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Palliative long-term abdominal drains vs large volume paracenteses for the management of refractory ascites in end-stage liver disease

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World Journal of Hepatology 2024年第3期16卷 428-438页

作者： Senamjit Kaur Rodrigo V Motta Bryony Chapman Victoria Wharton Jane D Collier Francesca Saffioti Oxford Liver unit Department of Gastroenterology and HepatologyOxford University Hospitals NHS Foundation TrustOxford OX39DUUnited Kingdom Oxford Liver unit and Translational Gastroenterology unit Nuffield Department of MedicineUniversity of OxfordOxford OX39DUUnited Kingdom

BACKGROUND Long-term abdominal drains(LTAD)are a cost-effective palliative measure to manage malignant ascites in the community,but their use in patients with end-stage chronic liver disease and refractory ascites is not routine *** safety and cost-effectiveness of LTAD are currently being studied in this setting,with preliminary positive *** hypothesised that palliative LTAD are as effective and safe as repeat palliative large volume paracentesis(LVP)in patients with cirrhosis and refractory ascites and may offer advantages in patients’quality of *** To compare the effectiveness and safety of palliative LTAD and LVP in refractory ascites secondary to end-stage chronic liver *** A retrospective,observational cohort study comparing the effectiveness and safety outcomes of palliative LTAD and regular palliative LVP as a treatment for refractory ascites in consecutive patients with end-stage chronic liver disease followed-up at our united Kingdom tertiary centre between 2018 and 2022 was ***’s exact tests and the Mann-Whitney U test were used to compare qualitative and quantitative variables,***-Meier survival estimates were generated to stratify time-related outcomes according to the type of *** Thirty patients had a total of 35 indwelling abdominal drains and nineteen patients underwent regular *** baseline characteristics were similar between the *** antibiotics were more frequently prescribed in patients with LTAD(P=0.012),while the incidence of peritonitis did not differ between the two groups(P=0.46).The incidence of acute kidney injury(P=0.014)and ascites/drain-related hospital admissions(P=0.004)were significantly higher in the LVP *** overall survival was similar in the two groups(log-rank P=0.26),but the endpoint-free survival was significantly shorter in the LVP group(P=0.003,P<0.001,P=0.018 for first ascites/drain-related admission,acute kidney injury and drain

关键词： Decompensated liver cirrhosis Indwelling abdominal catheter Rocket drain Palliative care Safety Quality of life

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Quantitative method for calculating spatial release region for laser-guided bomb

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Journal of Systems Engineering and Electronics 2024年第4期35卷 1053-1062页

作者： YANG Ping XIAO Bing CHEN Xin HAO Yuntao Air Force Early Warning Academy Wuhan 430019China unit 93175 of the PLA Changchun 136000China

The laser-guided bomb(LGB)is an air-to-ground pre-cision-guided weapon that offers high hit rates,great power,and ease of *** are guided by semi-active laser ground-seek-ing technology,which means that atmospheric conditions can affect their *** spatial release region(SRR)of LGBs is difficult to calculate precisely,especially when there is a poor field of *** can result in a lower real hit *** increase the hit probability of LGBs in tough atmospheric situa-tions,a novel method for calculating the SRR has been *** method is based on the transmittance model of the 1.06μm laser in atmospheric species and the laser diffuse reflection model of the target surface to determine the capture target time of the laser ***,it calculates the boundary ballistic space starting position by ballistic model and gets the spatial scope of the spatial release *** method can determine the release region of LGBs based on flight test data such as instantaneous velocity,altitude,off-axis angle,and atmospheric *** more effectively employing aircraft release conditions,atmospheric visibility and other factors,the SRR calculation method can improve LGB hit probabi-lity by 9.2%.

关键词： laser-guided bombs(LGBs) hit probability atmo-spheric transmittance spatial release region(SRR)boundary ballistic

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Should we perform decompressive laparotomy during severe acute pancreatitis with intra-abdominal hypertension below 25 mmHg:Only the gut knows

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1470-1473页

作者： Thibault Vieille Melissa Crotet Celia Turco Paul Monasterolo Hadrien Winiszewski Gael Piton Medical Intensive Care unit Besancon University HospitalBesancon 25000France Intensive Care unit Vesoul HospitalVesoul 70000France Department of Digestive Surgical Oncology-Liver Transplantation unit Besancon University HospitalBesancon 25000France Inserm UMRS-938 Centre de Recherche Saint-Antoine(CRSA)Sorbonne UniversitéParis 10041NY212France Intensive Care unit Nord Franche Comte HospitalTrevenans 90400France

We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 ***,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly *** report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.

关键词： Acute pancreatitis Abdominal compartment syndrome Decompressive laparotomy Mesenteric ischemia Intra-abdominal pressure Abdominal perfusion pressure

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Implementation of gastrointestinal function protection in severe acute pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 521-522页

作者： Fu-Zheng Tao Rong-Lin Jiang Shui-Fang Jin Intensive Care unit Taizhou Integrated Traditional Chinese and Western Medicine HospitalTaizhou 310075China Intensive Care unit the First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)Hangzhou 310006China

Severe acute pancreatitis(SAP)is a serious systemic disease associated with strong local inflammatory reactions and serious systemic pathophysiological disorders caused by trypsin *** with SAP are prone to exhibit gastrointestinal ***,gastrointestinal dysfunction further aggravates the systemic inflammatory response and metabolic abnormalities,resulting in a more critical condition of *** dysfunction is considered to be the“trigger”of multiple organ dysfunction syndrome[1].Thus,it is important to maintain gastrointestinal homeostasis in the treatment of SAP.

关键词： gastrointestinal pancreatitis acute

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Can we talk about “futile surgery” for the upfront treatment of the perihilar cholangiocarcinoma?

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 672-674页

作者： Maria Conticchio David Fuks Stylianos Tzedakis unit of Hepatobiliairy and Pancreatic Surgery Ente Ecclesiastico F.MiulliAcquaviva delle FontiBariItaly unit of Hepatobiliary Digestive and Endocrine SurgeryCochin HospitalUniversitéParis CitéParisFrance

In this work(1),Ratti et *** to identify a subgroup of patients with perihilar cholangiocarcinoma(PHC)for whom the benefit of surgery could be compromised by morbidity,mortality and the risk of early tumor *** for this study come from a multi-institutional database that includes consecutive patients undergoing elective surgery for PHC in 27 Western centers(with experience of more than 15 major liver resections per year)starting in January *** from 2,271 patients were analyzed *** there is neither international consensus on preoperative management nor standardization of surgical technique,the indications for resection were validated at a local multidisciplinary consultation *** optimization was standardized with endoscopic or percutaneous biliary drainage to treat jaundice and the performance of portal embolization was proposed in the event of insufficient volume of the future remaining liver.

关键词： Perihilar cholangiocarcinoma(PHC) upfront surgery predictive risk score

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To drain or not to drain after distal pancreatectomy: reflexions on the PANDORINA trial

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Hepatobiliary Surgery and Nutrition 2024年第4期13卷 675-677页

作者： Maxime Constant Alexandre Doussot Department of Digestive and Surgical Oncology Liver Transplantation UnitCHU BesanconBesançonFrance

We read with great interest the PANDORINA study(1).This international multicenter(mostly from the Netherlands)randomized controlled trial aimed at determining whether omitting drainage after distal pancreatectomy(DP)was equivalent in terms of complications to systematic drainage *** primary outcome was the occurrence of severe complications at 90 days defined as Dindo-Clavien grade≥*** main secondary outcome was the occurrence of grade B–C postoperative pancreatic fistula(POPF)at 90 *** both outcomes,the non-inferiority threshold was set at 8%.Randomization was performed intraoperatively,stratified by annual center volume(high volume defined as DP≥40/year)and the risk of POPF according to the distal fistula risk score(D-FRS)combining pancreas thickness(high risk,>19 mm)and main pancreatic duct diameter(high risk,>3 mm)measured both at the isthmus(2).

关键词： Drainage distal pancreatectomy(DP) randomized controlled trial

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Endo-hepatology: Why should we do endoscopic ultrasound-guided interventions to the liver that we could do through the skin?

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World Journal of Gastroenterology 2024年第40期30卷 4333-4338页

作者： Claudio Calvanese Pietro Fusaroli Gastroenterology unit Hospital of ImolaUniversity of BolognaImola 40026BolognaItaly

Endoscopic ultrasound(EUS)-guided interventions on the liver such as diffuse biopsy and portal pressure gradient measurement are emerging as potential alternatives to percutaneous *** purpose of this editorial was to address all the indications that could potentially make an EUS-guided approach a possible alternative to the percutaneous procedures with respect to the proce-dures that could join the EUS examination such as upper endoscopy for gastro-esophageal varices,pancreaticobiliary investigation with EUS,and other potential advantages in terms of patient *** issue of a holistic gastroenterologist approach was also discussed along with the potential for developing clinical research.

关键词： Endo-hepatology Endoscopic ultrasound Endosonography Liver disease Liver biopsy Portal hypertension

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NLRP3 inflammasome plays a vital role in the pathogenesis of age-related diseases in the eye and brain

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Neural Regeneration Research 2024年第7期19卷 1425-1426页

作者： Jack Jonathan Maran Odunayo Omolola Mugisho Buchanan Ocular Therapeutics unit Department of OphthalmologyNew Zealand National Eye CentreUniversity of AucklandAucklandNew Zealand

Key points:With aging,there is increased nucleotide-binding oligomerization domain-(NOD-)like receptor(NLR) protein-3(NLRP3) activation in neural and ocular *** of the NLRP3 inflammasome appears to be a common denominator in the pathogenesis of age-related diseases of the eye and *** inhibition of the NLRP3 inflammasome may be a potent therapy for preventing the development and progression of age-related eye and brain diseases.

关键词： NLRP3 pathogenesis inflam

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Exploring conservative management for cervical intraepithelial neoplasia grade 2 in organised cervical cancer screening programmes:a multicentre study in Italy

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Family Medicine and Community Health 2024年第S2期12卷 1-7页

作者： Silvia Gori Helena Frayle Alessio Pagan Marika Soldà Cesare Romagnolo Egle Insacco Licia Laurino Mario Matteucci Giuseppe Sordi Enrico Busato Manuel Zorzi Tiziano Maggino Annarosa Del Mistro CIN2 study Working Group Veneto Institute of Oncology IOV-IRCCS PadovaItaly Local Health unit Marca Trevigiana TrevisoItaly Local Health unit Serenissima VeneziaItaly Obstetrics and Gynecology Azienda Ospedale UniversitàPadovaItaly Local Health unit Scaligera VeronaItaly Veneto Tumour Registry Azienda ZeroPadovaItaly 不详

Cervical intraepithelial neoplasia grade 2(CIN2)lesions may regress spontaneously,offering an alternative to immediate treatment,especially for women of childbearing age(15–45 years).We conducted a prospective multicentre study on conservative CIN2 management,with semiannual follow-up visits over 24 months,biomarkers’investigation and treatment for progression to CIN3+or CIN2 persistence for more than 12 ***,we assess women’s willingness to participate and adherence to the study *** study was set in population-based organised cervical cancer *** April 2019 to October 2021,640 CIN2 cases were diagnosed in women aged 25–64 participating in the screening *** to our predefined inclusion and exclusion criteria,228(35.6%)women were not eligible;93(22.6%)of the 412 eligible refused,and 319(77.4%)were *** for personal reasons(ie,desire to become pregnant,anxiety,difficulty in complying with the study protocol)and external barriers(ie,residence elsewhere and language problems)accounted for 71%and 17%,*** 9%expressed a preference for *** primary ineligibility factor was the upper age limit of 45 *** enrolment,12(4%)women without evidence of progression requested treatment,125(39%)were lost to follow-up(mostly after 6–12 months)and 182(57%)remained ***,40%of enrolees did not fully adhere to the protocol,whereas only 5%(20/412)of the eligible women desired *** study demonstrates a good acceptance of conservative management for CIN2 lesions by the women,supporting its implementation within cervical screening programmes.

关键词： cervical conservative centre

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Improving the structural efficiency of textured threedimensional concrete printing wall by architectural design

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Frontiers of Structural and Civil Engineering 2024年第5期18卷 699-715页

作者： Wannapol SADAKORN Santirak PRASERTSUK Lapyote PRASITTISOPIN Architectural Technology Research unit Department of ArchitectureFaculty of ArchitectureChulalongkorn UniversityBangkok 10330Thailand Faculty of Architecture and Planning Thammasat UniversityPathumthani 12121Thailand

Three-dimensional concrete printing(3DCP)technology begins to be adopted into construction application *** studies have focused on producing a higher concrete quality and offering a user-friendly construction ***,the 3DCP construction cost is unlikely to be lower than that of conventional construction,which is especially important for projects where the cost is *** broaden the 3DCP construction applications,reduction of the quantity of 3DCP material usage is *** work aims to perform structural analysis of several patterns of geometric textured 3DCP shell wall structures.21 different cantilevered textured patterns of 3DCP shell wall structures were architecturally designed and then subjected to structural analysis by a finite element method(FEM).The results indicated that by designing appropriate patterns,the structural performance to weight ratio could be improved up to 300%.The study therefore offers an innovative design process for constructing 3DCP housing and suggests preconstruction analysis methods for 3DCP shell wall structures.

关键词： 3D printing concrete architectural design shell wall finite element method

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