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1.
《Pancreatology》2022,22(5):598-607
BackgroundResections for intraductal papillary mucinous neoplasia (IPMN) have increased dramatically during the last decade. Recurrence pattern and impact of adjuvant chemotherapy for solid pancreatic ductal adenocarcinoma (PDAC) is well known, but not for invasive IPMN (inv-IPMN).ObjectivesTo elucidate the impact of spatio-temporal recurrence pattern and adjuvant chemotherapy on overall survival for inv-IPMN compared with PDAC.MethodsWe conducted a retrospective single-center observational study of consecutive patients ≥18 years of age who underwent resection for inv-IPMN or PDAC at Karolinska University Hospital, between 2009 and 2018. Different initial recurrence sites and time frames as well as predictors for death were assessed with multivariable Cox and logistic regressions. Survival analyses were performed using the Kaplan-Meier model and log rank test.ResultsOf 396 resected patients, 92 were inv-IPMN and 304 PDAC. Both recurrence rate and death rate within three-years were lower for inv-IPMN compared to PDAC (p = 0.006 and p = 0.007 respectively). Across the whole cohort, the most common recurrence patterns were multi-site (25%), single-site liver (21%) and single-site locoregional (10%) recurrence. The most prominent predictors for death in multivariable Cox regression, especially if occurred within the first year, were multi-site (HR 17.0), single-site peritoneal (HR 13.6) and single-site liver (HR 13.1) recurrence. These predictors were less common in inv-IPMN compared to PDAC (p = 0.007). The effect of adjuvant chemotherapy was similar in the two groups.ConclusionResected inv-IPMN exhibits a less aggressive recurrence pattern than PDAC that translates into a more favorable overall survival.  相似文献   
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急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)是继发于肺内或全身的炎症反应过程,它由肺泡损伤导致并形成炎症性非心源性的肺水肿。模式识别受体(PRRs)参与先天免疫系统的激活,PRRs可以启动炎症信号级联反应,并释放促炎细胞因子。本综述对PRRs所包括的跨膜受体TLRs、胞质受体RLRs和NLRs以及下游炎症通路NF-κB、IRF、MAPK、NETs、RAGE和Nrf2信号通路及自噬进行总结,以阐述模式识别受体PRRs在ALI/ARDS发病机制中的作用。  相似文献   
3.
Background and objective: The second most common cancer in men after lung cancer is prostate cancer (PC).Previous studies assessed the association between food items or food groups and the risk of PC, but diet quality indicesare unique approaches to study any relations between diet and disease. Our objective was to investigate the effect ofhealthy eating index (HEI-2010) and Mediterranean-Style Dietary Pattern Score (MSDPS) on PC risk. Methods: Inthis case-control study, we recruited 97 patients with MS and 205 control subjects . Dietary intake was evaluted usinga valid and reliable food frequency questionnaire. The HEI and MSDPS were calculated. Logistic regression was usedto evaluate the relationship between HEI and MSDP scores and PC risk after adjusting the confounders. Results: Incomparison to controls, cases had lower score on HEI (61 vs. 70.07; P< 0.001), and higher score on MSDP (26.20 vs.24.49; P= 0.44). After comparing the highest and the lowest tertile of HEI, we observed a significant decreasing trendin the risk of PC (p for trend<0.001). Conclusion: Our findings suggested that a high quality diet, according to HEI,may decrease the risk of PC.  相似文献   
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摘要:目的 利用国家评价性抽验平台数据库中的数据,探索头孢拉定颗粒质量关键质量属性及快速定量方法。方法 应 用近红外光谱结合因子分析建立模式识别方法,探索不同厂家头孢拉定颗粒质量和工艺的一致性;利用近红外光谱和偏最小二 乘法建立定量模型,对头孢拉定颗粒中头孢拉定含量、头孢氨苄含量和水分含量进行快速量值预测。结果 利用模式识别模型 可区分不同厂家头孢拉定颗粒的质量和工艺一致性,建立的PLS定量模型能实现对头孢拉定含量、头孢氨苄含量和水分含量的 快速预测。结论 国家评价性抽验平台对为药品监管及靶向抽验提供有效的科学依据具有重要的价值。  相似文献   
6.
IntroductionThe natural history and patterns of ovarian cancer (OC) relapse are still unclear. Recurrent disease can be peritoneal, parenchymal, or nodal. This study aims to analyze the location and pattern of OC recurrence according to the primary site of disease and to the type of surgical approach used.Material and methodsAll OC patients underwent primary debulking surgery (PDS) or interval debulking surgery (IDS), with 2014 FIGO stage III-IV, and with platinum-sensitive recurrence were included in the study. Primary disease location and site of recurrences were divided into peritoneal, parenchymal, and nodal, according to the presence of peritoneal carcinomatosis, parenchymal metastasis, and nodal involvement, respectively.ResultsA total of 355 patients were initially considered; of them, 295 met the inclusion criteria. Two hundred thirty-three patients obtained no macroscopic residual tumor at the end of primary surgical treatment. Primary parenchymal disease relapsed in 84.6% cases at a parenchymal site (p < 0.001), 97.2% of peritoneal diseases relapsed on the peritoneum (p < 0.001), and 100% of nodal diseases had a nodal recurrence (p < 0.001). Stratifying by the surgical approach all these correlations have been confirmed both in the PDS (p < 0.001) and IDS (p < 0.001) groups.ConclusionOur study shows that the site of relapse in cases of platinum-sensitive OC recurrence is closely related to the primary location of the disease, regardless of the type of initial treatment. Therefore, more attention during followup should be paid to areas where the initial tumor was present.  相似文献   
7.
Given the negative trajectories of early behavior problems associated with ADHD, early diagnosis is considered critical to enable intervention and treatment. To this end, the current investigation employed machine learning to evaluate the relative predictive value of parent/teacher ratings, behavioral and neural measures of executive function (EF) in predicting ADHD in a sample consisting of 162 young children (ages 4–7, mean age 5.55, 82.6 % Hispanic/Latino). Among the target measures, teacher ratings of EF were the most predictive of ADHD. While a more extensive evaluation of neural measures, such as diffusion-weighted imaging, may provide more information as they relate to the underlying cognitive deficits associated with ADHD, the current study indicates that measures of cortical anatomy obtained in research studies, as well cognitive measures of EF often obtained in routine assessments, have little incremental value in differentiating typically developing children from those diagnosed with ADHD. It is important to note that the overlap between some of the EF questions in the BRIEF, and the ADHD symptoms could be enhancing this effect. Thus, future research evaluating the importance of such measures in predicting children’s functional impairment in academic and social areas would provide additional insight into their contributing role in ADHD.  相似文献   
8.
名医经验传承是中医药文化传承和发展的重要内容。本文结合当前名医经验传承研究的基本现状以及名医学术经验整理与深度传承发展的核心需求,提出基于知识图谱的名医经验传承模式研究构想。利用知识图谱在多维度知识及海量信息网络整合方面的优势,从名医学术源流整理,学术思想挖掘及临床经验整理等多个角度出发,探讨知识图谱构建和挖掘分析的研究思路。通过多主题、结构化的知识图谱构建,探索名医经验传承系统化、规范化建设的新思路。  相似文献   
9.
目的探讨高压氧综合治疗非动脉炎性前部缺血性视神经病变(non-arteritic anterior ischemic optic neuropathy,NAION)患者的临床疗效。方法选取2017年1月至2019年1月郑州市第二人民医院收治的NAION患者110例,采用随机数字表法将患者分为对照组(55例)和高压氧组(55例)。对照组给予激素冲击、改善微循环、营养神经等常规治疗;高压氧组在对照组基础上给予高压氧治疗,舱压0.2 MPa(2.0 ATA),每日1次,10次为1个疗程,共治疗30 d。观察并分析2组患者治疗前后的视力、视野平均敏感度(mean sensitivity, MS)、视野平均缺损(mean defect, MD)、图形视觉诱发电位(pattern visual evoked potential, PVEP)振幅、潜伏期,评定治疗有效率。观察高压氧综合治疗对NAION患者血清人软骨糖蛋白-39 (又称几丁质酶-3样蛋白-1,chtinase-3-like-1 protein, YKL-40)的影响。结果 2组患者治疗前的视力、视野MS、视野MD、PVEP振幅、潜伏期比较,差异均无统计学意义(P>0.05)。高压氧组治疗后视野MD低于对照组及本组治疗前,视力和视野MS高于对照组及本组治疗前,差异均有统计学意义(P<0.05)。高压氧组患者的PVEP振幅高于本组治疗前及对照组,潜伏期短于本组治疗前及对照组,差异均有统计学意义(P<0.05)。治疗7 d时2组血清YKL-40达到峰值,高压氧组治疗3、7、15、30 d时均低于同时间点对照组,差异均有统计学意义(P<0.05)。高压氧组患者的总有效率(83.63%)高于对照组(74.55%),组间差异无统计学意义(P>0.05)。结论高压氧综合治疗可以明显提高NAION患者的视力、视野MS,改善患者视野MD、PVEP振幅、潜伏期,减轻炎性反应,有利于提高临床疗效。  相似文献   
10.
目的探讨不同中国肝癌分期(CNLC)肝癌接受根治性切除术后的临床效果及长期生存的预后因素。方法回顾性分析2010年1月至2019年12月南京医科大学第一附属医院肝胆中心单一治疗组收治的行肝癌根治术的549例肝细胞癌(HCC)患者的临床病理学资料。男性462例(84.2%),女性87例(15.8%);中位年龄57岁(范围:21~84岁)。观察患者的术前变量、术中及术后情况、术后病理学检查结果等。采用门诊与电话相结合的方式进行随访。采用寿命表法进行生存率的估计,采用Kaplan-Meier法绘制总体生存和无瘤生存曲线,采用Log-rank检验比较不同组别生存过程的差异,采用多因素Cox回归模型分析影响预后的主要因素。结果 549例HCC患者中,CNLC Ⅰa期200例(36.4%),CNLC Ⅰb 期148例(27.0%),CNLC Ⅱa期49例(8.9%),CNLC Ⅱb期32 例(5.8%),CNLC Ⅲa期101例(18.4%),CNLC Ⅲb期19例(3.5%)。患者1、3、5、10年总体生存率分别为83.8%、69.0%、54.2%、37.7%,1、3、5年无瘤生存率分别为61.0%、44.2%、36.0%。CNLC Ⅰa期患者的1、3、5年总体生存率和无瘤生存率分别为97.3%、90.6%、80.5%和83.9%、65.0%、54.0%;CNLC Ⅰb期患者的1、3、5年总体生存率和无瘤生存率分别为87.9%、71.0%、47.7%和58.4%、42.3%、33.4%;CNLC Ⅱa和Ⅱb期患者的5年总体生存率(Ⅱa期:37.2%,Ⅱb期:44.3%)与CNLC Ⅰb期类似。CNLC Ⅲb期患者 1、3、5年总体生存率和无瘤生存率分别为35.3%、13.2%、0和23.5%、0、0。单因素分析结果显示,术前合并症状、术前甲胎蛋白水平、术前总蛋白水平、术前AST水平、术前总胆红素水平、术中出血量、术中或术后输血、术后并发症、肿瘤最大径和数目、微血管侵犯、大血管侵犯、肿瘤分化程度是HCC患者长期生存(≥5年)的预后因素(P值均<0.05)。多因素分析结果显示,术前AST水平、术中出血量、肿瘤数目、肿瘤最大径、大血管侵犯和肿瘤分级是HCC患者长期生存的独立预后因素(P值均<0.05)。结论不同CNLC的HCC患者具有不同的复发模式及预后。经过严格术前评估的CNLC Ⅱa~Ⅲb期HCC患者可从外科根治切除术中获得生存获益。术前AST水平、术中出血量、肿瘤数目、肿瘤最大径、大血管侵犯和肿瘤分化程度是影响HCC患者长期生存的独立预后因素。  相似文献   
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