Perspectives for delivery of therapeutics by extravasation of biodegradable microspheres in the brain

Development of therapeutics for brain diseases has remained challenging,in particular due to the difficulty of passing the blood-brain barrier.As a result,the current arsenal of therapeutics targeting the brain is limited to small,lipid-soluble drugs and there is a lack of options for treating neuroblastomas,Alzheimer’s disease,and many other devastating pathologies.Despite the advances in strategies for crossing the blood-brain barrier such as the use of nanoparticles(Hersh et al.,2022;Duan et al.,2023),such delivery systems have not yet reached clinical practice.Therefore,novel platforms for the transport of therapeutics across the blood-brain barrier remain highly desired.This specifically holds for large molecules such as monoclonal antibodies and recombinant proteins,as well as nucleotide-based therapeutics and cell therapies.Research efforts in this field are increasing exponentially,with thousands of publications in the last few years.

Exploring influences and risk of bias of studies on return to sport and work after lateral ankle sprain:A systematic review and metaanalysis

BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.

Transperineal laser ablation of the prostate as a treatment for benign prostatic hyperplasia and prostate cancer: The results of a Delphi consensus project

Objective: To evaluate transperineal laser ablation (TPLA) with Echolaser® (Echolaser® TPLA, Elesta S.p.A., Calenzano, Italy) as a treatment for benign prostatic hyperplasia (BPH) and prostate cancer (PCa) using the Delphi consensus method.Methods: Italian and international experts on BPH and PCa participated in a collaborative consensus project. During two rounds, they expressed their opinions on Echolaser® TPLA for the treatment of BPH and PCa answering online questionnaires on indications, methodology, and potential complications of this technology. Level of agreement or disagreement to reach consensus was set at 75%. If the consensus was not achieved, questions were modified after each round. A final round was performed during an online meeting, in which results were discussed and finalized.Results: Thirty-two out of forty invited experts participated and consensus was reached on all topics. Agreement was achieved on recommending Echolaser® TPLA as a treatment of BPH in patients with ample range of prostate volume, from <40 mL (80%) to >80 mL (80%), comorbidities (100%), antiplatelet or anticoagulant treatment (96%), indwelling catheter (77%), and strong will of preserving ejaculatory function (100%). Majority of respondents agreed that Echolaser® TPLA is a potential option for the treatment of localized PCa (78%) and recommended it for low-risk PCa (90%). During the final round, experts concluded that it can be used for intermediate-risk PCa and it should be proposed as an effective alternative to radical prostatectomy for patients with strong will of avoiding urinary incontinence and sexual dysfunction. Almost all participants agreed that the transperineal approach of this organ-sparing technique is safer than transrectal and transurethral approaches typical of other techniques (97% of agreement among experts). Pre-procedural assessment, technical aspects, post-procedural catheterization, pharmacological therapy, and expected outcomes were discussed, leading to statements and recommendations.Conclusion: Echolaser® TPLA is a safe and effective procedure that treats BPH and localized PCa with satisfactory functional and sexual outcomes.

Minimal active domain of human salivary histatin 1 is efficacious in promoting acute skin wound healing

Dear Editor,The skin barrier can be impaired by acute skin wounds,which may lead to a series of complications.It is essential to accelerate wound healing and rapidly restore the structural integrity and functionality of skin.One of the promising bioactive agents is human salivary histatin 1(Hst1),a 38-amino acid histidine-rich peptide that functions to maintain the homeostasis of oral mucosa with a cellular mechanism of promoting the adhesion,spreading,migration of epithelial cells and thus re-epithelialization[1].In recent years,Hst1 has been shown to be effective against various skin-related cell types,such as fibroblasts,myo-fibroblasts,keratinocytes and endothelial cells.In our latest in-vivo study,Hst1 not only promotes angiogenesis,re-epithelialization and collagen production,but also suppresses inflammation,thereby significantly accelerating acute skin wound healing in mice[2].All these studies show that Hst1 is a potent bioactive agent for accelerating acute skin wound healing.

国际糖尿病足工作组:指南的制定和方法学(2023)——《国际糖尿病足工作组:糖尿病相关的足病预防与管理指南(2023)》的一部分

糖尿病相关的足病是造成糖尿病患者经济负担和增加社会成本的主要原因之一。本指南以主要目标为导向,以循证医学为依据,且在全球得到合理实施。践行国际糖尿病相关的足病指南对于减轻患者经济负担和社会成本有着重要影响。国际糖尿病足工作组(IWGDF)从1999年起开始发布并随后更新国际指南。2023年更新版指南相关推荐均基于推荐、评估、发展和评价分级(GRADE)系统,包括制定相关临床问题和重要结局,完成系统的文献系统综述和荟萃分析,完成评判表汇总,并且给予具体、明确、操作性强的推荐以及理论依据。本文阐述了《国际糖尿病足工作组:糖尿病相关的足病预防和管理指南(2023版)》(以下简称为指南)的制定过程。指南由7个部分组成,包括预防、糖尿病相关的足溃疡分类、减压、周围动脉病变、感染、创面愈合干预以及活动性夏科神经骨关节病,分别由7个独立的国际专家工作组编写。IWGDF编辑委员会对7个章节进行了整合和简化,形成IWGDF实践指南。指南中的每条推荐均经过IWGDF编辑委员会成员和相关领域的独立的国际专家审阅通过。本文是IWGDF指南的制定和方法学。我们相信,医务人员、公共卫生机构和政策制定者采用和实施2023年IWGDF指南,将会改善糖尿病相关的足病的预防和管理水平,从而减少全球该疾病患者和减轻该疾病引起的全球社会负担。

糖尿病患者足溃疡减压指南(2023年更新版)——《国际糖尿病足工作组:糖尿病相关的足病预防与管理指南(2023)》的一部分

减轻组织的机械性压力在治愈糖尿病相关的足溃疡所需的多种干预措施中最为重要。本文是2023年国际糖尿病足工作组(IWGDF)发布的减压治疗促进糖尿病相关的足溃疡愈合的循证指南,也是对2019年IWGDF指南的更新。我们遵循推荐、评估、发展和评价分级(GRADE)方法学,以患者-干预-比较-结局(patient-intervention-control-outcome,PICO)模式设计临床问题和重要结果,进行系统评价和Meta分析,制定评判表汇总,为每个问题编写推荐和理由。每项推荐都是基于系统综述中发现的证据,在无证据情况下则采用专家意见,以及对判断项目的GRADE等级总结进行仔细权衡,包括可预期和不可预期的影响、证据的确定性、患者价值、所需资源、成本效益、公平性、可行性和可接受性。为了治愈糖尿病患者神经性前足底或中足底溃疡,要使用不可拆卸的齐膝高减压装置作为首选减压干预措施。如果患者存在对不可拆卸减压装置的禁忌证或不能耐受,考虑使用可拆卸齐膝(或踝)高减压装置作为减压干预措施的第二选择。如果无可用的减压装置,考虑使用合适的鞋具结合毡制泡沫作为减压干预措施的第三选择。如果这种非手术减压治疗不能治愈前足底溃疡,可以考虑跟腱延长术、跖骨头切除术、关节置换术或跖骨截骨术。为了治疗继发于屈趾畸形的神经性足底或小趾远端溃疡,可行趾屈肌腱切开术。为了促进后足、非足底或并发感染或缺血的溃疡的愈合,提出了进一步的推荐。所有推荐都已在减压临床路径中进行了总结,以帮助促进本指南在临床实践中的实施。这些减压推荐将帮助医务人员为糖尿病相关的足溃疡患者提供最佳的治疗和预后,降低患者感染、住院和截肢的风险。

糖尿病相关的足病的定义和标准(2023年更新版)

糖尿病相关的足病管理涉及多个学科,通用的专业词汇对于各学科间准确沟通交流至关重要。国际糖尿病足工作组(IWGDF)对相关文献进行了系统综述,构成了制定IWGDF指南的基础,并且明确了糖尿病相关的足病的一系列定义、标准及名词解释。本文介绍2023年IWGDF对这些定义和标准的更新,并建议在临床实践和研究中一致使用,以利于世界各地不同学科人员针对糖尿病相关的足病的专业性交流。

Results of percutaneous sclerotherapy and surgical treatment in patients with symptomatic simple liver cysts and polycystic liver disease

AIM: To evaluate the results of the treatment of simple liver cysts (solitary and multiple) and polycystic liver disease (PLD) using percutaneous sclerotherapy and/or surgical procedures in a single tertiary referral centre. METHODS: Retrospective analysis of 54 patients referred for evaluation and possible treatment of simple liver cysts (solitary and multiple) and PLD, from January 1997 to July 2006. RESULTS: Simple liver cysts were treated in 41 pts (76/) with a mean size of 12.6 cm. The most common reason for referral was abdominal pain or discomfort (85/). Percutaneous sclerotherapy was performed as initial treatment in 30 pts, showing cyst recurrence in 6 pts (20/). Surgical treatment was initially performed in 11 pts with cyst recurrence in 3 pts (27/). PLD was treated in 13 pts (24/) with a mean size of the dominant cyst of 13 cm. Percutaneous sclerotherapy for PLD was performed in 9 pts with recurrence in 7 pts (77.8/). Surgical treatment for PLD was undertaken in 4 pts (30.8/) with recurrence in all. Eventually, 2 pts with PLD in the presence of polycystic kidney disease underwent liver-and kidney transplantation because of deterioration of liver and kidney function. CONCLUSION: The majority of patients with simple liver cysts and PLD are referred for progressive abdominal pain. As initial treatment, percutaneous sclerotherapy is appropriate. Surgical deroofing is indicated in caseof cyst recurrence after percutaneous sclerotherapy. However, the results of percutaneous sclerotherapy and surgical treatment for PLD are disappointing. Partial liver resection is indicated when there is suspicion of a pre-malignant lesion.

Predictors of premature delivery in patients with intrahepatic cholestasis of pregnancy

瞄准：在怀孕(ICP ) 的肝内胆汁郁积为早熟评估临床的症状和生物化学的参数的预兆的价值。方法：有 ICP 的六十个征兆的病人在这回顾的分析被包括。Preterm 交货在 37 wk 怀孕期前被定义为交货。preterm 交货的预言者被二进制代码多揭示变量逻辑回归分析。结果：交货的吝啬的时间是 38.1 +/- 1.7 wk。没有死胎发生了。早产在八被观察(13.3%) 病人。全部的禁食浆液胆汁酸更高(47.8 +/- 15.2 对 41.0 +/- 10.0 mumol/L， P 【 0.05 ) ，并且瘙痒趋于更早开始(29.0 +/- 3.9 对 31.6 +/- 3.3 wk， P = 0.057 ) 在有早产的病人什么时候与那些相比与术语交货。二进制多逻辑回归分析揭示了的变量瘙痒的那早发作(或 1.70， 95% CI 1.23-2.95， P = 0.038 ) 并且浆液胆汁酸(或 2.13， 95% CI 1.13-3.25， P = 0.013 ) 是 preterm 的独立预言者交货。结论：瘙痒的早发作和浆液胆汁酸的高水平在 ICP 预言 preterm 交货，并且为穷人在风险定义病人的亚群新生的结果。

Future of bioartifi cial liver support

Many different artificial liver support systems(biological and non-biological) have been developed,tested pre-clinically and some have been applied in clinical trials.Based on theoretical considerations a biological artificial liver(BAL) should be preferred above the non-biological ones.However,clinical application of the BAL is still experimental.Here we try to analyze which hurdles have to be taken before the BAL will become standard equipment in the intensive care unit for patients with acute liver failure or acute deterioration of chronic liver disease.

Chemical composition of Galla chinensis extract and the effect of its main component(s) on the prevention of enamel demineralization in vitro

To determine the chemical composition of Galla chinensisextract （GCE） by several analysis techniques and to compare the efficacy of GCE and its main component（s） in inhibition of enamel demineralization, for the development of future anticaries agents, main organic composition of GCE was qualitatively determined by liquid chromatography-time of flight-mass spectrometry （LC-TOF-MS） and quantified by high-performance liquid chromatography-diode array detector （HPLC-DAD）. Inorganic ions were tested by inductively coupled plasma-atomic emission spectroscopy and F was especially measured by ion chromatography. Then, bovine enamel blocks were randomly divided into four treatment groups and were subjected to a pH-cycling regime for 12 times. Each cycle included 5-min applications with one of four treatments： 4g.L-1 GCE solution, 4g.L-1 gallic acid （GA） solution, I g.L-1 NaF solution （positive control）, deionized water （DDW, negative control）, and then 60-min application in pH 5.0 acidic buffer and 5-min application in neutral buffer. Acidic buffers were retained for calcium analysis. The main organic composition of GCE were GA and its isomer, and, to a lesser extent, small molecule gallotannins. The content of GA in GCE was 71.3%±0.2% （w/w）. Inorganic ions were present in various amounts, of which Ca was （136±2.82） μg.g-1, and Zn was （6.8±0.1） μg.g-1. No F was detected in GCE. in pH cycling, GA showed an effect similar to GCE in inhibiting enamel demineralization （P〉0.05）. GA was found to be the main effective, demineralization inhibiting component of GCE and could be a promising agent for the development of anticaries agents.

Consensus on the definition of colorectal anastomotic leakage: A modified Delphi study

BACKGROUND Despite the emerging knowledge about colorectal anastomotic leakage(CAL)through the increasing number of clinical and experimental studies, there is no generally accepted definition of CAL. Because of the wide variety of definitions used in literature, comparison of study outcomes and quality of care is complicated.AIM To reach consensus on the definition of CAL using a modified Delphi method.METHODS The RAND/UCLA appropriateness method was used. The expert panel consisted of international colorectal surgeons and researchers who had published three or more articles about CAL. The consensus process consisted of two online distributed questionnaires and a third round with a recommendation. In the questionnaires participants were asked to rate the appropriateness of statements using a 1-9 Likert scale. Consensus was defined as a panel median between 1-3 or 7-9 without disagreement. In the final round a recommendation was formed regarding the definition of CAL and the expert panel was asked if they agreed or disagreed.RESULTSTwenty-three authors participated in the first round and twenty-one finished the second round. After two rounds consensus was reached on 37 items(80%) in nine different categories. The International Study Group of Rectal Cancer definition is the most frequently advised general definition by our panel. Consensus was reached regarding the clinical symptoms of CAL, which serum markers contributes to the suspicion of CAL, which radiological and perioperative findings should be considered as CAL, which grading system is appropriate and if there should be a range of postoperative days in the definition. Eventually, 19 experts completed all three rounds of which 16(84%) agreed with our final recommendations for the definition of CAL.CONCLUSION A consensus-based recommendation for the definition of CAL was formed using our modified Delphi method that can be widely incorporated in the field.

Visualization of Disciplinary Profiles: Enhanced Science Overlay Maps

Purpose： The purpose of this study is to modernize previous work on science overlay maps by updating the underlying citation matrix, generating new clusters of scientific disciplines, enhancing visualizations, and providing more accessible means for analysts to generate their own maps Design/methodology/approach： We use the combined set of 2015 Journal Citation Reports for the Science Citation Index （n of journals = 8,778） and the Social Sciences Citation Index （n = 3,212） for a total of 11,365 journals. The set of Web of Science Categories in the Science Citation Index and the Social Sciences Citation Index increased from 224 in 2010 to 227 in 2015. Using dedicated software, a matrix of 227 × 227 cells is generated on the basis of whole-number citation counting. We normalize this matrix using the cosine function. We first develop the citing-side, cosine-normalized map using 2015 data and VOSviewer visualization with default parameter values. A routine for making overlays on the basis of the map （＂wc 15.exe＂） is available at http：//www.leydesdorff.net/wc 15/index.htm. Findings： Findings appear in the form of visuals throughout the manuscript. In Figures 1 9 we provide basemaps of science and science overlay maps for a number of companies, universities, and technologies. Research limitations： As Web of Science Categories change and/or are updated so is the need to update the routine we provide. Also, to apply the routine we provide users need access to the Web of Science. Practical implications： Visualization of science overlay maps is now more accurate and true to the 2015 Journal Citation Reports than was the case with the previous version of the routine advanced in our paper.Originality/value： The routine we advance allows users to visualize science overlay maps in VOSviewer using data from more recent Journal Citation Reports.

Are faecal markers good indicators of mucosal healing in inflammatory bowel disease?

AIM: To review the published literature concerning the accuracy of faecal inflammatory markers for identifying mucosal healing. METHODS: Bibliographical searches were performed in MEDLINE electronic database up to February 2015,using the following terms: "inflammatory bowel disease","Crohn′s disease","ulcerative colitis","faecal markers","calprotectin","lactoferrin","S100A12","endoscop*","mucosal healing","remission". In addition,relevant references from these studies were also included. Data were extracted from the published papers including odds ratios with 95%CI,P values and correlation coefficients. Data were grouped together according to each faecal marker,Crohn's disease or ulcerative colitis,and paediatric compared with adult study populations. Studies included in this review assessed mucosal inflammation by endoscopic and/or histological means and compared these findings to faecal marker concentrations in inflammatory bowel diseases(IBD) patient cohorts. Articles had to be published between 1990 and February 2015 and written in English. Papers excluded from the review were those where the faecal biomarker concentration was compared between patients with IBD and controls or other disease groups,those where serum biomarkers were used,those with a heterogeneous study population and those only assessing post-operative disease. RESULTS: The available studies show that faecal markers,such as calprotectin and lactoferrin,are promising non-invasive indicators of mucosal healing. However,due to wide variability in study design,especially with regard to the definition of mucosal healing and evaluation of marker cut offs,the available data do not yet indicate the optimal roles of these markers. Thirty-six studies published between 1990 and 2014 were included. Studies comprised variable numbers of study participants,considered CD(15-164 participants) or UC(12-152 participants) separately or as a combined group(11-252 participants). Eight reports included paediatric patients. Several indices were used to document mucosal inflammation,encompassing elevenendoscopic and eight histologic grading systems. The majority of the available reports focused on faecal calprotectin(33 studies),whilst others assessed faecal lactoferrin(13 studies) and one study assessed S100A12. Across all of the biomarkers,there is a wide range of correlation describing the association between faecal markers and endoscopic disease activity(r values ranging from 0.32 to 0.87,P values ranging from < 0.0001 to 0.7815). Correlation coefficients are described in almost all studies and are used more commonly than outcome measures such as sensitivity,specificity,PPV and/or NPV. Overall,the studies that have evaluated faecal calprotectin and/or faecal lactoferrin and their relationship with endoscopic disease activity show inconsistent results. CONCLUSION: Future studies should report the results of faecal inflammatory markers in the context of mucosal healing with clear validated cut offs.

Value of a comprehensive geriatric assessment for predicting one-year outcomes in patients undergoing transcatheter aortic valve implantation: results from the CGA-TAVI multicentre registry

Background In a three-month report from the CGA-TAVI registry, we found the Multidimensional Prognostic Index (MPI) and Short Physical Performance Battery (SPPB) to be of value for predicting short-term outcomes in elderly patients undergoing transcatheter aortic valve implantation (TAVI). In the present analysis, we examined the association of these tools with outcomes up to one year post-TAVI. Methods CGA-TAVI is an international, observational registry of geriatric patients undergoing TAVI. Patients were assessed using the MPI and SPPB. Efficacy of baseline values and any postoperative change for predicting outcome were established using logistic regression. Kaplan- Meier analysis was carried out for each comprehensive geriatric assessment tool, with survival stratified by risk category. Results One year after TAVI, 14.1% of patients deceased, while 17.4% met the combined endpoint of death and/or non-fatal stroke, and 37.7% the combined endpoint of death and/or hospitalisation and/or non-fatal stroke. A high-risk MPI score was associated with an increased risk of all-cause mortality (aOR = 36.13, 95% CI: 2.77–470.78, P = 0.006) and death and/or non-fatal stroke (aOR = 10.10, 95% CI: 1.48–68.75, P = 0.018). No significant associations were found between a high-risk SPPB score and mortality or two main combined endpoints. In contrast to a worsening SPPB, an aggravating MPI score at three months post-TAVI was associated with an increased risk of death and/or non-fatal stoke at one year (aOR = 95.16, 95% CI: 3.41–2657.01). Conclusions The MPI showed value for predicting the likelihood of death and a combination of death and/or non-fatal stroke by one year after TAVI in elderly patients.

The Scientometric Measurement of Interdisciplinarity and Diversity in the Research Portfolios of Chinese Universities

Purpose:Interdisciplinarity is a hot topic in science and technology policy.However,the concept of interdisciplinarity is both abstract and complex,and therefore difficult to measure using a single indicator.A variety of metrics for measuring the diversity and interdisciplinarity of articles,journals,and fields have been proposed in the literature.In this article,we ask whether institutions can be ranked in terms of their(inter-)disciplinary diversity.Design/methodology/approach:We developed a software application(interd_vb.exe)that outputs the values of relevant diversity indicators for any document set or network structure.The software is made available,free to the public,online.The indicators it considers include the advanced diversity indicators Rao-Stirling(RS)diversity and DIV*,as well as standard measures of diversity,such as the Gini coefficient,Shannon entropy,and the Simpson Index.As an empirical demonstration of how the application works,we compared the research portfolios of 42“Double First-Class”Chinese universities across Web of Science Subject Categories(WCs).Findings:The empirical results suggest that DIV*provides results that are more in line with one’s intuitive impressions than RS,particularly when the results are based on sampledependent disparity measures.Furthermore,the scores for diversity are more consistent when based on a global disparity matrix than on a local map.Research limitations:“Interdisciplinarity”can be operationalized as bibliographic coupling among(sets of)documents with references to disciplines.At the institutional level,however,diversity may also indicate comprehensiveness.Unlike impact(e.g.citation),diversity and interdisciplinarity are context-specific and therefore provide a second dimension to the evaluation.Policy or practical implications:Operationalization and quantification make it necessary for analysts to make their choices and options clear.Although the equations used to calculate diversity are often mathematically transparent,the specification in terms of computer code helps the analyst to further precision in decisions.Although diversity is not necessarily a goal of universities,a high diversity score may inform potential policies concerning interdisciplinarity at the university level.Originality/value:This article introduces a non-commercial online application to the public domain that allows researchers and policy analysts to measure“diversity”and“interdisciplinarity”using the various indicators as encompassing as possible for any document set or network structure(e.g.a network of co-authors).Insofar as we know,such a professional computing tool for evaluating data sets using diversity indicators has not yet been made available online.

Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

AIM: To identify the criteria for the differentiation of hilar cholangiocarcinoma (HCCA) from benign strictures. METHODS: A total of 68 patients underwent resection of lesions suspicious for HCCA between 1998 and 2006. The results of laboratory investigations, imaging studies and brush cytology were collected. These fi ndings were analyzed to obtain the fi nal diagnosis. RESULTS: Histological examination of the resected specimens confirmed HCCA in 58 patients (85%, group Ⅰ) whereas 10 patients (15%, groupⅡ) were diagnosed to have benign strictures. The most common presenting symptom was obstructive jaundice in 77% patients (79% group Ⅰvs 60% group Ⅱ P = 0.23). Laboratory findings showed greater elevation of transaminase levels in group Ⅰcompared to group Ⅱ The various imaging modalities showed vascular involvement exclusively in the malignant group (36%,P < 0.05). Brush cytology was positive for malignant cells in only 50% patients in group Ⅰ whereas none in group Ⅱ showed malignant cells. CONCLUSION: Despite improvements in imaging techniques, 10 patients (15%) with a presumptive diagnosis of HCCA were ultimately found to have benign strictures. Except for vascular involvement which was associated significantly with malignancy, there were no conclusive features of malignancy on regular imaging modalities. This uncertainty should be taken into account when patients with a suspicious lesion at the liver hilum are considered for resection.

Effect of hepatic artery embolization on liver hypertrophy response in a rabbit liver VX2tumor model

BACKGROUND:Portal vein embolization not only induces hypertrophy of the non-embolized liver,but also enhances tumor growth.The latter could be prevented by embolizing the hepatic arteries supplying the tumor-bearing liver segments.This study aimed to determine the effects of transcatheter arterial embolization(TAE)on tumor volume and liver regeneration in a rabbit VX2 tumor model.METHODS:Twenty-three rabbits underwent subcapsular tumor implantation with a VX2 tumor.Two weeks after implantation,18 rabbits were used for TAE experiments,5were for sham controls.Tumor response and liver regeneration response of the embolized cranial and non-embolized caudal liver lobes were assessed by CT volumetry,liver to body weight index,and the amount of proliferating hepatocytes.RESULTS:All super-selective arterial tumor embolization procedures were performed successfully.Despite embolization,the tumor volume increased after an initial steady state.The tumor volume after embolization was smaller than that of the sham group,but this difference was not significant.Massive necrosis of the tumor,however,was seen after embolization,without damage of the surrounding liver parenchyma.There was a significant atrophy response of the tumor bearing cranial lobe after super-selective arterial embolization of the tumor with a concomitant hypertrophy response of the non-embolized,caudal lobe.This regeneration response was confirmed histologically by a significantly higher number of proliferating hepatocytes on the Ki-67 stained slides.CONCLUSIONS:Super-selective,bland arterial coil embolization causes massive necrosis of the tumor,despite increase of volume on CT scan.Atrophy of the tumor bearing liver lobe is seen after arterial embolization of the tumor with a concomitant hypertrophy response of the non-embolized lobe,despite absence of histological damage of the tumor-surrounding liver parenchyma.

Long-term follow-up of quality of life in high-risk patients undergoing transcatheter aortic valve implantation for symptomatic aortic valve stenosis

BackgroundTranscatheter 大动脉的阀门培植(TAVI ) 与严重征兆的大动脉的狭窄为病人成为了标准治疗(作为) 为外科的大动脉的阀门代替在很高的风险考虑了。这亚学习的目的是评估长期的(> 4 年) 在 octogenarians 的生活(QoL ) 的健康相关的质量经历了 TAVI.MethodsA 单个中心在在 TAVI 以后经历了框架分析评价 4 年的二十个病人的观察登记。健康相关的 QoL 被评估，用短 Form-36 ( SF-36 )，吗 EuroQoL-5D ( EQ-5D )和 questionnaires.ResultsThe 平均数 SF-36 subscale 在后续获得的视觉类似物分数(EQ管)是物理的工作 40.8 ????????????????????????????搠?潮潶???吗?湡楧灯慬瑳?????????愠杮潩牧灡票?€ 敦潭潲潰汰瑩慥???????????????愠桴牥'啼蠹溃浚?

Investigation of ultrafast dynamics of CdTe quantum dots by femtosecond fluorescence up-conversion spectroscopy

The ultrafast carrier relaxation processes in CdTe quantum dots are investigated by femtosecond fluorescence upconversion spectroscopy.Photo-excited hole relaxing to the edge of the forbidden gap takes a maximal time of ～ 1.6 ps with exciting at 400 nm,depending on the state of the photo-excited hole.The shallow trapped states and deep trap states in the forbidden gap are confirmed for CdTe quantum dots.In addition,Auger relaxation of trapped carriers is observed to occur with a time constant of ～ 5 ps.A schematic model of photodynamics is established based on the results of the spectroscopy studies.Our work demonstrates that femtosecond fluorescence up-conversion spectroscopy is a suitable and effective tool in studying the transportation and conversion dynamics of photon energy in a nanosystem.