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Cellular crosstalk during cholestatic liver injury

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Liver Research 2017年第1期1卷 26-33页

作者： Joanne Thomson Laura Hargrove Lindsey kennedy Jennifer Demieville Heather Francis Research Central Texas Veterans Healthcare SystemTXUSA Digestive Disease Research Center Baylor Scott&White HealthTXUSA Medicine Texas A&M Health Science CenterTempleTXUSA

The functions of the liver are very *** detoxifying blood to storing glucose in the form of glycogen and producing bile to facilitate fat digestion,the liver is a very active and important *** liver is comprised of many varied cell types whose functions are equally *** line the biliary tree and aid in transporting and adjusting the composition of bile as it travels to the *** stellate cells and portal fibroblasts are located in different areas within the liver architecture,but both contribute to the development of fibrosis upon activation after liver *** cells,including those that constitute the peribiliary vascular plexus,are involved in functions other than blood delivery to and from the liver,such as supporting the growth of the biliary tree during *** cells are normally found in healthy livers but in very low ***,after injury,mast cell numbers greatly increase as they infiltrate and release factors that exacerbate the fibrotic *** not an all-inclusive list,these cells have individual roles within the liver,but they are also able to communicate with each other by cellular *** this review,we examine some of these pathways that can lead to an increase in the homeostatic dysfunction seen in liver injury.

关键词： Mast cells Paracrine Cholangiocytes Hepatic stellate cells Crosstalk

Assessment of the uncertainties in temperature change in China during the last century

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Chinese Science Bulletin 2010年第19期55卷 1974-1982页

作者： LI QingXiang DONG WenJie LI Wei GAO XiaoRong JONES P kennedy J PARKER D National Meteorological Information Center Beijing 100081 China Beijing Normal University Laboratory of Surface Process and Resources Economies Beijing 100875 China National Meteorological Center Beijing 100081 China Climatic Research Unit School of Environmental Sciences University of East Anglia Norwich NR4 7TJ UK Met Office Hadley Centre Exeter EX1 3PB UK

We have used the China Homogenized Historic Temperature dataset and some long-term station series of the neighbor countries from CRUTEM3,a 5°×5° gridded dataset of monthly mean temperature since 1900,to provide a 107-year record of surface temperature trends and *** derived a comprehensive set of uncertainty estimates to accompany the data:measurement and sampling errors,uncertainties in temperature bias estimates,and uncertainties arising from limited observational coverage on large-scale averages have all been *** reanalysed the temperature changes during the period of *** best estimates of trends for 1900-2006 with uncertainties at 95% confidence range are about 0.09±0.017°C/decade for the year as a whole,and 0.14±0.021°C/decade,0.11±0.021°C/decade,0.04±0.017°C/decade,and 0.07±0.017°C/decade for winter,spring,summer and autumn *** 1954-2006,the trends for annual,winter,spring,summer and autumn are:0.26±0.032°C/decade,0.35±0.046°C/decade,0.25±0.051°C/decade,0.16±0.037°C/decade and 0.22±0.055°C/*** saw the most significant warming trend in both 1900-2006 and 1954-2006,while during the most recent period(the satellite era,1979-2006),all the seasons show similar warming trends:0.45±0.13°C/decade,0.51±0.11°C/decade,0.52±0.16°C/decade,0.37±0.10°C/decade and 0.50±0.16°C/decade for annual,winter,spring,summer and *** arising from urbanization have been evaluated as less than 5% of the total warming trend for 1951-2001,so this bias was not removed.

关键词：不确定性温度变化中国历史评估变暖趋势偏差估计月平均温度抽样误差

ECMO in major burn patients: feasibility and considerations when multiple modes of mechanical ventilation fail

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Burns & Trauma 2017年第2期5卷 134-139页

作者： Jason D. kennedy Wesley Thayer Reuben Beuno Kelly Kohorst Avinash B. Kumar Department of Anesthesiology and Critical Care Vanderbilt University Medical Center 121121st Avenue S Suite 526 Nashville TN 37212 USA Department of Plastic Surgery Vanderbilt University Nashville TN USA

Background: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant *** presentation: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress *** hypoxemia continued to worsen on multiple modes of ventilation including volume control, pressure regulated volume control, pressure control, airway pressure release ventilation and volumetric diffusive *** both cases, the PaO2 ≤ 50 mm Hg on a FiO2100% during the trial of mechanical ventilation. The deterioration was rapid (<12 h since onset of worsening oxygenation) in both cases.A decision was made to trial the patients on ECMO. Veno-Venous ECMO (V-V ECMO) was successfully initiated following cannulation-under transesophgeal echo guidance—with the dual lumen Avalon? (Maquet, NJ, USA) cannula. ECMO support was maintained for 4 and 24 days, respectively. Both patients were successfully weaned off ECMO and were discharged to rehabilitation following their complex hospital ***: Early ECMO for isolated respiratory failure in the setting on maintained hemodynamics resulted in a positive outcome in our two burn patients suffered from acute respiratory distress syndrome.

关键词： ARDS Burns Extra corporeal membrane oxygenation Rescue ventilation Conventional ventilation failure Veno-venous ECMO

Oesophageal adenocarcinoma:In the era of extended lymphadenectomy,is the value of neoadjuvant therapy being attenuated?

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World Journal of Gastrointestinal Surgery 2021年第10期13卷 1235-1244页

作者： Jin-Soo Park Hans Van der Wall Catherine kennedy Gregory L Falk Upper GI Surgery Concord Repatriation General HospitalSydney 2137NSWAustralia Department of Medicine University of Notre DameSydney 2007NSWAustralia CNI Molecular Imaging Notre Dame UniversitySydney 2114NSWAustralia

BACKGROUND Neoadjuvant chemotherapy(NACT)and oesophagectomy is the standard of care for resectable oesophageal *** outcomes following resection have been improving over time while NACT remain largely ***,a recent meta-analysis of randomized control trials did not demonstrate a survival benefit in adding NACT,raising the possibility that improved surgical techniques may be reducing the perceived effectiveness of *** To compare the effect of addition of NACT to a standardized surgery and lymphadenectomy on overall and disease-free survival in patients undergoing curative oesophagectomy for oesophageal *** Patient data were analysed from a prospectively maintained surgical survival ***,surgical,and survival outcomes were compared between groups according to treatment and nodal *** The data of 243 consecutive patients were identified.79 patients were given NACT and 162 had surgery *** NACT group were younger,and there was less frequent stage I *** survival was similar between NACT and surgery only groups(5YS:48.7%vs 42.5%;P=0.113),as was diseasefree survival(5YS:40.6%vs 39.9%;P=0.635).There were≥30 nodes removed in 46 patients,and<30 in 197 patients,but were otherwise *** was improved survival in patients with≥30 nodes removed than those with<30 nodes(5YS:64.4%vs 40.7%;P=0.015),and a better disease-free survival that neared significance(5YS:54.9%vs 36.6%;P=0.078).CONCLUSION NACT did not appear to affect overall or disease-free ***,an overall survival benefit was observed in patients with≥30 lymph nodes removed,and a benefit in disease-free survival which was not significant.

关键词： Oesophagectomy Oesophageal adenocarcinoma Neoadjuvant chemotherapy Lymphadenectomy Survival outcome Surgical technique

Ankle arthrodesis:A systematic approach and review of the literature

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World Journal of Orthopedics 2016年第11期7卷 700-708页

作者： Youichi Yasui Charles P Hannon Dexter Seow John G kennedy Hospital for Special Surgery Department of Orthopaedic Surgery 2~(nd) Teikyo University School of Medicine

Ankle arthrodesis is a common treatment used for patients with end-stage ankle arthritis(ESAA). The surgical goal of ankle arthrodesis is to obtain bony union between the tibia and talus with adequate alignment [slight valgus(0°-5°)], neutral dorsiflexion, and slight external rotation positions) in order to provide a pain-free plantigrade foot for weightbearing activities. There are many variations in operative technique including deferring approaches(open or arthroscopic) and differing fixation methods(internal or external fixation). Each technique has its advantage and disadvantages. Success of ankle arthrodesis can be dependent on several factors, including patient selection, surgeons' skills, patient comorbidities, operative care, etc. However, from our experience, the majority of ESAA patients obtain successful clinical outcomes. This review aims to outline the indications and goals of arthrodesis for treatment of ESAA and discuss both open and arthroscopic ankle arthrodesis. A systematic step by step operative technique guide is presented for both the arthroscopic and open approaches including a postoperative protocol. We review the current evidence supporting each approach. The review finishes with a report of the most recent evidence of outcomes after both approaches and concerns regarding the development of hindfoot arthritis.

关键词： Ankle Osteoarthritis Arthrodesis Review Ankle fusion

Who Made the Olympic Rings?

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考试(双语读写) 2012年第9期 40-41页

作者： Pagan kennedy

皮埃尔·德·顾拜旦男爵(Baron Pierre de Coubertin)是现代奥林匹克运动会的创始人。他是一位法国贵族,脸上留着浓密的、好像上过蜡似的小胡子,看起来像是个重音符号。1914年,这位男爵宣布他为纪念现代奥林匹克运动会20周年设计了一个... 详细信息

皮埃尔·德·顾拜旦男爵(Baron Pierre de Coubertin)是现代奥林匹克运动会的创始人。他是一位法国贵族,脸上留着浓密的、好像上过蜡似的小胡子,看起来像是个重音符号。1914年,这位男爵宣布他为纪念现代奥林匹克运动会20周年设计了一个标志。"这真的可以称得上是一个国际性的标志,"他描述说,这个标志以五个圆环为素材,相套连成一体,象征着人类团结。那么,男爵的灵感是从哪里获得的呢?1984年,体育历史学家罗伯特·巴尼(Robert Barney)正在勘察一处希腊考古遗迹,当他俯身系鞋带时,注意到

关键词：现代奥林匹克运动会顾拜旦历史学家 Who Made the Olympic Rings 皇位继承奥运五环

Assessment of the usefulness of integrated disease surveillance and response on suspected ebola cases in the Brong Ahafo Region, Ghana

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Infectious Diseases of Poverty 2015年第1期4卷 168-175页

作者： Kofi Issah kennedy Nartey Richard Amoah Emmanuel George Bachan Jacob Aleeba Enuamah Yeetey Timothy Letsa Ghana Health Service Regional Health DirectorateP.O.Box 145SunyaniBrong Ahafo RegionGhana Kintampo Health Centre Ghana Health ServiceKintampoBrong Ahafo RegionGhana

Background:This study assessed the quality,core and support functions of the integrated disease surveillance and response(IDSR)system relating to 18 suspected cases of Ebola virus disease(EVD)in the Brong Ahafo Region,***:Data was collected on selected indicators of the surveillance system relating to 18 suspected cases of EVD,from epidemiological week 19 to 45 of *** conducted in-depth interviews with seven medical directors and two district directors of health services,and also reviewed documentation on the implementation of the core,support and quality functions of the IDSR *** also monitored news in the media and rumours about EVD within the community as well as in health facility surveillance ***:The study identified gaps in the implementation of IDSR relating to 18 suspected cases of *** staff heavily relied on haemorrhage as the only symptom for detection of suspected EVD *** blood samples and a swab of secretions from the mouth of the thirteenth patient(who died)tested negative for EVD using PCR assay in laboratory *** blood samples of three patients were discarded,as they did not fit the case definition for suspected cases,whilst two refused for their blood samples to be *** community-based surveillance(CBS)system has not been given a prominent role in EVD surveillance and response,as demonstrated by CBS volunteers and health staff not receiving any training in these *** was intense public interest in EVD in August and September *** interest has since waned for reasons that have to be formally *** fear of and anxiety about EVD still remain challenges due to a lack of in-depth knowledge about the disease in ***:Ghana has been one of the pioneers in the implementation of IDSR in *** this,gaps have been identified in the implementation of IDSR relating to EVD in the Brong Ahafo *** address these gaps,the CBS system has to activ

关键词： Ebola Disease surveillance Brong Ahafo Ghana

Safety of gastrointestinal endoscopy in patients with acute coronary syndrome and concomitant gastrointestinal bleeding

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World Journal of Clinical Cases 2021年第5期9卷 1048-1057页

作者： Ahmed A Elkafrawy Mohamed Ahmed Mohammad Alomari Ahmed Elkaryoni Kevin F kennedy Wendell KClarkston Donald R Campbell Digestive Disease and Surgery Institute Cleveland Clinic FoundationClevelandOH 44195United States Internal Medicine University of Missouri Kansas City School of MedicineKansas CityMO 64108United States Department of Gastroenterology and Hepatology Cleveland Clinic FloridaWestonFL 33331United States Division of Cardiovascular Medicine Loyola University Medical Center and Stritch School of MedicineMaywoodIL 60153United States Mid America Heart Institute Saint Luke's Health SystemKansas CityMO 64111United States Department of Gastroenterology Saint Luke's Hospital/University of Missouri Kansas CityKansas CityMO 64111United States

BACKGROUND Gastrointestinal bleeding(GIB)is a major concern in patients hospitalized with acute coronary syndrome(ACS)due to the common use of both antiplatelet medications and *** evaluating the safety of gastrointestinal endoscopy(GIE)in ACS patients with GIB are limited by their relatively small size,and the focus has generally been on upper GIB and esophago-gastroduodenoscopy(EGD)*** To evaluate the safety profile and the hospitalization outcomes of undergoing GIE in patients with ACS and concomitant GIB using the national database for hospitalized patients in the United *** The Nationwide Inpatient Sample database was queried to identify patients hospitalized with ACS and GIB during the same admission between 2005 and *** International Classification of Diseases Code,9th Revision Clinical Modification was utilized for patient *** were further classified into two groups based on undergoing endoscopic procedures(EGD,small intestinal endoscopy,colonoscopy,or flexible sigmoidoscopy).Both groups were compared regarding demographic information,outcomes,and *** analysis was conducted to identify factors associated with mortality and prolonged length of ***-square test was used to compare categorical variables,while Student’s t-test was used to compare continuous *** analyses were performed using SAS 9.4(Cary,NC,United States).RESULTS A total of 35612318 patients with ACS were identified between January 2005 and December 2014.269483(0.75%)of the patients diagnosed with ACS developed concomitant GIB during the same *** least one endoscopic procedure was performed in 68%of the patients admitted with both ACS and *** who underwent GIE during the index hospitalization with ACS and GIB had lower mortality(3.8%)compared to the group not undergoing endoscopy(8.6%,P<0.001).A shorter length of stay(LOS)was observed in patients who underwent GIE(mean 6.59±7.81 d)co

关键词： Gastrointestinal endoscopy Gastrointestinal bleeding Acute coronary syndrome Safety Outcomes Mortality

Current management of talar osteochondral lesions

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World Journal of Orthopedics 2017年第1期8卷 12-20页

作者： Arianna L Gianakos Youichi Yasui Charles P Hannon John G kennedy Department of Orthopedic Surgery 2~(nd) Jersey City Medical Center Department of Foot and Ankle Hospital for Special Surgery Department of Orthopaedic Surgery 2~(nd) Teikyo University School of Medicine 2~(nd) Department of Orthopaedic Surgery Rush University Medical Center (C.P.H.)

Osteochondral lesions of the talus(OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation(BMS), or replacement procedures, such as autologous osteochondral transplantation(AOT). Reparative procedures are generally indicated for OLT < 150 mm^2 in area. Replacement strategies are used for large lesions or after failed primary repair procedures. Although shortand medium-term results have been reported, longterm studies on OLT treatment strategies are lacking. Biological augmentation including platelet-rich plasma and concentrated bone marrow aspirate is becoming increasingly popular for the treatment of OLT to enhance the biological environment during healing. In this review, we describe the most up-to-date clinical evidence of surgical outcomes, as well as both the mechanical and biological concerns associated with BMS and AOT. In addition, we will review the recent evidence for biological adjunct therapies that aim to improve outcomes and longevity of both BMS and AOT procedures.

关键词： Osteochondral lesions of talus Comprehensive review Diagnosis Bone marrow stimulation Autologous autograft transfer Biologics