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Hypertension and Heart Failure as Predictors of Mortality in an Adult Congenital Heart Defect Population

Congenital Heart Disease 2021年第4期16卷 333-355页

作者： Cheryl Raskind-Hood Kashaine A.Gray Jayne Morgan Wendy M.Book Department of Epidemiology Emory School of Public HealthAtlantaGeorgiaUSA Department of Public Health Mercer University College of Health ProfessionsAtlantaGeorgiaUSA division of Cardiovascular Research Piedmont HospitalAtlantaGeorgiaUSA division of Cardiology Emory University School of MedicineAtlantaGeorgiaUSA

Early intervention to prevent premature mortality is vital for adults with congenital heart defects(CHD).Anatomic complexity and comorbid conditions are thought to contribute to CHD *** hypertension(HTN)and heart failure(HF)are the comorbid conditions among the most prevalent causes of death in the United States,and commonly accompany CHD,it is crucial to evaluate whether they are reliable predictors of mortality for adults with CHD(ACHD)independent of anatomic CHD complexity.A retrospective cross-sectional analysis of ACHD,aged 18–64,with concomitant HTN and/or HF and at least one health care encounter during 2008–2010 were *** 5,397 ACHD patients(18.3%HTN without HF,4.4%HF without HTN,8.3%with both),3.0%died(n=163)during the study ***,the sample was 45.1%white,61.4%female,and 29.0%had a complex *** those who died,23.3%had HTN without HF,17.2%had HF without HTN,and 42.3%had *** analyses revealed that older age,male gender,black race,and having public health insurance were associated with increased mortality during the three-year study period compared to ACHD patients who were younger,female gender,white race,and covered by private health *** patients diagnosed with non-complex CHD lesions(i.e.,shunts,valves,or shunts+valves)were at greater risk of dying compared to those with severe complex *** CHD type was assessed separately,those with valve lesions were more likely to die compared to those with complex CHD *** adjustment for age,gender,race,insurance and CHD complexity,ACHD patients with HF,with or without HTN,were equally likely to die during the study ***,ACHD patients with HF,without or without HTN,who had valve defects were more likely to die during the three-year study period compared to patients with complex CHDs.

关键词： Congenital heart defect risk factors hypertension heart failure mortality

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Reassessment of palliative surgery in conversion therapy of previously unresectable hepatocellular carcinoma: Two case reports and review of literature

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World Journal of Gastrointestinal Surgery 2024年第10期16卷 3312-3320页

作者： Yang-Bo Zhu Jia-Yi Qin Ting-Ting Zhang Wen-Jin Zhang Qi Ling division of Hepatobiliary and Pancreatic Surgery Department of SurgeryThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Key Lab of Combined Multi-Organ Transplantation Ministry of Public HealthThe First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Clinical Pharmacy The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Medical Imaging The First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

BACKGROUND Most patients with hepatocellular carcinoma(HCC)have lost the opportunity for direct surgery at the time of *** chemoembolization(TACE)combined with immune checkpoint inhibitors or tyrosine kinase inhibitors(TKI)can partially transform some unresectable HCC and improve the prognosis ***,based on the promising prospects of combined targeted and immunotherapy for the effective treatment of HCC,the positive role of palliative surgery in the conversion treatment of advanced HCC urgently needs further in-tensive *** SUMMARY In this study,we describe two successful cases of"conversion therapy for un-resectable HCC"achieved mainly by palliative surgery combined with TACE plus immunotherapy and TKIs.A 48-year-old patient with newly diagnosed HCC,presenting with a 6-cm mass in the segment VII/VIII of the right liver with mul-tiple intrahepatic metastases,could not undergo one-stage radical surgical *** underwent palliative surgery with radiofrequency of metastatic lesions and the palliative resection of the primary mass,and received subsequent TACE treatments twice in the early postoperative period(2 weeks and 6 weeks),in addition to targeted and immune combination therapy with sintilimab injection and oral *** evidence of recurrence was observed during the 11-month follow-up period after *** other patient was a 47-year-old patient with massive HCC(18 cm×15 cm×4.5 cm)in the left liver with severe *** left portal branch was occluded and a tumor thrombus formed,and the tumor partly involved the middle hepatic *** patient underwent palliative surgery of left hemihepatectomy(including resection of the middle hepatic vein)for HCC,followed by three TACE procedures and oral TKIs 2 weeks after *** months later,the re-examination via computed tomography revealed no tumour activity in the remaining right liver,while magnetic resonance imaging revealed slight local tumor enh

关键词： Hepatocellular carcinoma Transarterial chemoembolization Immunotherapy Conversion Therapy Tyrosine kinase inhibitors Case report

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Survival comparison between primary hepatic neuroendocrine neoplasms and primary pancreatic neuroendocrine neoplasms and the analysis on prognosis-related factors

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Hepatobiliary & Pancreatic Diseases International 2019年第6期18卷 538-545页

作者： Meng-Xia Li Qi-Yong Li Min Xiao Da-Long Wan Xin-Hua Chen Lin Zhou Hai-Yang Xie Shu-Sen Zheng division of Hepatobiliary Pancreatic Surgery First Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China division of Hepatobiliary Pancreatic Surgery Shulan(Hangzhou)HospitalHangzhou 310004China Key Laboratory of Combined Multi-organ Transplantation Ministry of Public HealthFirst Affiliated HospitalZhejiang University School of MedicineHangzhou 310003China

Background:Primary hepatic neuroendocrine neoplasms(PHNENs)are extremely rare and few articles have compared the prognosis of PHNENs with other neuroendocrine neoplasms(NENs).This study aimed to investigate the different prognosis between PHNENs and pancreatic NEN(Pan NENs)and evaluate the relevant prognosis-related ***:From January 2012 to October 2016,a total of 44 NENs patients were enrolled and divided into two groups according to the primary tumor location which were named group PHNENs(liver;n=12)and group Pan NENs(pancreas;n=32).Demographic,clinical characteristics and survival data were compared between the two groups with Kaplan-Meier method and log-rank *** factors were analyzed using the Cox regression ***:The overall survival of group PHNENs and group Pan NENs were 25.4±6.7 months and 39.8±3.7 months,respectively(P=0.037).The cumulative survival of group Pan NENs was significantly higher than that of group PHNENs(P=0.029).Univariate analysis revealed that sex,albumin,total bilirubin,total bile acid,aspartate aminotransferase,alkaline phosphatase,α-fetoprotein and carbohydrate antigen 19-9,histological types,treatments and primary tumor site were the prognostic *** multivariate analysis indicated that albumin(P=0.008),histological types NEC(P=0.035)and treatments(P=0.005)were the independent prognostic *** on the histological types,the cumulative survival of patients with well-differentiated neuroendocrine tumor was significant higher than that of patients with poorly differentiated neuroendocrine carcinoma in group PHNENs(P=0.022),but not in group Pan NENs(P>0.05).According to the different treatments,patients who received surgery had significantly higher cumulative survival than those with conservative treatment in both groups(P<0.05).Conclusions:PHNENs have lower survival compared to Pan *** types and treatments affect the *** resection still remains the first line of

关键词： Neuroendocrine neoplasms Survival Prognosis Hepatic neuroendocrine Pancreatic

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GENERAL DYNAMIC EQUATION AND DYNAMICAL CHARACTERISTICS OF VISCOELASTIC TIMOSHENKO BEAMS

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Applied Mathematics and Mechanics(English Edition) 1990年第2期11卷 177-184页

作者：肖灿章计伊周常保平 Research division of Engineering Mechanics. Shanxi Institute of Mechanical Engineering. Xi'an

In this paper, a governing differential equation of viscoelastic Timoshenko beam including both extension and shear viscosity is developed in the time domain by direct method. To measure the complex moduli and three parameters of standard linear solid, the forced vibration technique of beam is successfully used for PCL and PMMA specimens. The dynamical characteristics of viscoelastic Timoshenko beams, especially the damping properties, are derived from a considerable number of numerical computations. The analyses show that the viscosity of materials has great influence on dynamical characteristics of structures, especially on damping, and the standard linear solid model is the better one for describing the dynamic behavior of high viscous materials.

关键词： GENERAL DYNAMIC EQUATION AND DYNAMICAL CHARACTERISTICS OF VISCOELASTIC TIMOSHENKO BEAMS

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Non-invasive means of measuring hepatic fat content

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World Journal of Gastroenterology 2008年第22期14卷 3476-3483页

作者： Sanjeev R Mehta E Louise Thomas Jimmy D Bell Desmond G Johnston Simon D Taylor-Robinson division of Medicine Imperial College London St Mary's Campus Praed Street London W2 1NY United Kingdom Imaging Sciences Depart-ment Division of Clinical Sciences Imperial College London Hammersmith Campus Du Cane Road London W12 OHS United Kingdom

Hepatic steatosis affects 20% to 30% of the general adult population in the western world. Currently, the technique of choice for determining hepatic fat deposition and the stage of fibrosis is liver biopsy. However, it is an invasive procedure and its use is limited, particularly in children. It may also be subject to sampling error. Non-invasive techniques such as ultrasound, computerised tomography (CT), magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (1H MRS) can detect hepatic steatosis, but currently cannot distinguish between simple steatosis and steatohepatitis, or stage the degree of fibrosis accurately. Ultrasound is widely used to detect hepatic steatosis, but its sensitivity is reduced in the morbidly obese and also in those with small amounts of fatty infiltration. It has been used to grade hepatic fat content, but this is subjective. CT can detect hepatic steatosis, but exposes subjects to ionising radiation, thus limiting its use in longitudinal studies and in children. Recently, magnetic resonance (MR) techniques using chemical shift imaging have provided a quantitative assessment of the degree of hepatic fatty infiltration, which correlates well with liver biopsy results in the same patients. Similarly, in vivo 1H MRS is a fast, safe, non-invasive method forthe quantification of intrahepatocellular lipid (IHCL) levels. Both techniques will be useful tools in future longitudinal clinical studies, either in examining the natural history of conditions causing hepatic steatosis (e.g. non-alcoholic fatty liver disease), or in testing new treatments for these conditions.

关键词： Adipose tissue Ectopic fat Hepatic fat Insulin resistance Ultrasound Computerised tomography Magnetic resonance imaging Magnetic resonance spectroscopy

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Primary signet-ring cell carcinoma of the colon at early stage: A case report and a review of the literature

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World Journal of Gastroenterology 2006年第21期12卷 3446-3449页

作者： Kuang-I Fu Yasushi Sano Shigeharu Kato Hiroki Saito Atsushi Ochiai Takahiro Fujimori Yutaka Saito Takahisa Matsuda Takahiro Fujii Shigeaki Yoshida division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan Department of Surgical and Molecular PathologyDokkyo University School of Medicine880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan division of Gastrointestinal Oncology and Digestive Endoscopy National Cancer Center Hospital East KashiwaChiba 277-8577Japan division of Pathology National Cancer Center East Research Institute Chiba 277-8577Japan Department of Surgical and Molecular Pathology Dokkyo University School of Medicine 880 KitakobaysashiMibuShimotugaTochigi 321-0293Japan division of Endoscopy National Cancer Center Hospital TsukijiTokyo 104-0045Japan

A 67-year-old man, who had undergone surgery to resect multiple gastric cancers 4 years ago, visited our hospital for surveillance colonoscopy. Colonoscopy revealed a discolored, 7-mm in diameter, flat-elevated lesion with central depression in the transverse colon near the splenic flexure. Although the findings of endoscopy and barium enema were suggestive of submucosal invasion, the patient chose to undergo endoscopic mucosal resection. Pathological examination of the resected specimen revealed signet-ring cell carcinoma and a positive surgical margin. A second operation was performed, and no residual tumor or metastasis to lymph nodes was found in the resected specimens. Primary colorectal cancers composed of signet-ring cell carcinoma detected and treated at an early stage are extremely rare. We present a case and review the literature.

关键词： Signet-ring cell carcinoma Early colorectal cancer Endoscopic mucosal resection

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Long-term growth of intrahepatic papillary neoplasms: A case report

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World Journal of Gastroenterology 2019年第36期25卷 5569-5577页

作者： Takumu Hasebe Koji Sawada Hidemi Hayashi Shunsuke Nakajima Hiroyuki Takahashi Masahiro Hagiwara Koji Imai Sayaka Yuzawa Mikihiro Fujiya Hiroyuki Furukawa Toshikatsu Okumura Department of Medicine Division of Gastroenterology and Hematology/Oncology Asahikawa Medical University Asahikawa 0788510 Hokkaido Japan Department of Surgery Division of Gastroenterological and General Surgery Asahikawa Medical University Asahikawa 0788510 Hokkaido Japan Department of Diagnostic Pathology Asahikawa Medical University Hospital Asahikawa 0788510 Hokkaido Japan

BACKGROUND Intraductal papillary neoplasm of the bile duct (IPNB) is a type of tumor that presents in the intra- or extrahepatic bile ducts. Cystic-type intrahepatic IPNB often mimics simple liver cysts, making the diagnosis difficult. Because the growth of IPNB is slow, careful follow-up and timely therapeutic intervention is recommended. There are few reports with a follow-up period longer than a decade;thus, we report the case of a patient with an IPNB that grew for over 13 years. CASE SUMMARY A 65-year-old man was diagnosed, 13 years prior with a cystic hepatic tumor with abnormal imaging findings. The targeted tumor biopsy results showed no malignancy. Biannual follow-up examinations were performed because of the potential for malignancy. The cystic lesions showed gradual enlargement over 11 years and a 4 mm papillary proliferation appeared on the cyst wall, which is compatible with IPNB. The tumor was observed for another 2 years because of the patient’s wishes. The imaging findings showed enlargement to 8 mm and a new 9 mm papillary proliferation of the cystic tumor. Contrast-enhanced ultrasonography showed hyperenhancement during the arterial phase in both cyst walls, indicating intraductal tumor progression in both tumors. Thus, liver segment 8 subsegmentectomy was performed. The pathological findings indicated that the tumors contained mucin, and high-grade atypia was observed in the papillary lesions, showing *** The development of IPNB should be monitored in patients with cystic lesions and ultrasonography are useful tool for the evaluation.

关键词： Bile duct neoplasm Mucin Disease progression Ultrasonography Perfluorobutane Case report

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Prognostic impact of atrial fibrillation on clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease

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World Journal of Cardiology 2015年第7期7卷 397-403页

作者： Nileshkumar J Patel Aashay Patel Kanishk Agnihotri Dhaval Pau Samir Patel Badal Thakkar Nikhil Nalluri Deepak Asti Ritesh Kanotra Sabeeda Kadavath Shilpkumar Arora Nilay Patel Achint Patel Azfar Sheikh Neil Patel Apurva O Badheka Abhishek Deshmukh Hakan Paydak Juan Viles-Gonzalez Cardiovascular division Staten Island University Hospital Cardiovascular division Lankenau Institute of Medical Research Cardiovascular division Saint Peters University Hospital Cardiovascular division Western Reserve Health Education Cardiovascular division Tulane University School of Public Health and Tropical Medicine Cardiovascular division Lincoln Medical and Mental Health Center Cardiovascular division St. Lukes Roosevelt Hospital Cardiovascular division Icahn School of Medicine at Mount Sinai Cardiovascular division Yale School of Medicine Cardiovascular division Mayo Clinic Cardiovascular division University of Arkansas for Medical Sciences Cardiovascular division University of Miami Miller School of Medicine

Atrial fibrillation(AF) is the most common type of sustained arrhythmia,which is now on course to reach epidemic proportions in the elderly population. AF is a commonly encountered comorbidity in patients with cardiac and major non-cardiac diseases. Morbidity and mortality associated with AF makes it a major healthcare burden. The objective of our article is to determine the prognostic impact of AF on acute coronary syndromes,heart failure and chronic kidney disease. Multiple studies have been conducted to determine if AF has an independent role in the overall mortality of such patients. Our review suggests that AF has an independent adverse prognostic impact on the clinical outcomes of acute coronary syndromes,heart failure and chronic kidney disease.

关键词： Atrial fibrillation Heart failure Chronic kidney disease Acute coronary syndromes Prognostic impact

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Tackling clinical complexity: how inpatient subspecialty gastroenterology services enhance patient care

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Gastroenterology Report 2021年第6期9卷 606-607页

作者： Cinthana Kandasamy Darshan J.Kothari Sunil G.Sheth Department of Internal Medicine Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA division of Gastroenterology Duke University Medical CenterDurhamNCUSA division of Gastroenterology Durham VA Medical CenterDurhamNCUSA division of Gastroenterology&Hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA

Introduction Over the past three decades,the field of gastroenterology(GI)has undergone tremendous *** in research have led to a substantial growth in clinical knowledge across many GI ***,over this time,the prevalence of patient complexity,including the number of co-morbidities,mental illness burden,socioeconomic factors,and multidisciplinary needs,have continued to ***,subspecialization within GI has been an adaptive response to keep pace with the rapid expansion of medical knowledge and evolving patient needs.

关键词： patient clinical gastro

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Single dose dexamethasone prophylaxis of postembolisation syndrome after chemoembolisation in hepatocellular carcinoma patient:A randomised,double-blind,placebo-controlled study

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World Journal of Clinical Cases 2021年第30期9卷 9059-9069页

作者： Panot Sainamthip Chutcharn Kongphanich Naiyarat Prasongsook Sakkarin Chirapongsathorn Department of Pharmacology Chulalongkorn UniversityBangkok 10330Thailand Department of Radiology Phramongkutklao College of MedicineBangkok 10400Thailand division of Medical Oncology Department of MedicinePhramongkutklao College of MedicineBangkok 10400Thailand division of Gastroenterology and Hepatology Department of MedicinePhramongkutklao College of MedicineJatujak 10900Thailand

BACKGROUND Even in the immuno-oncology era,transcatheter arterial chemoembolisation(TACE)is the most effective way to treat intermediate stage hepatocellular carcinoma(HCC).Postembolisation syndrome(PES)is the most common side effect from TACE and there is still no standard prevention *** To evaluate the efficacy of single dose intravenous dexamethasone regimen to prevent PES after TACE among patients with *** This study enrolled patients with HCC who had eligible indication for TACE without macrovascular invasion/extrahepatic *** were randomly assigned to either an intravenous single dose of dexamethasone 8 mg or placebo one hour before *** primary outcome was a negative result of PES at 48 h after TACE,which was defined as score<2 of Southwest Oncology Group toxicity coding criteria using fever,nausea,vomiting and pain to *** the secondary end point was duration of admission between two *** One hundred patients were randomly assigned 1:*** intention-to-treat analysis,49 patients were randomly assigned to the dexamethasone and 51 to the placebo *** groups were similar for baseline *** negative PES rate was significantly higher in the dexamethasone group than in the placebo group(63.3%vs 29.4%;P=0.005).Mean Southwest Oncology Group toxicity coding PES was 2.14(95%CI:1.41-2.8)vs 3.71(95%CI:2.97-4.45)between the dexamethasone and placebo groups,*** incidence of fever was significantly lower in dexamethasone group with P<0.001,pain,nausea and vomiting were also lower in the dexamethasone group compared with the placebo group(P=0.16,P=0.11,and P=0.49).The dexamethasone regimen was generally well tolerated by patients with HCC patients including those with hepatitis B virus infection and well-controlled diabetes *** Single dose dexamethasone was effective at preventing PES among patients with HCC treated with *** study showed no adverse events

关键词： Hepatocellular carcinoma Chemoembolization Dexamethasone Double blind method Prevention Postembolization syndrome

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