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g.stric cancer in 2022:Is there still a role for endoscopic ultrasound?

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World Journal of g.strointestinal Endoscopy 2023年第1期15卷 1-9页

作者： gemma Rossi Maria Chiara Petrone Andrew J Healey Paolo g.org.o Arcidiacono Pancreato-Biliary Endoscopy and Endosonog.aphy Division Pancreas Translational and Clinical Research CenterSan Raffaele Scientific Institute IRCCSVita Salute San Raffaele UniversityMilan 20132Italy Department of Clinical Surg.ry University of EdinburghRoyal Infirmary of EdinburghEdinburgh EH164SAUnited Kingdom

g.stric cancer(g.)represents the fourth leading.cause of cancer death worldwide and many factors can influence its development(diet,g.og.aphic area,g.netic,Helicobacter pylori or Epstein-Barr virus infections).Hig. quality endoscopy represents the modality of choice for g. *** correct morpholog.c classification during.a hig.-resolution endoscopy is fundamental for oncolog.c diag.osis,stag.ng.and therapeutic *** its initial introduction in clinical practice the endoscopic ultrasound(EUS)has been considered a valuable tool for tumor(T-)and lymph nodes(N-)stag.ng.also in g.,in order to establish the best therapeutic strateg. for the patient(e.g.,upfront surg.ry vs neoadjuvant treatments).EUS tools as elastog.aphy,Doppler and contrast administration can improve diag.osis mainly in case of malig.ant lymph node *** has a marg.nal role in disease stag.ng.but has a fundamental role in case of a pre-endoscopic resection manag.ment and in the new era of endoscopic mucosal resection or submucosal dissection as minimally invasive *** and locoreg.onal stag.ng.of g. with EUS are a method of inarg.able value for the assessment of g.stric wall involvement and presence of infiltrated parag.stric lymph *** can also have a role in disease restag.ng.in those patients who have underg.ne neoadjuvant *** can also have a role in the advanced phases of the disease,in facilitating.palliative,minimallyinvasive treatments,such as g.stroenterostomy or biliary *** review intends to discuss the modern role of EUS in g. topic.

关键词： g.stric cancer Endoscopic ultrasound Endoscopic resection Neoadjuvant chemotherapy Therapeutic endoscopic ultrasound

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急救医疗系统规划和实施

国外医学情报 1984年第12期 199-201+209页

作者： gemma 美国福利保健部

为居民提供迅速、高效和有成果的急救医疗服务是世界上发展中国家和工业化国家卫生事业的规划人员和行政人员所关心的一个课题。原因至少有两个因素:(1)随着意外事故、自然灾害,心脏问题和呼吸困难而出现的急诊病人不断增加;(2)需要系... 详细信息

为居民提供迅速、高效和有成果的急救医疗服务是世界上发展中国家和工业化国家卫生事业的规划人员和行政人员所关心的一个课题。原因至少有两个因素:(1)随着意外事故、自然灾害,心脏问题和呼吸困难而出现的急诊病人不断增加;(2)需要系统地动用有限的资源,使所掌握的资金、设施、装备和人力发挥最大的效能。

关键词： EMS 医师助理急救医疗地区性急诊医疗病人监护 BLS 不发达国家创伤病人救护人员危重病例规划长远计划

Mag.etic resonance imag.ng.for prostate cancer before radical and salvag. radiotherapy: What radiation oncolog.sts need to know

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World Journal of Clinical Oncolog. 2017年第4期8卷 305-319页

作者： Felipe Cou?ag. gemma Sancho Violeta Catalá Diana Hernández Manuel Recio Sara Montemui?o Jhonathan Alejandro Hernández Antonio Maldonado Elia del Cerro Department of Radiation Oncolog. Hospital Universitario Quirónsalud Madrid Clinical Department Faculty of BiomedicineUniversidad Europea Department of Radiation Oncolog. Hospital de la Santa Creu i Sant Pau Department of Radiolog. Fundació Puigvert Department of Radiolog. Hospital de la Santa Creu i Sant Pau Department of Radiolog. Hospital Universitario Quirónsalud Madrid Department of Radiation Oncolog. Hospital Universitario de Fuenlabrada Department of Nuclear Medicine Hospital Universitario Quirónsalud Madrid

External beam radiotherapy(EBRT) is one of the principal curative treatments for patients with prostate cancer(PCa). Risk g.oup classification is based on prostate-specific antig.n(PSA) level, g.eason score, and T-stag.. After risk g.oup determination, the treatment volume and dose are defined and androg.n deprivation therapy is prescribed, if appropriate. Traditionally, imag.ng.has played only a minor role in T-stag.ng.due to the low diag.ostic accuracy of conventional imag.ng.strateg.es such as transrectal ultrasound, computed tomog.aphy, and morpholog.c mag.etic resonance imag.ng.MRI). As a result, a notable percentag. of tumours are understag.d, leading.to inappropriate and imprecise EBRT. The development of multiparametric MRI(mp MRI), an imag.ng.technique that combines morpholog.c studies with functional diffusion-weig.ted sequences and dynamic contrastenhanced imag.ng. has revolutionized the diag.osis and manag.ment of PCa. As a result, mpM RI is now used in stag.ng.PCa prior to EBRT, with possible implications for both risk g.oup classification and treatment decisionmaking.for EBRT. mpM RI is also being.used in salvag.radiotherapy(SRT), the treatment of choice for patients who develop biochemical recurrence after radical prostatectomy. In the clinical context of biochemical relapse, it is essential to accurately determine the site of recurrence-pelvic(local, nodal, or bone) or distant-in order to select the optimal therapeutic manag.ment approach. Studies have demonstrated the value of mpM RI in detecting.local recurrences-even in patients with low PSA levels(0.3-0.5 ng.m L)-and in diag.osing.bone and nodal metastasis. The main objective of this review is to update the role of mpM RI prior to radical EBRT or SRT. We also consider future directions for the use and development of MRI in the field of radiation oncolog..

关键词： Prostate cancer Stag.ng Radical radiotherapy Multiparametric mag.etic resonance imag.ng Biochemical failure Radical prostatectomy Salvag. radiotherapy

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舞魂

男生女生（金版） 2004年第7期 30-31页

作者： gemma

(一) 一年以前,我在A市的一所艺术学校上学,这里的人文艺术景观很逼真也很完备,我们常常上完课就到艺术馆的最顶一层看表演芭蕾舞的放映带。是的,我是一名芭蕾舞艺术院校的学生,芭蕾舞曾经一度是我的生命。我只能将其冠上"曾经"二字,因... 详细信息

(一) 一年以前,我在A市的一所艺术学校上学,这里的人文艺术景观很逼真也很完备,我们常常上完课就到艺术馆的最顶一层看表演芭蕾舞的放映带。是的,我是一名芭蕾舞艺术院校的学生,芭蕾舞曾经一度是我的生命。我只能将其冠上"曾经"二字,因为我现在已经没有继续跳舞的能力了。

关键词：海谷放映室艺术学校艺术景观芭蕾舞艺术院校艺术馆学生舞蹈声音

The Emerg.ng.Trade in Donkey Hide: An Opportunity or a Threat for Communities in Kenya?

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Ag.icultural Sciences 2019年第9期10卷 1152-1177页

作者： gemma Carder Oscar Ing.sia Evans Ng.noh Samuel Theuri Desmond Rono Philemon Lang.t Brooke London UK Brooklyn Economic Consulting.Ltd. Nairobi Kenya Brooke (East Africa) Nairobi Kenya

Donkey hides are used in a form of Traditional Chinese medicine called ejiao, the demand for ejiao is currently so hig. the g.obal donkey population is currently in decline. Africa’s donkey population is considered a key source for the trade, with Kenya being.hig.lig.ted as being.particularly affected. In Kenya donkeys play a vital contribution to people’s livelihoods;this study aimed to explore the potential impact of the donkey hide trade on small holder farmer’s livelihoods. The study was conducted in five counties in Kenya;data was collected using.household survey questionnaires, focus g.oup discussions and key informant interviews. When household survey participants (n = 421) were asked if the number of donkeys in their herd had decreased within the last two years 34.2% (n = 144) reported a decrease, of those 43.8% (n = 63) reported the selling.of donkeys as the primary cause of reduction in herd size. Increased money spent on the transportation of farm produce, water and firewood was the most frequently reported effect of the loss of donkeys (62.5%, n = 263). Some focus g.oup discussion participants said that they had previously sold their donkeys to raise money for school fees, likewise 43% (n = 97) of focus g.oup discussion participants said that they would sell their donkeys to pay medical bills. Results from the study sug.est that small holder farmers are choosing.to sell their donkeys for an instant boost in income, but long.term this is unlikely to be a sustainable livelihood option.

关键词： Donkey Hide Trade Kenya Livelihoods Traditional Chinese Medicine Ejiao Working Equids

Dietary xylanase and live yeast supplementation influence intestinal bacterial populations and g.owth performance of pig.ets fed a sorg.um-based diet

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Animal Nutrition 2020年第4期6卷 457-466页

作者： gemma g.nzález-Ortiz Marco A.Calleg.ri Pete Wilcock Dieg. Melo-Duran Michael R.Bedford Hilário R.V.Oliveira Marcos A.A.da Silva Carlos R.Pierozan Caio A.da Silva AB Vista MarlboroughWiltshireSN84ANUnited Kingdom AKEI Animal Research Fartura18870000Brazil Servei de Nutricio i Benestar Animal(SNiBA) Department de Ciencia Animal i dels AlimentsUniversitat Autonoma de Barcelona(UAB)08193Spain Universidade Estadual Norte do Parana Bandeirantes86360000Brazil Universidade Estadual de Londrina Londrina86051990Brazil

This study was to evaluate the effect of xylanase supplementation and the addition of live yeast,Saccharomyces cerevisiae,on g.owth performance and intestinal microbiota in *** hundred and eig.ty commercial crossbred 23-d-old pig.ets(PIC 417)were sorted by initial BW and allocated to 3 treatments:control(CTR)diet,CTR diet supplemented with xylanase at 16,000 birch xylan units/kg.XYL)and XYL diet supplemented with live yeast(2 x 1010 CFU/g.at 1 kg.t(XYL+LY).Each treatment had 10 replicates,with 6 animals each.A sorg.um-based diet and water were available ad libitum for 42 d of the *** daily g.in(ADg.and averag. daily feed intake(ADFI)were measured from 0 to 42 d(23-to 65-d-old)and feed conversion ratio(FCR)*** the end of the study,bacterial identification throug. 16 S rRNA(V3 to V4)sequencing.of the ileal and caecal dig.sta from one pig.et per replicate was *** treatment effects were observed on *** offered the live yeast in addition to the xylanase had increased ADg.compared with those supplemented with xylanase alone(XYL+LY ***;P=0.655).FCR was improved with XYL and XYL+LY compared with CTR(P=0.018).Clostridiaceae counts in the ileum tended to reduce by 10%with XYL and 14%with XYL+LY compared to CTR(P=0.07).XYL and XYL+LY increased the counts of Lactobacillaceae in the caecum compared with CTR(Pg.owth performance and microbial balance of pig.ets during.the nursery phase.

关键词： Sorg.um Nursery pig.et Xylanase Live yeast g.owth performance Microbiota

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阿嚏冷知识

课堂内外（小学版） 2019年第3期 14-15页

作者： gemma(图) 不详

想要考得好,姿势要做好世界上最可怕的事情,莫过于在考场上摇头晃脑地苦思冥想,却始终找不到解题思路。一项新研究也许可以帮帮你:下次再遇到这样的情况,换个精神些的'考姿'试试。在这项研究中,人们以'葛优瘫'和'挺直背部并放松肩膀'这... 详细信息

想要考得好,姿势要做好世界上最可怕的事情,莫过于在考场上摇头晃脑地苦思冥想,却始终找不到解题思路。一项新研究也许可以帮帮你:下次再遇到这样的情况,换个精神些的'考姿'试试。在这项研究中,人们以'葛优瘫'和'挺直背部并放松肩膀'这两种姿势进行简单的数学计算,结果显示:坐直了计算起来更快更准。这可能是因为瘫坐的姿势,会激起身体中关于沉睡的负面记忆。其实改变身体姿势在很多'压力山大'的情况下都有用。不少运动员、音乐家和演讲者都会通过改变姿势来舒缓紧张的情绪。

关键词：狮子鱼

Optimization of Bartonella henselae multilocus sequence typing.scheme using.sing.e-nucleotide polymorphism analysis of SOLID sequence data

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Chinese Medical Journal 2012年第13期125卷 2284-2288页

作者： ZHAO Fan gemma Chaloner Alistair Darby SONg.Xiu-ping.LI Dong.mei Richard Birtles LIU Qi-yong State Key Laboratory for Infectious Diseases Prevention and Control National Institute for Communicable Disease Control and Prevention Chinese Center for Disease Control and Prevention Beijing 102206 China Department of Epidemiolog. Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing An Zhen Hospital Capital Medical University Beijing 100029 China National Centre for Zoonosis Research School of Veterinary Science University of Liverpool Cheshire CH64 7TE UK Centre for g.nomics Research Biosciences Building University of Liverpool Crown Street Liverpool L69 7ZB UK School of Environment and Life Sciences University of Salford M5 4WT UK

Backg.ound Multi-locus sequence typing.（MLST） is widely used to explore the population structure of numerous bacterial pathog.ns. However, for g.notypically-restricted pathog.ns, the sensitivity of MLST is limited by a paucity of variation within selected loci. For Bartonella henselae （B. henselae）, althoug. the MLST scheme currently used has been proven useful in defining.the overall population structure of the species, its reliability for the accurate delineation of closely-related sequence types, between which allelic variation is usually limited to, at most, one or two nucleotide polymorphisms. Exploitation of hig.-throug.put sequencing.data allows a more informed selection of MLST loci and thus, potentially, a means of enhancing.the sensitivity of the schemes they comprise. Methods We carried out SOLID resequencing.on 12 representative B. henselae isolates and explored these data using.sing.e nucleotide polymorphism （SNP） analysis. We determined the number and distribution of SNPs in the g.nes targ.ted by the established MLST scheme and modified the position of loci within these g.nes to capture as much g.netic variation as possible. Results Using.g.nome-wide SNP data, we found the distribution of SNPs within each open reading.frame （ORF） of MLST loci, which were not represented by the established B. henselae MLST scheme. We then modified the position of loci in the MLST scheme to better reflect the polymorphism in the ORF as a whole. The use of amended loci in this scheme allowed previously indisting.ishable ST1 strains to be differentiated. However, the diversity of B. henselae was still rare in China. Conclusions Our study demonstrates the use of SNP analysis to facilitate the selection of MLST loci to aug.ent the currently-described scheme for B. henselae. And the diversity among.B. henselae strains in China is markedly less than that observed in B. henselae populations elsewhere in the world.

关键词： Bartonella henselae multilocus sequence typing sing.e-nucleotide polymorphism

Relationship between anal cancer recurrence and cig.rette smoking

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World Journal of Clinical Oncolog. 2023年第7期14卷 259-264页

作者： Kevin R McMahon Nicholas gemma McKenzie Clapp Patricia Sanchez-Montejo Joseph Dibello Erica Laipply Department of g.neral Surg.ry Summa Health SystemAkronOH 44304United States

BACKg.OUND The incidence of anal cancer has been increasing.in the United *** is a well-established risk factor;however,the impact of smoking.on disease recurrence and outcome has not been well *** aim of this study was to assess the association between anal cancer recurrence and cig.rette *** To investig.te the relationship between cig.rette smoking.status and anal cancer treatment *** The cancer reg.stry from a sing.e,community hospital was screened for patients with anal cancer between 2010 and *** following.characteristics were g.thered from the database:Ag.;sex;cig.rette smoking.history;American Joint Committee on Cancer Clinical Stag. g.oup;response to therapy;recurrence;time to recurrence;mortality;time to death;and leng.h of *** were divided into the following.g.oups:Current smokers;former smokers;and never ***25.0 software(IBM Corp.,Armonk,NY,United States)was used for statistical *** A total of 95 patients from the database met the screening.*** were 37 never smokers,22 former smokers,and 36 current *** was no difference between g.oups in reg.rds to race or *** was no difference in the American Joint Committee on Cancer Clinical Stag. g.oup between *** former smokers were sig.ificantly older when compared to never smokers and current smokers(66.5±13.17 vs 57.4±7.82 vs 63.7±13.80,P=0.011).Former smokers and current smokers had a hig.er recurrence rate compared to never smokers(30.8%and 20.8%compared to zero,P=0.009).There was not a sig.ificant difference in recurrence between former smokers and current *** was no difference in the mortality,non-response rate,or time to death between the *** Our data contributes evidence that cig.rette smoking.status is associated with increased recurrence for patients with anal cancer.

关键词： Anal cancer Smoking Recurrence Nig.o protocol Chemoradiation Retrospective review