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A case of methicillin-resistant Staphylococcus aureus infection following bile duct stenting

World Journal of Gastroenterology 2005年第9期11卷 1396-1398页

作者： markus k diener Alexis Ulrich Theresia Weber Moritz N Wente markus W Büchler Helmut Friess Department of General Surgery

AIM: To present a case of methicillin-resistant Staphylococcus aureus (MRSA) infection following bile duct stenting in a patient with malignant biliary ***: A 78-year-old male patient was admitted to a community hospital with progredient painless jaundice lasting over two weeks, weight loss and sweating at *** a stent should be implanted pre-operatively in jaundiced patients or whether these patients should directly undergo surgical resection, was ***: ERC and a biopsy from the papilla of Vater revealed an adenocarcinoma. In addition, a 7-Ch plastic stent was placed into the common bile duct. Persistent abdominal pain, increasing jaundice, weakness and indigestion led to the transfer of the patient to our hospital.A pylorus-preserving pancreatoduodenectomy wasperformed. Intraoperatively, bile leaked out of the transected choledochus andthe stent was found to be dislocated in the duodenum. A smear of the bile revealed an infection with MRSA, leading to post-operative isolation of the ***:As biliary stents can cause severe infection of the bile, the need for pre-operative placement of biliary stents should be carefully evaluated in each individual case.

关键词： Methicillin-resistant Staphylococcus aureus Bile Infection Stent Biliary obstruction Malignancy Surgery

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Prospective study to evaluate the prognostic value of different nutritional assessment scores in liver surgery: NURIMAS Liver (DRkS00006340)

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Hepatobiliary Surgery and Nutrition 2020年第4期9卷 400-413页

作者： Pascal Probst Juri Fuchs Michael R.Schön Georgios Polychronidis Christos Stravodimos Arianeb Mehrabi markus k.diener Philipp knebel markus W.Büchler katrin Hoffmann Department of General Visceral and Transplantation SurgeryUniversity of HeidelbergIm Neuenheimer Feld 11069120 HeidelbergGermany Department of General and Visceral Surgery Städtisches Klinikum KarlsruheMoltkestraße 9076133 KarlsruheGermany

Background:Malnutrition is recognised as a preoperative risk factor for patients undergoing hepatic *** is important to identify malnourished patients and take preventive therapeutic action before ***,there is no evidence regarding which existing nutritional assessment score(NAS)is best suited to predict outcomes of liver ***:All patients scheduled for elective liver resection at the surgical department of the University Hospital of Heidelberg and the Municipal Hospital of karlsruhe were screened for *** NASs were calculated before operation,and patients were categorised according to each score as being either at risk or not at risk for *** association of malnutrition according to each score and occurrence of at least one major complication was the primary endpoint,which was achieved using a multivariate logistic regression analysis including established risk factors in liver surgery as ***:The population consisted of 182 *** percentage of patients deemed malnourished by the NAS varied among the different scores,with the lowest being 2.20%(Mini Nutritional Assessment)and the highest 52.20%(Nutritional Risk Classification).Forty patients(22.0%)had a major *** of the scores were significantly associated with major ***:None of the twelve investigated NAS defined a state of malnutrition that was independently associated with postoperative *** means of measuring malnutrition in liver surgery should be investigated prospectively.

关键词： Malnutrition liver surgery hepatic resection nutritional assessment

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系统评价在循证医疗保健中的作用

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中国循证医学杂志 2006年第7期6卷 467-470页

作者： Gerd Antes markus k. diener 刁骧（译）李幼平张鸣明（审校） German Cochrane Centre Institute for Medical Biometrics and Medical Informatics University Hospital Freiburg Germany 不详

1为什么需要医疗研究结果的系统评价？医疗实践应基于为患者个体化诊治提供有关诊断试验和治疗程序的全面综合知识。而这种认识必须基于真实的、以病人为本的临床研究有效结果，以减少偏倚和机遇因素的误导作用。循证医学（EBM）或循证... 详细信息

1为什么需要医疗研究结果的系统评价？医疗实践应基于为患者个体化诊治提供有关诊断试验和治疗程序的全面综合知识。而这种认识必须基于真实的、以病人为本的临床研究有效结果，以减少偏倚和机遇因素的误导作用。循证医学（EBM）或循证医疗保健（EBHC）提倡医疗决策与相关研究结果的最新证据相结合。要求医疗决策基于当前可获得的最佳证据似乎理所当然，且得到现代医疗体系中大多数医务人员、患者及非医务工作者的认可。但过去几十年的研究表明，许多情况下，个体层面上的医疗决策和建议及社区医疗行为均与这种理想状态相去甚远。事实上，一些事例表明，在发现某种疗法的有害性之前，已有大量患者因此受到了严重伤害。究其原因，不外是在引入该疗法前未进行合理临床试验或无法获取当前的研究结果，而最糟的是已有结果却被忽视。

关键词：循证医学医疗保健系统评价医疗决策以病人为本医务工作者医疗研究综合知识治疗程序诊断试验

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不锈钢研发的最新进展——奥氏体、铁素体和双相不锈钢

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世界钢铁 2011年第1期11卷 55-60页

作者： markus O Speidel markus diener 瑞士材料科学院

评价了近期不锈钢的部分工业发展状况。对于奥氏体不锈钢而言,有两大引人注目的合金开发方向:低镍奥氏体不锈钢和高氮奥氏体不锈钢。这两类合金的设计目的不同,尤其是强度方面,但其合金开发原理和科研方法很相似,都围绕着氮这一合金元... 详细信息

评价了近期不锈钢的部分工业发展状况。对于奥氏体不锈钢而言,有两大引人注目的合金开发方向:低镍奥氏体不锈钢和高氮奥氏体不锈钢。这两类合金的设计目的不同,尤其是强度方面,但其合金开发原理和科研方法很相似,都围绕着氮这一合金元素对强度、塑性和耐蚀性的积极作用展开。现在人们已经相当了解氮对固溶强化、晶界强化和加工硬化的影响以及如何充分利用这些影响来开发全球市场所需的材料。在耐蚀性方面,铁素体、奥氏体和双相不锈钢彼此竞争,有关其耐蚀性比较的实验室数据也越来越多。但是,对于实际应用和合金选择而言,仅仅是实验室的数据是不够的,因此文章给出了多年来对24种工业生产的不锈钢暴露在室外海洋大气环境下的最新耐蚀性研究结果。希望在不久的将来能将更多制造商提供的钢种纳入到此项耐蚀性研究中来。这既能帮助消费者合理地选择合金,也可以帮助钢铁生产企业开发合适的钢种。

关键词：奥氏体不锈钢氮固溶强化晶界强化缝隙腐蚀

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Recent developments in stainless steels:austenitic,ferritic,duplex

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Baosteel Technical Research 2010年第S1期4卷 80-页

作者： markus O SPEIDEL markus diener Swiss Academy of Materials Science

A review is given concerning some of the recent industrial developments of stainless steels. In austenitic stainless steels,two different directions of alloy development are noticeable:low nickel austenitic stainless steels and high nitrogen stainless *** these two cases the aims are different,particularly in terms of strength,but the philosophy of alloy development and the scientific approaches are very similar and they all revolve about the role of nitrogen as an alloying element and how this affects strength,ductility and corrosion resistance. There is now a broad and useful basis of information as to how nitrogen affects solid solution hardening,grain boundary hardening and work hardening and how to make use of these effects in developing materials required by the world market. In the field of corrosion resistance,ferritic,duplex and austenitic stainless steels compete with each other and now there is a growing body of information concerning the relative corrosion resistance based on laboratory data. However,for practical applications and for alloy selection,more than just laboratory data are needed,and thus,the first results are presented here of a many years comparison of the corrosion resistance of 24 commercial stainless steels exposed to corrosion in outdoors marine *** is expressed to involve in the near future even more steels from a wider range of manufacturers in such corrosion *** might help consumers in appropriate alloy *** might also help steel makers in developing appropriate stainless steel grades.

关键词： developments of stainless steels mechanical properties corrosion resistance

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