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Liver transplantation as an alternative for the treatment of intrahepatic cholangiocarcinoma: Past, present, and future directions

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Hepatobiliary & Pancreatic Diseases International 2024年第2期23卷 129-138页

作者： Sudha Kodali Ashton A Connor Souhail Thabet Elizabeth W Brombosz R mark Ghobrial Sherrie and Alan Conover Center for Liver Disease and Transplantation Houston Methodist HospitalHoustonTX 77030USA jc Walter Jr Transplant Center Houston Methodist HospitalHoustonTX 77030USA Department of Medicine Weill Cornell Medical CollegeNew YorkNYUSA Department of Surgery Houston Methodist HospitalHoustonTX 77030USA Department of Surgery Weill Cornell Medical CollegeNew YorkNYUSA School of Medicine New Giza UniversityGizaEgypt

Intrahepatic cholangiocarcinoma(iCCA)is a rare biliary tract cancer with high mortality *** resection of the iCCA lesion is the first choice of treatment,with good prognosis after margin-negative ***,only 12%-40% of patients are eligible for resection at presentation due to cirrhosis,portal hypertension,or large tumor *** transplantation(LT)offers margin-negative iCCA extirpation for patients with unresectable ***,iCCA was a contraindication for LT until size-based selection criteria were introduced to identify patients with satisfied post-LT *** studies have shown that tumor biology-based selection can yield high post-LT survival in patients with locally advanced *** selection criterion is the tumor response to neoadjuvant *** with response to neoadjuvant therapy have better outcomes after LT compared with those without tumor response to neoadjuvant *** index that helps predict the treatment outcome is the *** survival outcomes have also opened the door for living donor LT for *** undergoing LT for iCCA now have statistically similar survival rates as patients undergoing *** combination of surgery and locoregional and systemic therapies improves the prognosis of iCCA patients.

关键词： Liver transplantation Cholangiocarcinoma Hepatectomy Transplant oncology Liver neoplasm

Relational coordination and healthcare management in lung cancer

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World Journal of Clinical Cases 2014年第12期2卷 757-768页

作者： José Antonio Vinagre Romero Juan Del Llano Se?arís Carmen De Pablos Heredero mark nuijten Clinical Management Business Organization Entrepreneurship Health Administration Business Organization Universidad Rey Juan Carlos Respiratory Unit at La Paz University Hospital28046 Madrid Spain Community Health Gaspar Casal Foundation Universidad Pompeu Fabra-CRES 28006 Madrid Spain Economics Rey Juan Carlos University School of Social Sciences Doctoral Program in Business Organization and Entrepreneurship 28032 Madrid Spain Rotterdam School of Management Erasmus University University of Maastricht the University of Groningen 3062 PA Rotterdam The Netherlands

In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination(RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels(Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.

关键词： Relational Coordination Lung cancer Clinical pathway Dialogic practices High performance work systems Healthcare performance

Germinal center kinases in immune regulation

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Cellular & Molecular Immunology 2012年第6期9卷 439-445页

作者： Hailei Yin Zhubing Shi ShiJiao Cuicui Chen Wenjia Wang mark I Greene Zhaocai Zhou Department of Trauma and Orthopaedics General Hospital of Jinan Military RegionJinanChina No.401 Hospital of People Liberation Army QingdaoChina State Key Laboratory of Cell Biology Institute of Biochemistry and Cell BiologyShangha nst tutes for Biological SciencesChinese Academy of SciencesShanghaiChina Department of Pathology and Laboratory Medicine University of PennsylvaniaPhiladelphiaPAUSA

Germinal center kinases （GCKs） participate in a variety of signaling pathways needed to regulate cellular functions including apoptosis, cell proliferation, polarity and migration. Recent studies have shown that GCKs are participants in both adaptive and innate immune regulation. However, the differential activation and regulatory mechanisms of GCKs, as well as upstream and downstream signaling molecules, remain to be fully defined. It remains unresolved whether and how GCKs may cross-talk with existing signaling pathways. This review stresses the progresses in research of GCKs relevant to the immune system.

关键词： germinal center kinases immune regulation signal transduction

Structural and biochemical studies of RIG-I antiviral signaling

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Protein & Cell 2013年第2期4卷 142-154页

作者： Miao Feng Zhanyu Ding Liang Xu Liangliang Kong Wenjia Wang Shi Jiao Zhubing Shi mark IGreene Yao Cong Zhaocai Zhou State Key Laboratory of Cell Biology Institute of Biochemistry and Cell BiologyShanghai Institutes for Biological SciencesChinese Academy of SciencesShanghai 200031China State Key Laboratory of Molecular Biology Institute of Biochemistry and Cell BiologyShanghai Institutes for Biological SciencesChinese Academy of SciencesShanghai 200031China Department of Pathology and Laboratory Medicine University of PennsylvaniaPA 19104USA

Retinoic acid-inducible gene I(RIG-I)is an important pattern recognition receptor that detects viral RNA and triggers the production of type-I interferons through the downstream adaptor MAVS(also called IPS-1,CARDIF,or VISA).A series of structural studies have elaborated some of the mechanisms of dsRNA recognition and activation of *** studies have proposed that K63-linked ubiquitination of,or unanchored K63-linked polyubiquitin binding to RIG-I positively regulates MAVS-mediated antiviral *** phos-phorylation of RIG-I appears to play an inhibitory role in controlling RIG-I antiviral signal *** we performed a combined structural and biochemical study to further define the regulatory features of RIG-I *** and dsRNA binding triggered dimeriza-tion of RIG-I with conformational rearrangements of the tandem CARD *** length RIG-I appeared to form a complex with dsRNA in a 2:2 molar ***-pared with the previously reported crystal structures of RIG-I in inactive state,our electron microscopic struc-ture of full length RIG-I in complex with blunt-ended dsRNA,for the first time,revealed an exposed active conformation of the CARD ***,we found that purified recombinant RIG-I proteins could bind to the CARD domain of MAVS independently of dsRNA,while S8E and T170E phosphorylation-mimick-ing mutants of RIG-I were defective in binding E3 ligase TRIM25,unanchored K63-linked polyubiquitin,and MAVS regardless of *** findings suggested that phosphorylation of RIG inhibited downstream signaling by impairing RIG-I binding with polyubiquitin and its interaction with MAVS.

关键词： RIG-I MAVS antiviral signaling polyubiq-uitin phosphorylation

Nicotine and its metabolite cotinine target MD2 and inhibit TLR4 signaling

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The Innovation 2021年第2期2卷 139-147页

作者： Hongyuan Li Yinghua Peng Cong Lin Xiaozheng Zhang Tianshu Zhang Yibo Wang Yuanpeng Li Siru Wu Hongshuang Wang mark RHutchinson Linda RWatkins Xiaohui Wang Laboratory of Chemical Biology Changchun Institute of Applied ChemistryChinese Academy of SciencesJilin 130022China Institute of Special Animal and Plant Sciences Chinese Academy of Agricultural SciencesJilin 130112China Discipline of Physiology Adelaide Medical SchoolUniversity of AdelaideAdelaideSAAustralia Department of Psychology and Neuroscience and the Center for NeuroscienceUniversity of Colorado at BoulderBoulderCO 80309USA Department of Applied Chemistry and Engineering University of Science and Technology of ChinaHefei 230026China ARC Centre of Excellence for Nanoscale Biophotonics University of AdelaideAdelaideSA 5000Australia

Nicotine is the principal alkaloid of tobacco often manufactured into cigarettes and belongs to a highly addictive class of *** attenuates the neuroinflammation induced by microglial ***,the molecular target(s)underlying anti-inflammatory action of nicotine has not been fully *** the psychoactive substances morphine,cocaine,and methamphetamine act as xenobiotic-associated molecular patterns and can be specifically sensed by the innate immune receptor Toll-like receptor 4(TLR4),here we sought to delineate whether nicotine and/or its metabolite cotinine may be recognized by the innate immune system via myeloid differentiation protein 2(MD2).

关键词： belongs alkaloid system

Progressive multifocal leukoencephalitis in a patient with sarcoidosis on hydroxychloroquine with negative cerebrospinal fluid testing for the John Cunningham virus

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Neuroimmunology and Neuroinflammation 2018年第1期5卷 18-24页

作者： Ovais Inamullah Casey Farin Linh Tran Roger McLendon mark Skeen Joel Morgenlander Neurology Department Duke University HospitalDurhamNC27705USA Child Neurology Department Duke University HospitalDurhamNC27705USA Pathology Department Duke University HospitalDurhamNC27705USA

Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease of the central nervous system caused by the John Cunningham (jc) virus typically seen in immuno-compromised patients. Several drugs that suppress that immune system have already been known to cause PML such as natalizumab and rituximab. We present a patient with sarcoidosis who develops PML in the rare setting of minimal immunosuppression with only hydroxychloroquine. There was significant delay in the diagnosis due to negative cerebrospinal fluid testing for jc virus and concern for neuro-sarcoidosis, but eventually a diagnosis of PML was made via brain biopsy.

关键词： Progressive multifocal leukoencephalopathy sarcoidosis hydroxychloroquine neuroimmunology

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医疗质量与患者安全的持续改进

中国医院 2010年第1期14卷 7-11页

作者：张晓辉美国联合委员会（jc） 1515 West 22nd StreetSuite1300W Oak BrookIllinois60523 USA

介绍了jcI的患者安全解决方案以及可供借鉴的其他领域的风险管理方法，医疗卫生领域对其他领域改进工具的应用，联合委员会的“医疗改造中心”及其项目以及建立安全文化的内容。

关键词：医院管理医疗质量患者安全

带血管自体腓骨移植修复胫骨良性骨肿瘤致骨缺损

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中国组织工程研究与临床康复 2007年第21期11卷 4081-4084页

作者：姚庆强王黎明蒋纯志桂鉴超许光跃徐燕梁斌南京医科大学附属南京第一医院骨科江苏省南京市210006

目的:观察带血管自体腓骨移植修复胫骨中上段良性骨肿瘤致骨缺损的临床应用结果。方法:选择2001-10/2006-12在南京医科大学附属南京第一医院骨科应用带血管腓骨移植修复因良性肿瘤所致胫骨长段骨缺损患者12例,患者均知情同意。肿瘤清除... 详细信息

目的:观察带血管自体腓骨移植修复胫骨中上段良性骨肿瘤致骨缺损的临床应用结果。方法:选择2001-10/2006-12在南京医科大学附属南京第一医院骨科应用带血管腓骨移植修复因良性肿瘤所致胫骨长段骨缺损患者12例,患者均知情同意。肿瘤清除后,采用健侧带血管腓骨皮瓣移植重建患侧胫骨,切取健侧腓骨长度为8￣23cm,平均长度13cm。术后定期随访,根据Enneking评分结果、移植腓骨转归的影像学评价结果和腓骨供区的随访结果进行效果评定,Enneking系统评分根据患者肢体疼痛、功能活动、自我感受、旋转活动度、精细操作、工作能力等6个方面对患肢进行评分,满分30分,26￣30分评为优,21￣25分评为良,16￣20分评为中,11￣15分评为差。结果:全部12例患者均获随访,随访时间6个月￣3年,其中6￣12个月3例,17￣26个月7例,27￣36个月2例,平均19个月。Enneking评分26￣30分7例,20￣25分4例,15￣20分1例。11例关节功能良好,可完成正常生活功能,仅1例因靠近膝关节至关节功能受限,经康复治疗后改善。X射线片均呈现理想的替代形态,无胫骨下端的成角畸形,腓骨均有不同程度的增粗,仅1例胫骨内侧平台塌陷约3.5mm,另11例无明显塌陷。12例患者无供区踝关节外翻畸形及腓总神经支配区感觉异常,腓骨长、短肌肌力四五级,踝关节活动不受限。结论:带血管腓骨移植用于修复胫骨良性骨肿瘤致骨缺损是可行的,但仍需要积累更多的病例数及更长期的随访以观察远期效果。

关键词：腓骨/移植移植,自体骨肿瘤

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为什么有些零售商在疫情中反而蒸蒸日上

五金科技 2020年第6期48卷 74-76页

作者：马克·J·格列文中国管理咨询网

成功适应大流行的社会距离要求的零售商提供了一个快速数字化枢纽的模型。一场危机揭示了它所遭受的破坏。在冠状病毒爆发之前苦苦挣扎的零售商现在正在崩溃。杰西潘尼(jc Penney)的处境不佳,无法直面这场危机,它拥有800多家商店,近85,... 详细信息

成功适应大流行的社会距离要求的零售商提供了一个快速数字化枢纽的模型。一场危机揭示了它所遭受的破坏。在冠状病毒爆发之前苦苦挣扎的零售商现在正在崩溃。杰西潘尼(jc Penney)的处境不佳,无法直面这场危机,它拥有800多家商店,近85,000名员工,最近申请破产,在过去两个月中加入了Neiman Marcus和***的零售破产名单。其他零售商被迫迅速转向,一些零售商也成功,如Target,它报告说,第一季度数字可比销售额增长了141%,尽管成本很大。沃尔玛似乎也处于有利地位,销售额也增长了10%,包括在线销售额增长了74%。

关键词：沃尔玛零售商销售额增长冠状病毒数字化