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Impact of medical and surgical intervention on survival in patients with cholangiocarcinoma

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World Journal of Gastrointestinal surgery 2013年第6期5卷 178-186页

作者： Amanda K Arrington Rebecca A Nelson Ann Falor Carrie Luu Rebecca L Wiatrek Marwan Fakih Gagandeep singh Joseph Kim Division of surgical Oncology City of Hope Comprehensive Cancer CenterDuarteCA 91010United States Department of Biostatistics City of Hope Comprehensive Cancer CenterDuarteCA 91010United States Department of surgery Harbor-UCLA Medical CenterTorranceCA 90509United States Department of Medical Oncology City of Hope Comprehensive Cancer CenterDuarteCA 91010United States

AIM:To examine surgical and medical outcomes for patients with cholangiocarcinoma using a populationbased cancer ***:Using the California Cancer Registry's Cancer surveillance Program,patients with intrahepatic cholangiocarcinoma treated in Los Angeles County from 1988 to 2006 were identified and evaluated for clinical and pathologic factors and therapies received(surgery,radiation,and chemotherapy).The surgical cohort was further categorized into three treatment groups:patients who received adjuvant chemotherapy,adjuvant chemoradiation,or underwent surgery alone(no chemotherapy or radiation administered).survival was assessed by Kaplan-Meier method;and Cox proportional hazard modeling was used in multivariate ***:Of 825 patients,60.2% received no *** the remaining 328 patients,18.5% chemotherapy only,7.4% chemoradiation,and 13.8% underwent *** male patients underwent surgical resection(P = 0.004).surgical patients were younger than the patients receiving chemotherapy or chemoradiation(P surgical cohort(n = 114),60.5% underwent surgery alone while 39.5% underwent surgery plus adjuvant therapy(chemotherapy n = 20;chemoradiation,n = 21)(P survival for all patients in the study was 6.6 *** survival was highest for patients who underwent surgery(23 mo),whereas both chemotherapy(9 mo) and chemoradiation(8 mo) alone were each less effective(P sis,extent of disease,receipt of surgery,and administration of chemotherapy(with/without surgery) were independent predictors of overall ***:This study demonstrates that surgery is a critical treatment *** treatment has yet to be standardized,but play a role in optimal therapy for cholangiocarcinoma.

关键词： Cholangiocarcinoma Chemotherapy surgery survival Therapies

Primary Malignant Melanoma of Female Urethra:A Case Report and Review of Literature

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Journal of Oncology Research 2019年第3期1卷 13-16页

作者： shashank Agrawal Tak GR Aditya Parikh Arvind Prakash Ganpule Abhishek Gajendra singh Ravindra Bhalchandra sabnis Mahesh Ramanlal Desai MBBs MSDNB(UROLOGY MBBs MSDNBMNAMS(Vice Chairman MBBs MSM.chDNB MBBs MSMch(Chairman MBBs MSFRCSFRCS(Medical Director

We report a very rare case report of female diagnosed with primary malignant melanoma.A 65 years old diabetic elderly postmenopausal female presented with a history of intermittent blood spots on undergarments for few *** examination revealed a single,tan colored,soft chestnut size and polypoidal non ulcerated mass lesion protruding through the urethral *** biopsy revealed poorly differentiated epithelial malignancy and immuno-histological analysis revealed positive with HMB 45 and protein s-100 suggestive of *** work up for the malignancy was *** urethrectomy with Mitrofanoff procedure with inguinal lymph node dissection was *** examination was suggestive of malignant melanoma of *** we discuss the clinicopathological features and management option possible in this scenario.

关键词： Female urethra melanoma

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髌骨肿瘤和肿瘤样病变:多中心经验

国际医学放射学杂志 2009年第3期 301-301页

作者： J.singh s.L.James H.M.Kroon K.Woertler s.E.Anderson A.M.Davies 尚全良 Department of Radiology The Royal Orthopaedic HospitalBristol Road SouthNorthfieldBirminghamUK

对在欧洲4个骨肿瘤中心登记的59例髌骨病变的病人进行了复习,其中46%是非肿瘤,39%是良性肿瘤,15%是恶性肿瘤。最常见的良性肿瘤是骨巨细胞瘤(11例),年轻人以良性肿瘤居多。40岁以下病人中髌骨病变有骨巨细胞瘤、成软骨细胞瘤、动脉瘤样... 详细信息

对在欧洲4个骨肿瘤中心登记的59例髌骨病变的病人进行了复习,其中46%是非肿瘤,39%是良性肿瘤,15%是恶性肿瘤。最常见的良性肿瘤是骨巨细胞瘤(11例),年轻人以良性肿瘤居多。40岁以下病人中髌骨病变有骨巨细胞瘤、成软骨细胞瘤、动脉瘤样骨囊肿、骨髓炎、骨样骨瘤、单房性骨囊肿;40岁以上病人髌骨病变常见有骨内痛风、

关键词：髌骨髌骨肿瘤骨肿瘤

经组织学证实的卵巢囊性腺纤维瘤的MRI形态学特征及强化模式评估

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国际医学放射学杂志 2013年第2期 182-182页

作者： Y.Z. Tang s. Liyanage P. Narayanan A. sahdev A. sohaib N. singh 李宁 Imaging Department Barts and the London NHS Trust London UK

目的评估经组织学证实的卵巢囊性腺纤维瘤(CAF)的MRI形态学及强化特征。方法回顾性分析47例经组织学证实的CAF(良性42例、交界性5例)。其中1例良性CAF合并同侧卵巢腺癌。记录其在MRI上的形态、信号及增强特征。结果 CAF的平均长径为80mm... 详细信息

目的评估经组织学证实的卵巢囊性腺纤维瘤(CAF)的MRI形态学及强化特征。方法回顾性分析47例经组织学证实的CAF(良性42例、交界性5例)。其中1例良性CAF合并同侧卵巢腺癌。记录其在MRI上的形态、信号及增强特征。结果 CAF的平均长径为80mm。45%的病例存在对侧卵巢的异常。85%的CAF可见实性成分,其中75%表现为T2WI上的低信号。74%的CAF可见分隔,其中1例为完全囊性的。大多数的实性成分及分隔的强化程度低于子宫肌层。对9例病人实性组织的对比剂流入率(WIR)进行评估,平均值为3.21/s。结论这是对经组织学证实的CAF进行MRI特征描述的数量最多的一次研究,包含了分隔、囊性成分及实性组织的典型的复杂附件病变。大多数实性成分表现为T2低信号和轻度强化。几乎一半的病例存在对侧卵巢的异常。要点①囊性腺纤维瘤是复杂的附件病变,包含分隔、囊性及实性成分。②囊性腺纤维瘤的一些MRI特征与卵巢恶性肿瘤相重叠。③几乎50%的囊性腺纤维瘤病人存在对侧卵巢的异常。④多数对侧卵巢病变为良性,但本研究发现4例交界性肿瘤。

关键词：囊性腺纤维瘤 MRI 附件肿瘤动态增强成像卵巢上皮性肿瘤

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低剂量甲氨蝶呤不能预防动脉粥样硬化事件

中华高血压杂志(中英文) 2019年第8期 799-799页

作者： Ridker PM Everett BM Pradhan A MacFadyen JG solomon DH Zaharris E Mam V Hasan A Rosenberg Y Iturriaga E Gupta M Tsigoulis M Verma s Clearfield M Libby P Goldhaber sZ seagle R Ofori C saklayen M Butman s.singh N Le May M Bertrand O Johnston J Paynter NP Glynn RJ CIRT Investigators 林凯玲余惠珍

炎症反应与动脉粥样硬化的血栓形成密切相关。卡纳单抗(canakinumab)为一种能与白细胞介素(interleukin,IL)1β结合抑制炎症反应的单克隆抗体。以往一项随机对照研究发现,给予卡纳单抗干预后,患者的心血管事件发生率明显低于安慰剂组。... 详细信息

炎症反应与动脉粥样硬化的血栓形成密切相关。卡纳单抗(canakinumab)为一种能与白细胞介素(interleukin,IL)1β结合抑制炎症反应的单克隆抗体。以往一项随机对照研究发现,给予卡纳单抗干预后,患者的心血管事件发生率明显低于安慰剂组。该文采用抑制炎症反应替代药物——低剂量甲氨蝶呤,企图验证应用甲氨蝶呤能否同样获益。研究人员对既往有心肌梗死或多支冠状动脉病变史、伴有2型糖尿病或代谢综合征的患者4786例进行一项随机、双盲试验

关键词：动脉粥样硬化甲氨蝶呤低剂量

结肠镜检阴性后发生结肠直肠癌的风险评估:十年结肠镜随访间隔期的证据

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世界核心医学期刊文摘（胃肠病学分册） 2006年第11期2卷 2-2页

作者： singh H. Turner D. 成虹 section of Gastroenterology 804-715 McDermot Ave Winnipeg Man. R3E3P4 Canada Dr.

Context: Limited evidence exists to guide the optimal frequency of repeat endoscopic examination for colorectal cancer screening after a negative colonoscopy. Objective: To determine the duration and magnitude of the risk of developing colorectal cancer following performance of a negative colonoscopy. Design, setting, and Patients: Population-based retrospective analysis of individuals whose colonoscopy evaluations did not result in a diagnosis of colorectal neoplasia. Patients who had been evaluated between April 1, 1989, and December 31, 2003, were identified using Manitoba Health’s physician billing claims database (N = 35 975). standardized incidence ratios (sIRs) were calculated to compare colorectal cancer incidence in our cohort with colorectal cancer incidence in the provincial population. stratified analysis was performed to determine the duration of the reduced risk. Patients with a history of colorectal cancer prior to the index colonoscopy, inflammatory bowel disease, resective colorectal surgery, and lower gastrointestinal endoscopy within the 5 years before the index colonoscopy were excluded. Cohort members were followed up from the time of the index colonoscopy until diagnosis of colorectal cancer, death, out-migration from Manitoba, or end of the study period on December 31, 2003. Main Outcome Measure: Incidence of colorectal cancer. Results: A negative colonoscopy was associated with sIRs of 0.69 (95%confidence interval [CI], 0.59-0.81) at 6 months, 0.66 (95%CI, 0.56-0.78) at 1 year, 0.59 (95%CI, 0.48-0.72) at 2 years, 0.55 (95%CI, 0.41-0.73) at 5 years, and 0.28 (95%CI, 0.09-0.65) at 10 years. The proportion of colorectal cancer located in the right side of the colon was significantly higher in the colonoscopy cohort than the rate in the Manitoba population (47%vs 28%; Psions: The risk of developing colorectal cancer remains decreased for more than 10 years following the performance of a negative colonoscopy. There is a need to impr

关键词：结肠直肠癌结肠镜随访结肠镜检间隔期结肠镜筛查风险评估结肠癌患病风险研究人群自然人群

发达国家纵向整合临床实习模式的发展及其对我国医学教育的启示

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中华医学教育杂志 2020年第9期40卷 748-752页

作者：李鸿鹤 David A Hirsh Tara A singh Yamini saravanan Rachel Hathaway Bianca shagrin Elizabeth Gaufberg Arundhati Ghosh 刘君李扬龄闻德亮中国医科大学国际医学教育研究院沈阳110122 哈佛大学医学院剑桥健康联盟马萨诸塞州剑桥市02139 中国医科大学沈阳110122

临床实习是医学生将理论知识转化为临床能力和深入临床环境学习的重要途径。纵向整合临床实习模式目前是一种创新性的临床教学方法和理念,它将连续性作为教学原则,很好地解决了原有临床实习中缺乏医疗连续性、课程连续性和教学指导连续... 详细信息

临床实习是医学生将理论知识转化为临床能力和深入临床环境学习的重要途径。纵向整合临床实习模式目前是一种创新性的临床教学方法和理念,它将连续性作为教学原则,很好地解决了原有临床实习中缺乏医疗连续性、课程连续性和教学指导连续性的问题,越来越多的医学院应用此种模式进行临床教学改革。本文对该实习模式的核心内涵、意义和哈佛剑桥模式及其发展与衍变进行阐述,并结合中国医学教育的实际需求进行分析,认为纵向整合临床实习模式可以提高我国临床医生培养质量,促进基层医疗人才队伍建设,增强住院医师规范化培训效果,有助于我国医学教育改革发展。

关键词：临床医学教育教育连续性纵向整合临床实习模式中国启示

镀锌焊接钢丝网水泥在一种模拟海洋环境中的疲劳特性

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哈尔滨建筑大学学报 1999年第1期32卷 43-47页

作者：熊光晶 L.IP G.singh 哈尔滨建筑大学英国Leeds大学

使正常养护28d的70个镀锌焊接钢丝网水泥试件持续受弯，最外层钢丝的计算应力达到腐蚀状态下容许值207N／mm2，再放入自制的以70℃干燥60min和40℃3．5％NaCl溶液浸渍30min为一周期的快速模拟海洋环境实验系统中，分别承受荷载一腐蚀共... 详细信息

使正常养护28d的70个镀锌焊接钢丝网水泥试件持续受弯，最外层钢丝的计算应力达到腐蚀状态下容许值207N／mm2，再放入自制的以70℃干燥60min和40℃3．5％NaCl溶液浸渍30min为一周期的快速模拟海洋环境实验系统中，分别承受荷载一腐蚀共同作用1、3、7和18个月（480－8640个周期），再对这些试件进行弯曲疲劳－腐蚀试验。分析评估了影响钢丝网水泥抗荷载－腐蚀性能的因素，给出了破坏概率－应力水平－疲劳寿命（P－s－N）关系，指出不必计算裂缝宽度.

关键词：钢丝网水泥腐蚀弯曲疲劳海洋环境

系统性红斑狼疮和抗磷脂抗体综合征相关的前房积脓性葡萄膜炎

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世界核心医学期刊文摘（眼科学分册） 2005年第10期1卷 41-41页

作者： Zink J.M. singh-Parikshak R. Johnson C.s. Zacks D.N. 杨建刚 Retina servi ce Kellogg Eye Center University of Michigan 1000 Wall St. Ann Arbor MI 481 05 United States

Purpose: To report a case of hypopyon uveitis associated with systemic lupus e rythematosus and antiphospholipid antibody syndrome. Methods: Interventional cas e report: a 49-year-old woman with a history of systemic lupus erythematosus a nd antiphospholipid antibody syndrome presented with sudden onset of pain, redne ss, photophobia, and decreased vision in the left eye. Examination revealed hypo pyon uveitis and vaso-occlusive retinopathy. Results: Following treatment with intravenous steroids and cyclophosphamide, the patient’s vision improved from C F to 20/80 with no inflammation 6 months following initial presentation. Conclus ions: In this case, systemic lupus and antiphospholipid syndromewere associated with hypopyon uveitis. Prompt treatment with systemic immunosuppressive therapy resulted in improvement in the hypopyon uveitis and vaso-occlusive retinopathy.

关键词：葡萄膜炎系统性红斑狼疮前房积脓视网膜病血管阻塞干预性免疫抑制剂静脉滴注