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| 1 | Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery显示文摘AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between groups.CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery. | Amilcare Parisi Daniel Reim Felice Borghi Ninh T Nguyen Feng Qi Andrea Coratti Fabio Cianchi Maurizio Cesari Francesca Bazzocchi Orhan Alimoglu Johan Gagnière Graziano Pernazza Simone D'Imporzano Yan-Bing Zhou Juan-Santiago Azagra Olivier Facy Steven T Brower Zhi-Wei Jiang Lu Zang Arda Isik Alessandro Gemini Stefano Trastulli Alexander Novotny Alessandra Marano Tong Liu Mario Annecchiarico Benedetta Badii Giacomo Arcuri Andrea Avanzolini Metin Leblebici Denis Pezet Shou-Gen Cao Martine Goergen Shu Zhang Giorgio Palazzini Vito D'Andrea Jacopo Desiderio | 2017 | World Journal of Gastroenterology2017，23，13： | 17 |
| 2 | Ampullary carcinoma:Effect of preoperative biliary drainage on surgical outcome显示文摘AIM: To evaluate the influence of preoperative biliary drainage on morbidity and mortality after surgical resection for ampullary carcinoma. METHODS: We analyzed retrospectively data for 82 patients who underwent potentially curative surgery for ampullary carcinoma between September 1993 and July 2007 at the Singapore General Hospital, a tertiary referral hospital. Diagnosis of ampullary carcinoma was confirmed histologically. Thirty-five patients underwent preoperative biliary drainage (PBD group), and 47 were not drained (non-PBD group). The mode of biliary drainage was endoscopic retrograde cholangiopancreatography (n = 33) or percutaneous biliary drainage (n = 2). The following parameters were analyzed: wound infection, intra-abdominal abscess, intra-abdominal or gastrointestinal bleeding, septicemia, biliary or pancreatic leakage, pancreatitis, gastroparesis, and re-operation rate. Mortality was assessed at 30 d (hospital mortality) and also longterm. The statistical endpoint of this study was patient survival after surgery. RESULTS: The groups were well matched for demographic criteria, clinical presentation and operative characteristics, except for lower hemoglobin in the non-PBD group (10.9 ± 1.6 vs 11.8 ± 1.6 in the PBD group).Of the parameters assessing postoperative morbidity, incidence of wound infection was signif icantly less in the PBD than the non-PBD group [1 (2.9%) vs 12 (25.5%)]. However, the rest of the parameters did not differ signif icantly between the groups, i.e. sepsis [10 (28.6%) vs 14 (29.8%)], intra-abdominal bleeding [1 (2.9%) vs 5 (10.6%)], intra-abdominal abscess [1 (2.9%) vs 8 (17%)], gastrointestinal bleeding [3 (8.6%) vs 5 (10.6%)], pancreatic leakage [2 (5.7%) vs 3 (6.4%)], biliary leakage [2 (5.7%) vs 3 (6.4%)], pancreatitis [2 (5.7%) vs 2 (4.3%)], gastroparesis [6 (17.1%) vs 10 (21.3%)], need for blood transfusion [10 (28.6%) vs 17 (36.2%)] and re-operation rate [1 (2.9%) vs 5 (10.6%)]. There was no early mortality in either group. Median survival was 44 mo (95% CI: 34.2-53.8) in the PBD group and 41 mo (95% CI: 27.7-54.3; P = 0.86) in the non-PBD group. CONCLUSION: Biliary drainage before surgery for ampullary cancer significantly reduced postoperative wound infection. Overall mortality was not influenced by preoperative drainage. | Sheikh Anwar Abdullah Tarun Gupta Khairul Azhar Jaafar Yaw Fui Alexander Chung London Lucien Peng Jin Ooi Steven Joseph Mesenas | 2009 | World Journal of Gastroenterology2009，15，23： | 16 |
| 3 | Role of the endothelium in inflammatory bowel diseases显示文摘Inflammatory bowel diseases(IBD) are a complex group of diseases involving alterations in mucosal immunity and gastrointestinal physiology during both initiation and progressive phases of the disease.At the core of these alterations are endothelial cells,whose continual adjustments in structure and function coordinate vascular supply,immune cell emigration,and regulation of the tissue environment.Expansion of the endothelium in IBD(angiogenesis),mediated by inflammatory growth factors,cytokines and chemokines,is a hallmark of active gut disease and is closely related to disease severity.The endothelium in newly formed or inflamed vessels differs from that in normal vessels in the production of and response to inflammatory cytokines,growth factors,and adhesion molecules,altering coagulant capacity,barrier function and blood cell recruitment in injury.This review examines the roles of the endothelium in the initiation and propagation of IBD pathology and distinctive features of the intestinal endothelium contributing to these conditions. | Walter E Cromer J Michael Mathis Daniel N Granger Ganta V Chaitanya J Steven Alexander | 2011 | World Journal of Gastroenterology2011，17，5： | 10 |
| 4 | 溃疡性结肠炎显示文摘溃疡性结肠炎(ulcerativecolitis,uc)是一种消化道炎症性疾病,病变主要位于结直肠。UC好发于青年人,发达国家的人群患病率较高。UC表现为结直肠弥漫性、连续性浅表炎症,以及相应的组织学改变。下消化道内镜或影像检查可以明确诊断。目前尚未发现UC的明确病因,其发病机制与遗传易感个体的结肠内环境变化有关,具有慢性、终身、易复发的病程特点。 | Alexander C Ford Paul Moayyedl Steven B Hanauer Joseph B Kirsner 谭蓓 吴东 | 2017 | 英国医学杂志中文版2017，20，7： | 7 |
| 5 | Surface-enhanced Raman scattering on dielectric microspheres with whispering gallery mode resonance显示文摘Conventionally, metallic nanostructures are used for surface-enhanced Raman spectroscopy(SERS), but recently there has been increasing interest in the enhancement of Raman scattering from dielectric substrates due to their improved stability and biocompatibility compared with metallic substrates. Here, we report the observation of enhanced Raman scattering from rhodamine 6 G molecules coated on silica microspheres. We excite the whispering gallery modes(WGMs) supported in the microspheres with a tapered fiber coupler for efficient WGM excitation, and the Raman enhancement can be attributed to the WGM mechanism. Strong resonance enhancement in pump laser intensity and modified Raman emission from the Purcell effect in the microsphere resonator are observed from the experiment and compared with theoretical results. A total Raman enhancement factor of 1.4 × 10~4 is observed, with contribution mostly from the enhancement in pump laser intensity. Our results show that, with an efficient pumping scheme, dielectric microspheres are a viable alternative to metallic SERS substrates. | STEVEN H.HUANG XUEFENG JIANG Bo PENG COREY JANISCH ALEXANDER COCKING SAHIN KAYA OZDEMIR ZHIWEN LIU LAN YANG | 2018 | Photonics Research2018，6，5： | 7 |
| 6 | Evaluation of a point of care ultrasound curriculum for Indonesian physicians taught by fi rst-year medical students显示文摘BACKGROUND: The purpose of this study was to assess the short-term efficacy of a 4-week ultrasound curriculum taught by American first-year medical students to general practitioners working in public health care clinics, or puskesmas, in Bandung, Indonesia.METHODS: We performed a prospective, observational study of Indonesian health care practitioners from public clinics in Bandung, Indonesia. These practitioners were enrolled in a 4-week ultrasound training course taught by first-year American medical students. A total of six sessions were held comprising of 38 ultrasound milestones. A pre-course and post-course written exam and practical exam was taken by each participant.RESULTS: We enrolled 41 clinicians in the course. The average pre-course exam score was 35.2% with a 2.4% pass rate, whereas the average post-course exam score was 82.0% with a 92.7% pass rate. The average practical score at the completion of the course was 83.2%(SD=0.145) with 82.9% of the class passing(score above 75.0%).CONCLUSION: Our data suggests that first-year medical students can effectively teach ultrasound to physicians in Indonesia using a 4-week intensive ultrasound training course. Future studies are needed to determine the amount of training required for proficiency and to evaluate the physicians' perceptions of the student-instructors' depth of knowledge and skill in point of care ultrasound. | Jonathan B.Lee Christina Tse Thomas Keown Michael Louthan Christopher Gabriel Alexander Anshus Bima Hasjim Katrina Lee Esther Kim Luke Yu Allen Yu Shadi Lahham Steven Bunch Maili Alvarado Abdulatif Gari John C.Fox | 2017 | World Journal of Emergency Medicine2017，8，4： | 4 |
| 7 | Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management显示文摘Inflammatory bowel diseases(IBD) are chronic idiopathic inflammatory conditions characterized by relapsing and remitting episodes of inflammation which can affect several different regions of the gastrointestinal tract, but also shows extra-intestinal manifestations. IBD is most frequently diagnosed during peak female reproductive years, with 25% of women with IBD conceiving after their diagnosis. While IBD therapy has improved dramatically with enhanced surveillance and more abundant and powerful treatment options, IBD disease can have important effects on pregnancy and presents several challenges for maintaining optimal outcomes for mothers with IBD and the developing fetus/neonate. Women with IBD, the medical team treating them(both gastroenterologists and obstetricians/gynecologists) must often make highly complicated choices regarding conception, pregnancy, and post-natal care(particularly breastfeeding) related to their choice of treatment options at different phases of pregnancy as well as post-partum. This current review discusses current concerns and recommendations for pregnancy duringIBD and is intended for gastroenterologists, general practitioners and IBD patients intending to become,(or already) pregnant, and their families. We have addressed patterns of IBD inheritance, effects of IBD on fertility and conception(in both men and women), the effects of IBD disease activity on maintenance of pregnancy and outcomes, risks of diagnostic procedures during pregnancy and potential risks and complications associated with different classes of IBD therapeutics. We also have evaluated the clinical experience using 'top-down' care with biologics, which is currently the standard care at our institution. Post-partum care and breastfeeding recommendations are also addressed. | Pegah Hosseini-Carroll Monica Mutyala Abhishek Seth Shaheen Nageeb Demiana Soliman Moheb Boktor Ankur Sheth Jonathon Chapman James Morris Paul Jordan Kenneth Manas Felix Becker Jonathan Steven Alexander | 2015 | World Journal of Gastrointestinal Pharmacology and Therapeutics2015，6，4： | 4 |
| 8 | The interaction of stem cells and vascularity in peripheral nerve regeneration显示文摘The degree of nerve regeneration after peripheral nerve injury can be altered by the microenvironment at the site of injury. Stem cells and vascularity are postulated to be a part of a complex pathway that enhances peripheral nerve regeneration;however, their interaction remains unexplored. This review aims to summarize current knowledge on this interaction, including various mechanisms through which trophic factors are promoted by stem cells and angiogenesis. Angiogenesis after nerve injury is stimulated by hypoxia, mediated by vascular endothelial growth factor, resulting in the growth of preexisting vessels into new areas. Modulation of distinct signaling pathways in stem cells can promote angiogenesis by the secretion of various angiogenic factors. Simultaneously, the importance of stem cells in peripheral nerve regeneration relies on their ability to promote myelin formation and their capacity to be influenced by the microenvironment to differentiate into Schwann-like cells. Stem cells can be acquired through various sources that correlate to their differentiation potential, including embryonic stem cells, neural stem cells, and mesenchymal stem cells. Each source of stem cells serves its particular differentiation potential and properties associated with the promotion of revascularization and nerve regeneration. Exosomes are a subtype of extracellular vesicles released from cell types and play an important role in cell-to-cell communication. Exosomes hold promise for future transplantation applications, as these vesicles contain fewer membrane-bound proteins, resulting in lower immunogenicity. This review presents pre-clinical and clinical studies that focus on selecting the ideal type of stem cell and optimizing stem cell delivery methods for potential translation to clinical practice. Future studies integrating stem cell-based therapies with the promotion of angiogenesis may elucidate the synergistic pathways and ultimately enhance nerve regeneration. | Sara Saffari Tiam M.Saffari Dietmar J.O.Ulrich Steven E.R.Hovius Alexander Y.Shin | 2021 | Neural Regeneration Research2021，16，8： | 3 |
| 9 | An Elevated Perspective: Dyke-Related Fracture Networks Analysed with Uav Photogrammetry显示文摘An abundance of data from seismic and geodetic monitoring has provided new insight into dyke propagation and emplacement mechanisms.These studies show that faulting and fracturing is part of the | Gregory DERING Steven MICKLETHWAITE Stephen J.BARNES Marco FIORENTINI Alexander CRUDEN Eric TOHVER | 2016 | Acta Geologica Sinica(English Edition)2016，90，S1： | 3 |
| 10 | Disentangling multiple scattering with deep learning:application to strain mapping from electron diffraction patterns显示文摘A fast,robust pipeline for strain mapping of crystalline materials is important for many technological applications.Scanning electron nanodiffraction allows us to calculate strain maps with high accuracy and spatial resolutions,but this technique is limited when the electron beam undergoes multiple scattering.Deep-learning methods have the potential to invert these complex signals,but require a large number of training examples.We implement a Fourier space,complex-valued deep-neural network,FCU-Net,to invert highly nonlinear electron diffraction patterns into the corresponding quantitative structure factor images.FCU-Net was trained using over 200,000 unique simulated dynamical diffraction patterns from different combinations of crystal structures,orientations,thicknesses,and microscope parameters,which are augmented with experimental artifacts.We evaluated FCU-Net against simulated and experimental datasets,where it substantially outperforms conventional analysis methods.Our code,models,and training library are open-source and may be adapted to different diffraction measurement problems. | Joydeep Munshi Alexander Rakowski Benjamin H.Savitzky Steven E.Zeltmann Jim Ciston Matthew Henderson Shreyas Cholia Andrew M.Minor Maria K.Y.Chan Colin Ophus | 2022 | npj Computational Materials2022，，1： | 2 |
| 11 | Comparison of ultrasound-measured properties of the common carotid artery to tobacco smoke exposure in a cohort of Indonesian patients显示文摘BACKGROUND: The purpose of this study was to use point-of-care ultrasound(POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery(CCA). The effect of both primary and secondary smoking on CCA properties was evaluated.METHODS: We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness(CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease.RESULTS: We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness.CONCLUSION: Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confi rm the utility of ultrasound fi ndings of cardiovascular disease and stroke. | Allen R.Yu Bima Hasjim Luke E.Yu Christopher Gabriel Alexander Anshus Jonathan B.Lee Michael J. Louthan Esther C.Kim Katrina Lee Christina Tse Thomas Keown Shadi Lahham Maili Alvarado Steven Bunch Abdulatif Gari J.Christian Fox | 2017 | World Journal of Emergency Medicine2017，8，3： | 2 |
| 12 | Reactive and non-reactive transport modelling in partially water saturated argillaceous porous media around the ventilation experiment,Mont Terri显示文摘At Mont Terri Underground Research Laboratory (URL) Switzerland, a specific experiment has been performed in a tunnel, in order to investigate the hydro-mechano-chemical (HMC) perturbations induced in the argillaceous formation by forced ventilation. This experiment has been selected in the international project DECOVALEX to be used for process model development and validation. The numerical simulation of the geochemical response to the ventilation experiment (VE) is the object of the present paper, focusing on the transport of chloride as a conservative species and sulphate as a reactive species. Utilising the validated hydro-mechanical (HM) results from earlier steps of the DECOVALEX task, reactive and non-reactive transport models, incorporating the current understanding of the geochemistry at the site, were successfully constructed for the whole experimental period. The associated parametric and process uncertainty analyses clearly demonstrate that the basic HM understanding must be sound. However, to demonstrate this degree of robustness, the explicit inclusion of process representations of water desaturation, liquid vaporisation, species exclusion porosity, and redox processes, is required. | Alexander Bond Steven Benbow James Wilson Alain Millard Shigeo Nakama Myles English Christopher McDermott Benoit Garitte | 2013 | Journal of Rock Mechanics and Geotechnical Engineering2013，5，1： | 2 |
| 13 | Molecular Dynamics Simulations of the Complete Satellite Tobacco Mosaic Virus显示文摘 | Peter L. Freddolino Anton S. Arkhipov Steven B. Larson Alexander McPherson Klaus Schulten | 2006 | Structure2006，，3： | 2 |
| 14 | Efficacy and safety of standard and anti-reflux self-expanding metal stent: A systematic review and meta-analysis of randomized controlled trials显示文摘BACKGROUND Self-expanding metal stents are the main palliative treatment modality for unresectable esophageal cancer. Gastroesophageal reflux is a common adverse outcome after placement of esophageal stent for cancer involving the gastroesophageal junction and the gastric cardia. Anti-reflux stents with valve have been designed to prevent the acid reflux. The superiority of anti-reflux stent over standard stent in preventing gastroesophageal reflux has not been established well. This study compares the anti-reflux stent and the standard stent in terms of their efficacy to prevent acid reflux.AIM To compare the standard and the anti-reflux stents in terms of their efficacy,safety, and complications.METHODS The meta-analysis included 8 randomized clinical trials(RCTs) to compare pooled outcomes of total 395 patients. Primary outcomes include improvement in reflux symptoms and dysphagia score. Secondary outcomes include complications of stent migration, occlusion, and bleeding.RESULTS A total of eight RCTs were included in the meta-analysis. Compared to the standard stent, the anti-reflux stent showed a trend towards reduction in the dysphagia score without reaching a statistical significance [Standardized mean difference(SMD):-0.33(-0.71, 0.05); P = 0.09, I2: 37%]. There was no statistical difference in the gastrointestinal reflux(GER) scores between the two types of stents [SMD:-0.17(-0.78, 0.45); P = 0.008, I2: 74%]. Compared to standard stent,anti-reflux stent showed no difference in the risk of stent migration [OR: 1.37(0.66, 2.83); P = 0.40, I2: 0 %], bleeding [OR: 1.43(0.40, 5.13); P = 0.59, I2: 0 %], and obstruction [OR: 1.66(0.60, 4.60); P = 0.33, I2: 0 %].CONCLUSION Traditional self-expanding standard esophageal stent and anti-reflux stent with valve are similar in terms of outcomes and complications. | Sudha Pandit Hrishikesh Samant James Morris Steven J Alexander | 2019 | World Journal of Gastrointestinal Endoscopy2019，11，4： | 2 |
| 15 | Malaria over-diagnosis in Cameroon:diagnostic accuracy of Fluorescence and Staining Technologies(FAST)Malaria Stain and LED microscopy versus Giemsa and bright field microscopy validated by polymerase chain reaction显示文摘Background:Malaria is a major world health issue and its continued burden is due,in part,to difficulties in the diagnosis of the illness.The World Health Organization recommends confirmatory testing using microscopy-based techniques or rapid diagnostic tests(RDT)for all cases of suspected malaria.In regions where Plasmodium species are indigenous,there are multiple etiologies of fever leading to misdiagnoses,especially in populations where HIV is prevalent and children.To determine the frequency of malaria infection in febrile patients over an 8-month period at the Regional Hospital in Bamenda,Cameroon,we evaluated the clinical efficacy of the Flourescence and Staining Technology(FAST)Malaria stain and ParaLens AdvanceTM microscopy system(FM)and compared it with conventional bright field microscopy and Giemsa stain(GS).Methods:Peripheral blood samples from 522 patients with a clinical diagnosis of“suspected malaria”were evaluated using GS and FM methods.A nested PCR assay was the gold standard to compare the two methods.PCR positivity,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were determined.Results:Four hundred ninety nine samples were included in the final analysis.Of these,30 were positive via PCR(6.01%)with a mean PPV of 19.62%and 27.99%for GS and FM,respectively.The mean NPV was 95.01%and 95.28%for GS and FM,respectively.Sensitivity was 26.67%in both groups and specificity was 92.78%and 96.21%for GS and FM,respectively.An increased level of diagnostic discrepancy was observed between technicians based upon skill level using GS,which was not seen with FM.Conclusions:The frequency of malarial infections confirmed via PCR among patients presenting with fever and other symptoms of malaria was dramatically lower than that anticipated based upon physicians’clinical suspicions.A correlation between technician skill and accuracy of malaria diagnosis using GS was observed that was less pronounced using FM.Additionally,FM increased the specificity and improved the PPV,suggesting this relatively low cost approach could be useful in resource-limited environments.Anecdotally,physicians were reluctant to not treat all patients symptomatically before results were known and in spite of a negative microscopic diagnosis,highlighting the need for further physician education to avoid this practice of overtreatment.A larger study in an area with a known high prevalence is being planned to compare the two microscopy methods against available RDTs. | Sean M.Parsel Steven A.Gustafson Edward Friedlander Alexander A.Shnyra Aderosoye J.Adegbulu Ying Liu Nicole M.Parrish Syed A.Jamal Eve Lofthus Leo Ayuk Charles Awasom Carolyn J.Henry Carole P.McArthur | 2017 | Infectious Diseases of Poverty2017，6，1： | 2 |
| 16 | Doped Nanocry- stals 显示文摘 | David J Norris Alexander L Efros Steven C Erwin | 2008 | Science2008，319，5871： | 1 |
| 17 | The activity of γδ T cells against paediatric liver tumour cells and spheroids in cell culture显示文摘 | Alexander Hoh Alexander Dewerth Fabian Vogt Julia Wenz Patrick A. Baeuerle Steven W. Warmann Joerg Fuchs Sorin Armeanu‐Ebinger | 2012 | Liver Int2012，，1： | 1 |
| 18 | A New Classification of Thoracolumbar Injuries: The Importance of Injury Morphology, the Integrity of the Posterior Ligamentous Complex, and Neurologic Status显示文摘 | Alexander R. Vaccaro Ronald A. Lehman R John Hurlbert Paul A. Anderson Mitchel Harris Rune Hedlund James Harrop Marcel Dvorak Kirkham Wood Michael G. Fehlings Charles Fisher Steven C. Zeiller D Greg Anderson Christopher M. Bono Gordon H. Stock Andrew K. B | 2005 | Spine2005，，20： | 1 |
| 19 | 地氟烷与七氟烷在门诊手术全身麻醉维持中的对比研究:对苏醒早晚期及围手术期咳嗽的影响显示文摘背景目前地氧垸已经用于门诊全身麻醉手术的维持阶段,其相对于七氖烷在围手术期的优略性尚存争议。尽管各研究一致指出,地氟烷比七氟烷苏醒更快,但这种差异对苏醒晚期的影响却未有明确报道。并且,地氟烷与七氟烷相比,对咳嗽发生率的影响也存在争议。方法本研究中纳入了130例在全身麻醉下行浅表门诊手术的患者,随机分为2组。所有患者都静脉注射丙泊酚2mg/kg诱导,置入喉罩,采用1%-3%的七氟烷或3%-8%的地氟炕维持麻醉,吸入混合空气或氧气。调节吸入麻醉药的浓度,维持血流动力学稳定,并维持脑电双频谱指数(BIS)于50—60。并用局部浸润和静脉注射酮洛酸30mg镇痛。在手术结束时给予预防性止吐药物,包括昂丹司琼4mg、地塞米松4mg及甲氧氨普胺10mg。评估标准包括睁眼恢复时间,对指令做出反应的时间,定向力恢复的时间,14分快通道评分,首次进食时间,能坐立,可站立,独立行走及出院时间。手术后早期及离院后24小时内,记录患者对于麻醉的满意度,手术后第1天恢复正常活动的能力,不良反应的发生(如咳嗽、意向性运动、氧饱和度〈90%、咽痛及手术后恶心、呕吐),手术后镇痛药及止吐药的使用情况。结果2组患者的流行病学资料相近。尽管围手术期地氯烷组咳嗽的总体发生率高于七氟烷组(分别为60%和32%,P〈0.05),然而在真正应用吸入麻醉药期间(即麻醉维持中),咳嗽发生率的组间差异无显著性。地氧烷组患者苏醒较快,但两组所有患者在离开手术室之前都达到了快通道恢复标准(快通道评分≥12)。此外,离院时间(七氟炕组90±31分钟,地氟炕组98±5分钟)及手术后第1天能恢复正常活动的患者比率(七氟烷48%,地氟炕60%),在两组间的差异无显著性。结论用地氧烷进行维持全身麻醉具有苏醒迅速、咳嗽发生率高的特点。尽管与七氟烷相比,地氟炕在麻醉早期恢复较快,但两组晚期恢复的差异无显著性。两种吸入麻醉药都适用于门诊手术的麻醉。 | Paul F. White Jun Tang Ronald H. Wender Roya Yumul O. lameson Stokes Alexander Sloninsky Robert Naruse Robert Kariger Evelyn Norel Steven Mandel Tom Webb Alan Zaentz 王琦(译) 李文志(校) | 2011 | 麻醉与镇痛2011，7，1： | 1 |
| 20 | Molecular epidemiol-ogy and evolution of enterovirus 71 strains isolated from 1970 to1998显示文摘 | Bipwn BA Steven OM Alexander JP | 1999 | J Virol1999，73，12： | 1 |
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