BACKGROUND: The feasibility and immediate outcome of laparoscopic fenestration for patients with congenital liver cysts have been generally recognized. The aim of the present study was to assess the long-term results ...BACKGROUND: The feasibility and immediate outcome of laparoscopic fenestration for patients with congenital liver cysts have been generally recognized. The aim of the present study was to assess the long-term results after laparoscopic fenestration. METHODS: A retrospective study was performed on 44 patients with congenital liver cysts who had undergone laparoscopic fenestration between June 1998 and December 2004. Among them, 30 were women and 14 men, aged 57 years on average (range 18-76 years). While 14 patients had solitary cysts, 20 had multiple cysts, and 10 had polycystic liver disease. The results of laparoscopic fenestration, including mortality, morbidity, mean postoperative hospital stay, and recurrences of cysts were evaluated. RESULTS: There was no perioperative death and the morbidity rate was 11% (5/44). All complications were treated conservatively. The mean postoperative hospital stay was 4 days. A mean follow-up of 57 months showed that the rates of cyst recurrence and symptom recurrence were 9% and 4.5%, respectively. CONCLUSION: Laparoscopic fenestration as a feasible and safe treatment procedure for patients with congenital liver cysts can yield very good long-term results.展开更多
AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed,bone preserving and anatomical hip arthroplasty with the MiniHip^(TM)system.METHODS In a prospective study,186 patients under...AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed,bone preserving and anatomical hip arthroplasty with the MiniHip^(TM)system.METHODS In a prospective study,186 patients underwent hip arthroplasty with a partial neck preserving short stem(MiniHip^(TM),Corin).Elderly patients were not excluded from this study,thus the mean age at the time of surgery was 59.3 years(range 32 to 82 years).Surgery and the follow-up assessments were performed at two Centers.Up until now,the mean follow-up was 112.5±8.2 mo.The Oxford Hip Score(OHS)and the Hip Dysfunction Osteoarthritis and Outcome Score(HOOS)was assessed pre-and each year after surgery.The clinical follow-up was accompanied by standardized a.p.and axial radiological examinations.Periprosthetic lucencies,hypertrophies within the Gruen zones one to fourteen were assessed.A subsidence of the stem was investigated according to Morray and heterotopic ossifications were assessed according to Brooker.RESULTS The OHS and HOOS improved from 18±3.3 to 46±2.0 and from 30±8.3 to 95±4.6 points,P<0.001 respectively.There were no differences regarding age,etiology,friction pairings,etc.,(P>0.05).Two stems were revised due to a symptomatic subsidence four and twelve months postoperatively.Thus,the survivorship for aseptic loosening at nine to ten years was 98.66%.Including one stem revision due to a symptomatic exostosis,bursitis and thigh pain as well as one revision because of a septic stem loosening,the overall survival for the stem with revision for any reason was 97.32%.Besides one asymptomatic patient,radiological signs of a proximal stress-shielding,such as bone resorptions within the proximal Gruen zones,were not noticed.Findings suggesting a distal loading,e.g.,bony hypertrophies or bone appositions of more than 2 mm,were also not detected.CONCLUSION Regarding these first long-term results on the MiniHip^(TM),the implant performed exceedingly well with a high rate of survivorship for aseptic loosening.Our radiological results within the Gruen zones support the design rationale of the Minihip to provide a reliable metaphyseal anchoring with the expected proximal,more physiological load transfer.This might minimize or exclude a stress shielding which might be associated with thigh pain,proximal bone loss and an increased risk of aseptic loosening.The MiniHip^(TM)is a reliable partial-neck retaining prosthesis with good a clinical long-term outcome in younger as well as elderly patients.展开更多
AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 pat...AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 patients were enrolled in a phase Ⅱ study on the treatment of loco-regionally advanced esophageal cancer with radiotherapy(68.4 Gy/44 fractions or 61.2 Gy/34 fractions) combined with 4-cycle chemotherapy consisting of DDP(25 mg/m^2 per day for 3 d) and PTX(175 mg/m^2 for 3 h). The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were toxicity and the treatment failure pattern.RESULTS A total of 76 patients were enrolled in this study, of whom 63.2% finished the whole regimen. The 5-year survival rates for the per-protocol population and intent-to-treat population were 25.4% and 26.4%, respectively, and the median survival rates were 23.7 mo and 28.5 mo, respectively. Grade 3 or 4 late toxicity was observed in only one patient(heart failure). In log-rank analysis, the pretreatment stage(stage Ⅱ + Ⅲ: 36.1 mo vs stage Ⅳ: 14.9 mo) and the completed cycle(1-3 cycles: 16.1 mo vs 4 cycles: 35.5 mo) were significant prognostic factors(P = 0.037 < 0.05 and P = 0.013 < 0.05).CONCLUSION Radiotherapy combined with chemotherapy consisting of PTX and DDP is a safe and effective definitive treatment for loco-regionally advanced esophageal squamous cancer.展开更多
AIM： To evaluate the long-term results and complications of Ahmed glaucoma valve （AGV） implantation in a cohort of Egyptian patients. METHODS： A retrospective study of 124 eyes of 99 patients with refractory glauc...AIM： To evaluate the long-term results and complications of Ahmed glaucoma valve （AGV） implantation in a cohort of Egyptian patients. METHODS： A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure （lOP） measurement before surgery and at ld, weekly for the 1st month, 3, 6mo, and ly after surgery and yearly afterward for 5y. lOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as lOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. RESULTS： Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery, lOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes （41.1%）, complicated cataract in 9 eyes （7.25%）, recessed tube in 8 eyes （6.45%）, tube exposure in 6 eyes （4.8%） and corneal touch in 6 eyes （4.8%）. Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes （1.6%）. ~ CONCLUSION： Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful lOP control after AGV implantation. However, effective complications management can improve the rate of success.展开更多
BACKGROUND Budd-Chiari syndrome is defined as hepatic venous outflow tract obstruction.For Asian Budd-Chiari syndrome patients,the major treatment modality is recanalization(percutaneous transluminal angioplasty with ...BACKGROUND Budd-Chiari syndrome is defined as hepatic venous outflow tract obstruction.For Asian Budd-Chiari syndrome patients,the major treatment modality is recanalization(percutaneous transluminal angioplasty with or without stent implantation).The cumulative 1-,5-,and 10-year primary patency rates and survival rates are reported to be excellent or satisfactory,but the long-term outcome of patients with restenosis(the most common complication after recanalization)is unknown.AIM To explore the treatment strategy for restenosis in patients with Budd-Chiari syndrome after interventional therapy and to evaluate the long-term follow-up results.METHODS The clinical data and follow-up results of 60 patients with restenosis after interventional therapy from November 1983 to December 2013 were retrospectively analyzed.RESULTS Sixty patients with restenosis were retrospectively divided into a percutaneous transluminal angioplasty(PTA)group(40 patients)and a PTA+stent group(20 patients)according to the primary recanalization method.For the patients with restenosis in the PTA group,13 refused treatment,and 27 received further treatment;among these patients,five had a second restenosis,two had a third restenosis,and one had a fourth restenosis.For the patients with restenosis in the PTA+stent group,nine refused treatment,ten received PTA alone,and the other received PTA+stent implantation.Among the patients who received further treatment,five had a second restenosis,three had a third restenosis,and one had a fourth restenosis.The 1-,5-,10-,20-,and 25-year cumulative survival rates of the 38 patients who received further treatment after restenosis were 100%,78.3%,78.3%,70.5%,and 70.5%,respectively;however,for the 22 patients who refused treatment,the survival rates were 72.7%,45.9%,30.6%,10.2%,and unavailable,respectively(P<0.001).CONCLUSION Long-term follow-up after interventional therapy is very important.Active treatment for patients with restenosis can improve prognosis,and minimally invasive treatment strategies for restenosis allows to obtain satisfactory results.展开更多
This paper summarized the long-term follow-up results and our clinical treatment experience of 426 patients with carcinoma of salivary gland, who had undergone surgical treatment in our department from 1957 to 1976 su...This paper summarized the long-term follow-up results and our clinical treatment experience of 426 patients with carcinoma of salivary gland, who had undergone surgical treatment in our department from 1957 to 1976 successively. Our study showed that the 10-year and 15-year survival rates were 63.3% and 59.1% respectively, much higher than the results presented by other researchers. The following four points were concluded: 1. The long-term treatment result of salivary gland carcinoma is determined not only on mode of treatment and clinical stage, but more on its pathologic type. For high malignant salivary carcinoma, comprehensive multidiscipline treatments should be adopted. 2. Management of primary focus." The different operative principle and mode shouht be worked out in advance according to pathologic type and primary site of tumors. 3. Management of lymphonode: For cases with undifferentiated carcinoma, low-differentiated mucoepiderrnoid carcinoma, squamous cell carcinoma, adenocarcinoma and papillary cystadenocarcinoma, elective neck dissection should be performed. 4. Prevention of distant metastasis: Preoperative biopsy should be avoided. Frozen-section should be made during the operation and, diagnosis and treatment be accomplished in the meantime.展开更多
BACKGROUND： Hepatitis B virus（HBV）-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not...BACKGROUND： Hepatitis B virus（HBV）-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS： The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups： those equal or older than 60 years（older group,n60） and those younger than 60 years（younger group, n305）.Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS： Except for age and preexisting chronic disease（P0.05）,no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence（P0.05）. The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group（P0.05）. Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group（odds ratio=3.615, P0.014）.CONCLUSIONS： Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.展开更多
Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. ...Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. Objective: To investigate remote (7 and more years) results of treatment in patients with DAAs in operative treatment only if there is a danger of aneurysm rupture. A total of 82 patients with atherosclerotic DAA identified between 2008 and 2011, and 22 patients with type 1 or 3 DeBakey dissecting aneurysms (DA) who had not been operated in the acute period due to a number of reasons were examined. The follow-up period of these groups was 7 or more years. When using a sparing treatment to treat DAA, we saw survival of 90.1 at 2 years, 76.8% at 4 years, 59.4% at 6 years, and 57.5% at 7 years with the uniform increase in mortality rate, mainly due to a comorbidity. Survival in DA group (77.3%) was better due to a younger age and was 68.4% in operated and 54% in non-operated patients at 7 years. It is symptomatic that the aneurysm rupture rate was not always affected by operative treatment. Therefore, it seems like medical treatment is more consistent with etiopathogenesis of the disease compared to surgery during the stabilization period.展开更多
Purpose: This study analyzed oncological and functional outcomes of treatment for Ewing’s sarcoma, as well as its significant risk factors through long-term follow up. Objective and Method: Between September 1990 and...Purpose: This study analyzed oncological and functional outcomes of treatment for Ewing’s sarcoma, as well as its significant risk factors through long-term follow up. Objective and Method: Between September 1990 and April 2009, 20 cases that were diagnosed and treated as Ewing’s sarcoma in Kosin University Gospel Hospital were entered onto the study. Mean follow-up period was 45.4 (12 - 108) months. There were 7 cases of male and 13 cases of female, and mean age was 19.9 (5 - 48) years old. Retrospective review was done about treatment outcomes, complications, and significant risk factors. Results: In terms of oncologic results, there were 9 cases of CDF (continuous disease free), 1 case of NED (no evidence of disease), 4 cases of AWD (alive with disease), 5 cases of DOD (dead of disease), and 1 case of DWOD (dead with other disease). Five-year overall survival rate of all the patients was 70.0% and event-free survival rate was 50.0%. The mean MSTS (Musculoskeletal Tumor Society) score was 15.9 (53%) points at last follow-up. Among prognostic factors of age at diagnosis, Enneking stage, size of tumor, site of primary lesion, and distant metastasis, 5-year survival rate of groups without metastasis were 90.9%, nevertheless 44.4% in other group with the metastasis showing statistical significance (p = 0.020). Postoperative complications were 3 cases of infection, each 2 cases of ankylosis and metal failure, and each 1 case of leg length discrepancy, periprosthetic fracture, and local recurrence. Conclusion: Five-year survival rate of this study was similar to that of multicenter studies in America and Europe. Among the prognostic factors, distant metastasis was proven to be most significant. Enneking stage, size of tumor and site of primary lesion are also important and could be statistically significant if with more cases.展开更多
AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longit...AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.展开更多
December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristi...December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.展开更多
Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long...Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long-term safety and effectiveness of tadalafil 2.5 mg and 5.0 mg once daily in Chinese men with erectile dysfunction （n = 635）. The primary endpoint of the study was safety at 12 months as assessed by the proportion of patients experiencing at least one treatment-emergent adverse event （serious or nonserious）. The secondary endpoints included safety and effectiveness, measured by the International Index of Erectile Function-Erectile Function （IIEF-EF） domain scores. Similar adverse events to the known safety profile of tadalafil, such as nasopharyngitis, upper respiratory tract infection, headache, and dizziness, were detected. No new cardiovascular safety concerns were observed. After 3 months of treatment, significant increases in IIEF-EF domain scores were detected for both 2.5-mg （least squares [LS] mean change： 6.3; 95% confidence interval [CI]： 5.4-7.1; P 〈 0.001） and 5.0-mg （LS mean change： 7.4; 95% CI： 6.8-7.9; P 〈 0.001） tadalafil doses, and significance was maintained up to 12 months. In addition, approximately 40% of patients regained normal erectile function （IIEF-EF 〉26） following 1 year of tadalafil once-daily treatment. The findings in this study provide evidence for the extended effectiveness and tolerability of tadalafil, demonstrating no new safety concerns, in a Chinese population and make once-daily tadalafil administration a viable option for improving sexual performance and satisfaction in Chinese men with erectile dysfunction.展开更多
Health-related quality-of-life （HRQOL） after a radical prostatectomy （RP） or extemal beam radiation therapy （EBRT） has not been studied in conjunction with oncological outcomes in relation to disease risk strati...Health-related quality-of-life （HRQOL） after a radical prostatectomy （RP） or extemal beam radiation therapy （EBRT） has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP （n = 86） and EBRT （n = 76） for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP （79%） and 54 EBRT （79%） patients over a 3-year follow-up period （median： 41 months） using the Medical Outcomes Study Short Form-36 （SF-36） and the University of Califomia Los Angeles Prostate Cancer Index （UCLA PCI）. The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk （74.6% vs. 75.0%, P = 0.931） and intermediate-risk （61.3% vs. 71.1%, P = 0.691） patients. For high-risk patients, progression-free survival was lower in the RP group （45.1%） than in the EBRT group （79.7%） （P = 0.002）. The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group （P 〈 0.001, P 〈 0.05 and P 〈 0.001, respectively）. With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group （P 〈 0.001 for each）. The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients （P 〈 0.001）. Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient＇s HRQOL after treatment did not depend on biochemical recurrence.展开更多
Primary hypothyroidism commonly occurs after radiotherapy(RT),and coincides with increased circulating thyroid-stimulating hormone(TSH)levels.We tested therefore the protective effect of suppressing TSH with L-thyroxi...Primary hypothyroidism commonly occurs after radiotherapy(RT),and coincides with increased circulating thyroid-stimulating hormone(TSH)levels.We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma(HL)in a prospective cohort study.From 1998 to 2001,a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL,scheduled for craniospinal irradiation and mediastinum/neck radiotherapy,respectively,underwent thyroid ultrasound and free triiodothyronine(FT3),free thyroxine(FT4),and TSH evaluation at the beginning and end of craniospinal iiradiation.From 14 days before and up to the end of radiotherapy,patients were administered L-thyroxine checking every 3 days TSH to ensure a value<0.3μIU/mL.During follow-up,blood tests and ultrasound were repeated;primary hypothyroidism was considered an increased TSH level greater than normal range.Twenty-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels˂0.3μIU/mL and well matched for other variables.Twenty years on,hypothyroidism-free survival rates differed significantly,being 60%±15%and 15.6%±8.2%in TSH-suppressed vs.not-TSH suppressed patients,respectively(P=0.001).These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae,but it should be confirmed in a larger cohort.展开更多
BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after...BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020.Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were invest-igated.Event rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were performed.Potential risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were enrolled.The proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,respectively.Tumor differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,respectively.Residual tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection.Univariate analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance examinations.Adverse outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance only.CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy needs improvement.Long-term adverse outcome rates might be higher than previously reported,irrespective of whether secondary surgery was performed.展开更多
Establishing satisfactory calculation methods of lake evaporation has been crucial for research and manage-ment of water resources and ecosystems. A 30 year dataset from Dickie Lake, south-central Ontario, Canada adde...Establishing satisfactory calculation methods of lake evaporation has been crucial for research and manage-ment of water resources and ecosystems. A 30 year dataset from Dickie Lake, south-central Ontario, Canada added to the limited long-term studies on lake evaporation. Evaporation during ice-free season was calcu-lated separately using seven evaporation methods, based on field meteorology, hydrology and lake water temperature data. Actual evaporation determined during a portion of a year was estimated using a lake en-ergy budget model, and the estimation was used as reference evaporation for evaluation of the seven methods. The deviation of method-induced evaporation from the reference evaporation was compared among the seven methods, and a performance rank was proposed based on the root mean squared deviation and coeffi-cient of efficiency. As for the whole ice-free season (roughly May to November), the water balance was the best method, followed by Makkink, DeBruin-Kejiman, Penman, Priestley-Taylor, Hamon, and Jensen-Haise methods. As for shorter duration (a week to a month), the DeBruin-Kejiman was the best method, followed by Penman, Priestley-Taylor, Makkink, Hamon, Jensen-Haise, and water balance method. Annual and sea-sonal changes of energy budget terms and the compensation function of lake heat storage in evaporation flux were also analyzed.展开更多
Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with mus...Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments. This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.展开更多
Polyurethane-fluorinated polysiloxane(PU-^(F)PDMS)with high-strength,high-bonding and low surface en-ergy is synthesized as the matrix,and the PU-^(F)PDMS/MCs/Ag marine anti-fouling coating on the sur-face of imitatio...Polyurethane-fluorinated polysiloxane(PU-^(F)PDMS)with high-strength,high-bonding and low surface en-ergy is synthesized as the matrix,and the PU-^(F)PDMS/MCs/Ag marine anti-fouling coating on the sur-face of imitation crab shells is constructed by assembling butenolide@1,1-stilbene-modified hydrolyzed polyglycidyl methacrylate/graphene oxide microcapsules(Bu@PGMAm/GO MCs)with compact multi-shell structure and Ag nanoparticles(AgNPs)step by step on the PU-^(F)PDMS matrix.The PU-^(F)PDMS/MCs/Ag bionic anti-fouling coatings achieve long-term and stable anti-fouling effect under the combination of robust low-surface-energy PU-^(F)PDMS matrix,steady-state sustained release of butenolide encapsulated by the compact multi-shell,bionic surface formed by the microcapsules and AgNPs,and the release of Ag^(+).The shear strength,tensile strength,and elongation at break of the PU-^(F)PDMS/MCs/Ag are 3.53 MPa,6.7 MPa,and 192.83%,respectively.Its static contact angle and sliding angle are 161.8°and 3.6°,respectively.The antibacterial rate of PU-^(F)PDMS/MCs/Ag against Escherichia coli,Staphylococcus aureus,and Candida albicans can reach 100%.Compared with glass blank,PU,PU-^(F)PDMS,PU-^(F)PDMS/Ag,and PU-^(F)PDMS/MCs,both the adhesion number and coverage percentage of chlorella adhere to PU-^(F)PDMS/MCs/Ag are the minimum values,which are 600 cell mm^(-2) and 1.53%,respectively.After 6 months of marine field test,the primer blank,PU,PU-^(F)PDMS all show different degrees of attachment by shellfish,spirorbis,al-gae and other biofouling,while the PU-^(F)PDMS/MCs/Ag coating is still not covered with biofouling,while the PU-^(F)PDMS/MCs/Ag coatings still exhibit little attachment of marine fouling.The PU-^(F)PDMS/MCs/Ag bionic anti-fouling coatings are expected to be widely used in the fields of anti-fouling,anti-icing,anti-fogging,drag reduction,self-cleaning,and antibacterial.展开更多
Superhydrophobic surface is a promising strategy for antibacterial and corrosion protection.However,the use of harmful fluorine-containing materials,poor mechano-chemical stability,the addition of fungicides and poor ...Superhydrophobic surface is a promising strategy for antibacterial and corrosion protection.However,the use of harmful fluorine-containing materials,poor mechano-chemical stability,the addition of fungicides and poor corrosion resistance often limit its practical application.In this paper,a high-robustness pho-tothermal self-healing superhydrophobic coating is prepared by simply spraying a mixture of hydropho-bically modified epoxy resin and two kinds of modified nanofillers(carbon nanotubes and SiO2)for long-term anticorrosion and antibacterial applications.Multi-scale network and lubrication structures formed by cross-linking of modified carbon nanotubes and repeatable roughness endow coating with high ro-bustness,so that the coating maintains superhydrophobicity even after 100 Taber abrasion cycles,20 m sandpaper abrasion and 100 tape peeling cycles.The synergistic effect of antibacterial adhesion and pho-tothermal bactericidal activity endows coating with excellent antibacterial efficiency,which against Es-cherichia coli(E.coli)and Staphylococcus aureus(S.aureus)separately reaches 99.6% and 99.8%.Moreover,the influence of modified epoxy resin,superhydrophobicity,organic coating and coating thicknesses on the anticorrosion of magnesium(Mg)alloy is systematically studied and analyzed.More importantly,the prepared coating still exhibits excellent self-cleaning,anticorrosion and antibacterial abilities after 20 m abrasion.Furthermore,the coating exhibits excellent adhesion(level 4B),chemical stability,UV radiation resistance,high-low temperature alternation resistance,stable heat production capacity and photother-mal self-healing ability.All these excellent performances can promote its application in a wider range of fields.展开更多
Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering va...Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering valuable insights into tumor biology and potential treatment strategies.Methods:We conducted a comprehensive multi-omics analysis of 132 patients with American Joint Committee on Cancer(AJCC)stage III TNBC,comprising 36 long-term survivors(RFS≥8 years),62 moderate-term survivors(RFS:3-8 years),and 34 short-term survivors(RFS<3 years).Analyses investigated clinicopathological factors,whole-exome sequencing,germline mutations,copy number alterations(CNAs),RNA sequences,and metabolomic profiles.Results:Long-term survivors exhibited fewer metastatic regional lymph nodes,along with tumors showing reduced stromal fibrosis and lower Ki67 index.Molecularly,these tumors exhibited multiple alterations in genes related to homologous recombination repair,with higher frequencies of germline mutations and somatic CNAs.Additionally,tumors from long-term survivors demonstrated significant downregulation of the RTK-RAS signaling pathway.Metabolomic profiling revealed decreased levels of lipids and carbohydrate,particularly those involved in glycerophospholipid,fructose,and mannose metabolism,in long-term survival group.Multivariate Cox analysis identified fibrosis[hazard ratio(HR):12.70,95%confidence interval(95%CI):2.19-73.54,P=0.005]and RAC1copy number loss/deletion(HR:0.22,95%CI:0.06-0.83,P=0.026)as independent predictors of RFS.Higher fructose/mannose metabolism was associated with worse overall survival(HR:1.30,95%CI:1.01-1.68,P=0.045).Our findings emphasize the association between biological determinants and prolonged survival in patients with TNBC.Conclusions:Our study systematically identified the key molecular and metabolic features associated with prolonged survival in AJCC stage III TNBC,suggesting potential therapeutic targets to improve patient outcomes.展开更多
文摘BACKGROUND: The feasibility and immediate outcome of laparoscopic fenestration for patients with congenital liver cysts have been generally recognized. The aim of the present study was to assess the long-term results after laparoscopic fenestration. METHODS: A retrospective study was performed on 44 patients with congenital liver cysts who had undergone laparoscopic fenestration between June 1998 and December 2004. Among them, 30 were women and 14 men, aged 57 years on average (range 18-76 years). While 14 patients had solitary cysts, 20 had multiple cysts, and 10 had polycystic liver disease. The results of laparoscopic fenestration, including mortality, morbidity, mean postoperative hospital stay, and recurrences of cysts were evaluated. RESULTS: There was no perioperative death and the morbidity rate was 11% (5/44). All complications were treated conservatively. The mean postoperative hospital stay was 4 days. A mean follow-up of 57 months showed that the rates of cyst recurrence and symptom recurrence were 9% and 4.5%, respectively. CONCLUSION: Laparoscopic fenestration as a feasible and safe treatment procedure for patients with congenital liver cysts can yield very good long-term results.
基金Supported by A sponsorship from Corin(Corin Group,Cirencest,United Kingdom)
文摘AIM To evaluate the clinical and radiological outcome nineand ten years after short-stemmed,bone preserving and anatomical hip arthroplasty with the MiniHip^(TM)system.METHODS In a prospective study,186 patients underwent hip arthroplasty with a partial neck preserving short stem(MiniHip^(TM),Corin).Elderly patients were not excluded from this study,thus the mean age at the time of surgery was 59.3 years(range 32 to 82 years).Surgery and the follow-up assessments were performed at two Centers.Up until now,the mean follow-up was 112.5±8.2 mo.The Oxford Hip Score(OHS)and the Hip Dysfunction Osteoarthritis and Outcome Score(HOOS)was assessed pre-and each year after surgery.The clinical follow-up was accompanied by standardized a.p.and axial radiological examinations.Periprosthetic lucencies,hypertrophies within the Gruen zones one to fourteen were assessed.A subsidence of the stem was investigated according to Morray and heterotopic ossifications were assessed according to Brooker.RESULTS The OHS and HOOS improved from 18±3.3 to 46±2.0 and from 30±8.3 to 95±4.6 points,P<0.001 respectively.There were no differences regarding age,etiology,friction pairings,etc.,(P>0.05).Two stems were revised due to a symptomatic subsidence four and twelve months postoperatively.Thus,the survivorship for aseptic loosening at nine to ten years was 98.66%.Including one stem revision due to a symptomatic exostosis,bursitis and thigh pain as well as one revision because of a septic stem loosening,the overall survival for the stem with revision for any reason was 97.32%.Besides one asymptomatic patient,radiological signs of a proximal stress-shielding,such as bone resorptions within the proximal Gruen zones,were not noticed.Findings suggesting a distal loading,e.g.,bony hypertrophies or bone appositions of more than 2 mm,were also not detected.CONCLUSION Regarding these first long-term results on the MiniHip^(TM),the implant performed exceedingly well with a high rate of survivorship for aseptic loosening.Our radiological results within the Gruen zones support the design rationale of the Minihip to provide a reliable metaphyseal anchoring with the expected proximal,more physiological load transfer.This might minimize or exclude a stress shielding which might be associated with thigh pain,proximal bone loss and an increased risk of aseptic loosening.The MiniHip^(TM)is a reliable partial-neck retaining prosthesis with good a clinical long-term outcome in younger as well as elderly patients.
基金Supported by National Natural Science Foundation of China,No.21172043 and No.21441010
文摘AIM To evaluate the long-term effectiveness and late toxicities of paclitaxel(PTX) plus cisplatin(DDP) with concurrent radiotherapy for locally advanced esophageal squamous cancer.METHODS Between 2008 and 2011, 76 patients were enrolled in a phase Ⅱ study on the treatment of loco-regionally advanced esophageal cancer with radiotherapy(68.4 Gy/44 fractions or 61.2 Gy/34 fractions) combined with 4-cycle chemotherapy consisting of DDP(25 mg/m^2 per day for 3 d) and PTX(175 mg/m^2 for 3 h). The primary endpoints were overall survival and progression-free survival, and the secondary endpoints were toxicity and the treatment failure pattern.RESULTS A total of 76 patients were enrolled in this study, of whom 63.2% finished the whole regimen. The 5-year survival rates for the per-protocol population and intent-to-treat population were 25.4% and 26.4%, respectively, and the median survival rates were 23.7 mo and 28.5 mo, respectively. Grade 3 or 4 late toxicity was observed in only one patient(heart failure). In log-rank analysis, the pretreatment stage(stage Ⅱ + Ⅲ: 36.1 mo vs stage Ⅳ: 14.9 mo) and the completed cycle(1-3 cycles: 16.1 mo vs 4 cycles: 35.5 mo) were significant prognostic factors(P = 0.037 < 0.05 and P = 0.013 < 0.05).CONCLUSION Radiotherapy combined with chemotherapy consisting of PTX and DDP is a safe and effective definitive treatment for loco-regionally advanced esophageal squamous cancer.
文摘AIM： To evaluate the long-term results and complications of Ahmed glaucoma valve （AGV） implantation in a cohort of Egyptian patients. METHODS： A retrospective study of 124 eyes of 99 patients with refractory glaucoma who underwent AGV implantation and had a minimum follow-up of 5y was performed. All patients underwent complete ophthalmic examination and intraocular pressure （lOP） measurement before surgery and at ld, weekly for the 1st month, 3, 6mo, and ly after surgery and yearly afterward for 5y. lOP was measured by Goldmann applanation tonometry and/or Tono-Pen. Complications and the number of anti-glaucoma medications needed were recorded. Success was defined as lOP less than 21 mm Hg with or without anti-glaucoma medication and without additional glaucoma surgery. RESULTS： Mean age was 23.1±19.9y. All eyes had at least one prior glaucoma surgery, lOP was reduced from a mean of 37.2±6.8 to 19.2±5.2 mm Hg after 5y follow-up with a reduced number of medications from 2.64±0.59 to 1.81±0.4. Complete and qualified success rates were 31.5% and 46.0% respectively at the end of follow-up. The most common complications were encapsulated cyst formation in 51 eyes （41.1%）, complicated cataract in 9 eyes （7.25%）, recessed tube in 8 eyes （6.45%）, tube exposure in 6 eyes （4.8%） and corneal touch in 6 eyes （4.8%）. Other complications included extruded AGV, endophthalmitis and persistent hypotony. Each of them was recorded in only 2 eyes （1.6%）. ~ CONCLUSION： Although refractory glaucoma is a difficult problem to manage, AGV is effective and relatively safe procedure in treating refractory glaucoma in Egyptian patients with long-term follow-up. Encapsulated cyst formation was the most common complication, which limits successful lOP control after AGV implantation. However, effective complications management can improve the rate of success.
文摘BACKGROUND Budd-Chiari syndrome is defined as hepatic venous outflow tract obstruction.For Asian Budd-Chiari syndrome patients,the major treatment modality is recanalization(percutaneous transluminal angioplasty with or without stent implantation).The cumulative 1-,5-,and 10-year primary patency rates and survival rates are reported to be excellent or satisfactory,but the long-term outcome of patients with restenosis(the most common complication after recanalization)is unknown.AIM To explore the treatment strategy for restenosis in patients with Budd-Chiari syndrome after interventional therapy and to evaluate the long-term follow-up results.METHODS The clinical data and follow-up results of 60 patients with restenosis after interventional therapy from November 1983 to December 2013 were retrospectively analyzed.RESULTS Sixty patients with restenosis were retrospectively divided into a percutaneous transluminal angioplasty(PTA)group(40 patients)and a PTA+stent group(20 patients)according to the primary recanalization method.For the patients with restenosis in the PTA group,13 refused treatment,and 27 received further treatment;among these patients,five had a second restenosis,two had a third restenosis,and one had a fourth restenosis.For the patients with restenosis in the PTA+stent group,nine refused treatment,ten received PTA alone,and the other received PTA+stent implantation.Among the patients who received further treatment,five had a second restenosis,three had a third restenosis,and one had a fourth restenosis.The 1-,5-,10-,20-,and 25-year cumulative survival rates of the 38 patients who received further treatment after restenosis were 100%,78.3%,78.3%,70.5%,and 70.5%,respectively;however,for the 22 patients who refused treatment,the survival rates were 72.7%,45.9%,30.6%,10.2%,and unavailable,respectively(P<0.001).CONCLUSION Long-term follow-up after interventional therapy is very important.Active treatment for patients with restenosis can improve prognosis,and minimally invasive treatment strategies for restenosis allows to obtain satisfactory results.
文摘This paper summarized the long-term follow-up results and our clinical treatment experience of 426 patients with carcinoma of salivary gland, who had undergone surgical treatment in our department from 1957 to 1976 successively. Our study showed that the 10-year and 15-year survival rates were 63.3% and 59.1% respectively, much higher than the results presented by other researchers. The following four points were concluded: 1. The long-term treatment result of salivary gland carcinoma is determined not only on mode of treatment and clinical stage, but more on its pathologic type. For high malignant salivary carcinoma, comprehensive multidiscipline treatments should be adopted. 2. Management of primary focus." The different operative principle and mode shouht be worked out in advance according to pathologic type and primary site of tumors. 3. Management of lymphonode: For cases with undifferentiated carcinoma, low-differentiated mucoepiderrnoid carcinoma, squamous cell carcinoma, adenocarcinoma and papillary cystadenocarcinoma, elective neck dissection should be performed. 4. Prevention of distant metastasis: Preoperative biopsy should be avoided. Frozen-section should be made during the operation and, diagnosis and treatment be accomplished in the meantime.
基金supported by grants from the Major State Basic Research Development Program of China(973 Program)(2009CB522404)Science Technology Research Development Program of Guangdong Province(2011B031800060)Science Technology Research Development Program of Guangzhou(2011Y1000332)
文摘BACKGROUND： Hepatitis B virus（HBV）-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS： The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups： those equal or older than 60 years（older group,n60） and those younger than 60 years（younger group, n305）.Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS： Except for age and preexisting chronic disease（P0.05）,no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence（P0.05）. The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group（P0.05）. Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group（odds ratio=3.615, P0.014）.CONCLUSIONS： Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.
文摘Descending aortic aneurysms (DAAs), including dissecting aneurysms (DA) have a multifactorial etiology and pathogenesis, therefore raising questions about the leading role of operative treatment to repair the lesion. Objective: To investigate remote (7 and more years) results of treatment in patients with DAAs in operative treatment only if there is a danger of aneurysm rupture. A total of 82 patients with atherosclerotic DAA identified between 2008 and 2011, and 22 patients with type 1 or 3 DeBakey dissecting aneurysms (DA) who had not been operated in the acute period due to a number of reasons were examined. The follow-up period of these groups was 7 or more years. When using a sparing treatment to treat DAA, we saw survival of 90.1 at 2 years, 76.8% at 4 years, 59.4% at 6 years, and 57.5% at 7 years with the uniform increase in mortality rate, mainly due to a comorbidity. Survival in DA group (77.3%) was better due to a younger age and was 68.4% in operated and 54% in non-operated patients at 7 years. It is symptomatic that the aneurysm rupture rate was not always affected by operative treatment. Therefore, it seems like medical treatment is more consistent with etiopathogenesis of the disease compared to surgery during the stabilization period.
文摘Purpose: This study analyzed oncological and functional outcomes of treatment for Ewing’s sarcoma, as well as its significant risk factors through long-term follow up. Objective and Method: Between September 1990 and April 2009, 20 cases that were diagnosed and treated as Ewing’s sarcoma in Kosin University Gospel Hospital were entered onto the study. Mean follow-up period was 45.4 (12 - 108) months. There were 7 cases of male and 13 cases of female, and mean age was 19.9 (5 - 48) years old. Retrospective review was done about treatment outcomes, complications, and significant risk factors. Results: In terms of oncologic results, there were 9 cases of CDF (continuous disease free), 1 case of NED (no evidence of disease), 4 cases of AWD (alive with disease), 5 cases of DOD (dead of disease), and 1 case of DWOD (dead with other disease). Five-year overall survival rate of all the patients was 70.0% and event-free survival rate was 50.0%. The mean MSTS (Musculoskeletal Tumor Society) score was 15.9 (53%) points at last follow-up. Among prognostic factors of age at diagnosis, Enneking stage, size of tumor, site of primary lesion, and distant metastasis, 5-year survival rate of groups without metastasis were 90.9%, nevertheless 44.4% in other group with the metastasis showing statistical significance (p = 0.020). Postoperative complications were 3 cases of infection, each 2 cases of ankylosis and metal failure, and each 1 case of leg length discrepancy, periprosthetic fracture, and local recurrence. Conclusion: Five-year survival rate of this study was similar to that of multicenter studies in America and Europe. Among the prognostic factors, distant metastasis was proven to be most significant. Enneking stage, size of tumor and site of primary lesion are also important and could be statistically significant if with more cases.
文摘AIM:To investigate the long-term outcomes in acute primary angle closure(APAC)patients treated with lens extraction(LE)surgery and to identify risk factors for glaucomatous optic neuropathy(GON).METHODS:In this longitudinal observational study,detailed medical histories of APAC patients and comprehensive ophthalmic examinations at final followup were collected.Logistic regression analysis was performed to identify predictors of blindness.Univariate and multivariate linear regression analyses were conducted to determine risk factors associated with visual outcomes.RESULTS:This study included 39 affected eyes of 31 subjects(26 females)with an average age of 74.1±8.0y.At 6.7±4.2y after APAC attack,2(5.7%)eyes had bestcorrected visual acuity(VA)worse than 3/60.Advanced glaucomatous visual field loss was observed in 15(39.5%)affected eyes and 5(25.0%)fellow eyes.Nine affected eyes(23.7%)had GON,and 11(28.9%)were blind.Six(15.4%)affected eyes and 2(9.1%)fellow eyes had suspicious progression.A significantly higher blindness rate in factory workers compared to office workers.Logistic regression identified that worse VA at attack(OR 10.568,95%CI 1.288-86.695;P=0.028)and worse early postoperative VA(OR 13.214,95%CI 1.157-150.881;P=0.038)were risk factors for blindness.Multivariate regression showed that longer duration of elevated intraocular pressure(P=0.004)and worse early postoperative VA(P=0.009)were associated with worse visual outcomes.CONCLUSION:Despite LE surgery,some APAC patients experience continued visual function deterioration.Lifelong monitoring is necessary.Target pressure and progression rates should be re-evaluated during follow-up.
基金supported by the National Natural Science Foundation of China(No.81873828)Chongqing Municipal Health Commission(High-Level Medical Reserved Personnel Training Project of Chongqing),the Innovation Program for Chongqing's Overseas Returnees(cx2019030)the Senior Medical Talents Program of Chongqing for Young and Middle-Aged.
文摘December 2020 to investigate the long-term follow-up results after testicular torsion(TT)in children.Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group,and the baseline characteristics,ultrasonographic indications,intraoperative findings,testicular volumes,and adverse events during follow-up were compared.A total of 145 cases were included in this study.Approximately 56.6%of patients who underwent salvage orchiopexy had testicular atrophy(TA),and the median testicular volume loss of the testes was 57.4%.Age less than 6 years,delayed surgery,and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy.Most atrophied testes appeared within 3-6 months after surgery.Compared with the corresponding age-matched healthy controls,the contralateral testicular volumes were larger in the orchiopexy(P=0.o01 without TA,and P=0.042 with TA)and orchiectomy groups(P=0.033).The adverse events were comparable in patients with orchiectomy or orchiopexy.In summary,follow-up before 3 months after surgery may not offer sufficient clinical value,while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring.The contralateral testes of patients with TT showed compensatory hypertrophy.We suggest performing orchiectomy when torsed testes are surgically assessed as Arda gradeⅢor inviable.
文摘Once-daily tadalafil administration has been well established; however, studies about tadalafil once-daily treatment in the Chinese population are lacking. In this phase 4, postmarketing study, we ascertained the long-term safety and effectiveness of tadalafil 2.5 mg and 5.0 mg once daily in Chinese men with erectile dysfunction （n = 635）. The primary endpoint of the study was safety at 12 months as assessed by the proportion of patients experiencing at least one treatment-emergent adverse event （serious or nonserious）. The secondary endpoints included safety and effectiveness, measured by the International Index of Erectile Function-Erectile Function （IIEF-EF） domain scores. Similar adverse events to the known safety profile of tadalafil, such as nasopharyngitis, upper respiratory tract infection, headache, and dizziness, were detected. No new cardiovascular safety concerns were observed. After 3 months of treatment, significant increases in IIEF-EF domain scores were detected for both 2.5-mg （least squares [LS] mean change： 6.3; 95% confidence interval [CI]： 5.4-7.1; P 〈 0.001） and 5.0-mg （LS mean change： 7.4; 95% CI： 6.8-7.9; P 〈 0.001） tadalafil doses, and significance was maintained up to 12 months. In addition, approximately 40% of patients regained normal erectile function （IIEF-EF 〉26） following 1 year of tadalafil once-daily treatment. The findings in this study provide evidence for the extended effectiveness and tolerability of tadalafil, demonstrating no new safety concerns, in a Chinese population and make once-daily tadalafil administration a viable option for improving sexual performance and satisfaction in Chinese men with erectile dysfunction.
文摘Health-related quality-of-life （HRQOL） after a radical prostatectomy （RP） or extemal beam radiation therapy （EBRT） has not been studied in conjunction with oncological outcomes in relation to disease risk stratification. Moreover, the long-term outcomes of these treatment approaches have not been studied. We retrospectively analyzed oncological outcomes between consecutive patients receiving RP （n = 86） and EBRT （n = 76） for localized prostate cancer. HRQOL and functional outcomes could be assessed in 62 RP （79%） and 54 EBRT （79%） patients over a 3-year follow-up period （median： 41 months） using the Medical Outcomes Study Short Form-36 （SF-36） and the University of Califomia Los Angeles Prostate Cancer Index （UCLA PCI）. The 5-year biochemical progression-free survival did not differ between the RP and EBRT groups for low-risk （74.6% vs. 75.0%, P = 0.931） and intermediate-risk （61.3% vs. 71.1%, P = 0.691） patients. For high-risk patients, progression-free survival was lower in the RP group （45.1%） than in the EBRT group （79.7%） （P = 0.002）. The general HRQOL was comparable between the two groups. Regarding functional outcomes, the RP group reported lower scores on urinary function and less urinary bother and sexual bother than the EBRT group （P 〈 0.001, P 〈 0.05 and P 〈 0.001, respectively）. With risk stratification, the low- and intermediate-risk patients in the RP group reported poorer urinary function than patients in the EBRT group （P 〈 0.001 for each）. The sexual function of the high-risk patients in the EBRT group was better than that of the same risk RP patients （P 〈 0.001）. Biochemical recurrence was not associated with the UCLA PCI score in either group. In conclusion, low- to intermediate-risk patients treated with an RP may report relatively decreased urinary function during long-term follow-up. The patient＇s HRQOL after treatment did not depend on biochemical recurrence.
文摘Primary hypothyroidism commonly occurs after radiotherapy(RT),and coincides with increased circulating thyroid-stimulating hormone(TSH)levels.We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma(HL)in a prospective cohort study.From 1998 to 2001,a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL,scheduled for craniospinal irradiation and mediastinum/neck radiotherapy,respectively,underwent thyroid ultrasound and free triiodothyronine(FT3),free thyroxine(FT4),and TSH evaluation at the beginning and end of craniospinal iiradiation.From 14 days before and up to the end of radiotherapy,patients were administered L-thyroxine checking every 3 days TSH to ensure a value<0.3μIU/mL.During follow-up,blood tests and ultrasound were repeated;primary hypothyroidism was considered an increased TSH level greater than normal range.Twenty-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels˂0.3μIU/mL and well matched for other variables.Twenty years on,hypothyroidism-free survival rates differed significantly,being 60%±15%and 15.6%±8.2%in TSH-suppressed vs.not-TSH suppressed patients,respectively(P=0.001).These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae,but it should be confirmed in a larger cohort.
基金Supported by the New National Excellence Program of the Ministry for Innovation and Technology From the Source of the National Research,Development and Innovation Fund,No.ÚNKP-22-4-SZTE-296,No.ÚNKP-23-3-SZTE-268,and No.ÚNKP-23-5-SZTE-719the EU’s Horizon 2020 Research and Innovation Program under Grant Agreement,No.739593.
文摘BACKGROUND Choosing an optimal post-polypectomy management strategy of malignant colorectal polyps is challenging,and evidence regarding a surveillance-only strategy is limited.AIM To evaluate long-term outcomes after endoscopic removal of malignant colorectal polyps.METHODS A single-center retrospective cohort study was conducted to evaluate outcomes after endoscopic removal of malignant colorectal polyps between 2010 and 2020.Residual disease rate and nodal metastases after secondary surgery and local and distant recurrence rate for those with at least 1 year of follow-up were invest-igated.Event rates for categorical variables and means for continuous variables with 95%confidence intervals were calculated,and Fisher’s exact test and Mann-Whitney test were performed.Potential risk factors of adverse outcomes were RESULTS In total,135 lesions(mean size:22.1 mm;location:42%rectal)from 129 patients(mean age:67.7 years;56%male)were enrolled.The proportion of pedunculated and non-pedunculated lesions was similar,with en bloc resection in 82%and 47%of lesions,respectively.Tumor differentiation,distance from resection margins,depth of submucosal invasion,lymphovascular invasion,and budding were reported at 89.6%,45.2%,58.5%,31.9%,and 25.2%,respectively.Residual tumor was found in 10 patients,and nodal metastasis was found in 4 of 41 patients who underwent secondary surgical resection.Univariate analysis identified piecemeal resection as a risk factor for residual malignancy(odds ratio:1.74;P=0.042).At least 1 year of follow-up was available for 117 lesions from 111 patients(mean follow-up period:5.59 years).Overall,54%,30%,30%,11%,and 16%of patients presented at the 1-year,3-year,5-year,7-year,and 9-10-year surveillance examinations.Adverse outcomes occurred in 9.0%(local recurrence and dissemination in 4 patients and 9 patients,respectively),with no difference between patients undergoing secondary surgery and surveillance only.CONCLUSION Reporting of histological features and adherence to surveillance colonoscopy needs improvement.Long-term adverse outcome rates might be higher than previously reported,irrespective of whether secondary surgery was performed.
文摘Establishing satisfactory calculation methods of lake evaporation has been crucial for research and manage-ment of water resources and ecosystems. A 30 year dataset from Dickie Lake, south-central Ontario, Canada added to the limited long-term studies on lake evaporation. Evaporation during ice-free season was calcu-lated separately using seven evaporation methods, based on field meteorology, hydrology and lake water temperature data. Actual evaporation determined during a portion of a year was estimated using a lake en-ergy budget model, and the estimation was used as reference evaporation for evaluation of the seven methods. The deviation of method-induced evaporation from the reference evaporation was compared among the seven methods, and a performance rank was proposed based on the root mean squared deviation and coeffi-cient of efficiency. As for the whole ice-free season (roughly May to November), the water balance was the best method, followed by Makkink, DeBruin-Kejiman, Penman, Priestley-Taylor, Hamon, and Jensen-Haise methods. As for shorter duration (a week to a month), the DeBruin-Kejiman was the best method, followed by Penman, Priestley-Taylor, Makkink, Hamon, Jensen-Haise, and water balance method. Annual and sea-sonal changes of energy budget terms and the compensation function of lake heat storage in evaporation flux were also analyzed.
文摘Muscle-in-vein conduits are used alternatively to nerve grafts for bridging nerve defects. The purpose of this study was to examine short- and long-term regeneration results after digital nerve reconstruction with muscle-in-vein conduits. Static and moving two-point discriminations and Semmes-Weinstein Monofilaments were used to evaluate sensory recovery 6–12 months and 14–35 months after repair of digital nerves with muscle-in-vein in 7 cases. Both follow-ups were performed after clinical signs of progressing regeneration disappeared. In 4 of 7 cases, a further recovery of both two-point discriminations and in another case of only the static two-point discrimination of 1–3 mm could be found between the short-term and long-term follow-up examination. Moreover, a late recovery of both two-point discriminations was demonstrated in another case. Four of 7 cases showed a sensory improvement by one Semmes-Weinstein Monofilaments. This pilot study suggests that sensory recovery still takes place even when clinical signs of progressing regeneration disappear.
基金supported by the National Natural Science Foundation of China(Nos.52003148 and 52261045)the State Key Laboratory of Marine Resource Utilization in South China Sea,Hainan University(No.MRUKF2021023)+3 种基金the Key Research and Development Project of Shaanxi Province(No.2023-YBGY-475)the Key Scientific Research Project of Education Department of Shaanxi Province(No.22JS003)the Industrialization Project of the State Key Laboratory of Biological Resources and Ecological Environment(Cultivation)of Qinba Region(No.SXC-2310)the key cultivation project funds of Shaanxi University of Technology(No.SLGKYXM2201).
文摘Polyurethane-fluorinated polysiloxane(PU-^(F)PDMS)with high-strength,high-bonding and low surface en-ergy is synthesized as the matrix,and the PU-^(F)PDMS/MCs/Ag marine anti-fouling coating on the sur-face of imitation crab shells is constructed by assembling butenolide@1,1-stilbene-modified hydrolyzed polyglycidyl methacrylate/graphene oxide microcapsules(Bu@PGMAm/GO MCs)with compact multi-shell structure and Ag nanoparticles(AgNPs)step by step on the PU-^(F)PDMS matrix.The PU-^(F)PDMS/MCs/Ag bionic anti-fouling coatings achieve long-term and stable anti-fouling effect under the combination of robust low-surface-energy PU-^(F)PDMS matrix,steady-state sustained release of butenolide encapsulated by the compact multi-shell,bionic surface formed by the microcapsules and AgNPs,and the release of Ag^(+).The shear strength,tensile strength,and elongation at break of the PU-^(F)PDMS/MCs/Ag are 3.53 MPa,6.7 MPa,and 192.83%,respectively.Its static contact angle and sliding angle are 161.8°and 3.6°,respectively.The antibacterial rate of PU-^(F)PDMS/MCs/Ag against Escherichia coli,Staphylococcus aureus,and Candida albicans can reach 100%.Compared with glass blank,PU,PU-^(F)PDMS,PU-^(F)PDMS/Ag,and PU-^(F)PDMS/MCs,both the adhesion number and coverage percentage of chlorella adhere to PU-^(F)PDMS/MCs/Ag are the minimum values,which are 600 cell mm^(-2) and 1.53%,respectively.After 6 months of marine field test,the primer blank,PU,PU-^(F)PDMS all show different degrees of attachment by shellfish,spirorbis,al-gae and other biofouling,while the PU-^(F)PDMS/MCs/Ag coating is still not covered with biofouling,while the PU-^(F)PDMS/MCs/Ag coatings still exhibit little attachment of marine fouling.The PU-^(F)PDMS/MCs/Ag bionic anti-fouling coatings are expected to be widely used in the fields of anti-fouling,anti-icing,anti-fogging,drag reduction,self-cleaning,and antibacterial.
基金the National Natural Science Foundation of China(Nos.U2106226,52105297)the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(No.52021003)the Science and Technology Development Project of Jilin Province(Nos.20210203022SF,20210508029RQ).
文摘Superhydrophobic surface is a promising strategy for antibacterial and corrosion protection.However,the use of harmful fluorine-containing materials,poor mechano-chemical stability,the addition of fungicides and poor corrosion resistance often limit its practical application.In this paper,a high-robustness pho-tothermal self-healing superhydrophobic coating is prepared by simply spraying a mixture of hydropho-bically modified epoxy resin and two kinds of modified nanofillers(carbon nanotubes and SiO2)for long-term anticorrosion and antibacterial applications.Multi-scale network and lubrication structures formed by cross-linking of modified carbon nanotubes and repeatable roughness endow coating with high ro-bustness,so that the coating maintains superhydrophobicity even after 100 Taber abrasion cycles,20 m sandpaper abrasion and 100 tape peeling cycles.The synergistic effect of antibacterial adhesion and pho-tothermal bactericidal activity endows coating with excellent antibacterial efficiency,which against Es-cherichia coli(E.coli)and Staphylococcus aureus(S.aureus)separately reaches 99.6% and 99.8%.Moreover,the influence of modified epoxy resin,superhydrophobicity,organic coating and coating thicknesses on the anticorrosion of magnesium(Mg)alloy is systematically studied and analyzed.More importantly,the prepared coating still exhibits excellent self-cleaning,anticorrosion and antibacterial abilities after 20 m abrasion.Furthermore,the coating exhibits excellent adhesion(level 4B),chemical stability,UV radiation resistance,high-low temperature alternation resistance,stable heat production capacity and photother-mal self-healing ability.All these excellent performances can promote its application in a wider range of fields.
基金supported by grants from the Medical Engineering Jiont Fund of the Fudan University(No.IDH2310117)。
文摘Objective:Triple-negative breast cancer(TNBC)is a highly aggressive subtype that lacks targeted therapies,leading to a poorer prognosis.However,some patients achieve long-term recurrence-free survival(RFS),offering valuable insights into tumor biology and potential treatment strategies.Methods:We conducted a comprehensive multi-omics analysis of 132 patients with American Joint Committee on Cancer(AJCC)stage III TNBC,comprising 36 long-term survivors(RFS≥8 years),62 moderate-term survivors(RFS:3-8 years),and 34 short-term survivors(RFS<3 years).Analyses investigated clinicopathological factors,whole-exome sequencing,germline mutations,copy number alterations(CNAs),RNA sequences,and metabolomic profiles.Results:Long-term survivors exhibited fewer metastatic regional lymph nodes,along with tumors showing reduced stromal fibrosis and lower Ki67 index.Molecularly,these tumors exhibited multiple alterations in genes related to homologous recombination repair,with higher frequencies of germline mutations and somatic CNAs.Additionally,tumors from long-term survivors demonstrated significant downregulation of the RTK-RAS signaling pathway.Metabolomic profiling revealed decreased levels of lipids and carbohydrate,particularly those involved in glycerophospholipid,fructose,and mannose metabolism,in long-term survival group.Multivariate Cox analysis identified fibrosis[hazard ratio(HR):12.70,95%confidence interval(95%CI):2.19-73.54,P=0.005]and RAC1copy number loss/deletion(HR:0.22,95%CI:0.06-0.83,P=0.026)as independent predictors of RFS.Higher fructose/mannose metabolism was associated with worse overall survival(HR:1.30,95%CI:1.01-1.68,P=0.045).Our findings emphasize the association between biological determinants and prolonged survival in patients with TNBC.Conclusions:Our study systematically identified the key molecular and metabolic features associated with prolonged survival in AJCC stage III TNBC,suggesting potential therapeutic targets to improve patient outcomes.
