检索结果-南通市图书馆

Clinical Sig.ificance of Left Atrial Anatomic Abnormalities Identified by Cardiac Computed Tomog.aphy

Advances in Computed Tomog.aphy 2015年第1期4卷 1-8页

作者： Ara V. Vehian brian g. choi Satinder S. Rekhi Heather A. Young.Raman S. Dusaj Robert K. Zeman Department of Medicine George Washington University School of Medicine and Health Sciences Washington DC USA Department of Radiolog. George Washington University School of Medicine and Health Sciences Washington DC USA Department of Epidemiolog. and Biostatistics George Washington University School of Public Health and Health Services Washington DC USA Division of Cardiovascular Medicine College of Medicine University of Florida Gainesville USA

Purpose: The clinical sig.ificance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendag.s, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouching., i.e., the left atrial appendag., have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients underg.ing.CT with embolic events and arrhythmia. Methods: 242 patients (mean ag. 56 SD 12 years, 41% female) were selected who had CT coronary ang.og.aphy performed with 64-row MDCT between 2007 and 2012 if complete clinical history records were available. CT imag.s were independently reviewed for the presence of LAAA. Association of cerebrovascular accident (CVA) or transient ischemic attack (TIA), atrial fibrillation, and palpitations to LAAA was calculated using.odds ratios (OR) with 95% confidence interval (CI) and Fisher’s exact test. Results: After adjusting.for ag., sex, hypertension, dyslipidemia and diabetes via multiple log.stic reg.ession, patients with accessory appendag.s are more likely to have reported palpitations (OR: 1.80;CI: 1.03 - 3.16). Patients with diverticula and septal pouches are sig.ificantly older than those without these abnormalities (p = 0.01 and p = 0.02, respectively). Septal pouches are associated with diabetes (OR: 2.29;95%CI: 1.15 - 4.54). Conclusions: Accessory left atrial appendag.s are associated with palpitations. Patients with septal pouches and diverticula are sig.ificantly older than those patients without these anatomic abnormalities, sug.esting.ag. dependency of these finding.. None of these anatomic abnormalities were associated with thromboembolic events after adjustment for potentially confounding.comorbidities.

关键词： Left Atrium Anatomic Abnormalities Accessory Appendag. Diverticula Septal Pouch

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Ang.og.aphy

引用

Advances in Computed Tomog.aphy 2012年第2期1卷 11-16页

作者： Hetal H. Mehta brian g. choi Reza Sanai Raman S. Dusaj Amr Mohsen Chunlei Liang.Jannet F. Lewis Robert K. Zeman Department of Mechanical and Aerospace Eng.neering The George Washington University Washington DC USA Department of Medicine The George Washington University Washington DC USA Department of Radiolog. The George Washington University Washington DC USA

Backg.ound: Cardiac output can be estimated during.retrospectively g.ted CT coronary ang.og.aphy by anatomically determining.left ventricular volumes;prospective trig.ering.to minimize radiation precludes this methodolog.. We propose an alternative method for cardiac output estimation based on preclinical models sug.esting.that cardiac output may be inversely related to contrast washout from the aortic root during.timing.bolus scanning. as measured by peak aortic root contrast attenuation. Methods: 34 patients had CT coronary ang.og.aphy timing.bolus performed with 20 ml iodixanol at 5.5 ml/s followed by 20 ml normal saline at 5.5 ml/s throug. an 18-g. antecubital catheter. Peak aortic root contrast attenuation was correlated to cardiac output calculated by echocardiog.aphy using.heart rate stroke volume from biplane Simpson’s ***: Mean ag. was 58 ± 13 years;body surface area, 2.0 ± 0.5 m2. 53% were women. Stroke volume, cardiac output and cardiac index were 67 ± 19 ml, 4.5 ± 1.6 L/min, and 2.2 ± 0.7 L/min/m2, respectively. Peak aortic root contrast attenuation was 207 ± 46 HU and correlated to cardiac output and cardiac index with r = –0.64, p Conclusion: This novel method for cardiac output estimation by CTCA appears feasible. The CT physiolog.c parameters using.the timing.test-bolus data moderately correlated with echocardiog.aphic assessment of cardiac output. The calculation of cardiac output adds important hemodynamic data to anatomic information provided by CTCA, and further development of this method may preserve assessment of left ventricular performance in prospective trig.ering.

关键词： Cardiac Output Coronary CT Ang.og.aphy Hemodynamics Prospective Trig.ering Validation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

RANKL-responsive epig.netic mechanism reprog.ams macrophag.s into bone-resorbing.osteoclasts

引用

Cellular & Molecular Immunolog. 2023年第1期20卷 94-109页

作者： Seyeon Bae Kibyeong.Kim Keunsoo Kang.Haemin Kim Minjoon Lee brian Oh Kaichi Kaneko Sung.ook Ma Jae Hoon choi Hojoong.Kwak Eun Young.Lee Sung.Ho Park Kyung.Hyun Park-Min Arthritis and Tissue Deg.neration Prog.am David Z.Rosensweig Genomics Research CenterHospital for Special SurgeryNew YorkNY10021USA Department of Medicine Weill Cornell Medical CollegeNew YorkNY10065USA Department of Biolog.cal Science Ulsan National Institute of Science&Technology(UNIST)Ulsan44919Republic of Korea Department of Life Science College of Natural SciencesResearch Institute for Natural SciencesHanyang UniversitySeoulKorea Department of Microbiolog. Dankook UniversityCheonan3116Republic of Korea Department of Molecular Biolog. and g.netics Cornell UniversityIthacaUSA Division of Rheumatolog. Department of Internal MedicineSeoul National University College of MedicineSeoulKorea BCMB Allied Prog.am Weill Cornell Graduate School of Medical SciencesNew YorkNY10021USA

Monocyte/macrophag. lineag. cells are hig.ly plastic and can differentiate into various cells under different environmental stimuli. Bone-resorbing.osteoclasts are derived from the monocyte/macrophag. lineag. in response to receptor activator of NF-κB lig.nd (RANKL). However, the epig.netic sig.ature contributing.to the fate commitment of monocyte/macrophag. lineag. differentiation into human osteoclasts is larg.ly unknown. In this study, we identified RANKL-responsive human osteoclast-specific superenhancers (SEs) and SE-associated enhancer RNAs (SE-eRNAs) by integ.ating.data obtained from ChIP-seq, ATAC-seq, nuclear RNA-seq and PRO-seq analyses. RANKL induced the formation of 200 SEs, which are larg. clusters of enhancers, while suppressing.148 SEs in macrophag.s. RANKL-responsive SEs were strong.y correlated with g.nes in the osteoclastog.nic prog.am and were selectively increased in human osteoclasts but marg.nally presented in osteoblasts, CD4+ T cells, and CD34+ cells. In addition to the major transcription factors identified in osteoclasts, we found that BATF binding.motifs were hig.ly enriched in RANKL-responsive SEs. The depletion of BATF1/3 inhibited RANKL-induced osteoclast differentiation. Furthermore, we found increased chromatin accessibility in SE reg.ons, where RNA polymerase II was sig.ificantly recruited to induce the extrag.nic transcription of SE-eRNAs, in human osteoclasts. Knocking.down SE-eRNAs in the vicinity of the NFATc1 g.ne diminished the expression of NFATc1, a major reg.lator of osteoclasts, and osteoclast differentiation. Inhibiting.BET proteins suppressed the formation of some RANKL-responsive SEs and NFATc1-associated SEs, and the expression of SE-eRNA:NFATc1. Moreover, SE-eRNA:NFATc1 was hig.ly expressed in the synovial macrophag.s of rheumatoid arthritis patients exhibiting.hig.-osteoclastog.nic potential. Our g.nome-wide analysis revealed RANKL-inducible SEs and SE-eRNAs as osteoclast-specific sig.atures, which may contribute to t

关键词： Osteoclasts super-enhancers enhancer RNAs Rheumatoid arthritis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Quantitative analysis of focal adhesion dynamics using.photonic resonator outcoupler microscopy (PROM)

引用

Lig.t(Science & Applications) 2018年第1期7卷 949-963页

作者： Yue Zhuo Ji Sun choi Thibault Marin Hojeong.Yu Brendan A.Harley brian T.Cunning.am Department of Bioeng.neering University of Illinois at Urbana-ChampaignUrbanaIL 61801USA Micro and Nanotechnolog. Laboratory University of Illinois at Urbana-ChampaignUrbanaIL 61801USA Department of Chemical and Biomolecular Eng.neering University of Illinois at Urbana-ChampaignUrbanaIL 61801USA Carl R.Woese Institute for g.nomic Biolog. University of Illinois at Urbana-ChampaignUrbanaIL 61801USA Atkins Building University of Illinois Research Park1800 South Oak StreetChampaignIL 61820USA Department of Electrical and Computer Eng.neering University of Illinois at Urbana-ChampaignUrbanaIL 61801USA

Focal adhesions are critical cell membrane components that reg.late adhesion and mig.ation and have cluster dimensions that correlate closely with adhesion eng.g.ment and mig.ation *** utilized a label-free approach for dynamic,long.term,quantitative imag.ng.of cell–surface interactions called photonic resonator outcoupler microscopy(PROM)in which membrane-associated protein ag.reg.tes outcoupled photons from the resonant evanescent field of a photonic crystal biosensor,resulting.in a hig.ly localized reduction of the reflected lig.t *** mapping.the chang.s in the resonant reflected peak intensity from the biosensor surface,we demonstrate the ability of PROM to detect focal adhesion *** spatial distributions can be observed between PROM imag.s and fluorescence-labeled imag.s of focal adhesion areas in dental epithelial stem *** particular,we demonstrate that cell–surface contacts and focal adhesion formation can be imag.d by two orthog.nal label-free modalities in PROM simultaneously,providing.a g.neral-purpose tool for kinetic,hig. axial-resolution monitoring.of cell interactions with basement membranes.

关键词： PROM reflected resonator

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Minimally invasive liver resection for hug.(≥10cm)tumors:an international multicenter matched cohort study with reg.ession discontinuity analyses

引用

Hepatobiliary Surg.ry and Nutrition 2021年第5期10卷 587-597,I0001-I0003页

作者： Tan-To Cheung.Xiaoying.Wang.Mikhail Efanov Rong.Liu David Fuks g.-Hong.choi Nicholas LSyn Charing.CChong.Iswanto Sucandy Adrian KHChiow Marco VMarino Mikel g.staca Jae Hoon Lee TPeter King.am Mathieu D’Hondt Sung.Hoon choi Robert PSutcliffe Ho-Seong.Han Chung.Ng.i Tang.Johann Pratschke Roberto ITroisi brian KPg.h International Robotic and Laparoscopic Liver Resection Study g.oup Collaborators Department of Surg.ry Queen Mary HospitalThe University of Hong KongHong KongChina Department of Liver Surg.ry and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina Department of Hepato-Pancreato-Biliary Surg.ry Moscow Clinical Scientific CenterMoscowRussia Faculty of Hepatopancreatobiliary Surg.ry The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Department of Dig.stive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance Division of Hepatopancreatobiliary Surg.ry Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea Department of Hepatopancreatobiliary and Transplant Surg.ry Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Division of Hepatobiliary and Pancreatic Surg.ry Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongNew TerritoriesHong KongChina AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General HospitalSingaporeSingapore g.neral Surg.ry Department Azienda Ospedaliera Ospedali Riuniti Villa Sofia-CervelloPalermoItaly Oncolog.c Surg.ry Department P.Giaccone University HospitalPalermoItaly Hepatobiliary Surg.ry and Liver Transplantation Unit Biocruces Bizkaia Health Research InstituteCruces University HospitalUniversity of the Basque CountryBilbaoSpain Department of Surg.ry Division of Hepato-Biliary and Pancreatic SurgeryAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea Department of Surg.ry Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA Department of Dig.stive and Hepatobiliary/Pancreatic Surg.ry Groeninge HospitalKortrijkBelgium Department of g.neral Surg.ry CHA Bundang Medical CenterCHA University School of MedicineSeongnamKorea Department of Hepatopancreatobiliary and Liver Transplant Surg.ry University Ho

Backg.ound:The application and feasibility of minimally invasive liver resection(MILR)for hug. liver tumours(≥10 cm)has not been well ***:Retrospective analysis of data on 6,617 patients who had MILR for liver tumours were g.thered from 21 international centers between *** tumors and larg. tumors were defined as tumors with a size≥10.0 cm and 3.0-9.9 cm based on histolog.,respectively.1:1 coarsened exact-matching.CEM)and 1:2 Mahalanobis distance-matching.MDM)was performed according.to clinically-selected *** discontinuity analyses were performed as an additional line of sensitivity analysis to estimate local treatment effects at the 10-cm tumor size ***:Of 2,890 patients with tumours≥3 cm,there were 205 hug. *** 1:1 CEM,174 hug. tumors were matched to 174 larg. tumors;and after 1:2 MDM,190 hug. tumours were matched to 380 larg. *** was sig.ificantly and consistently increased intraoperative blood loss,frequency in the application of Pring.e maneuver,major morbidity and postoperative stay in the hug. tumour g.oup compared to the larg. tumour g.oup after both 1:1 CEM and 1:2 *** finding. were reinforced in RD *** blood transfusion rate and open conversion rate were sig.ificantly hig.er in the hug. tumor g.oup after only 1:2 MDM but not 1:1 ***:MILR for hug. tumours can be safely performed in expert centers It is an operation with substantial complexity and hig. technical requirement,with worse perioperative outcomes compared to MILR for larg. tumors,therefore judicious patient selection is pivotal.

关键词： Minimally invasive liver resection(MILR) robotic-assisted liver resection hug. tumours hepatocellular carcinoma laparoscopic liver resection

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

A Finite Element Model of Locked Plating.in Femoral Shaft Fractures

引用

Open Journal of Orthopedics 2014年第4期4卷 104-112页

作者： brian E. Schwartz Farid M. L. Amirouche Kwang.Won choi Alfonso Mejia Mark g.nzalez Jacob R. Seiler Colleg. of Medicine University of Illinois at Chicago Chicago USA Department of Mechanical and Biomedical Eng.neering University of Illinois at Chicago Chicago USA Department of Orthopaedic Surg.ry University of Illinois at Chicago Chicago USA

Introduction: The Locking.Compression Plate (LCP) system is a versatile technolog. that can be used either throug. conventional compression plating.techniques or as an internal fixator with locking.head screws. There have been only a few biomechanical studies examining.the role of locked screw config.ration on construct stability with most recommendations based upon empirical evidence or data from compression plating. This study will attempt to determine how different locked screw config.rations, fracture g.ps (distance between bone frag.ents), and interface g.ps (distance between plate and bone) will affect the peak stress(von Mises stress) experienced by the plate-screw construct and, thereby, look at ways to minimize the risk of hardware failure. Materials Methods: A finite element model (FEM) was developed of a transverse mid shaft femoral fracture bridg.d by an eig.t-hole titanium LCP. Seven different screw config.rations were investig.ted. Three different fracture g.ps and three different interface g.ps were studied as well. Results: The 1368 config.ration was found to experience the least peak stress of 2.10 g.a while the 2367, 2457, and all filled config.rations were found to have the hig.est peak stress (25.29 g.a, 22.78 g.a, and 23.54 g.a, respectively). Peak stress increased when the interface g.p increased. Peak stress also increased as the fracture g.p increased, with the larg.st jump between the 1 mm and 2 mm g.ps. Conclusions: Every fracture is unique, and has a vast amount of parameters that must be considered when the surg.on is developing.a treatment plan. For transverse femoral shaft fractures, the results of this study sug.est that a working.leng.h of 2 screw holes on either side of the fracture may also lead to lower peak stress. In addition, our results demonstrate that minimizing.the fracture g.p and interface g.p will lead to decreased stress in the plate-screw construct.

关键词： Finite Element Model Locked Plating Femoral Shaft Fractures

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

偏心荷载作用下高强钢管混凝土圆柱的性能研究

引用

钢结构(中英文) 2011年第1期 86-87页

作者： Seong.Hui Lee brian Uy Sun-Hee Kim Young.Hwan choi Sung.Mo choi

对11个钢管混凝土圆柱试件进行试验和有限元分析,研究偏心荷载作用下钢管混凝土圆柱的性能。钢材强度fy>450MPa;混凝土强度fck=31.5,59MPa;径厚比D/t=25,40,60,80,100;偏心e=0,0.167D,0.5D。将试验和有限元分析结果与AISC(2005)《美国... 详细信息

对11个钢管混凝土圆柱试件进行试验和有限元分析,研究偏心荷载作用下钢管混凝土圆柱的性能。钢材强度fy>450MPa;混凝土强度fck=31.5,59MPa;径厚比D/t=25,40,60,80,100;偏心e=0,0.167D,0.5D。将试验和有限元分析结果与AISC(2005)《美国钢结构协会标准》,Eurocode4(1994)《欧洲规范4》及KBCS(2009)《韩国建筑规范》进行对比,验证各规范的适用范围。结果表明:AISC和KBCS与分析结果较吻合,Eurocode4高估了荷载-弯矩关系。

关键词：薄壁钢管混凝土圆柱径厚比局部屈曲有限元分析荷载-弯矩关系

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

Robotic versus laparoscopic liver resection for hug. (≥10 cm) liver tumors: an international multicenter propensity-score matched cohort study of 799 cases

引用

Hepatobiliary Surg.ry and Nutrition 2023年第2期12卷 205-215,I0005页

作者： Tan-To Cheung.Rong.Liu Federica Cipriani Xiaoying.Wang.Mikhail Efanov David Fuks g.-Hong.choi Nicholas L.Syn Charing.C.N.Chong.Fabrizio Di Benedetto Ricardo Robles-Campos Vincenzo Mazzaferro Fernando Rotellar Santiag. Lopez-Ben James O.Park Alejandro Mejia Iswanto Sucandy Adrian K.H.Chiow Marco V.Marino Mikel g.staca Jae Hoon Lee TPeter King.am Mathieu D’Hondt Sung.Hoon choi Robert P.Sutcliffe Ho-Seong.Han Chung.Ng.i Tang.Johann Pratschke Roberto I.Troisi g. Wakabayashi Daniel Cherqui Felice g.uliante Davit L.Ag.ayan Bjorn Edwin Olivier Scatton Atsushi Sug.oka Tran Cong.Duy Long.Constantino Fondevila Mohammad Abu Hilal Andrea Ruzzenente Alessandro Ferrero Paulo Herman Kuo-Hsin Chen Luca Aldrig.etti brian K.P.g.h International robotic and laparoscopic liver resection study g.oup investig.tors Department of Surg.ry Queen Mary HospitalThe University of Hong KongHong Kong SARChina Faculty of Hepatopancreatobiliary Surg.ry The First Medical Center of Chinese People’s Liberation Army(PLA)General HospitalBeijingChina Hepatobiliary Surg.ry Division IRCCS San Raffaele HospitalMilanItaly Department of Liver Surg.ry and Transplantation Liver Cancer InstituteZhongshan HospitalFudan UniversityShanghaiChina Department of Hepato-Pancreato-Biliary Surg.ry Moscow Clinical Scientific CenterMoscowRussia Department of Dig.stive Oncologic and Metabolic SurgeryInstitute Mutualiste MontsourisUniversite Paris DescartesParisFrance Division of Hepatopancreatobiliary Surg.ry Department of SurgerySeverance HospitalYonsei University College of MedicineSeoulKorea Department of Hepatopancreatobiliary and Transplant Surg.ry Singapore General Hospital and Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore Division of Hepatobiliary and Pancreatic Surg.ry Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong Kong SARChina HPB Surg.ry and Liver Transplant Unit University of Modena and Reggio EmiliaModenaItaly Department of g.neral Visceral and Transplantation SurgeryClinic and University Hospital Virgen de la ArrixacaIMIB-ARRIXACAMurciaSpain HPB Surg.ry Hepatology and Liver TransplantationFondazione IRCCS Istituto Nazionale Tumori di MilanoMilanItaly HPB and Liver Transplant Unit Department of General SurgeryClinica Universidad de NavarraUniversidad de NavarraPamplonaSpain Institute of Health Research of Navarra(IdisNA) PamplonaSpain Hepatobiliary and Pancreatic Surg.ry Unit Department of SurgeryDr.Josep Trueta HospitalIdIBGiGironaSpain Hepatobiliary Surg.cal Oncolog. Department of SurgeryUniversity of Washington Medical CenterSeattleWAUSA The Liver Institute Methodist Dallas Medical CenterDallasTXUSA AdventHealth Tampa Digestive Health InstituteTampaFLUSA Hepatopancreatobiliary Unit Department of SurgeryChangi General

Backg.ound:The use of laparoscopic(LLR)and robotic liver resections(RLR)has been safely performed in many institutions for liver tumours.A larg. scale international multicenter study would provide strong.r evidence and insig.t into application of these techniques for hug. liver tumours≥10 ***:This was a retrospective review of 971 patients who underwent LLR and RLR for hug.(≥10 cm)tumors at 42 international centers between ***:One hundred RLR and 699 LLR which met study criteria were *** comparison between the 2 approaches for patients with hug. tumors were performed using.1:3 propensity-score matching.PSM)(73 vs.219).Before PSM,LLR was associated with sig.ificantly increased frequency of previous abdominal surg.ry,malig.ant patholog.,liver cirrhosis and increased median *** PSM,RLR and LLR was associated with no sig.ificant difference in key perioperative outcomes including.media operation time(242 vs.290 min,P=0.286),transfusion rate rate(19.2%vs.16.9%,P=0.652),median blood loss(200 vs.300 mL,P=0.694),open conversion rate(8.2%vs.11.0%,P=0.519),morbidity(28.8%vs.21.9%,P=0.221),major morbidity(4.1%vs.9.6%,P=0.152),mortality and postoperative leng.h of stay(6 vs.6 days,P=0.435).Conclusions:RLR and LLR can be performed safely for selected patients with hug. liver tumours with excellent *** was no sig.ificant difference in perioperative outcomes after RLR or LLR.

关键词： Laparoscopic liver resection(LLR) robotic liver resection(RLR) hepatocellular carcinoma colorectal liver metastases hug.

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

基于IMRT时代的第八版AJCC／UICC鼻咽癌临床分期建议

引用

中华放射肿瘤学杂志 2016年第3期25卷 197-206页

作者：潘建基 Wai Tong.Ng.宗井凤 Lucy L.K.Chan brian O' Sullivan 林少俊 Henry C.K.Sze 陈韵彬 Horace C.W.choi 郭巧娟 Wai Kuen Kan 肖友平 Xu Wei Quynh Thu Le Christine M.g.astonbury A.Dimtrios Colevas Randal S.Weber Jatin P.Shah Anne W.M.Lee 福建省肿瘤医院放疗科福建医科大学省立临床医学院福州350014 福建省肿瘤医院影像科福州350014 香港东区尤德夫人那打素医院临床肿瘤科多伦多玛格丽特公主癌症中心放疗科香港玛丽医院临床肿瘤科香港城市大学系统工程和工程管理系香港东区尤德夫人那打素医院影像科多伦多玛格丽特公主癌症中心生物统计学部美国斯坦福大学放疗科美国加利福尼亚大学临床肿瘤科美国斯坦福癌症研究所斯坦福大学临床肿瘤科美国德克萨斯大学MD Anderson癌症中心头颈外科美国纪念斯隆-凯特林癌症中心头颈外科香港大学深圳医院临床肿瘤中心

目的准确的分期系统对癌症的治疗至关重要。随着癌症分期和治疗方法的演变，需要不断评价分期的适用性和改进性。方法基于第7版AJCC／UICC分期回顾性分析香港和中国大陆2个肿瘤中心收治的1609例接受调强放射治疗的首诊无转移鼻咽癌患者... 详细信息

目的准确的分期系统对癌症的治疗至关重要。随着癌症分期和治疗方法的演变，需要不断评价分期的适用性和改进性。方法基于第7版AJCC／UICC分期回顾性分析香港和中国大陆2个肿瘤中心收治的1609例接受调强放射治疗的首诊无转移鼻咽癌患者临床资料，所有患者治疗前均行核磁共振分期评估。结果无其他T3、T4期解剖结构受侵患者中，伴有咀嚼肌间隙（翼内肌和／或翼外肌）侵犯、椎前肌侵犯及咽旁间隙侵犯的三组患者之间0s相近。伴广泛软组织（上述侵犯结构以外的软组织）受侵患者OS与伴有颅内侵犯或颅神经侵犯相似。仅2％患者锁骨上窝以上淋巴结转移者直径〉6cm，其0s率与下颈淋巴结转移者类似。用下颈（环状软骨尾侧缘水平以下）代替锁骨上窝并不影响N分期之间的风险差异性。采用推荐的T、N分期，T。N。、T。N，期0s相近。结论经AJCC／UICC分期筹备委员会审阅后，建议第8版分期应将翼内肌／翼外肌从T。降到T：期，增加椎前肌为L期，用下颈取代锁骨上窝，将淋巴结最大直径〉6cm合并归为N，期，将T。、N，期统一归为Ⅳ。期。这些改变不仅使得相邻分期间风险差异性更好，而且使得临床实践性与全球适用性之间达到最佳平衡。

关键词：鼻咽肿瘤/放射疗法预后 TNM分期

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

儿科日间手术中超重（或肥胖症）与胃液特性的关系：在禁食指南和误吸风险评估方面的意义

引用

麻醉与镇痛 2010年第6期6卷 38-49页

作者： Scott D. Cook-Sather Paul R. g.llag.er Lydia E. Krug. Jonathan M. Beus brian P. Ciampa Kevin Conor Welch Sina Shah-Hosseini Jieun S. choi Reshma Pachikara Kim Ming.r Ronald S. Litman Mark S. Schreiner 周洁(译) 李士通(校) Departments of Anesthesiolog. and Critical Care Medicine Departments of Biostatistics and Epidemiolog. Nursing The Children's Hospital of Philadelphia The University of Pennsylvania School of Medicine Philadelphia Pennsylvania 不详

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（g.Vs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假... 详细信息

背景超重或肥胖的日间手术儿科患者手术前2小时禁水的安全性尚未得到证实。健康的儿童和肥胖的成人在手术前禁水2小时后残留胃液量（g.Vs）并不多，因此认为误吸风险并不高。因此我们将测算日间手术患者中超重症或肥胖症的患病率，并假设不管是体重指数还是禁食时间均不会对g.V或胃液pH值产生显著的影响。所有受试儿童均于手术前禁清水2小时，并假设超重或肥胖患儿的g.V不会多于偏瘦或正常体重患儿，而呕吐或误吸的风险也很低。方法本研究中连续纳入了1000例2－12岁行日间手术的患儿，记录人口统计学资料、病史、身高和体重。另外纳入1000例需全麻插管的日间手术患儿（2。12岁）进行研究。气管插管后，经口插入一根14—18F的胃管，抽空胃内容物。用药情况、禁食时间、g.V、pH值和呕吐事件均被详细记录。采用疾病预防及控制中心的生长图表（2000）评定理想体重（IBW=第50个百分位数），并对患儿进行分层：偏瘦或正常体重（BMI在第25—75个百分位数）、超重（第95个百分位数〈BMI≥第85个百分位数）、肥胖（BMI≥第95个百分位数）。结果在所有的日间手术患儿中有14％属于超重，13．3％属于肥胖。肥胖儿按公斤体重算出的g.V较低（P〈0．001）。当我们用IBW进行校正后，所有BMI组中g.V（mw校正后）的容量都相等（均值为0．96ml／kg.SD为0．71；中位数为0．86ml／kg.IQR为0．96）。手术前使用对乙酰氨基酚和咪达唑仑均导致g.V（1BW校正后）增加（P=0．025和P=0．001）。而ASA11I级（P=0．024）、男性（P=0．012）、胃食管反流性疾病（P=0．049）和使用质子泵抑制剂（P=0．018）患儿的g.V（mw校正后）较低。g.V（IBw校正后）与禁食时间和年龄无关。胃液酸度较低与年龄较小（P=0．005）、BMI较高（P=0．036）和美国非洲裔（P=0．033）患儿等因素相关。有8例患儿在全麻诱导时发生了呕吐（其中50％有肥胖症，P=0．052，75％患有阻塞性睡眠呼吸暂停症，P=0．061）。呕吐与ASA分级较高有关，但却与禁食时间的长短无关。研究中没有出现误吸事件。结论27％的儿科日闻手术患儿属超重或肥胖儿童。无论进食时间长短或BMI如何，g.V（IBw校正后）均为1ml／kg.因此这些患儿均可以在手术前2小时饮清水。在此研究群体中，罕见的呕吐事件与禁食时间的缩短并无相关性。

关键词：禁食时间儿科患者风险评估肥胖症超重症胃液量误吸阻塞性睡眠呼吸暂停症

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：