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1Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases显示文摘AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta mohamed el sorogy emad hamdy mohamed el hemly ahmed a el-geidi tharwat kandil mohamed el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan mohamed abdel wahab 2017World Journal of Gastroenterology2017,23,38:15
2Clinicopathological features and surgical outcome of patients with fibrolamellar hepatocellular carcinoma(experience with 22 patients over a 15-year period)显示文摘AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepato-cellular carcinoma(FL-HCC)over a 15-year period. METHODS This is a retrospective study including 22 patients with a pathologic diagnosis of FL-HCC who underwent hepatectomy over a 15-year period. Tumor characteristics,survival and recurrence were evaluated. RESULTS There were 11 male and 11 female with a median age of 29 years(range from 21 to 58 years). Two(9%)patients had hepatitis C viral infection and only 2(9%)patients had alpha-fetoprotein level > 200 ng/m L. The median size of the tumors was 12 cm(range from 5-20 cm). Vascular invasion was detected in 5(23%)patients. Four(18%)patients had lymph node metastases. The median follow up period was 42 mo and the 5-year survival was 65%. Five(23%)patients had a recurrent disease,4 of them had a second surgery with 36 mo median time interval. Vascular invasion is the only significant negative prognostic factor CONCLUSION FL-HCC has a favorable prognosis than common HCC and should be suspected in young patients with non cirrhotic liver. Aggressive surgical resection should be done for all patients. Repeated hepatectomy should be considered for these patients as it has a relatively indolent course.Mohamed Abdel Wahab Ehab El Hanafy Ayman El Nakeeb Mahmoud Abdelwahab Ali 2017World Journal of Gastrointestinal Surgery2017,9,2:12
3Synthesis of linear low-density polyethylene-g-poly(acrylic acid)-co-starch/organo-montmorillonite hydrogel composite as an adsorbent for removal of Pb(Ⅱ) from aqueous solutions显示文摘The purpose of this work is to remove Pb(II) from the aqueous solution using a type of hydrogel composite. A hydrogel composite consisting of waste linear low density polyethylene, acrylic acid, starch, and organo-montmorillonite was prepared through emulsion polymerization method. Fourier transform infrared spectroscopy(FTIR), Solid carbon nuclear magnetic resonance spectroscopy(CNMR)), silicon-29 nuclear magnetic resonance spectroscopy(Si NMR)), and X-ray diffraction spectroscope((XRD) were applied to characterize the hydrogel composite. The hydrogel composite was then employed as an adsorbent for the removal of Pb(II) from the aqueous solution. The Pb(II)-loaded hydrogel composite was characterized using Fourier transform infrared spectroscopy(FTIR)),scanning electron microscopy(SEM)), and X-ray photoelectron spectroscopy((XPS)). From XPS results, it was found that the carboxyl and hydroxyl groups of the hydrogel composite participated in the removal of Pb(II). Kinetic studies indicated that the adsorption of Pb(II)followed the pseudo-second-order equation. It was also found that the Langmuir model described the adsorption isotherm better than the Freundlich isotherm. The maximum removal capacity of the hydrogel composite for Pb(II) ions was 430 mg/g. Thus, the waste linear low-density polyethylene-g-poly(acrylic acid)-co-starch/organo-montmorillonite hydrogel composite could be a promising Pb(II) adsorbent.Maryam Irani Hanafi Ismail Zulkifli Ahmad Maohong Fan 2015Journal of Environmental Sciences2015,27,1:11
4Effect of Altering Linoleic Acid and Linolenic Acid Dietary Ratios on the Performance and Tissue Fatty Acid Profiles of Prawn, Macrobrachium rosenbergii (de Man 1879) Post Larvae显示文摘A. M. A. S. Goda M. M. Habashy M. A. Hanafy R. A. Mohamed H. A. Mabrouk T. M. El-Afifi S. A.Nada K. A. Mohamed 2011Journal of Agricultural Science and Technology(B)2011,1,7:11
5Predictors of long term survival after hepatic resection for hilar cholangiocarcinoma:A retrospective study of 5-year survivors显示文摘AIM:To determine predictors of long term survival after resection of hilar cholangiocarcinoma(HC) by comparing patients surviving > 5 years with those who survived < 5 years.METHODS:This is a retrospective study of patients with pathologically proven HC who underwent surgical resection at the Gastroenterology Surgical Center,Mansoura University,Egypt between January 2002 and April 2013.All data of the patients were collected from the medical records.patients were divided into two groups according to their survival:patients surviving less than 5 years and those who survived > 5 years.RESULTS:There were 34(14%) long term survivors(5 year survivors) among the 243 patients.Fiveyear survivors were younger at diagnosis than those surviving less than 5 years(mean age,50.47 ± 4.45 vs 54.59 ± 4.98,p = 0.001).Gender,clinical presentation,preoperative drainage,preoperative serum bilirubin,albumin and serum glutamic-pyruvic transaminase were similar between the two groups.The level of CA 19-9 was significantly higher in patients surviving < 5 years(395.71 ± 31.43 vs 254.06 ± 42.19,p = 0.0001).Univariate analysis demonstrated nine variables to be significantly associated with survival > 5 year,includingyoung age(p = 0.001),serum CA19-9(p = 0.0001),non-cirrhotic liver(p = 0.02),major hepatic resection(p = 0.001),caudate lobe resection(p = 0.006),well differentiated tumour(p = 0.03),lymph node status(0.008),R0 resection margin(p = 0.0001) and early postoperative liver cell failure(p = 0.02).CONCLUSION:Liver status,resection of caudate lobe,lymph node status,R0 resection and CA19-9 were demonstrated to be independent risk factors for long term survival.Mohamed Abd El Wahab Ayman El Nakeeb Ehab El Hanafy Ahmad M Sultan Ahmed Elghawalby Waleed Askr Mahmoud Ali Mohamed Abd El Gawad Tarek Salah 2016World Journal of Gastrointestinal Surgery2016,8,6:10
6Post-endoscopic retrograde cholangiopancreatography pancreatitis: Risk factors and predictors of severity显示文摘AIM To detect risk factors for post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP) and investigate the predictors of its severity.METHODS This is a prospective cohort study of all patients who underwent ERCP.Pre-ERCP data,intraoperative data,and post-ERCP data were collected.RESULTS The study population consisted of 996 patients.Their mean age at presentation was 58.42(± 14.72) years,and there were 454 male and 442 female patients.Overall,PEP occurred in 102(10.2%) patients of the study population; eighty(78.4%) cases were of mild to moderate degree,while severe pancreatitis occurred in 22(21.6%) patients.No hospital mortality was reported for any of PEP patients during the study duration.Age less than 35 years(P = 0.001,OR = 0.035),narrower common bile duct(CBD) diameter(P = 0.0001) and increased number of pancreatic cannulations(P = 0.0001) were independent risk factors for the occurrence of PEP.CONCLUSION PEP is the most frequent and devastating complication after ERCP.Age less than 35 years,narrower median CBD diameter and increased number of pancreaticcannulations are independent risk factors for the occurrence of PEP.Patients with these risk factors are candidates for prophylactic and preventive measures against PEP.Ayman El Nakeeb Ehab El Hanafy Tarek Salah Ehab Atef Hosam Hamed Ahmad M Sultan Emad Hamdy Mohamed Said Ahmed A El Geidie Tharwat Kandil Mohamed El Shobari Gamal El Ebidy 2016World Journal of Gastrointestinal Endoscopy2016,8,19:10
7Pathological,immunohistochemical and microbiologicalal analysis of lacrimal sac biopsies in patients with chronic dacrocystitis显示文摘AIM:To analyze cases of obstruction of the nasolacrimal duct which creates a fertile environment for secondary bacterial Infection and can result in dacryocystitis,which is a constant threat to cornea and orbital soft tissue and a potential source of endophthalmitis following intraocular surgery.The majority of obstructions of the lacrimal excretory outflow system are acquired ones occurring in adulthood and involving the distal parts of the system.Acquired obstruction may be primary/idiopathic or secondary to a wide variety of infectious,inflammatory,traumatic,mechanical,toxic or neoplastic causes mimicking idiopathic inflammation.These cases are treated by dacryocystorhinostomy(DCR).METHODS:The present study was conducted to determine the histopathologic,immunohistochemical and current microbiologic characteristics of lacrimal sac specimens in patients undergoing external dacryocystorhinostomy.RESULTS:Non-specific lacrimal sac pathology was present in all 33 cases and 81.8%of the cases showed moderate chronic inflammation with a chronic inflammatory score(CIS)ranging between 4 and 6,whereas 12.12%showed severe inflammatory changes with a CIS of 7.Mild degree of inflammation was seen in6.06%with a CIS of 3.The total prevalence of grampositive,gram-negative,and culture-negative samples were 59.4%,37.5%,and 3%respectively.CONCLUSION:Non-specific chronic inflammation withfibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens.Rowayda Mahmoud Amin Faten Aly Hussein Hisham Farouk Idriss Nesrine Fathy Hanafy Dina Mohamed Abdallah 2013International Journal of Ophthalmology(English edition)2013,6,6:7
8Serum MiRNA as Predictive and Prognosis Biomarker in Advanced Stage Non-small Cell Lung Cancer in Indonesia显示文摘Background and objective Lung cancer is the most common cause of death in men in the world and in Indonesia where nonsmall cell carcinoma lung cancer(NSCLC) constitutes 85% of all lung cancer cases. The high mortality rate is due to a poor prognosis and is often diagnosed as having advanced stages. If it is known at the initial stage, the prognosis of lung cancer will be better. Prognosis can be predicted with a marker of prognostic biology, one of which is micro RNA(mi RNA). This study aims to prove that serum mi RNA can be predictive biological marker and prognosis in NSCLC patients in Indonesia.Methods This study was cohort retrospective among 52 subjects in 'Dharmais' Hospital National Cancer Center. Sample was obtained from patients’ serum. Mi R-34, mi R-148, mi R-155 and mi R-222 serum are measured through Real-Time PCR(q PCR). Data were analyzed and interpreted with descriptive analysis, bivariate analysis(Mann Whitney-U for two type of variables or Kruskal-Wallis for more than two type of variables. Kaplan-Meier analysis was used to know association between characteristic which are sociodemographic, performance status, clinico-pathology, and survival rate in mi RNA expression. Results From this study, mi RNA expression: mi R-34(46.15%), mi R-148(23.08%), mi R-155(40.38%) and mi R-222(32.69%). Performance status score was statistically significant correlation with mi R-148(P=0.049) and mi R-222(P=0.018). High mi R-34 is associated with multiple M1 b metastatic type(P=0.020), cancer cell type(adenocarcinoma, P=0.009) and adenocarcinoma epidermal growth factor receptor(EGFR) mutation(negative, P=0.031). There was a significant correlation between the high mi R-222 as a poor prognosis in advanced stage NSCLC with M1 b metastasis(Median Survival/MS: 27 d, P=0.049) and positive EGFR mutations(MS: 74 d, P=0.049) and correlation of mi R-155 with adenocarcinoma(MS: 69 d, P=0.034) and positive EGFR gene mutations(MS: 58 d, P=0.023).Conclusion High mi R-34 expression in advanced stage NSCLC is the predictive factor for multiple metastatic, adenocarcinoma cell type and adenocarcinoma negative EGFR mutation. High expression of mi R-155 and mi R-222 are poor prognoses, especially high mi R-222 found in metastasis M1 b and positive EGFR mutation and mi R-155 found in adenocarcinoma and positive EGFR gene mutations. Further studies regarding correlation between mi RNA and survival rate are needed.Arif R HANAFI Achmad M JAYUSMAN Serafim ALFASUNU Ahmad H SADEWA Dibyo PRAMONO Didik S HERIYANTO Sofia M HARYANA 2020中国肺癌杂志2020,23,5:6
9Predictors of long-term survival after pancreaticoduodenectomy for peri-ampullary adenocarcinoma: A retrospective study of 5-year survivors显示文摘Background: Pancreaticoduodenectomy(PD) is the standard curative treatment for periampullary tumors. The aim of this study is to report the incidence and predictors of long-term survival( ≥ 5 years) after PD. Methods: This study included patients who underwent PD for pathologically proven periampullary adenocarcinomas. Patients were divided into 2 groups: group(I) patients who survived less than 5 years and group(II) patients who survived ≥ 5 years. Results: There were 47(20.6%) long-term survivors( ≥ 5 years) among 228 patients underwent PD for periampullary adenocarcinoma. Patients with ampullary adenocarcinoma represented 31(66.0%) of the long-term survivors. Primary analysis showed that favourable factors for long-term survival include age < 60 years old, serum CEA < 5 ng/mL, serum CA 19-9 < 37 U/mL, non-cirrhotic liver, tumor size < 2 cm, site of primary tumor, postoperative pancreatic fistula, R0 resection, postoperative chemotherapy, and no recurrence. Multivariate analysis demonstrated that CA 19-9 < 37 U/mL [OR(95% CI) = 1.712(1.24 8–2.34 8), P = 0.001], smaller tumor size [OR(95% CI) = 1.335(1.032–1.726), P = 0.028] and R0 resection [OR(95% CI) = 3.098(2.095–4.582), P < 0.001] were independent factors for survival ≥ 5 years. The prognosis was best for ampullary adenocarcinoma, for which the median survival was 54 months and 5-year survival rate was 39.0%, and the poorest was pancreatic head adenocarcinoma, for which the median survival was 27 months and 5-year survival rate was 7%. Conclusions: The majority of long-term survivors after PD for periampullary adenocarcinoma are patients with ampullary tumor. CA 19-9 < 37 U/mL, smaller tumor size, and R0 resection were found to be independent factors for long-term survival ≥ 5 years.Ayman El Nakeeb Mohamed El Sorogy Helmy Ezzat Rami Said Mohamed El Dosoky Mohamed Abd El Gawad Ahmed M Elsabagh Ehab El Hanafy 2018Hepatobiliary & Pancreatic Diseases International2018,17,5:6
10Intraoperative endoscopic retrograde cholangiopancreatography: A useful tool in the hands of the hepatobiliary surgeon显示文摘AIM: To evaluate the efficacy of intraoperative endoscopic retrograde cholangio-pancreatography(ERCP) combined with laparoscopic cholecystectomy(LC) forpatients with gall bladder stones(GS) and common bile duct stones(CBDS).METHODS: Patients treated for GS with CBDS were included. LC and intraoperative transcystic cholangiogram(TCC) were performed in most of the cases. Intraoperative ERCP was done for cases with proven CBDS.RESULTS: Eighty patients who had GS with CBDS were included. LC was successful in all cases. Intraoperative TCC revealed passed CBD stones in 4 cases so intraoperative ERCP was performed only in 76 patients. Intraoperative ERCP showed dilated CBD with stones in 64 cases(84.2%) where removal of stones were successful; passed stones in 6 cases(7.9%); short lower end stricture with small stones present in two cases(2.6%) which were treated by removal of stones with stent insertion; long stricture lower 1/3 CBD in one case(1.3%) which was treated by open hepaticojejunostomy; and one case(1.3%) was proved to be ampullary carcinoma and whipple's operation was scheduled. CONCLUSION: The hepatobiliary surgeon should be trained on ERCP as the third hand to expand his field of therapeutic options.Ayman El Nakeeb Ahmad M Sultan Emad Hamdy Ehab El Hanafy Ehab Atef Tarek Salah Ahmed A El Geidie Tharwat Kandil Mohamed El Shobari Gamal El Ebidy 2015World Journal of Gastroenterology2015,21,2:6
11Effect of Synthesis Technique and Carbonate Content on the Crystallinity and Morphology of Carbonated Hydroxyapatite显示文摘The syntheses of nanosized carbonated hydroxyapatite(CHA) were performed by comparing dropwise and direct pouring of acetone solution of Ca(N03)2-4H20 into mixture of(NH4)2HP04 and NH4HCO3 at room temperature controlled at pH 11.Direct pouring method was later applied to study the increment of carbonate content in syntheses.The as-synthesized powders were characterized by various characterization techniques.The crystallographic results of the produced powders were obtained from X-ray diffraction analysis,whilst the carbonate content in the produced powders was determined by the CHNS/O elemental analyzer.Fourier transform infrared analysis confirmed that the CHA powders formed were B-type.Field emission scanning electron microscopy revealed that the powders were highly agglomerated in nanosized range and hence energy filtered transmission electron microscopy was employed to show elongated particles which decreased with increasing carbonate content.Chia Ching Kee Hanafi Ismail Ahmad Fauzi Mohd Noor 2013Journal of Materials Science & Technology2013,29,8:5
12Comparison of Effectiveness of Gefitinib, Erlotinib, and Afatinib in Advanced Non-small Cell Lung Cancer Patients with EGFR Mutation Positive in Indonesian Population显示文摘Background and objective EGFR-tyrosine kinase inhibitors(EGFR-TKIs) were used to treat non-small cell lung cancer(NSCLC) patients with EGFR mutation positive. This study aims to compare the effectiveness of first line TKIs;gefitinib, erlotinib, and afatinib in the treatment of advanced stage NSCLC patients with EGFR mutation positive in the Indonesian population.Methods A retrospective cohort study of 88 NSCLC patients with EGFR mutation positive treated with gefitinib(n=59), erlotinib(n=22), and afatinib(n=7) was performed in national cancer hospital in Indonesia.Inclusion criteria were stage IIIb or IV NSCLC with adenocarcinoma subtype. Subjects less than 18 years or with a history of other malignancy were excluded. Outcomes were treatment response, progression-free survival(PFS), and mortality rate. Results Complete response, partial response, and stable disease were shown in 1.1%, 35.2%, and 31.8% of subjects, respectively. There were 31.8% of subjects developed progressive disease during treatment. Regarding EGFR mutation positive profile, a total of 56.8% subjects had deletion in exon 19, 42% subjects had mutation in exon 21, and rare mutation in exon 18 was found in 3.4% of total subjects. Demography and clinical characteristics had no significant association with the risk of progressive disease. The median PFS of subjects was 11 months(95%CI: 6.8-15.2 months). There was no statistical difference of PFS between treatment groups.Conclusion Gefitinib, erlotinib, and afatinib have similar effectiveness in advanced stage NSCLC with EGFR mutation positive. Afatinib tends to be associated with longer PFS but further investigation is required.Noorwati SUTANDYO Arif HANAFI Mulawarman JAYUSMAN 2019中国肺癌杂志2019,22,9:4
13Challenges in COVID-19 drug treatment in patients with advanced liver diseases:A hepatology perspective显示文摘The global incidence of coronavirus disease 2019(COVID-19)continues to increase despite health care efforts.The disease is caused by coronavirus 2 with high transmission and mortality rates.Little is known about the management of COVID-19 in advanced liver disease.The aim of work was to propose a plan for management of this drastic disease in case of this specific population with review of medications that could be suitable for advanced liver disease.All the guidelines and medications available for treatment of COVID-19 were reviewed with selection of the less toxic medications that could be used in advanced liver disease.Drugs suitable to manage COVID-19 in patients with liver disease might include remdesivir intravenously,nitazoxanide+sofosbuvir,ivermectin,tocilizumab,convalescent plasma,and low molecular weight heparin in certain situations.Advanced liver disease is associated with portal hypertension and splenomegaly with reduction of blood elements and immune dysfunction and impaired T cell function.Thus,when confronted by cytokine storm as an immune response to COVID-19,there may be an increase in the mortality rate of these patients.Through this review,a plan to treat COVID-19 in this special group of patients with advanced cirrhosis is proposed.Amr Shaaban Hanafy Sherief Abd-Elsalam 2020World Journal of Gastroenterology2020,26,46:4
14Pancreatic Anastomotic Leakage after Pancreaticoduodenectomy. Risk factors, Clinical predictors, and Management (Single Center Experience)显示文摘Ayman El Nakeeb Tarek Salah Ahmad Sultan Mohamed El Hemaly Waleed Askr Helmy Ezzat Emad Hamdy Ehab Atef Ehab El Hanafy Ahmed El-Geidie Mohamed Abdel Wahab Talaat Abdallah 2013World Journal of Surgery2013,,6:4
155-Nitro-1,2,4-triazole-3-one:A Review of Recent Advances显示文摘The 3?Nitro?1,2,4?triazole?5?one(NTO)is a high energy density materials of keen interest for both commercial and scientific worlds owing to its reduced sensitivity,better thermal stability and high performances. It plays a significant role to replace the current energetic ingredients. In this review,we summarize various strategies involved in the synthesis of NTO as well as the existing approaches to tailor its particle morphology and sizes. The most prominent properties of NTO,such as insensitivity and performance,which are usually required to produce efficient formulations,have been concisely discussed. In addition,this overview reports on some newer forms of NTO including derivatives and co?crystals available in the literature,which can enhance the NTO features and extend its applications. The advantages and shortcomings of various NTO forms for specific and potential use are also highlighted together with the attempts made to overcome these issues. Therefore,efforts will certainly continue to improve characteristics and performances of NTO either by chemical modification or by co?crystallization in order to produce promising formulations for widespread applications in the near future.Sabrina Hanafi Djalal Trache Slimane Abdous Zineddine Bensalem Abderrahmane Mezroua 2019含能材料2019,27,4:3
16On the convergence of Tabu search显示文摘Hanafi S 2000Journal of Heuristic2000,,7:2
17Outcomes of pancreaticoduodenectomy in elderly patients显示文摘BACKGROUND: Although the mortality and morbidity of pancreaticoduodenectomy(PD) have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly patients.METHODS: We studied all patients who had undergone PD in our center between January 1995 and February 2015. The patients were divided into three groups based on age: group I(patients aged <60 years), group II(those aged 60 to 69 years) and group III(those aged ≥70 years). The primary outcome was the rate of total postoperative complications. Secondary endpoint included total operative time, hospital mortality, length of postoperative hospital stay, delayed gastric emptying, re-exploration, and survival rate.RESULTS: A total of 828 patients who had undergone PD for resection of periampullary tumor were included in this study. There were 579(69.9%) patients in group I, 201(24.3%) in group II, and 48(5.8%) in group III. The overall incidence of complications was higher in elderly patients(25.9% in group I, 36.8% in group II, and 37.5% in group III; P=0.006). There were more patients complicated with delayed gastric emptying in group II compared with the other two groups. There was no significant difference in the incidence of postoperative pancreatic fistula, biliary leakage, pancreatitis, pulmonary complications and hospital mortality.CONCLUSIONS: PD can be performed safely in selected elderly patients. Advanced age alone should not be a contraindication for PD. The outcome of elderly patients who have undergone PD is similar to that of younger patients, and the increased rate of complications is due to the presence of associated comorbidities.Ayman El Nakeeb Ehab Atef Ehab El Hanafy Ali Salem Waleed Askar Helmy Ezzat Ahmed Shehta Mohamed Abdel Wahab 2016Hepatobiliary & Pancreatic Diseases International2016,15,4:2
18电子医疗数据云服务安全显示文摘医疗信息技术的重要性最近几年得到了戏剧性的提升。研究者、开发者以及公司已经开始努力发展手机、网络、桌面以及企业E健康应用。这些发展又提升了E健康应用和健康信息系统(HIS)之间的互通和数据交换的重要性,进而导致了对敏感数据和数据交换的安全性的担忧。这篇文章强调了基于云计算服务的HISs和E健康应用之间的标准化数据交换机制和互通性。这项服务在包含有大量的病人记录的HISs上提供一个单一的检索电子医疗记录和搜索此类信息的E健康应用的入口。再者,这项研究提出一个统一的安全平台提供给开发者、安全医疗提供者和组织者一个连接框架的渠道去检索和管理医疗记录,以及提供给大量注册者个人一个连接通道到自己的医疗记录(PHR)。此项服务和平台已经在埃及亚历山大大学医学院示范的医生、病人和医院管理者之间进行了定性的评估。评估结果比较乐观,不过原型的实现还需要更多的研究。Asmaa S.Radwan Ayman A.Abdel-Hamid Yasser Hanafy 尹捍东 2013电子世界2013,,17:2
19Seed germination and proline accumulation in Rice ( Oryza sativa L ) as affected by salt concentrations 显示文摘MOMAYEZI M R ZAHARAH A R HANAFI M M 2009J Trop Agric Food Sci2009,32,2:1
20Fuzzy γ- open sets and fuzzy γ- Connectivity显示文摘Hanafy IM 1999J Fuzzy Math1999,7,2:1
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