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91.
At present, there have not been any detailed studies examining the size relationships of the intercostal arteries. This study was carried out to investigate the relationship between the vessel lumenal diameter of ipsilateral, paired anterior and posterior IC arteries, as well as with the length of the IC space supplied by each artery. Samples were collected from the second‐sixth anterior and posterior IC arteries near their site of origin, and the lengths of the corresponding IC spaces were measured in 42 cadavers. Lumenal diameters of both the anterior and posterior IC arteries at consecutive IC space closely followed second degree polynomial regression models (R2 = 0.9655, and R2 = 0.9741, respectively), and reached maximum size at the fifth IC space, which was found to be the longest of the IC spaces. No direct relationship was observed between diameters of the paired anterior and posterior IC arteries, although there was a trend for the larger anterior IC arteries to be paired with the larger posterior IC arteries. The calculated rate of blood flow at each IC artery was approximately two‐fold greater in males than in females. These results suggest that the length of the IC space, and hence the extent of the thoracic wall supplied, is a major factor in determining the diameter of both anterior and posterior IC arteries. Since COPD is such a prevalent disease, this study also examined its influence on the IC arteries, and found that the posterior IC arteries are significantly larger among afflicted subjects. Clin. Anat. 28:219–226, 2015. © 2014 Wiley Periodicals, Inc.  相似文献   
92.
Thoracic duct cysts, which may be of congenital or degenerative origin, are very rare lesions. Most patients are asymptomatic, but when symptoms are present they include cough, dyspnea, dysphagia and chest pain. However, in this case report a 35-year-old male patient presented to us with intermittent abdomen pain. Clinical symptoms and radiographic findings helped to identify a giant thoracic duct cyst in this patient. Surgical resection of the cyst resolved the abdominal symptoms. This was the first case reported in the literature of a thoracic duct cyst with the symptoms of abdominal pain.  相似文献   
93.
Colon cancer can be treated with 5-fluorouracil (5-FU), but 5-FU resistance frequently occurs. We determined whether 5-FU resistance arises as a result of endoplasmic reticulum (ER) stress. 5-FU–resistant SNUC5 colon cancer cells (SNUC5/FUR cells) expressed higher levels of ER stress–related proteins than drug-sensitive SNUC5 cells. SNUC5/FUR cells also exhibited more intense ER staining and higher level of mitochondrial Ca2+ overload. SNUC5/FUR cells transfected with siRNA against GRP78, ATF6, ERK, or AKT were more sensitive to 5-FU than siControl RNA-transfected cells. These results suggested that 5-FU resistance was associated with ER stress in colon cancer.  相似文献   
94.
Objective To retrospectively study the risk factors of aortic arch calcificationand its influence on the survival prognosis of maintenance peritoneal dialysis patients. Methods One hundred seventy-seven cases of maintenance peritoneal dialysis patients were enrolled, including 66 cases of aortic arch calcification cases. Their general dialysis data were collected for the evaluation of dialysis adequacy and residual renal function, and their chest X-rays were recorded to assess the degree of aortic arch calcification. The two variables Logistics regression was used to analyze independent risk factors of aortic arch calcification; Kaplan-Meier analysis was used to analyze the influence on prognosis of dialysis patients; and multivariate COX regression was employed to analyze independent risk factors of death in dialysis patients. Results Among the 177 selected cases of peritoneal dialysis patients, 66 cases (37.29%) presented with aortic arch calcification. Elevated serum phosphorus was an independent risk factor of aortic arch calcification (OR=54.69,95%CI: 10.01-298.65, P<0.01). The probability of survival in patients with mild and moderate (severe) calcification of aortic arch was less than those without calcification. Moderate (severe) calcification of aortic arch was the independent risk factor of all-cause mortality and cardiovascular disease mortality, whose hazard ratios in patients with calcification were 3.779 times and 5.636 times of those in patients without calcification respectively. Conclusions Hyperphosphatemia is an independent risk factor promoting the development of calcification of aortic arch. The probability of survival in patients with mild and moderate (severe) calcification of aortic arch is less than those without calcification; moderate (severe) calcification of aortic arch is the independent risk factor of all-cause mortality and cardiovascular disease mortality.  相似文献   
95.
目的 观察长眼轴患者行白内障超声乳化术后角膜生物力学的变化。方法 收集拟接受白内障手术的患者58例68眼,将其分为长眼轴组(28例34眼)和正常眼轴组(30例34眼),应用可视化角膜生物力学分析仪(corneal visualization scheimpflug technology,Corvis ST)对患者术前及术后1周、1个月的角膜生物力学参数进行测量。结果 术前及术后1周、1个月两组峰距、中央角膜厚度、矫正眼压、眼压及长眼轴组第二压平时间和最大形变幅度的总体比较,差异均有统计学意义(均为P<0.05);术后1周与术前相比,两组峰距、中央角膜厚度、矫正眼压、眼压明显增大,长眼轴组最大形变幅度较术前减小,差异均有统计学意义(均为P<0.05),但术后1个月正常眼轴组峰距、中央角膜厚度、矫正眼压、眼压均恢复到术前水平(均为P>0.05),而长眼轴组最大形变幅度较术前减小,矫正眼压、眼压较术前均增高(均为P<0.05)。术后1个月与术后1周比较,两组峰距、中央角膜厚度、矫正眼压、眼压均有减小趋势(均为P<0.05)。长眼轴组术后1周中央角膜厚度、矫正眼压及最大形变幅度的变化量与眼轴长度均存在正相关性(r=0.493,P=0.003;r=0.575,P<0.001;r=0.587,P<0.001),而正常眼轴组的相关参数的变化量与眼轴长度均无相关性(均为P>0.05)。结论 白内障超声乳化术能影响角膜生物力学,且长眼轴患者较正常眼轴者术后更易引起角膜生物力学改变,在白内障术后应注意其用药时间及激素类药物的使用,防止伤口愈合不良导致迁延感染及高眼压的发生。  相似文献   
96.
Microhaplotype loci (microhaps, MHs) are a novel type of molecular marker of less than 300 nucleotides, defined by two or more closely linked SNPs associated in multiple allelic combinations. The value of these markers is enhanced by massively parallel sequencing (MPS), which allows the sequencing of both parental haplotypes at each of the many multiplexed loci. This review describes the features of these multi-SNP markers and documents their value in forensic genetics, focusing on individualization, biogeographic ancestry inference, and mixture deconvolution. Foreseeable applications also include missing person identification, relationship testing, and medical diagnostic applications. The technique is not restricted to humans.  相似文献   
97.

Purpose

This study examined whether hyperspectral stimulated Raman scattering (hsSRS) microscopy can detect differences in meibum lipid to protein composition of normal and evaporative dry eye subjects with meibomian gland dysfunction.

Methods

Subjects were evaluated for tear breakup time (TBUT), staining, meibum expression and gland dropout. Expressed meibum was analyzed using SRS vibrational signatures in the CH stretching region (2800–3050?cm?1). Vertex component analysis and K-means clustering were used to group the spectral signatures into four fractions containing high lipid (G1) to high protein (G4).

Results

Thirty-three subjects could be statistically analyzed using pooled meibum (13 with stable tear films (TBUTs?>?10?s) and 20 with unstable tear films (TBUTs?≤?10?s). Significant differences in meibum from subjects with unstable vs. stable TBUTs were found for the G1 fraction (medians 0.164 and 0.020, respectively; p?=?0.012) and the G2 fraction (medians 0.244 and 0.272, respectively; p?=?0.045). No differences were observed for the G3 and G4 fractions. Single orifice samples were not significantly different vs. pooled samples from the fellow eye, and eyelid sector samples (nasal, central and temporal) G2:G3 fractional components were not significantly different (p?=?0.449). Spearman analysis suggested a significant inverse correlation between G1 fraction and TBUT (R?=??0.351; p?=?0.045).

Conclusions

hsSRS microscopy allows compositional analysis of expressed meibum from humans which correlated to changes in TBUT. These findings support the hypothesis that hsSRS may be useful in classifying meibum quality and evaluating the effects of therapy.  相似文献   
98.
Small-cell lung cancer (SCLC) is an aggressive disease with distinct pathological, clinical, and molecular characteristics from non–small-cell lung cancer. SCLC has high metastatic potential, resulting in a clinically poor prognosis. Early concurrent chemo-radiation is the standard of care for limited-stage SCLC (LS-SCLC). Prophylactic cranial irradiation (PCI) is recommended for patients with LS-SCLC without progression of disease after initial therapy. A combination of etoposide and cisplatin or carboplatin remains the mainstay of first-line treatment for ES-SCLC, with the addition of atezolizumab, now becoming standard. Most SCLCs initially respond to therapy but almost invariably recur. Topotecan and amrubicin (in Japan) remain the primary chemotherapy options for relapsed SCLC. Immunotherapy, including nivolumab with or without ipilimumab, is now available for refractory disease. In general, the poor prognosis of SCLC has not improved significantly for more than 3 decades. Recently, next-generation molecular profiling studies have identified new therapeutic targets for SCLC. A variety of proapoptotic agents, compounds capitalizing on DNA-repair defects, immunotherapy agents, and antibody–drug conjugates are being evaluated in SCLC, with a number of them showing early promise.  相似文献   
99.

Background

Treatment of advanced anal squamous cell cancer (SCC) is usually with the combination of cisplatin and 5-fluorouracil, which is associated with heterogeneous responses across patients and significant toxicity. We examined the safety and efficacy of a modified schedule, FOLFCIS (leucovorin, fluorouracil, and cisplatin), and performed an integrated clinical and genomic analysis of anal SCC.

Patients and Methods

We reviewed all patients with advanced anal SCC receiving first-line FOLFCIS chemotherapy – essentially a FOLFOX (leucovorin, fluorouracil, and oxaliplatin) schedule with cisplatin substituted for oxaliplatin – in our institution between 2007 and 2017, and performed deep sequencing to identify genomic markers of response and key genomic drivers.

Results

Fifty-three patients with advanced anal SCC (48 metastatic; 5 unresectable, locally advanced) received first-line FOLFCIS during this period; all were platinum-naive. The response rate was 48% (95% confidence interval [CI], 32.6%-63%). With a median follow-up of 41.6 months, progression-free survival and overall survival were 7.1 months (95% CI, 4.4-8.6 months) and 22.1 months (95% CI, 16.9-28.1 months), respectively. Among all patients with advanced anal SCC that underwent sequencing during the study period, the most frequent genomic alterations consisted of chromosome 3q amplification (51%) and mutations in PIK3CA (29%) and KMT2D (22%). No genomic alteration correlated with response to platinum-containing treatment. Although there were few cases, patients with human papillomavirus-negative anal SCC did not appear to benefit from FOLFCIS, and all harbored distinct genomic profiles with TP53, TERT promoter, and CDKN2A mutations.

Conclusions

FOLFCIS appears effective and safe as first-line chemotherapy in patients with advanced anal SCC and represents an alternative treatment option for these patients.  相似文献   
100.

Objective

To compare perioperative and long-term outcomes in patients undergoing hemiarch and aggressive arch replacement for acute type A aortic dissection (ATAAD).

Methods

From 1996 to 2017, we compared outcomes of hemiarch (n = 322) versus aggressive arch replacements (zones 2 and 3 arch replacement with implantation of 2-4 arch branches, n = 150) in ATAAD. Indications for aggressive arch were arch aneurysm >4 cm or intimal tear in the aortic arch that was not resectable by hemiarch replacement, or dissection of arch branches with malperfusion.

Results

Patients in the aggressive arch group were significantly younger (mean age: 57 vs 61 years old) and had significantly longer hypothermic circulatory arrest, cardiopulmonary bypass, and aortic crossclamp times. There were no significant differences in perioperative outcomes between hemiarch and aggressive arch groups, including 30-day mortality (5.3% vs 7.3%, P = .38) and postoperative stroke rate (7% vs 7%, P = .96). Over 15 years, Kaplan–Meier survival was similar between hemiarch and aggressive arch groups (log-rank P = .55, 10-year survival 70% vs 72%). Given death as a competing factor, incidence rates of reoperation over 15 years (2.1% vs 2.0% per year, P = 1) and 10-year cumulative incidence of reoperation (14% vs 12%, P = .89) for arch and distal aorta pathology were similar between the 2 groups.

Conclusions

Both hemiarch and aggressive arch replacement are appropriate approaches for select patients with ATAAD. Aggressive arch replacement should be considered for an arch aneurysm >4 cm or an intimal tear at the arch unable to be resected by hemiarch replacement, or dissection of the arch branches with malperfusion.  相似文献   
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