简介：AbstractThe current literature lacks strong guidelines regarding surgical management of patients with aspirin-exacerbated respiratory disease (AERD), who present with the clinical triad of chronic rhinosinusitis with nasal polyposis (CRSwNP), bronchial asthma, and aspirin/nonsteroidal anti-inflammatory drug intolerance. To further define the effectiveness of sinus surgery in treating AERD patients, this review article discusses current evidence regarding outcomes associated with more extensive surgery, the benefits of frontal sinus surgery on polyposis, and the role of Draf III intervention. Numerous studies suggest that Draf III frontal sinusotomy may be an efficacious early intervention due to increased neo-ostial patency and subsequent distribution of topical therapies. Future studies that further investigate the efficacy and safety of extensive surgery in AERD patients are warranted.

简介：Objective:Curativegastriccancersurgeryentailsremovaloftheprimarytumorwithadequatemarginsincludingregionallymphnodes.Europeanrandomizedcontrolledtrialswithrecruitmentinthe1990'sreportedincreasedmorbidityandmortalityforD2comparedtoD1.Here,weexaminedtheextentoflymphadenectomyduringgastriccancersurgeryandtheassociatedriskforpostoperativecomplicationsandmortalityusingthestrengthsofapopulation-basedstudy.Methods:AprospectivenationwidestudyconductedwithintheNationalRegisterofEsophagealandGastricCancer.AllpatientsinSwedenfrom2006to2013whounderwentgastriccancerresectionswithcurativeintentwereincluded.PatientswerecategorizedintoD0,D1,orD1+/D2,andanalyzedregardingpostoperativemorbidityandmortalityusingmultivariablelogisticregression.Results:Intotal,349(31.7%)patientshadaD0,494(44.9%)D1,and258(23.4%)D1+/D2lymphadenectomy.The30-dpostoperativecomplicationrateswere25.5%,25.1%and32.2%(D0,D1andD1+/D2,respectively),and90-dmortalityrateswere8.3%,4.3%and5.8%.Afteradjustmentforconfounders,inmultivariableanalysis,therewerenosignificantdifferencesinriskforpostoperativecomplicationsbetweenthelymphadenectomygroups.For90-dmortality,therewasalowerriskforD1vs.D0.Conclusions:ThemajorityofgastriccancerresectionsinSwedenhaveincludedonlyalimitedlymphadenectomy(D0andD1).Moreextensivelymphadenectomy(D1+/D2)seemedtohavenoimpactonpostoperativemorbidityormortality.

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简介：Thegoverningequationsofsurface-deformationinfully-penetratedGTAWweldpoolarederived.ThesolutionschemeoftheLagrangemultiplier,whichmakesthetopsurface-deformationequationbecoupledwiththatforthebottom-surfaceofasingleweldpool,isgivenout.Throughnumericalanalysisofweldpoolsurface-deformationinGTAW,itisfoundthatthereisclearcorrelationbetweenthepenetrationextentandtheLagrangemultiplier,inadditiontotherelationshipbetweenthepenetrationextentandthemaximumdepressionandhumpaswellasthedepressedvolumeofthetopsurfaceofweldpool.Itlaysgoodfoundationfortop-sidesensingbasedweldpenetrationcontrol.

简介：城市的簇在一个国家是工业和都市化的高水平的期望的产品，以及是在全球竞争的参予的基本单位。关于中国，城市的簇为增加中国都市化过程被认为是主导的形成。然而，迄今为止没有技术的重合、有效、可信的方法学的系统和集合识别中国城市的簇。这研究调查地理信息技术支持提供中国城市的簇的分发的更好的理解的一个计算机化的鉴定方法的潜力。鉴定方法在ArcInfo宏语言编程的帮助下基于一个地理信息数据库，一个数字举起模型，和社会经济的数据被执行。在方法，初步的边界根据交通可接近性被识别，并且最后的鉴定从在rasterized的帮助下在一个区域限制城市数字，人口，和GDP被完成社会经济的数据集。结果证明方法识别九中国城市的簇，即，珀尔河三角洲，更低的长江山谷，Beijing-Tianjin-Hebei区域，东北中国平原，中间的长江山谷，华中平原，西方的台湾海峡，Guanzhong和Chengdu重庆城市的簇。这研究代表包含中国城市的簇的计算机化的鉴定的第一研究。而且与另外的相关研究相比，研究途径，联合交通可接近性和社会经济的特征，被显示是识别城市的簇的一个不同、有效、可靠的方法。

简介：Baseduponstudiesfromrandomizedclinicaltrials,theextended(D2)lymphnodedissectionisnowrecommendedasastandardprocedureforlocaladvancedgastriccancerworldwide.However,therationalextentlymphadenectomyforlocaladvancedgastriccancerhasremainedatopicofdebateinthepastdecades.Duetothelimitationoflowmetastaticrateinpara-aorticnodes(PAN)inJCOG9501,theclinicalbenefitofD2+para-aorticnodaldissection(PAND)forpatientswithstageT4and/orstageN3disease,whichisverycommoninChinaandothercountriesexceptJapanandKorea,cannotbedetermined.Furthermore,theroleofsplenectomyforcompleteresectionofNo.10andNo.11nodeshasbeencontroversial,andhowever,thefinalresultsfromtherandomizedtrialofJCOG0110haveyettobecompleted.GastriccancerwiththeNo.14andNo.13lymphnodemetastasisisdefinedasM1stageinthecurrentversionoftheJapaneseclassification.WeproposethatD2+No.14vand+No.13lymphadenectomymaybeanoptioninapotentiallycurativegastrectomyfortumorswithapparentmetastasistotheNo.6nodesorinfiltratetoduodenum.Theexaminedlymphnodeandextranodalmetastasisaresignificantlyassociatedwiththesurvivalofgastriccancerpatients.

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简介：Coronaryarterybypassgrafting(CABG)isenteringaneweraasminimallyinvasivetechniques,off-pumpsurgeryandtotal'arterialrevascularizationhavefotmdrolesinthesurgicaltreatmentofpatientswithcoronaryarterydisease.Thecontinueddevelopmentofthetechniquesofpercutaneouscoronaryintervention(PCI)isalsohavinganimpactonthetypeofpatientreferredforCABG.

简介：瞄准：与良性的职业人员静电干扰增生(BPH)在病人为职业人员静电干扰发炎程度和感染调查风险因素以便更高效地管理职业人员静电干扰发炎。方法：有在四川大学的韦斯特中国医院里经历在2005年9月和2005年12月之间的TURP的BPH的六十个病人被学习。前列腺液体(PF)为能分泌的IgA(SIgA)的测量被收集并且补充3(C3)。前列腺织物为由即时PCR的严峻的细菌的16SrDNA是镇定的，检验在织物的SIgA并且检验发炎。为职业人员静电干扰发炎或感染的可能的临床、有免疫力的风险因素被使用逻辑回归方法分析。结果：在尿分析法，职业人员静电干扰感染和在PF的C3的高集中的反常的白血房间计数是为职业人员静电干扰发炎程度的风险因素(P=0.025，0.034和0.035，分别地并且机会比率[或]=18.269，8.284和1.508，分别地)。为职业人员静电干扰感染的风险因素在PF包括C3集中和SIgA的集中(P=0.003和0.013，分别地并且OR=1.645并且0.993，分别地)。结论：现在的学习建议那职业人员静电干扰发炎与泌尿道感染，职业人员静电干扰感染和激活的补充被联系，那职业人员静电干扰感染与BPH在病人的前列腺与激活的补充并且在调整粘膜免疫下面被联系。单个有免疫力的规定应该与BPH在职业人员静电干扰发炎的治疗和病人的感染被考虑，这也被建议。

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简介：Treatmentofpancreaticcancerismultimodalandsurgeryisanessentialpart,mandatoryforcurativepotential.Alsochemotherapyisessential,andseriouspostoperativecomplicationsorrapiddiseaseprogressionmayprecludecompletionofmultimodaltreatment.Thesequenceoftreatmentinterventionshasthereforebecomeanimportantconcern,andnumerousongoingrandomizedcontrolledtrialscompareclinicaloutcomeafterupfrontsurgeryandneoadjuvanttreatmentwithsubsequentresection.Inpreviousyears,borderlineresectableandlocallyadvancedpancreaticcancerwasmostoftenconsideredunresectable.Moreeffectivechemotherapytogetherwiththelatestimprovementsinsurgicalexpertisehasresultedinextendedoperations,pushingthebordersofresectability.Multivisceralresectionswithorwithoutresectionofmajormesen-tericvesselsarenowperformedinnumerouspatients,resultinginbetteroutcome,recordedasoverallsurvivaland/orpatientreportedoutcome.Butpostoperativemorbidityincreasesconcurrently,andclinicalbenefitmustbecarefullyevaluatedagainstriskofpotentialharm,associatedwithnewcomprehensivemultimodaltreatmentsequences.Eventhoughcost/utilityanalysesaredeficient,extendedsurgeryhasresultedinsignifi-cantlylongerandbetterlifeformanypatientswithnoothertreatmentalternative.Improvedselectionofpatientstosurgeryand/orchemotherapywillinthenearfuturebepossible,basedonbettertumorbiologyinsight.Clinicallyavailablebiomarkersenablingpersonalizedtreatmentareforthcoming,buttheseoptionsarestilllimited.Theimportanceofsurgicalresectionforeachpatient’sprognosisispresentlyincreasing,justifyingsustainedexpansionofthesurgicaltreatmentmodality.

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简介：精索静脉曲张在临床的实践被认出了为在一个世纪。原来，这些过程为疼痛的管理被利用，但是自从1952，修理主要为男不孕的处理。然而，因为pathophysiology不是清楚的，精索静脉曲张的诊断和治疗是争论的，研究的入口标准在中心之中变化了，并且有很少使随机化的临床的试用。不过，临床医生们继续为精索静脉曲张的修正开发技术，基本科学家在精索静脉曲张的pathophysiology上继续调查，并且从未来的使随机化的试用的新结果数据出现在世界的文学。因此，Andrology的亚洲杂志的这个特殊版本被建议报导许多与精索静脉曲张有关的新信息，作为这个工程的特定的部分，现在的文章作为进化的全面评论和校正过程的精炼被开发。

简介：ＡｓｏｕｒｃｅｅｘｔｅｎｔａｎａｌｙｓｉｓｏｆｔｈｅＬａｎｃａｎｇｅａｒｔｈｑｕａｋｅ（Ｍｓ＝７．６）ｏｆ１９８８ＳＩ－ＨＵＡＺＨＥＮＧ（郑斯华）ＪＩＡＮＹＡＮＧ（杨健）ＣｅｎｔｅｒｆｏｒＡｎａｌｙｓｉｓａｎｄｐｒｅｄｉｃｔｉｏｎ，ＣｈｉｎａＳｅｉｓ...

简介：比较在主要debulking外科(PDS)和neoadjuvant化疗之间的幸存和perioperative病态的目的在与先进上皮的卵巢的癌症(EOC)对待病人由间隔debulking外科(NAC/IDS)列在后面。我们回顾地与阶段IIIC或IVEOC考察了67个病人的方法从2006年1月在北京大学癌症医院对待到2009年6月。在那里，37和30个病人分别地经历了PDS和NAC/标志。结果在全面幸存(OS)或没有前进的幸存(PFS)的差别都没在NAC/IDS组和PDS组之间被观察(OS：41.2对39.1个月，P=0.23；PFS：27.1对24.3个月，P=0.37)。最佳的debulking率在NAC/IDS组是60%，它在PDS组(32.4%)(P=0.024)比那显著地高。NAC/IDS组显著地有比PDS的肠的功能的估计的血损失和输送，更低的nasogastricintubation率，和更早的移动和恢复组织的更少的intraoperative(P<0.05)。结论NAC/IDS不比PDS侵略，并且关于最佳的cytoreduction率，intraoperative血损失，和手术后的恢复提供优点，没有显著地损害与在对待有阶段IIIC或IVEOC的病人的PDS相比的幸存。因此，NAC/IDS可以是为EOC病人的一种珍贵治疗选择。

简介：AbstractPrecision medicine requires coordinated and integrated evidence-based combinatorial approaches so that diagnosis and treatment can be tailored to the individual patient. In this context, the treatment approach to mild obstructive sleep apnea (OSA) is fraught with substantial debate as to what is mild OSA, and as to what constitutes appropriate treatment. As such, it is necessary to first establish a proposed consensus of what criteria need to be employed to reach the diagnosis of mild OSA, and then examine the circumstances under which treatment is indicated, and if so, whether and when anti-inflammatory therapy (AIT), rapid maxillary expansion (RME), and/or myofunctional therapy (MFT) may be indicated.

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简介：<正>Theskullbasegenerallyreferstotheanterior,middleandposteriorcranialfossaandstructuresontheoutsidesideoftheseskullareas.Thecranialroofandskullbaseareseparatedbyalineconnectingtheexternaloccipitalprotuberance,parietalnotchandsupraorbitalridge[1].Theskullbasesupportsthebrainabove,isconnectedto

简介：AbstractEndoscopic endonasal orbital surgery is evolving. With increasing knowledge, expertise, and technology, the historical limits of the endonasal endoscopic approach to the orbit have been redefined. This review discusses the clinical presentation and etiology, and highlights the pertinent anatomy, and discusses the diagnostic workup and surgical approach to orbital tumors and post-operative care. The role of the multidisciplinary team is not to be underestimated. The introduction of a classification system to ensure standardization of technical difficulty and outcome data will assist with international collaboration and further consolidate our attainment of knowledge in this developing field.