Background: Combined hepatocellular-cholangiocarcinoma(cHCC-CC) is a rare primary liver malignancy. We conducted a systematic review and meta-analysis to assess the evidence available on the long-term outcomes of cHCC...Background: Combined hepatocellular-cholangiocarcinoma(cHCC-CC) is a rare primary liver malignancy. We conducted a systematic review and meta-analysis to assess the evidence available on the long-term outcomes of cHCC-CC patients after either hepatectomy or liver transplantation(LT). Data Sources: Relevant studies published between January 2000 and January 2018 were identified by searching Pub Med and Embase and reviewed systematically. Data were pooled using a random-effects model. Results: A total of 42 observational studies involving 1691 patients(1390 for partial hepatectomy and 301 for LT) were included in the analysis. The median tumor recurrence and 5-year overall survival(OS) rates were 65%(range 38%–100%) and 29%(range 0–63%) after hepatectomy versus 54%(range 14%–93%) and 41%(range 16%–73%) after LT, respectively. Meta-analysis found no significant difference in OS and tumor recurrence between LT and hepatectomy groups. Conclusion: Hepatectomy rather than LT should be considered as the prior treatment option for cHCC-CC.展开更多
Background： Hepatic angiosarcoma is a rare malignant vascular tumor presenting unique treatment challenges.The aim of the present study was to determine the treatment and prognosis of this entity.Data sources： A sys...Background： Hepatic angiosarcoma is a rare malignant vascular tumor presenting unique treatment challenges.The aim of the present study was to determine the treatment and prognosis of this entity.Data sources： A systematic literature search was conducted using PubMed, Embase and Chinese BiomedicalLiterature database, to identify articles published from January 1980 to July 2017. Search termswere “hepatic angiosarcoma” and “liver angiosarcoma”. Additional articles were retrieved through manualsearch of bibliographies of the relevant articles. Pooled individual data concerning the prognosis followingvarious therapeutic modalities were analyzed.展开更多
AIM:To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease(IBD).METHODS:This study included 63 ulcerative coliti...AIM:To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease(IBD).METHODS:This study included 63 ulcerative colitis(UC) and 41 Crohn's disease(CD) patients.Forty-seven healthy patients were included as the control group.Heart rate was calculated using electrocardiography,corrected QT dispersion(QTcd) and the Bazett's formula.Homeostasis model assessment(HOMA) was used to determine insulin resistance(IR).HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.RESULTS:Prolonged QTcd was found in 12.2% of UC patients,and in 14.5% of CD patients compared with the control group(P < 0.05).A significant difference was found between the insulin values(CD:10.95 ± 6.10 vs 6.44 ± 3.28,P < 0.05;UC:10.88 ± 7.19 vs 7.20 ± 4.54,P < 0.05) and HOMA(CD:2.56 ± 1.43 vs 1.42 ± 0.75,P < 0.05;UC:2.94 ± 1.88 vs 1.90 ± 1.09,P < 0.05) in UC and CD patients with and without prolonged QTcd.Disease behavior types were determined in CD patients with prolonged QTcd.Increased systolic arterial pressure(125 ± 13.81 vs 114.09 ± 8.73,P < 0.01) and age(48.67 ± 13.93 vs 39.57 ± 11.58,P < 0.05) in UC patients were significantly associated with prolonged QTcd.CONCLUSION:Our data show that IBD patients have prolonged QTcd in relation to controls.The routine followup of IBD patients should include determination of HOMA,insulin values and electrocardiogram examination.展开更多
Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and mortality.Therapeutic management is difficult,due to lack of conclusive data and individual disease progression.High-do...Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and mortality.Therapeutic management is difficult,due to lack of conclusive data and individual disease progression.High-dose UDCA was used for years as a pharmacotherapeutic agent to prevent disease progression,based on a positive trend in pilot studies,but has recently been proven to have a negative effect in advanced disease.Immunosuppressants might be useful in patients with overlap syndromes.Dominant bile duct stenoses should be treated endoscopically,and cholangiocellular carcinoma (CCC) still remains a therapeutic challenge in PSC patients.Early diagnosis of CCC must be improved and new strategies such as neoadjuvant radiochemotherapy with subsequent liver transplantation in selected patients are further options to be considered.展开更多
Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery...Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery,offering the best prognosis.Preneoplastic lesions of the pancreas include pancreatic intraepithelial neoplasia and mucinous cystic neoplasms,with intraductal papillary mucinous neoplasms being the most commonly diagnosed.Our study focused on predicting PC by identifying early signs using noninvasive techniques and artificial intelligence(AI).A systematic English literature search was conducted on the PubMed electronic database and other sources.We obtained a total of 97 studies on the subject of pancreatic neoplasms.The final number of articles included in our study was 44,34 of which focused on the use of AI algorithms in the early diagnosis and prediction of pancreatic lesions.AI algorithms can facilitate diagnosis by analyzing massive amounts of data in a short period of time.Correlations can be made through AI algorithms by expanding image and electronic medical records databases,which can later be used as part of a screening program for the general population.AI-based screening models should involve a combination of biomarkers and medical and imaging data from different sources.This requires large numbers of resources,collaboration between medical practitioners,and investment in medical infrastructures.展开更多
基金supported by a grant from Foundation of Xiamen Science and Technology Bureau(3502Z20174074)
文摘Background: Combined hepatocellular-cholangiocarcinoma(cHCC-CC) is a rare primary liver malignancy. We conducted a systematic review and meta-analysis to assess the evidence available on the long-term outcomes of cHCC-CC patients after either hepatectomy or liver transplantation(LT). Data Sources: Relevant studies published between January 2000 and January 2018 were identified by searching Pub Med and Embase and reviewed systematically. Data were pooled using a random-effects model. Results: A total of 42 observational studies involving 1691 patients(1390 for partial hepatectomy and 301 for LT) were included in the analysis. The median tumor recurrence and 5-year overall survival(OS) rates were 65%(range 38%–100%) and 29%(range 0–63%) after hepatectomy versus 54%(range 14%–93%) and 41%(range 16%–73%) after LT, respectively. Meta-analysis found no significant difference in OS and tumor recurrence between LT and hepatectomy groups. Conclusion: Hepatectomy rather than LT should be considered as the prior treatment option for cHCC-CC.
文摘Background： Hepatic angiosarcoma is a rare malignant vascular tumor presenting unique treatment challenges.The aim of the present study was to determine the treatment and prognosis of this entity.Data sources： A systematic literature search was conducted using PubMed, Embase and Chinese BiomedicalLiterature database, to identify articles published from January 1980 to July 2017. Search termswere “hepatic angiosarcoma” and “liver angiosarcoma”. Additional articles were retrieved through manualsearch of bibliographies of the relevant articles. Pooled individual data concerning the prognosis followingvarious therapeutic modalities were analyzed.
文摘AIM:To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease(IBD).METHODS:This study included 63 ulcerative colitis(UC) and 41 Crohn's disease(CD) patients.Forty-seven healthy patients were included as the control group.Heart rate was calculated using electrocardiography,corrected QT dispersion(QTcd) and the Bazett's formula.Homeostasis model assessment(HOMA) was used to determine insulin resistance(IR).HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR.RESULTS:Prolonged QTcd was found in 12.2% of UC patients,and in 14.5% of CD patients compared with the control group(P < 0.05).A significant difference was found between the insulin values(CD:10.95 ± 6.10 vs 6.44 ± 3.28,P < 0.05;UC:10.88 ± 7.19 vs 7.20 ± 4.54,P < 0.05) and HOMA(CD:2.56 ± 1.43 vs 1.42 ± 0.75,P < 0.05;UC:2.94 ± 1.88 vs 1.90 ± 1.09,P < 0.05) in UC and CD patients with and without prolonged QTcd.Disease behavior types were determined in CD patients with prolonged QTcd.Increased systolic arterial pressure(125 ± 13.81 vs 114.09 ± 8.73,P < 0.01) and age(48.67 ± 13.93 vs 39.57 ± 11.58,P < 0.05) in UC patients were significantly associated with prolonged QTcd.CONCLUSION:Our data show that IBD patients have prolonged QTcd in relation to controls.The routine followup of IBD patients should include determination of HOMA,insulin values and electrocardiogram examination.
文摘Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease with major morbidity and mortality.Therapeutic management is difficult,due to lack of conclusive data and individual disease progression.High-dose UDCA was used for years as a pharmacotherapeutic agent to prevent disease progression,based on a positive trend in pilot studies,but has recently been proven to have a negative effect in advanced disease.Immunosuppressants might be useful in patients with overlap syndromes.Dominant bile duct stenoses should be treated endoscopically,and cholangiocellular carcinoma (CCC) still remains a therapeutic challenge in PSC patients.Early diagnosis of CCC must be improved and new strategies such as neoadjuvant radiochemotherapy with subsequent liver transplantation in selected patients are further options to be considered.
文摘Pancreatic cancer(PC)has a low incidence rate but a high mortality,with patients often in the advanced stage of the disease at the time of the first diagnosis.If detected,early neoplastic lesions are ideal for surgery,offering the best prognosis.Preneoplastic lesions of the pancreas include pancreatic intraepithelial neoplasia and mucinous cystic neoplasms,with intraductal papillary mucinous neoplasms being the most commonly diagnosed.Our study focused on predicting PC by identifying early signs using noninvasive techniques and artificial intelligence(AI).A systematic English literature search was conducted on the PubMed electronic database and other sources.We obtained a total of 97 studies on the subject of pancreatic neoplasms.The final number of articles included in our study was 44,34 of which focused on the use of AI algorithms in the early diagnosis and prediction of pancreatic lesions.AI algorithms can facilitate diagnosis by analyzing massive amounts of data in a short period of time.Correlations can be made through AI algorithms by expanding image and electronic medical records databases,which can later be used as part of a screening program for the general population.AI-based screening models should involve a combination of biomarkers and medical and imaging data from different sources.This requires large numbers of resources,collaboration between medical practitioners,and investment in medical infrastructures.
