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快速康复模式下结直肠癌传统开放手术与腹腔镜手术的疗效对比:一项基于多中心的随机对照试验(EnROL)

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消化肿瘤杂志（电子版） 2015年第2期7卷 76-76页

作者： Kennedy RH francis EA Wharton R 袁玉杰

目的腹腔镜辅助手术和多重管理方案（即加速康复程序,Enhanced Recovery Program,ERP）极大地改变了结直肠癌患者的围手术期管理,并改善了临床治疗结局。然而,腹腔镜手术尚未成为世界范围内结直肠癌手术治疗的标准,大量有着良好开腹手... 详细信息

目的腹腔镜辅助手术和多重管理方案（即加速康复程序,Enhanced Recovery Program,ERP）极大地改变了结直肠癌患者的围手术期管理,并改善了临床治疗结局。然而,腹腔镜手术尚未成为世界范围内结直肠癌手术治疗的标准,大量有着良好开腹手术技术的外科医生仍采用传统手术方式治疗。究竟传统开腹手术辅助ERP能否与腹腔镜辅助的微创治疗匹敌？这一问题还存在争议。EnROL（Enhanced Recovery Open versus Laparoscopic）多中心随机对照试验旨在解答上述问题。资料和方法该研究为Ⅲ期多中心随机对照临床试验,纳入可择期手术的成年结直肠癌患者（年龄≥18岁）,按1∶1随机分配至腹腔镜组或开腹组,两组均应用快速康复多重管理程序（ERP）进行围手术期管理。通过纳入中心、肿瘤部位（结肠或直肠）、年龄组（〈66/66~75/〉75岁）再进行分层分析。研究的主要结局指标为术后1个月的机体疲劳感（使用多维疲劳量表MFI-20评价）,次要结局指标包括：住院时间、术后并发症、患者其他不适情况及身体机能（简表SF-36）。术后7天或更早出院之前,受试患者和结局评估人员都不知晓治疗情况。手术质量及病理评估由中心负责人员进行盲评。该研究在英国临床伦理委员会南部牛津中心B注册,注册号为No.07/H0605/150。结果研究从2008年7月开始,至2012年4月结束,共在英国的12个中心纳入204例病人（其中腹腔镜组103人,开放结合ERP组101人）。腹腔组的切除范围[（6.8±3.7）vs.（18.4±7.5）cm]以及术中出血量[（115±152）vs.（257±290）ml]较开腹组减少,但手术时间[（182±69）vs.（135±54）min]相对延长,总体手术相关损伤评分[（31.2±6.0）vs.（31.8±6.0）]没有明显差别。两组病人术后1个月的机体疲劳感评分无显著差异[MFI-20（12.28,95%CI：11.3~13.1）vs.（12.05,95%CI：11.2~13.1）;P=0.93]。然而,腹腔镜组的中位住院时间较开腹组明显缩短（5 vs.7天;四分位点间距：4~9 vs.5~11天;P=0.033）。其他次要结局和病理报告质量均未见显著差异。结论虽然有经验的外科医生运用开腹手术结合加速康复程序可使结直肠癌患者术后疲乏感及其他不适情况降低至腹腔镜手术治疗相当的水平,但是住院时间会有明显的延长。在治疗结局无明显差别的前提下,腹腔镜辅助结直肠癌手术结合快速康复程序更应被推广使用。

关键词：结直肠癌 EnROL 快速康复腹腔镜手术随机对照试验结局指标开腹手术康复程序腔镜组外科医生

An update on the influence of natural climate variability and anthropogenic climate change on tropical cyclones

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Tropical Cyclone Research and Review 2023年第3期12卷 216-239页

作者： Suzana J.Camargo Hiroyuki Murakami Nadia Bloemendaal Savin S.Chand Medha S.Deshpande Christian Dominguez-Sarmiento Juan Jesús Gonz´alez-Alem´an Thomas R.Knutson I.-I.Lin Il-Ju Moon Christina M.Patricola Kevin A.Reed Malcolm J.Roberts Enrico Scoccimarro Chi Yung(francis)Tam Elizabeth J.Wallace Liguang Wu Yohei Yamada Wei Zhang Haikun Zhao Lamont-Doherty Earth Observatory Columbia UniversityPalisadesNYUSA National Oceanographic and Atmospheric Administration/Geophysical Fluid Dynamics Laboratory PrincetonNJUSA University Corporation for Atmospheric Research BoulderCOUSA Vrije University Amsterdam AmsterdamNetherlands Federation University Australia BallaratVictoriaAustralia Indian Institute of Tropical Meteorology Ministry of Earth SciencesPuneIndia Instituto de Ciencias de la Atmosfera y Cambio Clim´atico Universidad Nacional Autonoma de Mexico(UNAM)Mexico CityMexico Spanish State Meteorological Agency(AEMet) MadridSpain National Taiwan University TaiwanChina Jeju National University JejuRepublic of Korea Iowa State University AmesIAUSA Stony Brook University Stony BrookNYUSA Met Office ExeterUnited Kingdom Fondazione Centro Euro-Mediterraneo sui Cambiamenti Climatici BolognaItaly The Chinese University of Hong Kong Hong KongChina Old Dominion University NorfolkVAUSA Fudan University ShanghaiChina Japan Agency for Marine-Earth Science and Technology YokohamaJapan Utah State University LoganUTUSA Nanjing University of Information Science and Technology NanjingChina

A substantial number of studies have been published since the Ninth International Workshop on Tropical Cyclones(IWTC-9)in 2018,improving our understanding of the effect of climate change on tropical cyclones(TCs)and associated hazards and *** studies have reinforced the robustness of increases in TC intensity and associated TC hazards and risks due to anthropogenic climate *** modeling and observational studies suggested the potential influence of anthropogenic climate forcings,including greenhouse gases and aerosols,on global and regional TC activity at the decadal and century time ***,there are still substantial uncertainties owing to model uncertainty in simulating historical TC decadal variability in the Atlantic,and the limitations of observed TC *** projected future change in the global number of TCs has become more uncertain since IWTC-9 due to projected increases in TC frequency by a few climate models.A new paradigm,TC seeds,has been proposed,and there is currently a debate on whether seeds can help explain the physical mechanism behind the projected changes in global TC *** studies also highlighted the importance of large-scale environmental fields on TC activity,such as snow cover and air-sea *** projections on TC translation speed and medicanes are new additional focus topics in our *** and future research are proposed relevant to the remaining scientific questions and assisting policymakers.

关键词： tropical climate variability

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美国“例外”论的终结

Socio-Demographic Determinant of Yellow Fever Patient: A Retrospective Study (2020), Federal Medical Center, Asaba

国际政治 2002年第2期

作者：弗朗西斯·福山(francis Fukuyama)

美国约翰斯·霍普金斯大学教授弗朗西斯·福山说，9月11日恐怖主义袭击标志着美国例外论的终结。美国现在除了抛弃其自我陶醉并与世界其余部分站在一起，几乎别无选择。

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Journal of Biosciences and Medicines 2022年第12期10卷 225-238页

作者： Ngozi Esther Ezunu Joy Ifeyinwa Egeonu Ajiri Henry Osihro Uyi-Oghosa Onyemushani Said Abdulkareem Omole Clementina Oyakhire Onyema Edith Wayemeru Chidera Olivia Okey-Ezufo chik.dibia Eze-Otulaka Faith Inegbejie Clever Ajiri Oghale Diana Chinenye Ofomata Grace Nnenna Onubogu Orhomuromo Paul Okpomo Eguolo Unique Okorhi Onobhase Theresa Agbele Anastacia Okwudili Ojimba Adesuwa Queen Aigbokhaode francis Chinedu Ugoeze Victor Azubike Osiatuma Emmanuel Okechukwu Ezunu Obianuju Nkemjika Jisieike Erhinyaye Omoyibo Efe Department of Nursing Federal Medical Centre Asaba Nigeria CCDRC Federal Medical Centre Asaba Nigeria Department of Internal Medicine Federal Medical Centre Asaba Nigeria Department of Radiology Federal Medical Centre Asaba Nigeria Department of Health Information Management Federal Medical Centre Asaba Nigeria Department of Pediatrics Federal Medical Centre Asaba Nigeria

Background: Yellow fever is transmitted primarily to humans and non-human primates through the bite of an infected female mosquito Aedes Spp. It is prevented mainly by vaccination. Method: This retrospective observational study at the Center for Communicable Disease Control and Research (CCDCR) Federal Medical Center Asaba (F.M.C) was conducted on all patients diagnosed and managed with yellow fever in the year 2020. We studied a total number of 57 patients’ case files seen within the period. A chi-square test was done to test the null and alternative hypotheses. Result: About 48 (84.2%) males and female 9 (15.8%) females were mostly affected and gender was significant with a chi-squared value of 26.6 and p-value of 0.00. Conclusion: To eradicate this virus, vaccination and health promotions should be encouraged by the health care workers supported by the government. This is to ensure that a greater proportion of the affected community can be immunized.

关键词： Yellow Fever Socio-Demograpic Determinants Asaba

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结膜松弛症的临床病例对照及组织病理学研究

世界核心医学期刊文摘（眼科学分册） 2005年第8期1卷 41-41页

作者： francis I.C. Kim P. 宋虎平 Chatswood Grove 12-1 4 Malvern Avenue Chatswood NSW 2007 Australia Dr.

Background/aims: Conjunctivochalasis, a secondary cause of the watery eye, is frequently seen in the older age group as an elevation of the bulbar conjunctiva lying along the lateral or central lower lid margin. A prospective, interventio nal, casecontrolled clinical and histopathological study was conducted. The rele vant features of 18 patients (29 eyes) who had their conjunctivochalasis resecte d as part of the surgical management of their watery eye syndrome were examined. In the control group, tissue was obtained from an age matched series of 24 norm al subjects undergoing routine cataract surgery. Methods: 24 controls (24 specim ens) and 18 patients (29 specimens) had conjunctival strip biopsies, taken from the usual lid margin level bulbar conjunctiva in line with the inferior limbus ( controls), and the clinically apparent conjunctivochalasis (patients). These wer e submitted for histological study. Resolfs: 23 of 24 control sections demonstra ted normal conjunctival variation. Four of 29 patient specimens demonstrated a c hronic non-granulomatous conjunctivitis, while three eyes of the patient group (two patients) demonstrated features of elastosis. Of the four patients who had the inflammatory infiltrates, three had functional nasolacrimal duct obstruction s (FNLDOs) and one had a primary acquired nasolacrimal duct obstruction (PANDO). Of the two patients who had elastosis, one had an FNLDO and the other had norma l lacrimal drainage and was Jones 1 positive. Conclusion: Six of 18 patients-th at is, seven of 29 specimens of conjunctivochalasis demonstrated signs of elasto sis or of chronic non-granulomatous inflammation. Clinically, patients had a sp ectrum of aetiologies of their watery eye syndrome.

关键词：结膜松弛症病理学研究下睑缘泪溢泪液排泄系统白内障手术干预性鼻泪管阻塞肉芽肿性炎症炎性浸润

同种异体富血小板血浆用于关节软骨衍生的软骨形成的支架

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中国口腔颌面外科杂志 2019年第2期17卷 170-170页

作者： Vinod E Vinod francis D ManickamAmirtham S 赵泽亮不详

软骨的有限自我恢复能力使得必须使用基于细胞和组织工程的疗法。关节软骨衍生的软骨形成剂(CP)的分离、扩展和表征的最新进展,已经在其软骨修复的作用中得到普及。富血小板血浆(PRP)是用于体外和体内研究的可靠的生物支架,已报道在软... 详细信息

软骨的有限自我恢复能力使得必须使用基于细胞和组织工程的疗法。关节软骨衍生的软骨形成剂(CP)的分离、扩展和表征的最新进展,已经在其软骨修复的作用中得到普及。富血小板血浆(PRP)是用于体外和体内研究的可靠的生物支架,已报道在软骨和骨疾病的治疗中得到应用。

关键词：富血小板血浆软骨形成关节软骨生物支架同种异体组织工程软骨修复 PRP

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《为他人得幸福而祈祷》

绿风 2021年第2期 F0002-F0002页

作者：弗朗西斯·雅姆不详

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自适应光学:空间安全守卫者

环球科学 2021年第9期 38-43页

作者：托尼·特拉武永塞利娜·多热维尔弗朗西斯·贝内特田泽葳(翻译) 不详

对天文学家来说,这一切都如魔法一般:你正盯着显示器,一个宇宙天体的模糊图像逐渐变得清晰锐利,展现出更多细节。我们将其称作“闭环”,它指代的是自适应光学循环,这是一种天文望远镜能够更正大气扰动造成的模糊的工具。自适应光学本质... 详细信息

对天文学家来说,这一切都如魔法一般:你正盯着显示器,一个宇宙天体的模糊图像逐渐变得清晰锐利,展现出更多细节。我们将其称作“闭环”,它指代的是自适应光学循环,这是一种天文望远镜能够更正大气扰动造成的模糊的工具。自适应光学本质上就是让星星不再“眨眼”,消除我们和太空之间大气的影响,将模糊的图像变得清晰。

关键词：自适应光学天文望远镜空间安全大气扰动模糊图像守卫者

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主动脉溃疡样病变的影像学特点和自然病程

放射学实践 2001年第6期16卷 431-431页

作者： LeslieE.Quint DavidM.Williams IsaacR.francis 张淑倩河北省人民医院医学影像中心

目的：了解CT扫描所示的主动脉溃疡样病变的自然病程，同时明确CT征象对预测病变的转归有无帮助。方法：作者回顾性分析了1994年－1999年，4年间所有CT及CT增强扫描显示有主动脉溃疡样病变的病例，评价病变的特点包括主动脉腔大小和内... 详细信息

目的：了解CT扫描所示的主动脉溃疡样病变的自然病程，同时明确CT征象对预测病变的转归有无帮助。方法：作者回顾性分析了1994年－1999年，4年间所有CT及CT增强扫描显示有主动脉溃疡样病变的病例，评价病变的特点包括主动脉腔大小和内膜血肿情况，对最初的CT表现，临床表现和随后的CT结果作对照分析。结果：在38例中有56个主动脉溃疡样病变，其中33个病灶行CT扫描随访（平均18．4个月），研究21个病灶及其邻近主动脉的稳定性，2个病灶无变化，尽管伴发的壁内血肿1－2个月后回缩，10个病灶显示主动脉直径轻或中度增加（平均随访时间为19．8个月），伴或不伴有病灶增大，或病灶构成了主动脉壁轮廓，在所有56个病灶中，37个病灶临床表现稳定，2个病灶伴有反复发作的胸痛和／或背痛，8个病灶接受了手术切除或放置支架，2个病灶所在的病人死亡。7个病灶所在的病人失随访。最初的CT特征并不能预测其最后的CT结果，尽管缺乏与临床稳定性相关的胸膜渗出，结论：大多数主动脉溃疡样病变是无症状的，且不随时间而发生变化，大约1／3的病变继续演变，通常导致主动脉内径的轻度扩大。

关键词：主动脉溃疡样病变 CT扫描病程病灶