| 1 | Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis显示文摘AIM: To determine patient and process of care factors associated with performance of timely laparoscopic cholecystectomy for acute cholecystitis. METHODS: A retrospective medical record review of 88 consecutive patients with acute cholecystitis was conducted. Data collected included demographic data, co-morbidities, symptoms and physical findings at presentation, laboratory and radiological investigations, length of stay, complications, and admission service (medical or surgical). Patients not undergoing cholecystectomy during this hospitalization were excluded from analysis. Hierarchical generalized linear models were constructed to assess the association of pre-operative diagnostic procedures, presenting signs, and admitting service with time to surgery.RESULTS: Seventy cases met inclusion and exclusion criteria, among which 12 were admitted to the medical service and 58 to the surgical service. Mean ± SD time to surgery was 39.3 ± 43 h, with 87% of operations performed within 72 h of hospital arrival. In the adjusted models, longer time to surgery was associated with number of diagnostic studies and endoscopic retrograde cholangio-pancreatography (ERCP, P = 0.01) as well with admission to medical service without adjustment for ERCP (P < 0.05). Patients undergoing both magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) scans experienced the longest waits for surgery. Patients admitted to the surgical versus medical service underwent surgery earlier (30.4 ± 34.9 vs 82.7 ± 55.1 h, P < 0.01), had less post-operative complications (12% vs 58%, P < 0.01), and shorter length of stay (4.3 ± 3.4 vs 8.1 ± 5.2 d, P < 0.01).CONCLUSION: Admission to the medical service and performance of numerous diagnostic procedures, ERCP, or MRCP combined with CT scan were associated with longer time to surgery. Expeditious performance of ERCP and MRCP and admission of medically stable patients with suspected cholecystitis to the surgical service to speed up time to surgery should be considered. | Chris N Daniak David Peretz Jonathan M Fine Yun Wang Alan K Meinke William B Hale | 2008 | World Journal of Gastroenterology2008，14，7： | 13 |
| 2 | Mechanisms underlying the cardiac pacemaker: the role of SK4 calcium-activated potassium channels显示文摘心脏的心律调整器的合适的表示和功能是心生理学的一个批评特征。在人权中庭的 sinoatrial 节点(圣) 每分钟产生电的刺激约 70 次,它从一个传导性的网络宣传到在收缩期间导致房间收缩的心肌层。尽管 SAN 和另外的节的传导性的结构超过一个世纪以前被识别,涉及心脏的自动性的产生的机制仍然保持高度辩论了。在这短评论,我们调查与人的心脏的传导系统和被建议了位于心律调整器活动下面的各种各样的机制的开发有关的当前的数据。我们也介绍人的胚胎的茎导出房间的 cardiomyocyte 系统,它作为一个模型被使用学习心律调整器。最后,我们在心律调整器房间描述我们 SK4 Ca 2+-activated K + 隧道传导力的以前未被认出的角色的最近的描述。由精致地在心脏舒张的去极期间平衡里面的水流, SK4 隧道看起来在人的心脏的自动性起一个关键作用。 | David WEISBROD Shiraz Haron KHUN Hanna BUENO Asher PERETZ Bernard ATTALI | 2016 | Acta Pharmacologica Sinica2016，37，1： | 4 |
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