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Perioperative steroid administration reduces overall complications in patients undergoing liver resection:A meta-analysis

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World Journal of Gastrointestinal Surgery 2021年第9期13卷 1079-1094页

作者： Hao-Han Hai Phoebe Aw thomas zheng jie teng Vishal G Shelat NUS Yong Loo Lin School of Medicine Singapore 119228Singapore NTU Lee Kong Chian School of Medicine Singapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Hepatic resection(HR)results in an inflammatory response that can be modified by perioperative steroid ***,it remains to be determined if this response's attenuation translates to a reduction in *** To evaluate if perioperative administration of steroids reduces complications following *** A systematic review of randomized controlled trials(RCTs)was conducted on PubMed,Embase,and Cochrane Central Register of Controlled Trials to evaluate the effect of perioperative steroid(compared to placebo or no intervention)use in patients undergoing *** outcomes were extracted,and meta-analysis was *** 8 RCTs including 590 patients were *** steroid administration was associated with significant reduction in postoperative complications[odds ratios:0.58;95%confidence intervals(CI):0.35-0.97,P=0.04].There was also improvement in biochemical and inflammatory markers,including serum bilirubin on postoperative day 1[MD:-0.27;95%CI:(-0.47,-0.06),P=0.01],Creactive protein on postoperative day 3[MD:-4.89;95%CI:(-5.83,-3.95),P<0.001],and interleukin-6 on postoperative day 1[MD:-54.84;95%CI:(-63.91,-45.76),P<0.001].CONCLUSION Perioperative steroids administration in HR may reduce overall complications,postoperative bilirubin,and *** studies are needed to determine the optimal dose and duration and patient selection.

关键词： Steroid Liver resection Outcome Systematic review

Occam’s razor or Hickam’s dictum-COVID-19 is not a textbook aetiology of acute pancreatitis:A modified Naranjo Score appraisal

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World Journal of Gastroenterology 2023年第13期29卷 2050-2063页

作者： thomas zheng jie teng Branden Qi Yu Chua Puay Khim Lim Kai Siang Chan Vishal G Shelat Lee Kong Chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Surgical Science Training Centre Tan Tock Seng HospitalSingapore 308433Singapore

BACKGROUND Acute pancreatitis(AP)is a disease spectrum ranging from mild to severe *** the coronavirus disease 2019(COVID-19)pandemic,numerous reports of AP have been published,with most authors concluding a causal relationship between COVID-19 and *** case reports or small case series are unable to accurately determine the cause-effect relationship between COVID-19 and *** To establish whether COVID-19 is a cause of AP using the modified Naranjo scoring *** A systematic review was conducted on PubMed,World of Science and Embase for articles reporting COVID-19 and AP from inception to August *** criteria were cases of AP which were not reported to be due to COVID-19 infection,age<18 years old,review articles and retrospective cohort *** original 10-item Naranjo scoring system(total score 13)was devised to approximate the likelihood of a clinical presentation to be secondary to an adverse drug *** modified the original scoring system into a 8-item modified Naranjo scoring system(total score 9)to determine the cause-effect relationship between COVID-19 and AP.A cumulative score was decided for each case presented in the included *** of the modified Naranjo scoring system is as follows:≤3:Doubtful,4-6:Possible,≥7:Probable *** The initial search resulted in 909 articles,with 740 articles after removal of duplicates.A total of 67 articles were included in the final analysis,with 76 patients which had AP reported to be due to *** mean age was 47.8(range 18-94)*** of patients(73.3%)had≤7 d between onset of COVID-19 infection and diagnosis of *** were only 45(59.2%)patients who had adequate investigations to rule out common aetiologies(gallstones,choledocholithiasis,alcohol,hypertriglyceridemia,hypercalcemia and trauma)of *** G4 testing was conducted in 9(13.5%)patients to rule out autoimmune *** 5(6.6%)patients underwent endoscopic ultra

关键词： COVID-19 Infections Pancreatic diseases Pancreatitis Post-acute COVID-19 syndrome

Acute appendicitis–advances and controversies

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World Journal of Gastrointestinal Surgery 2021年第11期13卷 1293-1314页

作者： thomas zheng jie teng Xuan Rong Thong Kai Yuan Lau Sunder Balasubramaniam Vishal G Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Department of Undergraduate Medicine Lee Kong Chian School of MedicineSingapore 308232Singapore

Being one of the most common causes of the acute abdomen,acute appendicitis(AA)forms the bread and butter of any general surgeon’s *** the recent advancements in AA’s management,much controversy in diagnostic algorithms,possible differential diagnoses,and weighing the management options has been generated,with no absolute consensus in the *** Alvarado described his eponymous clinical scoring system in 1986 to stratify AA risk,there has been a burgeoning of additional scores for guiding downstream management and mortality ***,advancing literature on the role of antibiotics,variations in appendicectomy,and its adjuncts have expanded the surgeon’s repertoire of management *** to the varied presentation,diagnostic tools,and management of AA have also been proposed in special groups such as pregnant patients,the elderly,and the *** article seeks to raise the critical debates about what is currently known about the above aspects of AA and explore the latest controversies in the *** the ever-evolving coronavirus disease 2019 situation worldwide,we also discuss the pandemic’s repercussions on patients and how surgeons’practices have evolved in the context of AA.

关键词： Appendicitis Diagnosis Management COVID-19 Controversy Advances

Choledochoscopy:An update

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World Journal of Gastrointestinal Endoscopy 2021年第12期13卷 571-592页

作者： Tsinrong Lee thomas zheng jie teng Vishal G Shelat School of Medicine Nanyang Technological UniversitySingapore 308232Singapore Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore

Choledochoscopy,or cholangioscopy,is an endoscopic procedure for direct visualization within the biliary tract for diagnostic or therapeutic *** its conception in 1879,many variations and improvements are made to ensure relevance in diagnosing and managing a range of intrahepatic and extrahepatic biliary *** ranges from improved visual impression and optical guided biopsies of indeterminate biliary strictures and clinically indistinguishable pathologies to therapeutic uses in stone fragmentation and other ablative ***,with the evolving understanding of biliary disorders,there are significant innovative ideas and techniques to fill this void,such as nuanced instances of biliary stenting and retrieving migrated ductal *** this in mind,we present a review of the current advancements in choledochoscopy with new supporting evidence that further delineates the role of choledochoscopy in various diagnostic and therapeutic interventions,complications,limitations and put forth areas for further study.

关键词： Choledochoscopy Cholangioscopy Indeterminate biliary strictures Difficult bile stones Primary sclerosing cholangitis Cholangiocarcinoma

Carcinosarcoma of gallbladder:A world review

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World Journal of Clinical Oncology 2021年第12期12卷 1244-1263页

作者： thomas zheng jie teng Branden Qi Yu Chua Vishal G Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Undergraduate Medicine Lee Kong Chian School of MedicineSingapore 308232Singapore

BACKGROUND Gallbladder carcinosarcoma is a rare hepatobiliary tumor comprising of both carcinomatous and sarcomatous *** to its rarity,the literature with regards to the topic is scarce and currently lacking,spanning less than 100 *** To summarize the current literature on gallbladder *** A literature review was performed on the PubMed database using the keywords“Gallbladder”AND“Carcinosarcoma”from 1970 to ***,similar searches were performed on MEDLINE and Web of *** Risk factors noted include female gender,gallstones and chronic *** the absence of any diagnostic biochemical testing or tumor markers,imaging modality serves as the key initial impression tool,which can be histologically confirmed only *** surgery is the only curative option,the use of adjunctive chemotherapy has been considered on top of excision in recent years,with some *** While this study has taken steps to bridge the gap in the literature,more cases should be reported to further ascertain the current associations and management potential for gallbladder carcinosarcoma.

关键词： Carcinosarcoma Gallbladder Gallstone Malignancy Carcinoma Sarcoma

Sequential organ failure assessment score is superior to other prognostic indices in acute pancreatitis

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World Journal of Critical Care Medicine 2021年第6期10卷 355-368页

作者： thomas zheng jie teng Jun Kiat Thaddaeus Tan Samantha Baey Sivaraj K Gunasekaran Sameer P Junnarkar Jee Keem Low Cheong Wei Terence Huey Vishal G Shelat Department of General Surgery Tan Tock Seng HospitalSingapore 308433Singapore Undergraduate Medicine Lee Kong Chian School of MedicineSingapore 308232Singapore Department of General Surgery Singapore General HospitalSingapore 169608Singapore Undergraduate Medicine Yong Loo Lin School of MedicineSingapore 119077Singapore

BACKGROUND Acute pancreatitis(AP)is a common surgical condition,with severe AP(SAP)potentially *** prognostic indices,including;acute physiology and chronic health evaluation II score(APACHE II),bedside index of severity in acute pancreatitis(BISAP),Glasgow score,harmless acute pancreatitis score(HAPS),Ranson’s score,and sequential organ failure assessment(SOFA)evaluate AP severity and predict *** To evaluate these indices'utility in predicting severity,intensive care unit(ICU)admission,and *** A retrospective analysis of 653 patients with AP from July 2009 to September 2016 was *** demographic,clinical profile,and patient outcomes were *** was defined as per the revised Atlanta *** for APACHE II score,BISAP,HAPS,and SOFA within 24 h of admission were retrospectively obtained based on laboratory results and patient evaluation recorded on a secure hospital-based online electronic *** with<10%missing data was imputed via mean *** patient information such as demographics,disease etiology,and patient outcomes were also derived from electronic medical *** The mean age was 58.7±17.5 years,with 58.7%***(n=404,61.9%),alcohol(n=38,5.8%),and hypertriglyceridemia(n=19,2.9%)were more common aetiologies.81(12.4%)patients developed SAP,20(3.1%)required ICU admission,and 12(1.8%)deaths were attributed to ***’s score and APACHE-II demonstrated the highest sensitivity in predicting SAP(92.6%,80.2%respectively),ICU admission(100%),and mortality(100%).While SOFA and BISAP demonstrated lowest sensitivity in predicting SAP(13.6%,24.7%respectively),ICU admission(40.0%,25.0%respectively)and mortality(50.0%,25.5%respectively).However,SOFA demonstrated the highest specificity in predicting SAP(99.7%),ICU admission(99.2%),and mortality(98.9%).SOFA demonstrated the highest positive predictive value,positive likelihood ratio,diagnostic odds ratio,and overall accuracy i

关键词： Pancreatitis Severity scoring Intensive care unit Mortality Sequential Organ Failure Assessment score Ranson’s score

Ultrafine Sn nanocrystals in a hierarchically porous N-doped carbon for lithium ion batteries

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Nano Research 2017年第6期10卷 1950-1958页

作者： Xinghua Chang teng Wang Zhiliang Liu Xinyao zheng jie zheng Xingguo Li Beijing National Laboratory for Molecular Sciences (BNLMS) College of Chemistry and Molecular Engineering Peking University Beijing 100871 China Academy for Advanced Interdisciplinary Studies Peking University Beijing 100871 China

We report a simple method of preparing a high performance, Sn-based anode material for lithium ion batteries （LIBs）. Adding H2O2 to an aqueous solution containing Sn2＋ and aniline results in simultaneous polymerization of aniline and oxidation of Sn2＋ to SnO2, leading to a homogeneous composite of polyaniline and SnO2. Hydrogen thermal reduction of the above composite yields N-doped carbon with hierarchical porosity and homogeneously distributed, ultrafine Sn particles. The nanocomposite exhibits excellent performance as an anode material for lithium ion batteries, showing a high reversible specific capacity of 788 mAh·g^-1 at a current density of 100 mA·g^-1 after 300 cycles and very good stability up to 5,000 mA·g^-1. The simple preparation method combined with the good electro- chemical performance is highly promising to promote the application of Sn based anode materials.

关键词： Sn polyaniline nanocomposite lithium ion battery (LIB)

Controllable and large-area growth of ZnO nanosheet arrays under ambient condition as superior anodes for scalable aqueous batteries

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Carbon Energy 2023年第12期5卷 241-251页

作者： Dongdong Zhang Yanqing Fu Qiliang Wei Yapeng zheng Lin Wang jie teng Weiyou Yang Institute of Micro/Nano Materials and Devices Ningbo University of TechnologyNingboZhejiangPeople's Republic of China College of Materials Science and Engineering Hunan UniversityChangshaPeople's Republic of China

Two-dimensional(2D)oxides have been the focus of substantial research interest recently,owing to their fascinating physico-chemical ***,fabrication of large-area 2D oxide materials in a controlled manner under mild conditions still remains a formidable ***,we develop a facile and universal strategy based on the sonochemistry approach for controllable and large-area growth of quasi-aligned single-crystalline ZnO nanosheets on a Zn substrate(Zn@SC-ZnO)under ambient *** obtained ZnO nanosheets possess the desired exclusively exposed(001)facets,which have been confirmed to play a critical role in significantly reducing the activation energy and facilitating the stripping/plating processes of ***,the constructed Zn@SC-ZnO||Zn@SC-ZnO symmetric cell has very low polarization overpotential down to~20 mV,with limited dendrite growth and side reactions for Zn *** developed Zn@SC-ZnO//MnO_(2)aqueous Zn-ion batteries(ZIBs)show a voltage efficiency of 88.2%under 500 mA g^(-1)at the stage of 50%depth of discharge,which is state of the art for ZIBs reported to ***,the as-assembled large-size cell(5 cm×5 cm)delivers an open circuit potential of 1.648 V,and can be robustly operated under a high current of 20 mA,showing excellent potential for future scalable applications.

关键词： ambient conditions aqueous Zn-ion batteries crystal growth nanosheet arrays ZnO

Recent progress in graphene-reinforced aluminum matrix composites

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Frontiers of Materials Science 2021年第1期15卷 79-97页

作者： Jinlong SU jie teng College of Materials Science and Engineering Hunan UniversityChangsha 410082China

Recent years witnessed a growing research interest in graphene-reinforced aluminum matrix composites(GRAMCs).Compared with conventionalreinforcements of aluminum matrix composites(AMCs),graphene possesses manyattractive characteristics such as extremely high strength and modulus,unique self-lubricating property,high thermal conductivity(TC)and electrical conductivity(EC),andlow coefficient of thermal expansion(CTE).A lot of studies have demonstrated that theincorporation of graphene into Al or Al alloy can effectively enhance mechanical andphysical properties of the Al *** purpose of this work is aimed to trace recentdevelopment of ***,this paper covers a brief overview of fabricationmethods of ***,mechanical,tribological,thermal and electrical properties ofrecently developed GRAMCs are presented and ***,challenges andcorresponding solutions related to GRAMCs are reviewed.

关键词： graphene aluminum metal matrix composite mechanical properties tribological properties