检索结果-南通市图书馆

Optimizing outcomes for patients with gastric cancer peritoneal carcinomatosis

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2018年第10期10卷 282-289页

作者： jennifer l leiting Travis E Grotz Division of Hepatobiliary and Pancreas Surgery Mayo Clinic

Peritoneal carcinomatosis (PC) from gastric cancer has traditionally been considered a terminal progression of the disease and is associated with poor survival out-comes. Positive peritoneal cytology similarly worsens the survival of patients with gastric cancer and treatment options for these patients have been limited. Recent ad-vances in multimodality treatment regimens have led to innovative ways to care for and treat patients with this disease burden. One of these advances has been to use neoadjuvant therapy to try and convert patients with positivecytologyorlow-volume PC to negative cytolo-gy with no evidence of active peritoneal disease.These strategies include the use of neoadjuvant systemic chemotherapy alone,using neoadjuvant laparoscopic heated intraper itoneal chemotherapy(NlHIPEC)after systemic chemotherapy,or using neoadjuvant intra-peritoneal and systemic chemother apy(NIPS)in a bi-dir ectional manner. For patients with higher volume PC,cytoreductive surgery (CRS) and hyperthermic intrape-ritoneal chemotherapy(HIPEC)have been mainstays of treatment. When used together, CRS and HIPEC can improve overall outcomes in properly selected patients,but overall survival outcomes remain unacceptably low.The extent of peritoneal disease, commonly measured by the peritoneal carcinomatosis index (PCI), and the com-pleteness of cytor eduction,has been shown to greatly impact outcomes in patients undergoing CRS and HIPEC.The uses of NlHIPEC and NlHIPEC plus NIPS have both been shown to decrease the PCI and thus increase the opportunity for complete cytoreduction. Newer therapies like pressurized intraperitoneal aerosol chemother apy and immunotherapy, such as catumaxomab, along with improved systemic chemotherapeutic regimens, are being explored with great interest.There is exciting progress being made in the management of PC from gastric can-cer and its’ treatment is no longer futile.

关键词： Peritoneal carcinomatosis index Peritoneal carcinomatosis Gastric cancer Cytoreductive surgery Heated intraperitoneal chemotherapy Neoadjuvant intraperitoneal and systemic chemotherapy

Comparison of open and closed hyperthermic intraperitoneal chemotherapy: Results from the United States hyperthermic intraperitoneal chemotherapy collaborative

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastrointestinal Oncology 2020年第7期12卷 756-767页

作者： jennifer l leiting Jordan M Cloyd Ahmed Ahmed Keith Fournier Andrew J lee Sophie Dessureault Seth Felder Jula Veerapong Joel M Baumgartner Callisia Clarke Harveshp Mogal Charles A Staley Mohammad Y Zaidi Sameer H Patel Syed A Ahmad Ryan J Hendrix laura lambert Daniel E Abbott Courtney Pokrzywa Mustafa Raoof Christopher J laRocca Fabian M Johnston Jonathan Greer Travis E Grotz Division of Hepatobiliary and Pancreas Surgery Mayo ClinicRochesterMN 55901United States Division of Surgical Oncology Department of SurgeryThe Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of Surgical Oncology University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Gastrointestinal Oncology Moffitt Cancer CenterDepartment of Oncologic SciencesMorsani College of MedicineTampaFL 33612United States Division of Surgical Oncology Department of SurgeryUniversity of CaliforniaSan DiegoCA 92093United States Division of Surgical Oncology Department of SurgeryMedical College of WisconsinMilwaukeeWI 53226United States Division of Surgical Oncology Winship Cancer InstituteEmory UniversityAtlantaGA 30322United States Department of Surgery University of Cincinnati College of MedicineCincinnatiOH 45267United States Division of Surgical Oncology Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterMA 01655United States Peritoneal Surface Malignancy Program Section of Surgical Oncology Huntsman Cancer InstituteUniversity of UtahSalt Lake CityUT 84112United States Division of Surgical Oncology Department of SurgeryUniversity of WisconsinMadisonWI 53792United States Christopher la Rocca Division of Surgical OncologyDepartment of SurgeryCity of Hope National Medical CenterDuarteCA 91010United States Department of Surgery Johns Hopkins UniversityBaltimoreMD 21287United States

BACKGROUND Cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)for peritoneal carcinomatosis can be performed in two ways:Open or closed abdominal technique.AIM To evaluate the impact of HIPEC method on post-operative and long-term survival outcomes.METHODS Patients undergoing CRS with HIPEC from 2000-2017 were identified in the United States HIPEC collaborative database.Post-operative,recurrence,and overall survival outcomes were compared between those who received open vs closed HIPEC.RESUlTS Of the 1812 patients undergoing curative-intent CRS and HIPEC,372(21%)patients underwent open HIPEC and 1440(79%)underwent closed HIPEC.There was no difference in re-operation or severe complications between the two groups.Closed HIPEC had higher rates of 90-d readmission while open HIPEC had a higher rate of 90-d mortalities.On multi-variable analysis,closed HIPEC technique was not a significant predictor for overall survival(hazards ratio:0.75,95%confidence interval:0.51-1.10,P=0.14)or recurrence-free survival(hazards ratio:1.39,95%confidence interval:1.00-1.93,P=0.05)in the entire cohort.These findings remained consistent in the appendiceal and the colorectal subgroups.CONClUSION In this multi-institutional analysis,the HIPEC method was not independently associated with relevant post-operative or long-term outcomes.HIPEC technique may be left to the discretion of the operating surgeon.

关键词： Mucinous appendiceal carcinoma Cytoreductive surgery Multi-institutional

Pancreatic surgery and tertiary pancreatitis services warrant provision for support from a specialist diabetes team

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Diabetes 2024年第4期15卷 598-605页

作者： Vasileios K Mavroeidis jennifer Knapton Francesca Saffioti Daniel l Morganstein Department of HPB Surgery Bristol Royal InfirmaryUniversity Hospitals Bristol and Weston NHS Foundation TrustBristol BS28HWUnited Kingdom Department of Gastrointestinal Surgery Southmead HospitalNorth Bristol NHS TrustBristol BS105NBUnited Kingdom Department of Academic Surgery Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom Department of Gastroenterology and Hepatology Oxford University Hospitals NHS Foundation TrustOxford OX39DUUnited Kingdom UCl Institute for liver and Digestive Health University College LondonLondon NW32PFUnited Kingdom Department of Endocrinology Chelsea and Westminster Hospital NHS Foundation TrustLondon SW109NHUnited Kingdom Department of Gastrointestinal Unit Royal Marsden NHS Foundation TrustLondon SW36JJUnited Kingdom

Pancreatic surgery units undertake several complex operations,albeit with consi-derable morbidity and mortality,as is the case for the management of complicated acute pancreatitis or chronic pancreatitis.The centralisation of pancreatic surgery services,with the development of designated large-volume centres,has contribu-ted to significantly improved outcomes.In this editorial,we discuss the complex associations between diabetes mellitus(DM)and pancreatic/periampullary disease in the context of pancreatic surgery and overall management of complex pancreatitis,highlighting the consequential needs and the indispensable role of specialist diabetes teams in support of tertiary pancreatic services.Type 3c pan-creatogenic DM,refers to DM developing in the setting of exocrine pancreatic disease,and its identification and management can be challenging,while the glycaemic control of such patients may affect their course of treatment and outcome.Adequate preoperative diabetes assessment is warranted to aid identification of patients who are likely to need commencement or escalation of glucose lowering therapy in the postoperative period.The incidence of new onset diabetes after pancreatic resection is widely variable in the literature,and depends on the type and extent of pancreatic resection,as is the case with pancreatic parenchymal loss in the context of severe pancreatitis.Early involvement of a specialist diabetes team is essential to ensure a holistic management.In the current era,large volume pancreatic surgery services commonly abide by the principles of enhanced recovery after surgery,with inclusion of provisions for optimisation of the perioperative glycaemic control,to improve outcomes.While various guidelines are available to aid perioperative management of DM,auditing and quality improvement platforms have highlighted deficiencies in the perioperative management of diabetic patients and areas of required improvement.The need for perioperative support of diabetic patients by specialist diabetes teams is uniform

关键词： Pancreatectomy Pancreatoduodenectomy Whipple’s Pancreatitis Diabetes specialist Type 3c pancreatogenic diabetes mellitus

Implementation of an international medical student pen-pal club:survey outcomes of perceptions in cultural competency and global health

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Global Health Journal 2024年第1期8卷 11-15页

作者： Max J.Goodman jennifer livschitz Ji Won Kim Megan l.Schultz Medical College of Wisconsin MilwaukeeWI 53226USA Department of Pediatrics Division of Emergency MedicineMedical College of WisconsinMilwaukeeWI53226USA

Background:Pen-pal clubs(PPC)are used worldwide for students to learn about different cultures and other skillsets without the need for travel.Many medical students are interested in global health opportunities abroad but costs,scheduling,and other barriers allow few to participate in such experiences.It is important that medical students have nuanced global medical perspectives and can contribute to the global medical community.Objective:The purpose of this study is to demonstrate that an international medical student PPC improves medical students'perspectives of cultural competency and global health engagement.Methods:In 2021,a novel medical student PPC was established that began between an American and Japanese medical school.Following a shareholders meeting,it was decided that the number of medical schools involved globally be expanded through previous institutional affiliations and online presences.In total,the club connected 50 American medical students and 52 medical students from 17 high-and middle-income countries.The primary form of communication was online;pen-pals were encouraged to communicate monthly using provided topics,although frequency and way of communication was their discretion.In February 2022,American PPC members were emailed a qualitative survey to assess the PPC's impact.Results:The survey was completed by 42%of American PPC members,95%of which were 22-26 years.Participants were preclinical medical students,60%whom were female and the majority either white(47%)or Asian(43%).Overall,the PPC positively influenced American medical students'perception of global medicine,medical education,and their cultural competency after joining the PPC compared to prior(P=0.004).Conclusion:PPCs encourage medical students to think from a global perspective and foster open-mindedness within varying social and cultural contexts.Having a global communication platform for students during medical school education may be an additional way to train aspiring global leaders.

关键词： Pen-pals Medical student Global health Cultural competency

Are there sex-based disparities in cataract surgery?

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

International Journal of Ophthalmology(English edition) 2024年第1期17卷 137-143页

作者： Matthew D.Geiger Anne M.lynch Alan G.Palestine Nathan C.Grove Karen l.Christopher Richard S.Davidson Michael J.Taravella Naresh Mandava jennifer l.Patnaik Department of Ophthalmology University of Colorado School of MedicineAuroraCO 80045USA

AIM:To investigate sex-based differences in the occurrence of intra-operative and post-operative complications and associated visual outcomes following cataract surgery.METHODS:This was a retrospective study of patients who had phacoemulsification cataract surgery at the University of Colorado School of Medicine.Data collected included the patient’s health history,ocular comorbidities,operative and post-operative complications,and the post-operative best corrected visual acuity(BCVA).The data were analyzed using univariate and multivariable logistic regression with generalized estimating equations to account for the correlation of some patients having two eyes included in the study.RESUlTS:A total of 11977 eyes from 7253 patients were included in the study.Ocular comorbidities differed by sex,with males having significantly higher percentages of traumatic cataracts(males 0.7%vs females 0.1%),prior ocular surgery(6.7%vs 5.5%),and mature cataracts(2.8%vs 1.9%).Conversely,females had significantly higher rates of pseudoexfoliation(2.0%vs 3.2%).In unadjusted analysis,males had higher rates of posterior capsular rupture(0.8%vs 0.4%)and vitreous loss(1.0%vs 0.6%),but this difference was not significant after adjustment for confounders.Males had a significantly increased risk of post-operative retinal detachment,but in multivariable analysis this was no longer significant.Males were significantly less likely to undergo post-operative neodymium-doped yttrium aluminum garnet(Nd:YAG)laser capsulotomy for posterior capsule opacification(OR=0.8,95%CI=0.7-0.9,P=0.0005).The BCVA was slightly worse for males pre-operatively;but post-operatively,both sexes exhibited similar visual acuity of Snellen equivalent 20/25.CONClUSION:The study finds that in a cohort of patients presenting for cataract surgery,sex differences exist in pre-operative comorbidities and surgical characteristics that contribute to higher rates of some complications for males.However,observed surgical complication rates exhibit almost no difference by sex afte

关键词： cataract surgery sex-based disparity phacoemulsification outcomes

How completely are randomized controlled trials of non-pharmacological interventions following concussion reported? A systematic review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Journal of Sport and Health Science 2024年第4期13卷 537-547页

作者： Jacqueline Josee van Ierssel Olivia Galea Kirsten Holte Caroline luszawski Elizabeth Jenkins jennifer O’Neil Carolyn A Emery Rebekah Mannix Kathryn Schneider Keith Owen Yeates Roger Zemek Children’s Hospital of Eastern Ontario Research Institute OttawaON K1H 8L1Canada The Centre for Health Activity and Rehabilitation ResearchUniversity of OtagoDunedin 9016New Zealand Sport Injury Prevention Research Centre Faculty of KinesiologyUniversity of CalgaryCalgaryAB T2N 1N4Canada Alberta Children’s Hospital Research Institute University of Calgary CalgaryAB T2N 1N4Canada Hotchkiss Brain Institute University of CalgaryCalgaryAB T2N 4N1Canada Department of Psychology University of CalgaryCalgaryAB T2N 1N4Canada g Faculty of MedicineUniversity of OttawaOttawaON K1H 8M5Canada School of Rehabilitation Sciences University of OttawaOttawaON K1H 8M5Canada Bruyere Research Institute OttawaON K1N 5C8Canada Departments of Pediatrics and Emergency Medicine Harvard Medical SchoolBostonMA 02115USA Departments of Pediatrics and Emergency Medicine University of OttawaOttawaON K1H 8M5Canada

Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDlINE,Embase,PsycInfo,CINAHl,and Web of Science up to May 2022.Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)checklists.Additional information was sought my study authors where reporting was incomplete.Risk of bias(ROB)was assessed with the Cochrane ROB-2 Tool.RCTs examining non-pharmacological interventions following concussion.Results:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck cooling.Median scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified supervisor.Reporting completeness improved after TIDieR and CERT publication,but publication in highly cited journals and low ROB

关键词： Concussion Intervention Randomized controlled trial Systematic review

A rat model of multicompartmental traumatic injury and hemorrhagic shock induces bone marrow dysfunction and profound anemia

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Animal Models and Experimental Medicine 2024年第3期7卷 367-376页

作者： lauren S.Kelly jennifer A.Munley Erick E.Pons Kolenkode B.Kannan Elizabeth M.Whitley letitia E.Bible Philip A.Efron Alicia M.Mohr Department of Surgery and Sepsis and Critical Illness Research Center University of Florida College of MedicineGainesvilleFloridaUSA Pathogenesis LLCGainesvilleFloridaUSA

Background:Severe trauma is associated with systemic inflammation and organ dysfunction.Preclinical rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human trauma.The aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic injury.Methods:Male Sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(lCHS),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve controls.Weight,plasma toll-l ike receptor 4(TlR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(CFU-GEMM,BFU-E,and CFU-E)growth,plasma granulocyte colony-stimulating factor(G-CSF)and right lung histologic injury were assessed on day 7,with significance defined as p valueslts:Polytrauma resulted in markedly more profound inhibition of weight gain compared to lCHS(p=0.0002)along with elevated plasma TlR4(plower hemoglobin(plarged spleen to body weight ratios(p=0.004).Both lCHS and PT demonstrated suppression of CFU-E and BFU-E growth compared to naive(plasma G-CSF was elevated in PT compared to both na?ve and lCHS(plCHS and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial edema.Conclusions:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe model.This may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.

关键词： anemia i nflammation polytrauma pseudofracture shock

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

苛碱体系低模数硅酸钠溶液的结构

中南大学学报（自然科学版） 2024年第4期55卷 1281-1290页

作者：连选彭志宏申雷霆齐天贵周秋生李小斌刘桂华中南大学冶金与环境学院湖南长沙410083

通过红外光谱测试技术,研究二氧化硅质量浓度、模数以及放置时间对苛碱体系低模数m(m≤1)硅酸钠溶液结构的影响,比较纯硅酸钠溶液和预脱硅溶液在结构上的差异。研究结果表明:苛碱体系预脱硅溶液结构与纯硅酸钠溶液结构相似,模数0.75≤m... 详细信息

通过红外光谱测试技术,研究二氧化硅质量浓度、模数以及放置时间对苛碱体系低模数m(m≤1)硅酸钠溶液结构的影响,比较纯硅酸钠溶液和预脱硅溶液在结构上的差异。研究结果表明:苛碱体系预脱硅溶液结构与纯硅酸钠溶液结构相似,模数0.75≤m≤1.00,ρ(SiO2)≤20 g/l的硅酸钠溶液主要含有硅氧环状和三元环状这2种复杂阴离子;模数m≤0.50、30≤ρ(SiO2)≤50 g/l的硅酸钠溶液以单体和线型这2种简单形态出现;钠硅渣形成过程主要消耗单体硅酸根离子,ρ(SiO2)=50 g/l左右的预脱硅溶液结构稳定,溶液中的铝酸根离子不会影响硅酸根离子结构。

关键词：苛碱体系纯硅酸钠溶液预脱硅溶液结构红外光谱

二抗物种特异性对双色STORM成像的影响(特邀)

同方期刊数据库博看期刊评论

在线全文

学校读者我要写书评

暂无评论

激光与光电子学进展 2024年第6期61卷 145-152页

作者：邓师禹胡芬侯梦迪杨建宇李任植潘雷霆弱光非线性光子学教育部重点实验室南开大学物理科学学院泰达应用物理研究院天津300071 药物化学生物学全国重点实验室南开大学生命科学学院细胞应答交叉科学中心天津300071 南开大学深圳研究院广东深圳518083 极端光学协同创新中心山西大学山西太原030006

随机光学重建显微术(STORM)基于免疫荧光标记技术,具有原理易懂、光路简单、分辨率极高等特点,一直受到科研工作者的青睐,但分辨率的提升对抗体的特异性提出了更高的要求。相较一抗直接标记,“一抗+二抗”的间接标记法在实际应用中普适... 详细信息

随机光学重建显微术(STORM)基于免疫荧光标记技术,具有原理易懂、光路简单、分辨率极高等特点,一直受到科研工作者的青睐,但分辨率的提升对抗体的特异性提出了更高的要求。相较一抗直接标记,“一抗+二抗”的间接标记法在实际应用中普适性更强。二抗相对一抗存在物种特异性的问题,生产时需要对其进行预吸附来提升物种特异性。为了探究二抗物种特异性对双色STORM成像的影响,基于经典的红细胞骨架模型中血影蛋白N端和C端的互斥位置关系,对二者使用高、低吸附二抗标记后分别进行双色STORM成像,对照模拟中有无信号串扰条件下的互相关分析结果,结果表明低吸附二抗会造成二者共定位的假象。进一步,分别通过高、低吸附二抗对MDA-MB-231乳腺癌细胞CD47和PD-l1两种膜蛋白进行双色STORM成像,结果揭示两种蛋白无共定位关系。本研究为二抗物种特异性的评估提供了一种基于红细胞骨架结构模型的超分辨成像新策略,助力双色STORM成像精准阐明蛋白分子互作关系。

关键词：超分辨成像随机光学重建显微术免疫荧光红细胞膜骨架互相关分析