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tourniquets do not increase the total blood loss or reamputation risk in transtibial amputations

World Journal of Orthopedics 2017年第1期8卷 62-67页

作者： Christian Wied peter t tengberg Gitte Holm thomas Kallemose Nicolai B Foss Anders troelsen Morten t Kristensen Depart-ment of Orthopedic Surgery Copenhagen University Hospital Hvidovre Clinical Research Centre Copenhagen University Hospital Hvidovre Department of Anesthesiology and Intensive Care Copenhagen University Hospital Hvidovre Physical Medicine and Rehabilita-tion Research--Copenhagen Department of Physical TherapyCopenhagen University Hospital Hvidovre

AIM to investigate the total blood loss(tBL) and the safety with respect to the re-amputation rate after transtibial amputation(ttA) conducted with and without a tourniquet. MEtHODS the study was a single-centre retrospective cohort study of patients with a primary ttA admitted between January 2013 and April 2015. All patients with a primary ttA were assessed for inclusion if the amputation was performed because of arteriosclerosis or diabetic complications. All patients underwent a standardized ttA procedure that was performed approximately 10 cm below the knee joint and performed with sagittalflaps. the pneumatic tourniquet, when used, was inflated around the femur to a pressure of 100 mmH g above the systolic blood pressure. the number of blood transfusions within the first four postoperative days was recorded. the intraoperative blood loss(OBL), which is defined as the volume of blood lost during surgery, was determined from the suction volume and by the weight difference of the surgical dressings. the trigger for a blood transfusion was set at a decrease in the Hgb level transfusions were performed with pooled red blood cells containing 245 m L per portion, which equals 55 g/L of haemoglobin. the tBL during the first four postoperative days was calculated based on the haemoglobin level and the estimated blood volume. the re-amputation rate was evaluated within 30 d. RESULtS Seventy-four out of 86 consecutive patients who underwent ttA within the two-year study period were included in the analysis. Of these, 38 were operated on using a tourniquet and 36 were operated on without using a tourniquet. there were no significant preoperative differences between the groups. the patients in both groups had a postoperative decrease in their Hgb level compared with preoperative baseline values. the patients operated on using a tourniquet received approximately three millilitres less blood transfusion per kilogram body weight compared with patients o

关键词： total blood loss Intraoperative blood loss transtibial amputation Lower extremity amputation Pneumatic tourniquet Re-amputation

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the evolution and refinement of vasoepididymostomy techniques

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Asian Journal of Andrology 2013年第1期15卷 49-55页

作者： peter t Chan Department of Urology Royal Victoria Hospital McGill University Health Center Montreal Quebec H3A 1A1 Canada

Obstructive azoospermia secondary to epididymal obstruction can be corrected by microsurgical reconstruction with vasoepididymostomy （VE）. Although alternative management such as epididymal or testicular sperm aspiration in conjunction with intracytoplasmic sperm injection is feasible, various studies have established the superior cost-effectiveness of VE as a treatment of choice. Microsurgical VE is considered one of the most technically challenging microsurgeries. Its success rate is highly dependent on the skills and experience of the surgeons. Various techniques have been described in the literature for VE. We have pioneered a technique known as longitudinal intussusception VE （LIVE） in which the epididymal tubule is opened longitudinally to obtain a larger opening to allow its tubular content to pass through the anastomosis. Our preliminary data demonstrated a patency rate of over 90%. this technique has been widely referenced in the recent literature including robotic-assisted microsurgery. the history of the development of different VE approaches, the oreoDerative evaluation along with the techniaues of various VE will be described in this article.

关键词： longitudinal intussusception vasoepididymostomy (LIVE) intracytoplasmic sperm injection (ICSI) male infertility microsurgery obstructive azoospermia vasoepididymostomy (VE)

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Imaging in translational cancer research

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Cancer Biology & Medicine 2022年第11期19卷 1565-1585页

作者： Felix t.Kurz Heinz-peter Schlemmer Department of Radiology German Cancer Research CenterHeidelberg 69120Germany

this review is aimed at presenting some of the recent developments in translational cancer imaging research,with a focus on novel,recently established,or soon to be established cross-sectional imaging techniques for computed tomography(Ct),magnetic resonance imaging(MRI),and positron-emission tomography(PEt)imaging,including computational investigations based on machine-learning techniques.

关键词： Cancer imaging computed tomography(Ct) magnetic resonance imaging(MRI) positron emission tomography(PEt) cross-sectional imaging

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the effects of gonadal hormones on learning and memory in male mammals： A review

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Current Zoology 2011年第4期57卷 543-558页

作者： Stuart t. LEONARD peter J. WINSAUER Department of Pharmacology and Experimental therapeutics Louisiana State University Health Sciences Center 1901 Perdido Street New Orleans LA 70112-1393

the primary role of the gonadal steroid hormones in mammals is to regulate reproduction and related behaviors; however, both androgens and estrogens are also integrally involved in mediating higher brain function and processes including cognition, neural development, and neural plasticity. In particular, a number of studies show that estradiol modulates dendritic spine growth and synapse density （synaptic plasticity） in the hippocampus of females, and that increased estradiol levels are generally associated with improvements on a variety of learning and memory tasks. While the majority of research has focused on the beneficial effects of estradiol in females, much less attention has been given to testosterone and its effects on learning and memory in males. Similar to estradiol titers in females, testosterone titers in males decline with age, albeit more gradually, and this decline has been correlated with impairment of certain cognitive tasks. Moreover, studies involving both humans and animals indicate that testosterone and its metabolites can augment responding on certain behavioral tasks, depending on the subject＇s current hormonal state, the response required, and the stimuli involved （e.g., those involving spatial or nonspatial stimuli）. While the exact mechanisms by which testosterone exerts its effects on learning and memory are not fully understood, recent findings suggest that testosterone modulates learning and memory in males through an interaction with the cholinergic system. the overall objective of this review is to discuss studies investigating the role of the gonadal hormones in mediating learning and memory processes in male mammals [Current Zoology 57 （4）： 543-558, 2011].

关键词： testosterone Learning and memory Cholinergic system Mammals Cognition Androgens

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Novel ecosystems created by coal mines in central Queensland’s Bowen Basin

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Ecological Processes 2013年第1期2卷 368-379页

作者： peter D Erskine Andrew t Fletcher Centre for Mined Land Rehabilitation The University of QueenslandBrisbane QLD 4072Australia

Introduction:Open-cut coal mining began in central Queensland’s Bowen Basin approximately 50 years *** this period of time,mine rehabilitators have used a variety of tree,shrub,and groundcover species to create‘novel ecosystems’to stabilise soils and provide vegetative cover for pre-supposed final end-land *** examine post-mining rehabilitation from multiple soil and vegetation monitoring activities in the Bowen Basin to assess the similarity of landforms,plant composition,and trends in plant diversity compared to unmined reference ***:Rehabilitated spoil dumps and reference sites were assessed using soil and vegetation data contained in compliance monitoring reports from Goonyella Riverside,Moura,Oaky Creek,Rolleston,and Blackwater ***,soil chemistry,and plant species mixes of rehabilitation aged from 2 to 22 years were compared to selected reference ***:Mines in this region have generally proposed one of two post-rehabilitation end-land uses:either pasture for cattle grazing or reconstructed native communities which potentially provide native fauna *** data from a selection of these mine sites suggest that when their rehabilitation was compared to nearby reference sites median slope values were between 2.5 and 7 times steeper and soil pH,electrical conductivity,and phosphorus levels were significantly *** steeply sloped landforms,poor soil characteristics,depauperate native species pool,and uniform presence of exotic pasture grasses in the rehabilitation indicate that most of these newly created ecosystems should not be used for cattle grazing and also have few natural ***:Legislative and community expectations have changed progressively over time and,although much of the rehabilitation is currently dominated by an assemblage of exotic buffel grass(Cenchrus ciliaris)and Acacia spp.,recent environmental authorities suggest these‘novel ecosystems’will be judged against native refere

关键词： Coal mining Completion criteria Environmental conditions Novel ecosystems

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Carbon dioxide accumulation during analgosedated colonoscopy: Comparison of propofol and midazolam

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World Journal of Gastroenterology 2012年第38期18卷 5389-5396页

作者： Ludwig t Heuss Shajan peter Sugandha Christoph Beglinger Department of Gastroenterology University Hospital4031 Basel Switzerland

AIM: to characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. MEtHODS: Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation (SpO 2 ) was measured by pulse oximetry (POX), and capnography (PcCO 2 ) was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points: baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. the number of patients in both study groups who regained baseline PcCO 2 values (± 1.5 mmHg) five minutes after the procedure was ***: A total of 97 patients entered this study. the data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. therefore, 83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n = 42) or midazolam (n = 41) for sedation. Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups, respectively]. A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms. the mean SpO 2 at baseline (%) was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of hypoxemia (SpO 2 < 85%) or apnea were

关键词： Colonoscopy Deep sedation Propofol Hypoventilation Blood gas monitoring transcutaneous

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Molecular simulation study of dynamical properties of room temperature ionic liquids with carbon pieces

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Science China Chemistry 2016年第5期59卷 594-600页

作者： Guang Feng Wei Zhao peter t.Cummings Song Li State Key Laboratory of Coal Combustion School of Energy and Power Engineering Huazhong University of Science and Technology Department of Chemical and Biomolecular Engineering Vanderbilt University

Room temperature ionic liquids(RtILs) with dispersed carbon pieces exhibit distinctive physiochemical properties. to explore the molecular mechanism, RtILs/carbon pieces mixture was investigated by molecular dynamics(MD) simulation in this work. Rigid and flexible carbon pieces in the form of graphene with different thicknesses and carbon nanotubes in different sizes were dispersed in a representative RtIL 1-butyl-3-methyl-imidazolium dicyanamide([Bmim][DCA]). this study demonstrated that the diffusion coefficients of RtILs in the presence of flexible carbons are similar to those of bulk RtILs at varying temperatures, which is in contrast to the decreased diffusion of RtILs in the presence of rigid carbons. In addition, interfacial ion number density at rigid carbon surfaces was higher than that at flexible ones, which is correlated with the accessible external surface area of carbon pieces. the life time of cation-anion pair in the presence of carbon pieces also exhibited a dependence on carbon flexibility. RtILs with dispersed rigid carbon pieces showed longer ion pair life time than those with flexible ones, in consistence with the observation in diffusion coefficients. this work highlights the necessity of including the carbon flexibility when performing MD simulation of RtILs in the presence of dispersed carbon pieces in order to obtain the reliable dynamical and interfacial structural properties.

关键词： room temperature ionic liquids carbon pieces flexibility dynamical property ion pair stability interfacial structure

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Heat shock protein 47 promotes tumor survival and therapy resistance by modulating AKt signaling via PHLPP1 in colorectal cancer

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Cancer Biology & Medicine 2020年第2期17卷 343-356页

作者： Yijye Chern peter Zhang Hyelim Ju Isabella t.tai Division of Gastroenterology Department of MedicineUniversity of British ColumbiaVancouver V6T 1Z4Canada Michael Smith Genome Sciences Center British Columbia Cancer AgencyVancouver V5Z 4S6Canada

Objective:Heat shock protein 47(HSP47)is a collagen-specific molecular chaperone that facilitates collagen *** role in cancer remains largely *** this study,we investigated the roles o f HSP47 in colorectal cancer(CRC)and therapy ***:Expression o f HSP47 in CRC tissues was examined(1)in paired human CRC/adjacent normal tissues,using real time quantitative reverse transcription polymerase chain reaction(qRt-PCR),the Cancer Genome Atlas(tCGA)database,and 22 independent m icroarray databases(curated CRC).In vitro studies on several CRC cell lines(H C t 116,RKO and C C L228)with modulated HSP47 expression were conducted to assess cell viability and apoptosis(tU N EL assay and caspase-3/-7)during exposure to *** signaling and co-imm unoprecipitation studies were performed to examine HSP47 and PHLPP1 *** vivo studies using tumor xenografts were conducted to assess the effects of HSP47 modulation on tum or growth and therapy ***:HSP47 was upregulated in CRC and was associated with poor prognosis in individuals with *** vitro,HSP47 overexpression supported the survival of CRC cells,whereas its knockdown sensitized cells to 5-fluorouracil(5-FU).HSP47 promoted survival by inhibiting apoptosis,enhancing AKt phosphorylation,and decreasing expression of the AKt-specific phosphatase PHLPP1 when cells were exposed to *** effects were partly results of the interaction between HSP47 and PHLPP1,which decreased PHLPP1 stability and led to more persistent AKt *** vivoy HSP47 supported tumor growth despite 5-FU ***:HSP47 supports the growth of CRC tumors and suppresses the efficacy of chemotherapy via modulation of AKt signaling.

关键词： HSP47 AKt PHLPP1 colorectal cancer resistance

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treatment strategies for colorectal carcinoma with synchronous liver metastases: Which way to go?

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World Journal of Gastroenterology 2015年第22期21卷 7014-7021页

作者： peter Ihnát Petr Vávra Pavel Zonca Department of Surgical Studies Faculty of MedicineUniversity of Ostrava Department of Surgery University Hospital Ostrava

AIM: to offer an up-to-date review of all availabletreatment strategies for patients with synchronous colorectal liver metastases(CLM).MEtHODS: A comprehensive literature search was performed to identify articles related to the management of patients with synchronous CLM. A search of the electronic databases PubMed, MEDLINE, and Google Scholar was conducted in September *** following search terms were used: synchronous colorectal liver metastases, surgery, stage Ⅳ colorectal cancer, liver-first approach, and up-front *** terms were employed in various combinations to maximize the search. Only articles written in English were included. Particular attention was devoted to studies and review articles that were published within the last six years(2009-2014). Additional searches of the cited references from primary articles were performed to further improve the review. the full texts of all relevant articles were accessed by two independent ***: Poor long-term outcomes of patients with synchronous CLM managed by a traditional treatment strategy have led to questions about the timing and sequence of possible therapeutic interventions. thus,alternative paradigms called reverse strategies have been proposed. Presently, there are four treatment strategies available:(1) primary first approach(or traditional approach) comprises resection of the primary colorectal tumor followed by chemotherapy;subsequent liver resection is performed 3-6 mo after colorectal resection(provided that CLM are still resectable);(2) simultaneous resection of the primary colorectal tumor and CLM during a single operation presents intriguing options for a highly select group of patients, which can be associated with significant postoperative morbidity;(3) liver-first(or chemotherapy-first) approach comprises preoperative chemotherapy(3-6 cycles) followed by liver resection,adjuvant chemotherapy, and resection of the primary colorectal tumor(it is best suited for patient

关键词： Colorectal cancer Liver-first approach Reverse strategy Simultaneous resection Up-fronthepatectomy

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Diagnosis in bile acid-CoA:Amino acid N-acyltransferase deficiency

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World Journal of Gastroenterology 2012年第25期18卷 3322-3326页

作者： Nedim Hadzi Laura N Bull peter t Clayton AS Knisely Paediatric Liver Service and Institute of Liver Studies King's College HospitalLondon SE5 9RSUnited Kingdom Liver Center Laboratory University of California San FranciscoSan FranciscoCA 94110United States Biochemistry Research Group Clinical and Molecular Genetics UnitUniversity College London Institute of Child HealthLondon WC1 N1EHUnited Kingdom Institute of Liver Studies King's College HospitalLondon SE5 9RSUnited Kingdom

Cholate-CoA ligase （,EEL） and bile acid-CoA： amino acid N-acyltransferase （BAAt） sequentially mediate bile-acid amidation. Defects can cause intrahepatic cholestasis. Distinction has required gene sequencing. We assessed potential clinical utility of immunostaining of liver for CCL and BAAt. Using commercially available antibodies against BAAt and CCL, we immunostained liver from an infant with jaundice, deficiency of amidated bile acids, and transcription-terminating mutation in BAAt. CCL was normally expressed. BAAt expression was not de- tected. Immunostaining may facilitate diagnosis in bile- acid amidation defects.

关键词： Amidation Bile acid-CoA Amino acid N-ac- yltransferase Cholate-CoA ligase, Cholestasis Conjuga-tion Electrospray ionisation-mass spectroscopy Immu-nohistochemistry Liver Neonatal hepatitis SIC27A5 transmission electron microscopy

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