5,952 results match your criteria Lower Gastrointestinal Bleeding


Cases report: severe colonic bleeding in ulcerative colitis is refractory to selective transcatheter arterial embolization.

BMC Gastroenterol 2019 Apr 16;19(1):55. Epub 2019 Apr 16.

Servicio de Aparato Digestivo. Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, C/ Dr. Esquerdo 46, 28007, Madrid, Spain.

Background: Severe haemorrhage is an uncommon but life-threatening complication of ulcerative colitis (UC). Superselective transcatheter embolization has shown to be an effective and safe therapeutic modality in patients with lower gastrointestinal bleeding of various aetiologies; nevertheless, its role in UC-related acute bleeding is unknown.

Cases Presentation: Efficacy and safety of selective transcatheter arterial embolization in three consecutive UC patients diagnosed with massive haemorrhage admitted in a tertiary institution are reported. Read More

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http://dx.doi.org/10.1186/s12876-019-0970-8DOI Listing

Clinical efficacy of octreotide acetate combined with thrombin in the treatment of liver cirrhosis complicated with gastrointestinal hemorrhage.

Exp Ther Med 2019 May 5;17(5):3417-3422. Epub 2019 Mar 5.

Department of Hepatological Surgery, Weifang People's Hospital, Weifang, Shandong 261041, P.R. China.

Clinical efficacy of octreotide acetate combined with thrombin in the treatment of liver cirrhosis complicated with gastrointestinal hemorrhage was investigated. A retrospective analysis of 157 patients with liver cirrhosis and gastrointestinal hemorrhage admitted to Weifang People's Hospital from March 2012 to September 2014 was performed. Among them, 74 patients treated with octreotide acetate were enrolled into the octreotide group, and 83 patients treated with octreotide acetate combined with thrombin were enrolled into the combination group. Read More

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http://dx.doi.org/10.3892/etm.2019.7345DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447786PMC

Intestinal Tuberculosis: A Rare Case of Massive Gastrointestinal Bleed in a Post-Renal Transplant Recipient.

Indian J Nephrol 2019 Mar-Apr;29(2):132-134

Department of Nephrology, PGIMER, Chandigarh, India.

Massive rectal bleeding is an uncommon presentation of ileal tuberculosis (TB). We report an uncommon cause of anemia in a post-renal transplant patient due to massive lower gastrointestinal (LGI) bleed. The index case had a normal upper and LGI endoscopy, but the technetium labeled red blood cell scan showed active bleeding from terminal ileum and caecum. Read More

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http://dx.doi.org/10.4103/ijn.IJN_360_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440334PMC

Gastrointestinal Hemorrhage Is Associated with Mortality after Acute Ischemic Stroke.

Curr Neurovasc Res 2019 Apr 12. Epub 2019 Apr 12.

The Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing. China.

Objective: Gastrointestinal (GI) hemorrhage is serious during the acute phase and reported to be related with an increased risk of death during the acute phase of acute ischemic stroke in particular. Our study was designed to investigate the relationship between GI hemorrhage and the mortality of acute ischemic stroke, assessing the influence of cerebrovascular risk factors, brain herniation and oral anticoagulation on the onset of GI hemorrhage. The identified risk factors for the occurrence of GI hemorrhage help to elucidate their respective roles in the mortality of acute ischemic stroke. Read More

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http://www.eurekaselect.com/171592/article
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http://dx.doi.org/10.2174/1567202616666190412160451DOI Listing
April 2019
2 Reads

[Endoscopy, angiography, surgery: diagnostic and therapeutic algorithms for diverticular bleeding].

Authors:
W Schwenk

Chirurg 2019 Apr 11. Epub 2019 Apr 11.

Klinik für Allgemein‑, Viszeral- und Gefäßchirurgie, Städtisches Klinikum Solingen gGmbH, Gotenstraße 1, 42653, Solingen, Deutschland.

Diverticular bleeding is a complication of diverticular disease but in contrast to diverticulitis, publications concerning diverticular bleeding are less common. Diverticular bleeding is the cause of approximately 20-50% of cases of lower gastrointestinal bleeding and in rare cases can be life-threatening. The main symptom of diverticular hemorrhage is painless hematochezia and the German guidelines recommend that further diagnostics of suspected diverticular bleeding should be performed in hospital. Read More

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http://link.springer.com/10.1007/s00104-019-0950-0
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http://dx.doi.org/10.1007/s00104-019-0950-0DOI Listing
April 2019
5 Reads

Early colonoscopy in patients with acute diverticular bleeding is associated with improvement in healthcare-resource utilization.

Gastroenterol Rep (Oxf) 2019 Apr 16;7(2):115-120. Epub 2018 Aug 16.

Division of Gastroenterology & Hepatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.

Background: Diverticular bleeding (DB) is the most common cause of severe acute lower gastrointestinal bleeding (GIB) in developed countries. The role of early colonoscopy (<24 hours) continues to remain controversial and data on early colonoscopy in acute DB are scant. We aimed to evaluate the effect of timing of colonoscopy on outcomes in patients with acute DB using a nationwide inpatient sample. Read More

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http://dx.doi.org/10.1093/gastro/goy031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454850PMC
April 2019
2 Reads

Functional capillary impairment in patients with ventricular assist devices.

Sci Rep 2019 Apr 11;9(1):5909. Epub 2019 Apr 11.

Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.

The implantation of continuous - flow ventricular assist devices (VAD) is suggested to evoke angiodysplasia contributing to adverse events such as gastrointestinal bleeding. We evaluated in vivo capillary density and glycocalyx dimensions to investigate possible systemic microvascular changes in patients with chronic heart failure and VAD support vs. standard medical treatment. Read More

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http://dx.doi.org/10.1038/s41598-019-42334-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459831PMC
April 2019
1 Read

Effect of Angiotensin II Inhibitors on Gastrointestinal Bleeding in Patients With Left Ventricular Assist Devices.

J Am Coll Cardiol 2019 Apr;73(14):1769-1778

Department of Pharmacy Services, Medical University of South Carolina, Charleston, South Carolina.

Background: Angiotensin II receptor activation may result in angiogenesis, and ultimately arteriovenous malformations (AVM), through transforming growth factor (TGF)-β and angiopoietin-2 pathway activation.

Objectives: The goal of this study was to determine whether angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) were associated with lower risk of major gastrointestinal bleeds (GIB) and AVM-related GIBs in continuous-flow left ventricular assist device (CF-LVAD) patients.

Methods: The authors reviewed HeartMate II CF-LVAD recipients between January 2009 and July 2016. Read More

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http://dx.doi.org/10.1016/j.jacc.2019.01.051DOI Listing
April 2019
1 Read

Gastrointestinal Bleeding After HeartMate II or HVAD Implantation: Incidence, Location, Etiology, and Effect on Survival.

ASAIO J 2019 Apr 4. Epub 2019 Apr 4.

From the Division of Cardiothoracic Transplantation and Circulatory Support, Baylor College of Medicine, Houston, Texas.

The number of patients on destination therapy is increasing as long-term survival on continuous-flow left ventricular assist device (CF-LVAD) therapy has improved. Gastrointestinal bleeding (GIB) is a common complication after CF-LVAD implantation, and its risk correlates with longer support time, emphasizing the importance of GIB management. The lower pulsatility of CF-LVADs may promote arteriovenous malformations, that amplify the bleeding risk. Read More

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http://dx.doi.org/10.1097/MAT.0000000000000998DOI Listing
April 2019
1 Read

A Newly Designed 3-Dimensional Printer-Based Gastric Hemostasis Simulator with Two Modules for Endoscopic Trainees (with Video).

Gut Liver 2019 Apr 17. Epub 2019 Apr 17.

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background/aims: : We used 3-dimensional (3D) printing technology to create a new hemostasis simulator for the stomach and investigated its efficacy and realism in endoscopic hemostasis training.

Methods: : A new stomach hemostasis simulator, with two hemostasis modules for hemoclipping and injection, was constructed using a 3D printer. Twenty-one endoscopists, including 11 first-year fellows (beginner group) and 10 faculty members (expert group), tested the performance of the simulator. Read More

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http://www.gutnliver.org/journal/view.html?doi=10.5009/gnl18
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http://dx.doi.org/10.5009/gnl18389DOI Listing
April 2019
3 Reads

The clinical value of a new method of functional lymph node dissection in video-assisted thoracic surgery right non-small cell lung cancer radical resection.

J Thorac Dis 2019 Feb;11(2):477-487

Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.

Background: To evaluate the safety, thoroughness and feasibility of "tunnel-type mediastinal lymph node dissection" in video-assisted thoracic surgery (VATS) for right non-small cell lung cancer (NSCLC) radical resection, which functionally dissected the lymph nodes of station 2R/4R/7.

Methods: A retrospective study was performed in the clinical data of 196 patients with VATS right NSCLC radical resection. According to the different methods of lymph node dissection of station 2R, 4R and 7, they were divided into the tunnel-type group (n=102) and the routine group (n=94). Read More

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http://dx.doi.org/10.21037/jtd.2019.01.15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409250PMC
February 2019
1 Read

Management of Complications of Colorectal Submucosal Dissection.

Clin Endosc 2019 Mar 29;52(2):114-119. Epub 2019 Mar 29.

Division of Gastroenterology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Endoscopic submucosal dissection (ESD) is a useful procedure for the treatment of superficial gastrointestinal neoplasm. Compared with endoscopic mucosal resection (EMR), ESD has several benefits, which include resectability of various difficult lesion, accurate histologic assessment of specimen, and lower recurrence rate. However, the risk of procedure- related complications is higher with ESD than with EMR. Read More

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http://dx.doi.org/10.5946/ce.2019.063DOI Listing
March 2019
1 Read

Nonsteroidal anti-inflammatory drugs versus placebo for post-endoscopic retrograde cholangiopancreatography pancreatitis: a systematic review and meta-analysis.

Endosc Int Open 2019 Apr 2;7(4):E477-E486. Epub 2019 Apr 2.

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HC/FMUSP, Gastrointestinal Endoscopy Unit, São Paulo, Brazil.

 Endoscopic retrograde cholangiopancreatography (ERCP) is the primary therapeutic procedure for treatment of diseases that affect the biliary tree and pancreatic duct. While the therapeutic success rate of ERCP is high, the procedure can cause complications, such as acute pancreatitis (PEP), bleeding, and perforation. This meta-analysis aimed to assess the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) in preventing PEP following (ERCP). Read More

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http://dx.doi.org/10.1055/a-0862-0215DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6445649PMC
April 2019
2 Reads

Recent use of NSAID and NOAC medications are associated with a positive CT arteriogram.

Abdom Radiol (NY) 2019 Apr 4. Epub 2019 Apr 4.

Section of Gastroenterology and Hepatology, Lewis Katz School of Medicine at Temple University, 3401 North Broad Street, Philadelphia, PA, 19140, USA.

Background: Computed tomography angiography (CTA) is a diagnostic modality utilized in patients with suspected active lower gastrointestinal (GI) bleeding. CTA use in clinical practice is limited by the risk of contrast-induced nephropathy, and the loss of patients from direct physician observation while undergoing the test. Identifying clinical predictors of a positive result would be useful in guiding physician utilization of CTA studies. Read More

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http://dx.doi.org/10.1007/s00261-019-02005-3DOI Listing
April 2019
3 Reads

Early unplanned reoperations after gastrectomy for gastric cancer are different between laparoscopic surgery and open surgery.

Surg Endosc 2019 Apr 1. Epub 2019 Apr 1.

Department of Gastric Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou, 350001, Fujian, China.

Background: To compare the differences in occurrence rates, time intervals, main causes, and management strategies of early unplanned reoperations (EUROs) after gastrectomy for gastric cancer (GC) between laparoscopic and open surgery.

Methods: From Jan. 2005 to Dec. Read More

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http://dx.doi.org/10.1007/s00464-019-06722-0DOI Listing
April 2019
1 Read

Risk factors for thromboembolic and bleeding events in anticoagulated patients with atrial fibrillation: the prospective, multicentre observational PREvention oF thromboembolic events - European Registry in Atrial Fibrillation (PREFER in AF).

BMJ Open 2019 Mar 30;9(3):e022478. Epub 2019 Mar 30.

University of Birmingham Institute of Cardiovascular Sciences, University of Birmingham, UHB and SWBH NHS Trusts, Birmingham, UK.

Objectives: We identified factors associated with thromboembolic and bleeding events in two contemporary cohorts of anticoagulated patients with atrial fibrillation (AF), treated with either vitamin K antagonists (VKA) or non-VKA oral anticoagulants (NOACs).

Design: Prospective, multicentre observational study.

Setting: 461 centres in seven European countries. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-022478DOI Listing
March 2019
1 Read

Efficacy and safety of Xa inhibitors for the treatment of cancer-associated venous thromboembolism.

Expert Opin Drug Saf 2019 Mar 29:1-8. Epub 2019 Mar 29.

a Department of Medicine , University of Ottawa, and the Ottawa Hospital Research Institute , Ottawa , Canada.

Introduction: Cancer patients with cancer-associated thrombosis (CAT) are at an elevated risk of recurrent venous thromboembolism (VTE) and of major bleeding while receiving treatment with anticoagulation. Recently, Xa inhibitors have been assessed in cancer patients for the treatment of CAT, providing clinicians and patients with more treatment options. Areas covered: In this narrative review, the authors evaluate the evidence regarding the efficacy and safety of edoxaban, rivaroxaban, and apixaban in the treatment of CAT. Read More

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http://dx.doi.org/10.1080/14740338.2019.1601699DOI Listing
March 2019
1 Read

Treatment of cancer-associated venous thromboembolism in the age of direct oral anticoagulants.

Ann Oncol 2019 Mar 27. Epub 2019 Mar 27.

Department of Medicine I, Clinical Division of Haematology and Haemostaseology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.

Background: Anticoagulation for cancer-associated venous thromboembolism (VTE) can be challenging due to complications-including bleeding and potential drug-drug interactions with chemotherapy-associated with vitamin K antagonists and inconvenience of low-molecular-weight heparin (LMWH). Direct oral anticoagulants (DOACs) could partially overcome these issues, but until recently there were no large clinical trials assessing their efficacy and safety in cancer patients.

Methods: This review summarizes clinical treatment guidelines, prior clinical and real-world evidence for anticoagulant choice, recent clinical trials assessing DOACs for cancer-associated VTE (ie, Hokusai-VTE Cancer, SELECT-D, CARAVAGGIO, and ADAM VTE), and special considerations for DOAC use. Read More

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http://dx.doi.org/10.1093/annonc/mdz111DOI Listing
March 2019
2 Reads

Optimal Rivaroxaban Dose in Asian Patients With Atrial Fibrillation and Normal or Mildly Impaired Renal Function.

Stroke 2019 Mar 27:STROKEAHA118024210. Epub 2019 Mar 27.

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest and Heart Hospital, United Kingdom (G.Y.H.L.).

Background and Purpose- Although rivaroxaban 15 mg (R15) was only given to patients with creatinine clearance (CrCl) ≤50 mL/min in the pivotal clinical trial, this dose has been commonly prescribed in Asian patients with nonvalvular atrial fibrillation regardless of renal function. There is a paucity of information on the clinical outcomes of R15 compared with rivaroxaban 20 mg (R20) in patients with CrCl ≥50 mL/min. This study aimed to examine the effectiveness and safety of 2 doses of rivaroxaban in Asian patients with atrial fibrillation and CrCl ≥50 mL/min. Read More

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http://dx.doi.org/10.1161/STROKEAHA.118.024210DOI Listing
March 2019
2 Reads

FOLFOX plus ziv-aflibercept or placebo in first-line metastatic esophagogastric adenocarcinoma: A double-blind, randomized, multicenter phase 2 trial.

Cancer 2019 Mar 26. Epub 2019 Mar 26.

Center for Esophageal and Gastric Cancer, Dana-Farber/Brigham and Women's Cancer Center, Boston, Massachusetts.

Background: Antiangiogenic therapy is a proven therapeutic modality for refractory gastric and gastroesophageal junction adenocarcinoma. This trial assessed whether the addition of a high affinity angiogenesis inhibitor, ziv-aflibercept, could improve the efficacy of first-line mFOLFOX6 (oxaliplatin, leucovorin, and bolus plus infusional 5- fluorouracil) in metastatic esophagogastric adenocarcinoma.

Methods: Patients with treatment-naive metastatic esophagogastric adenocarcinoma were randomly assigned (in a 2:1 ratio) in a multicenter, placebo-controlled, double-blind trial to receive first-line mFOLFOX6 with or without ziv-aflibercept (4 mg/kg) every 2 weeks. Read More

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http://dx.doi.org/10.1002/cncr.32029DOI Listing
March 2019
1 Read

Predictors of blood transfusion and in-hospital outcomes in patients with gastric antral vascular ectasia (GAVE): a nationwide population-based analysis.

Ann Transl Med 2019 Feb;7(3):46

Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA.

Background: Gastric antral vascular ectasia (GAVE) is a rare cause of chronic non-variceal upper gastrointestinal (GI) bleeding and can turn into life-threatening bleed in some patients. Packed red blood cell (PRBC) transfusions are often required in these patients during hospitalization. We aimed to investigate the hospitalization outcomes and predictors of PRBC transfusions in patients with GAVE lesions. Read More

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http://dx.doi.org/10.21037/atm.2019.01.11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389573PMC
February 2019
1 Read

Multiple venous malformations in the left colon and rectum: a long-standing case managed conservatively and an update of current literature.

BMJ Case Rep 2019 Mar 21;12(3). Epub 2019 Mar 21.

Gastroenterology, University Hospital of Wales, Cardiff, UK.

Venous or cavernous malformations of the colon or rectum are a rare cause of lower gastrointestinal bleeds. It has been previously described as a diffuse cavernous haemangioma which was thought to be a benign vascular tumour. It mainly affects the rectosigmoid area of the gastrointestinal tract and is most common in children and young adults. Read More

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http://dx.doi.org/10.1136/bcr-2018-227700DOI Listing
March 2019
12 Reads

Utilization of Intensive Care Unit Nutrition Consultation Is Associated With Reduced Mortality.

JPEN J Parenter Enteral Nutr 2019 Mar 22. Epub 2019 Mar 22.

Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.

Background: The aim of this project was to investigate the prevalence of nutrition consultation (NC) in U.S. intensive care units (ICUs) and to examine its association with patient outcomes. Read More

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http://dx.doi.org/10.1002/jpen.1534DOI Listing
March 2019
1 Read

Nomogram for Predicting Risk of Intestinal Complications After Colorectal Cancer Surgery.

Med Sci Monit 2019 Mar 21;25:2104-2111. Epub 2019 Mar 21.

Department of General Surgery, Yangpu Hospital, Tongji University School of Medicine, Shanghai, China (mainland).

BACKGROUND Intestinal complications are a major cause of morbidity after colorectal cancer surgery. This study aimed to develop an effective nomogram for predicting risk of intestinal complications following colorectal cancer surgery. MATERIAL AND METHODS We retrospectively analyzed 1876 patients who underwent colorectal cancer surgery at Yangpu and Zhuji hospitals from January 2013 to October 2018. Read More

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https://www.medscimonit.com/abstract/index/idArt/915692
Publisher Site
http://dx.doi.org/10.12659/MSM.915692DOI Listing
March 2019
9 Reads

Intraoperative Blood Pressure Lability Is Associated with Postoperative Hemorrhage after Uncomplicated Bariatric Surgery.

Obes Surg 2019 Mar 20. Epub 2019 Mar 20.

Yale School of Medicine, New Haven, CT, USA.

Background: Postoperative hemorrhage is a rare complication in bariatric surgery. We aim to determine if differences in blood pressure or perioperative medication administration contribute to postoperative bleeding in patients who were hemodynamically stable intraoperatively.

Methods: This was a retrospective case-control study of all bariatric surgery patients from 2014 to 2017 at a high volume academic center. Read More

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http://dx.doi.org/10.1007/s11695-019-03839-yDOI Listing
March 2019
1 Read

A Bleeding Dieulafoy's Lesion in the Anal Canal.

Cureus 2019 Jan 8;11(1):e3853. Epub 2019 Jan 8.

Gatsroenterology, Staten Island University Hospital, Northwell Health, Staten Island, USA.

Dieulafoy's lesion (DL) is a dilated aberrant submucosal vessel that erodes through the overlying epithelium in the absence of a primary ulcer. It is a known cause of gastrointestinal (GI) bleeding and commonly located in the lesser curvature of the stomach, but it is rare in the anal canal. We report a unique case of a middle-aged man presenting with lower GI bleeding secondary to an anal DL diagnosed by colonoscopy, managed successfully with endoscopic hemoclips. Read More

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http://dx.doi.org/10.7759/cureus.3853DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411322PMC
January 2019
4 Reads

Management of per rectal bleeding is resource intensive.

ANZ J Surg 2019 Apr 18;89(4):E113-E116. Epub 2019 Mar 18.

Department of Colorectal Surgery, Royal North Shore Hospital, Sydney, New South Wales, Australia.

Background: Haematochezia or per rectal (PR) bleeding is the most common presentation of lower gastrointestinal bleeding. This study analyses the hospital resources used in the management of patients with PR bleeding.

Methods: A retrospective analysis was performed on patients who presented with PR bleeding from June 2012 to December 2013 to a single tertiary centre in Sydney, Australia. Read More

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http://dx.doi.org/10.1111/ans.15149DOI Listing
April 2019
3 Reads

A Fully Magnetically Levitated Left Ventricular Assist Device - Final Report.

N Engl J Med 2019 Mar 17. Epub 2019 Mar 17.

From Brigham and Women's Hospital Heart and Vascular Center and Harvard Medical School, Boston (M.R.M.); University of Chicago School of Medicine and Medical Center, Chicago (N.U., V.J., G.S.), Advocate Christ Medical Center, Oak Lawn (W.G.C., A.J.T.), and Abbott, Abbott Park (J.C., I.T., P.S.) - all in Illinois; Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital (Y.N., M.Y.) and Montefiore Einstein Center for Heart and Vascular Care (D.J.G.), New York; University of Colorado School of Medicine, Aurora (J.C.C.); St. Vincent Heart Center, Indianapolis (C.T.S., M.N.W.); Duke University Medical Center, Durham (C.A.M., C.B.P.), and the University of North Carolina, Chapel Hill (J.N.K., P.B.T.) - both in North Carolina; Baptist Health Medical Center, Little Rock, AR (S.W.H., J.R.); Washington University School of Medicine, St. Louis (G.A.E., A.I.); Advent Health Transplant Institute, Orlando, FL (N.Y.R., S.C.S.); University of Minnesota, Minneapolis (R.C., R.J.); Houston Methodist Hospital, Houston (A. Bhimaraj, B.A.B.); University of Nebraska Medical Center, Omaha (B.D.L., J.Y.U.); Yale Medical School, New Haven, CT (A.A.M.); MedStar Washington Hospital Center, Washington, DC (E.J.M., F.S.); University of Michigan, Ann Arbor (K.A., F.D.P.); St. Thomas Hospital, Nashville (A. Babu, D.C.); and Piedmont Hospital, Atlanta (D.D., A.K.).

Background: In two interim analyses of this trial, patients with advanced heart failure who were treated with a fully magnetically levitated centrifugal-flow left ventricular assist device were less likely to have pump thrombosis or nondisabling stroke than were patients treated with a mechanical-bearing axial-flow left ventricular assist device.

Methods: We randomly assigned patients with advanced heart failure to receive either the centrifugal-flow pump or the axial-flow pump irrespective of the intended goal of use (bridge to transplantation or destination therapy). The composite primary end point was survival at 2 years free of disabling stroke or reoperation to replace or remove a malfunctioning device. Read More

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http://dx.doi.org/10.1056/NEJMoa1900486DOI Listing
March 2019
1 Read
55.873 Impact Factor

Vascular Remodeling of Visceral Arteries Following Interruption of the Splenic Artery During Liver Transplantation.

Liver Transpl 2019 Mar 18. Epub 2019 Mar 18.

Liver Transplant Center, General Surgery 2U, University of Torino; A.O.U. Città della Salute e della Scienza, Torino, Italy.

Splenic artery (SA) ligation can be performed during liver transplantation (LT) to avoid portal hyperperfusion, which is involved in the pathogenesis of both small-for-size and splenic artery syndrome. Splenic artery can also be used as an inflow for arterial reconstruction. Exceptionally, SA interruption or agenesis has been associated with positive remodeling of collateral arteries supplying the spleen via left gastric artery, short gastric vessels and gastroepiploic arcade, with subsequent severe upper gastrointestinal bleeding. Read More

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http://dx.doi.org/10.1002/lt.25447DOI Listing
March 2019
1 Read

Jejunal varices as a rare cause of recurrent gastrointestinal bleeding in a 74-year-old man with extrahepatic portal hypertension after pancreato-biliary surgery.

BMJ Case Rep 2019 Mar 14;12(3). Epub 2019 Mar 14.

Department of Gastroenterology and Hepatology, University Hospital of Cologne, Cologne, North Rhine-Westphalia, Germany.

A 74-year-old man presented to our hospital with recurrent lower gastrointestinal bleeding. His past medical history was remarkable for a duodenal papilla carcinoma and he underwent a pylorus-preserving pancreaticoduodenectomy 4 years before. During diagnostic work-up a severe portal vein stenosis after surgery and multiple dilated intramural jejunal varices, which formed as collateral pathways could be detected. Read More

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http://dx.doi.org/10.1136/bcr-2018-228527DOI Listing
March 2019
1 Read

Editorial: blood transfusion for lower gastrointestinal bleeding.

Authors:
Ali S Taha

Aliment Pharmacol Ther 2019 Apr;49(7):956-957

Gastroenterology Unit, University Hospital Crosshouse & University of Glasgow, Scotland, UK.

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http://dx.doi.org/10.1111/apt.15172DOI Listing
April 2019
1 Read

Editorial: blood transfusion for lower gastrointestinal bleeding-authors' reply.

Aliment Pharmacol Ther 2019 Apr;49(7):957

Western University, London, ON, Canada.

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http://dx.doi.org/10.1111/apt.15189DOI Listing
April 2019
1 Read

Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease.

Rheumatol Int 2019 Mar 13. Epub 2019 Mar 13.

Department of Paediatrics, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, ul. 3-go Maja 13-15, 41-800, Zabrze, Poland.

Immunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis in developmental age. The disease is most often characterized by a self-limiting course and good prognosis, but sometimes serious complications, like gastrointestinal bleeding or glomerulonephritis, may develop. The neutrophil to lymphocyte (NLR) and the platelet to lymphocyte (PLR) ratios are indicators related to clinical outcome in various inflammatory diseases. Read More

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http://dx.doi.org/10.1007/s00296-019-04274-zDOI Listing
March 2019
4 Reads

Malakoplakia of the colon following renal transplantation in a 73 year old woman: report of a case presenting as intestinal perforation.

Diagn Pathol 2019 Mar 13;14(1):22. Epub 2019 Mar 13.

Department of Radiology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de L'Assomption, Montreal, QC, Canada.

Background: Malakoplakia is a chronic inflammatory disease characterized by tissue infiltrates of large granular macrophages containing distinctive intracytoplasmic inclusions termed Michaelis-Gutmann (MG) bodies. The genitourinary system is the most commonly involved site, followed by the gastrointestinal tract. Malakoplakia may occur as a complication of primary or secondary immunosuppression and, therefore, renal transplant recipients are at risk. Read More

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http://dx.doi.org/10.1186/s13000-019-0799-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416959PMC
March 2019
2 Reads

Comparison of Argon Plasma Coagulation and Injection Therapy with Adrenalin and Polidocanol in the Management of Bleeding Angiodysplasia in Upper Gastrointestinal Tract.

Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2018 Dec;39(2-3):63-68

University Children's Hospital, Medical Faculty Skopje, Republic of Macedonia.

Introduction: The term angiodysplasia (AD) refers to acquired malformation of the blood vessels (communications between veins and capillaries), frequently found within the gastrointestinal mucosa and submucosa. AD of stomach and duodenum are cause of upper gastrointestinal bleeding in 4%-7% of patients. The means of treatment are usually endoscopic, including argon plasma coagulation (APC), electrocoagulation, mechanical hemostasis by clippsing, laser photo-coagulation and injection therapy. Read More

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https://content.sciendo.com/view/journals/prilozi/39/2-3/art
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http://dx.doi.org/10.2478/prilozi-2018-0043DOI Listing
December 2018
3 Reads

Continuous-Flow Left Ventricular Assist Device Survival Improves with Multidisciplinary Approach.

Ann Thorac Surg 2019 Mar 7. Epub 2019 Mar 7.

Background: Continuous flow-left ventricular assist devices (CF-LVADS) have revolutionized the management of advanced heart failure. Device complications continue to limit survival, but enhanced management strategies have shown promise. This study compared outcomes for HeartmateII recipients before and after implementation of a multidisciplinary continuous support Heart Team (HTMCS) strategy. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00034975193026
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http://dx.doi.org/10.1016/j.athoracsur.2019.01.063DOI Listing
March 2019
6 Reads

Decreased Serum Monocyte Chemoattractant Protein-1 (MCP-1) Expression in Patients with Upper Gastrointestinal Bleeding.

Med Sci Monit 2019 Mar 10;25:1822-1827. Epub 2019 Mar 10.

Department of Digestive Medicine, Rizhao Traditional Chinese Medicine Hospital, Rizhao, Shandong, China (mainland).

BACKGROUND The aim of this study was to investigate the expression of monocyte chemoattractant protein-1 (MCP-1) and its correlation with the blood lipid level in upper gastrointestinal bleeding (UGIB). MATERIAL AND METHODS A total of 118 patients with UGIB were enrolled in this study. The relevant indicators for blood lipid levels were detected using a biochemical analyzer. Read More

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http://dx.doi.org/10.12659/MSM.911897DOI Listing
March 2019
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Pseudo to pseudo connection: pseudoaneurysm draining into the pseudocyst causing pseudohaemobillia.

BMJ Case Rep 2019 Mar 6;12(3). Epub 2019 Mar 6.

Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA.

Haemosuccus pancreaticus (HP) is an exceedingly rare cause of lower gastrointestinal (GI) bleed where pseudoaneurysm of the peripancreatic vessels ruptures into a pancreatic pseudocyst and blood travel through the pancreatic duct, thereby, draining into GI tract via the ampulla of Vater. We present a case of 65-year-old African-American woman with a history of alcohol abuse presented with melena for 1 day. The contrast-enhanced CT of abdomen/pelvis showed peripancreatic vascular pseudoaneurysm with active haemorrhage. Read More

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http://dx.doi.org/10.1136/bcr-2018-228441DOI Listing
March 2019
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Endoscopic Detachable Snare Ligation Improves the Treatment for Colonic Diverticular Hemorrhage.

Digestion 2019 Mar 6:1-9. Epub 2019 Mar 6.

Division of Endoscopic Center, University of Tsukuba Hospital, Tsukuba, Japan.

Background/aims: Recently, endoscopic detachable snare ligation (EDSL) has become increasingly common as treatment for colonic diverticular hemorrhage. This study aimed to evaluate the efficacy and safety of EDSL in comparison with endoscopic clipping (EC) as treatment for colonic diverticular hemorrhage.

Methods: From April 2013 to September 2017, 131 patients were treated with EDSL or EC at the Tokyo Metropolitan Bokutoh Hospital. Read More

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http://dx.doi.org/10.1159/000498847DOI Listing
March 2019
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Early predictors of outcomes of hospitalization for cirrhosis and assessment of the impact of race and ethnicity at safety-net hospitals.

PLoS One 2019 6;14(3):e0211811. Epub 2019 Mar 6.

Division of Gastroenterology and Hepatology, Indiana University, Indianapolis, Indianapolis, United States of America.

Background: Safety-net hospitals provide care for racially/ethnically diverse and disadvantaged urban populations. Their hospitalized patients with cirrhosis are relatively understudied and may be vulnerable to poor outcomes and racial/ethnic disparities.

Aims: To examine the outcomes of patients with cirrhosis hospitalized at regionally diverse safety-net hospitals and the impact of race/ethnicity. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211811PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402644PMC
March 2019
4 Reads

Effectiveness and Safety of Non-Vitamin K Antagonist Oral Anticoagulant and Warfarin in Cirrhotic Patients With Nonvalvular Atrial Fibrillation.

J Am Heart Assoc 2019 Mar;8(5):e011112

3 Center for Big Data Analytics and Statistics Chang Gung Memorial Hospital Linkou, Taoyuan Taiwan.

Background Liver cirrhotic patients with nonvalvular atrial fibrillation have been excluded from randomized clinical studies regarding oral anticoagulants for stroke prevention. Whether non-vitamin K antagonist oral anticoagulants ( NOAC s) are superior to warfarin for these patients remains unclear. Methods and Results This nationwide retrospective cohort study, with data collected from the Taiwan National Health Insurance Research Database, enrolled 2428 liver cirrhotic patients with nonvalvular atrial fibrillation taking apixaban (n=171), dabigatran (n=535), rivaroxaban (n=732), or warfarin (n=990) from June 1, 2012, to December 31, 2016. Read More

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https://www.ahajournals.org/doi/10.1161/JAHA.118.011112
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http://dx.doi.org/10.1161/JAHA.118.011112DOI Listing
March 2019
9 Reads

Next endoscopic approach for acute lower gastrointestinal bleeding without an identified source on colonoscopy: upper or capsule endoscopy?

Endosc Int Open 2019 Mar 28;7(3):E337-E346. Epub 2019 Feb 28.

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, Japan.

 We evaluated the utility of esophagogastroduodenoscopy (EGD) or capsule endoscopy (CE) as the next diagnostic approach after negative colonoscopy (CS) results in acute-onset hematochezia.  We retrospectively analyzed 401 patients emergently hospitalized for acute hematochezia who underwent CS within 48 hours of arriving at two large emergency hospitals and in whom a definitive bleeding source was not identified. The positive endoscopic findings, requirement for additional therapeutic procedures, and 30-day rebleeding rates were compared among three strategies: EGD following CS (CS-EGD), CE following CS (CS-CE), and CS alone. Read More

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http://dx.doi.org/10.1055/a-0824-6647DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6395095PMC
March 2019
2 Reads

Acute Lower Gastrointestinal Bleeding in Patients Treated With Non-Vitamin K Antagonist Oral Anticoagulants Compared With Warfarin in Clinical Practice: Characteristics and Clinical Outcome.

Gastroenterology Res 2019 Feb 26;12(1):21-26. Epub 2019 Feb 26.

Division of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, 26504 Rio, Greece.

Background: Acute lower gastrointestinal bleeding (ALGIB) can occur in patients on anticoagulant therapy (either warfarin or non-vitamin K oral anticoagulants (NOACs)). Use of NOACs has been increasing compared to warfarin in recent years. We analyzed patients with ALGIB on anticoagulation therapy and compared characteristics, management and clinical outcome in patients treated with NOACs versus warfarin. Read More

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http://dx.doi.org/10.14740/gr1115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396796PMC
February 2019
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Lactic Acid Is an Independent Predictor of Mortality and Improves the Predictive Value of Existing Risk Scores in Patients Presenting With Acute Gastrointestinal Bleeding.

Gastroenterology Res 2019 Feb 26;12(1):1-7. Epub 2019 Feb 26.

Department of Internal Medicine, Stony Brook Medicine, Stony Brook, NY, USA.

Background: There are validated clinical risk scores for risk stratifying patients presenting with acute upper gastrointestinal bleed (GIB), including Glasgow-Blatchford score (GBS), Pre-endoscopic Rockall score (RS-PE) and post-endoscopic complete Rockall Score (RS-C), and AIMS65. Several studies have explored the predictive value of lactic acid (LA) in the context of GI bleeding, but the prognostic role of LA and its incremental value in combination with existing clinical risk scores is not well defined.

Methods: We conducted a retrospective analysis of consecutive patients presenting to the emergency department of a single large academic tertiary care center from January 2014 to December 2015 with a charted diagnosis of acute GIB, inclusive of both upper and lower sources. Read More

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http://dx.doi.org/10.14740/gr1085wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396793PMC
February 2019
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Early Gastrointestinal Complications From Ventricular Assist Devices is Increased by Non-Pulsatile Flow.

Heart Lung Circ 2019 Feb 2. Epub 2019 Feb 2.

Baker Heart and Diabetes Institute, Melbourne, Vic, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Vic, Australia. Electronic address:

Background: Measurements of organ flow and perfusion during cardiopulmonary bypass suggest that perfusion of the splanchnic bed can be impaired by non-pulsatile flow. We postulated that non-pulsatile flow from centrifugal ventricular assist devices might also compromise splanchnic blood flow and cause bowel ischaemia especially in the period of circulatory instability early post-implant. The aim of the present studies was to compare the incidence of gastrointestinal (GI) complications in patients having a non-pulsatile device with the incidence in those having a pulsatile device. Read More

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http://dx.doi.org/10.1016/j.hlc.2019.01.009DOI Listing
February 2019
4 Reads

Phase I trial of concurrent stereotactic body radiotherapy and nelfinavir for locally advanced borderline or unresectable pancreatic adenocarcinoma.

Radiother Oncol 2019 Mar 20;132:55-62. Epub 2018 Dec 20.

Department of Internal Medicine, Division of Hematology Oncology, University of Nebraska Medical Center, Omaha, USA.

Introduction: The HIV protease inhibitor nelfinavir (NFV) displays notable radiosensitizing effects. There have been no studies evaluating combined stereotactic body radiotherapy (SBRT) and NFV for borderline/unresectable pancreatic cancer. The primary objective of this phase I trial (NCT01068327) was to determine the maximum tolerated SBRT/NFV dose, and secondarily evaluate outcomes. Read More

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http://dx.doi.org/10.1016/j.radonc.2018.11.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6400311PMC
March 2019
3 Reads

Stereotactic body radiotherapy dose and its impact on local control and overall survival of patients for locally advanced intrahepatic and extrahepatic cholangiocarcinoma.

Radiother Oncol 2019 Mar 20;132:42-47. Epub 2018 Dec 20.

Department of Radiation Oncology, University Hospitals Freiburg, Germany. Electronic address:

Purpose: Non-resectable cholangiocarcinoma (CCC) is a significant therapeutic challenge because of bad prognosis. This study analyzed the outcome after SBRT for intra- and extrahepatic CCC.

Material And Methods: Sixty-four patients with 82 CCC lesions from a retrospective multicenter database were analyzed. Read More

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http://dx.doi.org/10.1016/j.radonc.2018.11.015DOI Listing
March 2019
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Direct Oral Anticoagulants in Patients With Nonvalvular Atrial Fibrillation and Low Body Weight.

J Am Coll Cardiol 2019 Mar;73(8):919-931

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

Background: It is unclear whether the overall effectiveness and safety of direct oral anticoagulants (DOACs) are consistent in patients with nonvalvular atrial fibrillation (AF) and extremely low body weight (<50 kg).

Objectives: This study compared DOACs with warfarin in AF patients with low body weight.

Methods: Using data from the Korean National Health Insurance Service database from January 2014 to December 2016, AF patients with body weight ≤60 kg and who were treated with oral anticoagulants (n = 14,013 taking DOACs and n = 7,576 taking warfarin) were included and examined for ischemic stroke, intracranial hemorrhage (ICH), gastrointestinal bleeding, major bleeding, all-cause death, and composite outcome. Read More

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http://dx.doi.org/10.1016/j.jacc.2018.11.051DOI Listing
March 2019
5 Reads

[Meta-analysis on safety and efficacy of dual antiplatelet therapy combining with proton pump inhibitors for patients after percutaneous coronary intervention].

Zhonghua Xin Xue Guan Bing Za Zhi 2019 Feb;47(2):129-140

Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730030, China.

To analyze the impact of dual antiplatelet (DAPT) therapy combining with or without proton pump inhibitors (PPI) on the main outcomes after percutaneous coronary intervention (PCI). The PubMed, EMBASE and Cochrane Library were searched for relevant literature and the references obtained from these sources were retrieved manually from inception till September 2017. Inclusion and exclusion criteria were established follow the Cochrane review standard. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0253-3758.2019.02.010DOI Listing
February 2019
1 Read