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Delayed referral for liver transplant evaluation worsens outcomes in chronic liver disease patients requiring inpatient transplant evaluation

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World Journal of Transplantation 2023年第4期13卷 169-182页

作者： Katherine M Cooper Alessandro Colletta Nicholas J Hathaway Diana Liu Daniella Gonzalez Arslan Talat Curtis Barry Anita Krishnarao savant mehta Babak Movahedi Paulo N Martins Deepika Devuni Department of Medicine UMass Chan Medical SchoolWorcesterMA 01605United States Department of Medicine Division of GastroenterologyUMass Chan Medical SchoolWorcesterMA 01605United States Department of Surgery Transplant DivisionUMass Chan Medical SchoolWorcesterMA 01605United States

BACKGROUND Indications to refer patients with cirrhosis for liver transplant evaluation(LTE)include hepatic decompensation or a model for end stage liver disease(MELDNa)score≥*** studies have evaluated how delaying referral beyond these criteria affects patient *** To evaluate clinical characteristics of patients undergoing inpatient LTE and to assess the effects of delayed LTE on patient outcomes(death,transplantation).METHODS This is a single center retrospective cohort study assessing all patients undergoing inpatient LTE(n=159)at a large quaternary care and liver transplant center between 10/23/2017-7/31/*** referral was defined as having prior indication(decompensation,MELD-Na≥15)for LTE without *** referral was defined as referrals made within 3 mo of having an indication based on practice *** regression and Cox Hazard Regression were used to evaluate the relationship between delayed referral and patient *** Many patients who require expedited inpatient LTE had delayed *** regarding transplant candidacy were a leading cause of delayed ***,delayed referrals negatively affected overall patient outcome and an independent predictor of both death and not receiving a *** referral was associated with a 2.5 hazard risk of *** Beyond initial access to an liver transplant(LT)center,delaying LTE increases risk of death and reduces risk of LT in patients with chronic liver *** is substantial opportunity to increase the percentage of patients undergoing LTE when first clinically *** is crucial for providers to remain informed about the latest guidelines on liver transplant candidacy and the transplant referral process.

关键词： Liver transplantation Liver transplant evaluation Liver transplant referral Patient access Equity Patient outcomes

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Down-Regulation of Neurocan Expression in Reactive Astrocytes Promotes Axonal Regeneration and Facilitates the Neurorestorative Effects of Bone Marrow Stromal Cells in the Ischemic Rat Brain

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神经损伤与功能重建 2008年第6期3卷 404-410页

作者： LI HONG SHEN YI LI QI GAO SMITA savant-BHONSALE AND MICHAEL CHOPP Department of 1448 S. Rolling Road chester Michigan Neurology Henry Ford Hospital Detroit Michigan Theradigm Inc Baltimore Maryland Department of Physics Oakland University Rochester Michigan

脑卒中后缺血组织边界形成胶质疤痕,抑制轴突再生。神经蛋白聚糖是一种轴突延长抑制分子,在卒中后胶质疤痕中表达上调。骨髓基质干细胞(BMSCs)可降低胶质疤痕壁的厚度,加速缺血周边区的轴突重塑。为了进一步明确BMSCs在轴突再生中的作... 详细信息

脑卒中后缺血组织边界形成胶质疤痕,抑制轴突再生。神经蛋白聚糖是一种轴突延长抑制分子,在卒中后胶质疤痕中表达上调。骨髓基质干细胞(BMSCs)可降低胶质疤痕壁的厚度,加速缺血周边区的轴突重塑。为了进一步明确BMSCs在轴突再生中的作用及机制,本文重点研究脑缺血组织中BMSCs对神经蛋白聚糖表达的作用。31只成年雄性Wistar大鼠大脑中动脉阻塞(MCAo)2 h,24 h后从中选择16只给予尾静脉注射3×106鼠BMSCs(BMSCs组),15只注射磷酸盐缓冲生理盐水(对照组)。缺血后8 d处死实验大鼠,免疫染色表明反应性星形胶质细胞是神经蛋白聚糖的原始来源,且BMSCs组缺血半暗带脑组织的神经聚糖表达明显低于对照组,生长相关蛋白43表达高于对照组,这在蛋白印迹分析中得到确认。为了进一步检测BMSCs在星形胶质细胞神经蛋白聚糖表达中的作用,用激光捕获显微切割法从缺血周边区收集单纯的反应性星形胶质细胞。BMSCs组的神经蛋白聚糖基因表达明显下调(n=4/组)。原代培养的星形胶质细胞也表现出相同改变,糖氧剥离的星形胶质细胞再给氧时与BMSCs共培养会抑制神经蛋白聚糖基因的表达上调(n=3/组)。本研究表明BMSCs通过下调梗死周边星形胶质细胞中神经蛋白聚糖的表达来促进轴突再生。

关键词：骨髓基质干细胞卒中轴突再生神经蛋白聚糖反应性星形胶质细胞

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Changes Induced by Physical Activity, Weight Loss and Calorie Restriction in Body Composition, Lipoproteins and Functional Capacity in Obese Congolese Women

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Health 2020年第6期12卷 548-571页

作者： Moulongo Jean Georges André Makosso Vheiye Georges Eouani Max Lévy Eméry Mouanda Richard Le savant Ndalla Mathias Cyriaque Packa Tchissambou Bernard Massamba Alphonse Laboratory of Sports Biosciences Higher Institute of Physical Education and Sports Marien NGOUABI University Brazzaville Congo Unit of Nutritional Science and Metabolism Higher Institute of Physical Education and Sports Marien NGOUABI University Brazzaville Congo Department of Gynecology & Obstetrics Loandjili Hospital Pointe-Noire (Congo) and Faculty of Health Sciences Marien NGOUABI University Brazzaville Congo Clinical Psychology Research Division Marien NGOUABI University Brazzaville Congo Biomedical Analyses Center Makelekele Brazzaville Congo Laboratory of Numerical Analysis Computer Science and Applications Faculty of Sciences and Technology Marien NGOUABI University Brazzaville Congo

Background. The effects of physical exercises combined with a low-calorie diet on weight loss, body composition, lipoproteins profile, and physical fitness had been well described. However, Central Africa’s studies investigating these kinds of diets and exercise regimens are lacking. Objective. To investigate the effects of adding 14-weeks exercises to a hypocaloric diet on changes in body composition, lipoproteins concentrations, and physical capacities in obese Congolese women. Population and Methods. In total, 34 obese women aged 30 - 39 years (mean age: 33.7 ± 2.4 years) assigned to 14-weeks training program and low energy ketogenic diet. Body composition was assessed using classic methods and impedancemetry. Fasting plasma glucose (FPG) and fasting serum insulin were assessing using enzymatic colorimetric and radioim-munoradiometric methods. HOMA-IR and lipoproteins concentrations were assessed using standardized laboratory methods. VO2peak was measured on a treadmill during a progressive exercise test. Speed, cadence and stride length were measured along the 10-m level walkway. Muscular endurance was measured using the tests of sit-up and inflections-extensions of elbows. All the variables of the study were assessed at the beginning, in the 7-weeks, and in the 14-weeks of training methods. Results. Declines in body weight (16%), percent fat (12.1%), fat weight (26.4%), abdominal fat (34.2%), and waist circumference (10.4%) were found. A significant decrease in FPG (13%), fasting serum insulin (60.9%), HOMA-IR (64.7%), total cholesterol (12.2%), LDL-cholesterol (20.3%), triglycerides (92.8%), and VLDL-triglycerides (17.5%) was shown. In contrast, significant increase in HDL-cholesterol (27.13%) was found. The peak oxygen consumption VO2peak relative to body weight improved more in the 14-weeks training program (13.4%). Obese women exhibited higher values in the 14-weeks training program for speed gait (16.5%), cadence (9.1%), and stride length (15.7%) during no

关键词： Lipoproteins Body Composition Calorie Restriction Physical Exercise Obese Congolese Women

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Complex reconstructions following head and neck surgery

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中国口腔颌面外科杂志 2008年第B5期6卷 91-91页

作者： Dhairyasheel N savant Asian Institute of Oncology Mumbai India

Oral Cancer has among the highest incidences in India。Patients rarely present in early stages。Hence the standard surgical option is major composite resections with complex reconstructive techniques。Presenting an experience of over 800 such reconstructions using pectoralis major, latissimus dorsi flaps osteomyocutaneous flaps, free radial and fibular flaps also the use of Iliac crest vascularised flaps for mandibular reconstructions。The use of silastic tissue for mandibular reconstructions and the functional and cosmetic results along with the economic considerations will be discussed。

关键词：口腔癌头颈部外科手术治疗方法

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巨大视网膜裂孔的手术疗法和预后

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世界核心医学期刊文摘（眼科学分册） 2005年第3期1卷 47-48页

作者： Ghosh Y.K. Banerjee S. savant V. A.K. Tyagi 陈立军 Department of Vitreo Retinal Surgery Birmingham/Midland Eye Cent re City Hospital NHS Trust Dudley Road Birmingham B18 7QU United Kingdom

Objective. To report the management and outcome in retinal detachments associa ted with giant retinal tears (GRTs). Methods. Retrospective, case note analysis of patients treated between November 1991 and June 2002 at a tertiary referral h ospital. Results. The case notes of 29 patients (24 males, 5 females) with a fol low up ranging from five months to 7 years were reviewed. In all, 25 eyes had r etinal detachments with macular involvement and 10 patients had myopia more than 6 D. All patients underwent vitrectomy. A total of 23 patients had heavy liquid and 16 had scleral explants; 28 patients had silicone oil and one had C3F8 tamp onade. Intraoperative complications included lens trauma and iatrogenic GRT. Six eyes had recurrent retinal detachment and needed multiple surgical procedures. At the last follow up, 25 patients had anatomically attached retinas. In all, 1 8 fellow eyes were treated prophylactically. Three patients had total retinal de tachment and marked PVR. The visual acuity improved in 20 eyes. Conclusion. GRTs are more common in patients with high myopia. With newer techniques of surgical treatment of GRTs, the anatomical and visual outcomes are more favourable.

关键词：巨大视网膜裂孔手术疗法玻璃体切割术高度近视对侧眼预防性治疗玻璃体腔黄斑部晶体损伤第三中心医院

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南亚人和加勒比黑人糖尿病患者行超声乳化术后糖尿病视网膜病变的进展和视力情况

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世界核心医学期刊文摘（眼科学分册） 2005年第1期1卷 33-33页

作者：秦雪娇 Chatterjee S savant V.V Stavrou P. Birming ham and Midland Eye Centre City Hospital NHS TrustDudley RoadBir ming ham B187QUUnited Kingdom

*** determine diabetic reti nopathy or maculopathy progression and visual outcome foll owing phacoemulsifica-tion in South -Asian and Afro-Caribbean patients with *** of notes of p atients with type II diabetes undergoing phacoemulsification by one *** inclusion criteria were :(a)South-Asian or Afro-Caribbean ethnicity,(b)-monocular cases with a minimum postoperative follow-up of 6months,and(c)binocular cases with an interval of at least 6mo nths between the operation in the two *** nonoperated eye was used as *** development or progression of diabetic retinopathy or maculopathy and final visual acuity were *** all,30diabetic patients were *** were 19South-Asians(Pakistani,Indian,and Bangladeshi )and *** mean(±SD)age was 68.9(±10)*** or maculopathy progression was noted in seven patie nts(23.4%),two South-Asians,and five *** was no significant difference in the number of operated and fellow eyes whose retinopathy or maculopathy progressed *** of retinopathy or maculopathy oc-curred more often in Afro-Caribbean s compared to South-Asians(P=0.02,logistic regression analysis).The mean(±SD)postoperative follow-up was 12.4(±6.5)*** acuity improved by at least two or more Snellen lines in 19eyes(63.3%);26eyes(86.7%)achieved a final visual acuity of at l east 6/***-Caribbeans may be at a hi gher risk of progres-sion of retinopathy or maculopathy a fter phacoemulsification.

关键词：超声乳化术视力情况白内障超声乳化黄斑病变视网膜病变加勒比孟加拉人无显著性差异

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