The mitogen-activated protein kinase kinase kinase kinases(MAP4Ks)signaling pathway plays a pivotal role in axonal regrowth and neuronal degeneration following insults.Whether targeting this pathway is beneficial to b...The mitogen-activated protein kinase kinase kinase kinases(MAP4Ks)signaling pathway plays a pivotal role in axonal regrowth and neuronal degeneration following insults.Whether targeting this pathway is beneficial to brain injury remains unclear.In this study,we showed that adeno-associated virus-delivery of the Citron homology domain of MAP4Ks effectively reduces traumatic brain injury-induced reactive gliosis,tauopathy,lesion size,and behavioral deficits.Pharmacological inhibition of MAP4Ks replicated the ameliorative effects observed with expression of the Citron homology domain.Mechanistically,the Citron homology domain acted as a dominant-negative mutant,impeding MAP4K-mediated phosphorylation of the dishevelled proteins and thereby controlling the Wnt/β-catenin pathway.These findings implicate a therapeutic potential of targeting MAP4Ks to alleviate the detrimental effects of traumatic brain injury.展开更多
In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by fer...In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by ferric chloride were determined using 0.22-10μm pore-size filtration,Zetasizer analysis,and in situ flow through cell ATR-FTIR.The results showed that up to 20mg/L FA had almost no effect on the solubility of ferric hydroxide precipitates and adsorption of As(V)by the precipitates.When FA concentration increased from 0 to 20 mg/L,the adsorption of FA led to higher negative zeta potential of the precipitates and the strong electrostatic repulsion between the precipitates decreased the particle size of ferric hydroxide flocs fromlarger than 10μmto smaller than 1μm.In the presence of 5-20 mg/L FA,46%-63%As(V)was adsorbed onto the flocs with particle size in the range of 0.45-1μm.On the other hand,phosphate did not affect the size of ferric hydroxide flocs and significantly increased the dissolved As(V)concentration because it competed with As(V)for adsorption sites on ferric hydroxide precipitates.The addition of 5mg/L cationic organic flocculant significantly reduced the effect of FA on As(V)removal,but did not reduce the effect of phosphate on As(V)removal.The findings of this study will help develop effective arsenic treatment techniques and predict the mobility of arsenic in the environment.展开更多
BACKGROUND Metabolic dysfunction-associated steatohepatitis(MASH)is increasingly common,as is hepatocellular carcinoma(HCC)in the background of MASH.Liver transplantation(LT)provides superior long-term survival for pa...BACKGROUND Metabolic dysfunction-associated steatohepatitis(MASH)is increasingly common,as is hepatocellular carcinoma(HCC)in the background of MASH.Liver transplantation(LT)provides superior long-term survival for patients with unresectable MASH-HCC,but not all patients have equal access to transplant.MASH-HCC disproportionately affects Hispanic patients,but minorities are less likely to undergo LT for HCC.Additionally,females also undergo LT at lower rates than males.AIM To investigate whether race/ethnicity and sex affect LT waitlist outcomes.METHODS Records of adults with MASH-HCC in the United States Organ Procurement and Transplantation Network database listed for LT between 1/2015 and 12/2021 were analyzed.RESULTS Most of the 3810 patients waitlisted for LT for MASH-HCC were non-Hispanic(NH)white(71.2%)or Hispanic(23.4%),with only 49(1.1%)NH Black candidates.Hispanics underwent LT at lower rates than NH whites(71.6%vs 78.4%,P<0.001),but race/ethnicity did not affect waitlist mortality(P=0.06).Patients with Hispanic[hazard ratio(HR)=0.85,95%CI:0.77-0.95,P=0.002]or Asian(HR=0.79,95%CI:0.63-0.98,P=0.04)race/ethnicity were less likely to undergo LT.Women were also less likely to receive LT(male:HR=1.16,95%CI:1.04-1.29,P=0.01).Patients in regions 1 and 9 were less likely to be transplanted as well(P=0.07).CONCLUSION Hispanic patients are less likely to undergo LT for MASH-HCC,concerning given their susceptibility to MASH and HCC.There were very few NH Black candidates.Disparities were also unequal across regions,which is particularly concerning in states where at-risk populations have rising cancer incidence.Additional research is needed to identify strategies for mitigating these differences in access to LT for MASH-HCC.展开更多
BACKGROUND Endoscopic bariatric therapies(EBT)have been developed as an adjunctive therapy to treat persistent obesity and recurrent weight gain and dumping symptoms after metabolic and bariatric surgery(MBS).While th...BACKGROUND Endoscopic bariatric therapies(EBT)have been developed as an adjunctive therapy to treat persistent obesity and recurrent weight gain and dumping symptoms after metabolic and bariatric surgery(MBS).While the efficacy of revisional EBTs has been documented,no studies to date have examined how these procedures impact quality of life(QOL)and internalized weight bias(IWB).AIM To understand how endoscopic revisional therapies impact QOL,IWB,and dumping syndrome.METHODS Analysis included 19 participants treated for post-MBS recurrent weight gain and/or dumping syndrome.The short-form 36 survey,weight bias internalization scale,and the Sigstad scoring system were used to measure QOL,IWB,and dumping syndrome pre-and≥4 weeks post-EBT.RESULTS At 6-months,total body weight loss was 8.6%±7.15%(n=16),at 12-months was 13.4%±7.46%(n=16).Short-form 36 scores for all 8 scales significantly increased from pre-to post-procedure with the greatest improvement in the scales related to emotional(mean improvement=59.6,P<0.05)and physical health(mean improvement=31.1,P<0.05).Both total Sigstad score(mean difference=4.947,P<0.05)and total weight bias internalization score(mean difference=0.761,P<0.05)significantly decreased from pre-to post-procedure.CONCLUSION Findings suggest that revisional EBT may improve post-MBS QOL across a broad spectrum of outcomes beyond optimizing body weight.As early EBT results indicate positive mental and physical health outcomes,further research is needed to evaluate the relationship between these improvements,body weight and interdisciplinary post-MBS care.展开更多
BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(...BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(TXI)or computer-aided detection system(CAD)has been reported.AIM To investigate the effects of the scope on the detection of adenomas and sessile serrated lesions(SSLs).METHODS The subjects were patients who underwent pancolonic chromoendoscopy using the EVIS X1 video system center between May 2023 and October 2024.The patients were divided into the new(CF-XZ1200/CF-EZ1500)and 290 series(CF-HQ290Z/PCF-H290Z)groups.Propensity score matching was performed for age,sex,examination purpose,endoscopist,preparation,TXI use,and CAD use.The effects of the scope were analyzed in terms of the ADR,SSL detection rate(SDR),and mean number of adenomas per colonoscopy(APC).RESULTS Of the 7014 patients enrolled,2138 pairs were extracted by propensity score matching(mean age 55.4 years,45.5%male).The new scopes group had a significantly higher ADR than the 290 series group[51.5%vs 45.5%,odds ratio(OR)=1.27,95%CI:1.13-1.43,P<0.001].Similarly,the new scopes group had significantly higher SDR(7.8%vs 5.7%,OR=1.41,95%CI:1.11-1.80,P=0.005)and APC(0.90 vs 0.76,OR=1.11,95%CI:1.05-1.17,P<0.001)than the 290 series group.CONCLUSION In conclusion,the new scope(CF-XZ1200/CF-EZ1500)enhanced the detection of adenomas and SSLs compared to the old ones(290 series).展开更多
BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM T...BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM To investigate prognostic factors in patients with gastric cancer who underwent gastrectomy with CY1,and to evaluate the optimal postoperative chemotherapy regimen.METHODS This multicenter retrospective cohort study analyzed prognostic factors and postoperative chemotherapy in patients with CY1 gastric cancer who underwent gastrectomy,excluding those with macroscopic peritoneal dissemination.Data from 13 institutions(2015-2019)were reviewed.RESULTS Overall,82 patients met the inclusion criteria.The median overall survival was 22.8 months,and diffuse-type histology and the absence of postoperative chemotherapy were identified as independent poor prognostic factors.The 5-year survival rate was 82.4%for those receiving fluoropyrimidine plus docetaxel/oxaliplatin vs 21.8%for those with S-1 monotherapy or a cisplatin-based regimen.Median overall survival was not reached in the fluoropyrimidine+docetaxel/oxaliplatin group but was 22.9 months in the S-1/cisplatin group.Chemotherapy regimen was an independent prognostic factor(hazard ratio=5.47,P=0.004).The fluoropyrimidine plus docetaxel/oxaliplatin group had an average relative dose intensity of 82.1%,with significantly more patients achieving a relative dose intensity≥80%than in the S-1 monotherapy or cisplatin-based group(P=0.001).CONCLUSION Diffuse-type histology and the absence of postoperative chemotherapy influence the prognosis of patients with CY1 gastric cancer.Combination therapy with oxaliplatin or docetaxel may enhance the treatment intensity and improve survival outcomes after gastrectomy.展开更多
飞行器具有零部件多、结构复杂和装配精度要求高等特点,其装配有安全性装配、少可逆性装配等要求。根据飞行器相关的关键产品特性(Key product characteristic,KPC)和关键控制特性(Key control characteristic,KCC)参数,提出一种基于状...飞行器具有零部件多、结构复杂和装配精度要求高等特点,其装配有安全性装配、少可逆性装配等要求。根据飞行器相关的关键产品特性(Key product characteristic,KPC)和关键控制特性(Key control characteristic,KCC)参数,提出一种基于状态空间模型的装配误差敏感度量化分析方法,将飞行器多舱段精密装配过程中的误差敏感度分为3级指标,并进行阐述和定义。通过联立飞行器状态空间模型和输出方程,得到输入向量和输入矩阵的关系,进而求出状态转换矩阵,得到不同级别误差敏感度的理论表达式。将随机产生服从正态分布的装配特征误差代入系统矩阵,运用蒙特卡洛(Monte Carlo)仿真对不同装配特征的敏感度指标进行计算,并对比分析理论计算和蒙特卡洛仿真求得的特征级敏感度指标值。研究表明,将动态系统灵敏度分析方法应用到多工位装配过程可行,所提出的基于状态空间模型的飞行器装配误差敏感度分析方法合理,对飞行器舱段精密装配过程的精度评估具有参考意义。展开更多
Endoscopic ultrasound(EUS)is often used to detect the cause of acute pancreatitis(AP)after the acute attack has subsided.The limited data on its role during hospitalization for AP are reviewed here.The ability of EUS ...Endoscopic ultrasound(EUS)is often used to detect the cause of acute pancreatitis(AP)after the acute attack has subsided.The limited data on its role during hospitalization for AP are reviewed here.The ability of EUS to visualize the pancreas and bile duct,the sonographic appearance of the pancreas,correlation of such appearance to clinical outcomes and the impact on AP management are analyzed from studies.The most important indication for EUS appears to be for detection of suspected common bile duct and/or gall bladder stones and microlithiasis.Such an approach might avoid diagnostic endoscopic retrograde cholangio-pancreatography with its known complications.The use of EUS during hospitalization for AP still appears to be infrequent but may become more frequent in future.展开更多
Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus,...Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.展开更多
Coronary spasm is caused by a transient coronary nar -rowing due to the constriction of epicardial coronary artery, which leads to myocardial ischemia. More than 50 years have passed since the first recognition of cor...Coronary spasm is caused by a transient coronary nar -rowing due to the constriction of epicardial coronary artery, which leads to myocardial ischemia. More than 50 years have passed since the first recognition of coronary spasm, and many findings on coronary spasm have been reported. Coronary spasm has been considered as having pivotal roles in the cause of not only rest angina but also exertional angina, acute coronary syndrome, and heart failure. In addition, several new findings of the mechanism of coronary spasm have emerged recently. The diagnosis based mainly on coronary angiography and spasm provo-cation test and the mainstream treatment with a focus on a calcium-channel blocker have been established. At a glance, coronary spasm or vasospastic angina(VSA) has become a common disease. On the contrary, there are several uncertain or unsolved problems regarding coronary spasm, including the presence of medically refractory coronary spasm(intractable VSA), or an appropriate use of implantable cardioverter defibrillator in patients with cardiac arrest who have been confirmed as having coronary spasm. This editorial focused on coronary spasm, including recent topics and unsolved problems.展开更多
It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and progn...It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases(NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.展开更多
Magnetic refrigeration is a revolutionary, efficient, environmentally friendly cooling technology, which is on the threshold of commercialization. The magnetic rare earth materials are utilized as the magnetic refrige...Magnetic refrigeration is a revolutionary, efficient, environmentally friendly cooling technology, which is on the threshold of commercialization. The magnetic rare earth materials are utilized as the magnetic refrigerants in most cooling devices, and for many cooling application the Nd2Fe14B permanent magnets are employed as the source of the magnetic field. The status of the near room temperature magnetic cooling was reviewed.展开更多
基金supported by the TARCC,Welch Foundation Award(I-1724)the Decherd Foundationthe Pape Adams Foundation,NIH grants NS092616,NS127375,NS117065,NS111776。
文摘The mitogen-activated protein kinase kinase kinase kinases(MAP4Ks)signaling pathway plays a pivotal role in axonal regrowth and neuronal degeneration following insults.Whether targeting this pathway is beneficial to brain injury remains unclear.In this study,we showed that adeno-associated virus-delivery of the Citron homology domain of MAP4Ks effectively reduces traumatic brain injury-induced reactive gliosis,tauopathy,lesion size,and behavioral deficits.Pharmacological inhibition of MAP4Ks replicated the ameliorative effects observed with expression of the Citron homology domain.Mechanistically,the Citron homology domain acted as a dominant-negative mutant,impeding MAP4K-mediated phosphorylation of the dishevelled proteins and thereby controlling the Wnt/β-catenin pathway.These findings implicate a therapeutic potential of targeting MAP4Ks to alleviate the detrimental effects of traumatic brain injury.
基金financially supported by the New Jersey Department of Environmental ProtectionUS EPA。
文摘In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by ferric chloride were determined using 0.22-10μm pore-size filtration,Zetasizer analysis,and in situ flow through cell ATR-FTIR.The results showed that up to 20mg/L FA had almost no effect on the solubility of ferric hydroxide precipitates and adsorption of As(V)by the precipitates.When FA concentration increased from 0 to 20 mg/L,the adsorption of FA led to higher negative zeta potential of the precipitates and the strong electrostatic repulsion between the precipitates decreased the particle size of ferric hydroxide flocs fromlarger than 10μmto smaller than 1μm.In the presence of 5-20 mg/L FA,46%-63%As(V)was adsorbed onto the flocs with particle size in the range of 0.45-1μm.On the other hand,phosphate did not affect the size of ferric hydroxide flocs and significantly increased the dissolved As(V)concentration because it competed with As(V)for adsorption sites on ferric hydroxide precipitates.The addition of 5mg/L cationic organic flocculant significantly reduced the effect of FA on As(V)removal,but did not reduce the effect of phosphate on As(V)removal.The findings of this study will help develop effective arsenic treatment techniques and predict the mobility of arsenic in the environment.
文摘BACKGROUND Metabolic dysfunction-associated steatohepatitis(MASH)is increasingly common,as is hepatocellular carcinoma(HCC)in the background of MASH.Liver transplantation(LT)provides superior long-term survival for patients with unresectable MASH-HCC,but not all patients have equal access to transplant.MASH-HCC disproportionately affects Hispanic patients,but minorities are less likely to undergo LT for HCC.Additionally,females also undergo LT at lower rates than males.AIM To investigate whether race/ethnicity and sex affect LT waitlist outcomes.METHODS Records of adults with MASH-HCC in the United States Organ Procurement and Transplantation Network database listed for LT between 1/2015 and 12/2021 were analyzed.RESULTS Most of the 3810 patients waitlisted for LT for MASH-HCC were non-Hispanic(NH)white(71.2%)or Hispanic(23.4%),with only 49(1.1%)NH Black candidates.Hispanics underwent LT at lower rates than NH whites(71.6%vs 78.4%,P<0.001),but race/ethnicity did not affect waitlist mortality(P=0.06).Patients with Hispanic[hazard ratio(HR)=0.85,95%CI:0.77-0.95,P=0.002]or Asian(HR=0.79,95%CI:0.63-0.98,P=0.04)race/ethnicity were less likely to undergo LT.Women were also less likely to receive LT(male:HR=1.16,95%CI:1.04-1.29,P=0.01).Patients in regions 1 and 9 were less likely to be transplanted as well(P=0.07).CONCLUSION Hispanic patients are less likely to undergo LT for MASH-HCC,concerning given their susceptibility to MASH and HCC.There were very few NH Black candidates.Disparities were also unequal across regions,which is particularly concerning in states where at-risk populations have rising cancer incidence.Additional research is needed to identify strategies for mitigating these differences in access to LT for MASH-HCC.
文摘BACKGROUND Endoscopic bariatric therapies(EBT)have been developed as an adjunctive therapy to treat persistent obesity and recurrent weight gain and dumping symptoms after metabolic and bariatric surgery(MBS).While the efficacy of revisional EBTs has been documented,no studies to date have examined how these procedures impact quality of life(QOL)and internalized weight bias(IWB).AIM To understand how endoscopic revisional therapies impact QOL,IWB,and dumping syndrome.METHODS Analysis included 19 participants treated for post-MBS recurrent weight gain and/or dumping syndrome.The short-form 36 survey,weight bias internalization scale,and the Sigstad scoring system were used to measure QOL,IWB,and dumping syndrome pre-and≥4 weeks post-EBT.RESULTS At 6-months,total body weight loss was 8.6%±7.15%(n=16),at 12-months was 13.4%±7.46%(n=16).Short-form 36 scores for all 8 scales significantly increased from pre-to post-procedure with the greatest improvement in the scales related to emotional(mean improvement=59.6,P<0.05)and physical health(mean improvement=31.1,P<0.05).Both total Sigstad score(mean difference=4.947,P<0.05)and total weight bias internalization score(mean difference=0.761,P<0.05)significantly decreased from pre-to post-procedure.CONCLUSION Findings suggest that revisional EBT may improve post-MBS QOL across a broad spectrum of outcomes beyond optimizing body weight.As early EBT results indicate positive mental and physical health outcomes,further research is needed to evaluate the relationship between these improvements,body weight and interdisciplinary post-MBS care.
基金Ethics Committee of the Certified Institutional Review Board of the Yoyogi Mental Clinic(No.RKK227).
文摘BACKGROUND Recently,Olympus Corporation released new scopes(XZ1200/EZ1500).However,there have been few reports on this topic,although improvement in adenoma detection rate(ADR)by texture and color enhancement imaging(TXI)or computer-aided detection system(CAD)has been reported.AIM To investigate the effects of the scope on the detection of adenomas and sessile serrated lesions(SSLs).METHODS The subjects were patients who underwent pancolonic chromoendoscopy using the EVIS X1 video system center between May 2023 and October 2024.The patients were divided into the new(CF-XZ1200/CF-EZ1500)and 290 series(CF-HQ290Z/PCF-H290Z)groups.Propensity score matching was performed for age,sex,examination purpose,endoscopist,preparation,TXI use,and CAD use.The effects of the scope were analyzed in terms of the ADR,SSL detection rate(SDR),and mean number of adenomas per colonoscopy(APC).RESULTS Of the 7014 patients enrolled,2138 pairs were extracted by propensity score matching(mean age 55.4 years,45.5%male).The new scopes group had a significantly higher ADR than the 290 series group[51.5%vs 45.5%,odds ratio(OR)=1.27,95%CI:1.13-1.43,P<0.001].Similarly,the new scopes group had significantly higher SDR(7.8%vs 5.7%,OR=1.41,95%CI:1.11-1.80,P=0.005)and APC(0.90 vs 0.76,OR=1.11,95%CI:1.05-1.17,P<0.001)than the 290 series group.CONCLUSION In conclusion,the new scope(CF-XZ1200/CF-EZ1500)enhanced the detection of adenomas and SSLs compared to the old ones(290 series).
文摘BACKGROUND Peritoneal lavage cytology-positive(CY1)gastric cancer(stage IV)has a poor prognosis,though some cases fare better.Therefore,identifying prognostic factors and an optimal treatment strategy is crucial.AIM To investigate prognostic factors in patients with gastric cancer who underwent gastrectomy with CY1,and to evaluate the optimal postoperative chemotherapy regimen.METHODS This multicenter retrospective cohort study analyzed prognostic factors and postoperative chemotherapy in patients with CY1 gastric cancer who underwent gastrectomy,excluding those with macroscopic peritoneal dissemination.Data from 13 institutions(2015-2019)were reviewed.RESULTS Overall,82 patients met the inclusion criteria.The median overall survival was 22.8 months,and diffuse-type histology and the absence of postoperative chemotherapy were identified as independent poor prognostic factors.The 5-year survival rate was 82.4%for those receiving fluoropyrimidine plus docetaxel/oxaliplatin vs 21.8%for those with S-1 monotherapy or a cisplatin-based regimen.Median overall survival was not reached in the fluoropyrimidine+docetaxel/oxaliplatin group but was 22.9 months in the S-1/cisplatin group.Chemotherapy regimen was an independent prognostic factor(hazard ratio=5.47,P=0.004).The fluoropyrimidine plus docetaxel/oxaliplatin group had an average relative dose intensity of 82.1%,with significantly more patients achieving a relative dose intensity≥80%than in the S-1 monotherapy or cisplatin-based group(P=0.001).CONCLUSION Diffuse-type histology and the absence of postoperative chemotherapy influence the prognosis of patients with CY1 gastric cancer.Combination therapy with oxaliplatin or docetaxel may enhance the treatment intensity and improve survival outcomes after gastrectomy.
文摘Endoscopic ultrasound(EUS)is often used to detect the cause of acute pancreatitis(AP)after the acute attack has subsided.The limited data on its role during hospitalization for AP are reviewed here.The ability of EUS to visualize the pancreas and bile duct,the sonographic appearance of the pancreas,correlation of such appearance to clinical outcomes and the impact on AP management are analyzed from studies.The most important indication for EUS appears to be for detection of suspected common bile duct and/or gall bladder stones and microlithiasis.Such an approach might avoid diagnostic endoscopic retrograde cholangio-pancreatography with its known complications.The use of EUS during hospitalization for AP still appears to be infrequent but may become more frequent in future.
文摘Acute and chronic lateral ankle instability are common in high-demand patient populations. If not managed appropriately, patients may experience recurrent instability, chronic pain, osteochondral lesions of the talus, premature osteoarthritis, and other significantlong-term disability. Certain populations, including young athletes, military personnel and those involved in frequent running, jumping, and cutting motions, are at increased risk. Proposed risk factors include prior ankle sprain, elevated body weight or body mass index, female gender, neuromuscular deficits, postural imbalance, foot/ankle malalignment, and exposure to at-risk athletic activity. Prompt, accurate diagnosis is crucial, and evidence-based, functional rehabilitation regimens have a proven track record in returning active patients to work and sport. When patients fail to improve with physical therapy and external bracing, multiple surgical techniques have been described with reliable results, including both anatomic and nonanatomic reconstructive methods. Anatomic repair of the lateral ligamentous complex remains the gold standard for recurrent ankle instability, and it effectively restores native ankle anatomy and joint kinematics while preserving physiologic ankle and subtalar motion. Further preventative measures may minimize the risk of ankle instability in athletic cohorts, including prophylactic bracing and combined neuromuscular and proprioceptive training programs. These interventions have demonstrated benefit in patients at heightened risk for lateral ankle sprain and allow active cohorts to return to full activity without adversely affecting athletic performance.
文摘Coronary spasm is caused by a transient coronary nar -rowing due to the constriction of epicardial coronary artery, which leads to myocardial ischemia. More than 50 years have passed since the first recognition of coronary spasm, and many findings on coronary spasm have been reported. Coronary spasm has been considered as having pivotal roles in the cause of not only rest angina but also exertional angina, acute coronary syndrome, and heart failure. In addition, several new findings of the mechanism of coronary spasm have emerged recently. The diagnosis based mainly on coronary angiography and spasm provo-cation test and the mainstream treatment with a focus on a calcium-channel blocker have been established. At a glance, coronary spasm or vasospastic angina(VSA) has become a common disease. On the contrary, there are several uncertain or unsolved problems regarding coronary spasm, including the presence of medically refractory coronary spasm(intractable VSA), or an appropriate use of implantable cardioverter defibrillator in patients with cardiac arrest who have been confirmed as having coronary spasm. This editorial focused on coronary spasm, including recent topics and unsolved problems.
文摘It is widely accepted that the indications for hepatectomy in colorectal cancer liver metastases and liver metastases of neuro-endocrine tumors result in relatively better prognoses, whereas, the indications and prognoses of hepatectomy for non-colorectal non-neuroendocrine liver metastases(NCNNLM) remain controversial owing to the limited number of cases and the heterogeneity of the primary diseases. There have been many publications on NCNNLM; however, its background heterogeneity makes it difficult to reach a specific conclusion. This heterogeneous disease group should be discussed in the order from its general to specific aspect. The present review paper describes the general prognosis and risk factors associated with NCNNLM while specifically focusing on the liver metastases of each primary disease. A multidisciplinary approach that takes into consideration appropriate timing for hepatectomy combined with chemotherapy may prolong survival and/or contribute to the improvement of the quality of life while giving respite from systemic chemotherapy.
基金Project supported bythe U.S .Department of Energy ,Office of Basic Energy Sciences , Materials Science and Engineering Division and Astronautics Corporation of America , Milwaukee , Wisconsin
文摘Magnetic refrigeration is a revolutionary, efficient, environmentally friendly cooling technology, which is on the threshold of commercialization. The magnetic rare earth materials are utilized as the magnetic refrigerants in most cooling devices, and for many cooling application the Nd2Fe14B permanent magnets are employed as the source of the magnetic field. The status of the near room temperature magnetic cooling was reviewed.
