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Impact of multidisciplinary team working on the management of colorectal cancer

Chinese Medical Journal 2012年第2期125卷 172-177页

作者： Ye Ying-jiang shen zhan-long Sun Xian-tao Wang Zhi-feng shen Dan-hua Liu Hui-jun zhang Wan-lei Chen Ya-lin Zhou Jing Poston, G. J. Wang Shan Peking Univ Peoples Hosp Dept Surg Gastroenterol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Surg Oncol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Gastroenterol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Pathol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Radiol Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Ultrason Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Radiotherapy Beijing 100044 Peoples R China Peking Univ Peoples Hosp Dept Med Oncol Beijing 100044 Peoples R China Aintree Univ Hosp NHS Fdn Trust Dept Surg Liverpool L9 7AL Merseyside England

Background The continual and rapid development of techniques which are used for diagnosis and treatment makes management of colorectal cancer more difficult depending on single discipline.Colorectal cancer multidisciplinary team （MDT） working model is recommended by UK and other countries,but there is little information on the impact of MDT working on management of colorectal cancer in China.The aim of this study was to assess the effect on management of colorectal cancer after the inception of an MDT.Methods A total of 595 consecutive colorectal cancer patients were referred to the Department of Gastroenterological Surgery,the pre-MDT cohort include 297 patients,recruited from January 1999 to November 2002,and the MDT cohort had 298 patients enrolled from December 2002 to September 2006.Information recorded included：TNM stage from histological reports,degree of differentiation,the number of examined lymph nodes and CT TNM staging performed or not,and its accuracy,including local and distant recurrence.Results The number of examined lymph nodes and the accuracy of TNM staging by CT in the MDT group were significantly more than those in pre-MDT group.CT TNM staging was more accurate in the MDT group compared to the pre-MDT group （P=-0.044）.The rate of tumor recurrence in the MDT group was lower than pre-MDT group （log-rank test,P 〈0.001）.Multivariate analysis revealed that age （P=0.001）,management after inception of the MDT （P=0.002）,degree of differentiation （P=0.003）,number of examined lymph nodes （P=0.002）,and TNM stage （P=0.000） were important factors that independently influence overall survival.Conclusions The inception of MDT working improved the diagnostic accuracy and overall survival of colorectal cancer patients.MDT working promoted communication and cooperation between disciplines and ensured high-quality diagnosis,evidence-based decision making,and optimal treatment planning.

关键词： colorectal cancer TNM stages computed tomography overall survival liver metastases multidisciplinary team chemotherapy surgery

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北京地区医疗机构科技成果转化的PEST-SWOT分析

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医院管理论坛 2024年第3期41卷 75-78页

作者：金彦梁公文申占龙赵翔宇北京大学人民医院

目的探讨医疗机构科技成果转化工作策略。方法通过专利数据库、文献检索分析北京地区医疗机构近年来的专利及转化情况,结合政策文本进行PEST-SWOT分析。结果北京地区医疗机构专利申请、授权增多,进行成果转化的优势和机会明显,也存... 详细信息

目的探讨医疗机构科技成果转化工作策略。方法通过专利数据库、文献检索分析北京地区医疗机构近年来的专利及转化情况,结合政策文本进行PEST-SWOT分析。结果北京地区医疗机构专利申请、授权增多,进行成果转化的优势和机会明显,也存在一定的劣势与威胁,转化率需要提升。结论医疗机构应顺应政策要求,发挥资源优势,加强产业融合,提升成果价值和知识产权运营能力,完善转化机制。

关键词：医疗机构知识产权 PEST-SWOT分析成果转化

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Laparoscopic Heller-Dor operation for patients with achalasia

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Chinese Medical Journal 2006年第6期119卷 443-447页

作者： WANG Qiu-sheng LIU long DONG Lei shen zhan-long ZHOU Dong-hai HU Chun-xiang Department of Minimally Invasive Surgery Peking UniversityPeople＇s Hospital Beijing 100044 China

Background Laparoscopic Heller cardiomyotomy and Dor fundoplication is the surgical procedure of choice for esophageal achalasia. The aim of this study was to investigate the clinical outcome of laparoscopic Heller-Dor procedure in our initial series of 25 patients with achalasia. Methods Between October 2003 and January 2006, a total of 25 patients with achalasia underwent laparoscopic Heller-Dor operation. Among them, 9 were male and 16 were female with an average age of （41.5 ± 5.1） years （21- 66）. All the patients received upper gastrointestinal series （barium swallow）, esophagogastroscopy, esophageal manometry to exclude esophageal carcinoma and to confirm the diagnosis, and 21 patients also had 24-hour ambulatory pH studies. All the patients were operated by laparoscopic modified Heller＇s myotomy with Dor fundoplication. In addition, 2 of them had combined laparoscopic cholecystectomy ± excision of hepatic hemangioma and laparoscopic cholecystectomy, respectively. Results The average operating time was （110.6± 12.9） minutes （range, 60-180）, operative blood loss averaged （18.6±7.1） ml （5-50）, the median time to oral feeding was （1.6±0.4） days （1-4） and the median hospital stay was （12.6± 1.2） days （10-20）. There was no conversion to open surgery. Intraoperative mucosal perforation was encountered in six patients and was repaired in all of them by laparoscopic suture. All the patients had an uneventful recovery without postoperative complication. After a median follow-up of （10.6 ± 7.2） months （1 -27）, 24 patients were asymptomatic and 1 had mild postoperative dysphagia. Conclusions Laparoscopic Heller-Dor operation had the advantages of reduced compromise of the cardiopulmonary function, with less disruption of the supporting structures （phrenoesophageal membrane） of the antireflux mechanism, requiting simpler general anesthesia and providing excellent exposure permitting an easy fundoplication, less pain and reduced morbidity, shorter hospitalization and faster convalescence.

关键词： esophageal achalasia laparoscopy Heller-Dor operation

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Recent Advances in Enantioselective Reactions of Terminal Unactivated Alkenes

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Chinese Journal of Chemistry 2024年第7期42卷 760-776页

作者： Qihang Guo Xbxuzhong She zhan Lu Centerof ChemistryforFrontier Technologies Departmentof ChemistryZhejiang UniversityHangzhouZhejiang 310058China ZJU-Hangzhou Global Scientific and Technological Innovation Center HangzhouZhejiang 311215China College of Chemistry Zhengzhou UniversityZhengzhouHenan 450001China

α-Olefins as aliphatic terminal alkenes could be obtained easily from numerous contemporary synthetic reactions as well as petro-chemical industry,and also found in natural products.Compared to the alkenes attaching the directing groups or activating group,the catalytic asymmetric reaction of unactivated terminal alkenes presents great challenges due to the weak electron effect and small steric hindrance effect.This review mainly summarizes the latest progress of the asymmetric reaction of unactivated terminal olefins since 2016.

关键词： Asymmetric catalysis Terminal unactivated alkenes Hydrofunctionalization Difunctionalization Metal-catalyzed

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Potential risks of organic contaminated soil after persulfate remediation:Harmful gaseous sulfur release

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Journal of Environmental Sciences 2024年第1期135卷 1-9页

作者： Yuyang long Zixiao Wu Xiaodong Ding Jiansong Chen Dongsheng shen Jiali shentu Cai Hui Zhejiang Provincial Key Laboratory of Solid Waste Treatment and Recycling Zhejiang Engineering Research Center of Non-ferrous Metal Waste RecyclingInstrumental Analysis CenterSchool of Environmental Science and EngineeringZhejiang Gongshang UniversityHangzhou 310012China Shangyu Yingtai Fine Chemical Co. Ltd.Shaoxing 312000China Hangzhou Ecological Environment Monitoring Center Hangzhou 310007China

Persulfate is considered a convenient and efficient remediation agent for organic contaminated soil.However,the potential risk of sulfur into the soil remediation by persulfate remains ignored.In this study,glass bottles with different persulfate dosages and groundwater tables were set up to simulate persulfate remediation of organic pollutants(aniline).The results found sulfate to be the main end-product(83.0%–99.5%)of persulfate remediation after10 days.Moreover,H_(2)S accounted for 93.4%–99.4%of sulfur reduction end-products,suggesting that H_(2)S was the final fate of sulfur.H_(2)S was released rapidly after one to three days at a maximum concentration of 33.0 ppm,which is sufficient to make a person uncomfortable.According to the fitted curve results,H_(2)S concentration decreased to a safe concentration(0.15 ppm)after 20–85 days.Meanwhile,the maximum concentration of methanethiol reached 0.6 ppm.These results indicated that secondary pollution from persulfate remediation could release harmful gases over a long time.Therefore,persulfate should be used more carefully as a remediation agent for soil contamination.

关键词： Gaseous sulfur release H_2S long period potential risk Organic contaminated soil remediation Persulfate

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Access to Versatile Functionalized Cu(Ⅲ) Complexes Enabled by Direct Transmetalation to Well-Defined Copper(Ⅲ) Fluoride Complex Me_(4)N^(+)[Cu(CF_(3))_(3)F]^(-)

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Chinese Journal of Chemistry 2024年第10期42卷 1107-1113页

作者： Guangyu Wang Huaiyuan Li Xuebing Leng long Lu Qilong shen Key Laboratory of Fluorine and Nitrogen Chemistry and Advanced Materials Shanghai Institute of Organic ChemistryUniversity of Chinese Academy of SciencesChinese Academy of Sciences345 Lingling LuShanghai 200032China

The invention of a well-defined Cu(Ⅲ)fluoride complex Me_(4)N^(+)[Cu(CF_(3))_(3)(F)]^(-)1 enabled to access a versatile of functionalized Cu(Ⅲ)complexes[Me_(4)N]^(+)[Cu(X)(CF_(3))_(3)]^(-)(X=C_(6)F_(5),C_(6)F_(5)C≡C,CN,Cl,N_(3),^(t)BuOO,SCN,OAc,SAr),many of them for the first time.The availability of these complexes allowed us to evaluate the trans-influence order of ligand in Cu(Ⅲ)complexes:Bn>CF_(3)^(-)>C_(6)F_(5)^(-)>N_(3)^(-)>py~CH_(3)^(-)~C_(6)F_(5)C≡C>NO_(2)PhO^(-)~^(t)BuOO^(-)~CH_(3)COO^(-)>F^(-).

关键词： Fluorine Copper Cu(Ⅲ) Cu(Ⅲ)fluoride Trifluoromethyl

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Analysis and Optimization of Transient Mode Switching Behavior for Power Split Hybrid Electric Vehicle with Clutch Collaboration

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Automotive Innovation 2024年第1期7卷 150-165页

作者： Dehua Shi sheng Liu Yujie shen Shaohua Wang Chaochun Yuan long Chen Automotive Engineering Research Institute Jiangsu UniversityZhenjiang 212013China Jiangsu Province Engineering Research Center of Electric Drive System and Intelligent Control for Alternative Vehicles Zhenjiang 212013China

The power split hybrid electric vehicle(HEV)adopts a power coupling configuration featuring dual planetary gearsets and multiple clutches,enabling diverse operational modes through clutch engagement and disengagement.The multi-clutch configuration usually involves the collaboration of two clutches during the transient mode switching process,thereby substantially elevating control complexity.This study focuses on power split HEVs that integrate multi-clutch mechanisms and investigates how different clutch collaboration manners impact the characteristics of transient mode switching.The powertrain model for the power-split HEV is established utilizing matrix-based methodologies.Through the formulation of clutch torque curves and clutch collaboration models,this research systematically explores the effects of clutch engagement timing and the duration of clutch slipping state on transient mode switching behaviors.Building upon this analysis,an optimization problem for control parameters pertaining to the two collaborative clutches is formulated.The simulated annealing algorithm is employed to optimize these control parameters.Simulation results demonstrate that the clutch collaboration manners have a great influence on the transient mode switching performance.Compared with the pre-calibrated benchmark and the optimal solution derived by the genetic algorithm,the maximal longitudinal jerk and clutch slipping work during the transient mode switching process is reduced obviously with the optimal control parameters derived by the simulated annealing algorithm.The study provides valuable insights for the dynamic coordinated control of the power-split HEVs featuring complex clutch collaboration mechanisms.

关键词： Power split hybrid electric vehicle Transient mode switching Clutch collaboration Simulated annealing Powertrain model

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A Simplified Method for the Stress Analysis of Underground Transfer Structures Crossing Multiple Subway Tunnels

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Computer Modeling in Engineering & Sciences 2024年第6期139卷 2893-2915页

作者： shen Yan Dajiang Geng Ning Dai Mingjian long Zhicheng Bai College of Civil Engineering Tongji UniversityShanghai200092China China Construction 4th Engineering Bureau 6th Corp. Ltd.Shanghai201199China Department of Civil and Architecture Engineering Hubei Polytechnic UniversityHuangshi435003China

According to the design specifications,the construction of extended piles involves traversing the tunnel’s upper region and extending to the underlying rock layer.To address this challenge,a subterranean transfer structure spanning multiple subway tunnels was proposed.Deliberating on the function of piles in the transfer structure as springs with axial and bending stiffness,and taking into account the force balance and deformation coordination conditions of beams and plates within the transfer structure,we established a simplified mechanical model that incorporates soil stratification by combining it with the Winkler elastic foundation beam model.The resolved established simplifiedmechanicalmodel employed finite difference technology and the Newton-Simpsonmethod,elucidating the mechanical mechanism of the transfer structure.The research findings suggest that the load carried by the upper structural columns can be transferred to the pile foundation beneath the beams through the transfer structure,subsequently reaching the deep soil layer and ensuring minimal impact on adjacent tunnels.The established simplified analysis method can be used for stress analysis of the transfer structure,concurrently considering soil stratification,pile foundation behavior,and plate action.The pile length,pile section size,and beam section size within the transfer structure should account for the characteristics of the upper load,ensuring an even distribution of the beam bending moment.

关键词： Crossing tunnels transfer structure force mechanism simplify analysis layered soil mass

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Biological factors driving colorectal cancer metastasis

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World Journal of Gastrointestinal Oncology 2024年第2期16卷 259-272页

作者： Shuai-Xing An Zhao-Jin Yu Chen Fu Min-Jie Wei long-Hai shen Department of Pharmacology School of PharmacyChina Medical UniversityShenyang 110122Liaoning ProvinceChina Liaoning Key Laboratory of Molecular Targeted Antitumor Drug Development and Evaluation Liaoning Cancer Immune Peptide Drug Engineering Technology Research CenterKey Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors(China Medical University)Ministry of EducationShenyang 110122Liaoning ProvinceChina BD Department Greenpine Pharma Group Co.LtdTianjin 300020China Center of Oncology Genertec Liaoyou Gem Flower HospitalPanJin 124010Liaoning ProvinceChina

Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three years following initial treatment.The median survival duration after the diagnosis of metastatic CRC(mCRC)is only 9 mo.mCRC is traditionally considered to be an advanced stage malignancy or is thought to be caused by incomplete resection of tumor tissue,allowing cancer cells to spread from primary to distant organs;however,increa-sing evidence suggests that the mCRC process can begin early in tumor development.CRC patients present with high heterogeneity and diverse cancer phenotypes that are classified on the basis of molecular and morphological alterations.Different genomic and nongenomic events can induce subclone diversity,which leads to cancer and metastasis.Throughout the course of mCRC,metastatic cascades are associated with invasive cancer cell migration through the circulatory system,extravasation,distal seeding,dormancy,and reactivation,with each step requiring specific molecular functions.However,cancer cells presenting neoantigens can be recognized and eliminated by the immune system.In this review,we explain the biological factors that drive CRC metastasis,namely,genomic instability,epigenetic instability,the metastatic cascade,the cancer-immunity cycle,and external lifestyle factors.Despite remarkable progress in CRC research,the role of molecular classification in therapeutic intervention remains unclear.This review shows the driving factors of mCRC which may help in identifying potential candidate biomarkers that can improve the diagnosis and early detection of mCRC cases.

关键词： cancer Metastasis cascade Cancer immunity Genomic variation Epigenetic instability Lifestyle factor

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Controllable Condensation of Aromatics and Its Mechanisms in Carbonization

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China Petroleum Processing & Petrochemical Technology 2024年第1期26卷 34-46页

作者： Fan Xi Wang Chunlu Luo Yang Ren Qiang shen Haiping long Jun Sinopec Research Institute of Petroleum Processing Co. Ltd.Beijing 100083China

In order to obtain liquefied products with higher yields of aromatic molecules to produce mesophase pitch,a good understanding of the relevant reaction mechanisms is required.Reactive molecular dynamics simulations were used to study the thermal reactions of pyrene,1-methylpyrene,7,8,9,10-tetrahydrobenzopyrene,and mixtures of pyrene with 1-octene,cyclohexene,or styrene.The reactant conversion rates,reaction rates,and product distributions were calculated and compared,and the mechanisms were analyzed and discussed.The results demonstrated that methyl and naphthenic structures in aromatics might improve the conversion rates of reactants in hydrogen transfer processes,but their steric hindrances prohibited the generation of high polymers.The naphthenic structures could generate more free radicals and presented a more obvious inhibition effect on the condensation of polymers compared with the methyl side chains.It was discovered that when different olefins were mixed with pyrene,1-octene primarily underwent pyrolysis reactions,whereas cyclohexene mainly underwent hydrogen transfer reactions with pyrene and styrene,mostly producing superconjugated biradicals through condensation reactions with pyrene.In the mixture systems,the olefins scattered aromatic molecules,hindering the formation of pyrene trimers and higher polymers.According to the reactive molecular dynamics simulations,styrene may enhance the yield of dimer and enable the controlled polycondensation of pyrene.

关键词： carbonization controllable condensation aromatics mechanisms molecular simulation

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