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Objective@#To explore the feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) for the treatment of liver cancer with insufficient future liver remnant (FLR) .@*Methods@#The data regarding the clinical controlled trials in comparison of ALPPS and PVE in liver surgery were collected from the both domestic and international publications searched through the datebases of PubMed, Cochrane Library, Embase, CNKI, and VIP.Meta analysis was performed by RevMan 5.3 software.@*Results@#Total 10 studies with clinical control were analyzed (9 cohort studies and 1 randomized controlled study) .A total of 620 patients were included, with 165 cases in ALPPS group, 455 cases in PVE group.Results of Meta-analysis showed that there was statistically significant difference (P<0.05) between the two groups in the completion rate of two-steps surgery (OR=6.04, 95%CI: 2.97-12.31, Z=4.96) , FLR growth rate (MD=19.91, 95% CI: 8.64-31.18, Z=3.46) , two-steps surgical interval (MD=-30.48, 95%CI: -37.87--23.09, Z=8.09) , and R0 resection rate (OR=2.29, 95%CI=1.07-4.90, Z=2.13) .While there was no significant differences between the two groups in the mortality rate of postoperative within 90-days, postoperative the total complication rates, postoperative liver failure, and total hospital stay (all P>0.05) .@*Conclusions@#Compared to the PVE procedures, ALPPS appears an effective treatment method for liver tumor with insufficient FLR.Therefore, the applications of ALPPS and PVE are limited and depending on further investigation.
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Objective To establish the standardization process of acid-base balance analysis, analyze cases of acid-base balance disorder with the aid of acid-base balance coordinate graph.Methods The acid-base balance theory were reviewed systematically on recent research progress, and the important concepts, definitions, formulas, parameters, regularity and inference in the analysis of acid-base balance were studied. The analysis of acid-base balance disordered processes and steps were figured. The application of acid-base balance coordinate graph in the cases was introduced.Results The method of four parameters-four steps analysis was put forward to analyze the acid-base balance disorders completely. Four parameters included pH, arterial partial pressure of carbon dioxide (PaCO2), HCO3- and anion gap (AG). Four steps were outlined by following aspects: ① according to the pH, PaCO2 and HCO3-, the primary or main types of acid-base balance disorder was determined; ② primary or main types of acid-base disorder were used to choose the appropriate compensation formula and to determine the presence of double mixed acid-base balance disorder; ③ the primary acid-base balance disorders were divided into two parts: respiratory acidosis or respiratory alkalosis, at the same time, the potential HCO3- should be calculated, the measured HCO3- should be replaced with potential HCO3-, to determine whether there were three mixed acid-base disorders; ④ based on the above analysis the data judged as the simple AG increased-metabolic acidosis was needed to be further analyzed. The ratio of ΔAG↑/ΔHCO3-↓ was also needed to be calculated, to determine whether there was normal AG metabolic acidosis or metabolic alkalosis. In the clinical practice, PaCO2 (as the abscissa) and HCO3- (as the ordinate) were used to establish a rectangular coordinate system, through origin (0, 0) and coordinate point (40, 24) could be a straight line, and all points on the straight line pH were equal to 7.40. The acid-base balance coordinate graph could be divided into seven areas by three straight lines [namely pH = 7.40 isoline, PaCO2 = 40 mmHg (1 mmHg = 0.133 kPa) line and HCO3- = 24 mmol/L line]: main respiratory alkalosis area, main metabolic alkalosis area, respiratory+ metabolic alkalosis area, main respiratory acidosis area, main metabolic acidosis area, respiratory+ metabolic acidosis area and normal area. It was easier to determine the type of acid-base balance disorders by identifying the location of the (PaCO2, HCO3-) or (PaCO2, potential HCO3-) point on the acid-base balance coordinate graph.Conclusions Four parameters-four steps method is systematic and comprehensive. At the same time, by using the acid-base balance coordinate graph, it is simpler to estimate the types of acid-base balance disorders. It is worthy of popularizing and generalizing.
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Objective: To research three-dimensional computed tomography angiography (3D-CTA) combined three-dimensional digital subtraction angiography (3D-DSA) in the diagnosis of intracranial aneurysms. Methods: 3D-CTA and 3D-DSA were performed in 27 cases with Highly suspected in patients with intracranial aneurysms, And compared with the final outcome of surgery. To evaluate 3D-CTA and 3D-DSA in the detection rate of aneurysms, three-dimensional shape and spatial relations ability to display. Research 3D-CTA combined 3D-DSA in the diagnosis of intracranial aneurysms. Results: Twenty-seven cases of suspected patients, 25 cases of surgical treatment of confirmed aneurysms, 28 aneurysms found. 3D-CTA and 3D-DSA rate of aneurysms was no significant difference. 3D-CTA of the aneurysm can be accurately detected clearly shows its three-dimensional shape and spatial relationship with the surrounding skull, 3D-DSA for aneurysm neck, the tumor and the aneurysm and parent artery relationship shows clear and accurate. Conclusion: Imaging of intracranial aneurysm diagnosis, 3D-CTA and 3D-DSA have their respective advantages, combined two methods can improve the detection rate of aneurysms. 3D-CTA combined 3D-DSA have support of design for operation.
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Objective To explore disinfection efficacy of anerdian using swab and spray disinfection methods.Methods Hands of 30 subjects were randomly divided into the swab group and the spray group.The samples of before and after disinfection in each group were collected separately and observed their disinfection effect.Results The number of bacteria showed no significant difference between the two groups.The passing rate of disinfection reached 100％.The time of disinfection in the spray group was (2.58±0.32)s,significantly less than that in the swab group,(12.26±1.48)s,however,the drying time in the spray group was (42.37±1.79)s,significant longer than that in the swab group,(26.24±1.46)s.A subject hand disinfection used 0.5ml 0.2％ anerdian in the spray group,and 0.75ml 0.2％ anerdian and two cotton buds was used in the swab group.Conclusions There is identical disinfection efficacy between spray and swab methods.Spray disinfection method has short operating time,less use of disinfectant without using cotton buds,it is able to replace swab disinfection and will play an important role to reduce medical waste and health care costs.
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<p><b>BACKGROUND</b>Serine threonine kinase 15 (STK15) is a kind of mitotic kinase. The overexpression of STK15 is significantly associated with carcinogenesis in many tumors, however, its expression and significance in human lung cancer are still unclear. The aim of this study is to investigate the expression of STK15 in squamous cell carcinoma and adenocarcinoma of the lung and to analyze the correlation between STK15 expression and clinicopathological factors.</p><p><b>METHODS</b>The pattern of STK15 protein expression was detected in 44 squamous cell carcinomas, 36 adenocarcinomas and 20 paracancerous lung tissue samples by immunohistochemistry method using anti-STK15 antibody. The relative quantity of STK15 protein expression was detected by Western blot, and STK15 mRNA expression was detected by RT-PCR in 40 fresh lung cancer samples and corresponding paracancerous lung tissues.</p><p><b>RESULTS</b>Positive expression rate of STK15 protein was 68.75% (55/80) in lung cancer tissues and 0% in paracancerous controls (P < 0.001). STK15 expression was significantly related to differentiation grade of lung cancer (P=0.011), but not to histological classification, TNM stages or lymphatic metastasis (P > 0.05). The relative expression levels of STK15 protein (P < 0.001 ) and STK15 mRNA (P < 0.001) in lung cancer tissues were both significantly higher than those of corresponding paracancerous lung tissues.</p><p><b>CONCLUSIONS</b>The expression of STK15 protein and STK15 mRNA is significantly higher in lung cancer tissues than that in paracancerous lung tissues. The expression of STK15 correlates with differentiation of lung cancer.</p>
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The construction of biosafety laboratory was highly concerned these years because of the spread of high pathogenic diseases including SARS and avian influenza. In the past several years, the construction of many BSL-2/3 laboratories played an important role in preventing the dissemination of pathogens involved in the research. Meanwhile, serious problems were also raised because some project designers or constructors were not clear with the compulsory safety equipments in these laboratories so that the requirement of zero-leakage could not be achieved. The compulsory safety equipments emerging and disposing solid, liquid and gas offal in the biosafety laboratory were reviewed. The R&D of special equipments in biosafety laboratory in China was also introduced.