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| 1 | Conversion from calcineurin inhibitors to mTOR inhibitors stabilizes diabetic and hypertensive nephropathy after liver transplant显示文摘AIM: To investigate if conversion to the mammalian target of rapamycin inhibitors(mTORi) improves renal function in diabetic and/or hypertensive liver transplant patients immunosuppressed with tacrolimus or cyclosporine.METHODS: The study included 86 liver graft recipients immunosuppressed with mTORi treatment after orthotopic liver transplantation(OLT), including all liver recipients with worsening renal function before conversion to mTORi(n = 55 patients) and recipients with normal renal function who converted to m TORi for other reasons(n = 31 patients). We identified patients with diabetes mellitus(n = 28), arterial hypertension(n = 27), proteinuria(n = 27) and all three factors(n = 8)(some patients have hypertension and diabetes and no proteinuria). The primary endpoint was evolution in renal function defined as the development in plasma creatinine as a function of diabetes mellitus(DM), hypertension(HT) or proteinuria. We required elevated serum creatinine for at least two weeks to define renal dysfunction.RESULTS: Only patients that converted because of renal failure with plasma creatinine levels > 1.5 mg/dL showed an improvement of renal function(2.14 to 1.77 mg/dL)(P = 0.02). Patients with DM showed no improvement of serum creatinine levels(1.31 mg/dL to 1.37 mg/dL) compared with non DM patients(1.31 mg/dL to 1.15 mg/dL)(P = 0.01), HT patients(1.48 mg/dL to 1.5 mg/dL) with non HT patients(1.21mg/d L to 1.08 mg/dL) and patients with proteinuria(1.44 mg/dL to 1.41 mg/dL) and no proteinuria(1.31 mg/dL to 1.11 mg/dL). CONCLUSION: In OLT recipients with diabetes or hypertensive nephropathy, conversion to m TORi does not improve renal function but stabilizes plasma levels of creatinine. Proteinuria is not a contraindication to conversion to m TORi; it also stabilizes renal function. Conversion to m TORi should only be avoided in patients with diabetes, hypertension and proteinuria. | José M álamo Claudia Olivares Lydia Barrera Luis M Marín Gonzalo Suarez Carmen Bernal Juan Serrano Jordi Muntané Francisco J Padillo Miguel A Gómez | 2015 | World Journal of Transplantation2015，5，1： | 6 |
| 2 | Ketamine anesthesia reduces intestinal ischemia/reperfusion injury in rats显示文摘AIM: To investigate the effects of ketamine anesthesia on the motility alterations and tissue injury caused by ischemia/reperfusion in rats. METHODS: Thirty male Wistar rats weighing 200-250 g were used. Ischemia was induced by ob-structing blood flow in 25% of the total small intesti-nal length (ileum) with a vascular clamp for 45 min, after which either 60 min or 24 h of reperfusion was allowed. Rats were either anesthetized with pento-barbital sodium (50 mg/kg) or ketamine (100 mg/kg). Control groups received sham surgery. After 60 min of reperfusion, the intestine was examined for mor-phological alterations, and after 24 h intestinal basic electrical rhythm (BER) frequency was calculated, and intestinal transit determined in all groups. RESULTS: The intestinal mucosa in rats that were anesthetized with ketamine showed moderate altera-tions such as epithelial lifting, while ulceration and hemorrhage was observed in rats that received pento-barbital sodium after 60 min of reperfusion. Quantita-tive analysis of structural damage using the Chiu scaleshowed significantly less injury in rats that received ketamine than in rats that did not (2.35 ± 1.14 vs 4.58 ± 0.50, P < 0.0001). The distance traveled by a mark-er, expressed as percentage of total intestinal length, in rats that received pentobarbital sodium was 20% ± 2% in comparison with 25.9% ± 1.64% in rats that re-ceived ketamine (P = 0.017). BER was not statistically different between groups. CONCLUSION: Our results show that ketamine anesthesia is associated with diminished intestinal injury and abolishes the intestinal transit delay induced by ischemia/reperfusion. | Carlos Rodrigo Cámara Francisco Javier Guzmán Ernesto Alexis Barrera Andrés Jesús Cabello Armando Garcia Nancy Esthela Fernández Eloy Caballero Jesus Ancer | 2008 | World Journal of Gastroenterology2008，14，33： | 5 |
| 3 | High prevalence of hepatic steatosis and vascular thrombosis in COVID-19:A systematic review and meta-analysis of autopsy data显示文摘BACKGROUND Coronavirus disease 2019(COVID-19)disease can frequently affect the liver.Data on hepatic histopathological findings in COVID-19 is scarce.AIM To characterize hepatic pathological findings in patients with COVID-19.METHODS We conducted a systematic review with meta-analysis registered on PROSPERO(CRD42020192813),following PRISMA guidelines.Eligible trials were those including patients of any age and COVID-19 diagnosis based on a molecular test.Histopathological reports from deceased COVID-19 patients undergoing autopsy or liver biopsy were reviewed.Articles including less than ten patients were excluded.Proportions were pooled using random-effects models.Q statistic and I2 were used to assess heterogeneity and levels of evidence,respectively.RESULTS We identified 18 studies from 7 countries;all were case reports and case series from autopsies.All the patients were over 15 years old,and 67.2%were male.We performed a meta-analysis of 5 studies,including 116 patients.Pooled prevalence estimates of liver histopathological findings were hepatic steatosis 55.1%[95%confidence interval(CI):46.2-63.8],congestion of hepatic sinuses 34.7%(95%CI:7.9-68.4),vascular thrombosis 29.4%(95%CI:0.4-87.2),fibrosis 20.5%(95%CI:0.6-57.9),Kupffer cell hyperplasia 13.5%(95%CI:0.6-54.3),portal inflammation 13.2%(95%CI:0.1-48.8),and lobular inflammation 11.6%(95%CI:0.3-35.7).We also identified the presence of venous outflow obstruction,phlebosclerosis of the portal vein,herniated portal vein,periportal abnormal vessels,hemophagocytosis,and necrosis.CONCLUSION We found a high prevalence of hepatic steatosis and vascular thrombosis as major histological liver features.Other frequent findings included portal and lobular inflammation and Kupffer cell hyperplasia or proliferation.Further studies are needed to establish the mechanisms and implications of these findings. | Luis Antonio Díaz Francisco Idalsoaga Macarena Cannistra Roberto Candia Daniel Cabrera Francisco Barrera Alejandro Soza Rondell Graham Arnoldo Riquelme Marco Arrese Michael D Leise Juan Pablo Arab | 2020 | World Journal of Gastroenterology2020，26，48： | 3 |
| 4 | Simple Non-Invasive Systems Predict Long-Term Outcomes of Patients With Nonalcoholic Fatty Liver Disease显示文摘 | Paul Angulo Elisabetta Bugianesi Einar S. Bjornsson Phunchai Charatcharoenwitthaya Peter R. Mills Francisco Barrera Svanhildur Haflidadottir Christopher P. Day Jacob George | 2013 | Gastroenterology2013，，： | 2 |
| 5 | Terpenoids and triynepoxide from the aerial part of Rhantherium adpressum显示文摘 | M. Bouheroum S. Benayache F. Benayache L. Zaiter J. M. Barrera L. Francisco | 2007 | Chemistry of Natural Compounds2007，，1： | 1 |
| 6 | The steroids and fatty acids of the basidiomycete Scleroderma polyrhizum 显示文摘 | Antonio G Gonzalez Jaime Bermejo Barrera Francisco J Tolfdo Marante | 1983 | Phytochemistry1983，22，4： | 1 |
| 7 | Improving outcomes in pancreatic cancer: Key points in perioperative management显示文摘This review focused in the perioperative management of patients with pancreatic cancer in order to improve the outcome of the disease. We consider that the most controversial points in pancreatic cancer management are jaundice management, vascular resection and neoadjuvant therapy. Preoperative biliary drainage is recommended only in patients with severe jaundice, as it can lead to infectious cholangitis, pancreatitis and delay in resection, which can lead to tumor progression. The development of a phase Ⅲ clinical trial is mandatory to clarify the role of neo-adjuvant radiochemotherapy in pancreatic adenocarcinoma. Venous resection does not adversely affect postoperative mortality and morbidity, therefore, the need for venous resection should not be a contraindication to surgical resection in selected patients. The data on arterial resection alone, or combined with vascular resection at the time of pancreatectomy are more heterogeneous, thus, patient age and comorbidity should be evaluated before a decision on operability is made. In patients undergoing R0 resection, arterial resection can also be performed. | José M álamo Luis M Marín Gonzalo Suarez Carmen Bernal Juan Serrano Lydia Barrera Miguel A Gómez Jordi Muntané Francisco J Padillo | 2014 | World Journal of Gastroenterology2014，20，39： | 0 |
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