BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated ...BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated that at least 5%cancer patients might be suffering from bone metastases.In 2016,we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis.Since then,the therapeutic outcomes for patients have gradually improved.As life expectancy is a major determinant of surgical intervention,the strategy should be modified if the prolongation of survival is to be achieved.AIM To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.METHODS For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023,parameters including the site and number of bone metastases,laboratory data,and survival time,were extracted from electronic medical records and the Katagiri score was calculated.The association with survival was determined for each factor.RESULTS Data from 136 patients were obtained.The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0%in this study,which was 6%and an apparent improvement from 2014 when the scoring system was developed.Other factors significantly affecting survival included five or more bone metastases than less(P=0.0080),and treatment with chemotherapy(P<0.001),bone modifying agents(P=0.0175)and immune checkpoint inhibitors(P=0.0128).In recent years,advances in various treatment methods have extended the survival period for patients with advanced cancer.It is necessary not only to simply extend survival time,but also to maintain ADL and improve QOL.CONCLUSION Various therapeutic interventions including surgical approach for bone metastasis,which is a disorder of locomotor organs,are increasingly required.Guidelines and scoring system for prognosis need to be revised promptly.展开更多
Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment.This is important because the increasing availability of new devices allows us to perform procedures with a reduced l...Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment.This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss.We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery,focused especially on 6 studies comparing ultrasonic coagulating shears(UCS) and other instruments.We also describe our laparoscopic dissection techniques using UCS for colorectal cancer.The short-term outcomes of surgeries using UCS and Ligasure for laparoscopiccolorectal surgery were superior to conventional electrosurgery.Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used.On the other hand,a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery.It is therefore suggested that the choice of technique used should be made according to the surgeon’s preference.We also describe our laparoscopic dissection techniques using UCS(Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection,dissection technique,dissection technique around the feeding artery,and various other dissection techniques.We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS(Harmonic ACE) for colorectal cancer.展开更多
Al-Cu-Li alloy is a huge potential alloy for aerospace industry due to its low density and excellent comprehensive performances.In this study,the microstructures and mechanical properties of a novel cast Al-Cu-Li allo...Al-Cu-Li alloy is a huge potential alloy for aerospace industry due to its low density and excellent comprehensive performances.In this study,the microstructures and mechanical properties of a novel cast Al-Cu-Li alloy during the heat treatment were investigated.Results showed that most of the secondary phases along grain boundaries in as-cast state were dissolved into the Al matrix after homogenization and solution treatment,while the Cu-rich phases were slightly segregated once again on grain boundaries after aging.A relatively good combination of strength and ductility(average ultimate tensile strength of 430 MPa and elongation of 8.9%)was obtained after natural aging.Transmission electron microscopy(TEM)results revealed that there was a complicated precipitate distribution in this cast alloy after natural aging.Compared with the similar alloys which introduced dislocations before aging,the density of T1(Al_(2)CuLi)phases was decreased but the size was increased.The low volume fraction of d0 phase,medium density of needle-shaped precipitates and relativity narrow precipitates-free zone with varying widths near grain boundary are the reasons accounting for the improvement of performances.展开更多
文摘BACKGROUND Bone metastasis has various negative impacts.Activities of daily living(ADL)and quality of life(QOL)can be significantly decreased,survival may be impacted,and medical expenses may increase.It is estimated that at least 5%cancer patients might be suffering from bone metastases.In 2016,we published the Comprehensive Guidelines for the Diagnosis and Treatment of Bone Metastasis.Since then,the therapeutic outcomes for patients have gradually improved.As life expectancy is a major determinant of surgical intervention,the strategy should be modified if the prolongation of survival is to be achieved.AIM To monitor how bone metastasis treatment has changed before and after launch of our guidelines for bone metastasis.METHODS For advanced cancer patients with bone metastasis who visited the Department of Clinical Oncology at Akita University hospital between 2012 and 2023,parameters including the site and number of bone metastases,laboratory data,and survival time,were extracted from electronic medical records and the Katagiri score was calculated.The association with survival was determined for each factor.RESULTS Data from 136 patients were obtained.The 1-year survival rate for the poor prognosis group with a higher Katagiri score was 20.0%in this study,which was 6%and an apparent improvement from 2014 when the scoring system was developed.Other factors significantly affecting survival included five or more bone metastases than less(P=0.0080),and treatment with chemotherapy(P<0.001),bone modifying agents(P=0.0175)and immune checkpoint inhibitors(P=0.0128).In recent years,advances in various treatment methods have extended the survival period for patients with advanced cancer.It is necessary not only to simply extend survival time,but also to maintain ADL and improve QOL.CONCLUSION Various therapeutic interventions including surgical approach for bone metastasis,which is a disorder of locomotor organs,are increasingly required.Guidelines and scoring system for prognosis need to be revised promptly.
文摘Laparoscopic surgery for colorectal disease has become widespread as a minimally invasive treatment.This is important because the increasing availability of new devices allows us to perform procedures with a reduced length of surgery and decreased blood loss.We herein report the results of a literature review of energy sources for laparoscopic colorectal surgery,focused especially on 6 studies comparing ultrasonic coagulating shears(UCS) and other instruments.We also describe our laparoscopic dissection techniques using UCS for colorectal cancer.The short-term outcomes of surgeries using UCS and Ligasure for laparoscopiccolorectal surgery were superior to conventional electrosurgery.Some authors have reported that the length of surgery or blood loss when Ligasure was used for laparoscopic colorectal surgery is less than when UCS was used.On the other hand,a recent study demonstrated that there were no significant differences between the short-term outcomes of UCS and Ligasure for laparoscopic colorectal surgery.It is therefore suggested that the choice of technique used should be made according to the surgeon’s preference.We also describe our laparoscopic dissection techniques using UCS(Harmonic ACE) for colorectal cancer with regard to the retroperitoneum dissection,dissection technique,dissection technique around the feeding artery,and various other dissection techniques.We therefore review the outcomes of using various energy sources for laparoscopic colorectal surgery and describe our laparoscopic dissection techniques with UCS(Harmonic ACE) for colorectal cancer.
基金the Key Research and Development Project of Shandong Province(No.2018CXGC0403)。
文摘Al-Cu-Li alloy is a huge potential alloy for aerospace industry due to its low density and excellent comprehensive performances.In this study,the microstructures and mechanical properties of a novel cast Al-Cu-Li alloy during the heat treatment were investigated.Results showed that most of the secondary phases along grain boundaries in as-cast state were dissolved into the Al matrix after homogenization and solution treatment,while the Cu-rich phases were slightly segregated once again on grain boundaries after aging.A relatively good combination of strength and ductility(average ultimate tensile strength of 430 MPa and elongation of 8.9%)was obtained after natural aging.Transmission electron microscopy(TEM)results revealed that there was a complicated precipitate distribution in this cast alloy after natural aging.Compared with the similar alloys which introduced dislocations before aging,the density of T1(Al_(2)CuLi)phases was decreased but the size was increased.The low volume fraction of d0 phase,medium density of needle-shaped precipitates and relativity narrow precipitates-free zone with varying widths near grain boundary are the reasons accounting for the improvement of performances.
