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先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石的腹腔镜再手术经验
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作者 王增萌 彭春辉 +4 位作者 吴东阳 王凯 闫俊 黄心洁 陈亚军 《中华腔镜外科杂志(电子版)》 2024年第2期111-115,共5页
目的总结先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石的原因、腹腔镜再手术经验及手术效果。方法回顾首都医科大学附属北京儿童医院普外科2021年6月至2023年6月收治的17例先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石患儿的病例资料... 目的总结先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石的原因、腹腔镜再手术经验及手术效果。方法回顾首都医科大学附属北京儿童医院普外科2021年6月至2023年6月收治的17例先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石患儿的病例资料,总结吻合口狭窄/肝内胆管结石发生原因、腹腔镜再手术经验,对比再手术前后生化检查结果,并进行随访。结果17例患儿平均再手术年龄124.4±11.9个月,与前次根治手术的平均间隔时间73.9±11.4个月。原始胆总管囊肿Todani分型Ⅳa型11例(64.7%),Ⅰa型5例(29.4%),Ⅰc型1例(5.9%)。本次临床表现包括腹痛、发热、梗阻性黄疸、肝内胆管结石。再手术方式均为腹腔镜下手术,其中吻合口瘢痕狭窄9例(吻合口重建8例,吻合口扩大成形1例),肝总管先天性狭窄4例(吻合口重建2例,吻合口扩大成形2例),肝右动脉骑跨压迫肝总管2例(动脉前方吻合口重建),胆支肠襻粘连梗阻1例(粘连松解),先天性肝管膜状狭窄1例(隔膜切除后吻合口扩大重建)。再手术后1个月较术前中位丙氨酸氨基转移酶(21.6 vs.118.3 U/L,P<0.001)、门冬氨酸氨基转移酶(18.9 vs.162.0 U/L,P<0.001)、谷氨酰转肽酶(21.2 vs.418.9 U/L,P<0.001)、总胆红素(11.4 vs.27.3μmol/L,P=0.002)、总胆汁酸(6.4 vs.43.1μmol/L,P=0.002)水平均有明显下降。中位随访15.8个月,全部患儿均无临床症状复发、肝内胆管结石或肝功能异常。结论腹腔镜下手术可有效治疗先天性胆总管囊肿术后吻合口狭窄/肝内胆管结石,再手术策略是解除病因并重建宽阔平整的高位胆肠吻合口。 展开更多
关键词 腹腔镜手术 再手术 胆肠吻合口狭窄 肝内胆管结石 先天性胆总管囊肿 儿童
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Supporting IrO_(x) nanosheets on hollow TiO_(2) for highly efficient acidic water splitting
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作者 Ge Yu Ruilong Li +5 位作者 Yanmin Hu Xingen Lin Ze Lin dongyang wu Gongming Wang Xun Hong 《Nano Research》 SCIE EI CSCD 2024年第8期6903-6909,共7页
The efficiency of proton exchange membrane water electrolysis(PEM-WE)for hydrogen production is heavily dependent on the noble metal iridium-based catalysts.However,the scarcity of iridium limits the large-scale appli... The efficiency of proton exchange membrane water electrolysis(PEM-WE)for hydrogen production is heavily dependent on the noble metal iridium-based catalysts.However,the scarcity of iridium limits the large-scale application of PEM-WE.To address this issue,it is promising to select an appropriate support because it not only enhances the utilization efficiency of noble metals but also improves mass transport under high current.Herein,we supported amorphous IrO_(x) nanosheets onto the hollow TiO_(2) sphere(denoted as IrO_(x)),which demonstrated excellent performance in acidic electrolytic water splitting.Specifically,the annealed IrO_(x)catalyst at 150℃in air exhibited a mass activity of 1347.5 A·gIr^(−1),which is much higher than that of commercial IrO_(2) of 12.33 A·gIr^(−1) at the overpotential of 300 mV for oxygen evolution reaction(OER).Meanwhile,the annealed IrO_(x) exhibited good stability for 600 h operating at 10 mA·cm^(−2).Moreover,when using IrO_(x) and annealed IrO_(x) catalysts for water splitting,a cell voltage as low as 1.485 V can be achieved at 10 mA·cm^(−2).The cell can continuously operate for 200 h with negligible degradation of performance. 展开更多
关键词 oxygen evolution reaction hydrogen evolution reaction amorphous IrO_(x) hollow TiO_(2) proton exchange membrane water electrolysis
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Machine learning modeling identifies hypertrophic cardiomyopathy subtypes with genetic signature
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作者 Jiaqi Dai Tao Wang +15 位作者 Ke Xu Yang Sun Zongzhe Li Peng Chen Hong Wang dongyang wu Yanghui Chen Lei Xiao Hao Liu Haoran Wei Rui Li Liyuan Peng Ting Yu Yan Wang Zhongsheng Sun Dao Wen Wang 《Frontiers of Medicine》 SCIE CSCD 2023年第4期768-780,共13页
Previous studies have revealed that patients with hypertrophic cardiomyopathy(HCM)exhibit differences in symptom severity and prognosis,indicating potential HCM subtypes among these patients.Here,793 patients with HCM... Previous studies have revealed that patients with hypertrophic cardiomyopathy(HCM)exhibit differences in symptom severity and prognosis,indicating potential HCM subtypes among these patients.Here,793 patients with HCM were recruited at an average follow-up of 32.78±27.58 months to identify potential HCM subtypes by performing consensus clustering on the basis of their echocardiography features.Furthermore,we proposed a systematic method for illustrating the relationship between the phenotype and genotype of each HCM subtype by using machine learning modeling and interactome network detection techniques based on whole-exome sequencing data.Another independent cohort that consisted of 414 patients with HCM was recruited to replicate the findings.Consequently,two subtypes characterized by different clinical outcomes were identified in HCM.Patients with subtype 2 presented asymmetric septal hypertrophy associated with a stable course,while those with subtype 1 displayed left ventricular systolic dysfunction and aggressive progression.Machine learning modeling based on personal whole-exome data identified 46 genes with mutation burden that could accurately predict subtype propensities.Furthermore,the patients in another cohort predicted as subtype 1 by the 46-gene model presented increased left ventricular end-diastolic diameter and reduced left ventricular ejection fraction.By employing echocardiography and genetic screening for the 46 genes,HCM can be classified into two subtypes with distinct clinical outcomes. 展开更多
关键词 machine learning methods hypertrophic cardiomyopathy genetic risk
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儿童消化道择期手术后非计划再手术原因分析及其预后
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作者 王增萌 陈亚军 +3 位作者 彭春辉 庞文博 吴东阳 王凯 《中华普通外科杂志》 CSCD 北大核心 2022年第12期925-929,共5页
目的分析儿童消化道择期手术患儿术后发生非计划再手术的原因及其预后。方法回顾性分析2012年1月至2019年12月北京儿童医院普外科39例消化道择期手术后发生非计划再手术患儿的临床资料,分析原发疾病诊断、首次术式及手术级别、非计划再... 目的分析儿童消化道择期手术患儿术后发生非计划再手术的原因及其预后。方法回顾性分析2012年1月至2019年12月北京儿童医院普外科39例消化道择期手术后发生非计划再手术患儿的临床资料,分析原发疾病诊断、首次术式及手术级别、非计划再手术原因、非计划再手术术式以及患儿的预后。结果39例患儿的原发病包括胆道疾病、肛门和结直肠疾病及小肠疾病,其中二级手术4例(10%),三、四级手术35例(90%)。首次术式包括胆道-小肠手术19例(49%),单纯小肠手术11例(28%),肛门和结直肠手术9例(23%)。非计划再手术的直接原因包括吻合口漏(胆-肠、肠-肠)10例(26%),粘连性肠梗阻8例(20%),术后小肠套叠5例(13%),切口并发症(感染、裂开、切口疝)5例(13%),术后出血3例(8%),其他(首次手术损伤、术式选择缺陷)8例(20%)。术后24例患儿(62%)痊愈出院,9例患儿(23%)因非计划再手术导致需要进一步手术治疗,5例患儿(13%)死亡,1例(3%)发生短肠综合征。结论儿童消化道择期手术后非计划再手术大多发生于复杂手术,非计划再手术最常见的直接原因为吻合口漏、粘连性肠梗阻,非计划再手术对患儿的预后造成不良影响。 展开更多
关键词 再手术 消化系统外科手术 儿童 预后
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Whole-exome sequencing reveals genetic risks of early-onset sporadic dilated cardiomyopathy in the Chinese Han population 被引量:1
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作者 Lei Xiao dongyang wu +4 位作者 Yang Sun Dong Hu Jiaqi Dai Yanghui Chen Daowen Wang 《Science China(Life Sciences)》 SCIE CAS CSCD 2022年第4期770-780,共11页
To reveal genetic risks of early-onset sporadic dilated cardiomyopathy(DCM) patients in the Chinese Han population, we enlisted 363 DCM cases and 414 healthy controls. Whole-exome sequencing and phenotypic characteriz... To reveal genetic risks of early-onset sporadic dilated cardiomyopathy(DCM) patients in the Chinese Han population, we enlisted 363 DCM cases and 414 healthy controls. Whole-exome sequencing and phenotypic characterization were conducted. In total, we identified 26 loss-of-function(LOF) candidates and 66 pathogenic variants from 33 genes, most of which were novel.The deleterious variants can account for 25.07%(91/363) of all patients. Furthermore, rare missense variants in 21 genes were found to be significantly associated with DCM in burden tests. Other than rare variants, twelve common SNPs were significantly associated with an increased risk of DCM in allele-based genetic model association analysis. Of note, in the cumulative risk model, high-risk subjects had a 3.113-fold higher risk of developing DCM than low-risk subjects. Also, DCM in the high-risk group had a younger age of onset than that in the low-risk group. In terms of cardiac function, the mean left ventricular ejection fraction of patients with the deleterious variants was lower than those without(27.73%±10.02% vs. 30.61%±10.85%, P=0.026).To conclude, we mapped a comprehensive atlas of genetic risks in Chinese patients with DCM that might lead to new insights into the mechanisms and risk stratification for DCM. 展开更多
关键词 DCM GENETICS CASE-CONTROL risk stratification
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Nanofiber self-consistent additive manufacturing process for 3D microfluidics 被引量:1
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作者 Bin Qiu Xiaojun Chen +7 位作者 Feng Xu dongyang wu Yike Zhou Wenchang Tu Hang Jin Gonghan He Songyue Chen Daoheng Sun 《Microsystems & Nanoengineering》 SCIE EI CSCD 2022年第5期239-246,共8页
3D microfluidic devices have emerged as powerful platforms for analytical chemistry,biomedical sensors,and microscale fluid manipulation.3D printing technology,owing to its structural fabrication flexibility,has drawn... 3D microfluidic devices have emerged as powerful platforms for analytical chemistry,biomedical sensors,and microscale fluid manipulation.3D printing technology,owing to its structural fabrication flexibility,has drawn extensive attention in the field of 3D microfluidics fabrication.However,the collapse of suspended structures and residues of sacrificial materials greatly restrict the application of this technology,especially for extremely narrow channel fabrication.In this paper,a 3D printing strategy named nanofiber self-consistent additive manufacturing(NSCAM)is proposed for integrated 3D microfluidic chip fabrication with porous nanofibers as supporting structures,which avoids the sacrificial layer release process.In the NSCAM process,electrospinning and electrohydrodynamic jet(E-jet)writing are alternately employed.The porous polyimide nanofiber mats formed by electrospinning are ingeniously applied as both supporting structures for the suspended layer and percolating media for liquid flow,while the polydimethylsiloxane E-jet writing ink printed on the nanofiber mats(named construction fluid in this paper)controllably permeates through the porous mats.After curing,the resultant construction fluid–nanofiber composites are formed as 3D channel walls.As a proof of concept,a microfluidic pressure-gain valve,which contains typical features of narrow channels and movable membranes,was fabricated,and the printed valve was totally closed under a control pressure of 45 kPa with a fast dynamic response of 52.6 ms,indicating the feasibility of NSCAM.Therefore,we believe NSCAM is a promising technique for manufacturing microdevices that include movable membrane cavities,pillar cavities,and porous scaffolds,showing broad applications in 3D microfluidics,soft robot drivers or sensors,and organ-on-a-chip systems. 展开更多
关键词 FIBER FLUID ADDITIVE
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Identification of COL3A1 variants associated with sporadic thoracic aortic dissection: a case-control study
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作者 Yanghui Chen Yang Sun +13 位作者 Zongzhe Li Chenze Li Lei Xiao Jiaqi Dai Shiyang Li Hao Liu Dong Hu dongyang wu Senlin Hu Bo Yu Peng Chen Ping Xu Wei Kong Dao Wen Wang 《Frontiers of Medicine》 SCIE CSCD 2021年第3期438-447,共10页
Thoracic aortic dissection(TAD)without familial clustering or syndromic features is known as sporadic TAD(STAD).So far,the genetic basis of STAD remains unknown.Whole exome sequencing was performed in 223 STAD patient... Thoracic aortic dissection(TAD)without familial clustering or syndromic features is known as sporadic TAD(STAD).So far,the genetic basis of STAD remains unknown.Whole exome sequencing was performed in 223 STAD patients and 414 healthy controls from the Chinese Han population(N=637).After population structure and genetic relationship and ancestry analyses,we used the optimal sequence kernel association test to identify the candidate genes or variants of STAD.We found that COL3A1 was significantly relevant to STAD(P=7.35×10^(−6))after 10000 times permutation test(P=2.49×10^(−3)).Moreover,another independent cohort,including 423 cases and 734 non-STAD subjects(N=1157),replicated our results(P=0.021).Further bioinformatics analysis showed that COL3A1 was highly expressed in dissected aortic tissues,and its expression was related to the extracellular matrix(ECM)pathway.Our study identified a profile of known heritable TAD genes in the Chinese STAD population and found that COL3A1 could increase the risk of STAD through the ECM pathway.We wanted to expand the knowledge of the genetic basis and pathology of STAD,which may further help in providing better genetic counseling to the patients. 展开更多
关键词 sporadic thoracic aortic dissection exome sequencing gene COL3A1 case–control study extracellular matrix
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