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Impact of mechanical bowel preparation in elective colorectal surgery:A meta-analysis

World Journal of Gastroenterology 2018年第4期24卷 519-536页

作者： Katie E Rollins Hannah Javanmard-Emamghissi dileep n lobo Gastrointestinal Surgery Nottingham Digestive Diseases Centre National Institute of Health Research (NIHR) Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and University of Nottingham Queen’s Medical Centre

AIM To analyse the effect of mechanical bowel preparation vs no mechanical bowel preparation on outcome in patients undergoing elective colorectal *** Meta-analysis of randomised controlled trials and observational studies comparing adult patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation, subdivided into those receiving a single rectal enema and those who received no preparation at all prior to elective colorectal surgery. RESULTS A total of 36 studies(23 randomised controlled trials and 13 observational studies) including 21568 patients undergoing elective colorectal surgery were included. When all studies were considered, mechanical bowel preparation was not associated with any significant difference in anastomotic leak rates(OR = 0.90, 95%CI: 0.74 to 1.10, P = 0.32), surgical site infection(OR = 0.99, 95%CI: 0.80 to 1.24, P = 0.96), intraabdominal collection(OR = 0.86, 95%CI: 0.63 to 1.17, P = 0.34), mortality(OR = 0.85, 95%CI: 0.57 to 1.27, P = 0.43), reoperation(OR = 0.91, 95%CI: 0.75 to 1.12, P = 0.38) or hospital length of stay(overall mean difference 0.11 d, 95%CI:-0.51 to 0.73, P = 0.72), when compared with no mechanical bowel preparation, nor when evidence from just randomized controlledtrials was analysed. A sub-analysis of mechanical bowel preparation vs absolutely no preparation or a single rectal enema similarly revealed no differences in clinical outcome measures. COnCLUSIOn In the most comprehensive meta-analysis of mechanical bowel preparation in elective colorectal surgery to date, this study has suggested that the use of mechanical bowel preparation does not affect the incidence of postoperative complications when compared with no preparation. Hence, mechanical bowel preparation should not be administered routinely prior to elective colorectal surgery.

关键词： bowel preparation Mechanical antibiotics morbidity mortality surgery outcome complications meta-analysis

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Pancreas preserving distal duodenectomy: A versatile operation for a range of infra-papillary pathologies

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World Journal of Gastroenterology 2017年第23期23卷 4252-4261页

作者： W Kyle Mitchell Pradeep F Thomas Abed M Zaitoun Adam J Brooks dileep n lobo Gastrointestinal Surgery Nottingham Digestive Diseases CentreNational Institute for Health Research Nottingham Biomedical Research CentreNottingham University Hospitals and University of NottinghamQueen's Medical Centre Cellular Pathology Nottingham Digestive Diseases CentreNational Institute for Health Research Nottingham Biomedical Research CentreNottingham University Hospitals and University of NottinghamQueen's Medical Centre

To investigate the range of pathologies treated by pancreas preserving distal duodenectomy (PPDD) and present the outcome of *** lesions of the duodenum are treated conventionally by pancreaticoduodenectomy. Lesions distal to the major papilla may be suitable for a pancreas-preserving distal duodenectomy, potentially reducing morbidity and mortality. We present our experience with this procedure. Selective intraoperative duodenoscopy assessed the relationship of the papilla to the lesion. After duodenal mobilisation and confirmation of the site of the lesion, the duodenum was transected distal to the papilla and beyond the duodenojejunal flexure and a side-to-side duodeno-jejunal anastomosis was formed. Patients were identified from a prospectively maintained database and outcomes determined from digital health records with a dataset including demographics, co-morbidities, mode of presentation, preoperative imaging and assessment, nutritional support needs, technical operative details, blood transfusion requirements, length of stay, pathology including lymph node yield and lymph node involvement, length of follow-up, complications and outcomes. Related published literature was also ***-four patients had surgery with the intent of performing PPDD from 2003 to 2016. nineteen underwent PPDD successfully. Two patients planned for PPDD proceeded to formal pancreaticoduodenectomy (PD) while three had unresectable disease. Median post-operative follow-up was 32 mo. Pathologies resected included duodenal adenocarcinoma (n = 6), adenomas (n = 5), gastrointestinal stromal tumours (n = 4) and lipoma, bleeding duodenal diverticulum, locally advanced colonic adenocarcinoma and extrinsic compression (n = 1 each). Median postoperative length of stay (LOS) was 8 d and morbidity was low [pain and nausea/vomiting (n = 2), anastomotic stricture (n = 1), pneumonia (n = 1), and overwhelming post-splenectomy sepsis (n = 1, asplenic patient)]. PP

关键词： Pancreas preserving distal duodenectomy Duodenojejunostomy Duodenal disease Surgical technique Adults Indications Treatment Outcome

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A systematic review of patient reported outcome measures (PROMs) and quality of life reporting in patients undergoing laparoscopic cholecystectomy

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Hepatobiliary Surgery and nutrition 2019年第3期8卷 228-245页

作者： Prita Daliya Elizabeth H.Gemmill dileep n.lobo Simon L.Parsons Gastrointestinal Surgery Nottingham Digestive Diseases Centre and National Institute for Health Research(NIHR)Nottingham Biomedical Research CentreNottingham University Hospitals NHS Trust and University of NottinghamQueen’s Medical CentreNottingham NG72UHUK Department of General Surgery Sherwood Forest Hospitals NHS TrustKing’s Mill HospitalSutton-in-Ashfield NG174JLUK MRC/ARUK Centre for Musculoskeletal Ageing Research School of Life SciencesUniversity of NottinghamQueen’s Medical CentreNottingham NG72UKUK Trent Oesophago-Gastric Unit City Hospital CampusNottingham University Hospitals NHS TrustNottingham NG51PBUK

Patient reported outcome measures(PROMs)provide a valuable means of measuring outcomes subjectively from a patient's perspective,facilitating the assessment of service quality across healthcare providers,and assisting patients and clinicians in shared decision *** primary aim of this systematic review was to critically appraise all historic studies evaluating patient reported quality of life,in adult patients undergoing laparoscopic cholecystectomy for symptomatic *** secondary aim was to perform a quality assessment of cholecystectomy-specific PROM-validation studies.A literature review was performed in PubMed,Google ScholarTM,the Cochrane Library,Medline,CInAHL,EMBASE and PsychInFO databases up to September *** characteristics,PROM-specific details and a bias assessment were summarised for non-validation studies.A COnsensus-based Standards for the selection of health Measurement Instruments(COSMIn)analysis was performed to assess the methodological quality of identified PROM-validation *** one studies were found to evaluate health-related quality of life(HRQoL)after laparoscopic *** 94.1%of these studies included PROMs as a primary outcome measure,nce through randomised controlled trials(RCTs).There was significant variation in the selection and reporting of PROMs,with no studies declaring patient involvement in PROM selection,and 88.2%of studies failing to document the management of missing data points,or non-returned surveys(33.3%).In the 6 PROM-validation studies identified,only 5 psychometric properties were evaluated,the findings of which were limited due to the small number of *** systematic review identifies a lack in consistency of study design and PRO reporting in clinical *** an increasing number of studies are being performed to evaluate PROs,a lack of adherence to existing PRO administration and reporting guidelines is continuing to negatively affect st

关键词： Cholecystectomy patient reported outcomes(PROs) patient reported outcome measures(PROMs) quality of life(QoL) COnsensus-based Standards for the selection of health Measurement Instruments(COSMIn)

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胰腺癌的诊断新进展

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继续医学教育 2007年第25期21卷 1-5页

作者： Arjun S Takhar Ponni Palaniappan Rajpal Dhingsa dileep n lobo 英国诺丁汉皇后医疗中心教学医院外科

在英国，每年大约有6000人罹患胰腺癌，它已成为西半球前10位最常见的肿瘤死亡原因之一。男性的发病率略高，发病高峰在70-90岁年龄段。绝大多数胰腺癌患者在诊断后的一年内死亡，总的5年生存率为0.4％-4％，是所有癌症中生存率最低的... 详细信息

在英国，每年大约有6000人罹患胰腺癌，它已成为西半球前10位最常见的肿瘤死亡原因之一。男性的发病率略高，发病高峰在70-90岁年龄段。绝大多数胰腺癌患者在诊断后的一年内死亡，总的5年生存率为0.4％-4％，是所有癌症中生存率最低的一种恶性肿瘤。当前，手术切除是治疗胰腺癌最好的选择，

关键词：胰腺癌患者诊断 5年生存率死亡原因恶性肿瘤发病高峰手术切除西半球

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Development of a telehealth monitoring service after colorectal surgery:A feasibility study

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World Journal of Gastrointestinal Surgery 2017年第9期9卷 193-199页

作者： Damian D Bragg Helena Edis Sian Clark Simon L Parsons Binoy Perumpalath dileep n lobo Charles A Maxwell-Armstrong Gastrointestinal Surgery Nottingham Digestive Diseases Centre and National Institute of Health Research(NIHR)Nottingham Biomedical Research CentreNottingham University Hospitals and University of NottinghamQueen’s Medical CentreNottingham NG7 2UHUnited Kingdom

AIM To evaluate the feasibility of a text-messaging system to remotely monitor and support patients after discharge following elective colorectal surgery,within an enhanced recovery *** Florence(FLO) is a national Health Service telehealth solution utilised for monitoring chronic health conditions,such as hypertension,using *** were designed to monitor the well-being,basic physiological observations and any patient-reported symptoms,and provide support messages to patients undergoing colorectal surgery within an enhanced recovery after surgery protocol for 30 d after *** interactions with FLO and physiological readings were recorded and patients were invited to provide *** Over a four-week period,16 out of 17 patients used the FLO telehealth service at *** patients did not receive telephone follow-up at three days,as per our standard protocol,unless they reported being unwell or did not make use of the *** patients were readmitted within 30 d,and two of these were identified as being unwell by FLO prior to *** adverse events attributable to the use of the technology were *** The utilisation of telehealth in the early follow-up of patients who have undergone major colorectal surgery after discharge is *** use of this technology may assist in the early recognition and management of complications after discharge.

关键词： Telehealth Remote monitoring Colorectalsurgery Telephone follow up Readmission

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Caspase-cleaved cytokeratin-18 and tumour regression in gastro-oesophageal adenocarcinomas treated with neoadjuvant chemotherapy

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World Journal of Gastroenterology 2012年第16期18卷 1915-1920页

作者： Khaleel R Fareed Irshad n Soomro Khalid Hameed Arvind Arora dileep n lobo Simon L Parsons Srinivasan Madhusudan Laboratory of Molecular Oncology Academic Unit of OncologySchool of Molecular Medical SciencesFaculty of Medicine and Health SciencesUniversity of Nottingham nottingham University Hospitals Nottingham NG5 1PBUnited Kingdom Department of Pathology Nottingham University HospitalsNottingham NG5 1PBUnited Kingdom Division of Gastrointestinal Surgery Nottingham Digestive Diseases CentreNIHR Biomedical Research UnitNottingham University HospitalsNottingham NG7 2UHUnited Kingdom Department of Surgery Nottingham University HospitalsNottingham NG5 1PBUnited Kingdom

AIM:To examine cytokeratin-18(CK-18) and caspasecleaved CK-18 expression in tumours and correlate with clinicopathological outcomes including tumour regression grade(TRG) ***:Formalin-fixed human gastro-oesophageal cancers were constructed into tissue *** first set consisted of 122 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 97 gastric/gastrooesophageal cancer cases exposed to pre-operative platinum-based *** of CK-18 and caspase-cleaved CK-18 was investigated using ***:CK18 was commonly expressed in gastrooesophageal tumours(92.6%).Fifty-six point seven percent of tumours previously exposed to neoadjuvant chemotherapy were positive for caspase-cleaved CK-18 expression compared to only 24.6% of tumours not previously exposed to neoadjuvant chemotherapy(P = 0.009).In patients who received neoadjuvant chemotherapy,caspase-cleaved cytokeratin-18 expression correlated with favourable TRG response(TRG 1,2 or 3,P = 0.043).COnCLUSIOn:This is the largest study to date of CK-18 and caspase-cleaved CK-18 expression in gastrooesophageal *** provide the first evidence that caspase-cleaved CK-18 predicts tumour regression with neoadjuvant chemotherapy.

关键词： Tumour regression grade Gastro-oesophageal cancers Chemotherapy Full length cytokeratin-18 Caspase-cleaved cytokeratin-18

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Targeting LIF/LIFR signaling in cancer

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Genes & Diseases 2022年第4期9卷 973-980页

作者： Suryavathi Viswanadhapalli Kalarickal V.dileep Kam Y.J.Zhang Hareesh B.nair Ratna K.Vadlamudi Department of Obstetrics and Gynecology University of Texas Health San AntonioSan AntonioTX 78229USA Laboratory for Structural Bioinformatics Center for Biosystems Dynamics ResearchRIKENYokohamaKanagawa 230-0045Japan Evestra Inc.San AntonioTX 78245USA Mays Cancer Center University of Texas Health San AntonioSan AntonioTX 78229USA

Leukemia inhibitory factor (LIF), and its receptor (LIFR), are commonly over-expressed in many solid cancers and recent studies have implicated LIF/LIFR axis as a promising clinical target for cancer therapy. LIF/LIFR activate oncogenic signaling pathways including JAK/STAT3 as immediate effectors and MAPK, AKT, mTOR further downstream. LIF/LIFR signaling plays a key role in tumor growth, progression, metastasis, stemness and therapy resistance. Many solid cancers show overexpression of LIF and autocrine stimulation of the LIF/LIFR axis;these are associated with a poorer relapse-free survival. LIF/LIFR signaling also plays a role in modulating multiple immune cell types present in tumor micro environment (TME). Recently, two targeted agents that target LIF (humanized anti-LIF antibody, MSC-1) and LIFR inhibitor (EC359) were under development. Both agents showed effectivity in preclinical models and clinical trials using MSC-1 antibody are in progress. This article reviews the significance of LIF/LIFR pathways and inhibitors that disrupt this process for the treatment of cancer.

关键词： LIF LIFR LIFR inhibitor STAT3 Targeted therapy

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Analysis of Simple Sequence Repeats Information from Floral Expressed Sequence Tags Resources of Papaya (<i>Carica papaya</i>L.)

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American Journal of Plant Sciences 2017年第9期8卷 2315-2331页

作者： Priyanka Priyanka dileep Kumar Anurag Yadav Kusum Yadav U. n. Dwivedi Department of Biochemistry University of Lucknow Lucknow India College of Basic Sciences & Humanities Sardarkrushinagar Agricultural University Dantiwada Banaskantha India

Papaya (Carica papaya L.) is one of the most economically, medicinally and nutritionally important tropical fruit crops. Expressed sequence tags (ESTs) derived simple sequence repeat (SSR) markers are more valuable as they are derived from conserved genic portion. Development of EST-SSRs markers through in silico approach is cheaper, less time consuming and labour-intensive. In this study, we aimed to mine SSRs and developed EST-SSR primers from papaya floral ESTs. A total of 75,846 papaya floral ESTs were downloaded from public database national Centre for Biotechnology Information (nCBI). A total of 26,039 floral unigenes (7961 contigs and 18,078 singletons) were generated after assembly of these ESTs. From these floral unigenes, 433,782 perfect SSRs, 204,968 compound SSRs and 6061 imperfect SSRs were mined, respectively. In perfect SSRs, mononucleotide repeats were most abundant (94.7%) followed by tri- (3.1%) and di-nucleotide repeats (1.7%). The frequencies of tetra-, hexa- and penta-nucleotide repeats accounted for only (0.17%), (0.04%) and (0.03%), respectively. In mononucleotide repeats, the most abundant motif was A/T (69.3%) and in di- and tri-nucleotide repeats were AG/CT (61%) and AAG/CTT (31%), respectively. In imperfect SSRs, mononucleotide repeats (56.5%) were most abundant. 176 different types of motifs were identified. A total of 3807 primer pairs for floral papaya ESTs were successfully designed. These developed EST-SSR primers are being used for the genetic improvement of papaya such as study of cross-transferability across genera/species, evaluation of genetic diversity, and identification of sex-specific markers. These EST derived SSRs can also be used in filling gaps in existing linkage maps in papaya.

关键词： Papaya (Carica papaya L.) In Silico Simple Sequence Repeats Expressed Sequence Tags (ESTs) SSR Mining EST-SSR SSR Motifs Primer Pairs

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基于C^n^n三齿配体以及苯乙炔基或苯基的环金属化铂磷光络合物的比较研究（英文）

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有机化学 2018年第1期38卷 171-182页

作者： Robert Mroz dileep A.K.Vezzu Brian Wallace Deepak Ravindranathan Jeffrey Carroll Robert D.Pike 霍守权 Department of Chemistry East Carolina University Department of Chemistry College of William and Mary

合成了两个系列的以2-芳基-6-(1H-砒唑-1-基)砒啶[芳基=苯基(L1),2,4-二氟苯基(L2),3,5-二甲基苯(L3),3-甲氧基苯基(L4),2-噻吩基(L5),2-苯并噻吩基(L6)]为环金属化配体,以苯乙炔基或苯基为辅助配体的铂化合物1a^6a和1b^6b.其中2b,3b和5... 详细信息

合成了两个系列的以2-芳基-6-(1H-砒唑-1-基)砒啶[芳基=苯基(L1),2,4-二氟苯基(L2),3,5-二甲基苯(L3),3-甲氧基苯基(L4),2-噻吩基(L5),2-苯并噻吩基(L6)]为环金属化配体,以苯乙炔基或苯基为辅助配体的铂化合物1a^6a和1b^6b.其中2b,3b和5b的结构用X射线晶体衍射方法进行了测定.结果表明,辅助基团苯基与配位平面采取一种扭曲的构型.Pt—C(苯基)键较Pt—C(炔基)键弱.对铂化合物的光物理性质包括吸收和发射光谱进行了研究.苯乙炔基取代的铂化合物1a^6a在室温溶液里发射较强的磷光,而苯基取代的确铂化合物1b^3b仅发射很弱的光.但是,化合物4b^6b发射比较强的光,尽管发光效率还是比相应的4a^6a低.这一现象表明4b^6b和4a^6a的激发态可能定域在三齿环金属化配体上.化合物1a^6a表现的较高发光效率可能是因为较强的和刚性的炔基配体.

关键词：铂络合物磷光材料晶体结构光物理

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Critical care practice in India:Results of the intensive care unit need assessment survey(InIn2018)

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World Journal of Critical Care Medicine 2020年第2期9卷 31-42页

作者： Rahul Kashyap Kirtivardhan Vashistha Chetan Saini Taru Dutt dileep Raman Vikas Bansal Harpreet Singh Geeta Bhandari nagarajan Ramakrishnan Harshit Seth Divya Sharma Premkumar Seshadri Mradul Kumar Daga Mohan Gurjar Yash Javeri Salim Surani Joseph Varon 无 Department of Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States Department of Infectious Disease Mayo ClinicRochesterMN 55905United States Department of Internal Medicine Allegheny General HospitalPittsburghPA 15212United States Department of Radiology Mayo ClinicRochesterMN 55905United States Department of Medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 14061United States Department of neurology Mayo ClinicRochesterMN 55905United States and Department of PsychiatryHennepin County Medical CenterMinneapolisMN 55415United States Department of Medicine Cloud Physician HealthcareBangalore 560038India Department of Critical Care Medicine Mayo ClinicRochesterMN 55905United States Department of Internal Medicine Maulana Azad Medical College&Associated HospitalsNew DelhiDelhi 110002India Department of Anesthesiology Government Medical CollegeHaldwaniNainital 263129India Department of Critical Care Medicine Apollo HospitalsChennai 600006India Department of Hospitalist Medicine Allegany ClinicAllegany Health NetworkPittsburghPA 15222United States Premkumar Seshadri Department of MedicineMAAGF HealthcareChennai 600024India Department of Internal Medicine and Center for Occupational and Environment Health Maulana Azad Medical CollegeNew DelhiDelhi 110002India Department of Critical Care Medicine Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014India Department of Critical Care Medicine Regency Super Speciality HospitalLucknow 208005India nayati Healthcare New DelhiDelhi 110065India Department of Pulmonary and Critical Care Medicine Texas A&M UniversityCollege StationTX 77843United States Department of Critical Care United Memorial Medical CenterHoustonTX 77091United States InIn-2018 Investigators Team

BACKGROUnD A diverse country like India may have variable intensive care units(ICUs)practices at state and city *** To gain insight into clinical services and processes of care in ICUs in India,this would help plan for potential educational and quality improvement *** The Indian ICU needs assessment research group of diverse-skilled individuals was formed.A pan-India survey"Indian national ICU needs"assessment(InIn 2018-I)was designed on google forms and deployed from July 23rd-August 25th,*** survey was sent to select distribution lists of ICU providers from all 29 states and 7 union territories(UTs).In addition to emails and phone calls,social medial applications-WhatsApp™,Facebook™and LinkedIn™were used to remind and motivate *** completing and submitting the survey,providers gave their consent for research *** study was deemed eligible for category-2 Institutional Review Board exempt *** There were total 134 adult/adult-pediatrics ICU responses from 24(83%out of 29)states,and two(28%out of 7)UTs in 61 *** had median(IQR)16(10-25)beds and most,were mixed medical-surgical,111(83%),with 108(81%)being adult-only *** responders were young,median(IQR),38(32-44)years age and majority,n=108(81%)were *** consultants were,n=101(75%).A total of 77(57%)reported to have 24 h in-house intensivist.A total of 68(51%)ICUs reported to have either 2:1 or 2≥:1 patient:nurse *** than 80%of the ICUs were open,and mixed *** followed regularly by the ICUs included sepsis care,ventilator-associated pneumonia(83%each);nutrition(82%),deep vein thrombosis prophylaxis(87%),stress ulcer prophylaxis(88%)and glycemic control(92%).Digital infrastructure was found to be poor,with only 46%of the ICUs reporting high-speed internet *** In this large,national,semi-structured,need-assessment survey,the need for improved manpower including;in-house intensivists,and decreasing

关键词： Intensive care unit Critical care India Survey Intensive care unit survey Intensive care unit needs

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