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Review. Gastrointestinal Surgery in Neonates: Practice, Facts, and Trends

Open Journal of Pediatrics 2019年第2期9卷 154-182页

作者： Ralf-bodo Trobs Department of Pediatric Surgery Ruhr University of BochumHerneGermany Helios-Klinikum Duisburg Sankt Johannes HospitalDuisburgGermany

The author presents an overview of the current trends in acute neonatal gastrointestinal surgery. Necrotizing enterocolitis and focal intestinal perforation are disorders of different etiology, appearance, and prognosis. In neonates with focal perforation, a good prognosis can be expected. Primary anastomosis is a valid option for primary surgery. Meconium ileus is based on obstruction of the terminal ileum. Medical treatment is the primary therapeutic option, although surgery may be required. In contrast, meconium plug syndrome is based on stool plugging in the left colon, and surgery is not appropriate. Hirschsprung’s disease is confirmed on the basis of representative biopsy of the rectum just above the dentate line. There is a trend toward a single-step pull-through operation without protective stoma. Open hernia repair in small neonates can be performed via a mini-incision and without opening the external inguinal ring. Laparoscopic hernia repair has some advantages, especially in girls. In infants with pyloric stenosis, laparoscopic pyloromyotomy is a first line option for treatment. There is a general trend toward single-stage procedures and laparoscopic reconstructive surgery for gastrointestinal malformations. with the exception of tracheoesophageal fistula and low bowel obstruction, the vast majority of upper gastrointestinal malformations can be identified using prenatal ultrasound examination. One-stage repair with excellent results is even possible in neonates below 1000 g. Surgery of duodenal or small bowel atresia can be performed following the postnatal adaptation period. For some forms of anorectal malformation, the need for a protective stoma has been questioned in the last decade. Posterior sagittal anorectoplasty remains the standard procedure for the majority of cases. Midgut or segmental volvulus affects different groups of infants. If a neonate is suspected of having any type of volvulus, urgent surgery is required. Intestinal duplication carr

关键词： Neonatal Surgery Acute Abdomen Gastrointestinal Atresia Necrotizing Enterocolitis Bowel Obstruction

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Leucine signaling in the pathogenesis of type 2 diabetes and obesity

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world Journal of Diabetes 2012年第3期3卷 38-53页

作者： bodo C Melnik Department of Dermatology Environmental Medicine and Health TheoryUniversity of Osnabrück

Epidemiological evidence points to increased dairy and meat consumption,staples of the western diet,as major risk factors for the development of type 2 diabetes(T2D).This paper presents a new concept and comprehensive review of leucine-mediated cell signaling explaining the pathogenesis of T2D and obesity by leucine-induced over-stimulation of mammalian target of rapamycin complex 1(mTORC1).mTORC1,a pivotal nutrient-sensitive kinase,promotes growth and cell proliferation in response to glucose,energy,growth factors and amino *** proteins and meat stimulate insulin/insulin-like growth factor 1 signaling and provide high amounts of leucine,a primary and independent stimulator for mTORC1 *** downstream target of mTORC1,the kinase S6K1,induces insulin resistance by phosphorylation of insulin receptor substrate-1,thereby increasing the metabolic burden of β-***,leucine-mediated mTORC1-S6K1-signaling plays an important role in adipogenesis,thus increasing the risk of obesity-mediated insulin resistance. High consumption of leucine-rich proteins explains exaggerated mTORC1-dependent insulin secretion, increased β-cell growth and β-cell proliferation promoting an early onset of replicative β-cell senescence with subsequent β-cell *** of β-cell mass regulation with increased β-cell proliferation and apoptosis as well as insulin resistance are hallmarks of T2D,which are all associated with hyperactivation of *** contrast,the anti-diabetic drug metformin antagonizes leucine-mediated mTORC1 ***-derived polyphenols and flavonoids are identified as natural inhibitors of mTORC1 and exert anti-diabetic and anti-obesity ***,bariatric surgery in obesity reduces increased plasma levels of leucine and other branched-chain amino *** of leucine-mediated mTORC1 signaling by defining appropriate upper limits of the daily intake of leucine-rich animal and dairy proteins may offer a great chance

关键词： Adipogenesis Dairy proteins Diabetes Leucine Meat Mammalian target of rapamycin com- plex 1 Obesity

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Pathophysiology of Hypertrophic Pyloric Stenosis Revisited: The Use of Isotonic Fluid for Preoperative Infusion Therapy Is Supported

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Open Journal of Pediatrics 2014年第3期4卷 208-215页

作者： Ralf-bodo Troebs Klinik für Kinderchirurgie Marien Hospital Herne Ruhr University of Bochum Bochum Germany

Background: The aim of this study was to elucidate the preoperative clinical and biochemical profile of infants with IHPS to optimize infusion therapy. Patients and Method: we retrospectively analyzed data from 56 infants who were operated for IHPS. Our study includes growth and laboratory data prior to the initiation of therapy. Results: Median duration of propulsive vomiting was 4 d;the median age was 37 d (18 - 108), and the median body weight was 3840 g (2760 -5900). Metabolic alkalosis (MAlk) with a pH of 7.45 ± 0.06 and an stHCO3- of 28.7 ± 4.5 mmol/l was found. In a subgroup of the infants, negative base excess (BE) was observed. The sodium concentration was normal or reduced (mean/median of 137 mmol/l). There was a strong negative correlation between stHCO3- and K+. The carbon dioxide partial pressure tended to increase (5.72 ± 0.84 kPa). Calculations of osmolality revealed a normal osmolarity. Hypoglycemia did not occur. The creatinine clearance according to the Schwartz formula remained at a normal level (85.3 ± 24.3 ml/min/1.73 m2). Discussion: The presented case series is characterized by a short duration of preoperative vomiting. MAlk can be classified as a chloride deficiency syndrome. It is accompanied by normo- or hyponatremic dehydration with normal osmolality. Partial respiratory compensation occurred. A normal creatinine clearance indicated good glomerular renal function. Conclusion: The presented study supports the use of an isotonic infusion fluid with a low glucose concentration for preoperative infusion therapy.

关键词： Infantile Pyloric Stenosis Metabolic Alkalosis Dehydration Osmolality Glucose Lactate Creatinine Clearance Infusion Therapy

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Duodenal Atresia-Tandler’s “Epithelial Plug Stage” Revisited

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Open Journal of Pediatrics 2019年第1期9卷 103-110页

作者： Ralf-bodo Trobs Department of Pediatric Surgery St.Marie’s HospitalSaint Elisabeth GroupRuhr University of BochumWittenGermany

Background: Duodenal atresia is the most common type of intestinal atresia. Pathogenesis of duodenal atresia can be explained by an embryological theory that involves persistent physiologic epithelial occlusion (“epithelial plug”), first published in 1900. Tandler’s developmental arrest theory has been accepted by the majority of recognized modern textbooks to date. The aim of the presented study is to re-evaluate the relevance of Tandler’s observations. Method: Tandler’s paper was reviewed retrospectively and discussed from the point of view of subsequent research. Results and Discussion: Local epithelial proliferation, vacuolization failure and mesenchyme ingrowth may continuously serve as a partly convincing but incomplete embryologic model to explain membranous duodenal atresia. Tandler’s theory has some weak points regarding the epithelial-mesenchymal interaction, the predisposition of the post-ampullary region, the association of duodenal atresia with other malformations and trisomy 21, and familial occurrence. Shrinkage artifacts, misinterpretation of a three-dimensional problem investigated with a two-dimensional tool (light microscope), animal studies, and the lack of apoptosis call the real existence of a solid stage in early duodenal embryology into question. Conclusion: More sophisticated morphologic, genetic and molecular-biological investigations revealed new insights regarding endoderm to mesoderm signaling as an important key to the pathogenesis of duodenal atresia.

关键词： Duodenal Atresia Embryology Epithelial Plug Tandler’s Theory

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Quantum Model of Decision-Making in Economics

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Journal of Quantum Information Science 2015年第1期5卷 1-5页

作者： bodo Herzog Department of Economics ESB Business School Reutlingen Germany

The paper designs a quantum model of decision-making (QMDM) that utilizes neuroscientific evidence. The new model provides both normative and positive implications to economics. First, it enhances the study of decision-making which is an extension of the expected utility theory (EUT) in mathematical economics. Second, we demonstrate how the quantum model mitigates drawbacks of the expected utility theory of today.

关键词： Quantum Theory in Economics Decision-Making Utility Maximization

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Early Morbidity and Perioperative Course of Neonates with Esophageal Atresia and Tracheoesophageal Fistula in a Tertiary Pediatric Surgical Center

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Open Journal of Pediatrics 2016年第3期6卷 191-202页

作者： Ralf-bodo Troebs Jan wald Department of Pediatric Surgery St. Mary’s Hospital Herne St. Elisabeth Group Ruhr-University of Bochum Herne Germany Department of Diagnostic and Interventional Radiology St. Mary’s Hospital Herne St. Elisabeth Group Ruhr-University of Bochum Herne Germany

Background: The management of infants (infs.) with esophageal atresia and tracheoesophageal fistula (EA ± TEF) is demanding and complex. The aim of this study was to evaluate early morbidity, the timing of surgery, and the results of surgery. Patients and Method: we collected data of 30 consecutive infs. treated for EA ± TEF between 2006 and 2014. Results: The median gestational age was 38 weeks (12 preterm), and the median Birth weight (Bw) was 2660 g (4 infs. had a Bw 1500 g). The median Apgar score at 10 minutes was 10 (range 7 - 10). The median umbilical artery pH (UapH) was 7.30. According to the Spitz classification, 19 infs. were group 1, 9 infs. were group 2, and 2 infs. were group 3. Surgical repair was performed in 29 cases (25 EA;4 isolated TEF). Once the infs. arrived at the pediatric surgery department, surgery was postponed overnight in 11 cases. The duration of postoperative (p.o.) mechanical ventilation was significantly shorter for operations performed on day 2 after delivery. Twenty-four infs. (83%) underwent surgery within 2 days after delivery, and 5 infs. had later surgery. Chest drains (p.o.) for pneumothorax were inserted in 6 infs. (21%), and gastrostomy was performed in 6 cases (21%). No re-thoracotomy was required. The median length of hospital stay was 17.5 days (6 to 120). The incidence of p.o. mortality was 1 in 29 (3%). Discussion: The majority of the infs. presented growth retardation (indicated by low birth weight) and a stable immediate postnatal course. The data from this study support the concept of early but not emergent surgery for the majority of infs. with EA ± TEF. However, a remarkable rate of perioperative morbidity must be taken into account. Conclusion: Surgery for EA ± TEF can be performed safely during the first postnatal days with exception of very unstable preterm infants.

关键词： Esophageal Atresia Tracheoesophageal Fistula Short-Term Outcome Morbidity Urgency Ventilation Lengths of Stay

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语言学研究中的常见统计误区--《语言学统计方法:从R语言入门》评介

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当代语言学 2022年第1期24卷 140-147页

作者： bodo winter 李倩不详中国社会科学院语言研究所

随着现代语言科学研究方法论的发展,对语言现象的量化研究成为语言学各领域的热点,语言学理论的发展越来越依赖数据所揭示的规律,而如何正确处理和合理分析数据就成为我们当下理解语言现象和规律的关键。统计,作为数据处理和分析的工具... 详细信息

随着现代语言科学研究方法论的发展,对语言现象的量化研究成为语言学各领域的热点,语言学理论的发展越来越依赖数据所揭示的规律,而如何正确处理和合理分析数据就成为我们当下理解语言现象和规律的关键。统计,作为数据处理和分析的工具,得到学界前所未有的关注。近年来,学界涌现了一批适用于语言学问题的前沿统计方法D,能够对不同特性的数据进行有针对性的分析,相较传统的统计方法有明显优势。但这些方法通常技术性强,要求研究者具备一定的统计学基础,使用门槛较高。

关键词：科学研究方法论 R语言语言学理论语言学问题统计学基础数据处理和分析语言学研究理解语言

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Endoscopic Detection and Surgical Repair of Congenital Tracheo-Esophageal-Fistula(TEF)±Esophageal Atresia(EA)

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Open Journal of Pediatrics 2014年第4期4卷 283-290页

作者： Ralf-bodo Trobs werner Finke Department of Pediatric Surgery Marienhospital HerneSt.Elisabeth GroupRuhr-University of BochumHerneGermany Department of Anesthesiology and Surgical Intensive Care Marienhospital HerneSt.Elisabeth GroupRuhr-University of BochumHerneGermany

Purpose: This study was performed to evaluate the management of tracheoesophageal fistula (TEF) ± esophageal atresia (EA) under the guidance of preoperative tracheo-bronchoscopy (TrSc). Methods: Between 2007 and July 2014, a total of 26 consecutive newborns who underwent rigid TrSc for suspected TEF were identified. All associated charts and operation reports were retrospectively analyzed. Results: Distal TEF with EA (Gross C) predominated (n = 18). Furthermore, we managed 2 infants with proximal and distal TEF (Gross D) and 4 infants with isolated TEF (Gross E). In our hands, TrSc was feasible in infants with a birth weight above 1300 g. Twenty-five fistulas were identified by endoscopy in 23 patients. In one infant with a birth weight below 1000 g, an attempt to perform TrSc was interrupted, and urgent TEF closure was required. Fistula site at the carina was associated with a high rate of esophageal anastomosis under tension. During surgery, proximal TEF and isolated TEF were safely approached via right cervicotomy (n =5). Conclusion: This study supports the routine use of rigid TrSc at the time of surgery. Rigid TrSc allowed the surgical team to identify the number and location of TEFs, and the incidence of side effects was low.

关键词： Tracheoesophageal Fistula Esophageal Atresia Tracheo-Bronchoscopy Airway Management Cervical Approach

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Brevipedicelones D and E,Two C-O-C Flavonoid Dimmers from the Leaves of Garcinia brevipedicellata and Anti-onchocercal Activity

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Natural Products and Bioprospecting 2019年第1期9卷 61-68页

作者： Mirabel Akongwi Anastasie ETih Kennedy D.Nyongbela Moses Samje Raphael T.Ghogomu Bernard bodo Department of Organic Chemistry Faculty of ScienceUniversity of Yaounde 1P.O.Box 812YaoundeCameroon Pharmacochemistry Research Laboratory Department of ChemistryFaculty of ScienceUniversity of BueaP.O.Box 63BueaSouth West RegionCameroon Faculty of Science ANDI Centre of Excellence on Onchocerciasis ResearchUniversity of BueaP.O.Box 63BueaSouth West RegionCameroon Laboratoire de Chimie des Substances Naturelles Muse´um National d’Histoire Naturelle63 Rue Buffon75005 ParisFrance

A novel isoflavone–chromone flavonoid C–O–C dimmer,brevipedicelone D(1),along with one new C–O–C biflavonoid derivative,brevipedicelone E(2),were isolated from the ethyl acetate extract of the leaves of Garcinia brevipedicellata,a medicinal plant used in folk medicine in parts of *** structures were elucidated by extensive spectroscopic techniques,including 1D-and 2D-NMR,MS experiments,as well as comparing their spectral data with those of known ***-onchocercal screening of 1 showed moderate inhibition of adult worm motility of Onchocerca ochengi by 60%at the highest concentration(20 μg/mL)and inhibited motility of both the juvenile worms of *** and Loa loa by 90%at this same concentration.

关键词： Garcinia brevipedicellata Brevipedicelone Anti-onchocercal activity

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193nmLA-ICPMS对国际地质标准参考物质中42种主量和微量元素的分析

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岩石学报 2002年第3期18卷 408-418页

作者：柳小明高山袁洪林 bodo HATTENDORF DetlefG■NTHER 陈亮胡圣红西北大学大陆动力学教育部重点实验室中国地质大学(武汉)地球科学学院武汉430074 瑞士苏黎世高等理工学院无机化学实验室中国地质大学(武汉)地球科学学院

本文采用配备有 193nm Ar F准分子 (excimer)激光器的 Geo L as2 0 0 M剥蚀系统和 Elan6 10 0 DRC ICP- MS对 4个美国地质调查所 (USGS)玻璃标准参考物质以及 3个美国国家标准技术研究院 (NIST)人工合成硅酸盐玻璃标准参考物质中几乎覆... 详细信息

本文采用配备有 193nm Ar F准分子 (excimer)激光器的 Geo L as2 0 0 M剥蚀系统和 Elan6 10 0 DRC ICP- MS对 4个美国地质调查所 (USGS)玻璃标准参考物质以及 3个美国国家标准技术研究院 (NIST)人工合成硅酸盐玻璃标准参考物质中几乎覆盖整个质量数范围 (从 7L i到 2 38U)的 38个微量和 4个主量 (Na、Mg、Ti和 Mn)元素进行了分析。分析结果表明 ,无论是对 USGS还是 NIST玻璃 ,元素分析的相对标准偏差 RSDs和分析值与参考值之间的相对偏差 (RDs)一般优于 10 % ,RSD和RD较大的元素主要出现在含量很低或不均匀样品中。稀土元素的 RSD显示 ,除 AGV- 2 G可能存在不均匀现象外 ,其它所测样品在 6 0 μm尺度上 ,元素分布是均匀的。本研究证明 ,由于 ICP- MS具有 10 8cps(每秒计数 )的动态线性范围 ,本实验室的L A- ICPMS系统可定量分析含量在百分之几的主量元素及微量元素。分析精密度和准确度可与常规溶液雾化进样 ICP-

关键词： LA-ICPMS 电感耦合离子体质谱仪准分子激光器激光剥蚀玻璃标准参考物质微量元素

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