There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way...There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.展开更多
Impaired gastric accommodation is one of the most important etiologic factors in the pathophysiology of functional dyspepsia.Ultrasound is a potential alternative method to study changes in gastric volume as a reflect...Impaired gastric accommodation is one of the most important etiologic factors in the pathophysiology of functional dyspepsia.Ultrasound is a potential alternative method to study changes in gastric volume as a reflection of gastric accommodation.Ultrasound is suitable for patients because it is a non-invasive,easily repeated and non-radioactive procedure,and a previous study has demonstrated the feasibility of 3-dimensional ultrasound in examining functional dyspepsia.The brief article by Fan et al demonstrated that both the proximal gastric area and volume,measured by 2-and 3-dimensional ultrasound respectively,were significantly smaller in patients with functional dyspepsia than in healthy controls.These results are very interesting,but we raise the relevant point that it should have been mandatory to study both changes in gastric volume and their relationship with upper gastrointestinal symptoms in functional dyspepsia.In fact,the relationship between cardinal symptoms and several pathophysiologic mechanisms in functional dyspepsia remains a matter of debate.Moreover,further evaluation of distal gastric volume that has been previously implicated in the origin of functional dyspeptic symptoms is advisable.Therefore,impaired gastric accommodation does not serve as a clear marker of the cardinal symptoms experienced by patients with functional dyspepsia in daily life.展开更多
The asymptotic stability of delay differential equation x′(t)=Ax(t)+Bx(t τ) is concerned with,where A,B∈C d×d are constant complex matrices, x(t τ)=(x 1(t-τ 1),x 2(t-τ 2),...,x d(t-τ d))T,τ k>...The asymptotic stability of delay differential equation x′(t)=Ax(t)+Bx(t τ) is concerned with,where A,B∈C d×d are constant complex matrices, x(t τ)=(x 1(t-τ 1),x 2(t-τ 2),...,x d(t-τ d))T,τ k>0(k=1,...,d) stand for constant delays. Two criteria through evaluation of a harmonic function on the boundary of a certain region are obtained. The similar results for neutral delay differential equation x′(t)=Lx(t)+Mx(t-τ)+Nx′(t-τ) are also obtained,where L,M and N∈C d×d are constant complex matrices and τ>0 stands for constant delay. Numerical examples are showed to check the results which are more general than those already reported.展开更多
Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tum...Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS.展开更多
In this paper,some new criteria for univalence of analytic functions defined in the unit disk in terms of two parameters are presented.Moreover,the related result of Aharonov and Elias(Aharonov D,Elias U.Univalence cr...In this paper,some new criteria for univalence of analytic functions defined in the unit disk in terms of two parameters are presented.Moreover,the related result of Aharonov and Elias(Aharonov D,Elias U.Univalence criteria depending on parameters.Anal.Math.Phys.,2014,4(1-2):23–34)is generalized.展开更多
文摘There is continuing disparity between demand for and supply of kidneys for transplantation. This review describes the current state of kidney donation after cardiac death （DCD） and provides recommendations for a way forward. The conversion rate for potential DCD donors varies from 40%-80%. Compared to con-trolled DCD, uncontrolled DCD is more labour intensive, has a lower conversion rate and a higher discard rate. The super-rapid laparotomy technique involving direct aortic cannulation is preferred over in situ perfusion in controlled DCD donation and is associated with lower kidney discard rates, shorter warm ischaemia times and higher graft survival rates. DCD kidneys showed a 5.73-fold increase in the incidence of delayed graft function （DGF） and a higher primary non function rate compared to donation after brain death kidneys, but the long term graft function is equivalent between the two. The cold ischaemia time is a controllable factor that signifcantly infuences the outcome of allografts, for example, limiting it to 〈 12 h markedly reduces DGF. DCD kidneys from donors 〈 50 function like stan-dard criteria kidneys and should be viewed as such. As the majority of DCD kidneys are from controlled dona-tion, incorporation of uncontrolled donation will expand the donor pool. Efforts to maximise the supply of kid-neys from DCD include： implementing organ recovery from emergency department setting; improving family consent rate; utilising technological developments to optimise organs either prior to recovery from donors or during storage; improving organ allocation to ensure best utility; and improving viability testing to reduce primary non function.
文摘Impaired gastric accommodation is one of the most important etiologic factors in the pathophysiology of functional dyspepsia.Ultrasound is a potential alternative method to study changes in gastric volume as a reflection of gastric accommodation.Ultrasound is suitable for patients because it is a non-invasive,easily repeated and non-radioactive procedure,and a previous study has demonstrated the feasibility of 3-dimensional ultrasound in examining functional dyspepsia.The brief article by Fan et al demonstrated that both the proximal gastric area and volume,measured by 2-and 3-dimensional ultrasound respectively,were significantly smaller in patients with functional dyspepsia than in healthy controls.These results are very interesting,but we raise the relevant point that it should have been mandatory to study both changes in gastric volume and their relationship with upper gastrointestinal symptoms in functional dyspepsia.In fact,the relationship between cardinal symptoms and several pathophysiologic mechanisms in functional dyspepsia remains a matter of debate.Moreover,further evaluation of distal gastric volume that has been previously implicated in the origin of functional dyspeptic symptoms is advisable.Therefore,impaired gastric accommodation does not serve as a clear marker of the cardinal symptoms experienced by patients with functional dyspepsia in daily life.
文摘The asymptotic stability of delay differential equation x′(t)=Ax(t)+Bx(t τ) is concerned with,where A,B∈C d×d are constant complex matrices, x(t τ)=(x 1(t-τ 1),x 2(t-τ 2),...,x d(t-τ d))T,τ k>0(k=1,...,d) stand for constant delays. Two criteria through evaluation of a harmonic function on the boundary of a certain region are obtained. The similar results for neutral delay differential equation x′(t)=Lx(t)+Mx(t-τ)+Nx′(t-τ) are also obtained,where L,M and N∈C d×d are constant complex matrices and τ>0 stands for constant delay. Numerical examples are showed to check the results which are more general than those already reported.
文摘Endoscopic submucosal dissection(ESD)represents an organ-preserving alternative to surgical resection of early gastric cancer.However,even with ESD yielding en-bloc resection specimens,there are concerns regarding tumor spread such as with larger lesions,ulcerated lesions,undifferentiated pathology and submucosal invasion.Sentinel node navigational surgery(SNNS)when combined with ESD offers a minimally invasive alternative to the traditional extended gastrectomy and lymphadenectomy if lack of lymph node spread can be confirmed.This would have a clear advantage in terms of potential complications and quality of life.However,SNNS,though useful in other malignancies such as breast cancer and melanoma,may not have a sufficient sensitivity for malignancy and negative predictive value in EGC to justify this as standard practice after ESD.The results of SNNS may improve with greater standardization and more involved dissection,technological innovations and more experience and validation such that the paradigm for post-ESD resection of EGC may change and include SNNS.
基金The NSF(11501001)of Chinathe NSF(1908085MA18)of Anhui Provincethe Foundation(Y01002428)of Anhui University
文摘In this paper,some new criteria for univalence of analytic functions defined in the unit disk in terms of two parameters are presented.Moreover,the related result of Aharonov and Elias(Aharonov D,Elias U.Univalence criteria depending on parameters.Anal.Math.Phys.,2014,4(1-2):23–34)is generalized.
