检索结果-南通市图书馆

Iatrogenic bile duct injury with loss of confluence

World Journal of Gastrointestinal Surgery 2015年第10期7卷 254-260页

作者： Miguel-Angel Mercado Mario Vilatoba Alan Contreras Pilar Leal-Leyte Eduardo Cervantes-Alvarez Juan-Carlos Arriola Bruno-Adonai gonzalez Surgery Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán PECEM Facultad de MedicinaUniversidad Nacional Autónoma de México

AIM: To describe our experience concerning the surgical treatment of Strasberg E-4(Bismuth Ⅳ) bile duct injuries. METHODS: In an 18-year period, among 603 patients referred to our hospital for surgical treatment of complex bile duct injuries, 53 presented involvement of the hilar confluence classified as Strasberg E4 injuries. Imagenological studies, mainly magnetic resonance imaging showed a loss of confluence. The files of these patients were analyzed and general data were recorded, including type of operation and postoperative outcome with emphasis on postoperative cholangitis, liver function test and quality of life. The mean time of follow-up was of 55.9 ± 52.9 mo(median = 38.5, minimum = 2, maximum = 181.2). All other patients with Strasberg A, B, C, D, E1, E2, E3, or E5 biliary injuries were excluded from this ***: Patients were divided in three groups: G1(n = 21): Construction of neoconfluence + Roux-en-Y hepatojejunostomy. G2(n = 26): Roux-en-Y portoenterostomy. G3(n = 6): Double(right and left) Rouxen-Y hepatojejunostomy. Cholangitis was recorded in two patients in group 1, in 14 patients in group 2, and in one patient in group 3. All of them required transhepatic instrumentation of the anastomosis and six patients needed live ***: Loss of confluence represents a surgicalchallenge. There are several treatment options at different stages. Roux-en-Y bilioenteric anastomosis(neoconfluence, double-barrel anastomosis, portoenterostomy) is the treatment of choice, and when it is technically possible, building of a neoconfluence has better outcomes. When liver cirrhosis is shown, liver transplantation is the best choice.

关键词： Bile duct injury Hepatojejunostomy Biliary repair

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Symptomatic Val122del mutated hereditary transthyretin amyloidosis: Need for early diagnosis and prioritization for heart and liver transplantation

引用

Hepatobiliary & Pancreatic Diseases International 2021年第4期20卷 323-329页

作者： Adriano-Valerio Schettini Laura Llado JulieK Heimbach Josegonzalez Costello Marie Tranäng Olivier Van Caenegem Richard C Daly Peter Van den Bergh Carlos Casasnovas Joan Fabregat John J Poterucha Maxime Foguenne Bo Göran Ericzon Jan Lerut Institute for Experimental and Clinical Research(IREC) Catholic University of Louvain(UCL)Avenue Hippocrate 55Brussels 1200Belgium Liver Transplant Unit Department of SurgeryHospital Universitari de BellvitgeCalle de la Feixa LlargaBarcelona 08907Spain Division of Transplantation Surgery William J.von Liebig Transplant CenterMayo Clinic2001st St SWRochesterMN 55905USA Advanced Heart Failure and Transplant Unit Cardiology DepartmentHospital Universitari de BellvitgeCalle de la Feixa LlargaBarcelona 08907Spain Familial Amyloidotic Polyneuropathy World Transplant Registry(FAPWTR) Division of Transplantation SurgeryKarolinska Universitetssjukhuset HuddingeF82Karolinska InstitutetStockholm 14186Sweden Cardiothoracic Intensive Care Unit Department of Cardiovascular DiseasesUniversity Hospitals Saint-Luc-UCLAvenue Hippocrate 10Brussels 1200Belgium Cardiovascular Surgery Department Mayo Clinic2001st St SWRochesterMN 55905USA Neuromuscular Reference Centre University Hospital Saint-Luc-UCLAvenue Hippocrate 10Brussels 1200Belgium Neuromuscular Unit Neurology DepartmentHospital Universitari de BellvitgeCalle de la Feixa LlargaBarcelona 08907Spain Division of Gastroenterology and Hepatology Mayo Clinic2001st St SWRochester MN 08907USA Division of Transplantation Surgery CLINTECKarolinska Universitetssjukhuset HuddingeF82Karolinska InstitutetStockholm 14186Sweden

Background: Hereditary transthyretin(ATTRv) amyloidosis is an autosomal dominant disease linked to transthyretin gene mutations which cause instability of the transthyretin tetramer. After dissociation and misfolding they reassemble as insoluble fibrils(i.e. amyloid). Apart from the common Val30 Met mutation there is a very heterogeneous group of non-Val30 Met mutations. In some cases, the clinical picture is dominated by a rapidly evolving restrictive and hypertrophic cardiomyopathy. Methods: A case series of four liver recipients with the highly clinically relevant, rare and particularly aggressive Val122 del mutation is presented. Medical and surgical therapeutic options, waiting list policy for ATTRv-amyloidosis, including the need for heart transplantation, and status of heart-liver transplantation are discussed. Results: Three patients needed a staged(1 patient) or simultaneous(2 patients) heart-liver transplant due to rapidly progressing cardiac failure and/or neurologic disability. Domino liver transplantation was impossible in two due to fibrotic hepatic transformation caused by cardiomyopathy. After a follow-up ranging from 3.5 to 9.5 years, cardiac(allograft) function was maintained in all patients, but neuropathy progressed in three patients, one of whom died after 80 months. Conclusions: This is the first report in(liver) transplant literature about the rare Val122 del ATTRv mutation. Due to its aggressiveness, symptomatic patients should be prioritized on the liver and, in cases with cardiomyopathy, heart waiting lists in order to avoid the irreversible neurological and cardiac damage that leads to a rapid lethal outcome.

关键词： Hereditary transthyretin amyloidosis Heart transplantation Liver transplantation Non-Val30Met mutation Val122del mutation Domino liver transplantation

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Why not change classical treatments for glioblastoma in elderly patients?

引用

World Journal of Experimental Medicine 2013年第4期3卷 50-55页

作者： Eduardo Perez-Campos Javier Arjona Perez Laura Perez-Campos Mayoral Itandehui Gallegos Velasco Pedro Hernandez Cruz Primitivo gonzalez Olivera Department of Biochemistry and Immunology Technological Institute of OaxacaOaxacaCP 68030 Mexico Multidisciplinary Research Center UNAM-UABJO-MedicineMexico CityCP 68050 Mexico Clinical Pathology Clinical Pathology Laboratory "Dr. Eduardo Perez Ortega"Oaxaca CP 68000 Mexico Aurora Clinic NeurosurgeryOaxaca CP 68000 Mexico Laboratory of Cancer Glycobiology Multidisciplinary Research CenterUNAM-UABJO-MedicineMexico CityCP 68050 Mexico Surgical Oncology Puebla Mexico CP 72000 Mexico

In consideration of the poor results obtained with conventional treatments, a review of alternative treatments for elderly patients with glioblastoma was researched in this study. The proposal considers the elimination of human cytomegalovirus, modifying the immune response, arresting growths, blocking some signaling pathways, and modulating the effects of oxygen reactive species.

关键词： Glioblastoma Treatment Elderly patients Glioma Glioblastoma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

中世纪基督教的黄金时期

引用

金陵神学志 2012年第Z2期 191-214页

作者： Justo L.gonzalez 赵厚梅浙江神学院

英诺森三世说:"就像上帝在天空中造了两个大光,大的管昼,小的管夜一样,他在普世教会的天空中也造了两个大光——大的像管理白昼一样管理人的灵魂,小的像管理黑夜一样管理人的肉体。这两个大光就是教皇的权利和国王的权利。"随着十字军... 详细信息

英诺森三世说:"就像上帝在天空中造了两个大光,大的管昼,小的管夜一样,他在普世教会的天空中也造了两个大光——大的像管理白昼一样管理人的灵魂,小的像管理黑夜一样管理人的肉体。这两个大光就是教皇的权利和国王的权利。"随着十字军东征的尾声临近,中世纪基督教达到了它的顶峰。

关键词：法兰西中世纪基督教教皇权英诺森三世托钵修会神学家上帝托马斯·阿奎那亚里士多德

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Interstitial lung disease in rheumatoid arthritis:Current concepts in pathogenesis,diagnosis and therapeutics

引用

World Journal of Rheumatology 2015年第1期5卷 1-22页

作者： Eva M Olivas-Flores David Bonilla-Lara Jorge I Gamez-Nava Alberto D Rocha-Muoz Laura gonzalez-Lopez Hospital General Regional 180 Instituto Mexicano del Seguro Social (IMSS) Centro Universitario de Ciencias de la Salud (CUCS) Universidad de Guadalajara Hospital de Especialidades Centro Medico Nacional de Occidente Instituto Mexicano del Seguro Social (IMSS) Hospital General Regional 110 Departamento de Medicina Interna-Reumatologia Instituto Mexicano del Seguro Social (IMSS)

Rheumatoid arthritis(RA) is the most common chronic autoimmune inflammatory joint disease. RA-associated interstitial lung disease(RA-ILD) is a major extraarticular complication and causes symptoms that lead to a deterioration in the quality of life, high utilization of health resources, and an increased risk of earlier mortality. Early in the course of RA-ILD, symptoms are highly variable, making the diagnosis difficult. Therefore, a rational diagnostic strategy that combines an adequate clinical assessment with the appropriate use of clinical tests, including pulmonary function tests and high-resolution computed tomography, should be used. In special cases, lung biopsy or bronchioalveolar lavage should be performed to achieve an early diagnosis. Several distinct histopathological subtypes of RA-ILD are currently recognized. These subtypes also have different clinical presentations, which vary in therapeutic response and prognosis. This article reviews current evidence about the epidemiology of RA-ILD and discusses the varying prevalence rates observed in different studies. Additionally, aspects of RA-ILD pathogenesis, including the role of cytokines and other molecules such as autoantibodies, as well as the evidence linking several drugs used to treat RA with lung damage will be discussed. Some aspects of the clinical characteristics of RA-ILD are noted, and diagnostic strategies are reviewed. Finally, this article analyzes current treatments for RA-ILD, including immunosuppressive therapies and biologic agents, as well as other therapeutic modalities. The prognosis of this severe complication of RA is discussed. Additionally, this paper examines updated evidence from studies identifying an association between drugs used for the treatment of RA and the development of ILD.

关键词： Rheumatoid arthritis Interstitial lung disease Pathogenesis Diagnosis Therapeutic

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欧美兴起鸵鸟业

引用

中国畜牧兽医 1994年第1期 50-50页

作者： Ing.Vivian gonzalez ,骆凤玉

过去人们捕猎鸵鸟是为了获取有价值的鸵鸟羽毛,由于鸵鸟的肉质优良,皮可制革,因此现在已经人工饲养鸵鸟。鸵鸟的肉较瘦,与肉鸡和火鸡相比,鸵鸟肉的蛋白质含量高,而胆固醇含量低。鸵鸟的心、肝、胃及似牛尾的颈部都可制作美味佳肴。中... 详细信息

过去人们捕猎鸵鸟是为了获取有价值的鸵鸟羽毛,由于鸵鸟的肉质优良,皮可制革,因此现在已经人工饲养鸵鸟。鸵鸟的肉较瘦,与肉鸡和火鸡相比,鸵鸟肉的蛋白质含量高,而胆固醇含量低。鸵鸟的心、肝、胃及似牛尾的颈部都可制作美味佳肴。中美洲的Costa Rica有一家大型商业鸵鸟场。这个场是最近4年内建立起来的,其中包括一个种鸵鸟场。种鸵鸟场里饲养着70只红颈鸵鸟和非洲黑鸵鸟。鸵鸟蛋是进行人工孵化,雏鸵鸟于3日龄以后出售。Costa Rica

关键词：鸵鸟繁殖季节配种季节中美洲拉丁美洲

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

基于感应电动机定子热效应的不平衡电压与机械过载的关联模型

引用

国外大电机 2018年第3期 33-41页

作者： Jose L.gonzalez.Cordoba[墨西哥] 潘博(译) 不详哈尔滨理工大学

过热是感应电动机的一种负面影响，指的是感应电动机在机械或电气处于异常情况下受损，从而导致电动机的使用寿命减少或产生严重性的损坏。从这个角度来说，分析和解决感应电动机过热问题的一种新方法是将上述条件之间的热效应联系起来... 详细信息

过热是感应电动机的一种负面影响，指的是感应电动机在机械或电气处于异常情况下受损，从而导致电动机的使用寿命减少或产生严重性的损坏。从这个角度来说，分析和解决感应电动机过热问题的一种新方法是将上述条件之间的热效应联系起来。在这项研究中，提出了数学模型，通过试验提取的电压不平衡和机械过载对感应电机定子热效应进行验证。一般来说，上述的方法是基于感应电动机定子不同点处的热梯度提出的。这些热梯度是由不平衡电压或机械过载产生的。对于不平衡电压的估算，本文参考了IEEE141标准，IEEE1159标准和NEMA标准。相关模型在746W（1hp）的三相感应电动机上进行实验验证。结果验证了在不同定子点处获得的两个变量之间的相关I生的有效性：不平衡电压和机械过载。

关键词：关联模型热梯度感应电动机过载不平衡电压

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

釜山电影中心/釜山国际电影节

引用

城市环境设计 2020年第4期126卷 186-199页

作者：沃尔夫·狄·普瑞克斯 Markus Baumann Jan Brosch Jasmin Dieterle Sergio gonzalez Hallstein Guthu Rob Henderson Veronica Janovska Ivana Jug Matt Kirkham Jana Kucerova Dieter Segerer Anja Sorger Duccio Malagamba COOP HIMMELB(L)AU

项目大事记/CHRONOLOGY竞赛（一等奖）/Competition （1st Prize）:11/2005规划设计/Start of Planning:01/2007动工/Start of Construction:10/2008开放/Opening:29/09/2011项目参数/PROJECT DATA用地面积/Site Area:32 100m2建筑毛面积（室内）/Gross Floor Area （interior spaces）:57 981m2建筑净面积（室内）/Net Floor Area （interior spaces）:51 067m2建成区面积/Built-up Area:10 005m2（不包含屋顶/without roofs）

关键词：

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

Klotho in cardiovascular disease:Current and future perspectives

引用

World Journal of Biological Chemistry 2015年第4期6卷 351-357页

作者： Javier Donate-Correa Ernesto Martin-Nunez Carmen Mora-Fernandez Mercedes Muros-de-Fuentes Nayra Perez-Delgado Juan F Navarro-gonzalez Research Unit University Hospital Nuestra Senora de Candelaria Clinical Biochemistry Service University Hospital Nuestra Senora de Candelaria Nephrology Service University Hospital Nuestr Senora de Candelaria

Protein Klotho,beyond its role as a regulator of the phosphatemia,is also involved in the maintaining of the cardiovascular health,being associated its alterations with the development of cardiovascular damage and increased morbi-mortality. For all this,nowadays Klotho is the subject of a thorough research which is focused on uncover its intimate mechanisms of action,and in analyzing the utility of its modulation as a potential strategy with clinical applicability. Molecular mechanisms of Klotho are not well understood but an emerging research area links Klotho deficiency with vascular pathology. Changes in this protein have been associated with cardiovascular-related complications like inflammation,vascular calcification,and endothelial dysfunction. All this is particularly relevant if considering the recent discovery of Klotho expression in vascular tissue.

关键词： Klotho Cardiovascular disease Chronic kidney disea

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Recirculating chemohyperthermia as a treatment for non-muscle invasive bladder cancer:Current and future perspectives

引用

World Journal of Clinical Urology 2017年第2期6卷 34-39页

作者： Javier Flores-Carbajal Alejandro Sousa-Escandón Daniel Sousa-gonzalez Silvia Rodriguez Gomez Manuel Lopez Saavedra M Elia Fernandez Martinez Comarcal Hospital of Monforte

About 75% of all bladder cancer diagnosed are non-muscle invasive bladder cancer(NMIBC), recurring over 50% of them after transurethral resection of the bladder tumor. In order to prevent recurrences, adjuvant intravesical chemotherapy with mitomycin C and immunotherapy with bacillus Calmette-Gu-érin(BCG) is traditionally used. Unfortunately, many patients relapse after receiving these treatments and a significant proportion of them require surgery. After a one-to-three years BCG maintenance, the risk for progression at 5 years was 19.3% for T1G3 tumors. Many new treatment approaches are being investigated to increase the effectiveness of adjuvant intravesical therapy. One of the developing treatments for intermediate and high-risk NMIBC is the combination of intravesical chemotherapy and hyperthermia, called chemohyperthermia. This article provides a review of the mechanism of action, current status and indications, results and future perspectives.

关键词： Bladder cancer Thermotherapy Non-muscle invasive Chemohyperthermia Recirculating Intravesical chemotherapy Treatment Mechanism of action

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：