Background &Aims: In patients with stones in their bile ducts and gallbladders, cholecystectomy is generally recommended after endoscopic sphincterotomy and clearance of bile duct stones. However, only approximate...Background &Aims: In patients with stones in their bile ducts and gallbladders, cholecystectomy is generally recommended after endoscopic sphincterotomy and clearance of bile duct stones. However, only approximately 10%of patients with gallbladders left in situ will return with further biliary complications. Expectant management is alternately advocated. In this study, we compared the treatment strategies of laparoscopic cholecystectomy and gallbladders left in situ. Methods: We randomized patients (>60 years of age) after endoscopic sphincterotomy and clearance of their bile duct stones to receive early laparoscopic cholecystectomy or expectant management. The primary outcome was further biliary complications. Other outcome measures included adverse events after cholecystectomy and late deaths from all causes. Results: One hundred seventy-eight patients entered into the trial (89 in each group); 82 of 89 patients who were randomized to receive laparoscopic cholecystectomy underwent the procedure. Conversion to open surgery was needed in 16 of 82 patients (20%). Postoperative complications occurred in 8 patients (9%). Analysis was by intention to treat. With a median follow-up of approximately 5 years, 6 patients (7%) in the cholecystectomy group returned with further biliary events (cholangitis, n = 5; biliary pain, n = 1). Among those with gallbladders in situ, 21 (24%) returned with further biliary events (cholangitis, n = 13; acute cholecystitis, n = 5; biliary pain, n = 2; and jaundice, n = 1; log rank, P = .001). Late deaths were similar between groups (cholecystectomy, n = 19; gallbladder in situ, n = 11; P = .12). Conclusions: In the Chinese, cholecystectomy after endoscopic treatment of bile duct stones reduces recurrent biliary events and should be recommended.展开更多
2015年6月Rheumatology（Oxford）杂志发表了中国医学科学院北京协和医学院北京协和医院张文教授牵头的一项关于IgG4相关性疾病（IgG4-RD）的研究：“IgG4相关性疾病临床特征：来自118例中国患者的前瞻性队列研究”[L in W, Lu S, Chen ...2015年6月Rheumatology（Oxford）杂志发表了中国医学科学院北京协和医学院北京协和医院张文教授牵头的一项关于IgG4相关性疾病（IgG4-RD）的研究：“IgG4相关性疾病临床特征：来自118例中国患者的前瞻性队列研究”[L in W, Lu S, Chen H, et al. Clinical characteristics of immunoglobulin G4-related disease： a prospective study of 118 Chinese patients[ J]. Rheumatology （Oxford）, 2015 ],展开更多
Background and Purpose-Asian patients with cerebrovascular diseases have more intracranial atherosclerosis and less extracranial carotid artery stenosis compared with white patients.We systemically evaluated the distr...Background and Purpose-Asian patients with cerebrovascular diseases have more intracranial atherosclerosis and less extracranial carotid artery stenosis compared with white patients.We systemically evaluated the distribution of carotid arterial lesions in Chinese patients with transient monocular blindness(TMB),which was rarely reported.Methods-We prospectively evaluated 105 consecutive patients with TMB.All of the patients received ocular and physical examinations,blood tests for coagulation function and autoimmune diseases,and ultrasonography of cervical and intracranial arteries.All of the carotid lesions were confirmed by magnetic resonance angiography or cerebral angiography.Results-Of the 36(34.3%)patients with significant carotid stenosis(>50%),16(15.2%)had extracranial carotid stenosis;17(16.2%)had carotid siphon stenosis;and 3(2.9%)had both.The duration,onset,and patterns of visual loss were not different between patients with and without carotid arterial lesion.Conclusions-This study signified the importance of carotid siphon stenosis as a probable underlying etiology for TMB in Chinese patients.展开更多
文摘Background &Aims: In patients with stones in their bile ducts and gallbladders, cholecystectomy is generally recommended after endoscopic sphincterotomy and clearance of bile duct stones. However, only approximately 10%of patients with gallbladders left in situ will return with further biliary complications. Expectant management is alternately advocated. In this study, we compared the treatment strategies of laparoscopic cholecystectomy and gallbladders left in situ. Methods: We randomized patients (>60 years of age) after endoscopic sphincterotomy and clearance of their bile duct stones to receive early laparoscopic cholecystectomy or expectant management. The primary outcome was further biliary complications. Other outcome measures included adverse events after cholecystectomy and late deaths from all causes. Results: One hundred seventy-eight patients entered into the trial (89 in each group); 82 of 89 patients who were randomized to receive laparoscopic cholecystectomy underwent the procedure. Conversion to open surgery was needed in 16 of 82 patients (20%). Postoperative complications occurred in 8 patients (9%). Analysis was by intention to treat. With a median follow-up of approximately 5 years, 6 patients (7%) in the cholecystectomy group returned with further biliary events (cholangitis, n = 5; biliary pain, n = 1). Among those with gallbladders in situ, 21 (24%) returned with further biliary events (cholangitis, n = 13; acute cholecystitis, n = 5; biliary pain, n = 2; and jaundice, n = 1; log rank, P = .001). Late deaths were similar between groups (cholecystectomy, n = 19; gallbladder in situ, n = 11; P = .12). Conclusions: In the Chinese, cholecystectomy after endoscopic treatment of bile duct stones reduces recurrent biliary events and should be recommended.
文摘2019年发表的全球ARCHES试验(NCT02677896)结果显示,与安慰剂(placebo,PBO)+雄激素剥夺治疗(androgen deprivation therapy,ADT)相比,恩扎卢胺+ADT延长了转移性激素敏感性前列腺癌(metastatic hormone-sensitive prostate cancer,mHSPC)患者的总生存期和放射影像学无进展生存期(radiographic progression-free survival,rPFS)^([1])。然而,该试验无中国患者入组。欧洲肿瘤内科学会(European Society for Medical Oncology,ESMO)2023年会议报道了中国ARCHES研究(NCT04076059)的初步结果,这是一项评估恩扎卢胺+ADTvs.PBO+ADT在中国m HSPC患者中的疗效和安全性的多中心、随机、双盲、PBO对照的Ⅲ期试验^([2])。
文摘2015年6月Rheumatology（Oxford）杂志发表了中国医学科学院北京协和医学院北京协和医院张文教授牵头的一项关于IgG4相关性疾病（IgG4-RD）的研究：“IgG4相关性疾病临床特征：来自118例中国患者的前瞻性队列研究”[L in W, Lu S, Chen H, et al. Clinical characteristics of immunoglobulin G4-related disease： a prospective study of 118 Chinese patients[ J]. Rheumatology （Oxford）, 2015 ],
文摘Background and Purpose-Asian patients with cerebrovascular diseases have more intracranial atherosclerosis and less extracranial carotid artery stenosis compared with white patients.We systemically evaluated the distribution of carotid arterial lesions in Chinese patients with transient monocular blindness(TMB),which was rarely reported.Methods-We prospectively evaluated 105 consecutive patients with TMB.All of the patients received ocular and physical examinations,blood tests for coagulation function and autoimmune diseases,and ultrasonography of cervical and intracranial arteries.All of the carotid lesions were confirmed by magnetic resonance angiography or cerebral angiography.Results-Of the 36(34.3%)patients with significant carotid stenosis(>50%),16(15.2%)had extracranial carotid stenosis;17(16.2%)had carotid siphon stenosis;and 3(2.9%)had both.The duration,onset,and patterns of visual loss were not different between patients with and without carotid arterial lesion.Conclusions-This study signified the importance of carotid siphon stenosis as a probable underlying etiology for TMB in Chinese patients.
