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Delaying surgery after neoadjuvant chemoradiotherapy improves prognosis of rectal cancer

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World Journal of Gastrointestinal Oncology 2016年第9期8卷 695-706页

作者： Mehmet Mihmanli Esin Kabul Gürbulak Ismail Ethem Akgün Mustafa Fevzi Celayir Pinar Yazici Deniz Tuncel Tuba Tülin Bek Ayhan Oz Sinan Omeroglu department of General Surgery Sisli Etfal Training and Research Hospital department of Pathology Sisli Etfal Training and Research Hospital department of Radiation Oncology Sisli Etfal Training and Research Hospital

AIM To investigate the prognostic effect of a delayed interval between neoadjuvant chemoradiotherapy(CRT) and surgery in locally advanced rectal *** We evaluated 87 patients with locally advanced mid-or distal rectal cancer undergoing total mesorectal excision following an interval period after neoadjuvant CRT at ?i?li Hamidiye Etfal training and Research Hospital,Istanbul between January 2009 and January *** were divided into two groups according to the intervalbefore surgery: < 8 wk(group Ⅰ) and ≥ 8 wk(group Ⅱ).Data related to patients,cancer characteristics and pathological examination were collected and *** When the distribution of timing between group Ⅰ(n = 45) and group Ⅱ(n = 42) was viewed,comparison of interval periods(median ± SD) of groups showed a significant difference of as 5 ± 1.28 wk in group Ⅰ and 10.1 ± 2.2 wk in group Ⅱ(P < 0.001).The median follow-up period for all patients was 34.5(9.9-81) *** Ⅱ had significantly higher rates of pathological complete response(p CR) than group Ⅰ had(19% vs 8.9%,P = 0.002).Rate of tumor regression grade(TRG) poor response was 44.4% in group Ⅰ and 9.5% in group Ⅱ(P < 0.002).A poor pathological response was associated with worse disease-free survival(P = 0.009).The interval time did not show any association with local recurrence(P = 0.79).CONCLUSION Delaying the neoadjuvant CRT-surgery interval may provide nodal down-staging,improve p CR rate,and decrease the rate of TRG poor response.

关键词： Rectal carcinoma Pathological tumor response Neoadjuvant chemoradiotherapy Interval timing Tumor down-staging

Prediction of early recurrence of hepatocellular carcinoma after liver transplantation based on computed tomography radiomics nomogram

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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 543-550页

作者： Jing-Wei Zhao Xin Shu Xiao-Xia Chen Jia-Xiong Liu Mu-Qing Liu Ju Ye Hui-Jie Jiang Gui-Sheng Wang department of Radiology the Third Medical CenterChinese PLA General HospitalThe Training Site for Postgraduate of Jinzhou Medical UniversityBeijing 100039China department of Radiology the Third Medical CenterChinese PLA General HospitalBeijing 100039China medical School of Chinese PLA Beijing 100853China department of Radiology the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China

Background:Early recurrence results in poor prognosis of patients with hepatocellular carcinoma(HCC)after liver transplantation(LT).This study aimed to explore the value of computed tomography(CT)-based radiomics nomogram in predicting early recurrence of patients with HCC after ***:A cohort of 151 patients with HCC who underwent LT between December 2013 and July 2019 were retrospectively enrolled.A total of 1218 features were extracted from enhanced CT *** least absolute shrinkage and selection operator algorithm(LASSO)logistic regression was used for dimension reduction and radiomics signature *** clinical model was constructed after the analysis of clin-ical factors,and the nomogram was constructed by introducing the radiomics signature into the clinical *** predictive performance and clinical usefulness of the three models were evaluated using re-ceiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),***-bration curves were plotted to assess the calibration of the ***:There were significant differences in radiomics signature among early recurrence patients and non-early recurrence patients in the training cohort(Ptraining(0.882)and validation(0.917)***-Lemeshow testing confirmed that the nomogram showed good calibration in the training(P=0.138)and validation(P=0.396)*** showed if the threshold probability is within 0.06-1,the nomogram had better clinical usefulness than the clinical ***:Our CT-based radiomics nomogram can preoperatively predict the risk of early recurrence in patients with HCC after LT.

关键词： Radiomics Nomogram Liver transplantation Early recurrence Hepatocellular carcinoma

Dynamic Changes in Left and Right Cerebral Oxygen Saturation during Selective Cerebral Perfusion in Young Infants

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Congenital Heart Disease 2023年第6期18卷 639-647页

作者： Hwa-Young Jang Sang-Jun Beon Sung-Hoon Kim In-Kyung Song Won-Jung Shin department of Anesthesiology and Pain Medicine Laboratory for Cardiovascular DynamicsAsan Medical CenterUniversity of Ulsan College of MedicineSeoul05505Korea department of Physician Education and training Asan Medical CenterSeoul05505Korea

Objectives:We investigated whether the selective cerebral perfusion(SCP)technique causes differences in changes in cerebral perfusion between both hemispheres in young infants,using cerebral oxygen saturation(ScO2)as an ***,we determined the association between the discrepancy in ScO2 and cerebral perfu-sion pressure during ***:The difference in ScO2 between the left and right cerebral hemispheres(ΔScO2 Rt-Lt)was calculated during clamping of the innominate artery(IA)and during ***:In 25 infants(aged 2 to 78 days),the left and right ScO2 were well maintained(median 63.2%and 60.9%during IA clamping,respectively;64.0%and 65.6%during SCP,respectively).During IA clamping,right and left ScO2 decreased(med-ian-1.4%and-1.0%,respectively).During SCP,rightΔScO2 was higher compared to leftΔScO2(median 1.5%vs.0.6%;p<0.001).Eight patients had a higher rightΔScO2 than leftΔScO2 throughout *** had lowerΔScO2 Rt-Lt during IA clamping(median-3.2%vs.0.0%;p<0.001)and higherΔScO2 Rt-Lt during SCP than others(median 5.0%vs.-0.8%;p<0.001).During and after SCP,the correlation coefﬁcient between rightΔScO2 and change in the mean arterial pressure was higher in patients with a discrepancy than in others(r=0.731 vs.r=0.519;p<0.001).Conclusions:This study suggests that SCP permits adequate bilateral cerebral ***,the unilateral cerebral perfusion technique may cause a difference in cerebral perfusion between both hemispheres in young infants;this may depend on the perfusion pressure.

关键词： Cerebral circulation congenital heart defects monitoring near-infrared spectroscopy

Lamina cribrosa thickness in children with hyperopic anisometropic amblyopia

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International Journal of Ophthalmology(English edition) 2018年第10期11卷 1663-1667页

作者： Serkan Akkaya department of Ophthalmology Kayseri Training and Research Hospital

AIM：To determine lamina cribrosa thickness（LCT）in the optic nerve head region of the eyes in children with hyperopic anisometropic amblyopia and to compare this thickness with that of fellow eyes,hyperopic nonamblyopia,and age-matched ***：Thirty-two patients（12.0±1.8y,mean±standard deviation）with hyperopic anisometropic amblyopia,31 subjects with age-and refractive error-matched hyperopic non-amblyopia（10.7±2.2y）,and 32 age-matched controls（11.2±2.0y）were included in this prospective,crosssectional *** was measured using an enhanced depth-imaging program of a spectral domain optical coherence tomographic instrument in all participants,and the correlation between LCT and axial length was ***：The mean LCT was 180.9±29.4μm in amblyopic eyes,247.7±19.0μm in fellow eyes,251.6±27.3μm in hyperopic non-amblyopic eyes,and 240.2±15.8μm in control *** cribrosa in amblyopic eyes was significantly thinner than fellow,hyperopic non-amblyopic,and control eyes（P〈0.05）.There was no significant correlation in LCT and axial length between amblyopic（P=0.16）and control（P=0.31）***：Lamina cribrosa of eyes with hyperopic anisometropic amblyopia is significantly thinner than that of fellow eyes,hyperopic non-amblyopia,and age-matched *** LCT profile in amblyopic eyes is different from that observed in fellow,hyperopic non-amblyopic,and control eyes.

关键词： anisometropia amblyopia hyperopia lamina cribrosa optical coherence tomography

Predictive value of C-reactive protein/albumin ratio in acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2017年第4期16卷 424-430页

作者： Mustafa Kaplan Ihsan Ates Muhammed Yener Akpinar Mahmut Yuksel Ufuk Baris Kuzu Sabite Kacar Orhan Coskun Ertugrul Kayacetin department of Gastroenterology Turkey Yuksek Ihtisas Training and Research HospitalAnkara 06100Turkey department of Internal Medicine Ankara Numune Training and Research HospitalAnkara 06100Turkey

BACKGROUND:Serum C-reactive protein(CRP) increases and albumin decreases in patients with inflammation and ***,their role in patients with acute pancreatitis is not *** present study was to investigate the predictive significance of the CRP/albumin ratio for the prognosis and mortality in acute pancreatitis ***:This study was performed retrospectively with 192 acute pancreatitis patients between January 2002 and June *** scores,Atlanta classification and CRP/albumin ratios of the patients were ***:The CRP/albumin ratio was higher in deceased patients compared to *** CRP/albumin ratio was positively correlated with Ranson score and Atlanta classification in particular and with important prognostic markers such as hospitalization time,CRP and erythrocyte sedimentation *** addition to the CRP/albumin ratio,necrotizing pancreatitis type,moderately severe and severe Atlanta classification,and total Ranson score were independent risk factors of *** was found that an increase of 1 unit in the CRP/albumin ratio resulted in an increase of 1.52 times in mortality risk.A prediction value about CRP/albumin ratio >16.28 was found to be a significant marker in predicting mortality with 92.1% sensitivity and 58.0% *** was seen that Ranson and Atlanta classification were higher in patients with CRP/albumin ratio >16.28 compared with those with CRP/albumin ratio ≤*** with CRP/albumin ratio >16.28 had a 19.3 times higher chance of ***:The CRP/albumin ratio is a novel but promising,easy-to-measure,repeatable,non-invasive inflammationbased prognostic score in acute pancreatitis.

关键词： Atlanta classification C-reactive protein Glasgow prognostic score Ranson score acute pancreatitis

Disease that should be remembered: Sacrococcygeal pilonidal sinus disease and short history

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World Journal of Clinical Cases 2015年第10期3卷 876-879页

作者： Burhan Hakan Kanat Selim S?zen department of General Surgery Elaz?g Training and Research Hospital department of General Surgery Medical FacultyNam?k Kemal University

Pilonidal sinus disease has led to heated debates since it was first described in the medical literature. Although a consensus has been built on its etiology and pathogenesis, the same course has not progressed for treatment modality. This review is a short article about the process of pilonidal sinus disease from past to present. Some important points were mentioned between the years 1833, which is accepted as the milestone for the awareness of the disease, in which it was first reported until the year of 1880, in which it was given its name. Although its name has been the same for about two centuries, some other names such as "Jeep Disease" have also been used depending on the population affected by the disease. At present, it is indisputable that the disease is acquired. Large series were presented about the treatment in the last two decades. Some surgical methods were even named after the ones who first described them and they have many supporters. However, since the treatment modalities have some advantages and disadvantages and they do not have marked superiority over others, debates still continue. We hope that pilonidal sinus disease will not lose its significance and be underrated in parallel with the developments in technology and specialization in medicine.

关键词： Pilonidal sinus History Anorectal disease

Clinical characteristics of intermediate uveitis in adult Turkish patients

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International Journal of Ophthalmology(English edition) 2015年第4期8卷 759-763页

作者： Esra Kardes Betul Ilkay Sezgin Akcay Kansu Bozkurt Cihan Unlu Gurkan Erdogan Gulunay Akcali department of Ophthalmology Umraniye Research and Training Hospital

·AIM: To describe the clinical characteristics of Turkish patients with intermediate uveitis(IU) and to investigate the effect of clinical findings and complications on final visual acuity(VA).·METHODS: We retrospectively analyzed the medical records of patients with IU who had at least 6mo of follow-up and were older than 16 y.· RESULTS: A total of 78 eyes of 45 patients were included in the study and the mean follow-up period was19.4mo. The mean age at the time of presentation was42.9s. Systemic disease associations were found in17.7% of cases; sarcoidosis(8.8%) and multiple sclerosis(6.6%) were the most common diseases. Recurrence rate(odds ratio=45.53; 95%CI: 2.181-950.58), vitritis equals to or more than 3+ cells(odds ratio =57.456; 95%CI: 4.154-794.79) and presenting with VA less than 20/40(odds ratio =43.81; 95% CI: 2.184-878.71) were also found as high risk factors for poor final VA. At the last follow-up examination, 67.9% of eyes had VA of 20/40 or better.·CONCLUSION: IU is frequently seen at the beginning of the fourth decade of life. The disease is most commonly idiopathic in adult Turkish patients. Patients with severe vitritis at presentation and patients with frequent recurrences are at high risk for poor visual outcome.

关键词： intermediate uveitis Turkish adult

Application of imaging techniques in pancreaticobiliary maljunction

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World Journal of Clinical Cases 2022年第22期10卷 7642-7652页

作者： Jin-Ye Wang Pei-Yuan Mu Ye-Kai Xu Yuan-Yuan Bai Dong-Hua Shen department of Hepatobiliary Surgery Postgraduate Training Base of Jinzhou Medical UniversityThe PLA Rocket Force Characteristic Medical CenterBeijing 100088China department of Hepatobiliary Surgery The PLA Rocket Force Characteristic Medical CenterBeijing 100088China department of Ultrasound The PLA Rocket Force Characteristic Medical CenterBeijing 100088China

Imaging techniques are useful tools in the diagnosis and treatment of pancreaticobiliary maljunction(PBM).PBM is a precancerous lesion often relative to the disease of the pancreas and biliary tract,for example,cholecystolithiasis,protein plugs,and *** patients with PBM,early diagnosis and timely treatment are highly important,which is largely dependent on imaging *** continuous development of imaging techniques,including endoscopic retrograde cholangiopancreatography,magnetic resonance cholangiopancreatography,computed tomography,ultrasound,and intraoperative cholangiography,has provided appropriate diagnostic and therapeutic tools for *** techniques,including non-invasive and invasive,have distinct advantages and *** purpose of this paper is to review the application of various imaging techniques in the diagnosis and treatment of PBM.

关键词： Pancreaticobiliary maljunction Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography Ultrasound Computed tomography Intraoperative cholangiography

Effects of mesencephalic astrocyte-derived neurotrophic factor on sepsis-associated acute kidney injury

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World Journal of Emergency Medicine 2023年第5期14卷 386-392页

作者： Saifeng Chen Xuewei Hao Guo Chen Guorong Liu Xiaoyan Yuan Peiling Shen Dongfeng Guo Postgraduate training Base at Shanghai Gongli Hospital Ningxia Medical CollegeShanghai 200135China department of Emergency Medicine Shanghai Gongli HospitalShanghai 200135China

BACKGROUND:To determine the protective role of mesencephalic astrocyte-derived neurotrophic factor(MANF) in regulating sepsis-associated acute kidney injury(S-AKI).METHODS:A total of 96 mice were randomly divided into the control group,control+MANF group,S-AKI group,and S-AKI+MANF *** S-AKI model was established by injecting lipopolysaccharide(LPS) at 10 mg/kg ***(200 μg/kg) was administered to the control+MANF and S-AKI+MANF *** equal dose of normal saline was administered daily intraperitoneally in the control and S-AKI *** and kidney tissue samples were obtained for biochemical *** blotting was used to detect the protein expression of MANF in the kidney,and enzyme-linked immunosorbent assay(ELISA) was used to determine expression of MANF in the serum,pro-inflammatory cytokines(tumor necrosis factor-α [TNF-α] and interleukin-6 [IL-6]).Serum creatinine(SCr),and blood urea nitrogen(BUN)were examined using an automatic biochemical *** addition,the kidney tissue was observed for pathological changes by hematoxylin-eosin *** comparison between two groups was performed by unpaired Student’s t-test,and statistics among multiple groups were carried out using Tukey’s post hoc test following one-way analysis of variance(ANOVA).A P-value <0.05 was considered statistically ***:At the early stage of S-AKI,MANF in the kidney tissue was up-regulated,but with the development of the disease,it was *** function was worsened in the S-AKI group,and TNF-α and IL-6 were *** administration of MANF significantly alleviated the elevated levels of SCr and BUN and inhibited the expression of TNF-α and IL-6 in the *** pathological changes were more extensive in the S-AKI group than in the S-AKI+MANF ***:MANF treatment may significantly alleviate renal injury,reduce the inflammatory response,and alleviate or reverse kidney tissue *** may have a protective

关键词： Sepsis-associated acute kidney injury Mesencephalic astrocyte-derived neurotrophic factor Renal function Cytokines Endoplasmic reticulum stress