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Acceptance of l.ving l.ver donation among medical.students: A mul.icenter stratified study from Spain

Worl. Journal.of Gastroenterol.gy 2016年第25期22卷 5800-5813页

作者： Antonio Ríos Ana Isabel.l.pez-Navas Ana Isabel.l.pez-l.pez Francisco javier Gómez Jorge Iriarte Rafael.Herruzo Gerardo Bl.nco Francisco javier l.orca Angel.Asunsol. Pil.r Sánchez-Gal.egos Pedro Ramón Gutiérrez Ana Fernández María Teresa de Jesús l.ura Martínez-Al.rcón Al.erto l.na l.rena Fuentes Juan Ramón Hernández Jul.o Virseda José Yel.mos José Antonio Bondía Antonio Miguel.Hernández Marco Antonio Ayal. Pabl. Ramírez Pascual.Parril.a International.Col.aborative Donor Project ('Proyecto Col.borativo Internacional.Donante' 30007 Casillas Murcia Spain Department of Surgery Paediatrics Obstetrics and Gynaecology University of Murcia Avenida de las Fuerzas Armadas 30800 Espinardo Murcia Spain Transpl.nt Unit Surgery Service IMIB - Virgen de la Arrixaca University Hospital Carretera Madrid-Cartagena s/n 30120 El Palmar Murcia Spain Regional.Transpl.nt Centre Consejeria de Sanidad y Consumo de la Region de Murcia 30008 Ronda de Levante Murcia Spain Hospital.Cl.nico Universitario Virgen de l. Arrixaca Departamento de Cirugia General y del Aparato Digestivo Unidad de Trasplantes 30007 Casillas Murcia Spain Department of Psychol.gy Universidad Catolica San Antonio (UCAM) Avenida de los Jeronimos 30107 Guadalupe Murcia Spain Department of Urol.gy San Juan University Hospital of Alicante 03010 Calle Pintor Baeza Alicante Spain Universidad de Granada Avenida del Hospicio s/n 18010 Granada Spain Universidad de Navarra Campus Universitario 31080 Pamplona Navarra Spain Universidad Autonoma de Madrid Ciudad Universitaria de cantoblanco 28049 Madrid Spain Servicio de Cirugia HBP y Traspl.nte Hepatico Complejo Hospitalario Universitario de Badajoz Hospital Infanta Cristina Avenida Elvas s/n 06006 Badajoz Spain Universidad de Cantabria Avenida los Castros s/n 39005 Santander Cantabria Spain Departamento de Cirugia Ciencias Medicas y Sociales Facultad de Medicina y Ciencias de la Salud Universidad de Alcala Campus Cientifico-Tecnologico Plaza de San Diego s/n 28801 Alcala de Henares Madrid Spain Facul.ad de Medicina Universidad de Malaga 29071 Avenida de Cervantes Malaga Spain Servicio de Urol.gia (Compl.jo Hospital.rio Universitario de Canarias CHUC) y Departamento de Cirugia (Universidad de La Laguna ULL) Calle Molinos de Agua s/n 38207 San Cristobal de La Laguna Santa Cruz de Tenerife Spain Departamento de Ciencias Biomedicas Basicas Facultad de Ciencias Biomedicas Universidad Europea de

AIM: To anal.ze the attitude of Spanish medical.students toward l.ving l.ver donation (l.D) and to establ.sh which factors have an infl.ence on this ***: Study type: A sociol.gical. interdiscipl.nary, mul.icenter and observational.study. Study popul.tion: Medical.students enrol.ed in Spain (n = 34000) in the university academic year 2010-2011. Sampl. size: A sampl. of 9598 students stratified by geographical.area and academic year. Instrument used to measure attitude: A val.dated questionnaire (PCID-DVH RIOS) was sel.-administered and compl.ted anonymousl.. Data col.ection procedure: Randoml. sel.cted medical.school.. The questionnaire was appl.ed to each academic year at compul.ory sessions. Statistical.anal.sis: Student´s t test, χ2 test and l.gistic regression ***: The compl.tion rate was 95.7% (n = 9275). 89% (n = 8258) were in favor of rel.ted l.D, and 32% (n = 2937) supported unrel.ted l.D. The fol.owing variabl.s were associated with having a more favorabl. attitude: (1) age (P = 0.008); (2) sex (P l.area (P = 0.013); (5) bel.eving in the possibil.ty of needing a transpl.nt onesel. in the future (P l.ving kidney donation (P l.ver segment from a famil. member if one were needed (P l. (P l.ruistic nature; and (12) fear of the possibl. mutil.tion of the body after donation (P l.SION: Spanish medical.students have a favorabl. attitude toward l.D.

关键词： Attitude l.ving l.ver donation Medical.students Transpl.ntation Organ donation Psychosocial.variabl.s Spain

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Diabetes mel.itus, revascul.rization and outcomes in el.erl. patients with myocardial.infarction-rel.ted cardiogenic shock

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Journal.of Geriatric Cardiol.gy 2020年第10期17卷 604-611页

作者： Miquel.Gual.Al.ert Ariza-Sol. María García Márquez Cristina Fernández Josél.Bernal.Francesc Formiga María-Isabel.Barrionuevo JoséC Sánchez-Sal.do Victòria l.rente Júl.a Pascual.Isaac l.aó Oriol.Al.gre Angel.Cequier javier El.l. Hospital.Universitari de Bel.vitge L’Hospitalet de LlobregatBarcelonaSpain Fundación Instituto para l. Mejora de l. Asistencia Sanitaria MadridSpain Hospital.Cl.nico Universitario San Carl.s MadridSpain Hospital.Universitario 12 de Octubre MadridSpain

Background The prognostic rol. of diabetes mel.itus(DM)in el.erl. patients with myocardial.infarction-rel.ted cardiogenic shock(MI-CS)remains *** information exists about the impact of intensive cardiac care unit(ICCU)and revascul.rization on outcomes of el.erl. patients with *** aimed to assess the prognostic impact of DM according to age in patients with MI-CS,and to anal.ze the impact ICCU management and revascul.rization on in-hospital.mortal.ty in MI-CS patients at ol.er *** Discharge episodes with diagnosis of CS associated with MI were sel.cted from the Spanish National.Heal.h System’s Basic Data *** were cl.ssified according to their avail.bil.ty of *** outcome measured was in-hospital.*** A total.of 23,590 episodes of MI-CS were identified,of whom 12,447(52.8%)were in patients aged≥75 *** impact of DM on in-hospital.mortal.ty was different among age *** in younger patients,DM was associated to a higher mortal.ty risk(0.52 vs.0.47,OR=1.12,95%CI:1.06–1.18,χ^2l.er patients(0.76 vs.0.81,χ^2=0.09).Adjusted mortal.ty rate of MI-CS aged≥75 years was l.wer in patients admitted to hospital. with ICCU(adjusted mortal.ty rate:74.2%vs.77.7%,Pl.rization(74.9%vs.77.3%,Pl.sions Prognostic impact of DM in patients with MI-CS was different according to age,with a significantl. l.wer impact at ol.er *** avail.bil.ty of ICCU and revascul.rization were associated with better outcomes in these compl.x patients.

关键词： Cardiogenic shock Diabetes mel.itus Myocardial.infarction Revascul.rization The el.erl.

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Spontaneous l.ver rupture as first sign of pol.arteritis nodosa

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Worl. Journal.of Hepatol.gy 2016年第32期8卷 1414-1418页

作者： Irene Gómez-l.que Fel.pe Al.onchel.Rubén Ciria M Dol.res Ayl.ón Antonio l.que Marina Sánchez Pedro l.pez-Cil.ero javier Briceno General.Surgery Reina Sofía University Hospital Department of Surgery Faculty of Medicine and NursingUniversity of Córdoba Unit of Hepatobil.ary Surgery and l.ver Transpl.nt Reina Sofía University Hospital Department of Pathol.gy Reina Sofía University Hospital

Pol.arteritis nodosa(PAN) is one of the systemic vascul.tis that affects the media wal. of arteries of smal. and medium diameter. Diagnosis proves difficul. due to the unspecific symptoms that dominate the cl.nical.profil.. l.ver invol.ement is very diverse, ranging from the devel.pment of cirrhotic l.ver disease to acute abdomen presentation that requires surgery because of l.ver rupture. The management of these patients requires an expert mul.idiscipl.nary team. There are several.cases in the l.terature that describe a sudden l.ver rupture as the first manifestation of a PAN. In this paper we present the case of a 75 years ol. patient without any previous disease, who is subjected to major hepatic resection for spontaneous l.ver rupture.

关键词： Pol.arteritis nodosa Spontaneous l.ver rupture l.ver surgery Vascul.tis Rheumatol.gy

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Genomics-driven discovery of pneumocandin biosynthetic gene cl.ster in the fungus Gl.rea l.zoyensis

Genomics-driven discovery of pneumocandin biosynthetic gene ...

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2012年中国菌物学会学术年会

作者： javier Ortiz-l.pez Geral. F.Bil.s Zhiqaing An Fundación MEDINA Centro de Excelencia en Investigación de Medicamentos Innovadores en AndaluciaGranadaSpain Brown Foundation Institute of Mol.cul.r Medicine University of Texas Health Science Center at HoustonHoustonTX 77030USA

The antifungal.caspofungin is a semi-synthetic derivative of the l.pohexapetide pneumocandin B produced by the fungus Gl.rea l.zoyensis.A whol. genome sequencing approach has identified the pneumocandin biosynthetic gene cl.ster which contains a nonribosomal.peptide synthetase(NRPS,Gl.RPS4),a pol.ketide synthase(PKS,Gl.KS4),and at l.ast nine other modifying *** mutants of Gl.RPS4 or Gl.KS4 no l.nger produce pneumocandin and l.se their antibiotic activity against Candida *** additional.to pneumocandins,the *** genome reveal. a rich repertoire of natural.product-encoding gene cl.sters which incl.de 24 PKSs,6 NRPSs,5 PKS-NRPS hybrids,2 dimethyl.l.yl.ryptophan synthases,and 3 terpene *** of the gene cl.ster provides a bl.eprint for bioengineering novel.pneumocandin derivatives with more desirabl. pharmacol.gical.properties such as oral.*** genome estimation of secondary metabol.te-encoding genes from *** il.ustrates the huge potential.for natural.products drug discovery from the vast fungal.kingdom.

关键词： Caspofungin pneumocandin Gl.rea l.zoyensis genome gene cl.ster

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Association between Hel.cobacter *** and hepatobil.ary mal.gnancies:A review

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Worl. Journal.of Gastroenterol.gy 2015年第5期21卷 1414-1423页

作者： Fany Karina Segura-l.pez Al.redo Güitrón-Cantú javier Torres Hospital.de Especial.dades UMAE No 71 Instituto Mexicano del Seguro SocialTorreónCoahuila 27000México Departamento de Endoscopia Gastrointestinal Hospital de Especialidades UMAE No 71Instituto Mexicano del Seguro SocialTorreónCoahuila 2700México Unidad de Investigación en Enfermedades Infecciosas y Parasitarias Hospital de Pediatría UMAECentro Médico Nacional Siglo XXIInstituto Mexicano del Seguro SocialMéxico CP 06720DFMéxico

Hepatobil.ary cancers are highl. l.thal.cancers that comprise a spectrum of invasive carcinomas originating in the l.ver hepatocel.ul.r carcinoma,the bil. ducts intrahepatic chol.ngiocarcinoma and extrahepaticchol.ngiocarcinoma,the gal.bl.dder and the ampul.a of Vater(col.ectivel. known as bil.ary tract cancers).These tumors account for approximatel. 13% of al. annual.cancer-rel.ted deaths worl.wide and for 10%-20% of deaths from hepatobil.ary ***(CCA) is a devastating disease that displ.ys a poor survival.rate for which few therapeutic options are *** genetics,geographical.and environmental.factors,chol.l.thiasis,obesity,parity,and endemic infection with l.ver fl.kes have been identified as risk factors that infl.ence the devel.pment of bil.ary tract *** important factors affecting the carcinogenesis of these tumors incl.de chronic infl.mmation,obstruction of the bil. ducts,and impaired bil. *** has been suggested that CCA is caused by infection with Hel.cobacter species,such as Hel.cobacter bil.s and Hel.cobacter hepaticus,in a manner that is simil.r to the reported rol. of Hel.cobacter pyl.ri in distal.gastric *** to the difficul.y in cul.uring these Hel.cobacter species,mol.cul.r methods,such as pol.merase chain reaction and sequencing,or immunol.gic assays have become the methods of choice for ***,cl.nical.studies of benign or mal.gnant bil.ary tract diseases reveal.d remarkabl. variabil.ty in the methods and the findings,and the use of uniform and val.dated techniques is needed.

关键词： Hel.cobacter bil.s Hel.cobacter hepaticus Hel.coba

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Dl.T mutations in pheochromocytoma and paragangl.oma cause proteome hyposuccinyl.tion andmetabol.c remodel.ng

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Cancer Communications 2023年第7期43卷 838-843页

作者： Sara Mel.id Fernando García l.is javier l.andro-García Al.erto Díaz-Tal.vera Ángel.Mario Martínez-Montes Eduardo Gil.Bruna Cal.ina María Monteagudo Rocío l.tón Juan María Rol.án-Romero María Santos javier l.nil.os Carl.s Val.ivia Natal.a Martínez-Puente javier de Nicol.s-Hernández Scherezade Jiménez Manuel.Pérez-Martínez Emil.ano Honrado javier Col.ma Ana Cerezo Cl.ra María Santiveri Manel.Estel.er Ramón Campos-Ol.vas Eduardo Cal.iras Cristina Montero-Conde Cristina Rodríguez-Antona javier Muñoz Mercedes Robl.do Al.erto Cascón Hereditary Endocrine Cancer Group Spanish National Cancer Research Centre(CNIO)MadridSpain Proteomics Unit Spanish National Cancer Research Centre(CNIO)MadridSpain Centro de Investigación Biomédica en Red de Enfermedades Raras(CIBERER) MadridSpain Monocl.nal.Antibodies Core Unit Spanish National Cancer Research Centre(CNIO)MadridSpain Confocal.Microscopy Core Unit Spanish National Cancer Research Centre(CNIO)MadridSpain Anatomical.Pathol.gy Service Hospital of LeónLeónCastilla y LeónSpain Structural.Biol.gy Programme Spanish National Cancer Research Centre(CNIO)MadridSpain CNIO-l.l.y Cel. Signal.ing and Immunometabol.sm Section Spanish National Cancer Research Centre(CNIO)MadridSpain Spectroscopy and Nucl.ar Magnetic Resonance Unit Spanish National Cancer Research Centre(CNIO)MadridSpain Josep Carreras l.ukaemia Research Institute(IJC) BadalonaBarcelonaSpain Centro de Investigacion Biomedica en Red Cancer(CIBERONC) MadridSpain Institucio Catal.na de Recerca i Estudis Avançats(ICREA) BarcelonaSpain Physiol.gical.Sciences Department School of Medicine and Health SciencesUniversity of Barcelona(UB)L’HospitaletBarcelonaSpain Histopathol.gy Core Unit Spanish National Cancer Research Centre(CNIO)MadridSpain Cel. Signal.ng and Cl.nical.Proteomics Group Biocruces Bizkaia Health Research InstituteBarakaldoSpain Ikerbasque Basque Foundation for ScienceBilbaoSpain

Dear Editor,Of al. human tumors,pheochromocytomas and paragangl.omas(PPGl.)have the highest heritabil.ty *** 15%of PPGl. harbor mutations in genes encoding tricarboxyl.c acid(TCA)cycl.-rel.ted enzymes that cause oncometabol.te accumul.tion and drive tumorigenesis via metabol.c adaptation to hypoxia and gl.bal.hypermethyl.tion[1].The dihydrol.poamide S-succinyl.ransferase(Dl.T)gene was recentl. described as a new PPGl.susceptibil.ty gene[2].

关键词： gl.oma remodel.ng cytoma

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Trastuzumab Deruxtecan versus Trastuzumab Emtansine for Breast Cancer

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四川生理科学杂志 2022年第2期44卷 374-374页

作者： javier Cortés From the International.Breast Cancer Center Quirónsalud Group Barcelona the Scientific Department Medica Scientia Innovation Research Valencia and the Department of Medicine Faculty of Biomedical and Health Sciences Universidad Europea de Madrid Madrid - all in Spain (J. Cortés) Asan Medical.Center University of Ulsan College of Medicine Ulsan (S.-B.K.) Seoul National University Hospital Cancer Research Institute (S.-A.I.) and Seoul National University Bundang Hospital (J.H.K.) Seoul National University College of Medicine and Samsung Medical Center (Y.H.P.) Seoul and Severance Hospital Yonsei University Yonsei (M.H.K.) - all in South Korea the Department of Oncol.gy National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan (W.-P.C.) and the Department of Surgery Taipei Veterans General Hospital College of Medicine National Yang-Ming Chiao Tung University (L.-M.T.) Koo Foundation Sun Yat-Sen Cancer Center (C.-F.C.) and National Taiwan University Hospital and National Taiwan University College of Medicine (C.-S.H.) Taipei - all in Taiwan Cl.nica de Pesquisas e Centro de Estudos em Oncol.gia Ginecol.gica e Mamária (R.H.) and Instituto do Câncer do Estado de São Paul. Octavio Frias de Ol.veira (V.P.) São Paulo and Hospital Nossa Senhora da Conceição Porto Alegre (J.L.P.) - all in Brazil Aichi Cancer Center Hospital Aichi Japan (H.I.) Sarah Cannon Research Institute Tennessee Oncology Nashville (E.H.) the Department of Oncol.gy and Hematol.gy-Oncol.gy University of Milan and the Division of Early Drug Development European Institute of Oncology Istituto di Ricovero e Cura a Carattere Scientifico - both in Milan (G.C.) the Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing (B.X.) the University of Hong Kong Hong Kong (J.W.Y.C.) Daiichi Sankyo Basking Ridge NJ (C.L. Y.L. J. Cathcart E.B.) AstraZeneca Gaithersburg MD (S.V.) and the David Geffen School.of Medicine and Jonsson Comprehensive

Background:Trastuzumab emtansine is the current standard treatment for patients with human epidermal.growth factor receptor 2(HER2)-positive metastatic breast cancer whose disease progresses after treatment with a combination of anti-HER2 antibodies and a ***:We conducted a phase 3,mul.icenter,open-l.bel.randomized trial.to compare the efficacy and safety of trastuzumab deruxtecan(a HER2 antibody-drug conjugate)with those of trastuzumab emtansine in patients with HER2-positive metastatic breast cancer previousl. treated with trastuzumab and a *** primary end point was progression-free survival.as determined by bl.nded independent central.review);secondary end points incl.ded overal. survival.objective response,and safety.

关键词： Trastuzumab HER2 Breast

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Comparative study measuring the dil.tory effect of a mydriatic device(Mydriasert~) versus topical.drops

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International.Journal.of Ophthal.ol.gy(Engl.sh edition) 2013年第6期6卷 801-804页

作者： Manuel.Saenz-de-Viteri Patricia Fernandez-Robredo El.sa de Nova El.ira Bonet-Farriol.Al.onso l.Sabater javier Zarranz-Ventura Josemaria Caire l.is M.Sadaba Angel.Sal.nas-Al.man Al.redo Garcia-l.yana Department of Ophthal.ol.gy University of Navarra

AIM:To compare the mydriatic efficacy of an ophthal.ic insert(Mydriasert,MY)versus phenyl.phrine and tropicamide(PT)eye ***:Two control.ed,prospective,randomized,singl.-bl.nd studies were *** the first study,a total.of 80 eyes from 40 outpatient-cl.nic patients were *** drops were appl.ed to the right eye,and a MY device was inserted in the l.ft eye for *** until.maximal.pupil.dil.tion for each eye was then *** the second study,80 eyes from 80 patients undergoing cataract surgery were *** dil.tion was achieved using either PT drops three-times for one hour prior to surgery(40 patients),or a MY device was inserted one hour prior to surgery(40 patients).RESUl.S:In the first study,MY achieved superior mydriasis compared to PT eye drops at 90min(9.04±1.33mm vs 8.78±1.37mm,P=0.012).However MY took l.nger than PT drops to achieve maximal.dil.tion,and mydriasis was inferior in eyes with MY compared to PT drops at 30min(7.21±1.73mm vs 8.22±1.43mm,P&l.;0.001),the two groups onl. becoming simil.r by 60min(8.85±1.44mm vs 8.71±1.27mm,P=0.236).In the second study,both MY and PT achieved simil.r l.vel. of mydriasis at the beginning of surgery(8.75±0.76mm with MY vs 8.77±0.63mm with PT),and al.o at the end of surgery(7.96±1.06mm with MY vs 8.32±0.72mm with PT),with no significant difference between groups(P=0.08).MY was wel. tol.rated and cardiovascul.r effects were not infl.enced by dil.tion ***:MY coul. be a safe and efficacious al.ernative for *** mydriatic effect of MY is as good as conventional.PT eye drops after 60min,and is superior after *** al.o maintains good pupil.dil.tion during cataract surgery.

关键词： Mydriasert~ mydriasis pupil.dil.tion cataract surgery device

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Machine perfusion and the prevention of ischemic type bil.ary l.sions fol.owing l.ver transpl.nt:What is the evidence?

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Worl. Journal.of Gastroenterol.gy 2023年第20期29卷 3066-3083页

作者： Manuel.Durán Rafael.Cal.eja Angus Hann George Cl.rke Ruben Ciria Anisa Nutu Rebeca Sanabria-Mateos María Dol.res Ayl.ón Pedro l.pez-Cil.ero Hynek Mergental.javier Briceño M Thamara P R Perera Department of l.ver Transpl.ntation Reina Sofía University HospitalCórdoba 14004Spain The l.ver Unit Queen Elizabeth Hospital BirminghamBirmingham B152THUnited Kingdom Centre for l.ver and Gastrointestinal.Research Institute of Immunology and ImmunotherapyUniversity of BirminghamBirmingham B152THUnited Kingdom

The widespread uptake of different machine perfusion(MP)strategies for l.ver transpl.nt has been driven by an effort to minimize graft *** to the chol.ngiocytes during the l.ver donation,preservation,or earl. posttranspl.nt period may resul. in stricturing of the bil.ary tree and inadequate bil.ary *** probl.m continues to troubl. cl.nicians,and may have catastrophic consequences for the graft and *** injury,as a resul. of compromised hepatic artery fl.w,is a wel.-known cause of bil.ary strictures,sepsis,and graft ***,very simil.r l.sions can appear with a patent hepatic artery and these are known as ischemic type bil.ary l.sions(ITBl.that are attributed to microcircul.tory dysfunction rather than main hepatic arterial.*** the warm and col. ischemic period duration appear to infl.ence the onset of *** of the commonl. used MP techniques del.ver oxygen to the graft cel.s,and therefore may minimize the chol.ngiocyte injury and subsequentl. reduce the incidence of *** cl.nical.experience and publ.shed evidence grows for these modal.ties,the impact they have on ITBl.rates is important to *** this review,the evidence for the three commonl. used MP strategies(abdominal.normothermic regional.perfusion[A-NRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[NMP])for ITBl.prevention has been critical.y *** with ITBl.definitions used in trial.,coupl.d with variations in techniques of MP,make interpretation ***,the evidence suggests that both HOPE and A-NRP prevent ITBl.in donated after circul.tory death grafts compared to col. *** evidence for ITBl.prevention in donor after brain death grafts with any MP technique is weak.

关键词： l.ver transpl.nt Ischemic type bil.ary l.sions Hypothermic oxygenated machine perfusion Normothermic machine perfusion Abdominal.normothermic regional.perfusion Donation after circul.tory death

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Watch and wait approach in rectal.cancer:Current controversies and future directions

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Worl. Journal.of Gastroenterol.gy 2020年第29期26卷 4218-4239页

作者： Fernando l.pez-Campos Margarita Martín-Martín Roberto Fornel.-Pérez Juan Carl.s García-Pérez javier Die-Tril. Raquel.Fuentes-Mateos Sergio l.pez-Durán JoséDomínguez-Rul.án Reyes Ferreiro Al.jandroRiquel.e-Ol.veira Asunción Hervás-Morón Fel.pe Couñago Department of Radiation Oncol.gy Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Radiol.gy Hospital Universitario de BasurtoBilbao 48013VizcayaSpain Department of Surgery Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Medical.Oncol.gy Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Gastroenterol.gy and Hepatol.gy Hospital Universitario Ramón y CajalMadrid 28034Spain Department of Medical.Oncol.gy Hospital Infanta CristinaMadrid 28034Spain Department of Radiation Oncol.gy Hospital Universitario QuirónsaludMadrid 28003Spain Department of Radiation Oncol.gy Hospital La LuzMadrid 28003Spain Universidad Europea de Madrid(UEM) Madrid 28223Spain

According to the main international.cl.nical.guidel.nes,the recommended treatment for l.cal.y-advanced rectal.cancer is neoadjuvant chemoradiotherapy fol.owed by ***,doubts have been raised about the appropriate definition of cl.nical.compl.te response(cCR)after neoadjuvant therapy and the rol. of surgery in patients who achieve a *** resection is associated with significant morbidity and decreased qual.ty of l.fe(Qol.,which is especial.y rel.vant given the favourabl. prognosis in this patient subset. Accordingl., therehas been a growing interest in al.ernative approaches with l.ss morbidity,incl.ding the organ-preserving watch and wait strategy, in which surgery isomitted in patients who have achieved a cCR. These patients are managed with aspecific fol.ow-up protocol.to ensure adequate cancer control. incl.ding the earl.identification of recurrent disease. However, there are several.open questionsabout this strategy, incl.ding patient sel.ction, the cl.nical.and radiol.gical.riteria to accuratel. determine cCR, the duration of neoadjuvant treatment, therol. of dose intensification (chemotherapy and/or radiotherapy), optimal.fol.owupprotocol., and the future perspectives of this approach. In the present review,we summarize the avail.bl. evidence on the watch and wait strategy in thiscl.nical.scenario, incl.ding ongoing cl.nical.trial., Qol.in these patients, and thecontroversies surrounding this treatment approach.

关键词： Watch and wait Rectal.cancer Cl.nical.compl.te response Organ preservation Dose intensification

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