Predictors of outcome in the surgical treatment for epilepsy / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Knowledge about factors influencing the prognosis of resective epilepsy surgery can be used to identify which patients are most suitable for surgical treatment. The aim of this study was to identify preoperative prognostic factors associated with the chance of achieving long-term seizure freedom.</p><p><b>METHODS</b>We retrospectively reviewed seizure outcomes and clinical, electroencephalography (EEG), magnetic resonance imaging (MRI), histopathology, and surgical variables from 99 epilepsy surgery patients with at least one year of postoperative follow-up. Seizure outcomes were categorized based on the modified classification by the International League Against Epilepsy.</p><p><b>RESULTS</b>We found that the seizure-free rate was 27.9% after one year, and that it stabilized at about 20.0% between two and six years after surgery. Univariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis, MRI with visible focal lesions concordant with EEG, and regional ictal EEG and electrocorticography patterns were associated with a favorable surgical outcome. On the other hand, seizure recurrence within six months, incomplete focus resection, and surgical complications were associated with a poor outcome. Multivariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis and MRI with visible focal lesions were independent presurgical predictors of a favorable outcome (P < 0.01). Seizure recurrence within six months was the only significant independent predictor associated with a poor outcome (P < 0.01).</p><p><b>CONCLUSION</b>Hippocampal sclerosis and abnormal MRI findings are strongly associated with a favorable surgical outcome, whereas seizure recurrence within six months is associated with a poor outcome.</p>

Subcellular proteomic analysis of Tetrazanbigen on human hepatocellular carcinoma cell line QGY-7701 / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the clinical efficacy of cryotherapy ablation treatment for advanced hepatocellular carcinoma, and to analyse the predictive factors of cryotherapy ablation treatment.</p><p><b>METHODS</b>190 patients of hepatitis B-related advanced HCC from 2005 to 2008 in our hospital underwent curative cryoablation. We used clinical cohort method to analyze cryoablation group (147 cases) and control group (43 cases). The median OS (over survival time) and TTP (time to disease progression) were compared. We also evaluated the clinical significance of age, gender, location of portal vein tumor thrombus, HBeAg, tumor histological grade, Child-Pugh classification, end-stage liver disease (MELD) score, advanced liver cancer prediction system (ALCPS) score and the Eastern Cooperative Oncology Group performance status (ECOG PS) score for predicting the efficacy of cryoablation. Two Groups were compared with the x² test. Survival rates were estimated by the Kaplan-Meier method and compared by the log rank test. The Cox proportional hazards model was used to determine the independent factors on survival based on the variables selected in univariate analysis.</p><p><b>RESULTS</b>Median survival time of cryoablation group and Control group were 7.5 (4.2 to 14.6) months and 3.2 (1.2 to 8.6) months, median TTP were 3.5 (2.5 to 4.5) months and 1.5 (1.0 to 3.5 months), the differences between were statistically significant (P < 0.05). Median OS and TTP of advanced HCC patients who had Well-differentiated tumor, Child-pugh A-class and low score of MELD score, ALCPS score; ECOG PS score were significantly longer than that of the poorly differentiated tumor, Child-pugh B-class and the high those scores (P < 0.05). ECOG PS (P less than 0.05, 95% CI 1.074 - 2.143) and ALCPS (P < 0.05, 95% CI 1.005-2.121) were independent predictors for OS of advanced HCC.</p><p><b>CONCLUSIONS</b>Cryoablation treatment can prolong median OS and TTP of advanced HCC. ECOG PS and ALCPS are important predictors for survival time of advanced HCC.</p>

Application of molecular adsorbents recirculating system in the treatment for liver failure of hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the effect of treatments with the molecular adsorbents recirculating system (MARS) on liver failure patients of severe hepatitis B, in order to seek a safe and effective therapeutic method which contribute to the improved survival rate for severe hepatitis patients.</p><p><b>METHODS</b>52 liver failure patients of severe hepatitis B were performed intermittent MARS therapy for 6 to 8 hours per time in addition to standard medical treatment. Parameters in blood chemical data were collected before and after every treatment and analyzed in comparison with those parameters from controlled groups by means of plasma exchange and standard medical therapy.</p><p><b>RESULTS</b>MARS therapy achieved a remarkable improvement in clinical symptoms and physic signs, accompanied with a significant decrease in serum bilirubin, ammonia, urea nitrogen, fragrant amino acid, endotoxin, IL-6, and TNF-alpha levels (0.05); at the 72 hours bilirubin rebounding analysis. MARS treatments resulted in a significant decrease of bilirubin rebounding level in comparison with what PE did (0.01 ), though the bilirubin removal efficiency between two groups was not statistically significant. The overall survival rate of MARS therapy was 50% (26/52), which was better than that of standard medical therapy (40.5%, 17/42, P less than 0.05).</p><p><b>CONCLUSION</b>The results indicated that MARS was a safe and promising technology in the field of liver support therapy. It might be associated with considerable improved survival rate for liver failure patients.</p>