postsurgical

手术后
  • 文章类型: Journal Article
    粘连是腹部或骨盆手术最常见的并发症,仍然是一个具有挑战性的问题。为了更好地了解腹部粘连的发展趋势,我们对腹部粘连领域进行了全面的文献计量学分析.总的来说,从2004年至2023年在WebofScience索引的关于腹部粘连的手稿中索引的3410篇手稿中筛选并分析了2219篇有关腹部粘连的文章。进行了文献计量分析,和CiteSpace[6.2版。R3(64位)]和VOSviewer(版本1.6.19)用于可视化结果。2019年之前,年度出版物数量略有增长,美国贡献了最多的出版物。这个领域最多产的作者是戴蒙德,而十溪的出版物影响力最大。该领域最受欢迎的杂志是《外科研究杂志》,最常被共同引用的期刊是《生育与不育》。在分析了关键词之后,“预防”,“手术”和“腹膜粘连”是三个最共同引用的关键词,而“粘连性小肠梗阻”是引文爆发中最强的关键词。这里,第一次,在过去的十年中,我们使用文献计量学方法研究了腹部粘连。通过总结出版物的特点和预测未来的研究前景,为研究者建立了框架,为后续研究提供了依据。
    Adhesions are the most common complication of abdominal or pelvic surgery and remain a challenging problem. To better understand the development tendency of abdominal adhesions, we performed a comprehensive bibliometric analysis of the field of abdominal adhesions. In total, 2219 articles regarding abdominal adhesions were screened and analyzed from 3410 manuscripts indexed in the Web of Science-indexed manuscripts regarding abdominal adhesion from 2004 to 2023. A bibliometric analysis was performed, and CiteSpace [version 6.2. R3 (64-bit)] and VOSviewer (version 1.6.19) were used to visualize the results. The number of annual publications showed slight growth before 2019, and the USA contributed the most publications. The most prolific author in this domain was Diamond, while the publications from Ten Broek had the strongest influence. The most popular journal in this field was the Journal of Surgical Research, and the most frequently co-cited journal was Fertility and Sterility. After analyzing the keywords, \"prevention\", \"surgery\" and \"peritoneal adhesion\" were the 3 most co-cited keywords, while \"adhesive small bowel obstruction\" was the strongest keyword in the citation burst. Here, for the first time, we used bibliometric methods to study abdominal adhesions over the past ten years. By summarizing the characteristics of publications and predicting future research prospects, we established a framework for researchers and provided a basis for subsequent research.
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  • 文章类型: Journal Article
    目的:膀胱副神经节瘤(UBPGLs)是一种罕见的神经内分泌肿瘤,在诊断和手术方面具有挑战性。尚不清楚哪些因素有助于及时的术前诊断。这项研究的目的是确定导致手术前UBPGL诊断缺失的因素。
    方法:共有来自中国11个中心的73名患者,纳入来自欧洲6个中心和美国1个中心的51例患者.临床,收集手术和遗传数据,并对手术前和手术后确诊的患者进行比较.使用Logistic回归分析来确定与术前生化检测开始相关的临床因素。
    结果:在所有患者中,只有47.6%在手术前确诊。这些患者年轻(34.0vs.54.0年,p<.001),有较大的肿瘤(2.9vs.1.8cm,p<.001),更多的人患有SDHB致病性变异(54.7%vs.11.9%,p<.001)比手术后诊断的那些。术前诊断的患者表现出更多的排尿法术(39.7%vs.15.9%,p=.003),高血压(50.0%vs.31.7%,p=.041)和儿茶酚胺相关症状(37.9%vs.17.5%,p=.012)。多变量逻辑分析表明,年龄较小(<35岁,比值比[OR]=6.47,p=.013),排尿法术(OR=6.79,p=.007),高血压(OR=3.98,p=.011),出汗(OR=41.72,p=0.013)增加了开始术前生化测试的可能性。
    结论:大多数UBPGL患者是在手术后诊断的。年轻的年龄,高血压,排尿法术和出汗是协助进行早期生化检测的线索,因此可以及时进行术前诊断。
    OBJECTIVE: Paragangliomas of the urinary bladder (UBPGLs) are rare neuroendocrine tumours and pose a diagnostic and surgical challenge. It remains unclear what factors contribute to a timely presurgical diagnosis. The purpose of this study is to identify factors contributing to missing the diagnosis of UBPGLs before surgery.
    METHODS: A total of 73 patients from 11 centres in China, and 51 patients from 6 centres in Europe and 1 center in the United States were included. Clinical, surgical and genetic data were collected and compared in patients diagnosed before versus after surgery. Logistic regression analysis was used to identify clinical factors associated with initiation of presurgical biochemical testing.
    RESULTS: Among all patients, only 47.6% were diagnosed before surgery. These patients were younger (34.0 vs. 54.0 years, p < .001), had larger tumours (2.9 vs. 1.8 cm, p < .001), and more had a SDHB pathogenic variant (54.7% vs. 11.9%, p < .001) than those diagnosed after surgery. Patients with presurgical diagnosis presented with more micturition spells (39.7% vs. 15.9%, p = .003), hypertension (50.0% vs. 31.7%, p = .041) and catecholamine-related symptoms (37.9% vs. 17.5%, p = .012). Multivariable logistic analysis revealed that presence of younger age (<35 years, odds ratio [OR] = 6.47, p = .013), micturition spells (OR = 6.79, p = .007), hypertension (OR = 3.98, p = .011), and sweating (OR = 41.72, p = .013) increased the probability of initiating presurgical biochemical testing.
    CONCLUSIONS: Most patients with UBPGL are diagnosed after surgery. Young age, hypertension, micturition spells and sweating are clues in assisting to initiate early biochemical testing and thus may establish a timely presurgical diagnosis.
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  • 文章类型: Journal Article
    术后治疗对肿瘤复发和转移具有重要意义。抗CD47抗体(aCD47)可以阻断CD47信号调节蛋白-α(CD47-SIRPα)途径以恢复免疫力。这里,通过交联壳聚糖(CS)和普鲁兰(Pul)进行原位凝胶植入,用于术后治疗。一种高度选择的化疗药物,环巴胺(Cyc),将包封在脂质体(Cyc-Lip)中的aCD47共负载在凝胶中用于化学免疫疗法。重要的是,可以实现连续的药物释放动力学。纳米治疗剂被证实在aCD47之前以突释方式释放,这有利于立即杀死残留的肿瘤细胞,然后释放肿瘤抗原。同时,aCD47以持续释放的方式释放,以恢复巨噬细胞功能并发挥抗肿瘤免疫反应。之后,在4T1小鼠乳腺癌模型上证实了原位化学免疫疗法的疗效,这不仅可以有效地增强抗肿瘤作用以抑制肿瘤复发,而且可以建立长期的免疫记忆以抵抗肿瘤转移。
    Postsurgical treatment is of great importance to combat tumor recurrence and metastasis. Anti-CD47 antibodies (aCD47) can block the CD47-signal regulatory protein-alpha (CD47-SIRPα) pathway to restore immunity. Here, an in-situ gel implantation was engineered by crosslinking chitosan (CS) and pullulan (Pul) for postsurgical treatment. A highly selected chemotherapeutic, cyclopamine (Cyc), encapsulated in liposomes (Cyc-Lip) was co-loaded with aCD47 in gels for chemoimmunotherapy. Importantly, a sequential drug release kinetics can be achieved. Nanotherapeutics were confirmed to be released prior to aCD47 in a burst-release manner, which was benefit for immediately killing residual tumor cells followed by releasing tumor antigens. Meanwhile, aCD47 was released in a sustained-release manner to restore macrophage functions and exert anti-tumor immune responses. Afterwards, the efficacy of in-situ chemoimmunotherapy was confirmed on 4T1 mouse breast cancer models, which could not only efficiently augment anti-tumor effect to inhibit tumor recurrence but also establish a long-term immune memory to combat tumor metastasis.
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  • 文章类型: Journal Article
    肿瘤术后复发和转移仍然是肿瘤治疗的挑战。可以促进免疫原性的策略,激活适应性免疫反应并消除术后免疫抑制将是实现预期临床益处的有希望的方法。在这项研究中,免疫原性细胞死亡(ICD)启动抗肿瘤适应性免疫应答,通过PD1/PDL1途径加强免疫检查点阻断(ICB)治疗,用于术后治疗.这里,我们提出了一种生物响应和货物可捕获的凝胶储库,该储库由支链淀粉和壳聚糖通过基质金属蛋白酶(MMP)敏感肽交联,用于共同递送抗程序性死亡配体1抗体(aPDL1)和阿霉素包裹的脂质体(DOX-Lip)。该药物载体显示出预期的对术后肿瘤微环境(TME)中高表达的MMP的反应能力。对4T1乳腺癌小鼠模型的体内研究表明,该凝胶储库可以通过预防肿瘤的复发和转移来有效延长肿瘤切除后的小鼠生存期。结果表明,ICD结合基于生物反应性和可货物捕获的凝胶库的PD1/PDL1阻断可以促进DC的成熟并逆转肿瘤切除区的免疫抑制环境。从而放大全身抗肿瘤免疫反应。
    Tumor recurrence and metastasis after surgery remain challenges for tumor treatment. Strategy that can promote the immunogenicity, activate adaptative immune response and eliminate post-operative immunosuppression would be a promising way to achieve a desired clinical benefit. In this study, immunogenic cell death (ICD) priming anti-tumor adaptive immune response was executed to potentiate immune checkpoint blockade (ICB) therapy through the PD1/PDL1 pathway for postsurgical treatment. Here, we present a bio-responsive and cargo-catchable gel depot composed of pullulan and chitosan cross-linking through matrix metalloproteinase (MMP) sensitive peptide for co-delivery of anti-programmed death-ligand 1 antibody (aPDL1) and doxorubicin -encapsulated liposomes (DOX-Lip). This drug carrier showed expected ability to respond to the highly expressed MMP in postsurgical tumor microenvironment (TME). In vivo studies on 4T1 breast tumor mouse model demonstrated that the gel depot could efficiently prolong the mouse survival after tumor resection by preventing tumor recurrence and metastasis. The results suggested that ICD combining with PD1/PDL1 blockade based on the bio-responsive and cargo-catchable gel depot could facilitate the maturation of DCs and reverse the immunosuppressive environment in tumor resection area, thus amplifying the systemic anti-tumor immune response.
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  • 文章类型: Journal Article
    UNASSIGNED: Infectious endophthalmitis is a severe ocular inflammation which can cause devastating visual loss. The aim of the study was to identify the demographic and clinical features of infectious endophthalmitis in Western China for better prophylaxis and treatment of this disease.
    UNASSIGNED: A.
    retrospective, cross-sectional study was conducted based on the medical records of inpatients having infectious endophthalmitis in a tertiary referral center in Western China between 2005 and 2016.
    UNASSIGNED: The common cause of infectious endophthalmitis was trauma (82.6%), endogenous (7.8%), ophthalmic surgery (6.9%), and corneal ulcer with perforation (2.7%). These four etiological groups differed in age, gender, enucleation rate, visual outcome, etc. The number of cases in the first 6 years accounted for 38.7% of the total collection, which in the second 6 years accounted for 61.3%. The etiology patterns were different between these two periods. Altogether 51.3% of patients received pars plana vitrectomy, 13.9% of patients underwent evisceration, and the remaining 34.8% received other treatments. Of the 670 cases that had culture results, 266 (39.7%) were culture positive and 177 (66.5%) were Gram-positive organisms, 64 (24.1%) were Gram-negative organisms, 11 (4.1%) had fungal infection, and 14 (5.3%) were infected by multiple pathogens.
    UNASSIGNED: There was an upward trend of the occurrence of infectious endophthalmitis in Western China for the past decade. The demographic and clinical characteristics of infectious endophthalmitis in Western China had its own characteristics and differed from those of developed countries. Here, open globe trauma was the most common cause of endophthalmitis, most traumatic endophthalmitis patients were male, and most of the injuries were work related, implicate that we should strengthen the education and application of ocular safety regulation specifically targeting the workplace.
    中国西部12年1593例感染性眼内炎临床分析摘要背景:感染性眼内炎是一种严重危害视力的眼部感染性疾病。本研究着眼于分析中国西部一大型转诊中心12年来收治的感染性眼内炎患者的临床特点,为预防和早期治疗提供依据。 方法:回顾分析2005至2016年间四川大学华西医院眼科住院治疗的感染性眼内炎患者1593例的病例资料。 结果:感染性眼内炎的常见致病因素为外伤(82.6%),内源性(7.8%),眼科手术(6.9%)和角膜溃疡穿孔(2.7%)。这4种眼内炎在年龄、性别、眼内容物剜除率和视力等方面有所区别。前6年患者数量占38.7%,后6年占61.3%,这两个时间段的致病因素也有所差别。51.3%的患者接受了经睫状体平坦部玻璃体切除术,13.9%的患者行眼内容物剜除术,其余34.8%的患者接受了其他治疗。670例患者有培养结果,其中266例(24.1%)培养阳性。在这266例培养阳性患者中,177例(66.5%)是革兰阳性菌,64例(24.1%)是革兰阴性菌,11例(4.1%)是真菌,还有14例(5.3%)是多重感染。 结论:在过去的十年中,中国西部的感染性眼内炎发病有上升的趋势,其人口学和临床特点有别于发达国家,有其地域特色。这里开放性眼外伤是感染性眼内炎最常见的致病因素,大部分外伤后眼内炎为男性患者且与劳动作业相关。这提示我们应该加强工作场所的眼安全规范教育和采取眼外伤预防措施。.
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