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Role of bacteria in carcinogenesis, with special reference to carcinoma of the gallbladder

World Journal of Gastroenterology 2010年第43期16卷 5395-5404页

作者： Gopal Nath Anil k Gulati vijay k shukla Department of Microbiology Institute of Medical Sciences Banaras Hindu University Department of General Surgery Institute of Medical Sciences Banaras Hindu University

Carcinoma of the gallbladder (CaGB) is the fifth commonest gastrointestinal tract cancer and is endemic in several countries. The interplay of genetic susceptibility, infections, and life style factors has been proposed to be responsible for carcinogenesis of gallbladder. Persistence of infection leading to chronic inflammation, and production of certain toxins and metabolites with carcinogenic potentials, by certain bacteria has been speculated to be involved in the transformation of the gallbladder epithelium. Therefore, any bacteria that have evolved to acquire both of the above carcinogenic mechanisms can cause cancer. Salmonella typhi has been found to be prominently associated with CaGB. Chronic typhoid carriage (persistence) and production of mediators of chronic infl ammation and a genotoxic toxin (cytotoxic distending toxin, CdtB) are also known for this bacterium. Furthermore, the natural concentrating function of the gallbladder might amplify the carcinogenic effect of the mediators of carcinogenesis. In addition to S. typhi, certain species of Helicobacter (H. bilis and H. hepaticus) and Escherichia coli have also been implicated in carcinogenesis. As the isolation rate is verypoor with the presently available culture techniques, the existence of bacteria in a viable but non-cultivable state is quite likely; therefore, sensitive and specif ic molecular techniques might reveal the etiological role of bacterial infection in gallbladder carcinogenesis. If bacteria are found to be causing cancers, then eradication of such infections might help in reducing the incidence of some cancers.

关键词： Bacteria Chronic infl ammation Carcinogen Bacterial toxins Carcinoma gallbladder DNA damage

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Role of Combination Chemotherapy with 5-Fluorouracil, Cisplatin and Paclitaxel for Advanced Gall Bladder Cancer

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Journal of Cancer Therapy 2014年第3期5卷 246-252页

作者： Mumtaz Ahmad Ansari Satyendra k. Tiwary Uday Pratap Shahi vijay k. shukla Department of General Surgery and Radiotherapy Institute of Medical Sciences Banaras Hindu University Varanasi India

Aim: The prognosis for patients with advanced Gallbladder carcinoma is poor. Due to unresectability and relatively ineffective chemotherapy available, a need exists for effective chemotherapeutic regimen. The aim of this study was to determine the efficacy and safety profile of 5-fluorouracil, cisplatin and paclitaxel in patients with advanced Gallbladder cancer. Material and Methods: From January 2002 to July 2004, 40 patients of advanced carcinoma Gallbladder received 5-fluorouracil, cisplatin and paclitaxel. On day 1, paclitaxel was given (150 mg/m2), cisplatin was given on day 2 (50 mg/m2) and 5-fluorouracil was given from day 1 to day 3 (500 mg/m2). This cycle was repeated every three weeks and patient assessment was done. Results: Forty patients were enrolled in this study. Thirty-five were assessed for response. Five patients were lost in follow up. There were thirty females and ten males. A median of three cycles of treatment (range one to seven) was administered. Two patients achieved complete response and eleven had partial responses giving an overall response rate of 32.5% in the intention-to-treat population (95% confidence interval 11.1% to 46.5%). The median response duration was 5.3 months. The median time to progression and overall survival was 4.1 months and 11.2 months, respectively. The most common grade 3 adverse effects were neutropenia (30%), nausea (20%), vomiting (15%), diarrhea (10%), stomatitis (5%), and peripheral neuropathy (5%). Only one case had febrile neutropenia. There was no treatment related death. Conclusions: The combination of 5-fluorouracil, cisplatin and paclitaxel has promising anti-tumor activity and is well tolerated in patients with advanced and metastatic Gallbladder cancer.

关键词： Advanced Gallbladder Carcinoma Combination Chemotherapy Prognosis

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GRADE指南：Ⅶ.证据质量评价--不一致性

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中国循证医学杂志 2011年第12期11卷 1444-1451页

作者： Gordon H.Guyatt Andrew D.Oxman Regina kunz James Woodcock Jan Brozek Mark Helfand Pablo Alonso-Coello Paul Glasziou Roman Jaeschke Elie A.Akl Susan Norris Gunn Vist Philipp Dahm vijay k.shukla Julian Higgins Yngve Falck-Ytter Holger J.Schünemann 代表GRADE小组李幼平杨晓妍王莉蔡羽嘉陈群飞机构不详

本文针对二分类变量结局指标相对(而非绝对)治疗效果的不一致性。证据本身不会因不同研究结果具有一致性而升级,但可能因不一致而降低质量级别。衡量一致性的标准包括点估计值的相似性、可信区间的重叠程度以及统计学判定标准包括异质... 详细信息

本文针对二分类变量结局指标相对(而非绝对)治疗效果的不一致性。证据本身不会因不同研究结果具有一致性而升级,但可能因不一致而降低质量级别。衡量一致性的标准包括点估计值的相似性、可信区间的重叠程度以及统计学判定标准包括异质性检验和I2。系统评价作者应提出并检验少数几个与患者、干预措施、结局指标以及方法学相关的先验假设以探寻异质性来源。当不一致性很大且无法解释时,因不一致性而降低质量级别是恰当的,特别当某些研究显示有显著益处而其他显示无益甚至有害时(而非仅是疗效大与疗效小的比较)。明显的亚组效应可能不可靠。如果亚组效应满足以下条件,其可信度将会增加:基于少数几个有具体方向的先验假设、亚组比较来自研究内而非研究间、交互检验的P值小、结果有生物学意义。

关键词： GRADE 不一致性异质性变异性亚组分析交互作用

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Whipple’s operation with a modified centralization concept:A model in low-volume Caribbean centers

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World Journal of Clinical Cases 2022年第22期10卷 7620-7630页

作者： Shamir O Cawich Neil W Pearce vijay Naraynsingh Parul shukla Rahul R Deshpande Department of Clinical Surgical Sciences University of the West IndiesSt Augustine 000000Trinidad and Tobago University Surgical Unit Southampton General HospitalSouthampton SO166YDUnited Kingdom Department of Surgery Weill Cornell Medical CollegeNew YorkNY 10065United States Department of Surgery Manchester Royal InfirmaryManchester M139WLUnited Kingdom

Conventional data suggest that complex operations,such as a pancreaticoduodenectomy(PD),should be limited to high volume ***,this is not practical in small,resource-poor countries in the *** these settings,patients have no option but to have their PDs performed locally at low volumes,occasionally by general *** this paper,we review the evolution of the concept of the high-volume center and discuss the feasibility of applying this concept to low and middle-income ***,we discuss a modification of this concept that may be considered when incorporating PD into low-volume and resource-poor countries,such as those in the *** paper has two ***,we performed a literature review evaluating studies published on outcomes after PD in high volume *** data in the Caribbean is then examined and we discuss the incorporation of this operation into resource-poor hospitals with modifications of the centralization *** the authors’opinions,most patients who require PD in the Caribbean do not have realistic opportunities to have surgery in high-volume centers in developed *** these settings,their only options are to have their operations in the resource-poor,low-volume settings in the ***,post-operative outcomes may be improved,despite low-volumes,if a modified centralization concept is encouraged.

关键词： Pancreas Surgery Pancreatectomy Whipple’s Pancreaticoduodenectomy

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Comparison of visual analogue scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) score in evaluation of post septoplasty patients

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第1期6卷 53-58页

作者： Radhika Hiren shukla Sanjana vijay Nemade kiran Jaywant Shinde Department of ENT Smt.Kashibai Navale Medical College and General HospitalOff.Sinhsad RoadNarhePune411041MaharashtraIndia

Objective:To compare and correlate the efficacy of the NOSE score&the VAS score in determining the symptomatic benefit in patients undergoing *** and methods:Eighty patients with deviated nasal septum undergoing septoplasty were included in the *** score&VAS score(out of 100)was documented before and after *** were correlated and compared ***:In the NOSE score,the most bothersome symptom was trouble breathing through the nose(85.83);followed by Nasal obstruction or blockage(82.50).Wilcoxon test showed significant improvement with NOSE score and VAS score in all patients at 1 month and 3 ***’s coefficient showed a positive correlation between the two,though the score improvement and patient satisfaction rate was significantly high with NOSE ***:NOSE score and the VAS score both provide effective framework for evaluating treatment responses after ***,the NOSE score showed higher improvement and better patient satisfaction rate when used to measure of nasal obstruction as compared to the VAS score.

关键词： Deviated nasal septum Septoplasty NOSE score VAS score

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优化下肢慢性创面愈合中的技术应用:共识文件(译文)

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感染．炎症．修复 2017年第2期18卷 67-83页

作者： Raj Mani Divid J.Margolis vijay shukla Sadanori Akita Miltos Lazarides Alberto Piaggesi Vincent Falanga Luc Teot 谢挺付小兵 Marco Romanelli Chris Attinger 韩春茂陆树良 Sylvie Meaume 许樟荣 vijay Viswanathan 孙晓芳肖娴上海交通大学医学院附属第九人民医院急诊科创面修复中心上海200011

目的:慢性创面处理中技术创新随处可见。尽管多种技术得到了广泛的应用,但并不总是能够确保创面愈合的结局。这份共识文件为创面标准化处理的相关诊疗技术应用提供了循证研究依据。

关键词：慢性创面技术评估 SORT分类

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