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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021,28,24: | 49 |
| 2 | Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study显示文摘 | Patrick Marcellin Edward Gane Maria Buti Nezam Afdhal William Sievert Ira M Jacobson Mary Kay Washington George Germanidis John F Flaherty Raul Aguilar Schall Jeffrey D Bornstein Kathryn M Kitrinos G Mani Subramanian John G McHutchison E Jenny Heathcote | 2012 | The Lancet2012,,: | 14 |
| 3 | Inflammatory bowel diseases and spondyloarthropathies: From pathogenesis to treatment显示文摘Spondyloarthropathies(SpA) include many different forms of inflammatory arthritis and can affect the spine(axial SpA) and/or peripheral joints(peripheral SpA) with Ankylosing spondylitis(AS) being the prototype of the former. Extraarticular manifestations, like uveitis, psoriasis and inflammatory bowel disease(IBD) are frequently observed in the setting of SpA and are, in fact, part of the SpA classification criteria. Bowel involvement seems to be the most common of these manifestations. Clinically evident IBD is observed in 6%-14% of AS patients, which is significantly more frequent compared to the general population. Besides, it seems that silent microscopic gut inflammation, is evident in around 60% in AS patients. Interestingly, occurrence of IBD has been associated with AS disease activity. For peripheral SpA, two different forms have been proposed with diverse characteristics. Of note, SpA(axial or peripheral) is more commonly observed in Crohn's disease than in ulcerative colitis. The common pathogenetic mechanisms that explain the link between IBD and SpA are still ill-defined. The role of dysregulated microbiome along with migration of T lymphocytes and other cells from gut to the joint('gut-joint' axis) has been recognized, in the context of a genetic background including associations with alleles inside or outside the human leukocyte antigen system. Various therapeutic modalities are available with monoclonal antibodies against tumour necrosis factor, interleukin-23 and interleukin-17, being the most effective. Both gastroenterologists and rheumatologists should be alert to identify the coexistence of these conditions and ideally follow-up these patients in combined clinics. | George E Fragoulis Christina Liava Dimitrios Daoussis Euangelos Akriviadis Alexandros Garyfallos Theodoros Dimitroulas | 2019 | World Journal of Gastroenterology2019,25,18: | 13 |
| 4 | Delayed gastric emptying following pancreaticoduodenectomy:Incidence,risk factors,and healthcare utilization显示文摘AIM To characterize incidence and risk factors for delayed gastric emptying(DGE) following pancreaticoduodenectomy and examine its implications on healthcare utilization. METHODS A prospectively-maintained database was reviewed. DGE was classified using International Study Group of Pancreatic Surgery criteria. Patients who developed DGE and those who did not were compared. RESULTS Two hundred and seventy-six patients underwent pancreaticoduodenectomy(PD)(> 80% pyloruspreserving, antecolic-reconstruction). DGE developed in 49 patients(17.8%): 5.1% grade B, 3.6% grade C. Demographic, clinical, and operative variables were similar between patients with DGE and those without. DGE patients were more likely to present multiplecomplications(32.6% vs 4.4%, ≥ 3 complications, P < 0.001), including postoperative pancreatic fistula(POPF)(42.9% vs 18.9%, P = 0.001) and intra-abdominal abscess(IAA)(16.3% vs 4.0%, P = 0.012). Patients with DGE had longer hospital stay(median, 12 d vs 7 d, P < 0.001) and were more likely to require transitional care upon discharge(24.5% vs 6.6%, P < 0.001). On multivariate analysis, predictors for DGE included POPF [OR = 3.39(1.35-8.52), P = 0.009] and IAA [OR = 1.51(1.03-2.22), P = 0.035].CONCLUSION Although DGE occurred in < 20% of patients after PD, it was associated with increased healthcare utilization. Patients with POPF and IAA were at risk for DGE. Anticipating DGE can help individualize care and allocate resources to high-risk patients. | Somala Mohammed George Van Buren II Amy Mc Elhany Eric J Silberfein William E Fisher | 2017 | World Journal of Gastrointestinal Surgery2017,9,3: | 13 |
| 5 | Acute upper gastrointestinal bleeding in operated stomach: Outcome of 105 cases显示文摘AIM: To compare the causes and clinical outcome of patients with acute upper gastrointestinal bleeding (AUGB) and a history of gastric surgery to those with AUGB but without a history of gastric surgery in the past.METHODS: The causes and clinical outcome were compared between 105 patients with AUGB and a history of gastric surgery, and 608 patients with AUGB but without a history of gastric surgery.RESULTS: Patients who underwent gastric surgery in the past were older (mean age: 68.1±11.7 years vs 62.8±17.8 years, P= 0.001), and the most common cause of bleeding was marginal ulcer in 63 patients (60%). No identifiable source of bleeding could be found in 22 patients (20.9%) compared to 42/608 (6.9%) in patients without a history of gastric surgery (P = 0.003). Endoscopic hemostasis was permanently successful in 26 out of 35 patients (74.3%) with peptic ulcers and active bleeding or non-bleeding visible vessel. Nine patients (8.6%) were operated due to continuing or recurrent bleeding,compared to 23/608 (3.8%) in the group of patients without gastric surgery in the past (P= 0.028). Especially in peptic ulcer bleeding patients, emergency surgery was more common in the group of patients with gastric surgery in the past [9/73 (12.3%) vs 19/360 (5.3%), P = 0.025].Moreover surgically treated patients in the past required more blood transfusion (3.3±4.0 vs 1.5±1.7, P = 0.0001) and longer hospitalization time (8.6±4.0 vs 6.9±4.9 d,P = 0.001) than patients without a history of gastric surgery. Mortality was not different between the two groups [4/105 (3.8%) vs 19/608 (3.1%)].CONCLUSION: Upper gastrointestinal bleeding seems to be more severe in surgically treated patients than in non-operated patients. | Vassiliki N Nikolopoulou Konstantinos C Thomopoulos George I Theocharis Vassiliki A Arvaniti Constantine E Vagianos | 2005 | World Journal of Gastroenterology2005,11,29: | 9 |
| 6 | Pancreatic cancer: Advances in treatment显示文摘Pancreatic cancer is a leading cause of cancer mortality and the incidence of this disease is expected to continue increasing.While patients with pancreatic cancer have traditionally faced a dismal prognosis,over the past several years various advances in diagnosis and treatment have begun to positively impact this disease.Identification of effective combinations of existing chemotherapeutic agents,such as the FOLFIRINOX and the gemcitabine+nab-paclitaxel regimen,has improved survival for selected patients although concerns regarding their toxicity profiles remain.A better understanding of pancreatic carcinogenesis has identified several pre-malignant precursor lesions,such as pancreatic intraepithelial neoplasias,intraductal papillary mucinous neoplasms,and cystic neoplasms.Imaging technology has also evolved dramatically so as to allow early detection of these lesions and thereby facilitate earlier management.Surgery remains a cornerstone of treatment for patients with resectable pancreatic tumors,and advances in surgical technique have allowed patients to undergo resection with decreasing perioperative morbidity and mortality.Surgery has also become feasible in selected patients with borderline resectable tumors as a result of neoadjuvant therapy.Furthermore,pancreatectomy involving vascular reconstruction and pancreatectomy with minimally invasive techniques have demonstrated safety without significantly compromising oncologic outcomes.Lastly,a deeper understanding of molecular aberrations contributing to the development of pancreatic cancer shows promise for future development of more targeted and safe therapeutic agents. | Somala Mohammed George Van Buren Ⅱ William E Fisher | 2014 | World Journal of Gastroenterology2014,20,28: | 8 |
| 7 | Treatment of hemorrhoids: A survey of surgical practice in Australia and New Zealand显示文摘BACKGROUND Hemorrhoidal disease is the most common anorectal disorder.Hemorrhoids can be classified as external or internal,according to their relation to the dentate line.External hemorrhoids originate below the dentate line and are managed conservatively unless the patient cannot keep the perianal region clean,or they cause significant discomfort.Internal hemorrhoids originate above the dentate line and can be managed according to the graded degree of prolapse,as described by Goligher.Generally,low-grade internal hemorrhoids are effectively treated conservatively,by non-operative measures,while high-grade internal hemorrhoids warrant procedural intervention.AIM To determine the application of clinical practice guidelines for the current management of hemorrhoids and colorectal surgeon consensus in Australia and New Zealand.METHODS An online survey was distributed to 206 colorectal surgeons in Australia and New Zealand using 17 guideline-based hypothetical clinical scenarios.RESULTS There were 82 respondents(40%)to 17 guideline-based scenarios.Nine(53%)reached consensus,of which only 1(6%)disagreed with the guidelines.This was based on low quality evidence for the management of acutely thrombosed external hemorrhoids.There were 8 scenarios which showed community equipoise(47%)and they were equally divided for agreeing or disagreeing with the guidelines.These topics were based on low and moderate levels of evidence.They included the initial management of grade I internal hemorrhoids,grade III internal hemorrhoids when initial management had failed and the patient had recognised risks factors for septic complications;and finally,the decision-making when considering patient preferences,including a prompt return to work,or minimal post-operative pain.CONCLUSION Although there are areas of consensus in the management of hemorrhoids,there are many areas of community equipoise which would benefit from further research. | George E Fowler Javariah Siddiqui Assad Zahid Christopher John Young | 2019 | World Journal of Clinical Cases2019,7,22: | 8 |
| 8 | Pancreatic endometrial cyst mimics mucinous cystic neoplasm of the pancreas显示文摘Pancreatic cysts include a variety of benign, premalignant, and malignant lesions. Endometrial cysts in the pancreas are exceedingly rare lesions that are difficult to diagnose pre-operatively. This report describes the findings in a 43-year-old patient with a recent episode of acute pancreatitis who presented with a large cyst in the tail of the pancreas. Imaging demonstrated a loculated pancreatic cyst, and cyst fluid aspiration revealed an elevated amylase and carcinoembryonic antigen. The patient experienced an interval worsening of abdominal pain, fatigue, diarrhea, and a 15-pound weight loss 3 mo after the initial episode of pancreatitis. With concern for a possible pre-malignant lesion, the patient underwent a laparoscopic distal pancreatectomy with splenectomy, which revealed a 16cm×12cm×4cm lesion. Final histopathology was consistent with an intra-pancreatic endometrial cyst. Here we discuss the overlapping imaging and laboratory features of pancreatic endometrial cysts and mucinous cystic neoplasms of the pancreas. | Michael A Mederos Nicole Villafane Sadhna Dhingra Carlos Farinas Amy Mc Elhany William E Fisher George Van Buren II | 2017 | World Journal of Gastroenterology2017,23,6: | 7 |
| 9 | Gastrointestinal stromal tumor causing small bowel intussusception in a patient with Crohn’s disease显示文摘We report a case of jejunoileal intussusception in a 42-year-old patient with Crohn's disease caused by a gastrointestinal stromal tumor. The patient complained of vague diffuse abdominal pain for a period of 4 mo. Intussusception was suspected at computer tomography and magnetic resonance imaging scans. Segmental resection of the small intestine was performed. Pathological examination of the surgical specimen revealed a gastrointestinal stromal tumor as well as aphthous ulcerations and areas of inflammation, which were characteristic of Crohn's disease. This is the f irst report of small bowel intussusception due to a gastrointestinal stromal tumor coexisting with Crohn's disease. | George E Theodoropoulos Dimitrios Linardoutsos Dimitrios Tsamis Paraskevas Stamopoulos Dimitrios Giannopoulos Flora Zagouri Nikolaos V Michalopoulos | 2009 | World Journal of Gastroenterology2009,15,41: | 7 |
| 10 | Effects of mycophenolate mofetil vs cyclosporine administration on graft survival and function after islet allotransplantation in diabetic rats显示文摘AIM: To develop an experimental model of islet allotransplantation in diabetic rats and to determine the positive or adverse effects of MMF as a single agent. METHODS: Thirty-six male Wistar rats and 18 male Lewis rats were used as recipients and donors respectively. Diabetes was induced by the use of streptozotocin (60 mg/kg) intraperitoneally. Unpurified islets were isolated using the collagenase digestion technique and transplanted into the splenic parenchyma. The recipients were randomly assigned to one of the following three groups: group A (control group) had no immunosuppression; group B received cyclosporine (CsA) (5 mg/kg); group C receivedmycophenolate mofetil (MMF) (20 mg/kg). The animalswere killed on the 12th d. Blood and grafted tissues were obtained for laboratory and histological assessment. RESULTS: Median allograft survival was significantly higher in the two therapy groups than that in the controls (10 and 12 d for CsA and MMF respectively vs 0 d for the control group, P<0.01). No difference in allograft survival between the CsA and MMF groups was found. However,MMF had less renal and hepatic toxicity and allowed weight gain.CONCLUSION: Monotherapy with MMF for immunosu ppression was safe in an experimental model of islet allotransplantation and was equally effective with cyclosporine, with less toxicity. | Constantin Fotiadis Paraskevi Xekouki Apostolos E Papalois PantelisT Antonakis Ioannis Sfiniadakis Dimitrios Flogeras Eleutheria Karampela George Zografos | 2005 | World Journal of Gastroenterology2005,11,18: | 7 |
| 11 | 水力压裂监测新方法显示文摘深入了解水力压裂裂缝的几何形态和延伸情况有助于改善低渗油气藏压裂增产作业效果,改善油气井产能并提高油气采收率。应用地震方法对水力压裂裂缝进行监测和描述已经有多年了,而新的地震硬件和处理技术的出现使得这类监测更加有效、可靠。 | Les Bennett Joeol Le Calvez David R. ( Rich ) Sarver Kevin Tanner W.S.(Scott)Birk George Waters Julian Drew Gw e nola Michaud Paolo Primiero Leo Eisner Rob Jones David Leslie Michael John Williams Jim Govenlock Richard C. ( Rick ) Klein Kazuhiko Tezuka | 2007 | 国外测井技术2007,22,4: | 7 |
| 12 | Portopulmonary hypertension and serum endothelin levels in hospitalized patients with cirrhosis显示文摘BACKGROUND:Cirrhosis is associated with several extrahepatic manifestations including portopulmonary hypertension (PPHT).Recent data suggest that endothelins (ETs) are related to the pathophysiology of PPHT.The study aimed to measure serum ET levels in hospitalized cirrhotic patients and to determine their association with PPHT and patient outcome.METHODS:Fifty-seven cirrhotic patients [43 males;median age 58 (28-87) years] underwent Doppler echocardiography.Patients with systolic pulmonary arterial pressure ≥40 mmHg and pulmonary acceleration time <100 ms were deemed to have PPHT.ET-1,2,and 3 serum levels were measured with an ELISA assay.All-cause mortality was recorded over a median period of 24 months.RESULTS:Nine out of 57 patients (15.8%) had PPHT.Among various clinical variables,only autoimmune hepatitis was associated with PPHT (OR=11.5;95% CI,1.58-83.4;P=0.01).ET-1 levels [9.1 (1.6-20.7) vs 2.5 (1.4-9.2) pg/mL,P=0.02] and the ET-1/ET-3 ratio [4.73 (0.9-22.4) vs 1.6 (0.3-10.7),P=0.02] were significantly higher in patients with PPHT than in those without.ET-2 and ET-3 levels did not differ between the two groups.There was no difference in survival between the two groups,although ET-1 levels were associated with an adverse outcome in Cox regression analysis (HR=1.11;95% CI,1.02-1.22;P=0.02 per unit increase in ET-1).CONCLUSION:Our data suggest that ET-1 and the ET-1/ET-3 ratio are elevated in patients with PPHT and that ET-1 is associated with a poor outcome irrespective of PPHT. | Aristotelis Tsiakalos Gregorios Hatzis Ioannis Moyssakis Aggelos Karatzaferis Panayiotis D Ziakas George E Tzelepis | 2011 | Hepatobiliary & Pancreatic Diseases International2011,10,4: | 7 |
| 13 | Role of functional imaging in the development and refinement of invasive neuromodulation for psychiatric disorders显示文摘Deep brain stimulation(DBS) is emerging as a pow-erful tool for the alleviation of targeted symptoms in treatment-resistant neuropsychiatric disorders. Despite the expanding use of neuropsychiatric DBS, the mecha-nisms responsible for its effects are only starting to be elucidated. Several modalities such as quantitative elec-troencephalography as well a intraoperative recordings have been utilized to attempt to understand the under-pinnings of this new treatment modality, but functional imaging appears to offer several unique advantages. Functional imaging techniques like positron emission tomography, single photon emission computed tomog-raphy and functional magnetic resonance imaging have been used to examine the effects of focal DBS on activ-ity in a distributed neural network. These investigations are critical for advancing the field of invasive neuro-modulation in a safe and effective manner, particularly in terms of defining the neuroanatomical targets and refining the stimulation protocols. The purpose of this review is to summarize the current functional neuroim-aging findings from neuropsychiatric DBS implantation for three disorders: treatment-resistant depression, obsessive-compulsive disorder, and Tourette syndrome. All of the major targets will be discussed(Nucleus ac-cumbens, anterior limb of internal capsule, subcallosal cingulate, Subthalamic nucleus, Centromedial nucleus of the thalamus-Parafasicular complex, frontal pole, and dorsolateral prefrontal cortex). We will also address some apparent inconsistencies within this literature, and suggest potential future directions for this promis-ing area. | Nolan R Williams Joseph J Taylor Kayla Lamb Colleen A Hanlon E Baron Short Mark S George | 2014 | World Journal of Radiology2014,6,10: | 6 |
| 14 | Smoking in schizophrenic patients:A critique of the selfmedication hypothesis显示文摘A common remark among laypeople, and notably also among mental health workers, is that individuals with mental illnesses use drugs as self-medication to allay clinical symptoms and the side effects of drug treatments. Roots of the self-medication concept in psychiatry date back at least to the 1980 s. Observations that rates of smokers in schizophrenic patients are multiple times the rates for regular smoking in the general population, as well as those with other disorders, proved particularly tempting for a self-medication explanation. Additional evidence came from experiments with animal models exposed to nicotine and the identification of neurobiological mechanisms suggesting self-medication with smoking is a plausible idea. More recently, results from studies comparing smoking and non-smoking schizophrenic patients have led to the questioning of the self-medication hypothesis. Closer examination of the literature points to the possibility that smoking is less beneficial on schizophrenic symptomology than generally assumed while clearly increasing the risk of cancer and other smoking-related diseases responsible for early mortality. It is a good time to examine the evidence for the self-medication concept as it relates to smoking. Our approach is to focus on data addressing direct or implied predictions of the hypothesis in schizophrenic smokers. | Francesca Manzella Susan E Maloney George T Taylor | 2015 | World Journal of Psychiatry2015,5,1: | 4 |
| 15 | 聚合物淬火介质:基础显示文摘热处理工作者对所谓的“聚合物淬火介质”已进行了二十多年的试验,通常它们所提供的冷却特性介于水和石油产品之间。这种淬火介质是以水溶性聚合物为基础的,如纤维素衍生物,聚乙烯醇(PVA),聚丙烯酸钠(PSA),聚丙烯酰胺,聚乙烯吡咯烷酮(PVP),聚乙烷基恶唑啉(PEOX),和聚醚(PAO)。聚合物淬火介质虽然在某些方面相似,但其家族的每一成员都明显地区别于另一个。这些差别能显著地影响淬火性能。因此,热处理工作者需要对此有一个基本的了解,是什么使得一种聚合物区别于另一种,以帮助他们对给定的应用能选择最恰当的淬火介质。聚合物特点聚合物是一种通过对较小“简单” | George E Totten 庄祎哲 | 1990 | 国外金属热处理1990,11,6: | 4 |
| 16 | Liposarcoma of the stomach: A rare case report显示文摘Liposarcoma is the most common soft tissue sarcoma and accounts for 15%-20% of all mesenchymal malignancies. The tumor occurs most frequently in the limbs, retroperitoneum and rarely has a visceral location. We report a case of a gastric liposarcoma in a male patient. A 68 years old male patient was admitted to hospital for abdominal discomfort and fullness lasting for a month. He reported rare episodes of vomiting. The CT examination revealed a large epigastric mass (8 cm x 4 cm) involving the lesser curvature of the stomach, in contact with the pancreas and gallbladder. Fatty areas within the mass were evident. A total gastrectomy together with cholecystectomy was performed. The histopathological diagnosis was a well differentiated liposarcoma. The patient did not undergo any adjuvant treatment, he is under close follow up and two years later he is disease free. We report this case due to the rarity of this tumor in the stomach (nine cases reported in the literature). | Konstantinos Tepetes Gregory Christodoulidis Michael E Spyridakis Maria Nakou George Koukoulis Konstantinos Hatzitheofilou | 2007 | World Journal of Gastroenterology2007,13,30: | 3 |
| 17 | Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial显示文摘 | Ronald P DeMatteo Karla V Ballman Cristina R Antonescu Robert G Maki Peter WT Pisters George D Demetri Martin E Blackstein Charles D Blanke Margaret von Mehren Murray F Brennan Shreyaskumar Patel Martin D McCarter Jonathan A Polikoff Benjamin R Tan Kouros | 2009 | The Lancet2009,,9669: | 2 |
| 18 | Spectral analysis of drought index(Palmar) for India显示文摘 | Rao K N George C J Moray P E | 1973 | Indian J Met Geophys1973,24,2: | 2 |
| 19 | Ordered Intermetallics显示文摘 | E P George M Yamaguchi K S Kumar C T Liu | 1994 | Annual Review of Materials Science1994,,: | 2 |
| 20 | Should antibiotics be administered before arthroscopic knee surgery? A systematic review of the literature显示文摘AIM To explore the current evidence surrounding the administration of prophylactic antibiotics for arthroscopic knee surgery. METHODS Databases were searched from inception through May of 2018 for studies examining prophylactic antibiotic use and efficacy in knee arthroscopy. Studies with patient data were further assessed for types of arthroscopic procedures performed,number of patients in the study,use of antibiotics,and outcomes with the intention of performing a pooled analysis. Data pertaining to 'deep tissue infection' or 'septic arthritis' were included in our analysis. Reported data on superficial infection were not included in our data analysis. For the pooled analysis,a relative risk ratio was calculated and χ~2 tests were used to assess for statistical significance between rates of infection amongst the various patient groups. Post hoc power analyses were performed to compute the statistical power obtained from our sample sizes. Number needed to treat analyses were performed for statistically significant differences by dividing 1 by the difference between the infection rates of the antibiotic and no antibiotic groups. An alpha value of 0.05 was used for our analysis. Study heterogeneity was assessed by Cochrane's Q test as well as calculation of the I^2 value.RESULTS A total of 49682 patients who underwent knee ar-throscopy for a diverse set of procedures across 19 studies met inclusion critera for pooled analysis. For those not undergoing graft procedures,there were 27 cases of post-operative septic arthritis in 34487 patients(0.08%) who received prophylactic antibiotics and 16 cases in 10911(0.15%) who received none [risk ratio(RR) = 0.53,95% confidence interval(CI): 0.29-0.99,P = 0.05]. A sub-group analysis in which bony procedures were excluded was performed which found no significant difference in infection rates between patients that received prophylactic antibiotics and patients that did not(P > 0.05). All anterior cruciate ligament reconstruction studies used prophylactic antibiotics,but two studies investigating the effect of soaking the graft in vancomycin in addition to standard intravenous(IV) prophylaxis were combined for analysis. There were 19 cases in 1095 patients(1.74%) who received IV antibioitics alone and no infections in 2034 patients who received IV antibiotics and had a vancomycin soaked graft(RR = 0.01,95%CI: 0.001-0.229,P < 0.01).CONCLUSION Prophylactic antibiotics are effective in preventing septic arthritis following simple knee arthroscopy. In procedures involving graft implantation,graft soaking reduces the rate of infection. | John Carney Nathanael Heckmann Erik N Mayer Ram K Alluri Carleton Thomas Vangsness George F Hatch Ⅲ Alexander E Weber | 2018 | World Journal of Orthopedics2018,9,11: | 2 |