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Partial improvement in performance of patients with severe Alzheimer's disease at an early stage of fornix deep brain stimulation

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Neural Regeneration Research 2018年第12期13卷 2164-2172页

作者： Zhi-Qi Mao Xin Wang Xin Xu Zhi-Qiang Cui Long-Sheng Pan Xiao-Jing Ning Bai-Xuan Xu Lin Ma Zhi-Pei Ling Jian-Jun Jia Xin-Guang Yu Department of Neurosurgery Chinese PLA General Hospital School of Medicine Nankai University Department of Nuclear Medicine Chinese PLA General Hospital Department of Radiology Chinese PLA General Hospital Department of Neurology Chinese PLA General Hospital

Deep brain stimulation is a therapy for Alzheimer＇s disease（AD） that has previously been used for mainly mild to moderate cases. This study provides the first evidence of early alterations in performance induced by stimulation targeted at the fornix in severe AD patients. The performance of the five cases enrolled in this study was scored with specialized assessments including the Mini-Mental State Examination and Clinical Dementia Rating, both before and at an early stage after deep brain stimulation. The burden of caregivers was also evaluated using the Zarit Caregiver Burden Interview. As a whole, the cognitive performance of patients remained stable or improved to varying degrees, and caregiver burden was decreased. Individually, an improved mental state or social performance was observed in three patients, and one of these three patients showed remarkable improvement in long-term memory. The conditions of another patient deteriorated because of inappropriate antipsychotic medications that were administered by his caregivers. Taken together, deep brain stimulation was capable of improving some cognitive aspects in patients with severe AD, and of ameliorating their emotional and social performance, at least at an early stage. However, long-term effects induced by deep brain stimulation in patients with severe AD need to be further validated. More research should focus on clarifying the mechanism of deep brain stimulation. This study was registered with ***（NCT03115814） on April 14, 2017.

关键词： Alzheimer's disease deep brain stimulation fornix cognition memory mood performance early stage functional neurosurgery dementia

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Controversies around the treatment of peritoneal metastases of colorectal cancer

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World Journal of Gastrointestinal Oncology 2025年第1期17卷 260-264页

作者： Francisco J Morera-Ocon Clara Navarro-Campoy Ticiano Guastella Francisco Landete-Molina Department of general Surgery Hospital General de RequenaRequena 46340Spain Department of Gynecology and Obstetrics Hospital 9 OctubreValencia 46015Spain Department of Pathology Hospital General de RequenaRequena 46340Spain

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal *** resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal ***,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the *** tool is required in those patients to achieve more local control of the *** groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin *** patients present with complex surgical issues to manage,and consequently a large burden of complications has to be ***,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

关键词： Colorectal cancer Peritoneal metastasis Hyperthermic intraoperative chemotherapy Treatment strategies Peritoneal Surface Oncology GroupInternational

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The Influence of Emotions and Behavioral Theories behind Hand Hygiene in COVID-19 Pandemic

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Open Journal of Preventive Medicine 2021年第7期11卷 299-307页

作者： Sheng Chuu Anne Kiew Jia Lin Jacklyn Yek Prit Anand Singh Rajkumar Chandran Department of Anesthesiology and Intensive Care Unit Changi General Hospital Singapore

Background: Hand hygiene (HH) is essential in preventing healthcare-associated infections, especially during the COVID-19 pandemic, where SARS-CoV2 has shown the ability to survive on surfaces for days. In this study, we explore HH compliance rate and the factors associated with its increase during COVID-19 pandemic. Methods: HH compliance was assessed amongst doctors in Anesthesia and Surgical Intensive Care Unit by direct observation between 2018 and 2021. An anonymous survey was then sent to the doctors to understand factors influencing the observed improvement in HH compliance during the pandemic. Results: Compliance towards the five moments of HH has shown a statistically significant rising trend from a median HH compliance of 60% in 2018, to 70% in 2019 to 94% in 2020. However, HH compliance subsequently declined in the first quarter of 2021 to median of 87%. The follow-up survey had a response rate of 96% (n = 53). 90% of survey participants responded that their HH frequency had increased during the COVID-19 pandemic with 47% stating they were performing HH 11 - 20 times/day. 64% responded that this increased frequency had affected their skin condition. 62% responded that this increased frequency was sustainable even after the pandemic ends. Participants ranked considerations influencing HH compliance. “Prevent transmitting the infection to vulnerable patients” was ranked highest followed by “High infection rate”, “Fear of contracting COVID-19” and lastly, “Public health guidelines”. Conclusions: Despite the absence of new campaigns, HH compliance reached an all-time high. The pandemic has provided opportunity for behavioral change through “reflective” drivers of behavior such as emotions (“Fear”) and knowledge (“High infection rate”). Understanding the motivations behind current increased HH compliance and riding on the increased initial uptake of behavior may help convert HH into a habitual

关键词： Pandemics Hand Hygiene Infection Control Healthcare Associated Infection Fear Compliance Behavioral Theory

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Characteristics of fecal microbiota in non-alcoholic fatty liver disease patients

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Science China(Life Sciences) 2018年第7期61卷 770-778页

作者： Fan Li Gang Sun Zikai Wang Wenming Wu He Guo Lihua Peng Lili Wu Xu Guo Yunsheng Yang Department of Gastroenterology and Hepatology Chinese PLA General Hospital Department of Liver Disease PLA Army General Hospital Department of Gastroenterology General Hospital of Jinan Military Region

This study was designed to investigate the gut microbiota of patients with non-alcoholic fatty liver disease. The inclusive and exclusive criteria for NAFLD patients and healthy subjects were formulated, and detailed clinical data were collected. The genomic DNA of stool samples were extracted for 16 S r DNA sequencing, and the amplified V4-region was sequenced on the Illumina Miseq platform. Metastats analysis was performed to identify the differential taxa between the groups. Redundancy analysis was used to evaluate the association between gut microbial structure and clinical variables. Thirty NAFLD patients and37 healthy controls were involved. The 16 S r DNA sequencing showed that there was a dramatic variability of the fecal microbiota among all the individuals. Metastats analysis identified eight families and 12 genera with significant differences between the two groups. When some clinical parameters, such as waist-to-hip ratio(WHR) and homeostasis model assessment of insulin resistance(HOMA-IR), were enrolled in Redundancy analysis, the distribution of the two group of samples was obviously changed. The compositional shifts in fecal bacterial communities of NAFLD patients from the healthy controls were mainly at family or genus levels. According to our Redundancy analysis, insulin resistance and obesity might be closely related to both NAFLD phenotype and intestinal microecology.

关键词： non-alcoholic fatty liver disease bacterial microbiota 16S rDNA

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Expression of Wnt and NCX1 and its correlation with cardiomyocyte apoptosis in mouse with myocardial hypertrophy

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Asian Pacific Journal of Tropical Medicine 2015年第11期8卷 909-914页

作者： Jing He Yi Cai Leiming Luo Rong Wang Department of general Surgery PLA General Hospital

Objective:To study the correlation between expression of Wnt and NCXl and cardiomyocyte apoptosis in mouse with myocardial ***:C57B/16 male mice were given the subcutaneous injection of 1 mg/kg isoprenaline to build the myocardial hypertrophy *** 14 d of model building,mice were executed by cervical vertebra *** ratio of heart weight/body weight(HW/BW) and heart weight/tibia length(HW/TL) was observed and proved using HE staining mat detected the size of eaidiomyocytes.40 male C57B/16 mice were randomly divided into the sham group(normal saline) and model group(isoprenaline),with 20 mice in each *** terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling was applied to detect the cardiomyocyte apoptosis;while Western blot and immunohistochemistry were employed to detect the expression of Wnt and ***,the correlation between these two proteins and cardiomyocyte apoptosis was ***:Compared with the sham group,the ratio of HW/BW and HW/TL was increased in the model group,as well as the bigger and hypertrophied cardiomyocytes,decreased number and increased apoptosis of eaidiomyocytes,and increased positive expression of Wnt3 a,WntSa and NCXl in the cardiac muscle ***,there was positive correlation between the expression of Wnt and NCXl and the cardiomyocyte ***:The expression of Wnt3 a,Wnt5a and NCXl in mouse with myocardial hypertrophy is increased and positively correlated with the cardiomyocyte apoptosis.

关键词： Myocardial hypertrophy Wnt NCX1 Cardiomyocyte apop

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Recurrent orbital space-occupying lesions:a clinicopathologic study of 253 cases

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Chinese Journal of Cancer Research 2013年第4期25卷 423-429页

作者： Weiqiang Tang Yan Hei Lihua Xiao Department of Ophthalmology the First Hospital Affiliated to PLA General Hospital Institute of Orbital Diseases the General Hospital of the Armed Police Force

Objective：To analyze the clinical features,histopathologic classification and frequencies of various types of recurrent orbital space-occupying ***：A retrospective study was carried out in 253 consecutive patients with recurrent orbital spaceoccupying lesions treated by surgical excision in the Institute of Orbital Diseases,the general hospital of the Armed Police Force from January 2009 to December ***：The patients included 123 males and 130 females aged 2 to 78 years（mean,36.2 years）,and the last recurrence interval after operation ranged from 1 month to 40 years（median,4.75 years）.Of all the cases,159（62.8%）,65（25.7%）,20（7.9%）,8（3.2%） and 1（0.4%） had previously experienced once,twice,three,four and six times of surgeries,*** them,29（11.5%） cases had recurred 3 times or over,and 37（14.6%） cases got recurrence in 10 or more years *** of the patients with local recurrence presented with various clinical manifestations,while 31（12.3%） cases were *** hundred and thirty-one（91.3%） cases underwent surgical removal of the recurrent orbital lesions,and another 22（8.7%） cases had to receive the exenteration of *** of these recurrent orbital lesions after operation were as follows：lacrimal gland tumors,65（25.7%） cases;vasogenic diseases,54（21.3%） cases;neurogenic tumors,42（16.6%） cases;secondary tumors,24（9.5%） cases;orbital inflammation,21（8.3%） cases;myogenic tumors,14（5.5%） cases;fibrous and adipose tumors,12（4.7%） cases;lympho-hematopoietic tumors,7（2.8%） cases;bone or cartilage tumors,7（2.8%） cases;orbital cysts,6（2.4%） cases;and indefinitely differentiated tumor,1（0.4%） *** 10 top histopathologic diagnoses were lacrimal gland pleomorphic adenoma,hemangiolymphangioma,lacrimal gland adenoid cystic carcinoma,meningioma,inflammatory pseudotumor,neurofibroma,sebaceous gland carcinoma,vascular malformation,rhabdomyosarcoma and ***：The variety of recurrent orbital lesions a

关键词： Orbital space-occupying lesions recurrence lacrimal gland epithelial tumor vascular malformation orbital inflammatory lesions

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Irreversible electroporation for metastatic pancreatic carcinoma with liver metastasis:What does the evidence say

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World Journal of Clinical Cases 2025年第3期13卷 30-34页

作者： Ranit Seal Akash Bararia Bitan Kumar Chattopadhyay Nilabja Sikdar Department of general Surgery IPGME&R and SSKM HospitalKolkata 700020West BengalIndia Human Genetics Unit Indian Statistical InstituteKolkata 700108West BengalIndia Estaurine and Coastal Studies Foundation Howrah 711101India

Irreversible electroporation is a promising non-thermal ablation method that has been shown to increase overall survival in locally advanced pancreatic cancer in some ***,higher quality studies with proper controls and randomization are required to establish its superiority when added with neoadjuvant chemotherapy over the current management of choice,which is chemotherapy *** studies are required before establishment of any survival benefit in metastatic pancreatic carcinoma,and such evidence is lacking at present.

关键词： Irreversible electroporation Locally advanced pancreatic carcinoma Metastatic pancreatic carcinoma Advanced pancreatic carcinoma Chemotherapy

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Human umbilical cord Wharton's jelly-derived oligodendrocyte precursor-like cells for axon and myelin sheath regeneration

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Neural Regeneration Research 2013年第10期8卷 890-899页

作者： Hong Chen Yan Zhang Zhijun Yang Hongtian Zhang Department of Anesthesiology Military General Hospital of Beijing PLA Affiliated Bayi Brain hospital Military General Hospital of Beijing PLA

Human umbilical mesenchymal stem cells from Wharton＇s jelly of the umbilical cord were induced to differentiate into oligodendrocyte precursor-like cells in vitro. Oligodendrocyte precursor cells were transplanted into contused rat spinal cords. Immunofluorescence double staining indicated that transplanted cells survived in injured spinal cord, and differentiated into mature and immature oligodendrocyte precursor cells. Biotinylated dextran amine tracing results showed that cell transplantation promoted a higher density of the corticospinal tract in the central and caudal parts of the injured spinal cord. Luxol fast blue and toluidine blue staining showed that the volume of residual myelin was significantly increased at 1 and 2 mm rostral and caudal to the lesion epicenter after cell transplantation. Furthermore, immunofluorescence staining verified that the newly regenerated myelin sheath was derived from the central nervous system. Basso, Beattie and Bresnahan testing showed an evident behavioral recovery. These results suggest that human umbilical mesenchymal stem cell-derived oligodendrocyte precursor cells promote the regeneration of spinal axons and myelin sheaths.

关键词： neural regeneration stem cells spinal cord injury Wharton's jelly human umbilical mesenchymalstem cells oligodendrocyte precursor-like cells axon myelin sheath nerve repair grants-supportedpaper neuroregeneration

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An Audit of the Emergency Airway Service in a Regional hospital in Singapore

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Open Journal of Anesthesiology 2021年第7期11卷 195-206页

作者： Sheng Chuu Anne Kiew Hui Xin Marilyn Ng Kelvin How Yow Quek Jinxi Zheng Yeo Joanne Department of Anaesthesiology and Surgical Intensive Care Changi General Hospital Singapore

Background: Emergency endotracheal intubations (EEI) performed outside of operating theatre (OT) tend to be more challenging and associated with higher risk of complications. In 2011, with the objective of improving patient outcomes, we set up an Emergency Airway Service (EAS) at our 1000-bed regional hospital, with the aim of providing specialized assistance for outside of OT difficult airway management. Method: A retrospective audit of EAS activation from 12/9/2016 and 27/10/2020 was conducted. EAS forms and electronic medical records were reviewed. We collected information on patient characteristics, EAS activation characteristics and its outcomes. Descriptive analysis method was used to present the collected data. Results: There were a total of 275 activations, of which 268 were analysed. Reasons for activation were anticipated difficult intubation (42.2% n = 113), failed intubation attempt (52.6%, n = 141) and advanced intubation equipment required (5.2% n = 14). Intubation was attempted in 261/268 (97.4%) cases by the EAS team. Of these, 255 (97.7%) cases were successful while 6 (2.3%) cases failed intubation. Of the successful intubations by the EAS team, 208/255 (81.5%) were successful on the first attempt. Out of the 6 unsuccessful intubation cases, 1 case required a rescue cricothyroidotomy and 4 cases required an open tracheostomy. Intubation was deemed easy by the EAS team in 170/261 (65.1%) cases. 64/170 (37.6%) cases were intubated with a video laryngoscope (VL). There were 85 cases (32.3%) classified as difficult intubation by the EAS specialist, 13/85 (15.3%) were intubated using only VL, 54/85 (63.5%) cases were intubated using VL with style/bougie. Conclusion: Audit results showed that providing an experienced and well-equipped team of airway specialists round-the-clock to assist in difficult and potentially difficult endotracheal intubations is justifiable and may reduce complications associated with EEI.

关键词： Difficult Airway Emergency Endotracheal Intubation Airway Response Team Airway Service

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Interspace between the Popliteal Artery and the Capsule of the Knee (IPACK) Block for Anterior Cruciate Ligament Reconstruction Surgery: A Two Case Series

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Open Journal of Anesthesiology 2020年第4期10卷 134-143页

作者： Agnes Huang Prit Anand Singh Kwee Lian Woon Department of Anesthesia and Surgical Intensive Care Changi General Hospital Singapore

This case series describes the use of Interspace between the Popliteal Artery and the Capsule of the Knee (IPACK) block to provide motor-sparing analgesia for two consecutive patients undergoing anterior cruciate ligament reconstruction (ACLR) by the same surgeon. Case 1 demonstrates the use of a proximal IPACK block as a post-operative rescue block for a patient who still experienced severe pain despite having received a femoral nerve block and parenteral opioids. Case 2 describes the use of a modified IPACK block as part of a multimodal approach with opioid and motor sparing effects. In both cases, the IPACK block provided satisfactory pain relief in the immediate postoperative period without motor weakness, making it an effective analgesic method for day surgery. With the IPACK block shown to be an effective nerve block for ACLR, we explore other advantages, limitations and further research required to better define the role of this block.

关键词： IPACK Anterior Cruciate Ligament Reconstruction

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