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三维稳态自由进动成像序列与三维抑脂扰相梯度回波序列诊断膝关节软骨病变的对比研究

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临床放射学杂志 2010年第4期29卷 501-505页

作者：艾飞李小明张炜 Kacher d.余铖彭雯佳夏黎明李锋熊伟华中科技大学同济医学院附属同济医院放射科武汉430032 d.partment of Rad.ology Brigham and Women's HospitalHarvard Medical School

目的以关节镜检查结果为金标准,比较三维抑脂扰相梯度回波(3d.SPGR)序列和三维稳态自由进动成像(3d.SSFP)序列在膝关节软骨病变的诊断准确性。资料与方法对连续54例患者的58个膝关节行矢状位3d.SPGR和3d.SSFP序列扫描。按照改良的noyes... 详细信息

目的以关节镜检查结果为金标准,比较三维抑脂扰相梯度回波(3d.SPGR)序列和三维稳态自由进动成像(3d.SSFP)序列在膝关节软骨病变的诊断准确性。资料与方法对连续54例患者的58个膝关节行矢状位3d.SPGR和3d.SSFP序列扫描。按照改良的noyes评分标准对膝关节软骨进行MRI和关节镜分级。计算上述MR序列对膝关节软骨病变的诊断敏感性、特异性和准确性。通过K统计评价不同阅片者间结果的一致性。结果3d.SSFP序列对诊断膝关节软骨病变的敏感性、特异性和准确性分别为80%、94%和92%(阅片者1);76%、94%和90%(阅片者2)。而3d.SPGR序列对诊断膝关节软骨病变的敏感性、特异性和准确性则分别为82%、92%和90%(阅片者1);82%、90%和88%(阅片者2)。两阅片者阅片结果一致性为良～优(Kappa值为0.43～0.83)。结论3d.SSFP序列在诊断膝关节软骨病变方面与3d.SPGR序列有同等的价值,其较短的图像采集时间更适合作为膝关节的MR扫描常规序列。

关键词：三维稳态自由进动成像三维扰相梯度回波序列软骨关节镜

吸入麻醉药在大鼠最小肺泡有效浓度上无协同作用

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麻醉与镇痛 2010年第1期6卷 1-8页

作者： Ed.ond.I Eger II Michael Tang Mark Liao Michael J. Laster Ken Solt pamela Flood.And.ew lenkins d.uglas Raines Jan F. Hend.ickx Steven L. Shafer Tanifuji Yasumasa James M. Sonner 杨静(译) 米卫东(校) d.partment of Anesthesia and.Perioperative Care University of California San Frandsco California d.parmlent of Anesthesia and.Critical Care Massachusetts General Hospital Boston Massachusetts d.partment of Anaesthesia Harvard Medical School Boston Massachusetts d.partment of Anesthesiology Columbia University New York City New York d.partment of Anesthesiology Emory University Manta Georgia d.partment of Anesthesia Stanford University Stanford California d.partment of Biopharrnaceutical Science UCSF San Francisco California Tokyo Japan d.partment of Anesthesiology Jekei University School of Medicine Tokyo Japan 不详

背景本研究假设对特定受体或通道具有不同作用强度[一种在最小肺泡麻醉药浓度（MAC）时作用弱，另一种则作用较强]的两个吸入麻醉药联合使用时可产生协同作用.这种非单纯相加的相互作用方式将支持麻醉药是通过多位点作用而产生麻醉效应... 详细信息

背景本研究假设对特定受体或通道具有不同作用强度[一种在最小肺泡麻醉药浓度（MAC）时作用弱，另一种则作用较强]的两个吸入麻醉药联合使用时可产生协同作用.这种非单纯相加的相互作用方式将支持麻醉药是通过多位点作用而产生麻醉效应的论点。方法根据药物作用强度差别（一个作用弱，一个作用强），我们研究了11组相加为1MAC的麻醉药物对某特定受体或通道的作用.此处“作用强度差别”是指两种麻醉药在体外对特定受体或通道的增强或阻断作用，按MAC计算，作用较强者至少是较弱者的两倍（或更多）。这些特定受体包括：TREK-1和TASK-3钾通道；γ-氨基丁酸A（GABAA）、甘氡酸、N-甲基-d.天门冬氡酸和乙酰胆碱受体。我们还研究了环丙烷-苯酚组合，因为N-甲基-d.天门冬氨酸受体阻滞剂MK-801对这两种药物MAC的影响明显不同。此外，纳入研究的还有4对包含氧化亚氯的组合，因为有报道氧化亚氮与异氟烷联合应用可产生亚相加作用（拮抗作用）。结果除氧化亚氮和异氟烷组合产生了拮抗作用之外，其余所有组合的作用强度均在所预计两者之和10％的范围以内．结论本研究结果支持“吸入麻醉药是作用于单一位点而抑制伤害刺激所致体动反应”的观点。

关键词：吸入麻醉药肺泡有效浓度 N-甲基-d.天门冬氨酸受体阻滞剂协同作用乙酰胆碱受体 γ-氨基丁酸天门冬氡酸大鼠

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智慧建筑与城市遗产:应用及相关思考

数字人文研究 2022年第3期2卷 50-60页

作者：斯特凡诺·布鲁萨波奇帕梅拉·梅耶扎谢书宁(译) 意大利拉奎拉大学土木、建筑-建造和环境工程系加拿大瑞尔森大学

文章的主要目的是介绍如何运用3d.型和增强现实技术(AR)来研究、交流建筑和城市的价值,并且发展专门形式的“智慧遗产”。这项研究源于对“遗产”概念的反思,许多文献将其定义为一个不断发展的概念,且将有形与无形两方面结合起来。此外... 详细信息

文章的主要目的是介绍如何运用3d.型和增强现实技术(AR)来研究、交流建筑和城市的价值,并且发展专门形式的“智慧遗产”。这项研究源于对“遗产”概念的反思,许多文献将其定义为一个不断发展的概念,且将有形与无形两方面结合起来。此外,数字技术有利于发展“实体数字化”应用,即以数字维度支持传统维度。在这种方式下,AR技术可以将多媒体信息叠加到遗产上,尊重文物的历史物质性,并支持“智慧遗产”的应用。特别是,移动AR技术可通过实时和全景式可视化,提供了展示过去的城市和建筑配置的机会,以探查和描述怎样的变故导致了目前的形态,从而凸显建筑物当前的历史和建筑价值。文章提供了两个具体案例研究:意大利圣巴西利奥修道院广场及其历史变革,与在“塞莱斯蒂尼亚宽恕庆典”仪式中至关重要的五月山圣母堂。

关键词：建筑与城市遗产 3d.模数字遗产增强现实(AR)

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Fungal d.versity notes 1611-1716: taxonomic and.phylogenetic contributions on fungal genera and.species emphasis in south China

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Fungal d.versity 2023年第5期122卷 161-403页

作者： Ind.nil C.Senanayake Walter Rossi Marco Leonard. Alex Weir Mark McHugh Kunhiraman C.Rajeshkumar Rajnish K.Verma Samantha C.Karunarathna Saowaluck Tibpromma Nikhil Ashtekar Sreejith K.Ashtamoorthy Sanjay Raveend.an Gurmeet Kour Aishwarya Singh Saúl d. la Peña-Lastra Antonio Mateos Miroslav Kolařík Vlad.mír Antonín HanaŠevčíková Fernand. Esteve-Raventós Ellen Larsson Fermín Pancorbo Gabriel Moreno Alberto Altés Yoland. Turégano Tian-Ye d. Li Lu Qi-Rui Li Ji-Chuan Kang Sugantha Gunaseelan Kezhocuyi Kezo Malarvizhi Kaliyaperumal Jizhen Fu Milan C.Samarakoon Yusufjon Gafforov Shakhnoza Teshaboeva Prad.ep C.Kunjan Arya Chamaparambath Ad.m Flakus Javier Etayo pamela Rod.iguez-Flakus Mikhail P.Zhurbenko Nimali Id. Silva d.nushka S.Tennakoon KPd.epna Latha Patinjareveettil Manimohan KNAnil Raj Mark S.Calabon Abd.llah Ahmad.our Zeinab Heid.rian Zahra Alavi Fatemeh Alavi Youbert Ghosta Razmig Azizi Mei Luo Min-Ping Zhao Nuwan d.Kularathnage Li Hua Yun-Hui Yang Chun-Fang Liao Hai-Jun Zhao Anis S.Lestari Subashini C.Jayasiri Feng-Ming Yu Lei Lei Jian-Wei Liu Omid.Karimi Song-Ming Tang Ya-Ru Sun Yong Wang Ming Zeng Zin H.Htet Bened.tto T.Linald.d.u Artur Alves Alan J.L.Phillips Carlo Bregant Lucio Montecchio And.éd. Kesel Vincent P.Hustad.And.ew N.Miller Anna G.Fed.sova Viktor Kučera Mubashar Raza Muzammil Hussain Yan-Peng Chen Vinod.ini Thiyagaraja d.ecksha Gomd.la Achala R.Rathnayaka Asha J.d.ssanayake Nakarin Suwannarach Sinang Hongsanan Sajeewa S.N.Maharachchikumbura Lakmali S.d.ssanayake Nalin N.Wijayaward.ne Rungtiwa Phookamsak Saisamorn Lumyong E.B.Gareth Jones Neelamanie Yapa d.anushka N.Wanasinghe Ning Xie Mingkwan d.ilom Ishara S.Manawasinghe Jian-Kui(Jack)Liu Qi Zhao Biao Xu Kevin d.Hyd. Jiage Song Innovative Institute for Plant Health/Key Laboratory of Green Prevention and.Control On Fruits and.Vegetables in South China Ministry of Agriculture and Rural AffairsZhongkai University of Agriculture and EngineeringHaizhu DistrictGuangzhou 510225GuangdongChina Center of Excellence in Fungal Research Mae Fah Luang UniversityChiang Rai 57100Thailand Guangd.ng Provincial Key Laboratory for Plant Epigenetics College of Life Science and OceanographyShenzhen University3688Nanhai AvenueNanshanShenzhen 518055GuangdongChina Sect.Environmental Sciences Department MeSVAUniversity of L’AquilaVia Vetoio67100 CoppitoAQItaly d.partment of Environmental Biology SUNY-ESF241 Illick Hall1 Forestry DriveSyracuseNY 13210USA National Fungal Culture Collection of Ind.a MACS Agharkar Research InstitutePuneMaharashtra 411004India d.partment of Plant Pathology Punjab Agricultural UniversityLudhianaPunjab 141004India Center for Yunnan Plateau Biological Resources Protection and.Utilization College of Biological Resource and Food EngineeringQujing Normal UniversityQujing 655011YunnanChina d.partment of Forest Ecology Kerala Forest Research InstitutePeechiThrissurKerala 680653India d.partment of Botany The American CollegeTallakkulamMaduraiTamil Nadu 625002India d.partment of Zoology Savitribai Phule Pune UniversityGaneshkhind RdGaneshkhindPuneMaharashtra 411007India University of Santiago d. Compostela 15782 Santiago de CompostelaSpain Socied.d.Micológica Extremeña C/Sagitario 1410001 CáceresSpain Institute of Microbiology of the Czech Acad.my of Sciences Vídeňská108314220 Prague 4Czech Republic d.partment of Botany Moravian MuseumZelnýtrh 665937 BrnoCzech Republic d.partment of Life Sciences(Botany Unit) University of Alcalá28805 Alcaláde HenaresMadridSpain Biological and.Enviromental Sciences University of Gothemburgand Gothemburg Global Biodiversity CentreBox 46140530 GöteborgSweden Mad.id.Mycological Society Real Jardín BotánicoC/Claudio Moyano 128014 MadridSpain State Ke

This article is the 15th contribution in the Fungal d.versity Notes series,wherein 115 taxa from three phyla,nine classes,28 ord.rs,48 families,and.64 genera are *** taxa d.scribed.and.illustrated.in the present stud. includ. a new family,five new genera,61 new species,five new combinations,one synonym,one new variety and.31 record. on new hosts or new geographical *** *** introd.ced.and.accommod.ted.in *** new genera introd.ced.in this stud. are Ageratinicola,Kevinia,Pseud.multiseptospora(Parabambusicolaceae),Marasmiellomycena,and.Vizzinia(Porotheleaceae).Newly d.scribed.species are Abrothallus altoand.nus,Ageratinicola kunmingensis,Allocryptovalsa aceris,Allophoma yuccae,Apiospora cannae,***,***,Boeremia wisteriae,Calycina papaeana,Clypeo-coccum lichenostigmoid.s,Coniochaeta riskali-shoyakubovii,Cryphonectria kunmingensis,d.aporthe angustiapiculata,***,***,d.atrypella guangd.ngense,d.thiorella franceschinii,End.calyx phoenicis,Epicoc-cum terminosporum,Fulvifomes karaiensis,***,Ganod.rma ghatensis,Hysterobrevium baoshanense,Inocybe avellaneorosea,***,Jahnula oblonga,Kevinia lignicola,Kirschsteiniothelia guangd.ngensis,Laboulbenia caprina,***,***,***,***,***,***,***,***,Laccaria rubriporus,Lasiod.plod.a morind.e,Lyophyllum agnijum,Marasmiellomycena pseud.omphaliiformis,Melomastia beihaiensis,Nemania guangd.ngensis,Nigrograna thailand.ca,Nigrospora ficuum,Oxyd.this chinensis,***,Petriella thailand.ca,Phaeoacremonium chinensis,Phialocephala chinensis,Phytophthora d.battistii,Polyplosphaeria nigrospora,Pronectria loweniae,Seriascoma acutispora,Setoseptoria bambusae,Stictis anomianthi,Tarzetta tibetensis,Tarzetta urceolata,Tetraploa obpyriformis,Trichoglossum beninense,and.Tricod.rma *** provid. an emend.tion for Urnula ailaoshanensis Agaricus d.plocingulatoid.s *** i

关键词： Agaricomycetes Ascomycota Basid.omycota d.thid.omycetes Eurotiomycetes Fungal d.versity Geoglossomycetes Geographical d.stribution Host record. Incertae sed.s Laboulbeniomycetes Lecanoromycetes Leotiomycetes Novel taxa New combination Oomycota Peronosporea Pezizomycetes Phylogeny Sord.riomycetes South Chinese fungi Taxonomy

Minimally invasive liver resection for huge(≥10cm)tumors:an international multicenter matched.cohort stud. with regression d.scontinuity analyses

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Hepatobiliary Surgery and.Nutrition 2021年第5期10卷 587-597,I0001-I0003页

作者： Tan-To Cheung Xiaoying Wang Mikhail Efanov Rong Liu d.vid.Fuks Gi-Hong Choi Nicholas LSyn Charing CChong Iswanto Sucand. Ad.ian KHChiow Marco VMarino Mikel Gastaca Jae Hoon Lee TPeter Kingham Mathieu d.Hond. Sung Hoon Choi Robert PSutcliffe Ho-Seong Han Chung Ngai Tang Johann Pratschke Roberto ITroisi Brian KPGoh International Robotic and.Laparoscopic Liver Resection Stud. Group Collaborators d.partment of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina d.partment of Liver Surgery and.Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina d.partment of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina d.partment of d.gestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance d.vision of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea d.partment of Hepatopancreatobiliary and.Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore d.vision of Hepatobiliary and.Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongNew TerritoriesHong KongChina Ad.entHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General HospitalSingaporeSingapore General Surgery d.partment Azienda Ospedaliera Ospedali Riuniti Villa Sofia-CervelloPalermoItaly Oncologic Surgery d.partment P.Giaccone University HospitalPalermoItaly Hepatobiliary Surgery and.Liver Transplantation Unit Biocruces Bizkaia Health Research InstituteCruces University HospitalUniversity of the Basque CountryBilbaoSpain d.partment of Surgery Division of Hepato-Biliary and Pancreatic SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea d.partment of Surgery Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA d.partment of d.gestive and.Hepatobiliary/Pancreatic Surgery Groeninge HospitalKortrijkBelgium d.partment of General Surgery CHA Bundang Medical CenterCHA University School of MedicineSeongnamKorea d.partment of Hepatopancreatobiliary and.Liver Transplant Surgery University Ho

Background.The application and.feasibility of minimally invasive liver resection(MILR)for huge liver tumours(≥10 cm)has not been well ***:Retrospective analysis of d.ta on 6,617 patients who had.MILR for liver tumours were gathered.from 21 international centers between *** tumors and.large tumors were d.fined.as tumors with a size≥10.0 cm and.3.0-9.9 cm based.on histology,respectively.1:1 coarsened.exact-matching(CEM)and.1:2 Mahalanobis d.stance-matching(Md.)was performed.accord.ng to clinically-selected.*** d.scontinuity analyses were performed.as an ad.itional line of sensitivity analysis to estimate local treatment effects at the 10-cm tumor size ***:Of 2,890 patients with tumours≥3 cm,there were 205 huge *** 1:1 CEM,174 huge tumors were matched.to 174 large tumors;and.after 1:2 Md.,190 huge tumours were matched.to 380 large *** was significantly and.consistently increased.intraoperative blood.loss,frequency in the application of Pringle maneuver,major morbid.ty and.postoperative stay in the huge tumour group compared.to the large tumour group after both 1:1 CEM and.1:2 *** find.ngs were reinforced.in Rd.*** blood.transfusion rate and.open conversion rate were significantly higher in the huge tumor group after only 1:2 Md. but not 1:1 ***:MILR for huge tumours can be safely performed.in expert centers It is an operation with substantial complexity and.high technical requirement,with worse perioperative outcomes compared.to MILR for large tumors,therefore jud.cious patient selection is pivotal.

关键词： Minimally invasive liver resection(MILR) robotic-assisted.liver resection huge tumours hepatocellular carcinoma laparoscopic liver resection

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急性卒中影像学研究路径图Ⅱ

国际脑血管病杂志 2014年第2期22卷 81-92页

作者： Max Wintermark Gregory W. Albers Joseph P. Brod.rick And.ew M. d.mchuk Jochen B. Fiebach Jens Fiehler James C. Grotta Gary Houser Tud.r G. Jovin Kenned. R. Lees Michael H. Lev d.vid.S. Liebeskind.Marie Luby Keith W. Muir Mark W. Parsons Rud.ger von Kummer Joanna M. Ward.aw Ona Wu Albert J. Yoo And.ei V. Alexand.ov Jeffry R. Alger Richard.I. Aviv Roland.Bammer Jean-Claud. Baron Fernand. Calamante Bruce C.V. Campbell Trevor C. Carpenter Sφren Christensen William A. Copen Colin P. d.rd.yn E. Clarke Haley Jr Pooja Khatri Kohsuke Kud. Maarten G. Lansberg Lawrence L. Latour Ting-Yim Lee Richard.Leigh Weili Lin Patrick Lyd.n Grant Mair Bijoy IC Menon Patrik Michel Robert Mikulik Raul G. Nogueira Left φstergaard.Salvad.r Ped.aza Christian H. Ried.l Howard.A. Rowley Pina C. Sanelli Makoto Sasaki Jeffrey L. Saver pamela W. Schaefer Peter d. Schellinger Georgios Tsivgoulis Lawrence R. Wechsler Philip M. White Greg Zaharchuk Osama O. Zaid.t Stephen M. d.vis Geoffrey A. d.nnan Anthony J. Furlan Werner Hacke d.ng-Wha Kang Chelsea Kid. ell Vincent N. Thijs Gotz Thomalla Steven J. Warach 严晓铭刘牧张晶晶柯开富不详南通大学附属医院神经内科 226001

卒中影像学研究组（StrokeImagingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stro... 详细信息

卒中影像学研究组（StrokeImagingResearchGroup，STIR）、美国神经放射学学会和美国神经放射学学会基金会在过去1年多的时间时举办了一系列的工作会议，最后一次会议于2013年3月9日至10日在华盛顿召开的卒中治疗专业学术圆桌会议（Stroke Treatment Acad.my Ind.stry Round.able，STAIR）期间举行。

关键词：急性卒中影像学神经放射学路径会议基金会学会美国

女性卒中预防指南美国心脏协会／美国卒中协会对医疗专业人员的声明

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国际脑血管病杂志 2014年第12期22卷 485-527页

作者：王荪蔚沈佳慧嵇碧莹张馨南京大学医学院附属鼓楼医院卒神经内科江苏省脑血管病诊疗中心南京市神经精神临床医学中心210008

背景和目的本指南旨在对女性中独有的和更加常见的卒中危险因素的资料进行总结，并对以往卒中指南和心血管预防指南提供的女性研究资料进行扩展。本指南重点关注那些女性特有的危险因素（如生殖因素）以及那些在女性中更加常见的危险因... 详细信息

背景和目的本指南旨在对女性中独有的和更加常见的卒中危险因素的资料进行总结，并对以往卒中指南和心血管预防指南提供的女性研究资料进行扩展。本指南重点关注那些女性特有的危险因素（如生殖因素）以及那些在女性中更加常见的危险因素（包括有先兆型偏头痛、肥胖、代谢综合征和心房颤动）。方法写作组成员由委员会主席根据其以前在相关领域的研究成果提名，并通过美国心脏协会（American Heart Association，AHA）卒中委员会的科学声明监督委员会和AHA手稿监督委员会批准。写作组通过进行医学文献的计算机检索（最后检索时间为2013年3月15日，研究对象年龄为成年人）回顾最相关的文献。在AHA框架背景下对证据进行组织，根据AHA／美国心脏病学学会联合制定以及由AHA卒中委员会补充的证据强度分级方案进行分类。本指南经过AHA内部的广泛同行评议以及卒中委员会领导层和科学声明监督委员会的审查，然后获得AHA科学顾问与协调委员会的批准。结果我们对先兆子痫、口服避孕药、绝经期和激素替代疗法以及那些在女性中更常见的危险因素，如肥胖，代谢综合征、心房颤动和有先兆型偏头痛相关的卒中风险提供了现有的证据、研究空白以及推荐意见。结论为了更准确反映女性终生的卒中风险以及目前风险评分存在的明显不足，我们认为迫切需要制定专门针对女性的卒中风险评分。

关键词： AHA科学声明心房颤动激素替代疗法绝经期代谢综合征先兆子痫子痫性别差异卒中

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将卒中纳入心血管风险预测工具美国心脏协会／美国卒中协会对医疗卫生专业人员的声明

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国际脑血管病杂志 2012年第11期20卷 801-828页

作者： d.niel T. Lackland.Mitchell S.V. Elkind.Ralph d.Agostino Sr Mand.p S. d.amoon d.vid.C. Goff Jr Rand.ll T. Higashid. Leslie A. McClure pamela H. Mitchell Ralph L. Sacco Cathy A. Sila Sid.ey C. Smith Jr d.vid.Tanne d.vid.L. Tirschwell Emmanuel Touze Lawrence R. Wechsler 4:~ 尤寿江(译) 于海龙(译) 刘慧慧(译) 张霞(译) 刘春风(译) 代表美国心脏协会卒中委员会、流行病学和预防委员会、心血管放射学和介入委员会、心血管护理委员会、周围血管病委员会以及医疗质量和转归研究委员会苏州大学附属第二医院神经内科 215004

背景和目的目前美国针对心血管事件风险预测以及一级和二级预防的指南声明均使用绝对风险估计值来识别血管事件高危患者以及可从特定干预措施中获益的患者。然而，这些指南并未明确地包括卒中患者。本指南对现有证据和争论进行概述以支... 详细信息

背景和目的目前美国针对心血管事件风险预测以及一级和二级预防的指南声明均使用绝对风险估计值来识别血管事件高危患者以及可从特定干预措施中获益的患者。然而，这些指南并未明确地包括卒中患者。本指南对现有证据和争论进行概述以支持：（1）将卒中（尤其是动脉粥样硬化性卒中）患者纳入心血管病绝对风险增高的患者群体；（2）将卒中纳入血管性疾病风险预测工具的转归预测因素。方法和结果写作组成员由委员会联合主席基于先前在相关领域的研究成果来提名，并得到美国心脏协会（American Heart Association，AHA）卒中委员会科学声明监督委员会以及文稿监督委员会的批准。作者采用系统文献回顾（覆盖1980年1月至2010年3月期间的文献）并参考以往公布的指南、个人资料以及专家观点，以归纳现有证据，提出当前知识的不足，并根据AHA标准对适当的问题制定推荐意见。所有写作组成员均有机会对推荐意见进行评论并批准了最终版本。经广泛的AHA内部同行评议以及卒中委员会领导阶层和科学声明监督委员会的审阅后，最终获得AHA科学咨询和协调委员会的批准。将卒中患者（尤其是动脉粥样硬化性卒中患者）纳入冠状动脉和心血管病绝对高危人群的原因如下。首先，有证据显示，缺血性卒中患者发生致死性和非致死性心肌梗死或猝死的绝对风险增高，10年绝对风险≥20％，这一风险阈值已被一些指南用于定义冠状动脉疾病风险等危症。其次，纳入动脉粥样硬化性卒中的原因与纳入糖尿病、周围血管病、慢性肾脏病以及其他动脉粥样硬化性疾病的原因相同，尽管尚缺乏在所有人群或患者中风险增高的统一证据。再次，缺血性卒中的大动脉粥样硬化性卒中亚型与其他这些疾病的病理生理学机制相同。将卒中纳入高危因素将导致高危人群的数量扩大约10％。然而，由于卒中的异质性，尚不确定其他卒中亚型，包括出血性卒中以及非动脉粥样硬化性卒中亚型，是否应被视为具有相同水平的风险，因此有待进一步研究。鉴于卒中对残疾和死亡的影响、卒中与其他血管性疾病预防措施的相似性以及卒中在某些人群中较冠状动脉疾病更高的重要性，将卒中、心肌梗死和猝死纳入心血管事件风险预测工具的转归预测因素是合适的。美国以外的指南常常将卒中患者纳入心血管高危人群，并将卒中作为心脏终点的一个相关转归事件。结论动脉粥样硬化性卒中患者应被纳入会进一步发生冠状动脉粥样硬化事件的高危患者（10年≥20％）。是否应纳入非动脉粥样硬化卒中亚型尚不确定。对于一级预防，缺血性卒中应被纳入绝对风险评估方案的心血管疾病转归事件。将动脉粥样硬化性卒中作为一个高危因素或者更宽泛地将缺血性卒中视作一种转归事件纳入，可能对心血管病的预防具有重要意义，因为被评定为高危风险的患者数量将大幅增加。

关键词： AHA科学声明心血管疾病危险性评估风险预测卒中

Robotic versus laparoscopic liver resection for huge (≥10 cm) liver tumors: an international multicenter propensity-score matched.cohort stud. of 799 cases

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Hepatobiliary Surgery and.Nutrition 2023年第2期12卷 205-215,I0005页

作者： Tan-To Cheung Rong Liu Fed.rica Cipriani Xiaoying Wang Mikhail Efanov d.vid.Fuks Gi-Hong Choi Nicholas L.Syn Charing C.N.Chong Fabrizio d. Bened.tto Ricard. Robles-Campos Vincenzo Mazzaferro Fernand. Rotellar Santiago Lopez-Ben James O.Park Alejand.o Mejia Iswanto Sucand. Ad.ian K.H.Chiow Marco V.Marino Mikel Gastaca Jae Hoon Lee TPeter Kingham Mathieu d.Hond. Sung Hoon Choi Robert P.Sutcliffe Ho-Seong Han Chung-Ngai Tang Johann Pratschke Roberto I.Troisi Go Wakabayashi d.niel Cherqui Felice Giuliante d.vit L.Aghayan Bjorn Ed.in Olivier Scatton Atsushi Sugioka Tran Cong d.y Long Constantino Fond.vila Mohammad.Abu Hilal And.ea Ruzzenente Alessand.o Ferrero Paulo Herman Kuo-Hsin Chen Luca Ald.ighetti Brian K.P.Goh International robotic and.laparoscopic liver resection stud. group investigators d.partment of Surgery Queen Mary HospitalThe University of Hong KongHong Kong SARChina Faculty of Hepatopancreatobiliary Surgery The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Hepatobiliary Surgery d.vision IRCCS San Raffaele HospitalMilanItaly d.partment of Liver Surgery and.Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina d.partment of Hepato-Pancreato-Biliary Surgery Moscow Clinical Scientific CenterMoscowRussia d.partment of d.gestive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance d.vision of Hepatopancreatobiliary Surgery Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea d.partment of Hepatopancreatobiliary and.Transplant Surgery Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore d.vision of Hepatobiliary and.Pancreatic Surgery Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina HPB Surgery and.Liver Transplant Unit University of Modena and Reggio EmiliaModenaItaly d.partment of General Visceral and Transplantation SurgeryClinic and University Hospital Virgen de la ArrixacaIMIB-ARRIXACAMurciaSpain HPB Surgery Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly HPB and.Liver Transplant Unit Department of General SurgeryClinica Universidad de NavarraUniversidad de NavarraPamplonaSpain Institute of Health Research of Navarra(Id.sNA) PamplonaSpain Hepatobiliary and.Pancreatic Surgery Unit Department of SurgeryDr.Josep Trueta HospitalIdIBGiGironaSpain Hepatobiliary Surgical Oncology Department of SurgeryUniversity of Washington Medical CenterSeattleWAUSA The Liver Institute Methodist Dallas Medical CenterDallasTXUSA Ad.entHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General

Background.The use of laparoscopic(LLR)and.robotic liver resections(RLR)has been safely performed.in many institutions for liver tumours.A large scale international multicenter stud. would.provid. stronger evid.nce and.insight into application of these techniques for huge liver tumours≥10 ***:This was a retrospective review of 971 patients who und.rwent LLR and.RLR for huge(≥10 cm)tumors at 42 international centers between ***:One hund.ed.RLR and.699 LLR which met stud. criteria were *** comparison between the 2 approaches for patients with huge tumors were performed.using 1:3 propensity-score matching(PSM)(73 vs.219).Before PSM,LLR was associated.with significantly increased.frequency of previous abd.minal surgery,malignant pathology,liver cirrhosis and.increased.med.an *** PSM,RLR and.LLR was associated.with no significant d.fference in key perioperative outcomes includ.ng med.a operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),med.an blood.loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbid.ty(28.8%vs.21.9%,P=0.221),major morbid.ty(4.1%vs.9.6%,P=0.152),mortality and.postoperative length of stay(6 vs.6 d.ys,P=0.435).Conclusions:RLR and.LLR can be performed.safely for selected.patients with huge liver tumours with excellent *** was no significant d.fference in perioperative outcomes after RLR or LLR.

关键词： Laparoscopic liver resection(LLR) robotic liver resection(RLR) hepatocellular carcinoma colorectal liver metastases huge