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    题名 作者 年代 出处 被引量
1去个性化效应的社会认同模型显示文摘去个性化效应的社会认同模型(Social identity model of deindividuation effects,SIDE)是从去个性化理论发展而来,它挑战了去个性化是一定条件下个体失去自我而做出反规则、反社会行为的观点。SIDE从认知维度和策略维度对去个性化现象作了新的解释。新近研究为SIDE提供了证据,也在认同行为表达、网络交流等方面对理论进行了拓展和应用。SIDE的提出在一定程度上更适合现代社会心理学对群体影响和群体行为的研究,同时也需要在更加广泛的文化背景中进一步验证和完善。兰玉娟 佐斌 2009心理科学进展2009,17,2:30
2A NUMERICAL STUDY ON THE FORMATION AND DEVELOPMENT OF ISLAND-INDUCED CYCLONE AND ITS IMPACT ON TYPHOON STRUCTURE CHANGE AND MOTION显示文摘In this paper,the impact of the Taiwan Island topography on the structure change and motion ofTyphoon Dot(9017)during its crossing the Taiwan Island is studied with a modified version of aJMA operational regional model(Japan spectral model,JSM).A series of sensitivity experiments areconducted to detect the forming and developing mechanism of an island-induced cyclone.Results showthat lee side low pressure center plays a very important role in the formation of the induced-cyclonewhile a typhoon is approaching a large island with high mountains.The position and intensity of theinduced cyclone is sensitive to the height and location of island mountain,intensity of TC and under-lying surface topography distribution as well.A preliminary formation criterion of the island-inducedcyclone is obtained.孟智勇 永田雅 陈联寿 1996Acta meteorologica Sinica1996,10,4:24
3Outcomes of furazolidone-and amoxicillin-based quadruple therapy for Helicobacter pylori infection and predictors of failed eradication显示文摘AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication.Ya-Wen Zhang Wei-Ling Hu Yuan Cai Wen-Fang Zheng Qin Du John J Kim John Y Kao Ning Dai Jian-Min Si 2018World Journal of Gastroenterology2018,24,40:18
4Non-steroidal anti-inflammatory drugs:What is the actual risk of liver damage?显示文摘Non-steroidal anti-inflammatory drugs (NSAIDs) constitute a family of drugs, which taken as a group, represents one of the most frequently prescribed around the world. Thus, not surprisingly NSAIDs, along with antiinfectious agents, list on the top for causes of DrugInduced Liver Injury (DILI). The incidence of liver disease induced by NSAIDs reported in clinical studies is fairly uniform ranging from 0.29/100 000 [95% confidence interval (CI): 0.17-051] to 9/100 000 (95% CI: 6-15). However, compared with these results, a higher risk of liver-related hospitalizations was reported (3-23 per 100 000 patients). NSAIDs exhibit a broad spectrum of liver damage ranging from asymptomatic, transient, hyper-transaminasemia to fulminant hepatic failure. However, under-reporting of asymptomatic, mild cases, as well as of those with transient liver-tests alteration, in conjunction with reports non-compliant with pharmacovigilance criteria to ascertain DILI and flawed epidemiological studies, jeopardize the chance to ascertain the actual risk of NSAIDs hepatotoxicity. Several NSAIDs, namely bromfenac, ibufenac and benoxaprofen, have been withdrawn from the market due to hepatotoxicity; others like nimesulide were never marketed in some countries and withdrawn in others. Indeed, the contro-versy concerning the actual risk of severe liver disease persists within NSAIDs research. The present work intends (1) to provide a critical analysis of the dissimilar results currently available in the literature concerning the epidemiology of NSAIDS hepatotoxicity; and (2) to review the risk of hepatotoxicity for each one of the most commonly employed compounds of the NSAIDs family, based on past and recently published data.Fernando Bessone 2010World Journal of Gastroenterology2010,16,45:16
5Oral pathology in inflammatory bowel disease显示文摘The incidence of inflammatory bowel diseases(IBD)-Crohn's disease(CD) and ulcerative colitis(UC)- has been increasing on a global scale, and progressively, more gastroenterologists will be included in the diagnosis and treatment of IBD. Although IBD primarily affects the intestinal tract, extraintestinal manifestations of the disease are often apparent, including in the oral cavity, especially in CD. Specific oral manifestations in patients with CD are as follows: indurate mucosal tags, cobblestoning and mucogingivitis, deep linear ulcerations and lip swelling with vertical fissures. The most common non-specific manifestations, such as aphthous stomatitis and angular cheilitis, occur in both diseases, while pyostomatitis vegetans is more pronounced in patients with UC. Non-specific lesions in the oral cavity can also be the result of malnutrition and drugs. Malnutrition, followed by anemia and mineral and vitamin deficiency, affects the oral cavity and teeth. Furthermore, all of the drug classes that are applied to the treatment of inflammatory bowel diseases can lead to alterations in the oral cavity due to the direct toxic effects of the drugs on oral tissues, as well as indirect immunosuppressive effects with a risk of developing opportunistic infections or bone marrow suppression. There is a higher occurrence of malignant diseases in patients with IBD, which is related to the disease itself and to the IBD-related therapy with a possible oral pathology. Treatment of oral lesions includes treatment of the alterations in the oral cavity according to the etiology together with treatment of the primary intestinal disease, which requires adequate knowledge and a strong cooperation between gastroenterologists and specialists in oral medicine.miranda muhvic-urek marija tomac-stojmenovic brankica mijandrusic-sincic 2016World Journal of Gastroenterology2016,22,25:11
6Personalized targeted therapy for esophageal squamous cell carcinoma显示文摘Esophageal squamous cell carcinoma continues to heavily burden clinicians worldwide. Researchers have discovered the genomic landscape of esophageal squamous cell carcinoma, which holds promise for an era of personalized oncology care. One of the most pressing problems facing this issue is to improve the understanding of the newly available genomic data, and identify the driver-gene mutations, pathways, and networks. The emergence of a legion of novel targeted agents has generated much hope and hype regarding more potent treatment regimens, but the accuracy of drug selection is still arguable. Other problems, such as cancer heterogeneity, drug resistance, exceptional responders, and side effects, have to be surmounted. Evolving topics in personalized oncology, such as interpretation of genomics data, issues in targeted therapy, research approaches for targeted therapy, and future perspectives, will be discussed in this editorial.Xiaozheng Kang Keneng Chen Yicheng Li Jianying Li Thomas A D'Amico Xiaoxin Chen 2015World Journal of Gastroenterology2015,21,25:10
7Frequency control of future power systems: reviewing and evaluating challenges and new control methods显示文摘Integration of more renewable energy resources introduces a challenge in frequency control of future power systems.This paper reviews and evaluates the possible challenges and the new control methods of frequency in future power systems.Different types of loads and distributed energy resources(DERs) are reviewed.A model representation of a population of the water heater devices for the demand side frequency response is considered.A model representation of a population of battery energy storage system(BESS)-based DERs such as smart electric vehicles(EVs) charging, large-scale BESSs, and residential and non-residential BESSs, are highlighted.The simplified Great Britain power system and the 14-machine South-East Australian power system were used to demonstrate the effectiveness of the new methods in controlling power system frequency following a disturbance.These new methods are effective in recovering the fallen frequency response and present a great potential in controlling the frequency in future power systems.Zeyad Assi OBAID Liana M.CIPCIGAN Lahieb ABRAHIM Mazin T.MUHSSIN 2019Journal of Modern Power Systems and Clean Energy2019,7,1:8
8Effect of vildagliptin as add-on therapy to a low-dose metformin显示文摘AIM:To evaluate the efficacy and safety of the addition of vildagliptin to low-dose metformin and compare it to an uptitration of metformin in type 2 diabetes mellitus(T2DM) patients who have inadequate control with metformin monotherapy.METHODS:Eligible patients were randomized to receive vildagliptin 100 mg qd or metformin(500 mg qd for 2 wk and then 500 mg bid) added to open label me tformin 500 mg bid for the 24 wk.The primary endpoi nt was baseline to endpoint hemoglobin A1c(HbA1c) change.RESULTS:The adjusted mean change from baseline in HbA1c at the 24th wk was-0.51% in the vildagliptin/metformin group(mean baseline HbA1c:7.4%) and-0.37% in the metformin monothera py group(mean baseline HbA1c:7.3%).The mean diffe rence was-0.14% with 95% Confidence Interval(-0.24%,-0.05%).As non-inf e riority(margin of 0.4%) was achieved,a test for superiority was performed.This test showed statistically significant superiority of the combination over monotherapy group(P = 0.002).Gastrointestinal(GI) adverse events were signif icantly more frequent in the metformin group than the combin ation group(21.0% vs 15.4%,P = 0.032).CONCLUSION:In patients with T2DM inadequately controlled with metformin up to 1000 mg daily,the addition of vildagliptin 100 mg daily achieved larger HbA1c reduction with fewer GI events than with increa sing the metformin dose.Claudia Filozof Sherwyn Schwartz James E Foley 2010World Journal of Diabetes2010,1,1:8
9Load curve smoothing strategy based on unified state model of different demand side resources显示文摘Renewable energy based distributed generation(DG) has the potential to reach high penetration levels in the residential region. However, its integration at the demand side will cause rapid power fluctuations of the tieline in the residential region. The traditional generators are generally difficult to manage rapid power fluctuations due to their insufficient efficiency requirements and low responding speed. With an effective control strategy, the demand side resources(DSRs) including DGs, electric vehicles and thermostatically-controlled loads at thedemand side, are able to serve as the energy storage system to smooth the load fluctuations. However, it is a challenge to properly model different types of DSRs. To solve this problem, a unified state model is first developed to describe the characteristics of different DSRs. Then a load curve smoothing strategy is proposed to offset the load fluctuations of the tie-line of the residential region, where a control matrix deduced from the unified state model is introduced to manage the power outputs of different DSRs,considering the response order and the comfort levels.Finally, a residential region with households is used to validate the load curve smoothing strategy based on the unified state model, and the results show that the power fluctuation rate of the tie-line is significantly decreased.Meanwhile, comparative study results are shown to demonstrate the advantages of the unified state model based load curve smoothing strategy.Mingshen WANG Yunfei MU Tao JIANG Hongjie JIA Xue LI Kai HOU Tong WANG 2018Journal of Modern Power Systems and Clean Energy2018,6,3:8
10Effect of low-dose amitriptyline on globus pharyngeus and its side effects显示文摘AIM:To compare the efficacy and side effects of lowdose amitriptyline(AMT)with proton pump inhibitor treatment in patients with globus pharyngeus.METHODS:Thirty-four patients who fulfilled the RomeⅢcriteria for functional esophageal disorders were included in this study.Patients were randomly assigned to receive either 25 mg AMT before bedtime(AMT group)or 40 mg Pantoprazole once daily for 4 wk(conventional group).The main efficacy endpoint was assessed using the Glasgow Edinburgh Throat Scale(GETS).The secondary efficacy endpoints included the Medical Outcomes Study 36-item short form health survey[social functioning(SF)-36]and the Pittsburgh Sleep Quality Index.Treatment response was defined as a>50%reduction in GETS scores.All patients entering this study recorded side effects at days 1,8,15,22 and 29 using a visual analogue scale.RESULTS:Thirty patients completed the study.After 4 wk of treatment,the AMT group had a greater response than the conventional group(75%vs 35.7%,P=0.004).At day 3,the AMT group showed significantly more improvement than the Conventional group in GETS score(3.69±1.14 vs 5.64±1.28,P=0.000).After 4 wk of treatment,the AMT group showed significantly greater improvement in GETS score and sleep quality than the Conventional group(1.25±1.84 vs 3.79±2.33,4.19±2.07 vs 8.5±4.97;P<0.01 for both).Additionally,the AMT group was more likely than the Conventional group to experience improvement in the SF-36,including general health,vitality,social functioning and mental health(P=0.044,0.024,0.049 and 0.005).Dry mouth,sleepiness,dizziness and constipation were the most common side effects.CONCLUSION:Low-dose AMT is well tolerated and can significantly improve patient symptoms,sleep and quality of life.Thus,low-dose AMT may be an effective treatment for globus pharyngeus.Le-Qing You Jing Liu Lin Jia Shu-Man Jiang Gui-Qin Wang 2013World Journal of Gastroenterology2013,19,42:7
11The simultaneous removal of ammonium and manganese from surface water by MeO_x:Side effect of ammonium presence on manganese removal显示文摘Manganese and ammonium pollution in surface water sources has become a serious issue.In this study, a pilot-scale filtration system was used to investigate the effect of ammonium on manganese removal during the simultaneous removal of ammonium and manganese from surface water using a manganese co-oxide filter film(MeO_x ). The results showed that the manganese removal efficiency of MeO_x in the absence of ammonium was high and stable, and the removal efficiency could reach 70% even at 5.5 °C. When the influent ammonium concentration was lower than 0.7 mg/L, ammonium and manganese could be removed simultaneously. However, at an ammonium concentration of 1.5 mg/L, the manganese removal efficiency of the filter gradually decreased with time(from 96% to 46.20%). Nevertheless, there was no impact of manganese on ammonium removal. The mechanism by which ammonium negatively affected manganese removal was investigated, demonstrating that ammonium affected manganese removal mainly through two possible mechanisms. On one hand, the decreased p H caused by ammonium oxidation was unfavorable for the oxidation of manganese by MeO_x ; on the other hand, the presence of ammonium slowed the growth of new MeO_x and retarded the increase in the specific surface area of the Me Ox-coated sand, and induced changes in the morphology and crystal structure of Me Ox. Consequently, the manganese removal efficiency of the filter decreased when ammonium was present in the inlet water.Xuan Tian Ruifeng Zhang Tinglin Huang Gang Wen 2019Journal of Environmental Sciences2019,31,3:6
12Control mechanism and technique of floor heave with reinforcing solid coal side and floor corner in gob-side coal entry retaining显示文摘Floor heave is the most common convergence in gob-side entry retaining.The paper analyzes the form,process and characteristics of gob-side entry retaining with the comprehensive methods of theoretical analysis,numerical simulation and the field trial.Research results present that bending and folding floor heave is the main factor in the stage of the first panel mining;squeezing and fluidity floor heave plays a great role in the stable stage of gob-side entry retaining;the combination of the former two factors affects mainly the stage of the second mining ahead;abutment pressure is a fundamental contribution to the serious floor heave of gob-side entry retaining,and sides corners of solid coal body are key part in the case of floor heave controlling of gob-side entry retaining.Floor heave of gob-side entry retaining can be significantly controlled by reinforcing sides and corners of solid coal body,and influence rules on the floor heave of gob side entry retaining of sides supporting strength and the bottom bolt orientation in solid coal side are obtained.Research results have been successfully applied in gob-side entry retaining of G20-F23070 face haulage roadway in #2 coal mine of Pingmei Group,and the field observation shows that the proposed technique is an effective way in controlling the floor heave of gob-side entry retaining.Chen Yong Bai Jianbiao Yan Shuai Xu Ying Wang Xiangyu Ma Shuqi 2012International Journal of Mining Science and Technology2012,22,6:6
13Surrounding rock control of gob-side entry driving with narrow coal pillar and roadway side sealing technology in Yangliu Coal Mine显示文摘Gob-side entry driving can increase coal recovery ratio, and it is implied in many coal mines. Based on geological condition of 10416 working face tailentry in Yangliu Coal Mine, the surrounding rock deformation characteristics of gob-side entry driving with narrow coal pillar is analysed, reasonable size of coal pillar and reasonable roadway excavation time after mining are achieved. Surrounding rock control technology and effective roadway side sealing technology are proposed and are taken into field practice. The results showed that a safer and more efficient mining of working face can be achieved. In addition, results of this paper also have important theoretical significance and valuable reference for surrounding rock control technology of gob-side entry driving with narrow coal pillar under special geological condition.Zha Wenhua Shi Hao Liu San Kang Changhao 2017International Journal of Mining Science and Technology2017,27,5:6
14Chinese consensus on management of tyrosine kinase inhibitor-associated side effects in gastrointestinal stromal tumors显示文摘Tyrosine kinase inhibitors(TKIs) have improved the overall survival of patients with gastrointestinal stromal tumors(GISTs), but their side effects can impact dose intensity and, consequently, the clinical benefit. To date, no guideline or consensus has been published on the TKI-associated adverse reactions. Therefore, the Chinese Society of Surgeons for Gastrointestinal Stromal Tumor of the Chinese Medical Doctor Association organized an expert panel discussion involving representatives from gastrointestinal surgery, medical oncology, cardiology, dermatology, nephrology, endocrinology, and ophthalmology to consider the systemic clinical symptoms, molecular and cellular mechanisms, and treatment recommendations of GISTs. Here, we present the resultant evidence-and experience-based consensus to guide the management of TKI-associated side events in clinical practice.Jian Li Ming Wang Bo Zhang Xin Wu Tian-Long Lin Xiu-Feng Liu Ye Zhou Xin-Hua Zhang Hao Xu Li-Jing Shen Jing Zou Ping Lu Dong Zhang Wei-Jun Gu Mei-Xia Zhang Jian Pan Hui Cao 2018World Journal of Gastroenterology2018,24,46:6
15Amylopectin structure and crystallinity explains variation in digestion kinetics of starches across botanic sources in an in vitro pig model显示文摘Background: Starch is the main source of energy in commonly used pig diets.Besides effects related to the extent of starch digestion,also several effects related to variation in digestion rate have recently been demonstrated in non-ruminants.Different rates of starch digestion in animals and in in vitro models have been reported,depending on the botanic origin of starch.Starches from different botanic sources differ widely in structural and molecular properties.Predicting the effect of starch properties on in vitro digestion kinetics based on existing literature is hampered by incomplete characterization of the starches,or by a selective choice of starches from a limited number of botanic sources.This research aimed to analyse the relationships between starch properties and in vitro digestion kinetics of pure starches isolated from a broad range of botanic origins,which are used in non-ruminant diets or have a potential to be used in the future.Therefore we studied starch digestion kinetics of potato,pea,corn,rice,barley,and wheat starches,and analysed the granule diameter,number of pores,type and amount of crystalline structure,amylose content and amylopectin side-chain length of all starches.Results: Multivariate analysis revealed strong correlations among starch properties,leading us to conclude that effects of most starch characteristics are strongly interrelated.Across all analysed botanic sources,crystalline type and amylopectin chain length showed the strongest correlation with in vitro digestion kinetics.Increased percentages of A–type crystalline structure and amylopectin side chains of DP 6–24 both increased the rate of digestion.In addition,within,but not across,(clusters of) botanic sources,a decrease in amylose content and increase in number of pores correlated positively with digestion kinetics.Conclusion: The type of crystalline structure and amylopectin chain length distribution of starch correlate significantly with digestion kinetics of starches across botanic sources in an in vitro pig model.Variation in digestion kinetics across botanic sources is not additively explained by other starch properties measured,but appears to be confined within botanical sources.Bianca M.J.Martens Walter J.J.Gerrits Erik M.A.M.Bruininx Henk A.Schols 2019Journal of Animal Science and Biotechnology2019,10,1:6
16Research on the Lightweight Design of Body-Side Structure Based on Crashworthiness Requirements显示文摘Crash worthiness is the most significant variable during lightweight design of vehicle struc tures.However,crashworthiness studies using the single substructure-based method are limited due to the negligence of interactions among substructures.Thus,a whole structure-based study was conducted for the lightweight design of a body-side structure.In this study,a full finite element model was firstly created and then modified into a simplified model for structural improvements,where the major load-carrying subassemblies were improved from the perspectives of crashworthiness and manufacturing costs.Finally,sensitivity analyses were conducted to further optimize the strength distribution,based on which an adaptive response surface method was employed for thickness optimization of the structure.It is found that through the structural improvements and optimizations,the weight of the structure was significantly reduced even when its crashworthiness was improved.This indicates that the whole structure-based method is effective for lightweight design of vehicle structures.庄蔚敏 施宏达 解东旋 陈延红 杨昌海 2019Journal of Shanghai Jiaotong university(Science)2019,24,3:5
17Primary analysis and screening of microRNAs in gastric cancer side population cells显示文摘AIM: To explore the micro RNA(mi RNA) profiles and to determine the key mi RNAs within the side population(SP) cells of the gastric cancer cell line MKN-45. METHODS: We used fluorescence-activated cell sorting and Hoechst 33342 labeling to obtain SP cells from the human gastric carcinoma cell line MKN-45. The mi RNA expression profiles of the SP and major population(MP) cells were examined using a mi RNA gene chip, and key mi RNAs were obtained according to aberrant expression and the mi RNAs' possible targets as predicted by bioinformatics. RESULTS: Using a significance criterion of a 1.5-fold or greater difference in expression level, we observed an increase in the expression of 34 mi RNAs and a decrease in the expression of 34 mi RNAs when comparing SP to MP cells. Using quantitative real-time reverse transcription-polymerase chain reaction to test for differentially expressed mi RNAs combined with bioinformatics results, we found that the downregulated mi RNAs, such as hsa-mi R-3175 and hsa-mi R-203, and the upregulated mi RNAs, including hsa-mi R-130 a, hsa-mi R-324-5p, hsa-mi R-34 a, and hsa-mi R-25-star, may be important in maintaining and regulating the characteristics of SP cells. CONCLUSION: There are key mi RNAs expressed within the SP cells of the gastric cancer cell line MKN-45, andinclude hsa-mi R-3175, hsa-mi R-203, hsa-mi R-130 a, hsami R-324-5p, hsa-mi R-34 a, and hsa-mi R-25-star.Hai-Hong Zhang Guo-Li Gu Xiang-Yang Zhang Feng-Zhi Li Li Ding Qin Fan Ran Wu Wei Shi Xin-Yan Wang Lin Chen Xue-Ming Wei Xiao-Ying Yuan 2015World Journal of Gastroenterology2015,21,12:5
18Smoking in schizophrenic patients:A critique of the selfmedication hypothesis显示文摘A common remark among laypeople, and notably also among mental health workers, is that individuals with mental illnesses use drugs as self-medication to allay clinical symptoms and the side effects of drug treatments. Roots of the self-medication concept in psychiatry date back at least to the 1980 s. Observations that rates of smokers in schizophrenic patients are multiple times the rates for regular smoking in the general population, as well as those with other disorders, proved particularly tempting for a self-medication explanation. Additional evidence came from experiments with animal models exposed to nicotine and the identification of neurobiological mechanisms suggesting self-medication with smoking is a plausible idea. More recently, results from studies comparing smoking and non-smoking schizophrenic patients have led to the questioning of the self-medication hypothesis. Closer examination of the literature points to the possibility that smoking is less beneficial on schizophrenic symptomology than generally assumed while clearly increasing the risk of cancer and other smoking-related diseases responsible for early mortality. It is a good time to examine the evidence for the self-medication concept as it relates to smoking. Our approach is to focus on data addressing direct or implied predictions of the hypothesis in schizophrenic smokers.Francesca Manzella Susan E Maloney George T Taylor 2015World Journal of Psychiatry2015,5,1:4
19Short term outcomes of minimally invasive selective lateral pelvic lymph node dissection for low rectal cancer显示文摘BACKGROUND Pelvic recurrence after rectal cancer surgery is still a significant problem despite the introduction of total mesorectal excision and chemoradiation treatment(CRT),and one of the most common areas of recurrence is in the lateral pelvic lymph nodes.Hence,there is a possible role for lateral pelvic lymph node dissection(LPND)in rectal cancer.AIM To evaluate the short-term outcomes of patients who underwent minimally invasive LPND during rectal cancer surgery.Secondary outcomes were to evaluate for any predictive factors to determine lymph node metastases based on pre-operative scans.METHODS From October 2016 to November 2019,22 patients with stage II or III rectal cancer underwent minimally invasive rectal cancer surgery and LPND.These patients were all discussed at a multidisciplinary tumor board meeting and most of them received neoadjuvant chemoradiation prior to surgery.All patients had radiologically positive lateral pelvic lymph nodes on the initial staging scans,defined as lymph nodes larger than 7 mm in long axis measurement,or abnormal radiological morphology.LPND was only performed on the involved side.RESULTS Majority of the patients were male(18/22,81.8%),with a median age of 65 years(44-81).Eighteen patients completed neoadjuvant CRT pre-operatively.18 patients(81.8%)had unilateral LPND,with the others receiving bilateral surgery.The median number of lateral pelvic lymph nodes harvested was 10(3-22)per pelvic side wall.8 patients(36.4%)had positive metastases identified in the lymph nodes harvested.The median pre-CRT size of these positive lymph nodes was 10 mm.Median length of stay was 7.5 d(3-76),and only 2 patients failed initial removal of their urinary catheter.Complication rates were low,with only 1 lymphocele and 1 anastomotic leak.There was only 1 mortality(4.5%).There have been no recurrences so far.CONCLUSION Chemoradiation is inadequate in completely eradicating lateral wall metastasis and there are still technical limitations in accurately diagnosing metastases in these areas.A pre-CRT lymph node size of≥10 mm is suggestive of metastases.LPND may be performed safely with minimally invasive surgery.Kar Yong Wong Aloysius MN Tan 2020World Journal of Gastrointestinal Surgery2020,12,4:4
20Hepatitis C treatment in the elderly:New possibilities and controversies towards interferon-free regimens显示文摘Due to the progressive aging of the hepatitis C virus(HCV) population which have acquired the infection during its maximum spread after the Second World War, the management of the elderly HCV-infected patient is emerging as a hot topic. Unfortunately, although it is recognized that the progression of HCV-related liver disease gets faster with aging, and that even extrahepatic manifestations of HCV infection are probably worse in the elderly, till now, treatment attempts in this population have been significantly limited by the wellknown contraindications and side effects of interferon(IFN). The arrival of several new anti-HCV drugs, and the possibility to combine them in safe and effective anti-viral regimens, is relighting the hope of a cure for many elderly patients who had been cut out of IFN-based treatments. However, although these new regimens will be certainly more manageable, it should be underscored that IFN-free doesn't mean free from any contraindication or side-effect. Moreover, one issue which promises to become central is that of the possible interactions between antiviral therapy and the multiple drugs frequently assumed by elderly patients because of comorbidities. In this review, we will revise the epidemiology pointing to HCV as an infection of the elderly, the evidences that HCV harms the health of the aged patient more than that of the young one, and the available experiences of HCV treatment in the elderly with the 'old' IFN-based regimens and with the newer drugs. We will conclude that the availability of IFNfree regimens should prompt us to change our mind and consider a significantly larger number of possible candidates among elderly patients, who would take significant advantage from viral eradication. Rather than the anagraphic age, drug-drug interactions and, mainly in case of economic restrictions, an evaluation of life expectancy dependent on liver disease with respect to that dependent on comorbidities, are likely to be the key issues guiding treatment indication in the next future. The sooner we will change our mind with respect to an a priori obstacle for anti-HCV treatment in the elderly, the sooner we will begin to spare many aged HCV patients from avoidable liver-related complications.Umberto Vespasiani-Gentilucci Giovanni Galati Paolo Gallo Antonio De Vincentis Elisabetta Riva Antonio Picardi 2015World Journal of Gastroenterology2015,21,24:4
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