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Endoscopic and non-endoscopic approaches for the management of radiation-induced rectal bleeding

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World Journal of Gastroenterology 2016年第31期22卷 6972-6986页

作者： Joseph Paul Weiner andrew Thomas wong David Schwartz Manuel Martinez Ayse Aytaman David Schreiber Department of Radiation Oncology VA NY Harbor Healthcare System Brooklyn Campus Department of Radiation Oncology SUNY Downstate Medical Center Department of Gastro-enterology VA NY Harbor Healthcare System Brooklyn Campus Department of Gastroenterology SUNY Downstate Medical Center

Pelvic radiation is a commonly utilized treatment for malignancy of the genitourinary and lower gastrointestinal tract. Radiation proctitis and the resultant clinical picture varies from asymptomatic to potentially life threatening. Similarly, treatment options also vary greatly, from medical therapy to surgical intervention. Commonly utilized medical therapy includes sucralfate enemas, antibiotics, 5-aminosalicylic acid derivatives, probiotics, antioxidants, short-chain fatty acids, formalin instillation and fractionated hyperbaric oxygen. More invasive treatments include endoscopic-based, focally ablative interventions such as dilation, heater and bipolar cautery, neodymium/yttrium aluminum garnet argon laser, radiofrequency ablation or argon plasma coagulation. Despite its relatively common frequency, there is a dearth of existing literature reporting headto-head comparisons of the various treatment options via a randomized controlled approach. The purpose of our review was to present the reader a consolidation of the existing evidence-based literature with the goal of highlighting the comparative effectiveness and risks of the various treatment approaches. Finally, we outline a pragmatic approach to the treatment of radiation proctitis. In light of the lack of randomized data, our goal is to pursue as least invasive an approach as possible, with escalation of care tailored to the severity of the patient's symptoms. For those cases that are clinicallyasymptomatic or only mildly symptomatic, observation or medical management can be considered. Once a patient fails such management or symptoms become more severe, invasive procedures such as endoscopically based focal ablation or surgical intervention can be considered. Although not all recommendations are supported by level I evidence, reported case series and single-institutional studies in the literature suggest that successful treatment with cessation of symptoms can be obtained in the majority of cases.

关键词： Prostate cancer Radiation therapy Radiation proctitis Radiation proctopathy Medical treatment Endoscopic treatment Hyperbaric oxygen Neodymium/ yttrium aluminum garnet argon laser Argon plasma coagulation

Emergency department patient experience:Same location,same provider,different scores by different survey methods

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World Journal of Emergency Medicine 2019年第3期10卷 138-144页

作者： Wirachin Hoonpongsimanont Preet Kaur Sahota Yanjun Chen Maria Nguyen Christine Louis Jonathan Pena andrew wong Maxwell Jen Department of Emergency Medicine University of California Orange CA USA Institute for Clinical and Translational Sciences University of California Irvine CA USA

BACKGROUND: Recent findings on emergency department (ED) patient experience surveys and concerns for the low response rates challenge the quality and reliability of the survey reports. We assessed the consistency of an ED patient experience survey report and identifi ed the effects of patient demographics on ED patient experiences. METHODS: We conducted a prospective, cross-sectional study at a university-based ED from July to December 2017. We obtained ED patient experience scores from an institutional version (IS) survey and the Press Ganey Associates-distributed survey (PGA). We compared top box scores from the two reports using frequency analysis and performed multivariable logistic regressions to identify associations between IS patient demographics and scores. RESULTS: We obtained 289 PGA and 234 IS responses. The IS reported signifi cant, higher top box scores in doctor-specifi c patient questions compared to PGA (all four P-values < 0.01). Female, Christian and White patients were more likely to give top box scores (OR 3.07, OR 2.22 and OR 2.41, P-value < 0.05, respectively). CONCLUSION: We found significant differences in ED patient experience scores between the IS and PGA surveys. We recommend that healthcare providers consider patient demographic variables when interpreting ED experience score reports. Multiple survey techniques and distribution methods may be adopted to best capture ED patient experiences.

关键词： Patient experience Emergency department Patient satisfaction Press Ganey Survey methodology

Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer andrew wong Michael Roizman Amanda Gilligan andrew Lee Kee Meng Tan Susan Day Christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain Centre at Royal Melbourne Hospital ParkvilleVictoriaAustralia University of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The University of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders University College of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The University of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(5mL,regardless of anticoagulation *** Commencing anticoagulation<4days after stroke or TIA is associated with fewer ischaemic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： patients lesions ischaemic

Efficacy of enteric-coated mycophenolate sodium （myfortic） in patients with severe lupus nephritis

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Efficacy of enteric-coated mycophenolate sodium （myfortic）...

Crosstalk between degradation and bioenergetics: how autophagy and endolysosomal processes regulate energy production

The 8th International Congress on SLE

作者： Siu-ka Mak Kin-yee Lo Man-wai Lo Shuk-fan Chan Gensy MW Tong Ping-nam wong andrew KM wong Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina Renal Unit Department of Medicine ＆ GeriatricsKwong Wah HospitalKowloonHong Kong SARChina

＜正＞Purpose:The ideal treatment of lupus nephritis has yet to be *** use of both cyclophosphamide and mycophe- nolate mofetil have been associated with encouraging results, but the incidence of side-effects is *** is no data on the use of another formulation of mycophenolic acid, enteric-coated mycophenolate sodium.

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Neural Regeneration Research 2025年第3期20卷 671-681页

作者： Angelid Pabon Jagannatham Naidu Bhupana Ching-On wong Department of Biological Sciences Rutgers UniversityNewarkNJUSA

Cells undergo metabolic reprogramming to adapt to changes in nutrient availability, cellular activity, and transitions in cell states. The balance between glycolysis and mitochondrial respiration is crucial for energy production, and metabolic reprogramming stipulates a shift in such balance to optimize both bioenergetic efficiency and anabolic requirements. Failure in switching bioenergetic dependence can lead to maladaptation and pathogenesis. While cellular degradation is known to recycle precursor molecules for anabolism, its potential role in regulating energy production remains less explored. The bioenergetic switch between glycolysis and mitochondrial respiration involves transcription factors and organelle homeostasis, which are both regulated by the cellular degradation pathways. A growing body of studies has demonstrated that both stem cells and differentiated cells exhibit bioenergetic switch upon perturbations of autophagic activity or endolysosomal processes. Here, we highlighted the current understanding of the interplay between degradation processes, specifically autophagy and endolysosomes, transcription factors, endolysosomal signaling, and mitochondrial homeostasis in shaping cellular bioenergetics. This review aims to summarize the relationship between degradation processes and bioenergetics, providing a foundation for future research to unveil deeper mechanistic insights into bioenergetic regulation.

关键词： autophagy bioenergetics endolysosome energy production glycolysis metabolic reprogramming mitochondria

Advances in Graphene‑Based Electrode for Triboelectric Nanogenerator

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Nano-Micro Letters 2025年第1期17卷 378-403页

作者： Bin Xie Yuanhui Guo Yun Chen Hao Zhang Jiawei Xiao Maoxiang Hou Huilong Liu Li Ma Xin Chen Chingping wong State Key Laboratory of Precision Electronic Manufacturing Technology and Equipment Guangdong University of TechnologyGuangzhou 510006People’s Republic of China School of Electromechanical Engineering Guangdong University of TechnologyGuangzhou 510006People’s Republic of China School of Materials Science and Engineering Georgia Institute of TechnologyAtlantaGA 30332USA

With the continuous development of wearable electronics,wireless sensor networks and other micro-electronic devices,there is an increasingly urgent need for miniature,flexible and efficient nanopower generation *** nanogenerator(TENG)technology can convert small mechanical energy into electricity,which is expected to address this *** the core component of TENG,the choice of electrode materials significantly affects its *** metal electrode materials often suffer from problems such as durability,which limits the further application of ***,as a novel electrode material,shows excellent prospects for application in TENG owing to its unique structure and excellent electrical *** review systematically summarizes the recent research progress and application prospects of TENGs based on graphene *** precision processing methods of graphene electrodes are introduced,and the applications of graphene electrode-based TENGs in various scenarios as well as the enhancement of graphene electrodes for TENG performance are *** addition,the future development of graphene electrode-based TENGs is also prospectively discussed,aiming to promote the continuous advancement of graphene electrode-based TENGs.

关键词： Triboelectric nanogenerator Precision processing Graphene electrode Self-powered sensor

Aflibercept for diabetic macular oedema： a Meta-analysis of randomized controlled trials

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International Journal of Ophthalmology(English edition) 2018年第6期11卷 1002-1008页

作者： Chu Luan Nguyen andrew Lindsay Eugene wong Michael Chilov University of Sydney Sydney NSW 2000 Australia

AIM： To evaluate the relative efficacy and safety of aflibercept for treatment of diabetic macular oedema （DMO）. METHODS： A comprehensive search in MEDLINE, CENTRAL and EMBASE was undertaken for randomized controlled trials （RCTs） comparing intravitreal anti-vascular endothelial growth factor （anti-VEGF） versus another treatment. Primary outcome measures were proportion of patients with at least 15 letters of gain or loss on a logMAR visual acuity chart, and change in best corrected visual acuity （BCVA） and central macular thickness （CMT） from baseline. Safety outcomes were rates of death, thromboembolic events and any systemic or ocular serious adverse events. The final search was performed on November 2017. RESULTS： Four RCTs were included. Only one trial compared efficacy and safety of aflibercept with bevacizumab and ranibizumab over 1 or 2y. Three trials were included for Meta-analysis comprising 661 patients （331 in the aflibercept, and 330 in the photocoagulation group）. Aflibercept was more efficacious compared to photocoagulation in the proportion of patients with at least 15 letters of improvement and worsening, and in improvement of BCVA and reduction in CMT at 1 or 2y. The safety estimates at 1 or 2y did not differ statistically. CONCLUSION： Aflibercept offers superior benefits over photocoagulation in improving and preserving vision, with no differences in safety. Further comparative effectiveness trials between aflibercept and other anti-VEGF agents will aid ophthalmologists in treatment decisions.

关键词： aflibercept diabetic macular oedema Metaanalysis randomized controlled trial

Effects of Saccharomyces cerevisiae or boulardii yeasts on acute stress induced intestinal dysmotility

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World Journal of Gastroenterology 2016年第48期22卷 10532-10544页

作者： Christine West andrew M Stanisz Annette wong Wolfgang A Kunze McMaster Brain-Body Institute St. Joseph’s Healthcare Department of Biology McM aster University Department of Psychiatry and Behavioural Neurosciences Mc Master University

AIM To investigate the capacity of Saccharomyces cerevisiae(S. cerevisiae) and Saccharomyces boulardii(S. boulardii) yeasts to reverse or to treat acute stress-related intestinal *** Adult Swiss Webster mice were stressed for 1 h in a wire-mesh restraint to induce symptoms of intestinal dysmotility and were subsequently killed by cervical dislocation. Jejunal and colon tissue were excised and placed within a tissue perfusion bath in which S. cerevisiae, S. boulardii, or their supernatants were administered into the lumen. Video recordings of contractility and gut diameter changes were converted to spatiotemporal maps and the velocity, frequency, and amplitude of propagating contractile clusters(PCC) were measured. Motility pre- and post-treatment was compared between stressed animals and unstressed controls. RESULTS S. boulardii and S. cerevisiae helped to mediate the effects of stress on the small and large intestine. Restraint stress reduced jejunal transit velocity(mm/s)from 2.635 ± 0.316 to 1.644 ± 0.238, P < 0.001 and jejunal transit frequency(Hz) from 0.032 ± 0.008 to 0.016 ± 0.005, P < 0.001. Restraint stress increased colonic transit velocity(mm/s) from 0.864 ± 0.183 to 1.432 ± 0.329, P < 0.001 and frequency to a lesser degree. Luminal application of S. boulardii helped to restore jejunal and colonic velocity towards the unstressed controls; 1.833 ± 0.688 to 2.627 ± 0.664, P < 0.001 and 1.516 ± 0.263 to 1.036 ± 0.21, P < 0.001, respectively. S. cerevisiae also had therapeutic effects on the stressed gut, but was most apparent in the jejunum. S. cerevisiae increased PCC velocity in the stressed jejunum from 1.763 ± 0.397 to 2.017 ± 0.48, P = 0.0031 and PCC frequency from 0.016 ± 0.009 to 0.027 ± 0.007, P < 0.001. S. cerevisiae decreased colon PCC velocity from 1.647 ± 0.187 to 1.038 ± 0.222, P < 0.001. Addition of S. boulardii or S. cerevisiae supernatants also helped to restore motility to unstressed values in similar capacity. CONCLUSION The

关键词： Intestine Saccharomyces cerevisiae Saccharomyces boulardii Restraint stress Motility

Different Asian Monsoon Rainfall Responses to Idealized Orography Sensitivity Experiments in the HadGEM3-GA6 and FGOALS-FAMIL Global Climate Models

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Advances in Atmospheric Sciences 2018年第8期35卷 153-166页

作者： Kai Chi wong Senfeng LIU andrew G. TURNER Reinhard K. SCHIEMANN Department of Meteorology University of Reading Reading RG6 6BB United Kingdom State Key Laboratory of Numerical Modeling for Atmospheric Sciences and Geophysical Fluid Dynamics Institute of Atmospheric Physics Chinese Academy of Sciences Beijing 100029 China University of Chinese Academy of Sciences Beijing 100049 China

Recent work has shown the dominance of the Himalaya in supporting the Indian summer monsoon （ISM）, perhaps by surface sensible heating along its southern slope and by mechanical blocking acting to separate moist tropical flow from drier midlatitnde air. Previous studies have also shown that Indian snmmer rainfall is largely unaffected in sensitivity experiments that remove only the Tibetan Plateau. However, given the large biases in simulating the monsoon in CMIP5 models, such results may be model dependent. This study investigates the impact of orographic forcing from the Tibetan Plateau, Himalaya and Iranian Plateau on the ISM and East Asian snmmer monsoon （EASM） in the UK Met Office＇s HadGEM3-GA6 and China＇s Institute of Atmospheric Physics FGOALS-FAMIL global climate models. The models chosen featnre oppositesigned biases in their simulation of the ISM rainfall and circulation climatology. The changes to ISM and EASM circulation across the sensitivity experiments are similar in both models and consistent with previous studies. However, considerable differences exist in the rainfall responses over India and China, and in the detailed aspects such as onset and retreat dates. In particular, the models show opposing changes in Indian monsoon rainfall when the Himalaya and Tibetan Plateau orography are removed. Our results show that a multi-model approach, as suggested in the forthcoming Global Monsoon Model Intercomparison Project （GMMIP） associated with CMIP6, is needed to clarify the impact of orographic forcing on the Asian monsoon and to fully understand the implications of model systematic error.

关键词： Tibetan Plateau East Asian summer monsoon Indian summer monsoon model bias Global Monsoon Model Intercompaxison Project (GMMIP)