AVF is 14.9%(very stiff),20.6%(stiff),27.0%(neutral

关键词： Arch height flexibility Arch volume flexibility Classification Arch volume Three-dimensional Arch index