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Bias-Variation Dilemma Challenges Clinical Trials: Inherent Limitations of Randomized Controlled Trials and Meta-Analyses Comparing Hernia Therapies

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International Journal of Clinical Medicine 2014年第13期5卷 778-789页

作者： U. Klinge Andreas Koch D. Weyhe Enrico Nicolo R. Bendavid anette Fiebeler Berlin Germany Cottbus Germany Department of General and Visceral Surgery Pius-Hospital Oldenburg Oldenburg Germany Department of General Visceral and Transplant Surgery University Hospital of the RWTH Aachen Germany Department of Surgery University of Pittsburgh Medical Center McKeesport USA Shouldice Hospital Thornhill Ontario Canada

Purpose:Evaluation of hernia therapies according to the current rules of Evidence Based Medicine is widely reduced to results of RCTs or meta-analyses. RCTs have been accepted as a most important tool to confirm a superior effect of an intervention. Unfortunately, in hernia surgery, comparisons of RCTs and correspondingly their use in meta-analyses, are not, surprisingly often, able to confirm any significant impact of a specific procedure due to intrinsic restrictions in a multi-causal setting with its web of influences. Methods:Based on our own experiences of clinical studies in surgery, the present article outlines several situations, with their respective reasons, which argue the severe limitations of RCTs and meta-analysis to define an optimum treatment. Results:Meta-analyses accumulate the variations of each trial, which then may cover any clear causal relationship. RCTs usually are dealing with subgroups of standard patients thus excluding the majority of our patients. Low statistical power of current cohort sizes restricts the analysis of subgroups or of effects with low incidences. Simple comparisons of means frequently are hampered by nonlinear relationships to outcome. The relevance of a specific variable is difficult to separate from other influences. The limited surveillance period of studies ignores a delayed change in outcome. Randomization cannot guarantee a standardized patient’s condition. All the arguments have to be considered as a crucial and fundamental consequence of the bias-variance dilemma or principle of uncertainty in medicine, and underline the many limitations of RCTs to evaluate any specific impact of hernia therapies on e.g. infection, pain or recurrence. Conclusions: Many surgical issues cannot be and should not be investigated by RCTs, in particular, if a marked patients’ heterogeneity has to be considered or the low incidences of the outcome readout cannot be addressed with sufficient statistical power without getting lost in the v

关键词： Randomized Controlled Trial Hernia Surgery Registry Meta-Analysis Clinical Study

Endotracheal Metastasis from Colon Cancer: A Rare Case

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Open Journal of Thoracic Surgery 2015年第2期5卷 21-25页

作者： Anna Hartmann Schmidt Thomas Decker Christensen Line Bille Madsen anette H?jsgaard Sten Schytte Hans Kristian Pilegaard Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus Denmark Institute of Clinical Medicine Aarhus University Hospital Aarhus Denmark Department of Pathology Aarhus University Hospital Aarhus Denmark Department of Otorhinolaryngology Aarhus University Hospital Aarhus Denmark

Primary tracheal cancer is a well-known disease while metastases to the trachea from distant sites are exceedingly rare. We report a case of endotracheal metastasis from a colon cancer in a female, who underwent surgery for a sigmoid cancer with no metastases. Five years later, she was diagnosed with a solitary pulmonary metastasis and underwent a left lower lobectomy. After further two years, a tracheal metastasis was found. She was successfully treated with a tracheal resection. In conclusion, it is important to know that colorectal cancer may provide endotracheal metastases. Definitive and aggressive treatment of these metastases is advisable.

关键词： Colorectal Neoplasms Neoplasm Metastasis Tracheal Neoplasm

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评价漂白麦草浆循环回用性能的新方法

中华纸业 2008年第4期29卷 29-31页

作者：卓宇詹怀宇郭三川张成峰姜守乐 Heijnesson-Hulten anette 华南理工大学制浆造纸工程国家重点实验室 Eka Chemicals AB BohusSE44580Sweden

在实验室制备了CEH、DQP和DEopD三种漂白NaOH-AQ麦草浆,并通过纸页成形、压榨、干燥模拟造纸过程,得出了这三种漂白麦草浆循环回用过程中纸浆物理性质的变化。在此基础上,本文引入一种测定纤维"脱臼"点的方法,通过循环回用过程中纤维"脱... 详细信息

在实验室制备了CEH、DQP和DEopD三种漂白NaOH-AQ麦草浆,并通过纸页成形、压榨、干燥模拟造纸过程,得出了这三种漂白麦草浆循环回用过程中纸浆物理性质的变化。在此基础上,本文引入一种测定纤维"脱臼"点的方法,通过循环回用过程中纤维"脱臼"点的变化来反映纤维的损伤程度及其所引起的纤维强度性能的变化。

关键词： CEH DQP DEopD 漂白循环回用纤维“脱臼”点

BET抑制剂或成首个TNBC靶向药 008

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The Effect of Carotid Plaque Morphology on Longitudinal Fibrous Cap Stress Levels

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作者： anette Breindl 储旻华

年初《自然》（Nature）杂志在线发表的一项研究称，抑制bromodomain和extraterminal motif（BET）蛋白BRD4可使三阴乳腺癌（TNBC）异种移植模型肿瘤消退。如果这个结果能够在临床上复制，那么BET抑制剂有可能成为首个用于TNBC的靶向治...

年初《自然》（Nature）杂志在线发表的一项研究称，抑制bromodomain和extraterminal motif（BET）蛋白BRD4可使三阴乳腺癌（TNBC）异种移植模型肿瘤消退。如果这个结果能够在临床上复制，那么BET抑制剂有可能成为首个用于TNBC的靶向治疗药物。与雌激素或HER2受体过度表达

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World Journal of Mechanics 2012年第4期2卷 216-223页

作者： Samuel A.Thrysoe Anders F.Stegmann Nikolaj Eldrup anette Kl■rke William Paaske Won Yong Kim Jens V.Nygaard MR-Center Aarhus University HospitalAarhusDenmark Department of Cardiothoracic and Vascular Surgery T Aarhus University HospitalAarhusDenmark Department of Cardiology Aarhus University HospitalAarhusDenmark Aarhus School of Engineering Aarhus UniversityAarhusDenmark

Background and Purpose: Rupture of vulnerable carotid atherosclerotic plaques is a major cause of stroke. Stress levels may reflect risk of rupture in patients with carotid atherosclerotic plaques. Features thought to influence the risk of plaque rupture include the degree of stenosis, lipid-rich necrotic core (LR-NC) size, and thickness of the protective fibrous caps. We used computational models to investigate the effect of these variables on fibrous cap stress levels. Methods: Two-way coupled fluid-structure interaction longitudinal 2D simulations were performed on a bifurcation model based on idealized geometry derived from a symptomatic patient. Models with varying degrees of stenosis (50%-95%), fibrous cap thicknesses (0.05-1 mm), and LR-NC sizes (2 × 1 mm-6 × 3 mm) were simulated. The stress distribution for each model was calculated and peak principal stresses extracted. Regression analysis was used for assessing the relationship between the variables and stress levels. Results: Mechanical stresses increased with decreasing fibrous cap thicknesses ( β= -0.905, p Conclusions: Thin-capped plaques with large atheromas, known predictors of plaque vulnerability, were shown to exhibit the greatest mechanical stress levels.

关键词： Atherosclerosis Carotid Artery Fluid Structure Interaction Plaque Rupture Stroke

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异麦芽酮糖醇的性质和用途

中国食品添加剂 2000年第2期11卷 48-53页

作者： Ms. anette. Radowski MS. Ann Ang Palatinit SuBungsmittel GmbH Palatinit Asia- Pacific Pte.Ltd.

Ｐａｌａｔｉｎｉｔ公司生产的异麦芽酮糖醇是一种糖的替代物．它由双糖醇（多元醇）组成，而不是一种高度甜味剂．源于糖的异麦芽酮糖醇的味道像糖一样自然，展现了一种纯自然的甜味．异麦芽酮糖醇的感官特性，生理学性质及物理化学性... 详细信息

Ｐａｌａｔｉｎｉｔ公司生产的异麦芽酮糖醇是一种糖的替代物．它由双糖醇（多元醇）组成，而不是一种高度甜味剂．源于糖的异麦芽酮糖醇的味道像糖一样自然，展现了一种纯自然的甜味．异麦芽酮糖醇的感官特性，生理学性质及物理化学性质使得糖果、烘烤制品、医药和其他应用领域方面都大获裨益。

关键词：异麦芽酮糖醇物理性质化学性质生理学性质应用糖替代物食品配料

From Droplets and Particles to Hierarchical Spatial Organization： Nanotechnology Challenges for Microfluidics

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Journal of Physical Science and Application 2011年第3期1卷 125-134页

作者： J. Michael Kohler P. Mike Gvnther anette Funfak Jialan Cao Andrea Knauer Shuning Li Steffen Schneider G. Alexander Gross Techn. Univ. llmenau Institute of Micro- and Nanotechnologies/Institute for Physics Dept. Phys. Chem. and MicroreactionTechnology llmenau Germany

The compartimentation of fluids in the microliter, nanoliter and picoliter range leads recently to many applications of microfluidics in material development, diagnostics and biological screenings. Droplet-based microfluidics allows the improvement of nanoparticle homogeneity and the tuning of particle properties. It supports combinatorial synthesis of inorganic as well as organic substances and can be applied for the cultivation and screening of bacteria, eucaryotic cells and fish embryos. The well-ordered handling and the addressing of microfluid segments improves the information transfer between chemical, biological and electronic systems. Despite this remarkable technical progress, there is a particular importance of microfluidics for future nanotechnological solutions. The hierarchical spatial organization of liquids, particles and gels in microfluidics represents a fundamental biomimetic principle which overcomes the limits of planar technology and opens the gate for realizing complex structured threedimensional nanoarchitectures. Recent applications of microstructured fluids in chemistry and biology and concepts for future developments will be discussed.

关键词： Nanotechnology microfluidics nanoparticles segmented flow concentration spaces screening nested phases hierarchical organization droplet-based systems.

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有机硅树脂在外墙涂料中作用机理的微观研究

上海建材 2003年第3期 11-14页

作者： anette-Lork Ingeborg-Koenig-Lumer Dr.Hans.Mayer 德国威凯化学公司

借助高分辨率电子显微镜，进入微观世界，我们可以看到：硅树脂如何在填料间形成微观网络，有效排列而不堵塞毛细孔。硅树脂外墙涂料(SREP)理想地综合了有机聚合物外保护涂料体系与矿物建材的优点。硅树脂赋……

关键词：外墙涂料有机硅树脂防水乳胶漆

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