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Gastro-oesophageal reflux disease (GORD) is symptomatic reflux of gastric contents into the oesophagus. Factors predisposing to GORD are loss of the physiological antireflux barrier and anatomic abnormalities of the oesophagus or diaphragm. Conservative measures and medical management results in resolution of symptoms in a majority of children. Surgery is indicated in the event of failure of medical management or severe complications. Surgical procedures include open or laparoscopic fundoplication in children with normal neurology; fundoplication with or without vagotomy and pyloroplasty; surgical feeding jejunostomy and oesophago-gastric dissociation in the severely neurologically impaired children. 相似文献
44.
随着腹腔镜肝切除技术的发展与推广,腹腔镜肝切除中的一些难点,如术中出血的控制、解剖性肝切除、巨大肝癌切除、腹腔镜下联合肝脏分割与门静脉支结扎的二步肝切除术(ALPPS)等方面均基本解决。术中超声与荧光染色技术也得到普及。本文就上述问题做一概述,并对腹腔镜肝切除未来发展提出思路,以进一步推动我国腹腔镜肝切除的技术进步。 相似文献
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O. Morris M. Fairclough J. Grigg C. Prenant A. McMahon 《Journal of labelled compounds & radiopharmaceuticals》2019,62(1):4-23
Affinity peptide and protein‐ (APP) based radiotracers are an increasingly popular class of radiotracer in positron emission tomography (PET), which was once dominated by the use of small molecule radiotracers. Radiolabelled monoclonal antibodies (mAbs) are important examples of APPs, yet a preference for smaller APPs, which exhibit fast pharmacokinetics and permit rapid PET aided diagnosis, has become apparent. 18F exhibits favourable physical characteristics for APP radiolabelling and has been described as an ideal PET radionuclide. Notwithstanding, 18F radiolabelling of APP is challenging, and this is echoed in the literature where a number of diverse approaches have been adopted. This review seeks to assess and compare the approaches taken to 18F APP radiolabelling with the intention of highlighting trends within this expanding field. Generic themes have emerged in the literature, namely the use of mild radiolabelling conditions, a preference of site‐specific methodologies with an impetus for short, automated procedures which produce high‐yielding [18F]APPs. 相似文献
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评估玻璃体切割联合内界膜剥除对糖尿病性黄斑水肿(DME)的疗效。方法:回顾性病例对照研究。2014年6月至2017年1月间因糖尿病视网膜病变合并玻璃体积血或增殖病变于温州医科大学附属眼视光医院杭州院区行玻璃体切割手术治疗,且术前或术中经光学相干断层扫描(OCT)检查确诊合并DME的患者31例(33眼)纳入研究。16例(18眼)术中联合内界膜剥除作为剥膜组,15例(15眼)仅接受玻璃体切割手术治疗者作为对照组。所有手术均由同一医师主刀完成。术后1、3个月随访时复查OCT,对比观察黄斑中心厚度(CMT)和视力的术后变化情况。随访中CMT和最佳矫正视力(BCVA)比较采用重复测量方差分析,组间CMT和BCVA比较采用独立样本t检验。结果:手术前,手术后1、3个月2组间比较LogMAR视力总体差异有统计学意义(F=15.93,P<0.001)。术后 1个月时剥膜组BCVA高于对照组(t=2.55,P=0.02),但术后3个月时2组间差异无统计学意义(t=0.82, P=0.42)。手术前,手术后1、3个月CMT总体差异无统计学意义(F=2.85,P=0.065)。术后1、3个月时,剥膜组的CMT均低于对照组,2组间差异均有统计学意义(t=2.24,P=0.03;t=3.79,P=0.001)。术后1个月时,剥膜组有效(与术前比CMT减少20%以上)、无效(变化不超过20%)及恶化(增厚超过 20%)的例数分别为8、6、4例,术后3个月时则分别为11、5、2例,与对照组相比,术后1个月时组间差异无统计学意义(Z=-1.687,P=0.092),术后3个月时剥膜组DME改善有效比例明显高于对照组,组间差异有统计学意义(Z=-2.177,P=0.029)。结论:对于非牵拉性DME,内界膜剥除有助于术后早期DME消退。 相似文献
49.
M. Iachina P.M. Ljungdalh R.G. Sørensen L. Kaerlev J. Blaakær O. Trosko N. Qvist B.M. Nørgård 《Clinical oncology (Royal College of Radiologists (Great Britain))》2019,31(2):115-123
Aims
To examine the influence of pre-existing psychiatric disorder on the choice of treatment in patients with gynaecological cancer.Materials and methods
The analyses were based on all patients who underwent surgical treatment for endometrial, ovarian or cervical cancer who were registered in the Danish Gynecological Cancer Database in the years 2007–2014 (3059 patients with ovarian cancer, 5100 patients with endometrial cancer and 1150 with cervical cancer). Logistic regression model and Cox regression model, adjusted for relevant confounders, were used to estimate the effect of pre-existing psychiatric disorder on the course of cancer treatment. Our outcomes were (i) presurgical oncological treatment, (ii) macroradical surgery for patients with ovarian cancer, (iii) radiation/chemotherapy within 30 days and 100 days after surgery and (iv) time from surgery to first oncological treatment.Results
In the group of patients with ovarian cancer, more patients with a psychiatric disorder received macroradical surgery versus patients without a psychiatric disorder, corresponding to an adjusted odds ratio of 1.24 (95% confidence interval 0.62–2.41) and the chance for having oncological treatment within 100 days was odds ratio = 1.26 (95% confidence interval 0.77–2.10). As for patients with endometrial cancer, all outcome estimates were close to unity. The adjusted odds ratio for oncological treatment within 30 days after surgery in patients with cervical cancer with a history of psychiatric disorder was 0.20 (95% confidence interval 0.03–1.54).Conclusions
We did not find any significant differences in the treatment of ovarian and endometrial cancer in patients with pre-existing psychiatric diagnoses. When it comes to oncological treatment, we suggest that increased attention should be paid to patients with cervical cancer having a pre-existing psychiatric diagnosis. 相似文献50.
Micro‐evolution of the hepatitis B virus genome in hepatitis B e‐antigen‐positive carriers: Comparison of genotypes B and C at various immune stages 下载免费PDF全文