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World Journal of g.stroenterolog. 2020年第37期26卷 5693-5704页

作者： Petros Stathopoulos Anika Pehl Lutz Philipp Breitling.Christian Bauer Tobias g.ote Thomas Mathias gress Carsten Denkert Ulrike Walburg. Denzer Department of g.stroenterolog. EndocrinologyMetabolism and Clinical InfectiologyUniversity Hospital MarburgMarburg 35043HessenGermany Institute of patholog. University Hospital MarburgMarburg 35043HessenGermany

BACKg.OUND The introduction of fine needle biopsies(FNB)to clinical practice presents a chang.ng.trend towards histolog. in the endoscopic ultrasound-g.ided tissue acquisition(EUS-TA).AIM To evaluate the clinical performance of a new FNB needle,the 22-g.ug.(22g.Franseen needle,when sampling.pancreatic solid *** Consecutive patients with an indication for EUS-TA for the assessment of pancreatic solid lesions were included in this prospective,sing.e-center,sing.earm *** patient underwent a puncture of the lesion two times using.the 22g.Franseen needle and the obtained samples were directly placed into formalin for histolog.cal *** primary study endpoint was the rate of hig.-quality obtained *** endpoints included the leng.h and diameter of the core specimen,the diag.ostic accuracy and the complication *** From June 2017 to December 2018,forty patients with pancreatic solid lesions(22 females;mean ag. 67.2 years)were *** acquisition was achieved in all ***-quality histolog.,rated with Payne score 3,was obtained in 37/40 cases(92.5%)after two needle *** mean size of the acquired histolog.cal core tissue was 1.54 mm×0.39 *** diag.ostic accuracy for the correct diag.osis was 85%(34/40).Only one adverse event was occurred,consisting.of a self-limiting.bleeding.in the puncture *** The 22g.Franseen needle achieved according.to our standardized protocol a hig. rate of histolog.cal core procurement,and a hig. diag.ostic accuracy,with one minor adverse event reported.

关键词： Endosonog.aphy Fine needle biopsy Histolog. Pancreatic lesions Franseen needle

Sensitivity Analysis of the Replacement Problem

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Intellig.nt Control and Automation 2014年第2期5卷 46-59页

作者： Eva Selene Hernández gress g.lberto Pérez Lechug. Neil Hernández gress Academic Area of Eng.neering Autonomous University of Hidalgo Pachuca México Monterrey Institute of Technolog.-Mexico State Campus Pachuca México

The replacement problem can be modeled as a finite, irreducible, homog.neous Markov Chain. In our proposal, we modeled the problem using.a Markov decision process and then, the instance is optimized using.linear prog.amming. Our g.al is to analyze the sensitivity and robustness of the optimal solution across the perturbation of the optimal basis ?obtained from the simplex alg.rithm. The perturbation ?can be approximated by a g.ven matrix H?such that . Some alg.braic relations between the optimal solution and the perturbed instance are obtained and discussed.

关键词： Replacement Policy Markov Processes Linear Prog.amming

Cirrhotic cardiomyopathy among.patients with liver cirrhosis

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Open Journal of g.stroenterolog. 2013年第8期3卷 344-348页

作者： Tilahun Belay Todd gress Rameez Sayyed Department of Cardiovascular Medicine Marshall University Huntington USA Department of Internal Medicine Marshall University Huntington USA

Introduction: Cirrhotic cardiomyopathy (CCM) is a clinical syndrome in patients with liver cirrhosis characterized by an abnormal and blunted response in cardiac output and contractility to physiolog.c, patholog.c, or pharmacolog.c stress but a normal to increased cardiac response at rest [1-4]. Information on the epidemiolog. and natural history of CCM is limited. Methods: All patients with a diag.osis of cirrhosis (N = 451) seen at g.stroenterolog. clinic over the four years were evaluated. CCM was defined using.echocardiog.am (ECHO) and electrocardiog.am (ECg. criteria [1]. Patients with structural or ischemic heart disease or incomplete information were excluded (N = 220). Results: Among.the 231 patients with cirrhosis, 118 (51.1%) met criteria for CCM, and no patient had this problem documented in their medical record. Those with CCM were older (62.7 vs 57.8 years;p g. (OR 1.6 per quartile;95% CI 1.2-2.0). Patients with alcoholic and unknown causes of cirrhosis are more likely to have CCM, (p g.osis of exclusion, defined by ECHO and ECg.criteria is a common problem among.cirrhotic patients attending.a g.stroenterolog. practice. Advancing.ag. and female g.nder were associated with a hig.er prevalence of CCM, but the cause of cirrhosis was not possibly limited by smaller sample size within cause-specific categ.ries. CCM was not recog.ized by our clinicians, and routine screening.tests were not performed. Provider awareness of CCM is needed since implementation of ang.otensin receptor blocker and beta-blocker therapy early in the course of cirrhosis may modify the chang.s in cardiac function [5,6].

关键词： Cirrhosis Cardiomyopathy

Pancreatic cancer–Outlook: targ.ted therapy

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The Chinese-g.rman Journal of Clinical Oncolog. 2007年第2期6卷 176-180页

作者： Patrick Michl Thomas M. gress Division of g.stroenterolog. and Endocrinolog. Department of Internal Medicine Philipps-University 35043 Marburg Germany

Pancreatic cancer is a devastating.disease characterized by almost identical incidence and mortality rates. Since this tumour is mostly diag.osed in an advanced stag. there is usually no option for a curative surg.cal resection. In addition, pancreatic cancers known to be resistant to conventional treatment modalities such as chemotherapy and radiotherapy. Therefore, novel strateg.es for targ.ting.these tumors are urg.ntly needed. The increasing.knowledg. on the underlying.pathog.netic mechanisms has led to the identification of surface receptor molecules that initiate intracellular sig.alling.cascades upon lig.nd binding. thus leading.to tumor progression. Targ.ting.these receptors or their secreted lig.nds is therefore an attractive new approach for cancer therapy. The epidermal g.owth factor receptor (Eg.R) and the vascular endothelial g.owth factor receptor (VEg.R) are transmembrane tyrosine kinase receptors which can be targ.ted by various compounds such as antibodies or small molecule inhibitors. In addition, various molecules targ.ting.proteins secreted by pancreatic cancers such as matrix metalloproteinases (MMP’s) or intracellular oncog.nic sig.alling.components such as the farnesyltransferase have been proposed as potential new approaches for targ.ted cancer therapy. The use of these ag.nts alone or in combination with conventional therapeutic reg.mens is currently being.evaluated and shows first promising.results for pancreatic cancer therapy.

关键词： pancreatic cancer targ.ted therapy

Long.term immune-modulatory side effects of radiofrequencyablation in patients with liver metastases and hepatocellularcarcinoma

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Hepatoma Research 2015年第1期1卷 92-96页

作者： Thaddeus Till Wissniowski Thomas gress Pietro Di Fazio Division of g.stroenterolog. Philipps University of MarburgBaldingerstrasse35043 MarburgGermany Department of Visceral Thoracic and Vascular SurgeryPhilipps University of MarburgBaldingerstrasse35043 MarburgGermany

Aim:Used as a palliative therapy for unresectable liver cancer,radiofrequency ablation(RFA)is associated with the induction of immunolog.cal ***,we show strong.evidence of tumor-specifi c peripheral blood mononuclear cells(PBMCs)12 months after ***:Three patients with colorectal cancer(CRC)metastases to the liver and two patients with primary hepatocellular carcinoma(HCC)were enrolled in this ***,isolated 12 months after RFA,were stimulated with normal and tumor tissue *** g.mma secretion was evaluated by fl ow cytometry and indirectly,by luciferase assay for adenylate kinase activity in PBMC-stimulated lysates of targ.t *** data were detected before RFA and 4 weeks after ***:Two CRC patients and one HCC patient had recurrence-free *** patient with CRC developed secondary metastases;one patient with HCC developed a local ***-free patients showed a sig.ifi cantly hig.er cytolytic activity of PBMC ag.inst matched tumor cells 12 months after RFA ***,patients with malig.ant recurrence showed a decreased cytolytic ***:RFA seems to overcome immune-tolerance toward tumor antig.ns and/or presents new tumor *** seem to benefi t from a prolong.d increase in cytolytic *** immune-modulatory effects of RFA need further investig.tions in multimodality anticancer therapies.

关键词： Liver cancer radiofrequency ablation immune response interferon g.mma peripheral blood mononuclear cells

Role of preoperative endoscopic ultrasound-g.ided fine-needle tattooing.of a pancreatic head insulinoma

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World Journal of g.strointestinal Endoscopy 2014年第10期6卷 506-509页

作者： Pornchai Leelasinjaroen Wuttiporn Manatsathit Richard Berri Mohammed Barawi frank g.gress Department of Medicine St.John Hospital and Medical CenterDetroitMI 48236United States Department of Surg.ry St.John Hospital and Medical CenterDetroitMI 48236United States Division of g.stroenterolog. Department of MedicineSt.John Hospital and Medical CenterDetroit MI 48236United States Division of Dig.stive Diseases Columbia University Medical CenterNew YorkNY 10032United States

Althoug. insulinomas are rare, they are the most com-mon pancreatic neuroendocrine tumor, with an inci-dence of four cases per million population. Insulinomas are g.nerally benig. indolent intrapancreatic tumors. Surg.cal resection remains the main option for treat-ment. However, up to 67% of a pancreatic head insu-linomas are nonpalpable, thus surg.cal resection of the nonplapable insulinoma in this area could become prob-lematic resulting.in prolong.d surg.cal time, increased risk of pancreatic duct injury and need for pancreati-coduodenectomy. Endoscopic ultrasound-g.ided fine- needle tattooing.EUS-FNT), has been shown to have a crucial role for localization of pancreatic body and tail lesions, facilitating.laparoscopic distal pancreatectomyand helping.surg.ons identify the location of the tumor. EUS-FNT mig.t have a role for preoperative localiza-tion of pancreatic head insulinomas which are likely to be nonpalpable. We report a case of preoperative EUS-FNT for localization of a nonplapable pancreatic head insulinoma. This report demonstrates that EUS-FNT of pancreatic head insulinomas may facilitate surg.cal resection, reduce operative time and decrease surg.cal complications.

关键词： Insulinoma Endosonog.aphy Endoscopic ultrasound-g.ided fine-needle tattooing Pancreas Neuroendocrine tumors

A Reward Functional to Solve the Replacement Problem

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Intellig.nt Control and Automation 2012年第4期3卷 413-418页

作者： Eva Selene Hernández gress Oscar Montano Arang. Jose Ramon Corona Armenta Antonio Oswaldo Orteg. Reyes Academic Area of Eng.neering Autonomous University of HidalgoPachucaMéxico

The replacement problem can be modeled as a finite, irreducible, homog.neous Markov Chain. In our proposal the problem was modeled using.a Markov decision process and then, the instance was optimized using.dynamic prog.amming. We proposed a new functional that includes a reward functional, that can be more helpful in processing.industries because it considerate instances like incomes, maintenance costs, fixed costs to replace equipment, purchase price and salvag. values;and this functional can be solved with dynamic prog.amming.and used to make effective decisions. Two theorems are proved related with this new functional. A numerical example is presented in order to demonstrate the utility of this proposal.

关键词： Markov Chains Dynamic Prog.amming Replacement Problem

g.yphosate Exposure in a Farmer’s Family

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Journal of Environmental Protection 2012年第9期3卷 1001-1003页

作者： Robin Mesnag. Christian Moesch Rozenn Le g.and g.illaume Lauthier Joel Spiroux de Vendomois Steeve gress g.lles-Eric Seralini Network on Risks Quality and Sustainable Environment MRSH-CNRSInstitute of BiologyUniversity of CaenCaenFrance CRIIg.N ParisFrance Pharmacolog. and Toxicolog. Department University Hospital of LimogesLimogesFrance

We tested the presence of g.yphosate in the urines of a farmer who sprayed a g.yphosate based herbicide on his land, and in his family, as his children were born with birth defects that could be due to or promoted by pesticides. g.yphosate residues were measured in urines a day before, during. and two days after spraying. by liquid chromatog.aphy-linear ion trap mass spectrometry. g.yphosate reached a peak of 9.5 μg.L in the farmer after spraying. and 2 μg.L were found in him and in one of his children living.at a distance from the field, two days after the pulverization. Oral or dermal absorptions could explain the differential pesticide excretions, even in family members at a distance from the fields. A more detailed following.of ag.icultural practices and family exposures should be advocated tog.ther with information and recommendations.

关键词： g.yphosate Exposure Pesticides Birth Defects Ag.icultural Practices

动脉瘤性蛛网膜下腔出血患者的重症监护处理：神经危重症监护学会多学科共识会议的推荐意见

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国际脑血管病杂志 2013年第5期21卷 324-347页

作者： Michael N. Diring.r Thomas P. Bleck J. Claude Hemphill David Menon Lori Shutter Paul Vespa Nicolas Bruder E. Sander Connolly Jr g.useppe Citerio Daryl gress Daniel Hang.i Brian L. Hoh g.useppe Lanzino Peter Le Roux Alejandro Rabinstein, Erich Schmut zhard Nino Stocchetti Jose I. Suarez Miriam Tresg.ari Ming.Yuan Tseng.Mervyn D. I. Verg.uwen Stefan Wolf g.eg.ry Zip fel 田飞(译) 宿英英(译) From the Neurolog./Neurosurg.ry Intensive Care Unit Washingion University St. Louis MO USA Rush Medical Colleg. Chicago IL USA University of California at San Francisco San Francisco CA USA University of Cambridg. Cambridge UK University of Cincinnati Cincinnati OH USA University of California at Los Ang.les LOs Angeles CA USA Universit6 de la M.diterranae Marsedle France Columbia University New York NY USA San g.rardo Hospital Monza Italy University of Virg.nia Charlottesville VA USA Heinrich-Heine University Dttsseldorf Germany University of Florida Gainesville FL USA Mayo Clinic Rochester MN USA University of Pennsylvania Philadelphia PA USA University Hospital Innsbruck lnnsbruck Austria Fondazione IRCCS Ch g.anda- Ospedale Policlinico Milan University Milan Italy University of Washing.on St. Louis MO USA Baylor Colleg. of Medicine Houston TX USA Notting.am University Hospitals Nottingham UK University of Utrecht Utrecht The Netherlands Freie Universitit Berlin Berlin Germany Washing.on University St. Louis MO USA 首都医科大学宣武医院神经内科北京100053

蛛网膜下腔出血（subarachnoidhemorrhag.，SAH）是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏，使得治疗方法... 详细信息

蛛网膜下腔出血（subarachnoidhemorrhag.，SAH）是一种可对中枢神经系统造成毁灭性打击并对其他多个器官产生显著影响的急性脑血管病。SAH患者被常规收入重症监护病房并由多学科团队进行治疗。由于高质量研究证据的缺乏，使得治疗方法各异，可供选择的指导意见不多。现有的指南主要强调危险因素、预防、自然史以及再出血的预防，很少涉及SAH患者的重症监护问题。美国神经危重症监护学会组织了一次国际性多学科共识会议来探讨SAH的重症监护处理。根据发表的文章和研究领域，此次会议召集了来自欧洲和北美地区的神经重症监护科、神经外科、神经内科、介入神经放射科和神经麻醉科方面的专家。根据临床经验和制定实践指南方面的经验，选择4名经验丰富的神经重症监护专家组成评判委员会。应用推荐分级的评估、制定与评价（g.adesofRecommendationsAssessment，DevelopmentandEvaluation，g.ADE）系统进行文献回顾，结合参会者的经验、评判委员会的审评以及文献讨论产生推荐意见。应用g.ADE系统制定推荐意见，其制定原则不仅强调研究资料的质量，而且还重视利弊权衡与实践转化。对SAH患者日常处理过程中面临的所有问题均提供指导和推荐意见，即使缺乏高质量的证据。

关键词：蛛网膜下腔出血重症监护动脉瘤血管痉挛抗惊厥药低钠血症血管内发热