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| 1 | Mediastinal node staging by positron emission tomographycomputed tomography and selective endoscopic ultrasound with fine needle aspiration for patients with upper gastrointestinal cancer:Results from a regional centre显示文摘AIM To investigate the impact of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) and positron emission tomography-computed tomography(PET-CT) in the nodal staging of upper gastrointestinal(GI) cancer in a tertiary referral centre.METHODS We performed a retrospective review of prospectively recorded data held on all patients with a diagnosis of upper GI cancer made between January 2009 and December 2015. Only those patients who had both a PET-CT and EUS with FNA sampling of a mediastinal node distant from the primary tumour were included. Using a positive EUS-FNA result as the gold standard for lymph node involvement, the sensitivity, specificity, positive and negative predictive values(PPV and NPV) and accuracy of PET-CT in the staging of mediastinal lymph nodes were calculated. The impact on therapeutic strategy of adding EUS-FNA to PET-CT was assessed.RESULTS One hundred and twenty one patients were included. Sixty nine patients had a diagnosis of oesophageal adenocarcinoma(Thirty one of whom were junctional), forty eight had oesophageal squamous cell carcinoma and four had gastric adenocarcinoma. The FNA results were inadequate in eleven cases and the PET-CT findings were indeterminate in two cases, therefore thirteen patients(10.7%) were excluded from further analysis. There was concordance between PET-CT and EUS-FNA findings in seventy one of the remaining one hundred and eight patients(65.7%). The sensitivity, specificity, PPV and NPV values of PET-CT were 92.5%, 50%, 52.1% and 91.9% respectively. There was discordance between PET-CT and EUS-FNA findings in thirty seven out of one hundred and eight patients(34.3%). MDT discussion led to a radical treatment pathway in twenty seven of these cases, after the final tumour stage was altered as a direct consequence of the EUS-FNA findings. Of these patients, fourteen(51.9%) experienced clinical remission of a median of nine months(range three to forty two months). CONCLUSION EUS-FNA leads to altered staging of upper GI cancer, resulting in more patients receiving radical treatment that would have been the case using PET-CT staging alone. | Chris Harrington Lyn Smith Jennifer Bisland Elisabet López González Neil Jamieson Stuart Paterson Adrian John Stanley | 2018 | World Journal of Gastrointestinal Endoscopy2018，10，1： | 4 |
| 2 | Objective assessment of bradykinesia in Parkinson’s disease using evolutionary algorithms:clinical validation显示文摘Background:There is an urgent need for developing objective,effective and convenient measurements to help clinicians accurately identify bradykinesia.The purpose of this study is to evaluate the accuracy of an objective approach assessing bradykinesia in finger tapping(FT)that uses evolutionary algorithms(EAs)and explore whether it can be used to identify early stage Parkinson’s disease(PD).Methods:One hundred and seven PD,41 essential tremor(ET)patients and 49 normal controls(NC)were recruited.Participants performed a standard FT task with two electromagnetic tracking sensors attached to the thumb and index finger.Readings from the sensors were transmitted to a tablet computer and subsequently analyzed by using EAs.The output from the device(referred to as'PD-Monitor')scaled from−1 to+1(where higher scores indicate greater severity of bradykinesia).Meanwhile,the bradykinesia was rated clinically using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale(MDS-UPDRS)FT item.Results:With an increasing MDS-UPDRS FT score,the PD-Monitor score from the same hand side increased correspondingly.PD-Monitor score correlated well with MDS-UPDRS FT score(right side:r=0.819,P=0.000;left side:r=0.783,P=0.000).Moreover,PD-Monitor scores in 97 PD patients with MDS-UPDRS FT bradykinesia and each PD subgroup(FT bradykinesia scored from 1 to 3)were all higher than that in NC.Receiver operating characteristic(ROC)curves revealed that PD-Monitor FT scores could detect different severity of bradykinesia with high accuracy(≥89.7%)in the right dominant hand.Furthermore,PD-Monitor scores could discriminate early stage PD from NC,with area under the ROC curve greater than or equal to 0.899.Additionally,ET without bradykinesia could be differentiated from PD by PD-Monitor scores.A positive correlation of PD-Monitor scores with modified Hoehn and Yahr stage was found in the left hand sides.Conclusions:Our study demonstrated that a simple to use device employing classifiers derived from EAs could not only be used to accurately measure different severity of bradykinesia in PD,but also had the potential to differentiate early stage PD from normality. | Chao Gao Stephen Smith Michael Lones Stuart Jamieson Jane Alty Jeremy Cosgrove Pingchen Zhang Jin Liu Yimeng Chen Juanjuan Du Shishuang Cui Haiyan Zhou Shengdi Chen | 2018 | Translational Neurodegeneration2018，7，1： | 3 |
| 3 | 肺动脉内膜剥脱术治疗慢性栓塞性肺动脉高压——UCSD32例手术经验显示文摘目的 分析肺动脉内膜剥脱术(PEA)治疗慢性栓塞性肺动脉高压的围手术期资料,探讨美国加州大学圣迭戈分校(UCSD)手术经验.方法 回顾性研究UCSD 32例肺动脉血栓内膜剥脱手术资料,其中男17例,女15例;平均年龄(47.56±16.04)岁,平均病程(3.90±4.61)年;15例有深静脉血栓病史.采用全麻、胸骨正中切口、深低温、间断停循环双侧肺动脉内膜剥脱的手术方法.结果 根据术中病理标本Jamieson分型,Ⅰ型占21.8%,Ⅱ型占28.1%,Ⅲ型占37.5%.平均转机(236.32±37.27)min,主动脉阻断(111.69±28.14)min,停循环(38.00±13.58)min.术后机械通气(66.23±99.24)h,住ICU(4.62±4.50)天,无死亡.病人肺动脉收缩压由术前(81.03±16.92)mm Hg(1 mm Hg=0.133 kPa)降至术后(51.20±12.16)mm Hg,肺血管阻力由术前(88.91±42.32)kPa·s·L-1降至术后的(34.38±15.68)kPa·s·L-1,心排量由术前(3.65±1.08)L/min增加到术后(5.85±1.21)L/min,中心静脉压由(13.07±2.11)cmH2O(1 cmH2O=0.098 kPa)降至(9.86±3.02)cmH2O.术后短期随访显示,病人心功能(NYHA)恢复到Ⅰ级19例、Ⅱ级13例,生活质量明显改善.结论 PEA是治疗慢性栓塞性肺动脉高压的重要手段,手术成功率逐年提高;深低温、间断停循环、双侧肺动脉内膜剥脱及内膜外翻技术为PEA标准术式.多中心资料证实该术式可以有效降低肺动脉压和肺血管阻力,明显改善血流动力学指标和心肺功能.多数国内医疗中心没有足够手术经验,应尽量避免选择肺动脉压收缩≥100mmHg,肺血管阻力≥100kPa·s·L^-1及Ⅲ型病变者行PEA手术. | 顾松 刘岩 苏丕雄 翟振国 杨媛华 王辰 Michael M. Madani Stuart W. Jamieson | 2010 | 中华胸心血管外科杂志2010，26，4： | 2 |
| 4 | Virtually complete 1H,^13C and 15N resonance assignments of the second family 4 xylan binding module of Rhodothermus marinus xylanase 10A显示文摘 | Jamieson Stuart J Williamson Michael P Abou-Hachem Maher | 2002 | Journal of biomolecular NMR2002，22，2： | 1 |
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