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Hepatocellular carcinoma in patients with renal dysfunction: Pathophysiology, prognosis, and treatment challenges

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World Journal of Gastroenterology 2021年第26期27卷 4104-4142页

作者： Hsuan yeh Chung-Cheng Chiang Tzung-Hai Yen Department of Nephrology Chang Gung Memorial Hospital and Chang Gung UniversityTaipei 105Taiwan Department of Gastroenterology and Hepatology Chang Gung Memorial HospitalTaoyuan 333Taiwan

The population of patients with hepatocellular carcinoma(HCC)overlaps to a high degree with those for chronic kidney disease(CKD)and end-stage renal disease(ESRD).The degrees of renal dysfunction vary,from the various stages of CKD to dialysis-dependent ESRD,which often affects the prognosis and treatment choice of patients with *** addition,renal dysfunction makes treatment more difficult and may negatively affect treatment *** study summarized the possible causes of the high comorbidity of HCC and renal *** possible mechanisms of CKD causing HCC involve uremia itself,long-term dialysis status,immunosuppressive agents for postrenal transplant status,and miscellaneous factors such as hormone alterations and *** possible mechanisms of HCC affecting renal function include direct tumor invasion and hepatorenal ***,we categorized the risk factors that could lead to both HCC and CKD into four categories:Environmental toxins,viral hepatitis,metabolic syndrome,and vasoactive *** CKD and ESRD have been reported to negatively affect HCC prognosis,but more research is warranted to confirm ***,ESRD status itself ought not to prevent patients receiving aggressive *** study then adopted the well-known Barcelona Clinic Liver Cancer guidelines as a framework to discuss the indicators for each stage of HCC treatment,treatment-related adverse renal effects,and concerns that are specific to patients with pre-existing renal dysfunction when undergoing aggressive treatments against CKD and *** aggressive treatments include liver resection,simultaneous liver kidney transplantation,radiofrequency ablation,and transarterial ***,focusing on patients unable to receive active treatment,this study compiled information on the latest systemic pharmacological therapies,including targeted and immunotherapeutic *** on available clinical studies and Food and Drug Administration labe

关键词： Hepatocellular carcinoma Chronic kidney disease End-stage renal disease Hemodialysis Cancer prognosis Cancer therapeutics

Hepatic resection for hepatocellular carcinoma in end-stage renal disease patients: Two decades of experience at Chang Gung Memorial Hospital

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World Journal of Gastroenterology 2005年第14期11卷 2067-2071页

作者： Chun-Nan yeh Wei-Chen Lee Miin-Fu Chen Department of General Surgery Chang Gung Memorial Hospital Chang Gung UniversityTaoyuanTaiwanChina

AIM: Hepatocellular carcinoma (HCC) is a common disease in Taiwan. The prevalence of viral hepatitis infection and the subsequent development of HCC are well known to be higher in patients with end-stage renal disease (ESRD) requiring hemodialysis (HD) or peritoneal dialysis (PD) than among the general population. However, information on hepatic resection for ESRD-HCC patients is limited. METHODS: The clinical features of 26 ESRD-HCC patients who underwent hepatic resection from 1982 to 2001 were retrospectively reviewed. Meanwhile, the clinicopathological features and the outcome of 1 198 HCC patients without ESRD undergoing hepatic resection were used for comparison. RESULTS: Of 1 224 surgically resected HCC patients, 26 (4.2%) were ESRD-HCC. Univariate analysis revealed more associated disease, more physical signs of anemia and postoperative complications, lower hemoglobin, platelet, α-fetoprotein, elevated blood urea nitrogen (BUN) and creatinine levels, smaller tumors, lower HBsAg positivity, higher HCV positivity, and longer hospital stays in the ESRDHCC group compared with the HCC group. Furthermore, multivariate stepwise logistic regression analysis revealed that elevated BUN and creatinine levels were the only two independently significant factors in the patients in the ESRD-HCC group. Overall and disease-free survival rates were similar between the ESRD-HCC and HCC ***: Elevated BUN and creatinine were the only two main independent factors differentiating ESRD-HCC from HCC patients. ESRD should not be a contraindication of hepatic resection in HCC patients; however, careful operative techniques and perioperative care are crucial to achieving lower morbidity and mortality. Comparable overall survival and disease-free survival can be achieved in selected ESRD-HCC patients undergoing hepatic resection when compared with conventional HCC patients.

关键词： HCC ESRD

Several variants of the Dumont differential system and permutation statistics

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Science China Mathematics 2019年第10期62卷 2033-2052页

作者： Shi-Mei Ma Toufik Mansour David GLWang Yeong-Nan yeh School of Mathematics and Statistics Northeastern University at QinhuangdaoQinhuangdao066000 Department of Mathematics University of HaifaHaifa3498838 School of Mathematics and Statistics Beijing Institute of TechnologyBeijing102488 Institute of Mathematics Academia SinicaTaipei10617

The Dumont differential system on the Jacobi elliptic functions was introduced by Dumont(1979)and was extensively studied by Dumont, Viennot, Flajolet and so on. In this paper, we first present a labeling scheme for the cycle structure of permutations. We then introduce two types of Jacobi pairs of differential equations. We present a general method to derive the solutions of these differential equations. As applications,we present some characterizations for several permutation statistics.

关键词： Jacobi elliptic functions Dumont differential system permutation statistics context-free grammars

Role of prophylactic antibiotics in cirrhotic patients with variceal bleeding

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World Journal of Gastroenterology 2014年第7期20卷 1790-1796页

作者： Yeong yeh Lee Hoi-Poh Tee Sanjiv Mahadeva Department of Medicine School of Medical SciencesUniversiti Sains MalaysiaKubang Kerian 16150KelantanMalaysia Department of Internal Medicine Hospital Tengku Ampuan AfzanKuantan 25100PahangMalaysia Department of Medicine Faculty of MedicineUniversity of MalayaKuala Lumpur 50603Malaysia

Bacterial infections are common in cirrhotic patients with acute variceal bleeding,occurring in 20%within48 *** including early rebleeding and failure to control bleeding are strongly associated with bacterial ***,mortality from variceal bleeding is largely determined by the severity of liver *** a higher Child-Pugh score,patients with hepatocellular carcinoma are particularly susceptible to *** several hypotheses that include increased use of instruments,greater risk of aspiration pneumonia and higher bacterial translocation,it remains debatable whether variceal bleeding results in infection or vice versa but studies suggest that antibiotic prophylaxis prior to endoscopy and up to 8 h is useful in reducing bacteremia and spontaneous bacterial *** gram negative bacilli of enteric origin are most commonly isolated from cultures,but more recently,gram positives and quinolone-resistant organisms are increasingly seen,even though their clinical significance is ***(including ciprofloxacin and norfloxacin)used for short term(7 d)have the most robust evidence and are recommended in most expert *** term intravenous cephalosporin(especially ceftriaxone),given in a hospital setting with prevalent quinolone-resistant organisms,has been shown in studies to be beneficial,particularly in high risk patients with advanced cirrhosis.

关键词： Antibiotics Prophylaxis Cirrhosis Variceal bleeding Infection

Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

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Journal of Integrative Medicine 2022年第4期20卷 321-328页

作者： Chiung-Hui Huang Mei-Ling yeh Fang-Pey Chen Daphne Wu Department of Nursing Taipei Veterans General HospitalTaipei City 11217TaiwanChina School of Nursing National Taipei University of Nursing and Health SciencesTaipei City 11219TaiwanChina Center for Traditional Medicine Taipei Veterans General HospitalTaipei City 11217TaiwanChina Scool of Nursing National Taipei University of Nursing and Health Sciences and School of MedicineTaipei City 11217TaiwanChina

Background: Patients commonly develop postoperative pain after total knee arthroplasty(TKA).Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older ***: To examine the effect of low-level laser acupuncture(LA) in reducing postoperative pain, painrelated interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent ***, setting, participants and intervention: A single-blind randomized placebo-controlled trial was conducted. Patients(N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao(SP6), Taixi(KI3),Kunlun(BL60), Fengshi(GB31), Futu(ST32) and Neiguan(PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy *** outcome measures: The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain,postoperative pain-related interference in daily life and morphine consumption, were measured at hours24, 48 and 72 after ***: Generalized estimating equations revealed significant between-group differences in pain intensity(P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72(P < 0.05)and morphine consumption at hours 48 and 72(P < 0.05). The changes in pain-related interference in daily life were significant(P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood,and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24(P < 0.05).Conclusion: Low-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-le

关键词： Acupuncture Morphine Low-level laser Older patients Osteoarthritis Pain Total knee arthroplasty Randomized controlled trial

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： Prospective randomized trial Localanesthesia Ropivacaine Normal saline Laparoscopic cholecystectomy

The Impact of different warming devices on bacteria contamination in surgical field

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畜牧与兽医 2012年第S2期44卷 54-55页

作者： Ying-Ting Tsai Kuan-Sheng yeh Lih-Seng yeh Institute of Veterinary Clinical Sciences School of Veterinary Medicine National Taiwan University Department of Veterinary Medicine School of Veterinary Medicine National Taiwan University

Anesthesia may cause the development of *** altering the physiologic mechanisms of thermoregulation,such as redistribution of blood flow,reducing metabolic rate,and vasodilatation,heat generation is decreased and heat loss is *** related hypothermia is potentially associated with complications including coagulopathy,myocardial ischemia,surgical wound infection,*** by numerous studies,convection warmers are though to be the most effective active warming device and are widely accepted in veterinary medicine for maintaining normother-

关键词： warming contamination redistribution numerous potentially maintaining convection possibility wound excluded

Association of overtime work and obesity with needle stick and sharp injuries in medical practice

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World Journal of Clinical Cases 2021年第35期9卷 10937-10947页

作者： Yong-Hsin Chen Chih-Jung yeh Gwo-Ping Jong Department of Occupational Safety and Health Chung Shan Medical University HospitalTaichung 40201Taiwan Department of Public Health Chung Shan Medical UniversityTaichung 40201Taiwan Department of Internal Medicine Chung Shan Medical University Hospital and Chung Shan Medical UniversityTaichung 40201Taiwan

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical *** and overtime work among medical personnel increase the incidence of work *** To investigate whether overtime work and obesity increase the risk of *** This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical *** them,29 participants notified the hospital of having at least one NSI in *** data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or ***χ2 and Fisher’s exact tests were used to compare categorical *** logistic regression analysis and the Sobel test were used to assess the risk of *** Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against *** adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior *** overtime work mediated the association of medical specialty with *** In addition to promoting the use of safety needles and pr

关键词： Medical staff Needle stick and sharps injuries Overtime work Healthy body weight Obesity

Microstructures and properties of cancellous bone of avascular necrosis of femoral heads

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Acta Mechanica Sinica 2010年第1期26卷 13-19页

作者： Xuefeng Yao Peng Wang Ruchun Dai Hsien Yang yeh Dai Department of Engineering Mechanics AML Tsinghua University 100084 Beijing China Institute of Metabolism and Endocrinology The Second Xiang-Ya Hospital Central South University410011 Changsha China Department of Mechanical and Aerospace Engineering California State University Long Beach CA 90840-8305 USA

The aim of this study is to investigate microscopic structure and characterize cancellous bone of avascular necrosis of the femoral head （ANFH）. The rabbit model of the ANFH is established. The histopathologic features are studied successfully. The differences between the steroidinjection group （S.G.） and the controlled group （C.G.） are examined, including the weight of rabbits, the hematological examination and the three-dimensional stnactures. It is found that the plasma levels of cholesterol （CHO）, high-density lipoprotein （HDL） and low-density lipoprotein （LDL） in S.G. are lower than those in C.G. when the triglyceride （TG） increased in the S.G.; but the bone mineral content （BMC） and the structural model index （SMI） of the organ and tissue decreased significantly in S.G. Three-dimensional structures of the femoral head are obtained using micro-computed tomography （CT） scanning and the mechanical model is established to analyze the influences of these structural changes on the mechanical properties of the cancellous bone.

关键词： Avascular necrosis of the femoral head Cancellous bone Microstructure Mechanical properties