ABSTRACT
Children with biliary atresia generally present nutritional deficiency, and often have growth failure and neurodevelopmental impairments.Increasing evidence shows that malnutrition is not only a risk factor for growth failure and neurodevelopmental impairments in children with biliary atresia, but also a risk factor for morbidity and mortality.Nutritional support is extremely important to improve the prognosis.This article reviews the relationship between malnutrition, growth failure and neurodevelopmental impairments in children with BA, and discusses the timing and methods of nutritional support.
ABSTRACT
Objective@#To investigate the recovery of splenomegaly and hypersplenism after liver transplantation in children and explore the necessity of splenomegaly management before and during liver transplantation.@*Method@#The data of 22 children who were underwent liver transplantation with preoperative splenomegaly and hypersplenism who were not treated with splenomegaly before and during operation and with no recurrence of portal hypertension during postoperative follow-up in Department of Hepatobiliary Surgery, Children’s Hospital of Chongqing Medical University from December 2008 to January 2019 were collected. There were 13 male patients and 9 female patients with a median age of 6.5 months. The changes of erythrocyte, platelet, white blood cell and spleen length and thickness were analyzed by paired t-test before and at the 1st, 3rd and 6th months after surgery. Correlation analysis was performed on the change of spleen long diameter and thickness product and blood cell recovery.@*Results@#There were 21 cases of red blood cell decreased before surgery, with a mean value of(3.1±0.5)×1012/L, and(3.7±0.7)×1012/L, (4.6±0.6)×1012/L and (4.3±0.5)×1012/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the preoperative and postoperative groups were statistically significant (P<0.05). There were 7 cases of thrombocytopenia before operation, with an average of (70.0±17.0)×109/L, and (191.0±129.0)×109/L, (156.0±79.0)×109/L and (167.0±63.0)×109/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the first, third, and sixth months after surgery were significant compared with that before surgery (P<0.05). Leukocyte count decreased in 5 cases with an average value of (3.30±0.56)×109/L before surgery, (7.5±4.4)×109/L, (7.4±1.4)×109/L, (5.1± 2.5)×109/L at the 1st, 3rd and 6th months after operation, respectively. The differences between the two groups were significant (P<0.05). The average value of preoperative spleen length times thickness was (35.7±12.9) cm2 and at the 1st, 3rd, 6th month after surgery it was (26.2±8.1)cm2, (25.2±13.4)cm2, (27.2±7.4)cm2, respectively. The differences between the first, third months after surgery were significant compared with that before surgery (P<0.05). The white blood cell and platelet counts of children before and after surgery were correlated with spleen size negatively (correlation coefficients were -0.902, -0.933, respectively), and the differences were statistically significant (P<0.05).@*Conclusions@#In the early stage of liver transplantation, the size of spleen retracts to varying degrees, and hypersplenism can be alleviated continuously. Therefore, it is unnecessary to treat splenomegaly and hypersplenism before and during liver transplantation.
ABSTRACT
Objective To investigate the recovery of splenomegaly and hypersplenism after liver transplantation in children and explore the necessity of splenomegaly management before and during liver transplantation.Method The data of 22 children who were underwent liver transplantation with preopera-tive splenomegaly and hypersplenism who were not treated with splenomegaly before and during operation and with no recurrence of portal hypertension during postoperative follow-up in Department of Hepatobiliary Surgery,Children's Hospital of Chongqing Medical University from December 2008 to January 2019 were collected.There were 13 male patients and9 female patients with a median age of 6.5 months.The changes of erythrocyte,platelet,white blood cell and spleen length and thickness were analyzed by paired t-test before and at the 1st,3rd and 6th months after surgery.Correlation analysis was performed on the change of spleen long diameter and thickness product and blood cell recovery.Results There were 21 cases of red blood cell decreased before surgery,with a mean value of(3.1±0.5)X 1012/L,and(3.7±0.7)×1012/L,(4.6±0.6)×1012/L and(4.3±0.5)×1012/L at the 1st,3rd and 6th months after operation,respective-ly.The differences between the preoperative and postoperative groups were statistically significant(P＜0.05).There were 7 cases of thrombocytopenia before operation,with an average of(70.0±17.0)×109/L,and(191.0±129.0)×109/L,(156.0±79.0)×109/L and(167.0±63.0)×109/L at the 1st,3rd and 6th months after operation,respectively.The differences between the first,third,and sixth months after sur-gery were significant compared with that before surgery(P＜0.05).Leukocyte count decreased in 5 cases with an average value of(3.30±0.56)×109/L before surgery,(7.5±4.4)×109/L,(7.4±1.4)× 109/L,(5.1±2.5)×109/L at the 1st.3rd and 6th months after operation,respectively.The differences between the two groups were significant(P＜0.05).The average value of preoperative spleen length times thickness was(35.7±12.9)em2 and at the 1st,3rd.6th month after surgery it was(26.2±8.1)cm2,(25.2±13.4)cm2,(27.2±7.4)cm2,respectively.The differences between the first,third months after surgery were significant compared with that before surgery(P＜0.05).The white blood cell and platelet counts of children before and after surgery were correlated with spleen size negatively(correlation coefficients were-0.902,-0.933,respectively),and the differences were statistically significant(P＜0.05).Conclusions In the early stage of liver transplantation,the size of spleen retracts to varying degrees,and hypersplenism can be alleviated continuously.Therefore,it is unnecessary to treat splenomegaly and hyper-splenism before and during liver transplantation.
ABSTRACT
Objective To analyze the short-term and long-term effectiveness of radiofrequency ablation combined with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC).Methods The clinical data of 70 HCC patients who had received thermal ablation (group A) done or in combination with TACE (group B) were retrospectively analyzed.Results The rate of intrahepatic distant recurrence in group B (25 cases) was lower than that in group A (45 cases) (X2 =3.845,P =0.046) and the tumor-free survival rate was higher than group A (X2 =5.020,P =O.030).There were no differences in the local tumor progression rate (X2 =0.853,P =0.374) and overall survival (x2 =2.316,P =0.154) between two groups.Incidence of bone marrow suppression in group B was higher than that of group A (X2 =5.642,P =0.042).Major complications didn't occur in any group(X2 =2.016,P =0.183).The costs was higher(t =7.738,P ＜0.001) and the hospital stay was longer (t =5.921,P =0.003) in group B than group A.Conclusions Compared with ablation alone,combined therapy is able to reduce short-term recurrence,and improve tumor-free survival.Combine therapy is safe and effective method for small liver carcinoma.
ABSTRACT
Objective To construct the bioartificial liver by bone mesenchymal stem cell (BMSC) and alginate scaffold. Method Alginate scaffold was used as the cell carrier for the cultivation of BMSC and the differentiation from BMSC into hepatic like cells was induced by the cell factors of HGF, EGF and FGF-4 in the scaffold in vitro. The compatibility of the cells and the scaffold was observed by microscopy and the function of the differentiatd cells was tested. The gene of AFP and ALB was detected by RT-PCR. The secretion of ALB and the urea synthesis of the cells were tested by ALB kit and urea kit respectively. The glycogen synthesis and the CK-18 was tested by the glycogen stanning method and the immunofluorescence test. Results BMSC was able to attach, grow and proliferate well in the alginate scaffold, the well compatibility was observed by microscopy. ALB and urea were detected in the cultivating medium, the gene of ALB and AFP was identified by RT-PCR. The glycogen synthesis ability and the expression of CK-18 were induced during the differentiation. Conclusion The three dimensional atginate scaffold exhibited well compatibility with BMSC, BMSC could be differentiated into the hepatic like cell in the scaffold. BMSC and the alginate scaffold could be used to construct the bioartificial liver for the hepatic tissue engineering.
ABSTRACT
Objective To evaluate the efficacy of Budesonide/formoterol to control asthma under real-life conditions.Methods A muhi-center, open label, non-interventional study was conducted.Asthma control after 12 week therapy with Budesonide/formoterol was assessed by Asthma Control Questionnaire (ACQ) and modified Asthma Control Questionnaire (ACQ5).Results A total of 360 asthma patients were recruited,including 228 adult patients and 132 child patients.After 12 weeks' therapy,all the patients' medium value of ACQ was decreased significantly from 2.03 (adults 2.20, children 1.74) at baseline to 0.60 (adults 0.78, children 0.29) (P < 0.0001), and the medium value of ACQ5 was also decreased significantly from 2.4 (adults 2.24, children 1.76) at baseline to 0.47 (adults 0.62, children 0.20) (P < 0.0001).Conclusion Budesonide/formoterol is effective in asthma treatment, by which most asthma patients obtain and maintain clineal control.
ABSTRACT
Objective To evaluate a thrombolytic system of portal vein port-catheter kit (PC) in the treatment of portal vein thrombosis (PVT). Methods In this study, 42 PVT patients with liver cirrhosis and portal hypertension after splenectomy from 2005 to 2007 were divided into two groups. In group A (20 eases) thrombolysis was administered through the PC device. Urokinase at the dosage of 1000 U?kg-1?h-1 was given for a consecutive 3 -6 days through the PC, and then the therapy was converted to 100 AxaIU/kg of low molecular heparin twice a day for 7 days subcutaneously. In group B, the thrombolysis was performed on 22 patients through peripheral veins. The therapy was same as in group A except for that the urokinase dosage was doubled. The complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis, the long-term recurrence rate and the incidence of complication were compared between the two groups. Results The complete thrombolysis rate and the effective thrombolysis rate in group A were 75%, 90% respectively, compared with that of 41%, 59% respectively in group B. The significant differences in the complete thrombolysis rate, the effective thrombolysis rate, the time of thrombolysis and the incidence of complication were found between the two groups, while the thrombolysis recurrence rate had no significant difference between the two groups. Conclusion PC regime is an effective and safe method for the treatment of portal vein thrombosis.
ABSTRACT
Objective To evaluate the effect of combination splenectomy and endoscopic varices ligation in comparison with Hassab procedure in the treatment of portal hypertension. A prospective, controlled study was carried out on Splenectomy with EVL in comparision with portoazygous disconnection--the Hassab procedure to assess whether SEVL can achieve better results in the treatment of portal hypertension. Methods From Jan 1999 to June 2002, 103 cirrhotic patients with portal hypertension were admitted. These patients were randomized into two groups. Group A were treated by splenectomy combined with EVL(53 cases) , and group B were treated with Hassab procedure(50 cases). Results In both groups, there was a significant postoperative decrease in free portal pressure, the velocity and volume of portal flow (all P0.05). Portal vein thrombosis developed in 7 cases (13%) in group A, and in 14 cases (28%) in group B, P