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Single-incision vs three-incision laparoscopic cholecystectomy for complicated and uncomplicated acute cholecystitis

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World Journal of Gastroenterology 2013年第43期19卷 7743-7750页

作者： Shu-Hung Chuang Pai-Hsi Chen chih-ming chang chih-Sheng Lin Department of Biological Science and Technology National Chiao Tung University Department of Surgery Mackay Memorial HospitalHsin-Chu Branch College of Management Fu Jen Catholic University Department of Nursing Mackay Memorial HospitalHsin-Chu Branch

AIM:To compare the clinical outcome of single-incision laparoscopic cholecystectomy(SILC)and three-incision laparoscopic cholecystectomy(3ILC)for acute ***:From July 2009 to September 2012,136patients underwent SILC or 3ILC for acute cholecystitis at a tertiary referral *** experienced surgeon performed every procedure using 5 or 10 mm 30-degree laparoscopes,straight instruments,and conventional *** patients with perforated gallbladder and diffuse peritonitis and 23 patients with mild acute cholecystitis were *** remaining 108 patients were divided into complicated and uncomplicated groups according to pathologic *** demography,clinical data,operative results and complications were recorded and ***:Fifty patients with gangrenous cholecystitis,gallbladder empyema,or hydrops were classified as the complicated group,and 58 patients with acute cholecystitis were classified as the uncomplicated ***-three(46.0%)of the patients in the complicated group(n=50)and 39(67.2%)of the patients in the uncomplicated group(n=58)underwent SILC;all others underwent *** postoperative length of hospital stay(PLOS)was significantly shorter in the SILC subgroups than the 3ILC subgroups(3.5±1.1 d vs 4.6±1.3 d,P<0.01 in the complicated group;2.9±1.1 d vs 3.7±1.4 d,P<0.05 in the uncomplicated group).The maximum body temperature recorded at day 1 and at day 2 following the procedure was lower in the SILC subgroups,but the difference reached statistical significance only in the uncomplicated group(37.41±0.56℃vs 37.80±0.72℃,P<0.05 on postoperative day 1;37.10±0.43℃vs 37.57±0.54℃,P<0.01 on postoperative day 2).The operative time,estimated blood loss,postoperative narcotic use,total length of hospital stay,conversion rates,and complication rates were similar in both SILC and 3ILC *** complicated group had longer operative time(122.2±35.0 min vs 106.6±43.6 min,P<0.05),longer PLOS(4.1±1.3 d vs 3.2±1.2 d,P<0.

关键词： Single-incision laparoscopic cholecystectomy Single-incision laparoscopic surgery Laparoen doscopic single site surgery Cholecystectomy Acute cholecystitis Complicated cholecystitis Gangrenous cholecystitis

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Carcinoid tumor of the duodenum and accessory papilla associated with polycythemia vera

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World Journal of Gastroenterology 2005年第24期11卷 3794-3796页

作者： Horng-Yuan Wang ming-Jen Chen Tsen-Long Yang ming-chih chang Yu-Jan Chan Division of Gastroenterology Department of Surgery Division of Hematology Department of Pathology

Carcinoid tumors have been reported in a wide range of organs but most frequently involve the gastrointestinal tract; however, duodenal carcinoid tumors are rare. We report a 50-year-old male patient complaining of multiple melenas for 3 wk. The panendoscopy and endoscopic retrograde cholangiopancreaticography revealed swelling accessory papilla with an ulcer. The biopsy taken showed a carcinoid tumor. The lesion was removed by wide resection. Patient was found to have an abnormal blood cell count during the follow-up period with elevated levels of hemoglobin and hematocrit of 21.2 g/dL and 63.5%,respectively, thrombocytosis of 501 000/μL, and leukocytosis of 20 410/μL. He was diagnosed as a polycythemia vera by a hematologist after further evaluation. He received periodic phlebotomy and hydroxyurea treatment. The response was good and his hematocrit was stabilized by periodic phlebotomy in the range of 44-49% during the last 2 years. The possible origin of UGI bleeding by a duodenal carcinoid tumor, although rare, should be considered. There has been one case report of a duodenal carcinoid tumor that involved accessory papilla of the pancreas divisum and one case report of metastatic carcinoid tumor associated with polycythemia vera. It is different in our patient as compared with the latter report, which mentioned a polycythemia vera patient who was found to have a metastatic carcinoid in the 17 years follow-up period. Chemotherapy had been given before the carcinoid tumor was revealed. Our patient had no previous chemotherapy for polycythemia vera before he was found to have duodenal carcinoid tumor; this excludes the possibility of chemotherapy induced carcinoid tumor, although it had been suspected in the previous report. In our patient, the existence of both diseases may be by predisposition of each other since both diseases have an increased incidence of other neoplasm, or they may be coexistent incidentally.

关键词： Carcinoid tumor Accessory papilla Polycythemia vera

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Current Treatment and Controversy of Primary Gastric Lymphoma

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Journal of Cancer Therapy 2013年第1期4卷 145-152页

作者： ming-chih chang Mackay Memorial Hospital Mackay Medicine Nursing and Management College Taipei Chinese Taipei.

Primary gastric lymphoma (PGL) is not a common cancer and account for 10% of malignant lymphoma and 5% of gastric cancer. The correlation with Helicobacter pylori (H. pylori) infection with mucosa associated lymphoepithelial tumor (MALT) is now well documented and some of the low grade MALT can be cured sorely by triple agent eradication therapy. The most common type of PGL is diffuse large B cell lymphoma which now can be successfully treated with chemotherapy alone. There is still no consensus on the optimal treatment for PGL. In the recent 10 years chemotherapy combined with anti-CD 20 monoclonal antibody such as rituximab, achieved higher complete response rate and more than 80% are long-term survival. The so-called R-CHOP (rituximab, cyclophosphamide, vincristin, prednisolone) now become the new gold standard therapy. The role of surgical resection prior to chemotherapy is controversial and not commonly applied in recent publications. Yet some cases of suboptimal response to R-CHOP or patient is too fragile to tolerate the immuno-chemotherapy will be feasible to surgical resection as a salvage or alternative therapy. The radiotherapy as an adjuvant therapy is less commonly considered. Patients with advanced PGL with high international prognostic index risk and along with co-morbidity diseases are prone to get treatment related complications from above-mentioned modality of treatment, such as GI perforation, neutropenic septicemia, pulmonary infection, fulminate heaptitis B reactivation, respiratory and cardiac impairment can be seen.

关键词： Primary Gastric Lymphoma MALT Lymphoma Combination Rituximab and Chemotherapy Surgery

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Long-term hepatic consequences of chemotherapy-related HBV reactivation in lymphoma patients

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World Journal of Gastroenterology 2005年第34期11卷 5283-5288页

作者： Chi-Chung Wen Chao A.Hsiung Ih-Jen Su Ann-Lii Cheng ming-chih chang Chao-Jung Tsao Woei-Yao Kao Wu-Ching Uen Chiun Hsu chih-Hung Hsu Yen-Shen Lu Hwei-Fan Tien Tsu-Yi Chao Li-Tzong Chen Jacqueline Whang-Peng Pei-Jer Chen Division of Biostatics and Bioinformatics National Health Research Institutes Taipei Taiwan China Division of Clinical Research National Health Research Institutes Taipei Taiwan China Department of Oncology National Taiwan University Hospital Taipei Taiwan China Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan China Department of Internal Medicine Mackay Memorial Hospital Taipei Taiwan China Department of Internal Medicine Chi-Mei Hospital Tainan Taiwan China Department of Internal Medicine Tri-Service General Hospital Taipei Taiwan China Department of Internal Medicine Shin Kong Memorial Hospital Taipei Taiwan China Department of Oncology National Taiwan University Hospital Taipei Taiwan China Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan China Division of Cancer Research National Health Research Institutes Taipei Taiwan China

AIM: To investigate the long-term consequences of chemotherapy-related HBV reactivation in patients with ***: This study was based on the database of published prospective study evaluating HBV reactivation in HBV lymphoma patients during *** liver reserve (DLR) was defined as development of either one of the following conditions during follow-up: (1) newly onset parenchyma liver disease, splenomegaly or ascites without evidence of lymphoma involvement; (2) decrease of the ratio (albumin/globulin ratio) to less than 0.8 or increase of the ratio of INR of prothrombin time to larger than 1.2 without evidence of malnutrition or infection. Liver cirrhosis was diagnosed by imaging ***: A total of 49 patients were included. The median follow-up was 6.2 years (range, 3.9-8.1 years).There were 31 patients with and 18 patients without HBV reactivation. Although there was no difference of overall survival (OS) and chemotherapy response rate between the two groups, DLR developed more frequently in patients with HBV reactivation (48.4% vs 16.7%; P= 0.0342). Among the HBV reactivators, HBV genotype C was associated with a higher risk of developing DLR (P = 0.0768) and liver cirrhosis (P = 0.003). Four of five patients with sustained high titer of HBV DNA and two of three patients with multiple HBV reactivation developed DLR. Further, patients with a sustained high titer of HBV DNA had the shortest OS among the HBV reactivators (P= 0.0000). No patients in the non-HBV reactivation group developed hepatic failure or liver ***: Chemotherapy-related HBV reactivation is associated with the long-term effect of deterioration of hepatic function.

关键词： HBV reactivation Liver function Non-HodgkJn'slymphoma, Chemotherapy

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Enhancing postoperative pain control by surgically-initiated rectus sheath block in abdominal aortic aneurysm open repair: A case report

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World Journal of Clinical Cases 2025年第6期13卷 41-47页

作者： Kuan-Hua Chen ming-Yuan Kang Yi-Ting chang Sheng-Yang Huang Yung-Szu Wu Center for Cardiovascular Disease Taichung Veterans General HospitalTaichung 407219TaiwanChina Department of Anesthesiology Taichung Veterans General HospitalTaichung 407219TaiwanChina Division of Pediatric Surgery Department of SurgeryTaichung Veterans General HospitalTaichung 407219TaiwanChina School of Medicine National Yang Ming Chiao Tung UniversityTaipei 112304TaiwanChina Department of Post-Baccalaureate Medicine National Chung Hsing UniversityTaichung 402202TaiwanChina

BACKGROUND Abdominal aortic aneurysm(AAA)repair often involves significant postoperative pain,traditionally managed with systemic opioids,which can cause undesirable side *** case report explores the novel use of a surgically-initiated rectus sheath block with a catheter-over-needle assembly for pain management in AAA *** SUMMARY A 67-year-old female with hypertension and previous aortic dissection underwent elective open repair of an infrarenal AAA,which had grown from 3.4 cm to 4.3 cm over 14 months.A rectus sheath block was initiated surgically for postoperative pain *** patient reported low pain scores and did not require systemic intravenous opioids,enabling early ambulation and discharge on postoperative day seven without *** preventing complications of systemic opi-oids,the method indicating a promising direction for postoperative pain management in major vascular *** Surgically-initiated rectus sheath block as a valuable tool for managing postoperative pain in AAA repair.

关键词： Abdominal aortic aneurysm Postoperative pain management Rectus sheath block Surgical anesthesia Opioid-sparing techniques Case report

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Comparison of presentation and impact on quality of life of gastroesophageal reflux disease between young and old adults in a Chinese population

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World Journal of Gastroenterology 2011年第41期17卷 4614-4618页

作者： Shou-Wu Lee Chia-ming chang Chi-Sen chang Ai-Wen Kao ming-chih Chou Institute of Medicine Chung Shan Medical University Division of Gastroenterology Department of Internal MedicineTaichung Veterans General Hospital Department of Medicine Chung Shan Medical University Institute of Gerontology National Cheng Kang University Division of Geriatrics Department of Internal MedicineNational Cheng Kang University Hospital Division of Gastroenterology Department of Internal MedicineNational Cheng Kang University Hospital

AIM:To compare the presentation and impact on qual-ity of life of gastroesophageal reflux disease(GERD)in old and young age ***:Data from adult patients with GERD di-agnosed by endoscopic and symptomic characteristics were collected between January and November *** criteria included combined peptic ulcers,ma-lignancy,prior surgery,antacid medication for more than 2 mo,and *** patients were assigned to the elderly group if they were 65 years or older,or the younger group if they were under 65 *** had completed the GERD impact scale,the Chinese GERD questionnaire,and the SF-36 *** from other cases without endoscopic f ind-ings or symptoms were collected and these subjects comprised the control group in our ***:There were 111 patients with GERD and 44 normal cases:78(70.3%)and 33 patients(29.7%)were in the younger and elderly groups,*** were more female patients(60.3%)in the younger group,and more males(72.7%)in the elderly *** younger cases had more severe and fre-quent typical symptoms than the elderly ***-nif icantly more impairment of daily activities was noted in the younger patients compared with the elderly group,except for physical ***:Elderly patients with GERD were pre-dominantly male with rare presentation of typical symp-toms,and had less impaired quality of life compared with younger patients in a Chinese population.

关键词： Gastroesophageal reflux disease Quality oflife Age factors

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Solving Cauchy Issues of Highly Nonlinear Elliptic Equations Using a Meshless Method

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Computers, Materials & Continua 2022年第8期72卷 3231-3245页

作者： chih-Wen chang Department of Mechanical Engineering National United UniversityMiaoli360302Taiwan

In this paper,we address 3D inverse Cauchy issues of highly nonlinear elliptic equations in large cuboids by utilizing the new 3D homogenization functions of different orders to adapt all the specified boundary *** also add the average classification as an approximate solution to the nonlinear operator part,without requiring to cope with nonlinear equations to resolve the weighting coefficients because these constructions are owned many conditions about the true *** unknown boundary conditions and the result can be retrieved straightway by coping with a small-scale linear system when the outcome is described by a new 3D homogenization function,which is right to find the numerical solutions with the errors smaller than the level of noise being put on the over-specified Neumann conditions on the bottom of the ***,note that the new homogenization functions method(HFM)does not require dealing with the regularization and highly nonlinear *** robustness and accuracy of the HFM are verified by comparing the recovered results of several numerical experiments to the exact solutions in the entire region,even though a very large level of noise 50%is imposed on the over specified Neumann *** numerical errors of our scheme are in the order of O(10^(−1))-O(10^(−4)).

关键词： Inverse cauchy problems homogenization functions method(HFM) 3D highly nonlinear elliptic equations 3D homogenization functions

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A Meshless Method for Retrieving Nonlinear Large External Forces on Euler-Bernoulli Beams

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Computers, Materials & Continua 2022年第10期73卷 433-451页

作者： chih-Wen chang Department of Mechanical Engineering National United UniversityMiaoli360302Taiwan

We retrieve unknown nonlinear large space-time dependent forces burdened with the vibrating nonlinear Euler-Bernoulli beams under varied boundary data,comprising two-end fixed,cantilevered,clamped-hinged,and simply supported conditions in this *** though some researchers used several schemes to overcome these forward problems of Euler-Bernoulli beams;however,an effective numerical algorithm to solve these inverse problems is still not *** cope with the homogeneous boundary conditions,initial data,and final time datum for each type of nonlinear beam by employing a variety of boundary shape *** unknown nonlinear large external force can be recuperated via back-substitution of the solution into the nonlinear Euler-Bernoulli beam equation when we acquire the solution by utilizing the boundary shape function scheme and deal with a smallscale linear system to gratify an additional right-side boundary *** the robustness and accuracy,we reveal that the current schemes are substantiated by comparing the recuperated numerical results of four instances to the exact forces,even though a large level of noise up to 50%is burdened with the overspecified *** current method can be employed in the online real-time computation of unknown force functions in space-time for varied boundary supports of the vibrating nonlinear beam.

关键词： Inverse problems nonlinear Euler-Bernoulli beams ill-posed problems nonlinear space-time dependent force boundary shape functions

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Effect of platinum on the photocatalytic degradation of chlorinated organic compound

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Journal of Environmental Sciences 2011年第4期23卷 687-692页

作者： chih ming Ma Ya Wen Lee Gui Bing Hong Te Li Su Je Lueng Shie chang Tang chang Department of Cosmetic Application and Management St. Mary's Medicine Nursing and Management College Yilan County 266 Taiwan China. Department of Environmental Engineering I-Lan University Yilan City 260 Taiwan China

TiO 2 nanoparticles, doped with different Pt contents, were prepared by a modified photodeposition method using Degussa P-25 TiO 2 , H 2 PtCl 6 ·6H 2 O and methanol as the solvents. The physicochemical properties of Pt/TiO 2 were investigated by the nitrogen adsorption and desorption isotherm measurement technique, X-ray diffraction analysis and photoluminescence spectra, respectively. Reaction rates from photocatalytic removal of dichloromethane over Degussa P-25 TiO 2 and Pt/TiO 2 were evaluated. The average diameter and BET surface area of the TiO 2 catalyst particles were 300 nm and 50 m 2 /g, respectively. The degradation efficiency was 99.0%, 82.7%, 55.2%, and 57.9% with TiO 2 at inlet concentrations of 50, 100, 200, and 300 ppm, respectively. And the degradation efficiency was 99.3%, 79.7%, 76.5%, and 73.4% with a 0.005 wt.% Pt/TiO 2 at inlet concentrations of 50, 100, 200, and 300 ppm, respectively. In addition, we found that the photoluminescence emission peak intensities decreased with increases in the doping amount of Pt, which indicates that the irradiative recombination was weakened. Furthermore, the results showed that the UV/0.005 wt.% Pt/TiO 2 process was capable of efficiently decomposing gaseous DCM in air.

关键词： dichloromethane photodeposition method platinum TiO 2 light intensity

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Bariatric surgery in old age:a comparative study of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy in an Asia centre of excellence

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The Journal of Biomedical Research 2015年第2期29卷 118-124页

作者： chih-Kun Huang Amit Garg Hsin-chih Kuao Po-chih chang ming-Che Hsin Bariatric & Metabolic International(B.M.I) Surgery Centre E-Da Hospital Department of Health Management I-Shou University

Bariatric surgery has been proved to be the safest and efficient procedure in treating morbid obese patients,but data is still lacking in the elderly *** aim of our study was to compare the safety and efficacy of laparoscopic Roux-en-Y gastric bypass（LRYGB） and sleeve gastrectomy（LSG） in patients aged more than 55 *** performed2 a retrospective review of a prospectively collected *** patients with body mass index（BMI） §32 kg/mand aged more than 55 years undergoing LRYGB or LSG in BMI Surgery Centre,E-Da Hospital between January 2008 and December 2011 with at least one year of follow up were included for the ***,peri-operative data,weight loss and surgical complications were all recorded and *** age and BMI of these 68 patients22（22 males and 46 female） were 58.8 years（55-79 years） and 39.5 kg/m（32.00-60.40 kg/m）.LRYGB was performed in 44 patients and LSG in 24 *** two groups were comparable in their preoperative BMI,American Society of Anaesthesia（ASA） score and gender *** patients were significantly older than patients receiving *** proportion of type 2 diabetes preoperatively was significantly higher in LRYGB patients as compared to LSG patients（88.63% vs.50%; P,0.01）.The prevalence of other co-morbidities was similar and comparable2 between the *** BMI in the LRYGB and LSG groups at the end of 1 year were 28.8 kg/mand228.2 kg/m,respectively,and there was no statistically significant difference in mean percentage of excess weight loss（%EWL） at 1 *** percentage of resolution of diabetes was significantly higher in LRYGB（69.2%） as compared to LSG（33.3%）.On the other hand,there was no statistical difference in the percentage of resolution of hypertension,hyperlipidemia and fatty liver *** overall morbidity and re-operation rate was higher in LRYGB *** morbidly elderly patients,both surgeries achieved good weight loss and resolution of *** is s

关键词： obesity metabolic surgery Roux-en-Y gastric bypass laparoscopic sleeve gastrectomy effiacy safety

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