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World Journal of Clinical Cases 2016年第1期4卷 1-4页

作者： Alessandro Landi Valeria Palmarini Alessandro D'Elia Nicola Marotta Maurizio Salvati Antonio Santoro Roberto Delfini Department of neurology and Psychiatry Division of NeurosurgeryUniversity of Rome "Sapienza"

Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord *** measurements may are used to predicting the outcome of patients who have spinal cord *** tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or *** this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future.

关键词： Fiber tracking diffusion tensor imaging Surgery Magnetic resonance diffusion tensor imaging Intramedullary astrocytomas Spinal cord tumors Radiology

China Antihypertensive Trial in Acute Ischemic Stroke II (CATIS-2): rationale and design

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Stroke & Vascular neurology 2021年第2期6卷 286-290页

作者： Liping Liu Yilong Wang Xuewei Xie Dacheng Liu Aili Wang Penglian Wang Suwen Shen Chongke Zhong Yufei Wei Tan Xu Yuesong Pan Yong Jiang Xia Meng David Wang Yonghong Zhang Jiang He Yongjun Wang Department of neurology Beijing Tiantan HospitalCapital Medical UniversityBeijingChina China National Clinical Research Center for Neurological Diseases BeijingChina Department of epidemiology School of Public HealthMedical College of Soochow UniversitySuzhouChina Neurovascular division Department of NeurologyBarrow Neurological InstituteSt Joseph's Hospital and Medical CenterPhoenixArizonaUSA Department of epidemiology Tulane University School of Public Health and Tropical MedicineNew OrleansLouisianaUSA

Backgrounds Increased blood pressure(BP)for patients who had an acute ischaemic stroke is associated with poor functional outcome,however the optimal timing of antihypertensive therapy is *** We aim to compare early antihypertensive treatment to delayed antihypertensive treatment for reducing the risk of composite major disability and mortality at 3 months in acute ischaemic *** The China Antihypertensive Trial in Acute Ischemic Stroke II(CATIS-2)trial is a multicentre,randomised,open-label,blinded-endpoints trial that will be conducted in 100 hospitals in *** primary outcome is the composite of death and major disability(modified Rankin Scale score≥3)at 3 months of *** treatment will be received immediately after randomisation in the early treatment group,aimed at average systolic BP by 10%-20%reduction within the first 24 hours,and achieving an average BP level of<140/90 mm Hg within 5 *** in the delayed treatment group will discontinue any antihypertension medications for the first 7 days of randomisation,and will receive antihypertensive therapy achieving a BP goal of<140/90 mm Hg after 7 *** The CATIS-2 trial will be testing the hypotheses that early BP lowering leads to improved functional outcome without any other harms,and developing clinical guidelines of the BP management for patients who had an acute ischaemic stroke.

关键词： hypertensive acute mortality

Multilevel oblique corpectomies as an effective surgical option to treat cervical chordoma in a young girl

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World Journal of Clinical Cases 2014年第3期2卷 57-61页

作者： Roberto Delfini Daniele Marruzzo Roberto Tarantino Nicola Marotta Alessandro Landi Department of neurology and Psychiatry Division of Neurosurgery University of Rome "Sapienza"

Chordomas are malignant tumors arising from notochordal remnants. They are the most frequent tumors of the spine after plasmacytomas. Only 6% of chordomas are localized to the cervical level. In young patients, chordomas are rare and unpredictable. Despite this, the treatment of choice remains the total resection, as much as possible, followed by proton beam radiation. This case was managed using a precarotid and retrocarotid approach at the same time. The tumor was completely resected with the edges free from disease. The cervical spine was stabilized with an anterior plating C2-C4. Eighteen months after surgery the patient is still free from illness. Multilevel oblique corpectomies are an available and safe option for the treatment of upper cervical chordomas.

关键词： Cervical chordoma Multilevel oblique corpectomy Surgery RXT Retrocarotid approach

Autoimmune pancreatitis:Cornerstones and future perspectives

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World Journal of Gastroenterology 2024年第8期30卷 817-832页

作者： Camilla Gallo Giulia Dispinzieri Nicola Zucchini Pietro Invernizzi Sara Massironi division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryFondazione IRCCS San Gerardo dei TintoriUniversity of Milano-BicoccaMonza 20900Italy Department of Pathology Fondazione IRCCS San Gerardo dei TintoriMonza 20900Italy

Autoimmune pancreatitis(AIP)is an autoimmune subtype of chronic pancreatitis resulting from the aberrant immune response against the pancreas,leading to inflammation and *** AIP is rare,its incidence is increasing and is often misdiagnosed as other pancreatic *** is commonly classified into two *** 1 AIP(AIP-1)is typically associated with elevated serum immunoglobulin G4(IgG4)levels and systemic manifestations,while type 2 AIP is typically a more localized form of the disease,and may coexist with other autoimmune disorders,especially inflammatory bowel ***,there is emerging recognition of a third type(type 3 AIP),which refers to immunotherapy-triggered AIP,although this classification is still gaining acceptance in medical *** clinical manifestations of AIP mainly include painless jaundice and weight *** serum IgG4 levels are particularly characteristic of *** relies on a combination of clinical,laboratory,radiological,and histological findings,given the similarity of AIP symptoms to other pancreatic *** mainstay of treatment for AIP is steroid therapy,which is effective in most *** cases might require additional imm-unosuppressive *** review aims to summarize the current knowledge of AIP,encompassing its epidemiology,etiology,clinical presentation,diagnosis,and treatment *** also address the challenges and controversies in diagnosing and treating AIP,such as distinguishing it from pancreatic cancer and managing long-term treatment,highlighting the need for increased awareness and knowledge of this complex disease.

关键词： Autoimmunity Pancreatitis Autoimmune pancreatitis Immunoglobulin G4 Steroids Relapse

Combined Effects of Family History of Cardiovascular Disease and Serum C-reactive Protein Level on the Risk of Stroke: A 9.2-year Prospective Study among Mongolians in China

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Biomedical and Environmental Sciences 2017年第9期30卷 632-640页

作者： ZHU Zheng Bao HUANGFU Xin Feng ZHONG Chong Ke ZHOU Yi Peng TIAN Yun Fan BUREN Batu XU Tian WANG Ai Li LI Hong Mei ZHANG Ming Zhi ZHANG Yong Hong Department of epidemiology School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases Medical College of Soochow University Department of epidemiology Tongliao Center for Disease Prevention and Control Department of neurology Affiliated Hospital of Nantong University

Objective We aimed to evaluate the combined effect of a family history of cardiovascular disease（CVD） and high serum C‐reactive protein（CRP） on the stroke incidence in an Inner Mongolian population in China. Methods A prospective cohort study was conducted from June 2002 to July 2012, with 2,544 participants aged 20 years and over from Inner Mongolia, China. We categorized participants into four groups based on the family history of CVD and CRP levels. Results We adjusted for age; sex; smoking; drinking; hypertension; body mass index; waist circumference; and blood glucose, triglycerides, low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol levels. Compared with the group with no family history of CVD/low CRP levels, the group with family history of CVD/high CRP levels had a hazard ratio（HR） of 1.78 [95% confidence interval（CI）, 1.03‐3.07; P = 0.039] of stroke, and an HR of 2.14（95% CI, 1.09‐4.20; P = 0.027） of ischemic stroke. The HRs of hemorrhagic stroke for the other three groups were not statistically significant（all P 〉 0.05）. Conclusion Participants with both a family history of CVD and high CRP levels had the highest stroke incidence, suggesting that high CRP levels may increase stroke risk, especially of ischemic stroke, among individuals with a family history of CVD.

关键词： Family history of cardiovascular disease C‐reactive protein Stroke Prospective study

Role of dynamic computed tomography scans in patients with congenital craniovertebral junction malformations

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World Journal of Orthopedics 2017年第3期8卷 271-277页

作者： Otávio Turolo da Silva Enrico Ghizoni Helder Tedeschi Andrei Fernandes Joaquim Department of neurology Division of Neurosurgical State University of Campinas

AIM To evaluate the role of dynamic computed tomography(CT)scan imaging in diagnosing craniovertebral junction(CVJ)instability in patients with congenital CVJ *** Patients with symptomatic congenital CVJ malformations who underwent posterior fossa decompression and had a preoperative dynamic CT scan in flexion and extended position were included in this *** of the following craniometrical parameters were taken in flexed and extended neck position:Atlanto-dental interval(ADI),distance of the odontoid tip to the Chamberlain’s line,and the clivus-canal angle(CCA).Assessment of the facet joints congruence was also performed in both *** of the values obtained in flexion and extension were compared using a paired Student’s *** A total of ten patients with a mean age of 37.9 years were *** flexion imaging,the mean ADI was1.76 mm,the mean CCA was 125.4°and the mean distance of the odontoid tip to the Chamberlain’s line was+9.62 *** extension,the mean ADI was1.46 mm(P=0.29),the mean CCA was 142.2°(P<0.01)and the mean distance of the odontoid tip to the Chamberlain’s line was+7.11 mm(P<0.05).Four patients(40%)had facetary subluxation demonstrated in dynamic imaging,two of them with mobile subluxation(both underwent CVJ fixation).The other two patients with a fixed subluxation were not initially *** patient with atlantoaxial assimilation and C23 fusion without initial facet subluxation developed a latter CVJ instability diagnosed with a dynamic CT *** with basilar invagination had a lower CCA variation compared to the whole *** Craniometrical parameters,as well as the visualization of the facets location,may change significantly according to the neck *** imaging can provide additional useful information to the diagnosis of CVJ *** studies addressing the relationship between craniometrical changes and neck position are necessary.

关键词： Craniovertebral junction Dynamic imaging Basilar invagination Chiari malformation Treatment

C-reactive Protein Level,Apolipoprotein B-to-apolipoprotein A-1 Ratio,and Risks of Ischemic Stroke and Coronary Heart Disease among Inner Mongolians in China

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Biomedical and Environmental Sciences 2016年第7期29卷 467-474页

作者： TIAN Yun Fan ZHOU Yi Peng ZHONG Chong Ke BUREN Batu XU Tian LI Hong Mei ZHANG Ming Zhi WANG Ai Li ZHANG Yong Hong Department of epidemiology School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric DiseasesMedical College of Soochow University Department of epidemiology Tongliao Center for Disease Prevention and Control Department of neurology Affiliated Hospital of Nantong University

Objective We aimed to investigate the cumulative effect of high CRP level and apolipoprotein B-to-apolipoprotein A-1（ApoB/ApoA-1） ratio on the incidence of ischemic stroke（IS） or coronary heart disease（CHD） in a Mongolian population in *** From June 2003 to July 2012,2589 Mongolian participants were followed up for IS and CHD events based on baseline *** the participants were divided into four subgroups according to C-reactive protein（CRP） level and ApoB/ApoA-1 *** proportional hazard models were used to estimate the hazard ratios（HRs） and 95% confidence intervals（CIs） for the IS and CHD events in all the *** The HRs（95% CI） for IS and CHD were 1.33（0.84-2.12）,1.14（0.69-1.88）,and 1.91（1.17-3.11） in the ‘low CRP level with high ApoB/ApoA-1＇,‘high CRP level with low ApoB/ApoA-1＇,and ‘high CRP level with high ApoB/ApoA-1＇ subgroups,respectively,in comparison with the ‘low CRP level with low ApoB/ApoA-1＇ *** risks of IS and CHD events was highest in the ‘high CRP level with high ApoB/ApoA-1＇ subgroup,with statistical *** High CRP level with high ApoB/ApoA-1 ratio was associated with the highest risks of IS and CHD in the Mongolian *** study suggests that the combination of high CRP and ApoB/ApoA-1 ratio may improve the assessment of future risk of developing IS and CHD in the general population.

关键词： C-reactive protein Apolipoprotein B-to-apolipoprotein A-1 ratio Ischemic stroke Coronary heart disease

Urokinase-type plasminogen activator is a modulator of synaptic plasticity in the central nervous system:implications for neurorepair in the ischemic brain

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Neural Regeneration Research 2020年第4期15卷 620-624页

作者： Manuel Yepes division of Neuropharmacology and Neurologic Diseases Yerkes National Primate Research Center Department of neurology Emory University School of Medicine Department of neurology Veterans Affairs Medical Center

The last two decades have witnessed a rapid decrease in mortality due to acute cerebral ischemia that paradoxically has led to a rapid increase in the number of patients that survive an acute ischemic stroke with various degrees of ***,the lack of an effective therapeutic strategy to promote neurological recovery among stroke survivors has led to a rapidly growing population of disabled ***,understanding the mechanisms of neurorepair in the ischemic brain is a priority with wide scientific,social and economic *** ischemia has a harmful effect on synaptic structure associated with the development of functional *** agreement with these observations,experimental evidence indicates that synaptic repair underlies the recovery of neurological function following an ischemic ***,it has become evident that synaptic plasticity is crucial not only during development and learning,but also for synaptic repair after an ischemic *** plasminogen activating system is assembled by a cascade of enzymes and their inhibitors initially thought to be solely involved in the generation of ***,recent work has shown that in the brain this system has an important function regulating the development of synaptic plasticity via mechanisms that not always require plasmin ***-type plasminogen activator(uPA)is a serine proteinase and one of the plasminogen activators,that upon binding to its receptor(uPAR)not only catalyzes the conversion of plasminogen into plasmin on the cell surface,but also activates cell signaling pathways that promote cell migration,proliferation and *** role of uPA is the brain is not fully ***,it has been reported while uPA and uPAR are abundantly found in the developing central nervous system,in the mature brain their expression is restricted to a limited group of ***,following an ischemic injury to the mature brain the expressio

关键词： cerebral ischemia neurorepair plasminogen plasticity stoke synapse urokinase urokinase receptor

Serum pepsinogen Ⅱ is a better diagnostic marker in gastric cancer

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World Journal of Gastroenterology 2012年第48期18卷 7357-7361页

作者： Xue-Yuan Cao Zhi-Fang Jia Mei-Shan Jin Dong-Hui Cao Fei Kong Jian Suo Jing Jiang Department of Gastrointestinal Surgery Jilin University First Hospital division of Clinical epidemiology Jilin University First Hospital division of Pathology Jilin University First Hospital

AIM:To investigate screening makers for gastric cancer,we assessed the association between gastric cancer and serum pepsinogens(PGs).METHODS:The subjects comprised 450 patients with gastric cancer,111 individuals with gastric atrophy,and 961 healthy *** anti-Helicobacter pylori(***) immunoglobulin G(IgG),PGⅠand PG Ⅱ were detected by enzyme-linked immunosorbent *** atrophy and gastric cancer were diagnosed by endoscopy and histopathological *** ratios and 95%CIs were calculated using multivariate logistic ***:Rates of *** infection remained high in Northeastern *** of *** IgG positivity were greater in the gastric cancer and gastric atrophy groups compared to the control group(69.1% and 75.7% vs 49.7%,P < 0.001).Higher levels of PG Ⅱ(15.9 μg/L and 13.9 μg/L vs 11.5 μg/L,P < 0.001) and lower PGⅠ/PG Ⅱ ratio(5.4 and 4.6 vs 8.4,P < 0.001) were found in patients with gastric cancer or gastric atrophy compared to healthy controls,whereas no correlation was found between the plasma PGⅠconcentration and risk of gastric cancer(P = 0.537).In addition,multivariate logistic analysis indicated that *** infection and atrophic gastritis were independent risk factors for gastric *** plasma PGⅠ/PG Ⅱ ratio was associated with higher risks of atrophy and gastric ***,plasma PG Ⅱ?level?significantly?correlated?with?*** gastric ***:Serum PG Ⅱ concentration and PG Ⅰ/PG Ⅱ ratio are potential biomarkers for *** gastric *** Ⅱ is independently associated with risk of gastric cancer.

关键词： Gastric cancer Pepsinogens Helicobacter pylori Gastric atrophy Screening

Hepatocellular Carcinoma Incidence and Mortality in the USA by Sex, Age, and Race: A Nationwide Analysis of Two Decades

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Journal of Clinical and Translational Hepatology 2024年第2期12卷 172-181页

作者： Yazan Abboud Mohamed Ismail Hamza Khan Esli Medina-Morales Saqr Alsakarneh Fouad Jaber Nikolaos T.Pyrsopoulos Department of Internal Medicine Rutgers New Jersey Medical SchoolNewarkNJUSA Department of Internal Medicine University of Missouri-Kansas CityKansas CityMOUSA division of Gastroenterology and Hepatology Rutgers New Jersey Medical SchoolNewarkNJUSA

Background and Aims:While the incidence rates of hepa-tocellular carcinoma(HCC)are increasing,there are limited comprehensive data on demographic-specific incidence and mortality trends in the *** aimed to evaluate recent trends in HCC incidence and mortality among different de-mographic groups in the ***:Age-adjusted HCC incidence rates were calculated from the Centers for Disease Control's United States Cancer Statistics database,which combines incidence data on newly diagnosed cancer cases and covers approximately 98%of the population in the ***,age-adjusted HCC mortality rates were obtained from the Centers for Disease Control's National Center for Health Statistics database,which offers comprehensive Cov-erage spanning nearly 100%of deaths attributed to HCC in the *** were stratified by sex,age(older[≥55 years]and younger[<55 years]adults),race and ethnicity(Non-Hispanic White,Non-Hispanic Black,Hispanic,Non-Hispanic Asian/Pacific Islander,and Non-Hispanic American Indian/Alaska Native),and tumor stage at diagnosis(early and late).Annual and average annual percentage change(AAPC)were calculated using joinpoint regression.A sex-specific pairwise comparison was ***:Between 2001 and 2020,there were 467,346 patients diagnosed with HCC(26.0%women),with increasing incidence in both sexes without significant difference(p=0.65).In younger adults(78,169 patients),the incidence decreased in men but not in women(AAPC difference=-2.39,p=0.002).This was seen in various racial and ethnic groups,mostly driven by early-stage tumors(AAPC difference=-2.65,p=0.02).There were 329,973 deaths attributed to HCC between 2000 and 2020(28.4%women).In younger adults(43,093 deaths),mortal-ity decreased in men at a greater rate than in women(AAPC difference=1.61,p=0.007).This was seen in various racial and ethnic groups,most notably in non-Hispanic American Indian/Alaska Natives(AAPC difference=-4.51,p=0.01).Conclusions:Nationwide USA data,coveri

关键词： Liver cancer Hepatocellular carcinoma Incidence Mortality epidemiology Health disparity