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Hispanic Patients with Primary Biliary Cholangitis Have Decreased Access to Care Compared to Non-Hispanics

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Journal of Clinical and Translational Hepatology 2020年第4期8卷 391-396页

作者： Atoosa Rabiee Nathalie A Pena Polanco Aymara Fernandez De La Vara Cynthia Levy Department of Gastroenterology and Hepatology VA Medical CenterWashington DCUSA divison of Digestive Health and Liver Diseases Department of medicine University of Miami Miller School of medicine USA Department of medicine Jackson Memorial HospitalUniversity of MiamiMiamiFLUSA

Background and Aims:Hispanic patients with primary bili-ary cholangitis (PBC) have reduced rates of biochemical re-sponse to ursodeoxycholic acid (UDCA) and increased risk of disease progression compared to non-Hispanic patients. In this study, we sought to identify differences in demographics, comorbidities, environmental risk factors and socioeconomic status between Hispanic and non-Hispanic patients with PBC. Methods: In a case control study, we analyzed data from Hispanic (n=37 females and 1 male) and non-Hispanic (n=54 females and 4 males) patients with PBC seen at the University of Miami/Jackson Memorial hospital from January 1998 through January 2013. Data were obtained by filling out a questionnaire either via phone call, mail, or e-mail. Odds ratios were calculated to measure the association between exposure and ***: Baseline demographics, environmental risk factors and comorbidities were similar be-tween Hispanic and non-Hispanic patients with PBC. Hispanic patients were less likely to be married and fewer Hispanics had education beyond high school level compared to non-His-panics. Sixty four percent of Hispanic patients had a house-hold income of less than$50000, compared to 19.5% of non-Hispanics. Fewer Hispanic patients with PBC had health insur-ance coverage compared to non-Hispanics (86.5% vs. 98.1%;odds ratio: 0.1, 95% confidence interval: 0-0.9). Conclusions: Differences in disease severity and response to therapy observed in prior studies could not be explained by environmental exposures. In addition to genetic variation, socioeconomic discrepancies (access to care) may further ex-plain these differences.

关键词： Primary biliary cholangitis Ethnicity Health disparity

Recent advances in gastrointestinal cancers

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World Journal of Gastroenterology 2021年第28期27卷 4493-4503页

作者： Natacha Bordry Christoforos Astaras Marie Ongaro Nicolas Goossens Jean Louis Frossard Thibaud Koessler Department of Oncology University Hospital of Geneva(HUG)Genève 1205Switzerland divison of Gastroenterology and Hepatology University Hospital of Geneva(HUG)Genève 1205Switzerland

Gastrointestinal cancers occur in a total of eight different locations,each of them with a different standard of *** article is not an exhaustive review of what has been published in *** have concentrated on the thirteen phase III randomized studies that are *** these studies are oral presentations which have been given in one of the four major oncology congresses,namely American Society of Clinical Oncology(ASCO),ASCO gastrointestinal(GI),European Society of Medical Oncology(ESMO)and *** provide a concise view of these major trials and their main outcomes,and put these results into context.

关键词： Practice changing trials Immunotherapy Gastrointestinal cancers Gastrointestinal Gastric cancer

Inflammation in coronary artery diseases

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Chinese Medical Journal 2011年第21期124卷 3568-3575页

作者： LI Jian-jun divison of Dyslipidemia Cardiovascular Medicine Fu Wai Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing 100037 China

The concept that atherosclerosis is an inflammation has been increasingly recognized, and subsequently resulted in great interest in revealing the inflammatory nature of the atherosclerotic process. More recently, a large body of evidence has supported the idea that inflammatory mechanisms play a pivotal role throughout all phases of atherogenesis, from endothelial dysfunction and the formation of fatty streaks to plaque destabilization and the acute coronary events due to vulnerable plaque rupture. Indeed, although triggers and pathways of inflammation are probably multiple and vary in different clinical entities of atherosclerotic disorders, an imbalance between anti-inflammatory mechanisms and pro-inflammatory factors will result in an atherosclerotic progression. Vascular endothelial dysfunction and lipoprotein retention into the arterial intima have been reported as the earliest events in atherogenesis with which inflammation is linked. Inflammatory has also been extended to the disorders of coronary microvasculature, and associated with special subsets of coronary artery disease such as silent myocardial ischemia, myocardial ischemia-reperfusion, cardiac syndrome X, variant angina, coronary artery ectasia, coronary calcification and in-stent restenosis. Inflammatory biomarkers, originally studied to better understand the pathophysiology of atheroscleresis, have generated increasing interest among researches and clinicians. The identification of inflammatory biomarkers and cellular/molecular pathways in atherosclerotic disease represent important goals in cardiovascular disease research, in particular with respect of the development of theraoeutic strategies to orevent or reverse atherosclerotic diseases.

关键词： coronary artery disease atherosclerosis inflammation

Pearls and pitfalls in magnetic resonance imaging of hepatocellular carcinoma

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World Journal of Gastroenterology 2020年第17期26卷 2012-2029页

作者： Jelena Djokic Kovac Tamara Milovanovic Vladimir Dugalic Igor Dumic Departament of Radiology Clinical Center SerbiaBelgrade 11000Serbia School of medicine Belgrade UniversityBelgrade 11000Serbia Departament of Hepatology Clinical Center SerbiaBelgrade 11000Serbia Departament of Surgery Clinical Center SerbiaBelgrade 11000Serbia divison of hospital medicine Mayo Clinic College of Medicine and SciencesMayo Clinic Health SystemNew YorkNY 10029United States

Hepatocellular carcinoma(HCC)is the most common primary hepatic malignancy,which usually arises in cirrhotic *** the typical enhancement pattern,consisting of late arterial hyperenhancement followed by washout,is present in nodules larger than 1 cm,HCC can be confidently diagnosed without the need for tissue ***,HCC can display an atypical enhancement pattern,either as iso or hypovascular lesion,or hypervascular lesion without *** only the enhancement pattern of HCC could be atypical,but also a variety of histological types of HCC,such as steatotic,scirrhous,fibrolamellar,or combined hepatocellular-cholangiocellular carcinoma could raise diagnostic *** addition,distinct morphological types of HCC or different growth pattern can *** of these atypical and rare HCC presentations on magnetic resonance imaging is important for accurate differentiation from other focal liver lesions and timely diagnosis,which allows optimal treatment of patients.

关键词： Hepatocellular carcinoma Cirrhosis Magnetic resonance imaging Hepatocarcinogenesis

Endoplasmic Reticulum Stress-induced Endothelial Dysfunction Promotes Neointima Formation after Arteriovenous Grafts in Mice on High-fat Diet

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Current Medical Science 2023年第1期43卷 115-122页

作者： Yan-xia ZHONG Chen-chen ZHOU Ying-fang ZHENG Hong-kai DAI Ren-yu CHEN Yu-rou WANG Cheng-ye ZHAN Jin-long LUO Ai-ni XIE Emergency and Intensive Care Unit Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China divison of Cardiothoracic and Vascular Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective Endothelial dysfunction is one candidate for triggering neointima formation after arteriovenous grafts(AVGs),but the factors mediating this process are *** purpose of this study was to investigate the role of endoplasmic reticulum stress(ERS)-induced endothelial dysfunction in neointima formation following AVGs in high-fat diet(HFD)*** CCAAT-enhancer-binding protein-homologous protein(CHOP)knockout(KO)mice were *** were fed with HFD to produce HFD *** model were applied in the groups of WT ND,WT HFD,and CHOP KO *** umbilical vein endothelial cells(HUVECs)were cultured with oxidized low density lipoprotein(ox-LDL)(40 mg/L)for the indicated time lengths(0,6,12,24 h).ERS inhibitor tauroursodeoxycholic acid(TUDCA)was used to block *** staining was used to observe the changes of *** of ERS were detected by real-time *** expression levels and ERS activation were detected by Western *** cell function was determined by endothelial permeability assay and transendothelial migration *** HFD increased neointima formation in AVGs associated with endothelial *** the same time,ERS was increased in endothelial cells(ECs)after AVGs in mice consuming the *** vitro,ox-LDL was found to stimulate ERS,increase the permeability of the EC monolayer,and cause endothelial *** ERS with TUDCA or CHOP siRNA reversed the EC dysfunction caused by *** vivo,knockout of CHOP(CHOP KO)protected the function of ECs and decreased neointima formation after AVGs in HFD *** Inhibiting ERS in ECs could improve the function of AVGs.

关键词： endoplasmic reticulum stress endothelial dysfunction neointima formation arteriovenous grafts high-fat diet

Correlation of abnormal histology with endoscopic findings among mycophenolate mofetil treated patients

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World Journal of Gastrointestinal Endoscopy 2017年第8期9卷 405-410页

作者： Mitchell A Izower Merajur Rahman Ernesto P Molmenti Madhu C Bhaskaran Viren G Amin Sundas Khan Keith Sultan Department of medicine North Shore University Hospital Division of Gastroenterology Department of MedicineNorth Shore University Hospital Department of Surgery North Shore University Hospital divison of Nephrology Department of MedicineNorth Shore University Hospital the Feinstein Institute for Biomedical Research

To describe all abnormal histological findings and their associated endoscopic presentation in patients using mycophenolate mofetil (MMF). METHODSA retrospective review of all individuals prescribed MMF within 6 mo of a colonoscopy or flexible sigmoidoscopy between 07/2009 and 09/2015 was performed within Northwell Health system. Records were analyzed for age, gender, procedure indication, MMF indication, and both gross and microscopic findings. Only reports with abnormal histology were included. RESULTSOne hundred and eighty-four procedures from 170 patients were found, of which 39 met inclusion criteria. Fifty-one point three percent were female. MMF was used for solid organ transplant in 71.8%. Diarrhea was the indication for 71.8% of colonoscopies. Fifty-nine percent of reports revealed gross and microscopic abnormalities while 41.0% had only microscopic findings. Only 11 patients’ reports (28.2%) indicated a specific histopathology of MMF colitis. Among the entire group, only 23.1% of abnormal histology was isolated proximal to the splenic flexure. CONCLUSIONOur results demonstrate a high rate of left sided disease and microscopic findings without gross mucosal abnormalities among patients using MMF. Also, a broader definition of MMF-colonopathy may be appropriate, with a majority of our abnormal histology falling outside of the more narrowly defined MMF-colitis category. Given the high frequency of isolated microscopic abnormalities and distal disease, sigmoidoscopy with random biopsies may be an appropriate, less invasive initial endoscopic examination in selected MMF patients.

关键词： Mycophenolate mofetil Colitis Colonoscopy Diarrhea

Changes in smoking behavior and adherence to preventive guidelines among smokers after a heart attack

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Journal of Geriatric Cardiology 2013年第2期10卷 146-150页

作者： Yoon-Jung Choi Jong-Seon Park Ung Kim Sang-Hee Lee Jang-Won Son Dong-Gu Shin Young-Jo Kim Myung-Ho Jeong Young-Keun Ahn Myeong-Chan Cho Jang-Whan Bae Chong-Jin Kim Jin-Man Cho Kyoo-Rok Han Jun-Hee Lee divison of Cardiology Department of Internal Medicine Yeungnam University Hospital 170 Hyeonchung-ro Nam-gu Daegu 705-717 South Korea Division of Cardiology Department of Internal Medicine Chonnam National University Hospital 42 Jebong-ro Dong-gu Kwangju 501-757 South Korea divison of Cardiology Department of Internal Medicine Chungbuk National University Hospital 410 Sungbong-ro Heungdeok-gu Cheongju Chungcheongbuk-do 361-711 South Korea Division of Cardiology Department of Internal Medicine Kyunghee University Hospital 892 Dongnam-ro Gandong-gu Seoul 134-727 South Korea Division of Cardiology Department of Internal Medicine Hanrim University Hospital 94-195 Yeongdeungpo-dong Yeongdeungpo-gu Seoul 150-030 South Korea

Objective Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among smoking patients. Methods The study was carried out in smokers admitted with myocardial infarction (MI). Atotal of 275 patients who had been regularly followed for over one year after MI were randomly selected and enrolled in this *** investigated changes in smoking behavior and the adherence rate to ACC/AHA Guidelines for secondary prevention in patients with coronary artery disease at the time of, and one year after, the index event. Results The study population consisted of 275 patients (97.1% males) with a mean age of 57.0 ±11.2 years. Achievement of target goals at one year was as follows: smoking cessation, 52.3%; blood pressure, 83.9%; HbA1c, 32.7%; lipid profile, 65.5%; and body mass index (BMI), 50.6%. Over one year, 80% of the patients attempted to quit smoking; 27% of them re-started smoking within one month after discharge while 65% succeeded in cessation of smoking. At one year, only 52% of the patients overall had stopped smoking. From the multivariate logistic analysis including smoking patterns and clinical characteristics, the severity of coronary artery disease was the only independent predictor for smoking cessation (Relative risk (RR): 1.230; P = 0.022). Conclusions Only a small percentage of MI patients adhere to guidelines for secondary prevention and a sizable proportion fail to stop smoking. These findings underscore the need for an effective patient education system.

关键词： Coronary artery disease Myocardial infarction Prevention Smoking

A safe and effective surgical navigation technique in laparoscopic radical gastrectomy: Indocyanine green-mediated near-infrared fluorescent imaging

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Cancer Communications 2020年第6期40卷 270-272页

作者： Yan Qian Shirong Cai divison of Gastrointestinal Surgery Center the First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdong 510080P.R.China Gastric Cancer Center Sun Yat-sen UniversityGuangzhouGuangdong 510080P.R.China

In the past decades,gastric cancer(GC)is one of the most common cancers and causes of cancer-related deaths worldwide[1].China has the highest incidence of GC[2]and accounts for more than 40%of all new GC cases in the world[3].Radical lymphadenectomy serves as an important role in the staging and definitive management of GC[4,5].At present,laparoscopic radical gastrectomy has been shown to significantly improve the accuracy of tumor staging and long-term survival of GC patients[6].The retrieval of more lymph nodes(LNs)via lymphadenectomy is a current requirement for laparoscopic radical gastrectomy[5].Lymphadenectomy is usually performed according to the experience of ***,it is a substantial challenge for surgeons to efficiently and accurately acquire enough LNs without increasing the risk of complications as the vascular and lymphatic anatomy of stomach is extremely ***,surgeons are looking for more accurate strategies to perform adequate lymphadenectomy under laparoscopic guidance.

关键词： anatomy stomach radical

Predictive model for *** mortality after breast cancer surgery in Taiwan residents

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Chinese Journal of Cancer 2017年第4期36卷 184-192页

作者： Su-Hsin Huang Joon-Khim Loh Jinn-Tsong Tsai Ming-Feng Houg Hon-Yi Shi Department of Nursing Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung Medical University Kaohsiung Taiwan China Department of Healthcare Administration and Medical Informatics Kaohsiung Medical University 100.Shih.Chun 1st Road Kaohsiung Taiwan China divison of Neurosurgery Department of Surgery Kaohsiung Medical University Hospital Kaohsiung Taiwan China Department of Surgery Kaohsiung Municipal Ta-Tung Hospital Kaohsiung Taiwan China. Department of Computer Science National Pingtung University Pingtung Taiwan China Division of General & Gastroenterological Surgery Department of Surgery Kaohsiung Municipal Hsiao-Kang Hospital Kaohsiung Taiwan China Cancer Center Kaohsiung Medical University Hospital and Institute of Clinical Medicine Kaohsiung Medical University Kaohsiung Taiwan China Department of Business Management National Sun Yat-sen University Kaohsiung Taiwan China

Background:Few studies of breast cancer surgery outcomes have used longitudinal data for more than 2 *** study aimed to validate the use of the artificial neural network(ANN)model to predict the 5?year mortality of breast cancer patients after surgery and compare predictive accuracy between the ANN model,multiple logistic regression(MLR)model,and Cox regression ***:This study compared the MLR,Cox,and ANN models based on clinical data of 3632 breast cancer patients who underwent surgery between 1996 and *** estimation dataset was used to train the model,and a validation dataset was used to evaluate model *** sensitivity analysis was also used to assess the relative signifi?cance of input variables in the prediction ***:The ANN model significantly outperformed the MLR and Cox models in predicting 5?year mortality,with higher overall performance *** results indicated that the 5?year postoperative mortality of breast cancer patients was significantly associated with age,Charlson comorbidity index(CCI),chemotherapy,radiotherapy,hormone therapy,and breast cancer surgery volumes of hospital and surgeon(all Phospital,age,and ***:Compared with the conventional MLR and Cox models,the ANN model was more accurate in predict?ing 5?year mortality of breast cancer patients who underwent *** mortality predictors identified in this study can also be used to educate candidates for breast cancer surgery with respect to the course of recovery and health outcomes.

关键词： Breast cancer surgery Artificial neural networks Multiple logistic regression Cox regression 5-year mortality