Modelos de distribución de especies y estado de conservación de murciélagos amenazados en la región tumbesina de Ecuador y Perú / Species distribution models and conservation status of threatened bats in the Tumbesian region of Ecuador and Perú

Resumen Introducción: La biodiversidad se está perdiendo a un ritmo acelerado como resultado del cambio global. Herramientas como los modelos de distribución de especies (MDEs) han sido ampliamente usados para mejorar el conocimiento sobre el estado de conservación de las especies y ayudar a desarrollar estrategias de gestión para mitigar la pérdida de biodiversidad. Objetivo: Determinar cómo la distribución potencial predicha por los MDEs para ocho especies de murciélagos amenazados difiere de los mapas de distribución reportados por la UICN. También, inferir el área de distribución y estado de endemismo de cada especie, y evaluar la importancia de la región tumbesina para su conservación. Métodos: Basados en registros de presencia del rango global de las especies, usamos MDEs para evaluar el estado de conservación de estas ocho especies en la región tumbesina de Ecuador y Perú. Resultados: Las áreas estimadas por los MDEs eran 35-78 % más pequeñas para cuatro especies (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium y Lonchophylla hesperia) y 26-1 600 % más grandes para tres especies (Amorphochilus schnablii, Promops davisoni y Rhogeessa velilla) que aquellas reportadas por la UICN. Para Tomopeas ravus, el área estimada por el MDE y la UICN fue similar, pero difirió en la distribución espacial. Los MDEs coincidieron con áreas de endemismo informadas por autores previos para E. innoxius, R. velilla y T. ravus, pero fueron diferentes para A. schnablii, P. genovensium, P. davisoni y L. hesperia, debido en parte a las distribuciones proyectadas para estas últimas especies en valles secos interandinos según los MDEs. Conclusiones: La región tumbesina representa una porción significativa (40-96 %) de la distribución predicha de siete de las ocho especies estudiadas, subrayando la importancia de esta región para la conservación de murciélagos. Nuestros resultados muestran las probables distribuciones para estas especies y proporcionan una base importante para identificar vacíos de investigación y desarrollar medidas de conservación para murciélagos amenazados en el punto caliente de biodiversidad de Tumbes.

Abstract Introduction: Biodiversity is being lost at an accelerating rate because of global change. Tools such as species distribution models (SDMs) have been widely used to improve knowledge about species' conservation status and help develop management strategies to mitigate biodiversity loss. SDMs are especially important for species with restricted distributions, such as endemic species. Objective: To determine how potential distribution predicted by SDMs for eight threatened bat species differed from the distribution maps reported by the IUCN. Also, to infer the area of distribution and state of endemism of each specie, and to evaluate the importance of the Tumbesian region for their conservation. Methods: Based on presence records across the species' entire ranges, we used SDMs to assess the conservation status of these eight species in the Tumbesian region of Ecuador and Peru. Results: The areas estimated by SDMs were 35-78 % smaller for four species (Eptesicus innoxius, Lophostoma occidentale, Platalina genovensium and Lonchophylla hesperia) and 26-1 600 % larger for three species (Amorphochilus schnablii, Promops davisoni and Rhogeessa velilla) than those reported by the IUCN. For Tomopeas ravus, the area estimated by the SDM and IUCN was similar but differed in spatial distribution. SDMs coincided with areas of endemism reported by previous authors for E. innoxius, R. velilla, and T. ravus, but were different for A. schnablii, P. genovensium, P. davisoni, and L. hesperia, due in part to projected distributions for these latter species in dry inter-Andean valleys according to the SDMs. Conclusions: The Tumbesian region represents a significant portion (40-96 %) of the predicted distribution of seven of the eight species studied, underscoring the importance of this region for bat conservation. Our results show likely distributions for these species and provide an important basis for identifying research gaps and developing conservation measures for threatened bats in the Tumbes biodiversity hotspot.

Extent of lymphadenectomy for local advanced gastric cancer in the era of perioperative treatment and minimally invasive surgery / 中华胃肠外科杂志

The standard lymphadenectomy (D2) is the most important quality control index for the surgical treatment of locally advanced gastric cancer (LAGC). It is debatable whether there is a survival benefit of extended lymphadenectomy beyond D2 dissection. Para-aortic lymph nodes are not included in the range of D2 lymph node dissection. However, the patients with para-aortic node metastasis can get better survival after neoadjuvant chemotherapy and D2+ surgery. Lymph nodes along the superior mesenteric vein (No.14v) are considered as regional nodes, and the prognosis of patients with No.14v metastasis treated with D2+ lymph node dissection is significantly better than that of stage Ⅳ patients undergoing only D2 dissection. No.14v was not included in the D2 lymph node dissection paradigm. In case with nodal metastases in No.6 group, D2+ dissection is recommended. Lymph nodes at the splenic hilum (No.10) are not included in the range of D2 dissection, when the tumor infiltrates the greater curvature of the stomach, D2+ splenectomy or No.10 nodal dissection should be performed. Lymph nodes on the posterior surface of pancreatic head (No.13) do not belong to the D2 range, but the rate of metastasis is significantly higher when distal gastric cancer invades the duodenum, D2+ lymphadenectomy is recommended. Lymph node dissection in the posterior group of the common hepatic artery (No.8p) can improve the patient's long-term survival, but there is no support from of evidence-based medicine. In the era of perioperative treatment and minimally invasive surgery in China, open or laparoscopic D2 lymphadenectomy is recommended for cT3-4N1M0 patients and SOX neoadjuvant chemotherapy plus D2 surgery plus SOX adjuvant chemotherapy should be carried out for patients with cT3-4N2-4M0. Depending on the patient's condition and the experience of the surgical team, open or laparoscopic surgery can be performed.

In vitro lipolysis process and lipolysis mechanism of testosterone undecanoate type Ⅲ lipid formulations / 药学学报

The study evaluates the lipolysis rate and extent of type Ⅲ lipid formulations using testosterone undecanoate as a model drug after digestion with in vitro lipolysis model, and studies the digestive regularity with optical microscope and electrical conductivity. The results showed that for testosterone undecanoate type Ⅲ lipid formulations with castor oil as oil phase and Transcutol HP as latent solvent, the lipolysis rate and extent were increased with the increase of oil phase proportion and were decreased with excessive proportion of surfactant, in which can see liquid crystal phase during lipolysis process. The lipolysis rate of type ⅢB lipid preparations with different surfactant were ordered as Labrasol > Tween 80 > Cremophor EL, but the rate of type ⅢA is different in quick digestion phase and slow digestion phase. The lipolysis extent of type Ⅲ lipid formulations with different surfactant were ordered as Cremophor EL > Tween 80 > Labrasol. These may be related to the digestive effect of pancreatic lipase on different surfactants. This study implied that the lipolysis rate and extent of type Ⅲ lipid formulations are greatly influenced by the proportion of oil phase and surfactant, and the surfactant structure. These factors will affect the in vivo digestion and should be taken into account when screening type Ⅲ lipid formulations.

Assessing extinction risk from geographic distribution data in Neotropical freshwater fishes

The IUCN Red List (RL) provides high-quality conservation assessments for individual species, yet the rate and scale of environmental deterioration globally challenges the conservation community to develop expedited methods for risk assessment. Here we compare threat assessments for 3,001 species of Neotropical freshwater fishes (NFF) in the IUCN-RL using readily accessible data types as proxies for extinction risk: geographic range, elevation, and species publication date. Furthermore, using geographic and taxonomic data alone, we generated preliminary conservation assessments for 2,334 NFF species currently awaiting IUCN assessment, identifying an additional 671 NFF species as potentially threatened. This number of potentially threatened species represents an increase of 59% over the number of species currently assigned to threat categories by the IUCN-RL. These results substantially expand the number of threatened NFF species from 422 currently on the IUCN RL to 1,093 species as threatened or potentially threatened, representing about 18% of all NFF species. Extinction risk is greater in species with smaller geographic ranges, which inhabit upland rivers, and which were described more recently. We propose the Central and Southern Andes, and Eastern Guiana Shield as priorities in the upcoming IUCN RL assessment of NFF species conservation risk.(AU)

A Lista Vermelha (IUCN) fornece avaliações precisas sobre status de conservação das espécies, porém a taxa e escala de deterioração ambiental desafia a comunidade conservacionista a desenvolver métodos rápidos para avaliações de riscos de extinção. Aqui, comparamos as avaliações da IUCN para 3.001 espécies de peixes dulcícolas neotropicais com dados facilmente acessíveis de risco de extinção: extensão de ocorrências, altitude e data de publicação das espécies. Além disso, usando apenas dados geográficos e taxonômicos, geramos avaliações preliminares de conservação para 2.334 espécies de peixes neotropicais aguardando avaliação da IUCN, e identificamos 671 espécies adicionais como potencialmente ameaçadas. Este número de espécies potencialmente ameaçadas representa um aumento de 59% em relação aquelas classificadas nas categorias de ameaça pela IUCN. Estes resultados expandem o número de espécies ameaçadas segundo a IUCN de 422 para 1.093 espécies ameaçadas ou potencialmente ameaçadas, representando cerca de 18% das espécies de peixes neotropicais. O risco de extinção é maior para espécies com distribuições geográficas restritas, que habitam rios de terras altas e que foram descritas mais recentemente. Sugerimos a região Central e Meridional do Andes e o Escudo das Guianas Orientais como prioridades para as próximas avaliações da IUCN sobre a conservação das espécies de peixes dulcícolas neotropicais.(AU)

Farmers Extent of Adoption of Climate Resilient Agro-technologies

Climate change is possibly the most significant environmental challenge and possess serious threats to sustainable development in the world and more so in developing countries. Impact of climate change affects ecosystems, water resources, food and health. To adapt to the change and overcome the threats of climate change several climate-resilient agro-technologies have been introduced under the National Innovations on Climate Resilient Agriculture (NICRA) Project. The present study was conducted in Lakhimpur District of Assam to measure the extent of adoption of the climate-resilient agro-technologies introduced under the NICRA Project by the participant and non-participant farmers. A total of 160 farmers, 80 NICRA participant farmers and 80 non-participant farmers were interviewed. Findings revealed that the majority of the participant farmers (68.75 per cent) had a medium extent of adoption followed by 17.50 per cent with a low extent of adoption of climate-resilient agro-technologies. Only 13.75 per cent of the participant farmers were found to have a high level of adoption of climate-resilient agro-technologies. Among the non-participant farmers, majority of them (75.00 per cent) had a low extent of adoption followed by 17.50 per cent with a medium extent of adoption of climate-resilient agro-technologies. Only a very small proportion of them (7.50 per cent) had a high extent of adoption of climate-resilient agro-technologies.

Projected impact of global warming on the distribution of two pocket mouse species with implications on the conservation of Heteromys nelsoni (Rodentia: Heteromyidae)

Introduction: Understanding how species respond to climate change is critical for implementing conservation strategies. Objective: We explain through potential distributions and changes in altitudinal variation, the possible impacts of climate change in an endangered micro-endemic rodent of Mexico with narrow altitudinal range, Heteromys nelsoni and a rodent with a wide distributional and altitudinal range, Heteromys goldmani. Methods: We obtained historical and current records of both Heteromys species. Potential distribution models were generated using Maxent, including altitudes for each species and bioclimatic layers. We determined the Extent of Occurrence and Area of Occupancy for H. nelsoni according to the criteria of the IUCN in order to generate information about its risk status. Results: The altitude is not a variable that determines a shift in the distribution caused by climate change. In contrast, the temperature and precipitation are important for the potential distribution of both Heteromys species. The future changes in climatic conditions could reduce the area of suitable habitat for both species. Conclusions: The distribution surface is not greater than 33.44 km2 for H. nelsoni. Therefore, is urgent to re-evaluate their conservation status by the IUCN, mainly in its B criterion, and to take specific actions for their conservation. We suggest the creation of a terrestrial protected area.

Introducción: El entendimiento de cómo las especies responden al cambio climático es crítico para la implementación de estrategias de conservación. Objetivo: Explicar a través de distribuciones potenciales y cambios en la variación altitudinal, los posibles impactos del cambio climático en un roedor micro endémico de México, en peligro de extinción y con un rango altitudinal estrecho, Heteromys nelsoni y un roedor con una amplia distribución y rango altitudinal, Heteromys goldmani. Metodología: Obtuvimos registros históricos y actuales de ambas especies. Los modelos de distribución potencial se generaron utilizando Maxent, incluyendo altitudes y capas bioclimáticas. Determinamos la extensión de su presencia y el área de ocupación para H. nelsoni según los criterios de la IUCN, para generar información sobre su estado de riesgo. Resultados: La altitud no es una variable que determina un cambio en la distribución causada por el cambio climático. En contraste, la temperatura y precipitación son importantes para la distribución potencial de ambas especies de Heteromys. Los análisis sugieren que los cambios futuros en las condiciones climáticas podrían reducir el área de hábitat adecuado para ambas especies. Conclusión: La superficie de distribución de H. nelsoni no es mayor a 33.44 km2. Es urgente reevaluar su estado de conservación de la UICN, principalmente en su criterio B y tomar medidas específicas para su conservación. Sugerimos la creación de un área terrestre protegida.

New insights into leukotrichia in nonsegmental vitiligo: A cross-sectional study

Background: Leukotrichia has been considered a predictor of poor outcome in vitiligo. However, studies considering the different clinical aspects of leukotrichia in vitiligo patients are few. Aim: Our aim was to conduct a detailed clinical study to provide insights into the relevance and associations of leukotrichia in non-segmental vitiligo. Methods: In this cross-sectional study, vitiligo patients attending the dermatology outpatient clinic and phototherapy unit at Cairo University Hospital over a period of 6 months (April–September 2016) were included. Family history, clinical details, the Vitiligo Global Issues Consensus Conference classification, the Dermatology Life Quality Index, Vitiligo Area and Severity Index, Vitiligo Extent Score, Vitiligo Disease Activity Score and Vellus Score were determined and these measurements were correlated to leukotrichia. Results: Out of the 101 patients studied, leukotrichia was found in 47 (46.5%) patients, with vellus hair involved in 37 (78.7%), terminal hairs in 30 (63.8%) and both in 20 (42.5%) patients. Vellus hair involvement was significantly higher in generalized bilaterally symmetrical vitiligo than in acrofacial or unclassified vitiligo. The incidence of scalp leukotrichia also was higher in generalized symmetrical vitiligo than in acrofacial vitiligo. The Vellus Score showed significant associations with Vitiligo Area and Severity Index, Vitiligo Extent Score and the Dermatology Life Quality Index. Limitations: This was a short-term study with a small sample size. Prognostic and therapeutic correlations were not studied; prospective longitudinal studies are needed for further evaluation. Conclusion: Leukotrichia was found in almost half of the studied sample and its frequency varied among the different types of vitiligo.

Problems and strategy in surgical treatment of biliary tract tumors / 中华消化外科杂志

Biliary tract tumor is a high degree malignancy,which presents with early metastasis and poor prognosis.However,the incidence keeps increasing in recent years compared with other digestive system tumors,the clinical and basic research started late.The biliary tract system is very complicated,it starts up to the liver,descending through the pancreas into the duodenum,involving these three organs,beside this,the portal vein and the hepatic artery are in close proximity.Thus,there are many problems to be solved in current surgical treatment,including how to assess accurately before surgery,whether to undergo preoperative biliary drainage,the extent of liver resection,the extent of lymph node dissection,whether venous involvement should be resected and constructed,whether liver transplantation is useful to these tumors,operation scope of early gallbladder carcinoma.

Threshold analysis of extent of resection for patients with gradeⅢgliomas using MRI / 中国医师进修杂志

Objective To evaluate the prognostic significance of extent of resection (EOR) in patients with gradeⅢglioma, and the MRI sequence best related with tumor volume. Methods Ninety-six cases were studied retrospectively who were diagnosed as glioma of grade Ⅲ gliomas at Dalian Medical University Affiliated Hospital of Dalian Municipal Central Hospital during the period from 2010 to 2015. EOR was calculated using preoperative and postoperative contrast-enhanced T1-weighted and T2-weightedfluid attenuated inversion recovery (T2Flair) MR images. Univariate and multivariate analyses were performed to evaluate the correlation between EOR and overall survival (OS). Results The results of univariate analysis showed that patients with age<50 years(P=0.032), preoperative KPS>80 scores (P<0.01), no edema (P=0.005), postoperative chemotherapy (P<0.01) and T2Flair EOR≥68% (P<0.01) had better prognosis. Cox multivariate regression analysis showed that age(P=0.008), edema (P＝0.003), postoperative chemotherapy(P=0.000) and T2Flair EOR (P=0.004) were independent factors of prognosis for grade Ⅲ glioma patients. Conclusions T2Flair-EOR is one of the most significant prognostic predictors in patients with grade Ⅲ gliomas. An important survival advantage is associated with T2Flair-EOR≥68% for patients with gradeⅢgliomas.

Evaluation of the Efficacy of Subcostal Transversus Abdominis Plane Block for Patients Undergoing Open Liver Carcinoma Resection / 中山大学学报(医学科学版)

@#【Objective】To evaluate the efficacy of three different methods of subcostal transversus abdominis plane（TAP）block for patients undergoing open liver carcinoma resection.【Methods】A total of 60 adult patients，undergoing elective open liver carcinoma resection through a“reverse L”incision below the rib bow，were enrolled. The subjects were randomly divided into three groups（20 cases in each），including Group A，B and C，according to the position of local anesthetic injection. All patients underwent ultrasound- guided bilateral subcostal TAP block under local anesthesia. The TAP injection was injected at the middle line of the clavicle in Group A；Two separate injections were at the parasternal line and at the anterior axillary line in Group B；Multiple injections were proformed between the anterior median line and the middle axillary line in Group C. After completion of TAP block，the onset time，duration，blocking extent，hemodynamics and abdominal muscle thickness were evaluated. The operating time of TAP block and incidence of complications were recorded.【Results】The blocking extent of Group B or Group C was greater than that of Group A（P < 0.05），with no significant difference between Group B and Group C. The duration of TAP block in Group B or Group C was longer than that of Group A，while the onset time was not significantly different between the three groups. The mean arterial pressure and heart rate during laparotomy were higher than the base value in Group A，while there were no evident changes in Group B and Group C. The rectus abdominis became thinner after TAP block in all patients，but there was no significant difference in muscle thickness change among the three groups. The operating time of TAP block in the three groups was （8.4±1.9），（13.8±3.1），（23.3±4.2）min，respectively，with significant difference between any two groups（P < 0.05）. None of the patients enrolled showed such complications as local anesthetic poisoning，abdominal wall hematoma，nerve injury， abdominal viscera injury，and puncture point infection.【Conclusion】The outcome of subcostal TAP block for patients undergoing open liver surgery is related to injecting position of anesthetics. Two- point-injection method is superior to one- point-injection method or multiple-point-injection method，for adequate analgesic extent as well as less operating time.

Investigation of extent of liver resection for liver cancer combined with liver cirrhosis / 中华消化外科杂志

Liver resection is widely accepted as firstline treatment for patient with liver cancer.Most patients with liver cancer have varied degrees of liver cirrhosis,which is an important risk factor adversely affect the outcomes of liver resection.The adverse effects are more significant as the increase of degree of liver cirrhosis.At present,it is generally believed that liver resection of 60％ volume is appropriate for patients with liver cirrhosis when liver function is within Child A.However,surgeons usually assess whether a patient has liver cirrhosis using "Yes" or "No",ignoring the pathological severity of liver cirrhosis.How to determine the extent of liver resection for patients combined with liver cirrhosis is still controversial.The authors have proposed a method for evaluating the degree of cirrhosis before and during surgery.It is believed that the extent of liver resection should be appropriately reduced with the increase of degree of liver cirrhosis.Further studies are needed to investigate how to accurately assess the severity of liver cirrhosis and how to scientifically determine the extent of liver resection before operation.

Surgical Extent of Metastatic Spine Tumor Excision and Its Effects on Postoperative Ambulatory Function: Comparison of Extensive Wide versus Palliative Excision Surgery

STUDY DESIGN: Retrospective study. OBJECTIVES: To compare surgical outcomes such as the ambulatory period and survival according to different surgical excision tactics for metastatic spine tumors (MSTs). SUMMARY OF LITERATURE REVIEW: Surgical outcomes, such as pain relief and survival, in patients with MSTs have been reported in several studies, but the effects of differences in surgical extent on the ambulatory period have rarely been reported. MATERIALS AND METHODS: Ninety-six patients with MSTs who underwent palliative (n=60) or extensive wide excision (n=36) were included. Palliative excision was defined as partial removal of the tumor as an intralesional piecemeal procedure for decompression. Extensive wide excision was defined as a surgical attempt to remove the whole tumor at the index level as completely as possible. The primary outcome was the ambulatory period following surgery. Other demographic and radiographic parameters were analyzed to identify the risk factors for loss of ambulatory ability and survival. Perioperative complications were also assessed. RESULTS: The mean postoperative ambulatory period was longer in the extensive wide excision group (average 14.8 months) than in the palliative excision group (average 11.7 months) (p=0.021). The survival rates were not significantly different between the two surgical excision groups (p=0.680). However, postoperative ambulatory status and major complications within 30 days postoperatively were significant prognostic factors for survival (p=0.003 and p=0.032, respectively). CONCLUSIONS: The extent of surgical excision affected the ambulatory period, and the complication rates were similar, regardless of surgical excision tactics. A proper surgical strategy to achieve postoperative ambulatory ability and to reduce perioperative complications would have a favorable effect on survival.

Indications of 5-Aminolevulinic Acid and Intraoperative MRI in Glioma Surgery: First Cases in Latin America in a Single Reference Center

Introduction The improvement on the extent of resection (EOR) of gliomas with the combination of 5-aminolevulinic acid (5-ALA) and intraoperative magnetic resonance imaging (iMRI) has been demonstrated in previous studies. We present our results with the combined use of 5-ALA and (iMRI) in the surgery of glial lesions. Methods A total of 64 cases of patients with intracranial gliomas who underwent image-guided surgery using 5-ALA with and without (iMRI) were reviewed. All patients underwent an early postoperative MRI to evaluate the EOR. Other intra-operative techniques (awake surgery, electrophysiological stimulation and monitoring) were also performed according to the location of the tumor. Results A total of 18 tumors did not show intraoperative 5-ALA fluorescence (according to the World Health Organization [WHO] classification of tumors, 2 WHO-grade I, 14 WHOgrade II, 1 WHO-grade III and 1 WHO-grade IV), and 46 tumors showed intraoperative 5-ALA fluorescence (3 WHO-grade II, 3 WHO-grade III, 40 WHO-grade IV). In 28 of the 46 5-ALA positive cases, a safe 5-ALA free resection was achieved. In the 5-ALA negative cases, the (iMRI) findings guided the EOR, and complete resection was achieved in 11 cases. Complete resection was opted out in gliomas infiltrating eloquent areas. Conclusions The combined use of 5-ALA and IMRI showed improved results in glioma surgery, offering the safest maximal EOR. In the 5-ALA positive cases (mostly highgrade), fluorescence was a more useful tool. In the 5- ALA negative cases (mostly lowgrade), the (iMRI) was decisive to guide the EOR of the tumor.

Introdução Em estudos anteriores, foi demonstrado um aperfeiçoamento na extensão da resecção (EDR) de gliomas com a combinação de ácido 5-aminolevulínico (5-ALA) e a imagem de ressonância magnética intraoperatória (iRM). Nossos resultados são apresentados com o uso combinado de 5-ALA e (iRM) para a cirurgia de lesões gliais. Métodos Foram revisados 64 casos de gliomas intracranianos submetidos a cirurgia guiada por imagem por meio do uso de 5-ALA, com ou sem RMI. Todos os pacientes foram submetidos a ressonância magnética (RM) pré-operatória para a avaliação da EDR do tumor. Outras técnicas intraoperatórias (cirurgia acordado, estimulação eletrofisiológica e monitoração) também foram realizadas segundo a localização do tumor. Resultados Um total de 18 tumores não apresentaram fluorescência com o 5-ALA (segundo a classificação de tumores da Organização Mundial de Saúde [OMS], 2 com grau OMS I, 14 com grau II, 1 com grau III e 1 com grau IV) e 46 tumores foram fluorescentes (3 com grau II, 3 com grau III, 40 com grau IV). Dos 46 casos positivos para 5-ALA, em 28 foi obtida uma ressecção segura e livre. Nos casos negativos para 5-ALA, os achados da (iRM) orientaram a EDR, e alcançou-se ressecção total em 11 casos. A ressecção total foi descartada em gliomas com infiltração em áreas eloquentes. Conclusões O uso combinado de 5-ALA e (iRM) mostrou melhores resultados na cirurgia de gliomas, oferecendo uma EDR de segurança máxima. Nos casos positivos para 5-ALA (a maioria de grau alto), a fluorescência mostrou-se um instrumento mais útil. Nos casos negativos para 5-ALA (a maioria de grau baixo), a RMI foi decisiva para orientar a EDR tumoral.

Prowess and controversies in the resection extent of hilar cholangiocarcinoma / 中华肝胆外科杂志

There have been different views over the resection extent of hilar cholangiocarcinoma worldwide.In this review,we will describe expert-views on the resection extent of hepatic tissue,as well as the hilar vascular resection and reconstruction.We hope this article will be helpful to the optimal operation of hilar cholangiocarcinoma.

Comparison of Two Biopharmaceutics Classification Systems and Discussion of Their Applications / 中国药学杂志

OBJECTIVE: To compare the difference between two kinds of biopharmaceutics classification systems and their applications. METHODS: Literatures and guidelines on biopharmaceutics classification system(BCS) and biopharmaceutics drug disposition classification system(BDDCS) were collected, the differences in conception, classification criteria, and application were compared, and problems which should be paid attention to in application were summarized. RESULTS:A lot of issues such as solubility, permeability, extent of metabolism and so on are involved in the application of BCS and BDDCS. Different classification criteria may have different results. The recognition for the two kinds of pharmaceutics classification systems by different administration organizations is not yet completely consistent. CONCLUSION:BCS and BDDCS play important roles in understanding the properties of drugs, especially in drug development and evaluation of generic drug conformance, however, the source of data should be identified when quoting the data. Possible risks should be considered for rational use of the data.

Analysis on the Implementation Effect of Zero Makeup Policy for Drug and Medical Supplies in a Top Three Hospital in Zhuhai / 中国药师

Objective:To assess the impact of zero makeup policy for drug and medical supplies on hospitals. Methods:Descrip-tive statistics and comparative analysis were used to analyze the related indicators, profit and loss calculation and the cost of patients from April 2014 to March 2017.Results:After the policy was implemented, the number of outpatients and the number of outpatients choosing general doctors decreased. The average length of hospitalization was 8.88 days, and the proportion of drug consumption was 34.10%. The number of outpatients choosing medical experts, the number of inpatients and the proportion of surgical treatment in-creased. Although the policy benefited patients,the average medical expenditure still increased. There was policy loss in the hospital. Conclusion:The reform promotes the implementation of hierarchical medical system, optimizes the hospital income structure and re-duces drug proportion significantly,which achieves the original intentions of the policy to some extent.

MR early evaluation of microwave ablation extent of liver: a clinical study / 介入放射学杂志

Objective To discuss the application of MRI in making early assessment of the coagulation extent of liver tumor after microwave ablation(MWA).Methods From January 1,2015 to January 31,2016,CT-guided percutaneous MWA was employed in 46 patients with liver tumor.A total of 55 hepatic lesions were detected in the 46 patients,the mean diameter of the lesion was (26.0±5.3) mm.On the second day after MWA,MRI was performed to evaluate the ablation effect,the ablated extent (long axis×short axis) was calculated,the results were compared with the referential data provided by manufacturer.The MWA-related complications,including inadequate ablation and excessive ablation,were recorded and analyzed.Results MRI performed on the second day after MWA showed that successful MWA treatment was obtained in all the 55 hepatic lesions,and no serious complications occurred immediately after ablation.The used parameter settings of microwave energy included 60 W-5 min (n=4),60 W-8 min (n=4),60 W-10 min (n=14),70 W-8 min (n=40),70 W-10 min (n=11) and 80 W-10 min (n=18);the corresponding ablated extents produced by the above parameter settings were 41.3 mm×31.2 mm,52.0 mm×36.3 mm,51.5 mm×34.3 mm,52.9 mm×35.5 mm,56.8 mm×36.1 mm and 64.0 min×44.0 mm respectively;all the above actual ablated values were larger than the referential data provided by manufacturer,and among them the real ablated extent of 80 W-10 min group carried the biggest difference with that provided by manufacturer (64.0 mm×44.0 mm vs.54.0 mm×37.0 mm,P＜0.01).No inadequate ablation of lesion was observed,and excessive ablation was seen in 12 lesions,presenting as the involvement of the hepatic capsule or even the subcutaneous muscle layer.Conclusion Early MRI examination after MWA can precisely evaluate the ablation extent.The results of this study indicate that the actual ablated value is bigger than the referential value provided by manufacturer.Accurate prediction of ablation range before MWA is helpful in ensuring a complete ablation as well as in improving the safety of MWA.

Classification of natural products as sources of drugs according to the biopharmaceutics drug disposition classification system (BDDCS) / 中国天然药物

Natural products (NPs) are compounds that are derived from natural sources such as plants, animals, and micro-organisms. Therapeutics has benefited from numerous drug classes derived from natural product sources. The Biopharmaceutics Drug Disposition Classification System (BDDCS) was proposed to serve as a basis for predicting the importance of transporters and enzymes in determining drug bioavailability and disposition. It categorizes drugs into one of four biopharmaceutical classes according to their water solubility and extent of metabolism. The present paper reviews 109 drugs from natural product sources: 29% belong to class 1 (high solubility, extensive metabolism), 22% to class 2 (low solubility, extensive metabolism), 40% to class 3 (high solubility, poor metabolism), and 9% to class 4 (low solubility, poor metabolism). Herein we evaluated the characteristics of NPs in terms of BDDCS class for all 109 drugs as wells as for subsets of NPs drugs derived from plant sources as antibiotics. In the 109 NPs drugs, we compiled 32 drugs from plants, 50% (16) of total in class 1, 22% (7) in class 2 and 28% (9) in class 3, none found in class 4; Meantime, the antibiotics were found 5 (16%) in class 2, 22 (71%) in class 3, and 4 (13%) in class 4; no drug was found in class 1. Based on this classification, we anticipate BDDCS to serve as a useful adjunct in evaluating the potential characteristics of new natural products.

Outcomes of surgical intervention for necrotizing enterocolitis within different pathological range / 中华实用儿科临床杂志

Objective To explore the surgical intervention outcomes of necrotizing enterocolitis (NEC)pa-tients with different extent of the disease.Methods The data of 25 pediatric patients with NEC who were treated with surgical intervention in Shanghai Children′s Hospital from December 201 1 to December 201 5 were retrospectively ana-lyzed.According to the extent of the disease,the patients were divided into 3 groups:focal disease(F),multisegmental disease(M),and pan -involvement(P).The information including operation style,survival rate and time for close osto-my was analyzed.Results There were 1 1 cases with F,8 cases with M,and 6 cases with P.All patients received lapa-rotomy surgery,colostomy,or peritoneal drainage.There were 1 2 patients with very low birth weight,7 patients with low birth weight,6 patients with normal birth weight in this study.There were 1 7 cases with gastrointestinal perforation (9 cases with pneumoperitoneum,8 cases without pneumoperitoneum),8 cases without digestive tract perforation (4 cases without pneumoperitoneum,4 cases with enterostenosis after conservative treatment).In this study,close ostomy was commonly conducted 3 -6 months after the operation,except for 3 cases who received 2 or more times of operation.The survival rate in F group was 1 00.0%(1 1 /1 1 cases),higher than those in the Mgroup with 62.5%(5 /8 cases)and P group with 1 6.7%(1 /6 cases)(χ2 =4.898,1 0.31 2,all P 0.05).Conclusions The extent of disease is correlated to the outcomes of surgical in-tervention,as F had a better outcome than Mand P.Low birth weight is a risk factor for NEC.Protecting the edge of the bowel is a key factor to ensure the survival and improve the quality of life of NEC patients.Close ostomy should be con-sidered when the patients are in a stable condition (liver function and intestinal function recovery,good nutrition condi-tion,etc),and under special circumstances to conduct early or delayed closure of fistula.

Surgical method and extent of reoperation in patients with concomitant strabismus / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To investigate the surgical method and extent of reoperation in the concomitant strabismus patients with surgical under-correction and over-correction. METHODS: Ninety - six concomitant strabismus patients with surgical under - correction and over -correction were recruited in this study, which included 41 males and 55 females, aged 21. 90±14. 70. All individuals underwent routine eye examinations for strabismus before the surgery. Among the cases with concomitant esotropia, there were over-correction in 23 cases, under-correction in 15 cases. Among the cases with concomitant exotropia, there were over-correction in 28 cases, under - correction in 30 cases. The method of reoperation were based on angle of deviation, the method of original operation and acute visual acuity of patients. RESULTS:In over - correction cases with concomitant esotropia, medial rectus muscle of 9 cases were advanced, the corrective extent was (5. 51±2. 63) ? / mm;9 cases were performed advance of medial rectus muscle and recession of lateral rectus muscle, the corrective extent was (6. 25±1. 59) ? / mm; 3 cases were performed resection of medial rectus muscle and recession of lateral rectus muscle, the corrective extent was (4. 26±1. 04) ? /mm; only 2 cases were performed recession of lateral rectus muscle, the corrective extent was (4. 21±1. 91) ? /mm. In under - correction cases with concomitant esotropia, 6 cases were performed resection of lateral rectus muscle, the corrective extent was (4. 03±0. 98) ? /mm; 6 cases were performed resection of lateral rectus muscle and recession of medial rectus muscle, the corrective extent was (6. 86 ± 1. 32) ? / mm; 3 cases were performed recession of medial rectus muscle, the corrective extent was ( 4. 33 ± 0. 29 ) ? / mm. In over -correction cases with concomitant exotropia, 16 cases were performed advance of lateral rectus muscle, the corrective extent was (5. 37 ± 1. 56) ? / mm; 6 cases were performed recession of medial rectus muscle, the corrective extent was (6. 29 ± 3. 68) ? / mm; 5 cases were performed advance of lateral rectus muscle and recession of medial rectus muscle, the corrective extent was (5. 46±1. 78) ? / mm; 1 case were performed resection of lateral rectus muscle, the corrective extent was 5. 00? / mm. In under - correction cases with concomitant exotropia, 12 cases were performed resection of medial rectus muscle, the corrective extent was (4. 47 ± 0. 54) ? / mm; 16 cases were performed recession of lateral rectus muscle and resection of medial rectus muscle, the corrective extent was ( 5. 11 ± 0. 75 ) ? / mm; 2 cases were performed recession of lateral rectus muscle, the corrective extent was (2. 65±0. 42) ? / mm. CONCLUSION: In reoperation of concomitant strabismus patients with over-correction, weakening or/and strengthening the horizontal muscle which were performed surgery before has a greater and more unstable surgical corrective extent. While In reoperation of concomitant strabismuspatients with under -correction, weakening or/ and strengthening the horizontal muscle which were not performed surgery has a normal corrective extent as usual.