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Should we resect colorectal cancer in patients over the age of 85?

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World Journal of Gastrointestinal Oncology 2021年第3期13卷 185-196页

作者： david E Flynn derek Mao Stephanie Yerkovich Robert Franz Harish Iswariah Andrew hughes Ian Shaw diana Tam Manju Chandrasegaram department of General Surgery The Prince Charles HospitalChermside 4032QueenslandAustralia department of General Surgery The Prince Charles HospitalBrisbane 4032QueenslandAustralia The Common Good Foundation The Prince Charles HospitalBrisbane 4032QueenslandAustralia

BACKGROUNd The prevalence of colorectal cancer in the elderly is rising,with increasing numbers of older patients undergoing ***,there is a paucity of information on the surgical outcomes and operative techniques used in this *** To evaluate the post-operative outcomes for patients≥85 years old following colorectal cancer resection as well as evaluating the outcomes of laparoscopic resection of colorectal cancer in patients over *** Patients who underwent colorectal cancer resection at our institution between January 2010 and december 2018 were *** study was divided into two *** part one,patients were divided into two groups based on age:Those age≥85 years old(n=48)and those aged 75-84 years old(n=136).Short term surgical outcomes and clinicopathological features were compared using appropriate parametric and non-parametric *** part two,patient’s over 85 years old were divided into two groups based upon operative technique:Laparoscopic(n=37)vs open(n=11)colorectal ***-term postoperative outcomes of each approach were *** The median length of stay between patients over 85 and those aged 75-85 was eight days,with no statistically significant difference between the groups(P=0.29).No significant difference was identified between the older and younger groups with regards to severity of complications(P=0.93),American Society of Anaesthesiologists grading(P=0.43)or 30-d mortality(2%vs 2%,P=0.96).Patients over 85 who underwent laparoscopic colorectal resection were compared to those who underwent an open *** median length of stay between the groups was similar(8 vs 9 d respectively)with no significant difference in length of stay(P=0.18).There was no significant difference in 30-d mortality rates(0%vs 9%,P=0.063)or severity of complication grades(P=0.46)between the laparoscopic and open surgical *** No significant short term surgical differences were identified in patients≥

关键词： Aged Colorectal neoplasms General surgery Open abdomen techniques Laparoscopy Colorectal surgery

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网页制作莲花宝典之Flash5.0篇

电脑爱好者 2001年第12期 56-57页

作者： robin.d

携带着更多的新功能和更强大的特效,Flash5.0堪称为世纪末众多的网页多媒体编辑软件当中最受人瞩目的焦点之一。送上此宝典,愿您网页上的Flash动画让网友拍案叫绝。

关键词： Flash5.0 关键帧快捷键对话框下拉框

In situ electron holography of the dynamic magnetic field emanating from a hard-disk drive writer

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Nano Research 2015年第4期8卷 1241-1249页

作者： Joshua F. Einsle Christophe Gatel Aurelien Masseboeuf robin Cours Muhammad A. Bashir Mark Gubbins Robert M. Bowman Etienne Snoeck Centre for Nanostructured Media School of Mathematics and Physics Queen's University Belfast Belfast BT7 1NN UK CEMES-CNRS 29 rueJ. Marvig 31055 Toulouse France Universite de Toulouse Paul Sabatier 118 route de Narbonne 31062 Toulouse Cedex 9 France Seagate Technology I Disc Drive Springtown Industrial Estate Derry City Co. BT48 OBF Londonderry UK

The proliferation of mobile devices in society accessing data via the ＂cloud＂ is imposing a dramatic increase in the amount of information to be stored on hard disk drives （Hdd） used in servers. Forecasts are that areal densities will need to increase by as much as 35% compound per annum and by 2,020 cloud storage capacity will be around 7 zettabytes corresponding to areal densities of 2 Tb/in^2. This requires increased performance from the magnetic pole of the electromag- netic writer in the read/write head in the Hdd. Current state-of-art writing is undertaken by morphologically complex magnetic pole of sub 100 nm dimensions, in an environment of engineered magnetic shields and it needs to deliver strong directional magnetic field to areas on the recording media around 50 nm × 13 nm. This points to the need for a method to perform direct quantitative measurements of the magnetic field generated by the write pole at the nanometer scale. Here we report on the complete in situ quantitative mapping of the magnetic field generated by a functioning write pole in operation using electron holography. The results point the way towards a new nanoscale magnetic field source to further develop in situ transmission electron microscopy.

关键词： electron transmissionmicroscopy off-axis electronholography in situ magnetic field magnetic recording hard disk write pole

Repeat endoscopic retrograde cholangiopancreaticography after failed initial precut sphincterotomy for biliary cannulation

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World Journal of Gastroenterology 2014年第36期20卷 13153-13158页

作者： Michael Pavlides Ashley Barnabas Nilesh Fernandopulle Adam A Bailey Jane Collier Jane Phillips-hughes Anthony Ellis Roger Chapman Barbara Braden Translational Gastroenterology Unit Oxford University Hospitals Oxford OX3 9DU United Kingdom department of Radiology Oxford Uni-versity Hospitals Oxford OX3 9DU United Kingdom

AIM: To investigate the outcome of repeating endoscopic retrograde cholangiopancreaticography (ERCP) after initially failed precut sphincterotomy to achieve biliary cannulation.

关键词： Mortality Post-endoscopic retrograde cholangio-pancreaticography pancreatitis Precut sphincterotomy Endoscopic retrograde cholangio-pancreaticography Choledocholithiasis

Cycloaddition of CO_2 and propylene oxide by using M(HBTC)(4,4'-bipy)·3dMF(M=Ni,Co,Zn) metal-organic frameworks

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Chinese Journal of Catalysis 2018年第8期39卷 1311-1319页

作者： Seol-Hee Kim robin Babu dong-Woo Kim Wonjoo Lee dae-Won Park division of Chemical and Biomolecular Engineering Pusan National University Busan 609-735 Korea Korea Research Institute of Chemical Technology Ulsan 681-802 Korea

Three pillar-layered metal-organic frameworks（MOFs） based on M（HBTC）（4,4＇-bipy）.3dMF（M =Ni, Co, and Zn; HBTC = 1,3,5-benzenetricarboxylic acid, 4,4＇-bipy = 4,4′-bipyridine） were synthesized using a solvothermal method. Zn（HBTC）（4,4＇-bipy）.3dMF was synthesized for the first time using both a solvothermal and microwave method, and subsequently characterized by various physicochemical methods. The structure of M（HBTC）（4,4＇-bipy）.3dMF consisted of honeycomb grid layers of M2＋ ions and BTC units, which were further linked by the 4,4＇-bipy pillars to form a three-dimensional highly porous framework. All the MOFs displayed excellent synergistic catalytic properties with alkyl ammonium halides（TBAX） in the solventless fixation of CO_2 with epoxides to produce cyclic carbonates. The catalytic activities of these MOFs followed the trend Zn Co Ni,which was explained by the acid-base bifunctional properties. The microwave-synthesized Zn（HBTC）（4,4＇-bipy）.3dMF material exhibited physical, chemical, and catalytic properties that were similar to those of the catalyst obtained using a conventional solvothermal synthesis. The scope of various parameters, including recyclability, was studied, and a plausible reaction mechanism was suggested.

关键词： M(HBTC)(4,4'-bipy)·3dMF(M=Ni,Co,Zn) Microwave method Carbon dioxide Epoxide Cyclic carbonate

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胸腹主动脉瘤：杂交修复术结果

中国普通外科杂志 2015年第6期24卷 775-780页

作者： Gchad hughes Nicholas d Andersen Jennifer M Hanna Richard L McCann 老启芳美国北加利福尼亚杜伦杜克大学医学中心外科学系心胸外科学组美国北加利福尼亚杜伦杜克大学医学中心外科学系血管外科学组不详

目的:胸腹主动脉瘤(TAAA)的治疗依然是外科中最富挑战性的工作,特别是存在退行性变动脉瘤的老年患者同时患肺疾病更是如此。这篇更新后的单中心报道是关于我们对高危TAAA患者采用完全内脏动脉去分支化结合动脉瘤腔内隔绝的杂交修复术经... 详细信息

目的:胸腹主动脉瘤(TAAA)的治疗依然是外科中最富挑战性的工作,特别是存在退行性变动脉瘤的老年患者同时患肺疾病更是如此。这篇更新后的单中心报道是关于我们对高危TAAA患者采用完全内脏动脉去分支化结合动脉瘤腔内隔绝的杂交修复术经验。方法:从2005年3月—2012年6月间58名患者在单中心接受解剖外内脏血管去分支化及随后的动脉瘤腔内隔绝术。内脏旁路的中位数为4支,最初的33例采用同期手术方式,而最近的25例采用分期手术。结果:患者中位年龄为69.0岁,50%为女性,所有患者存在严重合并症而不适合传统开放修复术。平均主动脉直径(6.7±1.2)cm,30 d/住院病死率、脑卒中率、永久性轻瘫/截瘫率分别为9%、0%以及4%。最近25例分期手术患者的这三种并发症率分别为4%、0%以及0%。平均随访时间(26±21)个月,内脏人工血管通畅率95.3%,所有闭塞的内脏人工血管均为肾动脉,无1例引起永久性截瘫,2例患者需再干预,1例出现Ib型内漏,1例出现III型内漏,5年免于再干预率为94%,Kaplan-Meier总体生存率为1年78%、5年62%,5年主动脉相关生存率为87%。结论:这些更新后的结果 ,继续支撑着这一观点:运用完全内脏动脉去分支联合动脉瘤腔内隔绝的杂交技术治疗高龄且不适合传统开放手术的高危TAAA患者是一种理想的选择,而采取分期手术的方式能取得更佳的结果。

关键词：主动脉,胸主动脉,腹动脉瘤修复,腔内预后

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Comparison of in Clinic-Based Fecal Microbiome Collection Techniques for Increase in Study Participation and Utilization of Microbiome Analysis

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Open Journal of Urology 2019年第3期9卷 51-61页

作者： Benjamin d. Besasie dimpy P. Shah robin J. Leach Michael A. Liss department of Urology UT Health San Antonio San Antonio TX USA department of Epidemiology and Biostatistics UT Health San Antonio San Antonio TX USA

We compared the collection techniques of fecal specimens for dNA extraction and fecal microbiome analysis by utilizing the glove from a standard-of-care digital rectal exam (dRE) and the rectal swab from a pre-prostate biopsy bacterial rectal culture collected in clinical care settings. dNA yield from the swab technique compared to the glove technique yielded similar amounts of dNA (18.1 vs. 13.1 ng/μL, p = 0.06), slightly favoring the swab technique. However, utilizing dNA yield cutoffs of 15 ng/μL (37% vs. 29%, p = 0.18) and 30 ng/μL (15% and 9%, p = 0.16), we identified no differences in yield between the swab versus glove technique, respectively. Absorbance values for overall dNA quality were significantly different in favor of the glove technique (mean 1.6 vs. 2.0, p dication of dNA quality, only 26% (19/91) met the cutoff value using the swab group compared to 47.3% (53/112) if the glove technique was used (p d for the RNA quality with an absorbance value cutoff of 2.0 (2.2% vs. 30.4%, p d improve population sampling, gloves used from a dRE may be utilized as a consistent and efficient fecal dNA collection technique for fecal microbiome analysis. dNA yield and quality from the glove technique are comparable to—if not better than—rectal swab collection.

关键词： Fecal Microbiome Stool Collection Technique Swab Glove Urology digital Rectal Exam 16S rRNA Gene Sequencing

Rapid, Semi-Automated Fractionation of Freshwater dissolved Organic Carbon Using dAX 8 (XAd 8) and XAd 4 Resins in Tandem

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Natural Science 2016年第11期8卷 487-498页

作者： david d. hughes Peter J. Holliman Timothy Jones Alexander J. Butler Christopher Freeman Wolfson Carbon Capture Laboratory Bangor University Wales UK

Natural dissolved organic carbon (dOC) consists of different bio-molecular classes of compounds that are currently very difficult and time-consuming to isolate as individual compounds. However, it is possible to separate natural dOC into hydrophobic and hydrophilic fractions. Such characterisation approaches are becoming increasingly important because, over the past 20 years natural dOC concentrations have been rising rapidly in many parts of the world, most likely influenced by climate change. Higher dOC concentrations in drinking water catchments present a serious problem for the water industry because dOC can form disinfection by-products dBPs during water treatment (e.g. chlorination). Hence, there is an urgent need to better characterise natural dOC before, during and after water treatment. However, current dOC fractionation procedures are extremely laborious requiring days and continual manual monitoring to separate sufficient quantities of dOC for subsequent analysis. This seriously limits sample throughput and the parameter space which can be studied. In this paper, we propose a much more rapid semi-automated method (12.5 hours/litre/sample) which utilises readily available equipment, i.e., HPLC pump or similar and sequential columns of Amberlite dAX 8 and XAd 4 resins. The method reduces the manual input from continual attention to minutes. This paper describes the development of the method and its application in the fractionation of natural dOC from reservoir and lake samples fed from upland peat-land catchments. Recoveries are found to be comparable to those using the manual technique, with the dominant component being hydrophobic acid accounting for 35% - 40% of the natural dOC with the second largest, being hydrophilic acid at 20% - 27%.

关键词： dissolved Organic Carbon Hydrophilic Compounds Hydrophobic Compounds Fulvic Acids Humic Acids Resins

Confirmed Envenomation by Androctonus amoreuxi (Egyptian Yellow Fat Tail Scorpion)

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Case Reports in Clinical Medicine 2023年第4期12卷 88-92页

作者： Robert Cole Pueringer Kirk hughes Isaac Yelkin Jon B. Cole Travis d. Olives Minnesota Poison Control System Minneapolis USA department of Emergency Medicine Essentia Health Duluth USA department of Emergency Medicine Hennepin Healthcare Minneapolis USA

In the United States, envenomations by native scorpion species such as Centruroides are common and generally well-tolerated. On the contrary, Androctonus species envenomations are exceedingly rare outside the Middle East and North Africa but are particularly deadly. We report a case of envenomation by an Egyptian Yellow Fat Tail (Androctonus amoreuxi) scorpion and the subsequent clinical course. A hobbyist and dangerous scorpion collector was stung by his pet Androctonus amoreuxi, purchased online. Our patient rapidly developed severe localized pain followed by systemic effects, including tachycardia, hypertension, tachypnea, anxiety, GI symptoms, diplopia, dyspnea, profound myalgias, and intense paresthesias. Ultimately, he was diagnosed with a grade 2-to-3 scorpion envenomation based upon evidence of autonomic hyperactivity and cranial nerve dysfunction. He never progressed to cardiopulmonary compromise;neither dobutamine nor antivenom was administered, and he improved with supportive care alone. Case details were verified in person and via electronic medical record review.

关键词： Androctonus amoreuxi Fat Tail Scorpion Envenomation