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Very-early-stage Hepatocellular Carcinoma,Are We at Long Last on Route for Achieving Better Patient Outcomes?

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Journal of Clinical and Translational Hepatology 2021年第2期9卷 141-142页

作者： Paulina Vidal-Cevallos Norberto Chavez-Tapia obesity and digestive disease unit Medica Sur Clinic and FoundationMexico CityMexico

Hepatocellular carcinoma(HCC)represents∼90%of the primary liver cancer cases,and 90%of HCC cases occur in patients with chronic liver disease.1 It also represents the sixth most common cancer(4.7%)and the third leading cause of cancer-related death globally(8.3%).2 More troubling,the global incidence and mortality rates have been increasing since 1990.3 In the united States,the highest average annual percentage change(known as AAPC)reported between 2000 and 2012 involved individuals between 55 and 59 years of age(AAPC:8.9%;95%confidence interval:7.1–10.7%).

关键词： Carcinoma mortality cancer

obesity and cholangiocarcinoma

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World Journal of Gastroenterology 2013年第4期19卷 457-462页

作者： Mansour A Parsi Center for Endoscopy and Pancreatobiliary Disorders Digestive Disease InstituteCleveland ClinicClevelandOH 44195United States

It is estimated that about half of the population in developed countries are either overweight or *** some developing nations obesity rates have increased to surpass those seen in Western *** rate increase in obesity has many implications as obesity has been associated with numerous negative health effects including increased risks of hypertension,diabetes,cardiovascular disease,stroke,liver disease,apnea,and some cancer *** is now considered to be one of the major public health concerns facing the ***(bile duct cancers) are malignant tumors arising from cholangiocytes inside or outside of the *** cholangiocarcinomas are relatively rare,they are highly *** low survival rate associated with cholangiocarcinoma is due to the advanced stage of the disease at the time of *** is therefore especially important in this cancer *** data suggest that the incidence of cholangiocarcinoma in the western world is on the *** rate of obesity may be one of the factors responsible for this *** whether obesity is a risk factor for cholangiocarcinoma has significant clinical and societal implications as obesity is both prevalent and *** paper seeks to provide a summary of the current knowledge linking obesity and cholangiocarcinoma,and encourage further research on this topic.

关键词： Cholangiocarcinoma obesity Epidemiology Bile ducts Cancer

Laparoscopic sleeve gastrectomy and gastroesophageal reflux

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World Journal of Gastroenterology 2015年第36期21卷 10348-10357页

作者： Fabien Stenard Antonio Iannelli digestive and Oncology unit Mutualiste Hospital digestive unit Archet 2 HospitalUniversity Hospital of Nice Inserm U1065Team 8 "Hepatic complications of obesity" University of Nice Sophia-Antipolis

Bariatric surgery is the only effective procedure that provides long-term sustained weight loss. Sleeve gastrectomy(SG) has emerged over the last few years to be an ideal bariatric procedure because it has several advantages compared to more complex bariatric procedures,including avoiding an intestinal bypass. However,several published follow-up studies report an increased rate of gastroesophageal reflux(GERD) after a SG. GERD is described as either de novo or as being caused by aggravation of preexisting symptoms. However,the literature on this topic is ambivalent despite the potentially increased rate of GERDs that may occur after this common bariatric procedure. This article reviews the mechanisms responsible for GERD in obese subjects as well as the results after a SG with respect to GERD. Future directions for clinical research are discussed along with the current surgical options for morbidly obese patients with GERD and undergoing bariatric surgery.

关键词： Gastroesophageal reflux Sleeve gastrectomy Morbid

Report on Childhood obesity in China (7) Comparison of NCHS and WGOC

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Biomedical and Environmental Sciences 2008年第4期21卷 271-279页

作者： YI-QUN XU CHENG-YE JI 无 Institute of Child and Adolescent Health Peking University of Health Science Center Beijing 100083 China COOPERATIVE STUDY ON CHILDHOOD obesity： WORKING GROUP ON obesity IN CHINA

Objective To test the validity of Working Group on obesity in China （WGOC） reference in screening childhood obesity using obesity-related metabolic syndrome （MS） and its components as disease risk evidence. Methods A total of 2020 adolescents （1007 boys and 1013 girls） aged 14-16 years were sampled in Beijing, China. Anthropometric and biochemical measurements, as well as blood pressure parameters were available. Prevalence of overweight/obesity and related MS risk factors were analyzed across different body mass index （BMI） categories. The sensitivity and specificity of the WGOC cut-offs were compared with those of National Central Health Statistics （NCHS）. Results Significantly high prevalence of MS and its components were found both in the obesity and overweight groups, which were classified by the WGOC and NCHS references. Similar distribution pattern of MS risk factors existed among different BMI categories, but the frequency and clustering of these factors in the obesity group classified by the NCHS were much higher. Owing to its irrelevant high cut-offs for overweight/obesity （especially for girls since the mid- adolescence）, the NCHS reference had a high specificity but a low sensitivity. By contrast, the WGOC reference with a high sensitivity （90.1% for boys and 89.2% for girls） and a relative high specificity （96.4% and 92.8% for obese boys and girls, 78.1% and 68.9% for overweight boys and girls respectively） was more suitable to support the need for early screening, intervention, and treatment of childhood obesity in China. Conclusion High sensitivity is more important than specificity in choosing appropriate screening tools for childhood obesity. Validity test demonstrates that it is rational to use the WGOC reference, established on the basis of the Chinese own reference population as a uniform screening tool for childhood obesity, which can effectively overcome the unnecessary treatment and psychosociai implications of stigmatization caused by misclas

关键词： Body mass index Childhood obesity Overweight Metabolic syndromes Validity

Report on Childhood obesity in China (4) Prevalence and Trends of Overweight and obesity in Chinese Urban School-age Children and Adolescents, 1985-2000

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Biomedical and Environmental Sciences 2007年第1期20卷 1-10页

作者： CHENG-YE JI 无 Institute of Child and Adolescent Health Peking Medical University Health Science Center 38 Xueyuan Road Beijing 100083 China COOPERATIVE STUDY ON CHILDHOOD obesity： WORKING GROUP ON obesity IN CHINA （WGOC）

Objective To describe the nationwide prevalence of childhood overweight/obesity, and their group variations and trends over the past 20 years in the Chinese urban population. Methods Data sets of boys and girls at the age of 7-18 years collected from the series of Chinese national surveillance on students＇ constitution and health （CNSSCH） between 1985 and 2000 were divided into five socioeconomic and demographic groups, while BMI classification reference proposed by Working Group on obesity in China （WGOC） was used as screening reference to calculate the prevalence and trends of overweight/obesity in these groups. Results In 2000, the prevalence of obesity and overweight in boys aged 7-18 years was 11.3% and 6.5% in Beijing, 13.2% and 4.9% in Shanghai, 9.9% and 4.5% in coastal big cities, and 5.8% and 2.0% in coastal medium/small-sized cities, respectively, while the prevalence of of obesity and overweight in girls of the same age group was 8.2% and 3.7% in Beijing, 7.3% and 2.6% in Shanghai, 5.9% and 2.8% in coastal big cities, and 4.8% and 1.7% in coastal medium/small-sized cities, respectively. The prevalence of obesity was low in most of the inland cities at an early stage of epidemic overweight. The epidemic manifested a gradient distribution in groups, which was closely related to status （SES） of the study population. However, a dramatic and steady increasing trend was witnessed among all sex-age subgroups in the five urban groups, and such a trend was stronger in boys than in girls, and much stronger in children than in adolescents. Conclusion Although China is at an early stage of epidemic obesity by and large, the prevalence of obesity in her urban population, particularly in coastal big cities has reached the average level of developed countries. The increasing trend has been rapid since early 1990s, and the increments in obesity and overweight are exceptionally high. The prospect of epidemic obesity in China is in no way optimistic. Therefore, preventive

关键词： obesity Overweight Prevalence Epidemic changes Chinese urban areas School-age children and adolescents

Halothane hepatitis in Iran:A review of 59 cases

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World Journal of Gastroenterology 2008年第34期14卷 5322-5326页

作者： Payam Eghtesadi-Araghi Amir-Ali Sohrabpour Homayoon Vahedi Mehdi Saberi-Firoozi digestive disease Research Center Shariati HospitalMedical Sciences/University of Tehran Gastroenterology Research Center Shiraz University of Medical Sciences digestive disease Research Center Shariati Hospital Medical Sciences/University of Tehran

AIM:To study halothane hepatitis (HH) in Iran and its associated risk factors. METHODS: We retrospectively studied files of all cases diagnosed with HH referred to three referral hospitals and four private centers in Iran from April 1994 to September 2006. Information on age at surgery, gender, medications history, obesity, history of previous exposure, previous reaction to halothane, familial history, type of surgery, perioperative hypoxia or sepsis, morbidity and mortality were recorded and analyzed. RESULTS: A total of 59 cases were identifi ed. Forty- eight (81%) were women. The median age at the time of surgery was 44 years (range, 18 to 80 years). Sixty percent of patients were above 40-year-old. obesity was observed in 22.2%. Previous history of exposures to halothane was noted in 61% of which 50% had history of post-exposure reaction. Coronary artery bypass graft (CABG), cholecystectomy, and cosmetic surgeries (mainly weight reduction) were the most frequent surgeries. The mortality rate was 12.2%. In patients developing encephalopathy, it was as high as 50%. CONCLUSION: HH remains an important cause of morbidity and mortality in centers still using this anesthetic. However, a large percentage of these casescould have been avoided. To lessen occurrence of further cases of HH, the authors suggest that in female patients having a history of surgery (or delivery) with general anesthesia, the use of halothane should be absolutely avoided. Utilization of proper substitutes in adults’ anesthesia is advocated.

关键词： Anesthesia Inhalation Halothane Hepatitis Drug-Induced

Apolipoprotein A-V gene therapy for disease prevention/treatment:a critical analysis

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The Journal of Biomedical Research 2016年第2期30卷 88-93页

作者： Trudy M.Forte Vineeta Sharma Robert O.Ryan Center for Prevention of obesity Diabetes and Cardiovascular DiseaseChildren's Hospital Oakland Research Institute

Apolipoprotein（apo） A-V is a novel member of the class of exchangeable apo＇s involved in triacylglycerol（TG）*** a portion of hepatic-derived apoA-V is secreted into plasma and functions to facilitate lipoprotein Iipase-mediated TG hydrolysis,another portion is recovered intracellularly,in association with cytosolic lipid *** of apo A-V function is positively correlated with elevated plasma TG and increased risk of cardiovascular *** nucleotide polymorphisms（SNP） in the APOA5 locus can affect transcription efficiency or introduce deleterious amino acid ***,rare mutations in APOA5 that compromise functionality are associated with increased plasma TG and premature myocardial *** engineered mouse models and human population studies suggest that,in certain instances,supplementation with wild type（WT） apoA-V may have therapeutic *** is hypothesized that individuals that manifest elevated plasma TG owing to deleterious APOA5 SNPs or rare mutations would respond to WT apoA-V supplementation with improved plasma TG *** the other hand,subjects with hypertriglyceridemia of independent origin（unrelated to apoA-V function） may not respond to apoA-V augmentation in this *** in the ability to identify individuals predicted to benefit,advances in gene transfer technology and the strong connection between HTG and heart disease,point to apoA-V supplementation as a viable disease prevention / therapeutic *** would include individuals that manifest chronic TG elevation,have low plasma apoA-V due to an APOA5 mutation/polymorphism and not have deleterious mutations/polymorphisms in other genes known to influence plasma TG levels.

关键词： apolipoprotein A-V adeno-associated virus triacylglycerol lipoprotein lipase atherosclerosis single nucleotide polymorphism gene therapy

Research highlights from the Status report for step it up! The surgeon general's call to action to promote walking and walkable communities

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Journal of Sport and Health Science 2018年第1期7卷 5-6页

作者： David R.Brown Susan A.Carlson Gayathri S.Kumar Janet E.Fulton National Center for Chronic disease Prevention and Health Promotion Centers for Disease Control and Prevention Division of NutritionPhysical Activity and Obesity Physical Activity and Health Branch

In September 2015,the Office of the Surgeon General,*** of Health and Human Services,released Step it up!The surgeon general’s call to action to promote walking and walkable communities(Call to Action)to increase walking among people across the USA.1The Call to Action also recognized that walkable communities can accommodate wheelchair rolling and are inclusive of persons with *** Status Report for the Call to Action was released in 2017。

关键词：电话医生外科社区办公室

Higher body mass index deteriorates postoperative outcomes of pancreaticoduodenectomy

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Hepatobiliary & Pancreatic diseases International 2020年第2期19卷 163-168页

作者： Si-Yi Zou Wei-Shen Wang Qian Zhan Xia-Xing Deng Bai-Yong Shen Pancreatic disease Center Research Institute of Pancreatic DiseaseShanghai Institute of Digestive SurgeryRuijin HospitalSchool of MedicineShanghai Jiaotong UniversityShanghai 200025China

Background:Previous studies presented controversies in impact of body mass index(BMI)on perioper-ative complications in pancreatectomy,and mainly focused on Western *** study aimed to explore the impact of BMI on perioperative outcomes in Chinese patients undergoing ***:Seven hundred and seven adult patients undergoing open pancreaticoduodenectomy between January 2005 and December 2016 at Ruijin Hospital were studied retrospectively and categorized as obese(BMI≥25 kg/m^2),overweight(BMI≥23 kg/m^2 and<25 kg/m^2),or normal weight(BMI≥18.5 kg/m^2 and<23 kg/m^2).Associations of these BMI groups with perioperative outcomes were ***:The overweight and obese groups experienced higher risk of clinically related postoperative pan-creatic fistula(CR-POPF)(7.6%vs.9.9%vs.17.6%,P=0.002)and re-operation(1.1%vs.2.5%vs.5.1%,P=0.017),and longer systemic inflammation response syndrome(SIRS)duration[2(1–9)d vs.2(1–7)d vs.3(1–10)d,P=0.003]and postoperative hospital stay[19(2–84)d vs.19(7–158)d vs.23(8–121)d,P=0.023]than the normal weight group *** multiple logistic regression models showed obese as an independent risk factor for CR-POPF(P=0.013).The multiple linear regression analysis confirmed BMI as a predictor for prolonged postoperative hospital stay(P=0.005).Conclusions:Higher BMI results in higher morbidity of Chinese patients undergoing open *** is still a safe surgery procedure for overweight and obese patients,with intensive perioperative management.

关键词： Body mass index obesity Overweight Pancreaticoduodenectomy