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Trends and outcomes of transarterial chemoembolization in hepatocellular carcinoma:a national survey

Hepatobiliary & Pancreatic Diseases International 2017年第6期16卷 624-630页

作者： Khalid Mumtaz nishi patel Rohan M Modi Vihang patel Alice Hinton James Hanje Sylvester M Black Somashaker Krishna Division of Gastroenterology Hepatology and NutritionThe Ohio State University Wexner Medical Center Columbus OHUSA Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus OHUSA Department of Surgery The Ohio State University Wexner Medical Center Columbus OHUSA Division of Biostatistics College of Public Health The Ohio State University Columbus OH USA

BACKGROUND:Transarterial chemoembolization(TACE) is a palliative procedure frequently used in patients with advanced hepatocellular carcinoma(HCC). We examined the national inpatient trends of TACE and related outcomes in the United States over the last ***:We utilized the National Inpatient Sample(2002 to 2012) and performed trend analyses of TACE for HCC in all adult patients(age >18 years). Multivariate analyses for the outcomes of in-hospital "procedure-related complications"(PRCs) and "post-procedure complications"(PPCs) were performed. We also compared early(2002 to 2006) and late(2007 to 2012) eras by multivariate analyses to identify predictors of complications, healthcare resource utilization and ***:Overall, 19058 patients underwent TACE for HCC where PRCs and PPCs were seen in 24.2% and 17.6% of patients, respectively. The overall trends in the use of TACE(P<0.001) and associated PRCs(P=0.006) were observed to be increasing. There was less mortality [adjusted Odds ratio(a OR):0.58; 95% CI:0.41, 0.82], reduced length of hospital stay(-1.87 days; 95% CI:-2.77,-0.97) and increased hospital charges($19232; 95% CI:11013, 27451) in the late era. Additionally, there was increased mortality(a OR:4.07; 95% CI:2.96, 5.59), PRCs(a OR:3.21; 95% CI:2.56, 4.02), and PPCs(a OR:2.70; 95% CI:2.11, 3.46) among patients with ***:There is an increasing trend of TACE utilization in HCC. However, the outcomes are worse in patients with coagulopathy. Although PRCs have increased, mortality has decreased in recent years. These findings should be considered during TACE evaluation in patients with HCC.

关键词： transarterial chemoembolization hepatocellular carcinoma procedural complications mortality

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Outcomes of liver transplantation in patients with hepatorenal syndrome

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World Journal of Hepatology 2016年第24期8卷 999-1011页

作者： Rohan M Modi nishi patel Sherif N Metwally Khalid Mumtaz Department of Internal Medicine the Ohio State University Wexner Medical Center Department of Internal Medicine Division of Gastroenterology Hepatology and Nutrition the Ohio State University Medical Center

Hepatorenal syndrome(HRS) plays an important role in patients with liver cirrhosis on the wait list for liver transplantation(LT). The 1 and 5-year probability of developing HRS in cirrhotic with ascites is 20% and 40%, respectively. In this article, we reviewed current concepts in HRS pathophysiology, guidelines for HRS diagnosis, effective treatment options presently available, and controversies surrounding liver alone vs simultaneous liver kidney transplant(SLKT) in transplant candidates. Many treatment options including albumin, vasoconstrictors, renal replacement therapy, and eventual LT have remained a mainstay in the treatment of HRS. Unfortunately, even after aggressive measures such as terlipressin use, the rate of recovery is less than 50% of patients. Moreover, current SLKT guidelines include:(1) estimation of glomerular filtration rate of 30 m L/min or less for 4-8 wk;(2) proteinuria > 2 g/d; or(3) biopsy proven interstitial fibrosis or glomerulosclerosis. Even with these updated criteria there is a lack of consistency regarding longterm benefits for SLKT vs LT alone. Finally, in regards to kidney dysfunction in the post-transplant setting, an estimation of glomerular filtration rate < 60 mL /min per 1.73 m2 may be associated with an increased risk of patients having long-term end stage renal disease. HRS is common in patients with cirrhosis and those on liver transplant waitlist. Prompt identification and therapy initiation in transplant candidates with HRS may improve post-transplantation outcomes. Future studies identifying optimal vasoconstrictor regimens, alternative therapies, and factors predictive of response to therapy are needed. The appropriate use of SLKT in patients with HRS remains controversial and requires further evidence by the transplant community.

关键词： Liver transplantation Simultaneous liver kidney transplantation Vasopressors Dialysis Posttransplant outcomes Hepatorenal syndrome

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Impact of transjugular intrahepatic porto-systemic shunt on post liver transplantation outcomes: Study based on the United Network for Organ Sharing database

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World Journal of Hepatology 2017年第2期9卷 99-105页

作者： Khalid Mumtaz Sherif Metwally Rohan M Modi nishi patel Dmitry Tumin Anthony J Michaels James Hanje Ashraf El-Hinnawi Don Hayes Jr Sylvester M Black Wexner Medical Center Gastroenterology Hepatology and Nutrition Division the Ohio State University Department of Internal Medicine the Ohio State University Department of Pediatrics the Ohio State University Department of Surgery the Ohio State University Section of Pulmonary Medicine the Ohio State University

AIMTo determine the impact of transjugular intrahepatic porto-systemic shunt (TIPS) on post liver transplantation (LT) outcomes. METHODSUtilizing the United Network for Organ Sharing (UNOS) database, we compared patients who underwent LT from 2002 to 2013 who had underwent TIPS to those without TIPS for the management of ascites while on the LT waitlist. The impact of TIPS on 30-d mortality, length of stay (LOS), and need for re-LT were studied. For evaluation of mean differences between baseline characteristics for patients with and without TIPS, we used unpaired t-tests for continuous measures and χ2 tests for categorical measures. We estimated the impact of TIPS on each of the outcome measures. Multivariate analyses were conducted on the study population to explore the effect of TIPS on 30-d mortality post-LT, need for re-LT and LOS. All covariates were included in logistic regression analysis. RESULTSWe included adult patients (age ≥ 18 years) who underwent LT from May 2002 to September 2013. Only those undergoing TIPS after listing and before liver transplant were included in the TIPS group. We excluded patients with variceal bleeding within two weeks of listing for LT and those listed for acute liver failure or hepatocellular carcinoma. Of 114770 LT in the UNOS database, 32783 (28.5%) met inclusion criteria. Of these 1366 (4.2%) had TIPS between the time of listing and LT. We found that TIPS increased the days on waitlist (408 ± 553 d) as compared to those without TIPS (183 ± 330 d), P P P = 0.001) by TIPS to LOS. CONCLUSIONTIPS did increase time on waitlist for LT. More importantly, TIPS was not associated with 30-d mortality and re-LT, but it did lengthen hospital LOS after transplantation.

关键词： Transjugular intrahepatic porto-systemic shunt Shunt Liver Transplantation Ascites Model for end-stage liver disease Mortality Transjugular

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Nationwide retrospective study of hepatitis B virological response and liver stiffness improvement in 465 patients on nucleos(t)ide analogue

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World Journal of Gastroenterology 2022年第31期28卷 4390-4398页

作者： Alnoor Ramji Karen Doucette Curtis Cooper Gerald Yosel Minuk Mang Ma Alexander Wong David Wong Edward Tam Brian Conway David Truong Philip Wong Lisa Barrett Hin Hin Ko Sarah Haylock-Jacobs nishi patel Gilaad G Kaplan Scott Fung Carla S Coffin Department of Medicine University of British ColumbiaVancouver v6t 1z3Canada Department of Medicine University of AlbertaEdmonton t6g 2r7Canada Department of Medicine The Ottawa Hospital Research InstituteUniversity of OttawaOttawa ON K1H 8L6Canada Department of Medicine University of ManitobaWinnipeg r3e 3j7Canada Department of Medicine University of SaskatchewanSaskatoon s7n 5e5Canada Department of Medicine University Health NetworkToronto m5g 2c4Canada Pacific Gastroenterology Associates Vancouver v6z 2k5Canada Vancouver Infectious Disease Centre Vancouver v6z 2c7Canada Department of Medicine McGill UniversityMontreal h3a 0g4Canada Department of Microbiology and Immunology Dalhousie UniversityHalifax b3h 4r2Canada Cumming School of Medicine University of CalgaryCalgary t2n 1n4Canada

BACKGROUND Hepatitis B virus(HBV)nucleos(t)ide analog(NA)therapy reduces liver disease but requires prolonged therapy to achieve hepatitis B surface antigen(HBsAg)*** is limited North American real-world data using non-invasive tools for fibrosis assessment and few have compared 1st generation NA or lamivudine(LAM)to tenofovir disoproxil fumarate(TDF).AIM To assess impact of NA on virological response and fibrosis regression using liver stiffness measurement(LSM)(i.e.,FibroScan®).METHODS Retrospective,observational cohort study from the Canadian HBV *** collected included demographics,NA,HBV DNA,alanine aminotransferase(ALT),and *** were HBV monoinfected patients,treatment naïve,and received 1 NA with minimum 1 year *** In 465(median 49 years,37%female,35%hepatitis B e antigen+at baseline,84%Asian,6%White,and 9%Black).Percentage of 64(n=299)received TDF and 166 were LAM-treated with similar median duration of 3.9 and 3.7 years,*** mean baseline LSM was 11.2 kPa(TDF)vs 8.3 kPa(LAM)(P=0.003).At 5-year follow-up,the mean LSM was 7.0 kPa in TDF vs 6.7 kPa in LAM(P=0.83).There was a significant difference in fibrosis regression between groups(i.e.,mean-4.2 kPa change in TDF and-1.6 kPa in LAM,P<0.05).The last available data on treatment showed that all had normal ALT,but more TDF patients were virologically suppressed(<10 IU/mL)(n=170/190,89%)vs LAM-treated(n=35/58,60%)(P<0.05).None cleared *** In this real-world North American study,approximately 5 years of NA achieves liver fibrosis regression rarely leads to HBsAg loss.

关键词： Nucleos(t)ide analog therapy Functional cure Hepatitis B virus surface antigen loss Fibrosis regression Liver stiffness measurement Transient elastography

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Immunotherapy for esophageal cancer:Where are we now and where can we go

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World Journal of Gastroenterology 2024年第19期30卷 2496-2501页

作者： Yoshiaki Shoji Kazuo Koyanagi Kohei Kanamori Kohei Tajima Mika Ogimi Yamato Ninomiya Miho Yamamoto Akihito Kazuno Kazuhito Nabeshima Takayuki nishi Masaki Mori Department of Gastroenterological Surgery Tokai University School of MedicineKanagawa 259-1193Japan

Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past *** antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative ***,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 *** understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.

关键词： Esophageal cancer Immunotherapy Immune checkpoint inhibitor Programmed cell death-1 Anti-cytotoxic T-lymphocyte-associated protein 4 Neoadjuvant therapy Adjuvant therapy Clinical trials Combination therapy

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A novel shaft-less double suction mini pump

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Science China(Technological Sciences) 2010年第1期53卷 105-110页

作者： nishi Michihiro Kyushu Institute of Technology Sensui-cho 1TobataKitakyushu 804-8550Japan

A novel double suction shaft-less mini pump was developed for heat control of small energy systems in this *** mini pump impeller with an exit diameter of 40 mm was combined with the motor rotor supported by the hybrid dynamic *** specific speed of the pump was 125 min-1 m3 min-1 *** hydraulic performance of the pump was investigated experimen-tally under four rotational *** the test results,it was recognized that the pump could provide a flow discharge of 5 L/min and head of 1.5 m,which are applicable for the heat control system of a 3 kW fuel cell.A three-dimensional turbulent flow simulation in the pump was also conducted near the design *** numerical results showed that the average hydraulic performance of the mini pump was predicted *** the internal flow simulation,it was revealed that the favorable inflow condition upstream of impeller inlet could be attained by applying the double suction shaft-less design for the mini pump.

关键词： double suction seal-less shaft-less uniform inflow mini pump

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ELASTOMERIC SEISMIC-PROTECTION ISOLATORS FOR BUILDINGS AND BRIDGES

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Chinese Journal of Polymer Science 2013年第1期31卷 50-57页

作者： Toshio nishi Nobuo Murota International Division Tokyo Institute of Technology Department of Seismic Isolation &Vibration Control Development

A giant earthquake of magnitude 9.0 occurred in Pacific Ocean off of Tohoku District Japan on March 11,2011. The highest seismic intensity of 7 in JMA scale was recorded in Miyagi. In the Tohoku district, around 230 buildings are seismically isolated （hereafter, SI） mainly by elastomeric isolators （seismic rubber bearings）. According to the official survey reports by several organizations （for example）, the records of those buildings have verified the effectiveness of the seismic isolation. The response acceleration of the SI buildings was reduced by 30% to 50% of the input ground acceleration. Additionally, the difference of the conditions inside the room between SI and the fixed-base buildings was obvious as well as the damage in main structures of the buildings. The displacements of the isolators by the earthquake were around 200 mm according to the records of the instruments. As a result, the performance of SI buildings and the elastomeric isolators in the Tohoku District -- Off the Pacific Ocean Earthquake 2011 were excellent, and the efficiency of the seismic isolation was verified by the records of many buildings in wide area.

关键词： Elastomeric isolator Seismic isolation Rubber bearing.

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铁路三维电子沙盘搭建及其应用研究

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铁道标准设计 2024年第8期68卷 50-57页

作者：赵亮亮董凤翔黄旎诗中铁二院工程集团有限责任公司成都610031

为解决目前铁路行业电子沙盘存在的表达方式不一、应用内容单一、数据泄露风险大、数据加载效率低等问题,研究海量地理地质及BIM模型的数据处理、管理和应用方法,建立以BIM+GIS为技术核心的标准化电子沙盘,从而更好地服务于铁路设计和... 详细信息

为解决目前铁路行业电子沙盘存在的表达方式不一、应用内容单一、数据泄露风险大、数据加载效率低等问题,研究海量地理地质及BIM模型的数据处理、管理和应用方法,建立以BIM+GIS为技术核心的标准化电子沙盘,从而更好地服务于铁路设计和建造。根据鲁南高铁、拉林铁路、成渝中线高铁等项目实践总结,在中国铁路BIM联盟和国铁集团相关标准基础上提出了面向电子沙盘应用的地形、影像、BIM模型、专题图的数据制作标准,从坐标转换、数据转换、数据切片、知识图谱建立、模型发布、前端数据汇集的方法完成了电子沙盘的搭建。最后,在电子沙盘中实现了百公里级、多专业数据的在线高效组织和管理,提出的方法和标准适用于铁路设计、建设过程的管理和分析应用。

关键词：铁路 BIM GIS 智能化电子沙盘专题图高效组织

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Study on Performance and Flow Field of an Undershot Cross-Flow Water Turbine Comprising Different Number of Blades

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Journal of Thermal Science 2017年第5期26卷 413-430页

作者： Yasuyuki nishi Kentaro Hatano Terumi Inagaki Department of Mechanical Engineering Ibaraki University 4-12-1 Nakanarusawa-cho Hitachi-shi Ibaraki 316-8511JAPAN Graduate School of Science and Engineering Ibaraki University 4-12-1 Nakanarusawa-cho Hitachi-shi Ibaraki316-8511 JAPAN

Recently, small hydroelectric generators have gained attention as a further development in water turbine technology for ultra low head drops in open channels. The authors have evaluated the application of cross-flow water turbines in open channels as an undershot type after removing the casings and guide vanes to substantially simplify these water turbines. However, because undershot cross-flow water turbines are designed on the basis of cross-flow water turbine runners used in typical pipelines, it remains unclear whether the number of blades has an effect on the performance or flow fields. Thus, in this research, experiments and numerical analyses are employed to study the performance and flow fields of undershot cross-flow water turbines with varying number of blades. The findings show that the turbine output and torque are lower, the fluctuation is significantly higher, and the turbine efficiency is higher for runners with 8 blades as opposed to those with 24 blades.

关键词： Water Turbine Cross-Flow Turbine Free Surface Performance Flow Field Number of Blades

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Study on the Rotor Design Method for a Small Propeller-Type Wind Turbine

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Journal of Thermal Science 2016年第4期25卷 355-362页

作者： Yasuyuki nishi Yusuke Yamashita Terumi Inagaki Department of Mechanical Engineering Ibaraki University Graduate School of Science and Engineering Ibaraki University

Small propeller-type wind turbines have a low Reynolds number,limiting the number of usable airfoil ***,their design method is not sufBciently established,and their performance is often *** ultimate goal of this research is to establish high-performance design guidelines and design methods for small propeller-type wind *** that end,we designed two rotors:Rotor A,based on the rotor optimum design method from the blade element momentum theory,and Rotor B,in which the chord length of the tip is extended and the chord length distribution is *** examined performance characteristics and flow fields of the two rotors through wind tunnel experiments and numerical *** results revealed that the maximum output tip speed ratio of Rotor B shifted lower than that of Rotor A,but the maximum output coefficient increased by approximately 38.7%.Rotors A and B experienced a large-scale separation on the hub side,which extended to the mean in Rotor *** difference in separation had an impact on the significant decrease in Rotor A's output compared to the design value and the increase in Rotor B's output compared to Rotor A.

关键词： Wind Turbine Propeller-Type Horizontal Axis Blade Element Momentum Theory Rotor Design Method

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