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Is colonic lavage a suitable alternative for left-sided colonic emergencies?

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World Journal of Gastrointestinal Surgery 2021年第4期13卷 379-391页

作者： Hui Yu Tham Wen Hui lim Sneha Rajiv Jain Cheng Han Mg Snow Yunni Lin Jie Ling Xiao Fung Joon Foo Kar Yong Wong Choon seng Chong Department of Surgery University Surgical ClusterNational University HospitalSingapore 11759Singapore Department of Medicine Yong Loo Lin School of MedicineNational University of SingaporeSingapore 11759Singapore Department of Colorectal Surgery Singapore General HospitalSingapore 169608Singapore Department of General Surgery Sengkang HealthSingapore 544886Singapore Colorectal Surgery Service Department of General SurgeryTan Tock Seng HospitalSingapore 308433Singapore Division of Colorectal Surgery University Surgical ClusterNational University Health SystemSingapore 119228Singapore Department of General Surgery Yong Loo Lin School of MedicineNational University of SingaporeSingapore 119228Singapore

BACKGROUND The use of intra-operative colonic lavage(IOCL)with primary anastomosis remains controversial in the emergency left-sided large bowel pathologies,with alternatives including Hartmann’s procedure,manual decompression and subtotal *** To compare the peri-operative outcomes of IOCL to other *** Electronic databases were searched for articles employing IOCL from inception till July 13,*** ratio and weighted mean differences(WMD)were estimated for dichotomous and continuous outcomes ***-arm meta-analysis was conducted using DerSimonian and Laird random *** Of 28 studies were included in this meta-analysis,involving 1142 undergoing IOCL,and 634 other *** leads to comparable rates of wound infection when compared to Hartmann’s procedure,and anastomotic leak and wound infection when compared to manual *** was a decreased length of hospital stay(WMD=-7.750;95%CI:-13.504 to-1.996;P=0.008)compared to manual decompression and an increased operating ***-arm meta-analysis found that overall mortality rates with IOCL was 4%(CI:0.03-0.05).Rates of anastomotic leak and wound infection were 3%(CI:0.02-0.04)and 12%(CI:0.09-0.16)*** IOCL leads to similar rates of post-operative complications compared to other *** extensive studies are needed to assess the outcomes of IOCL for emergency left-sided colonic surgeries.

关键词： Colon Colonic irrigation Intra-operative colonic lavage Anastomosis Emergency surgery Colonic neoplasm

The Taoism Philosophy within Traditional Chinese Medicine:The Relation between Huang Di Nei Jing(《黄帝内经》Yellow Emperor's Inner Classic)and Dao De Jing(《道德经》Tao Te Jing)

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Chinese Medicine and Culture 2019年第4期2卷 184-188页

作者： Chee Hoong lim seng Keat lim Guo Lin Wong Linchao Qian Yun Jin Kim School of Traditional Chinese Medicine Xiamen University Malaysia

Taoism refers to an indigenous Chinese philosophical and religious tradition. For more than two and a half millennia, it has had a profound social and intellectual influence on Eastern Asia and since the 19 th century has deeply influenced Western countries. Dao De Jing(《道德经》Tao Te Jing) is still considered to be the primary text of Taoism. The Tao Te Jing is attributed to Laozi, the classical Chinese Philosopher, and describes the major doctrines of Taoism. It is most relevant to Traditional Chinese Medicine(TCM). This article offers a brief introduction to the Taoism within TCM – the relation between Huang Di Nei Jing(《黄帝内经》The Yellow Emperor’s Inner Classic) and Dao De Jing(《道德经》Tao Te Jing).

关键词： Dao De Jing (《》 Tao Te Jing) Huang Di Nei Jing (《》 The Yellow Emperorss Inner Classic) Taoism Philosophy

基于外周血基因表达谱特征的肾移植排斥风险评估模型

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基于外周血基因表达谱特征的肾移植排斥风险评估模型

作者：林杰胜（lim kiat Shenq）上海交通大学

学位级别：硕士

目的:建立并验证基于肾移植受者外周血基因表达谱特征的排斥风险评估模型,以期为临床中对排斥反应的无创性辅助诊断方法。方法:本研究对GEO公共数据库中,不同中心来源发生排斥反应的肾移植受者外周血的基因表达谱,进行整合分析,采用limM... 详细信息

目的:建立并验证基于肾移植受者外周血基因表达谱特征的排斥风险评估模型,以期为临床中对排斥反应的无创性辅助诊断方法。方法:本研究对GEO公共数据库中,不同中心来源发生排斥反应的肾移植受者外周血的基因表达谱,进行整合分析,采用limMA差异表达分析法和LASSO回归法进行基因筛选,将筛选出的结果,以Logistic回归法,建立肾移植排斥风险的评估模型,并对此模型采用受试者工作特征曲线、校准度分析和决策曲线分析进行验证和评价。结果:此肾移植排斥风险评估模型通过对肾移植受者外周血基因芯片中15个特异基因的表达谱特征进行计算分析,以一范围从0至100的排斥风险指数（RRS）来评估该受者发生排斥反应（包括:急性排斥反应,亚临床排斥反应及临界改变）的风险。RRS的值越大,经此模型评估的排斥风险就越大,当RRS的截断值设定为35.55时,此模型的AUC为0.836（0.812-0.859）,准确度为76.3%,灵敏度为73.0%,特异度为78.0%,阳性预测值为62.9%,阴性预测值为84.9%,并在决策曲线分析中显示此模型的应用将带给肾移植受者显著的临床获益。结论:此模型在GEO的样本数据集中,能有效地通过肾移植受者的外周血中15个特异基因的表达量评估其发生排斥反应的风险,同时可望避免非必要的有创性穿刺活检,但仍需进一步的临床试验加以证实。

关键词：肾移植风险评估模型急性排斥反应亚临床排斥反应临界改变生物信息学

Validation of genetic variants associated with metabolic dysfunctionassociated fatty liver disease in an ethnic Chinese population

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World Journal of Hepatology 2020年第12期12卷 1228-1238页

作者： Guan Huei Lee Wah Wah Phyo Wai Mun Loo Raymond Kwok Taufique Ahmed Asim Shabbir Jimmy So Calvin Jianyi Koh Juanda Leo Hartono Mark Muthiah Kieron lim Poh seng Tan Yin Mei Lee seng Geelim Yock Young Dan Division of Gastroenterology and Hepatology Department of MedicineNational University Health SystemSingapore 119228Singapore Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore Department of Medicine Khoo Teck Puat HospitalSingapore 768828Singapore Department of Surgery National University Health SystemSingapore 119228Singapore

BACKGROUND Genetic factors play an important role in the pathogenesis and development of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To study the association of single nucleotide polymorphisms(SNPs),previously identified in Western populations,with the risk of MAFLD in a Singapore Chinese population and their interactions with environmental and medical risk *** A retrospective case-control study was conducted with 72 MAFLD cases and 72 controls with no hepatic steatosis on computed tomography,magnetic resonance imaging,or controlled attenuation parameter *** were recruited from two tertiary *** alleles such as NCAN,GCKR,LYPLAL1,PNPLA3,PPP1R3B,FDFT1,COL13A1,EFCAB4B,PZP,and TM6SF2 were genotyped using the TaqMan®Predesigned SNP Genotyping *** Weight and body mass index(BMI)were 1.2-times higher in patients(70.6 kg,95%confidence interval[CI]:57.1-84.1 vs 60.8 kg,95%CI:48.5-73.1,P<0.001 and 26.9 kg,95%CI:23-40.8 vs 23.3 kg 95%CI:19-27.6,P<0.001 respectively).The prevalence of diabetes mellitus in patients was 40.3%and 20.8%in controls(P=0.011).Patients had higher mean triglycerides than controls(P<0.001).PNPLA3 GG was more likely to be associated with MAFLD(43.4%CC vs 69.7%GG,P=0.017,and 44.8%CG vs 69.7%GG,P=0.022).In multivariable analysis,hypertriglyceridemia(odds ratio[OR]:2.0495%CI:1.3-3.1,P=0.001),BMI(OR:1.295%CI:1.1-1.4,P<0.001)and PNPLA3 GG(OR:3.495%CI:1.3-9.2,P=0.014)were associated with MAFLD(area under the receiver operating characteristic curve of 0.823).CONCLUSION Among the Chinese population of Singapore,PNPLA3 homozygous GG allele is a strong predictor of MAFLD,whereas LYPLAL1,GCKR,FDFT1,COL13A1,PZP,and TM6SF2 are not significantly ***,high BMI,and PNPLA3 GG are independent predictors of MAFLD.

关键词： Single nucleotide polymorphism PNPLA3 Genotyping Metabolic dysfunction-associated fatty liver disease Non-alcoholic steatohepatitis Hypertriglyceridemia Body mass index Waist-hip ratio,Screening Hepatic steatosis

A novel benzo[4,5]furo[3,2-d]pyrimidine-based host as a n-type host for blue phosphorescent organic light-emitting diodes

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Science China Materials 2022年第4期65卷 1028-1033页

作者： Junsu Ha Junseop lim Jun Yeob Lee School of Chemical Engineering Sungkyunkwan University2066Seobu-roJangan-guSuwon-siGyeonggi-do16419Republic of Korea

An electron-transport-type host was synthesized using a benzo[4,5]furo[3,2-d]pyrimidine(BFP)core to develop a high triplet energy *** host was designed to have both the tetraphenylsilyl blocking group and the hole-transport-type carbazole *** the device application,the host was used as an electron-transport-type host mixed with a hole-transport-type 3,3'-di(9H-carbazol-9-yl)-1,1†-biphenyl(mCBP)host in the blue phosphorescent organic light-emitting diodes(PhO-LEDs)doped with a[[5-(1,1-dimethylethyl)-3-phenyl-1H-imidazo[4,5-b]pyrazin-1-yl-2(3H)-ylidene]-1,2-phenylene]bis-[[6-(1,1-dimethylethyl)-3-phenyl-1H-imidazo[4,5-b]pyrazin-1-yl-2(3H)-ylidene]-1,2-phenylene]iridium(Ir(cb)3)blue *** a result,the mCBP:CzBFPmSi mixed host showed high external quantum efficiency over 20%at 1000 cd m^(−2) and low efficiency roll-off in the blue PhOLEDs.

关键词： blue device host efficiency lifetime

Dosimetric Effect of Cobalt-Chrome Stabilization Hardware in Paraspinal Radiation Treatments

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2022年第3期11卷 176-187页

作者： Grace Tang Thomas LoSasso seng-Boh lim Yoshiya Yamada Mark Bilsky Dale Michael Lovelock Department of Medical Physics Memorial Sloan Kettering Cancer Center New York USA Department of Radiation Oncology Memorial Sloan Kettering Cancer Center New York USA Department of Neurosurgery Memorial Sloan Kettering Cancer Center New York USA

High density materials are assigned with an apparent density of 3.2 g/cm3 in 12-bit CT images due to saturation. This is often ignored in planning for spine tumors with titanium (density 4.40 g/cm3) spinal hardware. However, new cobalt-chrome hardware has a density of 8.11 g/cm3, which would increase dosimetric uncertainty if the true density is not utilized in planning. This effect was evaluated in this study. Calculation accuracy was examined using MapCHECK2 with a single 20 × 10 cm2 field with a titanium and a cobalt-chrome rod in a solid water phantom for 6X, 6FFF and 15X, at 2 cm and 6 cm beneath the rods. Measurement was compared to the calculation with density override (DO) with the true density and to the calculation with no-density override (NDO). Additionally, the dosimetric effect in clinical treatment plans was investigated for six IMRT and VMAT paraspinal cases. Plan quality was compared with the original NDO calculation and the DO recalculation. Compared to measurements, the treatment planning system (TPS) overestimated the dose locally by up to 13.2% for cobalt-chrome and 4.8% for titanium with NDO calculations. DO calculations improved the differences to 8.4% and 4.0%, respectively. Scatter from the rod increased the lateral dose and diminished as depth increased but was not properly accounted for by the TPS even with the correct density assigned. For the clinical plans, PTV coverage was lowered by an average of ~1.0% (range: 0.5% - 2.0%) and ~0.3% (range: 0.2% - 0.7%) in DO recalculations for cobalt-chrome and titanium, respectively. In conclusion, neglecting the true density of cobalt-chrome hardware during planning may result in an unexpected decrease in target coverage.

关键词： Cobalt-Chrome Spinal Hardware Paraspinal Radiation Therapy

Coexistence of Helicobacter pylori spiral and coccoid forms in experimental mice

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World Journal of Gastroenterology 1998年第6期4卷 30-33页

作者： HUA Jiesong 1, HO Bow 1, ZHENG Pengyuan 1, YEOH Khay Guan 2, NG Han Chong 1 and lim seng Gee 2

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关键词： Helicobacter pylori , antibodies ELISA spiral form coccoid form mouse

Voltage Unbalance Mitigation in Low Voltage Distribution Networks with Photovoltaic Systems

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Journal of Electronic Science and Technology 2012年第1期10卷 1-6页

作者： Kein Huat Chua Yun seng lim Jianhui Wong Ezra Morris Stella Morris Philip Taylor the Electrical and Electronics Engineering Department Universiti Tunku Abdul RahmanMalaysia. the School of Engineering Durham UniversityDurhamUK

This paper proposes a technique to mitigate the voltage unbalance issue caused by the high penetration of photovoltaic （PV） systems into the low voltage distribution networks （LVDN） using a single phase energy storage system （ESS）. The ESS comprises a hi-directional power flow inverter and a battery bank. The system is capable of absorbing the excess power and delivering power to the network in order to keep the voltage unbalance factor （VUF） below the statutory limit of 1%. Investigations are carried out in the experimental small-scale energy zone （SSEZ）. The experimental results demonstrate that the ESS is capable of mitigating the VUF of the network.

关键词： Energy storage system low voltagedistribution network photovoltaic voltage unbalance.

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针灸治疗过敏性鼻炎Meta分析与系统评价

针灸治疗过敏性鼻炎Meta分析与系统评价

作者：林光盛（lim Kuang seng）广州中医药大学

学位级别：硕士

本论文是课题组多年来对针灸治疗过敏性鼻炎的临床研究的基础上进行的。过敏性鼻炎(allergic rhinitis,AR)也称为变态反应性鼻炎、变异性鼻炎,主要由特应性体制的个体在接触致敏原后由IgE介导的介质(主要为组胺类物质)的释放、并有多种... 详细信息

本论文是课题组多年来对针灸治疗过敏性鼻炎的临床研究的基础上进行的。过敏性鼻炎(allergic rhinitis,AR)也称为变态反应性鼻炎、变异性鼻炎,主要由特应性体制的个体在接触致敏原后由IgE介导的介质(主要为组胺类物质)的释放、并有多种免疫活性的细胞及细胞因子等参与的鼻黏膜非感染性慢性炎性反应性疾病,是目前临床上较为常见的慢性疾病之一。其主要临床特征为:喷嚏、鼻分泌亢进、鼻塞、鼻痒以及鼻黏膜的肿胀等。该病临床上主要分为常年性变应性鼻炎以及季节性变应性鼻炎,后者也常常被称为"花粉症"。AR虽然不是一种严重的临床疾病,但往往严重影响了人们的日常生活、学习以及正常工作效率;尤其儿童,可对其身心健康、学习成绩造成一定的负面影响,给家庭造成一定的经济负担。相关的研究报道,近十多年来本病的患病人数正在逐年递增,目前全球大约有12%5%的人患病。目前的治疗方法主要以药物为主。其中临床常见的西药主要包括皮质类激素、抗组胺药、白三烯受体拮抗剂、减充血剂和肥大细胞膜稳定剂等等;而中医药在本病的治疗中也积累了大量经验,中医学认为:肺主皮毛,开窍于鼻,外邪侵犯皮毛、肺失宣降功能则表现为津液输布障碍,津液壅塞、鼻窍不通且清涕不止,这就是此谓的"鼻鼽";而且过敏性疾病大多本身由于平素体虚,当肺气虚损,卫外不固,风寒常常乘虚而入侵,病情反复易发。治疗以补肺祛风散寒为主,并配合针灸治疗,对证取穴,祛邪扶正,以取得良好效果,针灸治疗过敏性鼻炎往往是内、外因同调,主要选取头面部局部以及肺经、大肠经穴位为主;以"宣肺通窍"的同时配以阳明经穴或背俞穴来"益气固本"。目的:基于前期临床研究的基础上,本研究主要通过对针灸治疗过敏性鼻炎患者的相关文献进行系统评价及Meta分析,明确针灸在治疗本病过程中的确切疗效及有效方法,为进一步指导临床实践及研究针灸对本病的作用机制提供依据。方法:(1)检索方法:通过计算机文献数据库检索包括PubMed、Embase、Cochrane图书馆、中国学术期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)在内的数据库,且文献检索未设定语种限制,检索年限为数据库默认的起始年限至今的相关文献。检索方法为主题词和自由词相结合的检索策略:中文检索词:鼻炎、过敏性鼻炎、常年变应性鼻炎、花粉症、针灸、针刺、艾灸、电针、穴位等;英文检索词:rhinitis、allergic rhinitis、perennial allergic rhinitis、pollinosis、acupuncture and moxibustion、electric-acupuncture、needling、acupoint等。在检索到符合条件的文献后,追查纳入文献后的相关参考文献,尽可能纳入全面的相关研究,降低漏检的可能性;将检索到的文献导入Noteexpress数据管理软件进行查重后,再依次看文献摘要排除不符合纳入的病例,最终选择符合行系统评价的文献进行分析。(2)纳入标准:选取目前公开发表的关于针灸治疗过敏性鼻炎的以临床为主的、设计方案以随机对照研究的文献(Randomized Controlled Trials,RCT),可以包含盲法和非盲法的研究方案;并以观察疗效和安全性为主要目的;(2)患者具有过敏性鼻炎的临床症状,性别、病例来源、类型、病程不限;(3)研究对象的年龄均应大于18周岁,对照组与观察组患者的基线资料应具有均衡好、可比性,且第一诊断应均为本病,应具有明确的诊断标准以及排除标准;(4)观察组采用针灸治疗方法,平行对照组接受西医常规治疗或公认的阳性西药治疗;(5)文献中应报告观察组与对照组两组的总病例数,结局指标应有痊愈、显效、有效、无效等评价评价方法。(3)排除标准:(1)研究对象为动物、以临床报道不良反应报道为主以及以药物研究为主的药理学、药代动力学等非临床疗效评价研究的相关文献;(2)疗效评定指标中未公布治疗结果的和(或)统计分析方法不明确的临床试验;(3)随机对照方案不明确的临床试验;(4)患者自身前后对照的临床研究;(5)单纯性的描述研究;(6)文献性综述、临床病例报道、相关临床专家个人经验报道;(7)合并有其它疾病的;(8)中医针灸疗法与其他中医外治治疗方案相对比的临床疗效研究。(4)文献评价方法:所有被纳入系统评价的文献均分别由2名相关专业的研究者进行独立进行评阅,对明显不符合纳入标准的相关文献进行剔除,对通过阅读文献摘要符合、可能符合纳入标准的文献则仔细阅读全文,以确定是否真正符合纳入标准,同时评价者还要独立对每一篇符合纳入标准的文献进行质量评价和相关数据治疗提取,并进行交叉核对,意见不一致处,则由两人共同讨论分析,以求得意见一致,必要时由第三位研究者解决或向相关另一的专家咨询解决。对于符合纳入

关键词：针灸过敏性鼻炎系统评价 Meta分析