Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients com...Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients complain of symptoms, these include: dyspnea, dizziness, syncope and angina. HCM can lead to sudden cardiac death (SCD), mainly due to ventricular tachyarrhythmia or ventricular tachycardia. High-risk patients benefit from implantable cardioverter-defibrillators. Left ventricular outflow tract obstruction is not a rare feature in HCM, especially in symptomatic patients, and procedures that abolish that obstruction provide positive and consistent results that can improve longterm survival. HCM is the most common cause of sudden death in young competitive athletes and preparticipation screening programs have to be implemented to avoid these tragic fatalities. The structure of these programs is a matter of large debate. Worldwide registries are necessary to identify the full extent of HCMrelated SCD.展开更多
Surveillance with abdominal ultrasound with or without alpha-fetoprotein is recommended by clinical practice guidelines for patients who are considered to be at risk of developing hepatocellular carcinoma(HCC),includi...Surveillance with abdominal ultrasound with or without alpha-fetoprotein is recommended by clinical practice guidelines for patients who are considered to be at risk of developing hepatocellular carcinoma(HCC),including those with cirrhosis,advanced fibrosis and special subgroups of chronic hepatitis B(CHB).Application of the standard surveillance strategy to all patients with chronic liver disease(CLD)with or without cirrhosis imposes major sustainability and economic burdens on healthcare systems.Thus,a number of HCC risk scores were constructed,mainly from Asian cohorts,to stratify the HCC prediction in patients with CHB.Similarly,even if less than for CHB,a few scoring systems were developed for chronic hepatitis C patients or cirrhotic patients with CLD of different etiologies.Recently,a few newsworthy HCC-risk algorithms were developed for patients with cirrhosis using the combination of serologic HCC markers and clinical parameters.Overall,the HCC risk stratification appears at hand by several validated multiple score systems,but their optimal performance is obtained only in populations who show highly homogenous clinic-pathologic,epidemiologic,etiologic and therapeutic characteristics and this limitation poses a major drawback to their sustainable use in clinical practice.A better understanding of the dynamic process driving the progression from CLD to HCC derived from studies based on molecular approaches and genetics,epigenetics and liquid biopsy will enable the identification of new biomarkers to define the individual risk of HCC in the near future,with the possibility to achieve a real and cost/effective personalization of surveillance.展开更多
BACKGROUND Growth differentiation factor(GDF)-15 is a member of a transforming growth factor-βcytokine superfamily that regulates metabolism and is released in response to inflammation,hypoxia and tissue injury.It ha...BACKGROUND Growth differentiation factor(GDF)-15 is a member of a transforming growth factor-βcytokine superfamily that regulates metabolism and is released in response to inflammation,hypoxia and tissue injury.It has evolved as one of the most potent cytokines for predicting the severity of infections and inflammatory conditions,such as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To investigate the utility of GDF-15 in predicting the severity of SARS-CoV-2 infection.METHODS PubMed,Reference Citation Analysis,CNKI,and Goggle Scholar were explored by using related MeSH keywords and data such as the first author’s name,study duration,type and place of study,sample size and subgroups of participants if any,serum/plasma GDF-15 level in pg/mL,area under the curve and cut-off value in receiver operating characteristic analysis,method of measurement of GDF-15,and the main conclusion were extracted.RESULTS In all studies,the baseline GDF-15 level was elevated in SARS-CoV-2-infected patients,and it was significantly associated with severity,hypoxemia,viral load,and worse clinical consequences.In addition,GDF-15 levels were correlated with C-reactive protein,D-dimer,ferritin and procalcitonin,and it had superior discriminatory ability to detect severity and in-hospital mortality of SARS-CoV-2 infection.Hence,GDF-15 might be used to predict the severity and prognosis of hospitalized patients with SARS-CoV-2.CONCLUSION Serial estimation of GDF-15 levels in hospitalized patients with SARS-CoV-2 infection appeared to have useful prognostic value and GDF-15 can be considered a clinically prominent sepsis biomarker for SARS-CoV-2 infection.展开更多
Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive prop...Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.展开更多
文摘Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease that affects the left ventricle. HCM can appear at any age, with the majority of the patients remaining clinically stable. When patients complain of symptoms, these include: dyspnea, dizziness, syncope and angina. HCM can lead to sudden cardiac death (SCD), mainly due to ventricular tachyarrhythmia or ventricular tachycardia. High-risk patients benefit from implantable cardioverter-defibrillators. Left ventricular outflow tract obstruction is not a rare feature in HCM, especially in symptomatic patients, and procedures that abolish that obstruction provide positive and consistent results that can improve longterm survival. HCM is the most common cause of sudden death in young competitive athletes and preparticipation screening programs have to be implemented to avoid these tragic fatalities. The structure of these programs is a matter of large debate. Worldwide registries are necessary to identify the full extent of HCMrelated SCD.
文摘Surveillance with abdominal ultrasound with or without alpha-fetoprotein is recommended by clinical practice guidelines for patients who are considered to be at risk of developing hepatocellular carcinoma(HCC),including those with cirrhosis,advanced fibrosis and special subgroups of chronic hepatitis B(CHB).Application of the standard surveillance strategy to all patients with chronic liver disease(CLD)with or without cirrhosis imposes major sustainability and economic burdens on healthcare systems.Thus,a number of HCC risk scores were constructed,mainly from Asian cohorts,to stratify the HCC prediction in patients with CHB.Similarly,even if less than for CHB,a few scoring systems were developed for chronic hepatitis C patients or cirrhotic patients with CLD of different etiologies.Recently,a few newsworthy HCC-risk algorithms were developed for patients with cirrhosis using the combination of serologic HCC markers and clinical parameters.Overall,the HCC risk stratification appears at hand by several validated multiple score systems,but their optimal performance is obtained only in populations who show highly homogenous clinic-pathologic,epidemiologic,etiologic and therapeutic characteristics and this limitation poses a major drawback to their sustainable use in clinical practice.A better understanding of the dynamic process driving the progression from CLD to HCC derived from studies based on molecular approaches and genetics,epigenetics and liquid biopsy will enable the identification of new biomarkers to define the individual risk of HCC in the near future,with the possibility to achieve a real and cost/effective personalization of surveillance.
文摘BACKGROUND Growth differentiation factor(GDF)-15 is a member of a transforming growth factor-βcytokine superfamily that regulates metabolism and is released in response to inflammation,hypoxia and tissue injury.It has evolved as one of the most potent cytokines for predicting the severity of infections and inflammatory conditions,such as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To investigate the utility of GDF-15 in predicting the severity of SARS-CoV-2 infection.METHODS PubMed,Reference Citation Analysis,CNKI,and Goggle Scholar were explored by using related MeSH keywords and data such as the first author’s name,study duration,type and place of study,sample size and subgroups of participants if any,serum/plasma GDF-15 level in pg/mL,area under the curve and cut-off value in receiver operating characteristic analysis,method of measurement of GDF-15,and the main conclusion were extracted.RESULTS In all studies,the baseline GDF-15 level was elevated in SARS-CoV-2-infected patients,and it was significantly associated with severity,hypoxemia,viral load,and worse clinical consequences.In addition,GDF-15 levels were correlated with C-reactive protein,D-dimer,ferritin and procalcitonin,and it had superior discriminatory ability to detect severity and in-hospital mortality of SARS-CoV-2 infection.Hence,GDF-15 might be used to predict the severity and prognosis of hospitalized patients with SARS-CoV-2.CONCLUSION Serial estimation of GDF-15 levels in hospitalized patients with SARS-CoV-2 infection appeared to have useful prognostic value and GDF-15 can be considered a clinically prominent sepsis biomarker for SARS-CoV-2 infection.
基金This work was supported by grants from the Natural Science Foundation of Guangdong Province, China （No. $2011010001430）, the Science and Technology Planning Project of Guangdong Province, China （No. 2017A030223006, 2016A020215128, 2014A020212636, and 2013B021800161）, the Science and Technology Planning Project of Guangzhou, China （No. 201704020077）, the Research Fund of Guangdong General Hospital （No. y012015338）, the Yuexiu Science and Information Center of Guangzhou Scientific Foundation （No. 2012-GX-046）.
文摘Objective：Gastroscopy combined with gastric mucosa biopsies is currently regarded as a gold standard for diagnosis of gastric cancer.However,its application is restricted in clinical practice due to its invasive property.A new noninvasive population screening process combining the assay ofanti-Helicobacterpylori antibody and serum pepsinogen （PG） （ABC method） is adopted to recognize the high-risk patients for further endoscopy examination,avoiding the unnecessary gastroscopy for most population and saving the cost consumption for mass screening annually.Nevertheless,controversies exist for the grouping of ABC method and the intervals of gastroscopy surveillance for each group.In this review,we summarized these popular concerned topics for providing useful references to the healthcare practitioner in clinical practice.Data Sources：The PubMed databases were systematically searched from the inception dates to November 22,2017,using the keywords ＂Helicobacterpylori,＂ ＂Pepsinogens,＂ and ＂Stomach Neoplasms.＂Study Selection：Original articles and reviews on the topics were selected.Results：Anti-H.pylori antibody and serum PG concentration showed significant changes under the different status ofH.pylori infection and the progression of atrophic gastritis,which can be used for risk stratification of gastric cancer in clinic.In addition,anti-H,pylori antibody titer can be used for further risk stratification of gastric cancer contributing to determine better endoscopy surveillance interval.Conclusions：The early detection and diagnosis of gastric cancer benefit from the risk stratification,but the cutoff values for H.pylori antibody and serum PG concentration require further modification.
