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Peak stent discomfort occurs early and ureteral stent with distal loop design has less paineA pilot prospective randomised singleblinded trial over 2 weeks

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Asian Journal of Urology 2020年第4期7卷 357-362页

作者： Kheng Sit Lim Zhi Wei Law Marcus Way Lunn Chow Allen Soon Phang Sim Henry Sun Sien Ho Department of Urology Singapore General HospitalSingapore Department of Urology Tan Tock Seng HospitalSingapore

Objectives:The Polarisloop ureteric stent reduces the severity of stent discomfort by minimising stent material in the bladder.Early impact of ureteral stenting on quality of life(QoL)within 1 week remains unclear.The usefulness of the patient-administered ureteral stent symptoms questionnaire(USSQ)during this period of stent insertion was assessed.In this pilot single-blinded prospective randomised study,we investigate 1)the presence of early(within the 1st week)stent discomfort via the visual analog scale(VAS);2)determine the QoL of the loop stent against conventional stent.Methods:Forty adults requiring retrograde unilateral ureteral stent placements were enrolled.Patients with single ureteric stone or benign stricture were selected.Patients were randomised in 1:1 ratio to the loop and pigtail arm.The USSQ was administered before placement(baseline),USSQ and VAS were administered on Day 3,7,and 14.Results:There were no significant differences between the USSQ scores.Median pain scores on Day 3 were lower in the loop stent group(2.9 vs.4.0,pZ0.047).There was a significant reduction in pain from Day 3e7(0 vs.1,pZ0.016)in the pigtail group.Conclusions:Our results suggest that peak stent discomfort occurs but resolves quickly within 1 week of post-stent insertion.The loop stent offers a better pain profile compared with conventional stents at Day 3 but no difference in QoL.The loop stent reduces early pain experience post-stent insertion and may have a role in the care of patients who experience significant stent discomfort previously.

关键词： Quality of life Stent discomfort Ureteral stent symptoms questionnaire Ureteric stents

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Current research and treatment for gastrointestinal stromal tumors

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World Journal of Gastroenterology 2017年第27期23卷 4856-4866页

作者： kheng Tian lim Kok Yang Tan Department of Surgery Khoo Teck Puat Hospital

Gastrointestinal stromal tumors(GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and have gained considerable research and treatment interest,especially in the last two decades. GISTs are driven by mutations commonly found in the KIT gene and less commonly in the platelet-derived growth factor receptor alpha gene,BRAF gene and succinate dehydrogenase gene. GISTs behave in a spectrum of malignant potential,and both the tumor size and mitotic index are the most commonly used prognostic criteria. Whilst surgical resection can offer the best cure,targeted therapy in the form of tyrosine kinase inhibitors(TKIs) has revolutionized the management options. As the first-line TKI,imatinib offers treatment for advanced and metastatic GISTs,adjuvant therapy in high-risk GISTs and as a neoadjuvant agent to downsize large tumors prior to resection. The emergence of drug resistance has altered some treatment options,including prolonging the first-line TKI from 1 to 3 years,increasing the dose of TKI or switching to second-line TKI. Other newer TKIs,such as sunitinib and regorafenib,may offer some treatment options for imatinib-resistant GISTs. New molecular targeted therapies are being evaluated,such as inhibitors of BRAF,heat shock protein 90,glutamine and mitogenactivated protein kinase signaling,as well as inhibitors of apoptosis proteins antagonist and even immunotherapy. This editorial review summarizes the recent research trials and potential treatment targets that may influence our future patient-specific management of GISTs. The current guidelines in GIST management from Europe,North America and Asia are highlighted.

关键词：胃肠的 stromal 肿瘤工具包基因导出血小板的生长因素受体 alpha 基因 BRAF 基因 Succinate 脱氢酶基因 CD117 酷氨酸 kinase 禁止者分子的指向的治疗

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Current surgical management of duodenal gastrointestinal stromal tumors

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1166-1179页

作者： kheng Tian lim Department of Surgery Khoo Teck Puat HospitalSingapore 768828Singapore

Duodenal gastrointestinal stromal tumors(D-GISTs)are uncommon mesenchymal tumors and are managed differently to common duodenal epithelial tumors.They may pose surgical challenges due to their unique but complex pancreaticoduodenal location of the gastrointestinal tract near the ampulla of Vater,pancreas,mesenteric blood vessels,biliary and pancreatic ducts.The surgical management of D-GISTs can be performed safely with good oncological outcomes provided an adequate resection margin can be achieved.The current surgical options of resectable primary D-GISTs varies with increasing complexity depending on the location,size and involvement of surrounding structures such as wedge resection with primary closure,segmental resection with small bowel anastomosis or radical pancreaticoduodenectomy.Laparoscopic approaches have been shown to be feasible and safe with good oncological outcomes in experienced hands.The minimally invasive techniques including robotic-assisted approach will likely increase in the future.D-GISTs have a prognosis comparable to gastric and other small bowel GISTs.However,the heterogeneity of different studies and the limited use of systemic tyrosine kinase inhibitor in the neoadjuvant and adjuvant settings may influence the overall survival of resected D-GISTs.The use of limited resection when condition allows is recommended due to lower surgical morbidity,less postoperative complications and better oncologic outcomes.

关键词： Duodenum Gastrointestinal stromal tumors limited resection Pancreaticoduodenectomy Survival

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NOKPI COLLECTION Chrome Cups and Caffeine Kicks

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城市漫步（GBA版） 2018年第4期 66-66页

作者： kheng Swe lim 不详

The Place As you walk through the Wuyangcun neigh-borhood on a warm April evening,you may crave a space to sit and contemplate your work and life,fueled by caffeine and sugar.

关键词： template sugar evening

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复合材料负泊松比结构等效弹性力学理论建模

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青岛科技大学学报:自然科学版 2023年第5期44卷 87-99页

作者：赵昌方 GOH kheng lim 乐贵高任杰仲健林南京理工大学机械工程学院江苏南京210094 纽卡斯尔研究与创新研究所(NewRIIS) 新加坡609607 英国纽卡斯尔大学科学、农业和工程学院泰恩河畔纽卡斯尔NE17RU

为了解碳纤维增强复合材料(CFRP)超力学结构的负泊松比效应实现机理及等效弹性力学,通过结构图示分析了内凹负泊松比结构实现拉胀效应或负泊松比效应的过程;设立基本假设推导了负泊松比结构在2个面内方向的等效弹性力学理论模型;采用控... 详细信息

为了解碳纤维增强复合材料(CFRP)超力学结构的负泊松比效应实现机理及等效弹性力学,通过结构图示分析了内凹负泊松比结构实现拉胀效应或负泊松比效应的过程;设立基本假设推导了负泊松比结构在2个面内方向的等效弹性力学理论模型;采用控制变量法进行几何尺寸的参数化影响规律分析;通过与实验值和模拟值对比讨论了等效泊松比理论模型的预测效果。结果表明,采用Euler梁理论建立的等效弹性力学理论模型预测区间虽能包含实验和模拟结果,但存在较大误差,仍需进一步深入。

关键词：超力学结构内凹结构拉胀结构负泊松比结构等效弹性力学碳纤维复合材料(CFRP)

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