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Prognostic analysis of patients with pancreatic head adenocarcinoma less than 2cm undergoing resection

World Journal of Gastroenterology 2009年第34期15卷 4305-4310页

作者： Kun-chun Chiang chun-nan yeh Wei-Chen Lee Yi-Yin Jan Tsann-Long Hwang Pancreatic Cancer Team Department of SurgeryChang Gung Memorial Hospital Chang Gung University

AIM:To investigate the differences in clinicopathological features between patients with pancreatic cancer greater or less than 2 cm situated over the pancreatic head and the prognostic factors for survival of patients with pancreatic cancer2 cm)and 36 cases of small(S)-PAC(tumor≤2 cm).We compared the clinicopathological characteristics and prognosis of L-PAC and S-PAC *** clinicopathological characteristics of S-PAC were investigated to clarify the prognosis predictive factors of S-PAC. RESULTS:One hundred and fifty-nine PAC patients, aged 16-93 years(median,59.0 years)with a tumor at the pancreatic head undergoing intentional curative resection were *** S-PAC and L-PAC patients had similar demographic data,clinical features,and tumor markers(a similar positive rate of carcinoembryonic antigen and carbohy- drate antigen 19-9).There were also similar rates of lymph node metastasis,portal vein invasion,stage distribution,tumor differentiation,positive resection margin,surgical morbidity and mortality observedbetween the two *** a follow-up period ranging from 1.0 to 122.7 mo(median,10.9 mo), S-PAC and L-PAC patients had a similar prognosis after resection(P=0.4805).Among the S-PAC patients group,patients with higher albumin level(>3.5 g/dL) had more favorable survival than those with lower albumin levels,which was the only favorable predictive prognostic ***,early-staged(stageⅠ,Ⅱ) S-PAC patients tended to have a more favorable outcome than late-stage(stageⅢ,Ⅳ)S-PAC patients, but this was not statistically significant. CONCLUSION:S-PAC patients should not be regarded as early *** higher albumin level(>3.5 g/dL) an

关键词：胰腺癌临床治疗 HETHODS 预后

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Prognosis and feasibility of en-bloc vascular resection in stage Ⅱ pancreatic adenocarcinoma

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World Journal of Gastroenterology 2010年第8期16卷 997-1002页

作者： K Dilip Chakravarty Jun-Te Hsu chun-nan yeh Ta-Sen yeh Tsann-Long Hwang Miin-Fu Chen Department of General Surgery Chang Gung Memorial Hospital

AIM:To establish the prognosis and feasibility of en-bloc vascular resection of stage pancreatic adenocarcinoma of the head and uncinate ***:We retrospectively analyzed 87 patients with stage pancreatic adenocarcinoma,who were subjected to pancreaticoduodenectomy (PD) and pylo-rus-preserving PD (PPPD) between 1996 and 2006 in Chang Gung Memorial Hospital,Taiwan. Twelve and 75 patients underwent PD/PPPD with and without resection of portal vein/superior mesenteric vein (PV/SMV),***:The overall 1-and 3-year survival rates of patients undergoing PD/PPPD with and without vas-cular resection were 50.0% and 16.7%,and 44.4% and 12.2%,respectively. Morbidity and mortality rates in the PV/SMV resection vs non-resection group were 50.0% and 0.0%,and 40.0% and 2.7%,respectively. In multivariate analysis,serum bilirubin,histological differentiation and adjuvant chemotherapy were independent prognostic factors that influenced ***:In stage adenocarcinoma of the pancreatic head and uncinate process,serum bilirubin,histological differentiation and adjuvant chemotherapy were independent prognostic factors,and en-bloc vascular resection is a feasible option in carefully selected patients.

关键词： Pancreatic neoplasms Adenocarcinoma Portal vein Superior mesenteric vein Pancreaticoduo-denectomy Chemotherapy

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Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy

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World Journal of Gastroenterology 2009年第19期15卷 2376-2380页

作者： chun-nan yeh Hsiang-Lin Lee chun-Yi Tsai Chih-chung Lin Tzu-Chieh Chao Ta-Sen yeh Yi-Yin Jan Department of Surgery Chang Gung Memorial HospitalChang Gung University5 Fu-Hsing StreetKwei-ShanTaoyuan 33375TaiwanChina Department of Anesthesiology Chang Gung Memorial HospitalChang Gung University5 Fu-Hsing StreetKwei-ShanTaoyuan 33375TaiwanChina

AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of ***:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 *** group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before *** amount of analgesics use was also *** demographics,laboratory data,hospital stay,and perioperative complications were compared between the two ***:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory *** surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two ***,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at *** analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia *** group also had a shorter hospital ***:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain *** explains the lower meperidine use and earlier discharge for these patients.

关键词：腹腔镜胆囊切除术罗哌卡因局部麻醉手术后疼痛围手术期并发症实验室数据视觉模拟量表缓解疼痛

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Multifocal intraductal papillary mucinous neoplasm of the pancreas-A case report

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World Journal of Gastroenterology 2009年第5期15卷 628-632页

作者： Kun-chun Chiang Jun Te Hsu Shyh Chuan Jwo Tsann-Long Hwang Yi-Yin Jan chun-nan yeh Department of Surgery Chang Gung Memorial Hospital Chang Gung University 5 Fu-Hsing Street Kwei-Shan Taoyuan Taiwan 333 China

Cystic neoplasms of the pancreas are relatively rare, comprising 10 percent of pancreatic cysts and only 1 percent of pancreatic cancers. Cystic neoplasms include mucinous cystic neoplasms, serous cystadenomas, papillary cystic tumors, cystic islet cell tumors and intraductal papillary mucinous neoplasms of the pancreas (IPMNs). IPMN was first described in 1982. It has been most commonly described in 60 to 70 years old males, and represents a relatively ''new'' but increasingly recognized disease. The improvement and widespread use of modern imaging equipments and heightened awareness of physicians contribute to the increasing incidence of IPMN. The majority of IPMNs are located in the pancreatic head (75%) while the rest involves the body/tail regions. Multifocal IPMNs have been hypothesized, but the true presence of multifocality is unknown. Here we present a 72-yearold male diagnosed with IPMN (carcinoma in situ ) in the pancreatic head and a branch duct type IPMN (duct atypia) in the pancreatic body and tail. The patient underwent a Whipple intervention and a distal pancreatectomy. A three-year disease-free survival has been observed so far.

关键词：胰腺炎胰切除术临床治疗

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Impact of microplastics and nanoplastics on liver health:Current understanding and future research directions

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World Journal of Gastroenterology 2024年第9期30卷 1011-1017页

作者： chun-Cheng Chiang Hsuan yeh Ruei-Feng Shiu Wei-chun Chin Tzung-Hai Yen School of Medicine University of PittsburghPittsburghPA 15213United States Pittsburgh Liver Research Center University of PittsburghPittsburghPA 15213United States Division of Experimental Pathology Department of PathologyUniversity of PittsburghPittsburghPA 15213United States Division of Endocrinology Department of PediatricsUniversity of PittsburghPittsburghPA 15213United States Center of Excellence for The Oceans National Taiwan Ocean UniversityKeelung 20224Taiwan Institute of Marine Environment and Ecology National Taiwan Ocean UniversityKeelung 20224TaiwanChina Department of Materials Science and Engineering University of California MercedMercedCA 95343United States Department of Nephrology Clinical Poison CenterChang Gung Memorial HospitalTaoyuan 333TaiwanChina College of Medicine Chang Gung UniversityTaoyuan 333TaiwanChina

With continuous population and economic growth in the 21st century,plastic pollution is a major global ***,the health concern of microplastics/nanoplastics(MPs/NPs)decomposed from plastic wastes has drawn public attention only in the recent *** article summarizes recent works dedicated to understanding the impact of MPs/NPs on the liver-the largest digestive organ,which is one of the primary routes that MPs/NPs enter human *** interrelated mechanisms including oxidative stress,hepatocyte energy re-distribution,cell death and autophagy,as well as immune responses and inflammation,were also *** addition,the disturbance of microbiome and gut-liver axis,and the association with clinical diseases such as metabolic dysfunction-associated fatty liver disease,steatohepatitis,liver fibrosis,and cirrhosis were briefly ***,we discussed potential directions in regard to this trending topic,highlighted current challenges in research,and proposed possible solutions.

关键词： Microplastics nanoplastics Liver Reactive oxidative species Cell death Autophagy Innate immunity Metabolic dysfunction-associated fatty liver disease Gut-liver axis

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Predicting cholecystocholedochal fistulas in patients with Mirizzi syndrome undergoing endoscopic retrograde cholangiopancreatography

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World Journal of Gastroenterology 2020年第40期26卷 6241-6249页

作者： Chi-Huan Wu Nai-Jen Liu chun-nan yeh Shang-Yu Wang Yi-Yin Jan Department of Gastroenterology and Hepatology Linkou Medical CenterChang Gung Memorial HospitalChang Gung UniversityCollege of MedicineTaoyuan 333Taiwan Department of General Surgery Linkou Medical CenterChang Gung Memorial HospitalChang Gung UniversityCollege of MedicineTaoyuan 333Taiwan

BACKGROUND Mirizzi syndrome(MS) is defined as an extrinsic compression of the extrahepatic biliary system by an impacted stone in the gallbladder or the cystic duct leading to obstructive jaundice. Endoscopic retrograde cholangiopancreatography(ERCP) could serve diagnostic and therapeutic purposes in patients with MS in addition to revealing the relationships between the cystic duct, the gallbladder, and the common bile duct(CBD). Cholecystectomy is a challenging procedure for a laparoscopic surgeon in patients with MS, and the presence of a cholecystocholedochal fistula renders preoperative diagnosis important during *** To evaluate cholecystocholedochal fistulas in patients with MS during ERCP before *** From 2004 to 2018, all patients diagnosed with MS during ERCP were enrolled in this study. Patients with associated malignancy or those who had already undergone cholecystectomy before ERCP were excluded. In total, 117 patients with MS diagnosed by ERCP were enrolled in this study. Among them, 21 patients with MS had cholecystocholedochal fistulas. MS was further confirmed during cholecystectomy to check if cholecystocholedochal fistulas were present. The clinical data, cholangiography, and endoscopic findings during ERCP were recorded and *** Gallbladder opacification on cholangiography is more frequent in patients with MS complicated by cholecystocholedochal fistulas(P < 0.001). Pus in the CBD and stricture length of the CBD longer than 2 cm were two additional independent factors associated with MS, as demonstrated by multivariate analysis(odds ratio 5.82, P = 0.002;0.12, P = 0.008, respectively).CONCLUSION Gall bladder opacification is commonly seen in patients with MS with cholecystocholedochal fistulas during pre-operative ERCP. Additional findings such as pus in the CBD and stricture length of the CBD longer than 2 cm may aid the diagnosis of MS with cholecystocholedochal fistulas.

关键词： Cholecystectomy Cholecystocholedochal fistula Common bile duct Endoscopic retrograde cholangiopancreatography Mirizzi syndrome

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Sporadic somatic mutation of c-kit gene in a family with gastrointestinal stromal tumors without cutaneous hyperpigmentation

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World Journal of Gastroenterology 2006年第11期12卷 1813-1815页

作者： chun-nan yeh Tsung-Wen Chen Department of Surgery Chang Gung Memorial Hospital Chang Gung University 5Fu-Hsing StreetKwei-ShanTaoyuanTaiwanChina

没有皮肤的亢奋的色素沉着，我们与胃肠的基质肿瘤(大意) 在一个家庭描述了二个成员。病人是没有皮肤的亢奋的色素沉着的父亲和儿子。组织学的检查证明这些肿瘤是表示 CD34 和 CD117 的大意。从嵌入石蜡的标本提取的肿瘤 DNA 在直接定... 详细信息

没有皮肤的亢奋的色素沉着，我们与胃肠的基质肿瘤(大意) 在一个家庭描述了二个成员。病人是没有皮肤的亢奋的色素沉着的父亲和儿子。组织学的检查证明这些肿瘤是表示 CD34 和 CD117 的大意。从嵌入石蜡的标本提取的肿瘤 DNA 在直接定序分析以后在 11 c 工具包基因上在前在不同鳕鱼 ons 与一个删除变化揭示了体细胞突变。没有细菌线变化在从从父亲和儿子获得的外部白血球提取的 DNA 被检测。我们建议没有细菌线变化和亢奋的色素沉着，大意能被分散的体细胞突变在一个家庭引起。

关键词：基因突变胃肠肿瘤皮肤疾病色素沉着过多

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Successful laparoscopic management for cholecystoenteric fistula

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World Journal of Gastroenterology 2006年第5期12卷 772-775页

作者： chun-nan yeh Yi-Yin Jan Department of General Surgery Chang Gung Memorial HospitalChang Gung UniversityTaiwanChina

瞄准：自从 1987， laparoscopic 胆囊炎(LC ) 广泛地为胆囊损害被用作赞成治疗。Cholecystoenteric 管(CF ) 是胆囊疾病的不平常的复杂并发症，它是为从 LC 的变换的原因之一到开的胆囊炎。这里，我们报导了没有变换， laparoscopic ... 详细信息

瞄准：自从 1987， laparoscopic 胆囊炎(LC ) 广泛地为胆囊损害被用作赞成治疗。Cholecystoenteric 管(CF ) 是胆囊疾病的不平常的复杂并发症，它是为从 LC 的变换的原因之一到开的胆囊炎。这里，我们报导了没有变换， laparoscopic 成功地管理的 CF 的四个案例来临打开胆囊炎。方法：在从 2000 ～ 2004 的 4 年的时期期间，有在 Chang Gung 纪念的医院台北与 laparoscopic 管理成功地对待的 CF 的四个病人的医药记录回顾地被考察。结果：学习包括了二男性和二个女病人，年龄从 36 ～ 74 年(中部：53.5 年) 。所有四个病人有恰好上面的象限疼痛。四个病人中的二个被腹的 ultrasonography 与 pneumobilia 检测。一个病人正确地外科手术前地与 cholecystocolic 管被诊断由内视镜后退 cholangiopancreatography 和另一个被磁性的回声 cholangiopancreatography 作为胆囊十二指肠管诊断。CF 的正确外科手术前的诊断与 50% 外科手术前的诊断的率在四个病人中的二个被做。所有四个病人经历了 LC，管的闭合被与平静手术后的功课成功地使用 Endo-GIA 执行。四个病人的医院停留从 7 ～ 10 d (中部， 8 d ) 。结论：CF 是传统地被看作禁止徵候到 LC 的长期的胆囊疾病的已知的复杂并发症。CF 的正确外科手术前的诊断要求怀疑的高索引并且为病人的子集决定 laparoscopic 管理的成功。困难的 laparoscopic 修理在 laparoscopic 外科医生的富有经验的手里安全、有效。

关键词：胆囊瘘管病理机制治疗临床表现

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Designing a Secure and Scalable Data Sharing Mechanism Using Decentralized Identifiers(DID)

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Computer Modeling in Engineering & Sciences 2024年第10期141卷 809-822页

作者： Iuon-Chang Lin I-Ling yeh Ching-chun Chang Jui-Chuan Liu Chin-Chen Chang Department of Management Information Systems National Chung Hsing UniversityTaichung402Taiwan Information and Communication Security Research Center Feng Chia UniversityTaichung407Taiwan Department of Information Engineering and Computer Science Feng Chia UniversityTaichung407Taiwan

Centralized storage and identity identification methods pose many risks,including hacker attacks,data misuse,and single points of ***,existing centralized identity management methods face interoperability issues and rely on a single identity provider,leaving users without control over their ***,this paper proposes a mechanism for identity identification and data sharing based on decentralized *** scheme utilizes blockchain technology to store the identifiers and data hashed on the chain to ensure permanent identity recognition and data *** is stored on InterPlanetary File System(IPFS)to avoid the risk of single points of failure and to enhance data persistence and *** the same time,compliance with World Wide Web Consortium(W3C)standards for decentralized identifiers and verifiable credentials increases the mechanism’s scalability and interoperability.

关键词： Self-sovereign identity decentralized identifier blockchain

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Characterization of a novel rat cholangiocarcinoma cell culture model-CGCCA

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World Journal of Gastroenterology 2011年第24期17卷 2924-2932页

作者： chun-nan yeh Kun-Ju Lin Tsung-Wen Chen Ren-Ching Wu Lee-Cheng Tsao Ying-Tzu Chen Wen-Hui Weng Miin-Fu Chen Department of Surgery Chang Gung Memorial Hospital Chang Gung University Taoyuan 333 Taiwan China Department of Nuclear Medicine Chang Gung Memorial Hospital Chang Gung University Taoyuan 333 Taiwan China Department of Pathology Chang Gtmg Memorial Hospital Chang Gung University Taoyuan 333 Taiwan China Graduate Institute of Biotechnology and Department of Chemical Engineering and Biotechnology National Taipei University of Technology Taipei 106 Taiwan China

AIM:To characterize a culture model of rat CCA cells,which were derived from a transplantable TTA-induced CCA and designated as Chang Gung CCA(CGCCA).METHODS:The CGCCA cells were cultured at in vitro passage 12 times on a culture dish in DMEM *** measure the doubling time,103 cells were plated in a 96-well plate containing the growth *** cells were harvested 4 to 10 d after seeding,and astandard MTT assay was used to measure the *** phenotype of CACCA cell and xenograft was determined by immunohistochemical *** also determine the chromosomal alterations of CGCCA,G-banding and spectral karyotyping studies were *** CGCCA cell line was transplanted into the nude mice for examining its tumorigenicity.2-Deoxy-2-(18F)fluoro-Dglucose(FDG) autoradiography was also performed to evaluate the FDG uptake of the tumor ***:The doubling time for the CGCCA cell line was 32 *** transplantation into nude mice,FDG autoradiography showed that the tumors formed at the cell transplantation site had a latency period of 4-6 wk with high FDG uptake excluding necrosis ***,immunohistochemical staining revealed prominent cytoplasmic expression of c-erb-B2,CK19,c-Met,COX-Ⅱ,EGFR,MUC4,and a negative expression of *** data confirmed the phenotypic features of the CGCCA cell line coincide with the xenograft mice tumors,indicating cells containing the tumorigenicity of CCA originated from *** addition,karyotypic banding analysis showed that the diploid(2n) cell status combines with ring and giant rod marker chromosomes in these clones;either both types simultaneously appeared or only one type of marker chromosome in a pair appeared in a *** major materials contained in the marker chromosome were primarily identified from chromosome ***:The current CGCCA cell line may be used as a non-K-ras effect CCA model and to obtain information and reveal novel pathways for *** applications regarding tumor markers or

关键词：细胞培养评估模型表征大鼠表皮生长因子受体染色体改变肿瘤标志物光谱核型分析

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