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International Journal of Ophthalmology(English edition) 2019年第5期12卷 866-869页

作者： Gabriella Cirigliano Marco R Pastore Alberto A Perrotta Chiara De Giacinto Daniele Tognetto Eye clinic Department of Medical Surgical Sciences and HealthUniversity of Trieste

Dear Editor,Endothelial cell density decreases with age and in various ocular conditions,including corneal endotheliitis,uveitis,pseudoexfoliation syndrome,and birth injury(1)The reduction of endothelial cell density is exacerbated over time after intraocular surgery(1)Descemet stripping automated endothelial keratoplasty(DSAEK)is considered the primary procedure for patients with only endothelial dysfunction.

关键词： PBK Figure Combined Descemet stripping automated endothelial keratoplasty and intravitreal dexamethasone implant for concomitant pseudophakic bullous keratopathy and cystoid macular edema IOL IOP

Non-alcoholic fatty liver disease and psoriasis: So far, so near

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World Journal of Hepatology 2015年第3期7卷 315-326页

作者： Giulia Ganzetti Anna Campanati Annamaria Offidani Dermatologic clinic Polytechnic University of Marche Region

Psoriasis is a chronic inflammatory immune-mediated skin diseases which is frequently associated to comorbidities. Non-alcoholic fatty liver disease(NAFLD) is defined as an excessive accumulation of triglycerides in hepatocytes and includes a wide spectrum of liver conditions ranging from relatively benign steatosis to non-alcoholic steatohepatitis with fatty infiltration and lobular inflammation and to cirrhosis and endstage liver disease. Actually, psoriasis is considered a systemic diseases associated to comorbidities, as metabolic syndrome and NAFLD is seen the hepatic manifestation of the metabolic syndrome. The possible link between psoriasis, obesity and metabolic syndrome, which are known risk factors for NAFLD has beenrecently documented focusing in the crucial role of the adipose tissue in the development of the inflammatory background sharing by the above entities. According to recent data, patients with psoriasis show a greater prevalence of NAFLD and metabolic syndrome than the general population. Moreover, patients with NAFLD and psoriasis are at higher risk of severe liver fibrosis than those with NAFLD and without psoriasis. The link between these pathological conditions appears to be a chronic low-grade inflammatory status. The aim of this review is to focus on the multiple aspects linking NAFLD and psoriasis, only apparently far diseases.

关键词： Psoriasis Non-alcoholic fatty liver disease Adipose tissue Adipocytokines Biologic therapies Nonbiologictherapies

Role of Helicobacter pylori infection in gastric carcinogenesis:Current knowledge and future directions

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World Journal of Gastroenterology 2015年第41期21卷 11654-11672页

作者： Aleksandra Sokic-Milutinovic Tamara Alempijevic Tomica Milosavljevic clinic for Gastroenterology and Hepatology Clinical Center of Serbia and School of Medicine University of Belgrade

Helicobacter pylori(H. pylori) plays a role in the patho-genesis of gastric cancer. The outcome of the infection depends on environmental factors and bacterial and host characteristics. Gastric carcinogenesis is a multistep process that is reversible in the early phase of mucosal damage, but the exact point of no return has not been identified. Therefore, two main therapeutic strategies could reduce gastric cancer incidence:(1) eradication of the already present infection; and(2) immunization(prior to or during the course of the infection). The success of a gastric cancer prevention strategy depends on timing because the prevention strategy must be introduced before the point of no return in gastric carcinogenesis. Although the exact point of no return has not been identified, infection should be eradicated before severe atrophy of the gastric mucosa develops. Eradication therapy rates remain suboptimal due to increasing H. pylori resistance to antibiotics and patient noncompliance. Vaccination against H. pylori would reduce the cost of eradication therapies and lower gastric cancer incidence. A vaccine against H. pylori is still a research challenge. An effective vaccine should have an adequate route of delivery, appropriate bacterial antigens and effective and safe adjuvants. Future research should focus on the development of rescue eradication therapy protocols until an efficacious vaccine against the bacterium becomes available.

关键词： Helicobacter pylori Gastric cancer Vaccine Eradica

Arrhythmogenic epilepsy and pacing need: A matter of controversy

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World Journal of clinical Cases 2015年第10期3卷 872-875页

作者： Alper Kepez Okan Erdogan Marmara university Training and Research Hospital Cardiology Clinic

There is increasing awareness among the cardiology community regarding ictal bradyarrhythmias as a cause of loss of consciousness. A high degree of suspicion is necessary when diagnosing ictal bradyarrhythmias, and delay in diagnosing this condition may lead to morbidity associated with falls and trauma. Ictal bradyarrhythmias have also been suggested to be associated with sudden unexplained death in epilepsy, although evidence related to this association is limited. There is no guidelinedirected therapy for symptomatic ictal bradyarrhythmias due to a lack of randomized, controlled trials. Cardiac pacemaker therapy is commonly used for these patients; however, currently, there is no universal agreement on the pacing indications for these patients. In this review, we focus on the pathophysiology and clinical presentation of ictal bradyarrhythmias and then discuss the pacing need based on the available literature data.

关键词： Arrhythmogenic epilepsy Syncope Ictal bradyarrhythmia Pacemaker Anticonvulsive therapy

Mechanisms of fibrinolysis resistance and potential targets for thrombolysis in acute ischaemic stroke: lessons from retrieved stroke emboli

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Stroke & Vascular Neurology 2021年第4期6卷 658-667页

作者： Waleed Brinjikji Oana Madalina Mereuta Daying Dai David F Kallmes Luis Savastano Yang Liu Shahid M Nimjee Raul G Nogueira Mehdi Abbasi Ramanathan Kadirvel Radiology Mayo ClinicRochesterMinnesotaUSA Neurosurgery Mayo ClinicRochesterMinnesotaUSA Neurosurgery Ohio State University Medical CenterColumbusOhioUSA Neurology Emory University School of MedicineAtlantaGeorgiaUSA

There has been growing interest and insight into the histological composition of retrieved stroke *** of the main focuses of the stroke clot analysis literature has been the implications of clot composition on mechanical thrombectomy ***,the holy grail of clot analysis may not be in the field of clot-device interaction,but rather,in understanding mechanisms of fibrinolysis *** mechanisms underlying the low response to fibrinolytic therapy,even with the newer,more powerful agents,remain poorly *** factors such as embolus size,location and collateral status influence alteplase delivery and recanalisation rates;compositional analyses focused on histological and ultrastructural characteristics offer unique insights into mechanisms of alteplase *** this review,we strive to provide comprehensive review of current knowledge on clot composition and ultrastructural analyses that help explain resistance to fibrinolysis.

关键词： fibrin histological resistance

Interplay between chronic hepatitis B and atherosclerosis:Innovative perspectives and theories

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World Journal of Gastroenterology 2022年第4期28卷 497-499页

作者： Ivan Ranković Vladimir Milivojević Aleksandra PavlovićMarković Mihailo Bezmarević clinic for Gastroenterology and Hepatology University Clinical Center of SerbiaBelgrade 11000Serbia clinic for Gastroenterology and Hepatology University Clinical Center of SerbiaSchool of MedicineUniversity of BelgradeBelgrade 11000Serbia Department of Hepatobiliary and Pancreatic Surgery Clinic for General SurgeryMilitary Medical AcademyUniversity of DefenseBelgrade 11000Serbia

Elaboration of carotid atherosclerosis in the setting of hepatitis B virus(HBV)infection should emphasize the significance of extrahepatic manifestations of the infection *** processes comprise the pathoevolution of HBV infection,rendering it a multi-systemic disease in its *** work not only exemplified atherosclerosis as an often-underestimated contributor to the severity of HBV infection but has also highlighted the bidirectional relationship between the ***,it is suggested that HBV-induced inflammation is one of the root causes of atherosclerosis,which in turn has a consequent effect on the severity of the chronic infection disease state,creating a vicious ***,we coupled prior data with the current concepts of HBV infection to postulate intriguing perspectives and theories.

关键词： Hepatitis B virus infection Carotid atherosclerosis Hepatitis B e antigen Arterial inflammation Perspectives and trends

Long-term outcomes after fractional flow reserve-guided percutaneous coronary intervention in patients with severe coronary stenosis

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Journal of Geriatric Cardiology 2019年第4期16卷 329-337页

作者： Ying-Hua ZHANG Jing LI Andreas J. Flammer Yoshiki Matsuo Moo-Sik Lee Ryan J. Lennon Malcolm R. Bell David R. Holmes John F. Bresnahan Charanjit S. Rihal Lilach O. Lerman Amir Lerman Division of Cardiology Xuanwu Hospital Capital Medical UniversityBeijingChina Division of Cardiovascular Diseases Mayo ClinicRochesterUSA Cardiovascular Center CardiologyUniversity Hospital ZurichSwitzerland Department of Preventive Medicine College of Medicine Konyang UniversityDaejeonSouth Korea Biomedical Statistics Mayo ClinicRochesterUSA Division of Nephrology and Hypertension Mayo ClinicRochesterUSA

Objective To explore the safety and efficacy of FFR-guided percutaneous coronary intervention (PCI) in vessels with severe diameter stenosis. Methods & Results Of 1090 patients undergoing fractional flow reserve (FFR) assessment from 2002 to 2009,we identified 167 patients in whom FFR was measured in at least one 70%–89% stenotic lesion. These patients were subdivided into an FFR-defer group (n = 49) if PCI was deferred (FFR > 0.80),and an FFR-perform group (n = 118) if PCI was performed (FFR ≤ 0.80). Comparatively,an additional 1176 patients undergoing PCI in at least one lesion with 70%–89% stenosis but without measurement of FFR served as a control (angiography- guided) group. clinical outcomes were compared during a median follow-up of 49.0 months. The 5-year Kaplan-Meier estimated revascularization rates were 16% in the FFR-defer group and 33% in the FFR-perform group (P = 0.046). The incidence of major adverse cardiac events were comparable in these two groups (HR = 0.82,95% CI: 0.37–1.82,P = 0.63). The number of stents placed was significantly lower in the FFR-guided group (0.9 ± 0.8 vs. 1.4 ± 0.8,P clinically safe and associated with fewer stents use. This study suggests that extending the use of FFR to more severe coronary lesions may be reasonable.

关键词： Fractional flow reserve Outcome Percutaneous coronary intervention Severe stenosis Stent

Renal cell carcinoma presented with a rare case of icteric Stauffer syndrome:A case report

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World Journal of clinical Cases 2022年第25期10卷 9087-9095页

作者： Dimitar R Popov Krasimir A Antonov Evelina G Atanasova Christo P Pentchev Lyuben M Milatchkov Maria D Petkova Krasimir G Neykov Rosen K Nikolov Medical university of Sofia Sofia 1431Bulgaria clinic of Gastroenterology University Hospital’St.Ivan Rilski’Sofia 1431Bulgaria clinic of Urology National Oncology HospitalSofia 1756Bulgaria

BACKGROUND Paraneoplastic syndromes remain poorly understood and manifest as multifaceted clinical symptoms,making their diagnosis *** can be observed in various *** rare cases,it can be a paraneoplastic manifestation,most often associated with renal cell carcinoma and other urogenital tumors,as well as with bronchial *** classical form of Stauffer syndrome presents with a reversible anicteric increase of cholestatic liver function tests,thrombocytosis,coagulation impairment,and hepatosplenomegaly,without any proven hepatobiliary obstruction or *** SUMMARY We report a patient who presented with elevated liver enzymes,cholestatic jaundice,weight loss and pruritus,in whom renal cell carcinoma was incidentally found during ***,laboratory,and imaging tests excluded primary hepatic cause or metastatic *** and laboratory abnormalities reversed completely a few months after *** case is an example of the many sides of renal cell carcinoma,and it focuses the clinicians’attention on the differential diagnosis of cholestasis,including Stauffer syndrome and its ***,the correct diagnosis can be straightforward and the associated malignancy can be treated *** cases should be followed up with a multidisciplinary ***(IL)-6 is proposed to contribute to the pathophysiology of the *** probable mechanism is proinflammatory activity by the IL-6 cytokine,causing elevation of C-reactive protein and haptoglobin and inhibition of hepatobiliary transporter gene expression,impairing biliary *** Despite being rare,Stauffer syndrome is a potentially reversible paraneoplastic condition,when the primary cause is *** syndrome should be considered by clinicians because of the remediable liver disturbance,after successful treatment of the underlying malignancy.

关键词： Jaundice Cholestasis Renal cell carcinoma Stauffer syndrome Case report

Noninvasive assessment of portal hypertension in cirrhosis:Liver stiffness and beyond

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World Journal of Gastroenterology 2014年第45期20卷 16811-16819页

作者： Horia Stefanescu Bogdan Procopet Department of Medical and Surgical Sciences University of Bologna Regional Institute of Gastroenterology and Hepatology Liver Hemodynamic Unit Hospital Clinic 3rd Medical clinic Iuliu Hatieganu University of Medicine and Pharmacy

Liver stiffness measurement(LSM)is a good,but still limited tool to noninvasively assess complications and prognosis in patients with advanced liver *** review aims to consider the role of LSM for the diagnosis of portal hypertension-related complications and for assessment of prognosis in cirrhotic patients,and to highlight the drawbacks as well as some alternatives for improving the ***,this field is far from being closed,and deserves more *** is still a place for more carefully designed studies to find new,innovative and reliable approaches.

关键词： Liver stiffness Portal hypertension Complication Spleen stiffness Prediction

Complexities of diagnosis and management of COVID-19 in autoimmune diseases:Potential benefits and detriments of immunosuppression

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World Journal of clinical Cases 2020年第17期8卷 3669-3678页

作者： Tsvetoslav Georgiev Alexander Krasimirov Angelov clinic of Rheumatology University Hospital"St.Marina"First Department of Internal MedicineMedical University-VarnaVarna 9010Bulgaria clinic of Rheumatology University Hospital"St.Ivan Rilski"Medical University-SofiaSofia 1612Bulgaria

Recent advances in our understanding of coronavirus disease 2019(COVID-19)and the associated acute respiratory distress syndrome might approximate the cytokine release syndrome of severe immune-mediated ***,this presumption provides the rationale for utilization of therapy,until recently reserved mostly for autoimmune diseases(ADs),in the management of COVID-19 hyperinflammation condition and has led to an extensive discussion for the potential benefits and detriments of *** paper intends to examine the available recommendations,complexities in diagnosis and management when dealing with patients with ADs amidst the COVID-19 *** a flare of an underlying AD,overlapping pathological lung patterns,probability of higher rates of false-positive antibody test,and lack of concrete data are only a part of the detrimental and specific characteristics of COVID-19 outbreak among the population with *** administration of pharmaceutical therapy should not undermine the physical and psychological status of the patient with the maximum utilization of *** and clinicians should be vigilant for upcoming research for insight and perspective to fine-tune the clinical guidelines and practice and to weigh the potential benefits and detrimental effects of the applied immunomodulating therapy.

关键词： Autoimmune diseases Autoimmunity COVID-19 Coronavirus Serologic Tests Cross reactions