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Ablative fractional CO_(2)laser surgery improving sleep quality,pain and pruritus in adult hypertrophic scar patients:a prospective cohort study

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Burns & Trauma 2021年第1期9卷 372-382页

作者： Kaiyang Lv Huazhen Liu Haiting Xu Caixia Wang Shihui Zhu Xiaozhen Lou Pengfei Luo Shichu Xiao Zhaofan Xia Department of Plastic Surgery Xinhua HospitalShanghai Jiao Tong University School of MedicineShanghai 200092People’s Republic of China Department of Burn Surgery the First affiliated Hospital to Naval Medical UniversityShanghai 200433People’s Republic of China Department of Burn and Plastic Surgery Shandong Provincial Hospital Affiliated to Shandong UniversityJinanShandong 250021People’s Republic of China Department of Plastic Surgery The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical UniversityWenzhouZhejiang 325000People’s Republic of China Shanghai institute of Laser Technology Shanghai 200233People’s Republic of China

Background:Poor sleep quality is associated with a decrease in quality of life in patients with major burn scars,combined with pruritus and *** interventions have been reported to improve the sleep quality of patients with *** the current prospective cohort study,we investigated the efficacy of CO_(2)-ablative fractional laser(AFL)surgery vs conventional surgery in post-burn patients with hypertrophic scars with sleep quality as the primary study ***:In total 68 consecutive patients undergoing scar surgical treatment were recruited,including a CO_(2)-AFL surgery cohort(n=35)and a conventional surgery cohort(n=33).A subgroup from the AFL cohort was *** quality,pain and pruritus were *** linear regression analyses were performed to reveal the effect of CO_(2)-AFL ***:The CO_(2)-AFL surgery cohort had significantly lower Pittsburgh sleep quality index(PSQI)global scores than the conventional surgery cohort after the last surgical *** the subgroup of patients receiving hardware sleep monitoring,CO_(2)-AFL markedly increased deep sleep time,deep sleep efficiency and reduced initial sleep *** to the conventional surgery cohort,the CO_(2)-AFL cohort presented significantly lower pain and pruritus *** analysis showed pain and pruritus were significantly associated with PSQI scores,and there were also significant correlations between pain and pruritus *** linear regression analysis showed that surgery method was negatively linearly correlated with visual analog scale(VAS)pain score,brief pain inventory(BPI)total,VAS pruritus score,5-D itch scale total,four-item itch questionnaire(FIIQ)total and PSQI ***:CO_(2)-AFL surgery significantly improved sleep quality and reduced pain and pruritus of hypertrophic scar *** alleviation of sleep disorder was associated with improvement of deep sleep quality including deep sleep time and deep sleep deficiency

关键词： Burn scar Ablative CO_(2)fractional laser Cardiopulmonary coupling Sleep quality Pain Pruritus

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Multi-Omics and Its Clinical Application in Hepatocellular Carcinoma:Current Progress and Future Opportunities

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Chinese Medical Sciences Journal 2021年第3期36卷 173-186页

作者： Wanshui Yang Hanyu Jiang Chao Liu Jingwei Wei Yu Zhou Pengyun Gong Bin Song Jie Tian Department of Nutrition School of Public HealthAnhui Medical UniversityHefei 230032China Department of Radiology West China HospitalSichuan UniversityChengdu 610041China Beijing Advanced Innovation Center for Big Data-Based Precision Medicine School of Medicine and EngineeringBeihang UniversityBeijing 100191China Key Laboratory of Big Data-Based Precision Medicine(Beihang University) Ministry of Industry and Information TechnologyBeijing 100191China Key Laboratory of Molecular Imaging Institute of AutomationChinese Academy of SciencesBeijing 100190China Beijing Key Laboratory of Molecular Imaging Beijing 100190China University of Chinese Academy of Sciences Beijing 100049China School of Life Science and Technology Xidian UniversityXi'an 710126China Engineering research Center of Molecular and Neuro Imaging of Ministry of Education School of Life Science and TechnologyXidian UniversityXi'an 710126China

Hepatocellular carcinoma(HCC)is the sixth most common malignancy and the fourth leading cause of cancer related death *** covers over half of cases,leading HCC to be a vital threaten to public *** advances in diagnosis and treatments,high recurrence rate remains a major obstacle in HCC ***-omics currently facilitates surveillance,precise diagnosis,and personalized treatment decision making in clinical ***-invasive radiomics utilizes preoperative radiological imaging to reflect subtle pixel-level pattern changes that correlate to specific clinical *** has been widely used in histopathological diagnosis prediction,treatment response evaluation,and prognosis ***-throughput sequencing and gene expression profiling enabled genomics and proteomics to identify distinct transcriptomic subclasses and recurrent genetic alterations in HCC,which would reveal the complex multistep process of the *** accumulation of big medical data and the development of artificial intelligence techniques are providing new insights for our better understanding of the mechanism of HCC via multi-omics,and show potential to convert surgical/intervention treatment into an antitumorigenic one,which would greatly advance precision medicine in HCC management.

关键词： hepatocellular carcinoma radiomics proteomics genomics multi-omics

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Genetic mechanisms of critical illness in Covid-19

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四川生理科学杂志 2020年第4期42卷 455-455页

作者： Erola Pairo-Castineira Roslin institute University of Edinburgh Edinburgh UK MRC Human Genetics Unit Institute of Genetics and Molecular Medicine University of Edinburgh Western General Hospital Edinburgh UK Genomics England London UK Centre for Inflammation research The Queen’s Medical Research Institute University of Edinburgh Edinburgh UK Centre for Genomic and Experimental Medicine Institute of Genetics and Molecular Medicine University of Edinburgh Western General Hospital Edinburgh UK Edinburgh Clinical research Facility Western General Hospital University of Edinburgh Edinburgh UK Intensive Care National Audit & research Centre London UK institute for Molecular Bioscience The University of Queensland Brisbane Queensland Australia Biostatistics Group School of Life Sciences Sun Yat-sen University Guangzhou China The Crick institute London UK Intensive Care Unit Royal Infirmary of Edinburgh Edinburgh UK School of Life Sciences Westlake University Hangzhou China Westlake Laboratory of Life Sciences and Biomedicine Hangzhou China Wellcome Centre for Human Genetics University of Oxford Oxford UK Department of Medicine University of Cambridge Cambridge UK Department of Intensive Care Medicine Guy’s and St Thomas’ NHS Foundation Trust London UK School of Immunology and Microbial Sciences King’s College London London UK NIHR Health Protection research Unit for Emerging and Zoonotic Infections Institute of Infection Veterinary and Ecological Sciences University of Liverpool Liverpool UK MRC-University of Glasgow Centre for Virus research Institute of Infection Immunity and Inflammation College of Medical Veterinary and Life Sciences University of Glasgow Glasgow UK William Harvey research institute Barts and the London School of Medicine and Dentistry Queen Mary University of London London UK Centre for Tropical Medicine and Global Health Nuffield Department of Medicine University of Oxford Oxford UK Clinical research Centre at St Vincent’s University Hospital Un

Host-mediated lung inflammation is present,1 and drives mortality,2 in critical illness caused by *** genetic variants associated with critical illness may identify mechanistic targets for therapeutic development.3 Here we report the results of the GenOMICC(Genetics Of Mortality In Critical Care)genome-wide association study(GWAS)in 2244 critically ill Covid-19 patients from 208 UK intensive care units(ICus).We identify and replicate novel genome-wide significant associations,on chr12q24.13(rs10735079,p=1.65[Formula:see text]10-8)in a gene cluster encoding antiviral restriction enzyme activators(OAS1,OAS2,OAS3),on chr19p13.2(rs2109069,p=2.3[Formula:see text]10-12)near the gene encoding tyrosine kinase 2(TYK2),on chr19p13.3(rs2109069,p=3.98[Formula:see text]10-12)within the gene encoding dipeptidyl peptidase 9(DPP9),and on chr21q22.1(rs2236757,p=4.99[Formula:see text]10-8)in the interferon receptor gene *** identify potential targets for repurposing of licensed medications:using Mendelian randomisation we found evidence in support of a causal link from low expression of IFNAR2,and high expression of TYK2,to life-threatening disease;transcriptome-wide association in lung tissue revealed that high expression of the monocyte/macrophage chemotactic receptor CCR2 is associated with severe *** results identify robust genetic signals relating to key host antiviral defence mechanisms,and mediators of inflammatory organ damage in *** mechanisms may be amenable to targeted treatment with existing ***-scale randomised clinical trials will be essential before any change to clinical practice.

关键词： lung drugs critical

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High-risk corneal allografts: A therapeutic challenge

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World Journal of Transplantation 2016年第1期6卷 10-27页

作者： Tian Yu Vijayalakshmi Rajendran May Griffith John V Forrester Lucia Kuffová Section of Immunity Infection and Inflammation Division of Applied Medicine School of Medicine and Dentistry Institute of Medical Sciences University of Aberdeen Integrative Regenerative Medicine Centre Depart-ment of Clinical and Experimental Medicine Linkoping University Department of Ophthalmology Maisonneuve- Rosemont Hospital Ocular Immunology Program Centre for Ophthalmology and Visual Science University of Western Australia

Corneal transplantation is the most common surgical procedure amongst solid organ transplants with a high survival rate of 86% at 1-year post-grafting. This high success rate has been attributed to the immune privilege of the eye. However, mechanisms originally thought to promote immune privilege, such as the lack of antigen presenting cells and vessels in the cornea, are challenged by recent studies. Nevertheless, the immunological and physiological features of the cornea promoting a relatively weak alloimmune response is likely responsible for the high survival rate in "low-risk" settings. Furthermore, although corneal graft survival in "lowrisk" recipients is favourable, the prognosis in "high-risk" recipients for corneal graft is poor. In "high-risk" grafts, the process of indirect allorecognition is accelerated by the enhanced innate and adaptive immune responses due to pre-existing inflammation and neovascularization of the host bed. This leads to the irreversible rejection of the allograft and ultimately graft failure. Many therapeutic measures are being tested in pre-clinical and clinical studies to counter the immunological challenge of "high-risk" recipients. Despite the prevailing dogma, recent data suggest that tissue matching together with use of systemic immunosuppression may increase the likelihood of graft acceptance in "high-risk" recipients. However, immunosuppressive drugs are accompanied with intolerance/side effects and toxicity, and therefore, novel cell-based therapies are in development which target host immune cells and restore immune homeostasis without significant side effect of treatment. In addition, developments in regenerative medicinemay be able to solve both important short comings of allotransplantation:(1) graft rejection and ultimate graft failure; and(2) the lack of suitable donor corneas. The advances in technology and research indicate that wider therapeutic choices for patients may be available to address the worldwide problem

关键词： "High-risk" grafts Graft rejection Systemic immunosuppression Cell-based immunomodulation Keratoprosthesis Collagen-based hydrogels

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The feasibility, effectiveness and safety of totally thoracoscopic resection for right atrial myxoma

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South China Journal of Cardiology 2019年第4期20卷 236-244页

作者：何标川周勘陈泽锐柯英杰黄焕雷 Department of Cardiovascular Surgery Guangdong Provincial People’s Hospital Guangdong Cardiovascular Institute Guangdong Provincial Key Laboratory of South China Structural Heart Disease Guangdong Academy of Medical Sciences Department of Cardiovascular Surgery Guangdong Provincial People’s Hospital’s Nanhai Hospital The Second People’s Hospital of Nanhai District

Background Myxoma is the most frequent cardiac benign tumor which requires surgical removal even though in right atrium. Minimally invasive surgery has become the standard approach for removal of myxoma in our center. Herein, we report our initial experience of cardiac myxoma removal through mini-port totally thoracoscopic particular with focus on its feasibility, efficacy and short-term outcomes, as compared with median sternotomy. Methods From April 2015 to March 2019, 31 consecutive cases were ultimately identified and divided into two groups(Mini-port thoracoscopic group, n=14;versus conventional median sternotomic group, n=17). An echocardiography was routinely performed prior to discharge, at 1 st month, 6 th month, 12 th month and every year postoperatively. Retrospective analyses of perioperative data, postoperative outcomes and complications,and follow up data were performed. Results All the 31 patients successfully underwent right atrial myxoma removal surgery with no perioperative death, re-exploration for bleeding, residual mass or central nervous event in both groups. Intraoperative data from two group showed absence of significant difference except the intraoperative blood loss(150±50.01 m L in mini-port thoracoscopic group vs. 255.88±93.35 m L in conventional median sternomtomic group, P=0.01). There was no significant difference in perioperative blood transfusion and postoperative outcomes between the two groups. But the mini-port thoracoscopic group had a much less 24-hour postoperative drainage(136.71±148.20 m L vs. 341.17±211.29 m L, P=0.03). No significance difference could be identified between two groups about the incidence of postoperative morbidities and follow-up adverse events. Conclusion Totally mini-port video-assisted thoracoscopic approach for right atrial myxoma resection on peripheral cardiopulmonary bypass is feasible, effective with favorable safety in experienced cardiac center.[S Chin J Cardiol 2019;20(4):236-244]

关键词： myxoma right atrial tumor removal minimally invasive thoracoscopic cardiac surgery

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Predictive analytics with ensemble modeling in laparoscopic surgery:A technical note

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Laparoscopic, Endoscopic and Robotic Surgery 2022年第1期5卷 25-34页

作者： Zhongheng Zhang Lin Chen Ping Xu Yucai Hong Department of Emergency Medicine Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of Critical Care Medicine Jinhua Hospital of Zhejiang University School of MedicineJinhua 321000China Emergency Department Zigong Fourth People's HospitalZigong 643000China institute of Medical Big Data Zigong Academy of Artificial Intelligence and Big Data for Medical Science Artificial IntelligenceZigong 643000China Artificial Intelligence Key Laboratory of Sichuan Province Zigong 643000China

Predictive analytics have been widely used in the literature with respect to laparoscopic surgery and risk ***,most predictive analytics in this field exploit generalized linearmodels for predictive purposes,which are limited by model assumptionsdincluding linearity between response variables and additive interactions between *** many instances,such assumptions may not hold true,and the complex relationship between predictors and response variables is usually *** address this limitation,machine-learning algorithms can be employed to model the underlying *** advantage of machine learning algorithms is that they usually do not require strict assumptions regarding data structure,and they are able to learn complex functional forms using a nonparametric ***,two or more machine learning algorithms can be synthesized to further improve predictive *** a process is referred to as ensemble modeling,and it has been used broadly in various ***,this approach has not been widely reported in the laparoscopic surgical literature due to its complexity in both model training and *** this technical note,we provide a comprehensive overview of the ensemble-modeling technique and a step-by-step tutorial on how to implement ensemble modeling.

关键词： Ensemble modeling Laparoscopic surgery Machine learning

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Brief potentially ictal rhythmic discharges on intraoperative electrocorticography predict a good outcome of focal cortical dysplasia after surgical resection: a case report

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Acta Epileptologica 2023年第3期6卷 163-167页

作者： Sofía S.Sánchez‑Boluarte Wilfor Aguirre‑Quispe Manuel Herrera Aramburú William O.Tatum Walter De La Cruz Ramírez School of Medicine Cesar Vallejo UniversityAv.Victor LarcoTrujilloTrujillo 1770Peru Departamento de Epilepsia Instituto Nacional de Ciencias NeurológicasJr.Ancash 1271LimaLima 15001Peru Neurosciences Clinical Effectiveness and Public Health Research GroupUniversidad Científica del SurPanamericana Sur 19Villa EL SalvadorLimaLima 15067Peru Department of Neurology Mayo ClinicMangurian Bldg.Fourth Floor4500 San Pablo RoadFL 32224 JacksonvilleUSA

Background Focal cortical dysplasia(FCD)is a common cause of drug-resistant ***(EEG)biomarkers that predict good postoperative outcomes are essential for identifying patients with focal *** presentation We report the case of a 21-year-old female with seizure onset at the age of 9,characterized by left-hand dystonic posturing and impaired awareness,which evolved to bilateral tonic-clonic seizures,evaluated in a neurological referral center in Lima,*** 6-h video-EEG,interictal EEG revealing focal brief potentially ictal rhythmic discharges(BIRDs)over the right frontal central region,lasting less than 10 *** ictal features were characterized by low-voltage fast activity over the same *** magnetic resonance imaging(MRI)demonstrated a focal lesion of focal cortical dysplasia type II in the right frontal *** patient underwent a lesionectomy guided by electrocorticography,which showed continuous *** showing a brief burst of spikes lasting longer than 0.5 s,were also identified on intraoperative electrocorticography(ECoG)and helped define the extent of *** patient obtained an Engel Outcome Class IA at 6 years of *** The atypical BIRDs on ECoG can be used as a prognostic biomarker for prolonged seizure-freedom outcome in patients with *** reports are needed in developing countries with and without brain MRI lesions to advance outpatient presurgical evaluations despite limited resources.

关键词： Electrocorticography Cortical dysplasia-focal epilepsy syndrome Drug-resistant epilepsy Frontal lobe epilepsy

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Predictive value of initial procalcitonin level in perioperative period of critically ill cancer patients

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Precision Medicine research 2022年第1期4卷 14-18页

作者： Yu-Lin Wu Cui-Han Wang Yan-Kun Zhang Xiao-Wu Zhang Rui Xia Shan-Shan Lin Bei-Tian Jia Ya-Meng Cui Dong-Hao Wang Tianjin Medical University Cancer institute and Hospital Tianjin 300060China Tianjin Hospital of Integration of Taditional Chinese and Western Medicine&Nankai Hospital Tianjin 300102China Tianjin Fourth Central Hospital Tianjin 300142China Tianjn University of Traditional Chinese Medicine Tianjin301617China

The predictive value of the initial procalcitonin(PCT)level was explored in the perioperative peniod of citically ill cancer ***:It is quite important to predict infections in patients in the intensive care unit (ICU).Cancer surgery is characterized by large trauma,long duration,and wide operation scope;and there are many inflammatory factors in the *** manifestations of systermic inflammatory response syndrome(SIRS)。such as fever,elevated white blood cells,and elevated infammatory indicators,frequently occur in patients during the penioperative period as a result of the above *** factors are diverse and complex;additionally,advanced cancer and the trauma of major surgery are important factors that influence PCT blood *** all of the aforementioned factors make it dificult to distinguish the postoperative inflammatory response fom the true infection in clinical practice,conventional methods cannot prediet disease sevenity or disease ***:A total of 53 patients with endotracheal intubation admitted to the ICU of Tianjin Medical University Cancer institute and Hospital from January 2020 to May 2020,were retrospectively *** to the patient source,35 cases were assigned to ORIG(Operating Room to ICU Group),and 18 cases were assigned to General Ward to ICU group(GWO).At the ICU admission,the patient's age,sex,surgical site of tumor,reason for ICU and other data were recorded to form a database;PCT,B-type natiuretic peptide(BNP),high sensitivity toponin I(hsTni),serumn creatinine(Cr),serum cystatin C(Cys-c)and other laboratory indicators were detected;scores of acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and sequential organ failure assessment(SOFA)were marked 24 h after ICU admission;Proportion of Antibiotics,Time Antibiotic Application,and Time Indicators(Ventilator support Time,Endotracheal Intubation Time,ICU Stay Time)were recorded during the period from ICU admission to ICU discharge.

关键词： critically ill cancer patients perioperative period mechanical ventilation procalcitonin disease severity

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Role of molecular biomarkers in glioma resection: a systematic review

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Chinese Neurosurgical Journal 2020年第2期6卷 103-109页

作者： Lianwang Li Yinyan Wang Yiming Li Shengyu Fang Tao Jiang Beijing Neurosurgical institute Capital Medical UniversityNo.119 South 4th Ring West RoadFengtai DistrictBeijing 10070China Department of Neurosurgery Beijing Tiantan HospitalCapital Medical UniversityNo.119 South 4th Ring West RoadFengtai DistrictBeijing 10070China

New discoveries based on genetic and epigenetic evidence have significantly expanded the understanding of diffuse *** biomarkers detected in diffuse gliomas are not only potential targets for radiotherapy,chemotherapy,and immunotherapy,but are also able to guide surgical *** studies have suggested that the optimal extent of resection of diffuse gliomas varies according to the expression of specific molecular ***,the specific guiding role of these biomarkers in the resection of diffuse gliomas has not been systemically *** review summarizes several critical molecular biomarkers of tumorigenesis and progression in diffuse gliomas and discusses different strategies of tumor resection in the context of varying genetic *** ongoing study and advances in technology,molecular biomarkers will play a more important role in glioma resection and maximize the survival benefit from surgery for diffuse gliomas.

关键词： Glioma Molecular biomarkers Guidance Resection

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Expert consensus on drug treatment of chronic subdural hematoma

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Chinese Neurosurgical Journal 2022年第1期8卷 51-59页

作者： Jianning Zhang Chinese Society of Neurosurgery Chinese Medical Association Chinese Neurosurgical Critical Care Specialist Council Collaborational Group of Chinese Neurosurgical Translational and Evidence-based Medicine Department of Neurosurgery Tianjin Medical University General HospitalTianjin 300052China Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System Ministry of EducationTianjin 300052China Tianjin Key Laboratory of Injuries Variations and Regeneration of Nervous SystemTianjin 300052China Tianjin Neurological institute Tianjin 300052China 不详

Chronic subdural hematoma(CSDH)is a chronic space-occupying lesion formed by blood accumulation between arachnoid and dura mater,which is usually formed in the third week after traumatic brain *** treatment is usually the first choice for patients with CSDH having a significant space-occupying *** of the patients showed good results of surgical treatment,but still some patients had a postoperative recurrence(the recurrence rate was up to 33%).Because CSDH is often seen in the elderly,patients are weak and have many basic *** risk of surgical treatment is high;serious complications and even death(the death rate is up to 32%)can often *** overall good prognosis rate of patients aged more than 90 years is 24%.The drug treatment can provide a safe and effective treatment for elderly patients who are weak,intolerable to surgery,or failed in ***-dose and long-term use of atorvastatin(20mg/d)is suggested for continuous treatment for at least 8 weeks,while low-dose and short-term use of dexamethasone can improve the therapeutic effect of atorvastatin on *** should undergo CT or MRI scanning at least one time within 2 weeks after the start of drug treatment.

关键词： CSDH treatment drug death

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