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Objective: To investigate the association between prealbumin and the long-term prognosis of patients with hilar cholangiocarcinoma(HCCA) following radical surgery. Methods: The clinical data of 262 HCCA patients who underwent radical surgery admitted from January 2010 to January 2017 at the First Affiliated Hospital of Army Medical University were collected,retrospectively. There were 158 males and 104 females; aged (57.6±9.9)years old(range:32 to 78 years). According to the preoperative serum prealbumin level(170 mg/L),the patients were divided into low prealbumin group(n=143) and normal prealbumin group(n=119). Follow-up until September 2020,the main research indicator was overall survival(OS), and the secondary research indicator was recurrence-free survival(RFS). The measurement data conforming to the normal distribution adopted the t test,the measurement data not conforming to the normal distribution adopted the Mann-Whitney U test,and the count data adopted the χ2 test. The Kaplan-Meier method was used to calculate the cumulative survival rate. The Log-rank test was used for univariate analysis of the cumulative survival rate. Variables with P<0.10 in univariate analysis were included in the Cox proportional hazards model for multivariate analysis. Results: The 1-, 3-, and 5-year OS rate of the 262 patients was 73.4%, 32.1%, and 24.0%, respectively, and the 1-, 3-, and 5-year RFS rate was 54.6%, 25.2%, and 16.2%, respectively. Median OS and RFS were 21 months and 12 months for patients with low prealbumin and 25 months and 19 months for patients with normal prealbumin. The OS rate and RFS rate of patients in the low prealbumin group were lower than those in the normal prealbumin group, and the difference was statistically significant (both P<0.05). The results of univariate analysis indicated that low prealbumin, CA19-9>150 U/L, tumor infiltration length>3 cm, preoperative jaundice, macrovascular invasion, microvascular invasion, lymph node metastasis, and poor differentiation maybe the risk factors of OS,and low prealbumin,tumor invasion length>3 cm,macrovascular invasion, microvascular invasion,lymph node metastasis,and poor differentiation maybe the risk factors of RFS for postoperative for radical resection in patients with HCCA (all P<0.10). Multivariate results suggested that low prealbumin,tumor invasion length>3 cm,microvascular invasion,lymph node metastasis,and poor differentiation were independent risk factors affecting OS and RFS in patients with HCCA after radical operation (all P<0.05). Conclusion: Preoperative prealbumin level can predict the long-term prognosis of patients with hilar cholangiocarcinoma following radical surgery.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Bile Duct Neoplasms/surgery , Cholangiocarcinoma/surgery , Klatskin Tumor/surgery , Lymphatic Metastasis , Prealbumin , Prognosis , Retrospective StudiesABSTRACT
Object To investigate the changes of neurovascular coupling (NVC) in the contralateral cerebral motor region under the action of repetitive transcranial magnetic stimulation (rTMS) at different frequencies. Methods Some experiments were designed, the electroencephalography (EEG) signals and the near-infrared spectra (NIRS) of the subjects were obtained under different rTMS stimulation frequencies, and EEG power spectrum of each frequency band and NIRS blood oxygen signals to the contralateral movement area were computed and the change characteristics and correlation were analyzed.Results For different stimulation frequencies, the energy of each frequency band of EEG increased after the stimulation, and then decreased rapidly. The oxyhemoglobin (HbO2) concentration was decreased during stimulation, and then raised. The change rate of the two signals varied with different stimulation frequencies, while the change trend was the same.The EEG power spectrum was negatively correlated with the change of HbO2 concentration after stimulation, and it had delayed effect in varying degrees in the period after stimulation.Conclusion The effect of rTMS on the coupling of nerves and vessels in the contralateral cerebral motor region can be reliably revealed by the study of EEG combined with NIRS. This study will be helpful to the development of effective RTMS treatment parameters, and the results are expected to be applied in clinical treatment.
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Objective To explore the effect of the transcranial ultrasound stimulation(TUS)on transcranial magneto-acoustic stimulation(TMAS).Methods The healthy mice and Parkinson's disease(PD)mice were contrastively stimulated by TMAS and TUS.A TMAS group,a TUS group and a control group were established,and then the behavior and the electrophysiology results were analyzed and compared in the three groups. Results Both the chronic TMAS treatment and TUS treatment improved the motor ability and learning ability of the healthy mice and the PD mice. In addition, the TMAS-group mice showed better performances than the TUS-group mice and the ones in the control group.Conclusion TMAS has its effects promoted by TUS and mechanism explained in detail,which is actually a combined stimulation of coupling electric field and ultrasonic field.[Chinese Medical Equipment Journal,2018,39(5):17-21,49]
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Objective To solve the problem of the low signal to noise ratio (SNR)and limited imaging quality using single pulse exciting method in magnetoacoustic imaging, as well as the limited imaging speed using wave averaging processing method to magnetoacoustic signal. Methods M-sequence coded exciting method was proposed to enhance SNR imaging efficiency. The SNR improvement and sidelobe level were investigated using M-sequence code by simulation and experiments.Results The SNR of magnetoacoustic signal were 19.4,29.6,and 40.4 dB respectively under 7,31 and 127 bit M-sequence coded excitation. Three bits of M-sequence coded excitation magnetoacoustic signals had the integrated sidelobe level being 14.1,10.0 and 7.6 dB,and the peak sidelobe level being 26.3,24.3 and 21.3 dB.In case the SNR was increased by 40 dB,127 bit of M-sequence coded excitation shortened the sampling and procession time from 53.1 s to 0.520 s when compared with singl-pulse excitation combined with waveform average.Conclusion The coded excitation is significant for magnetoacoustic signal SNR and imaging quality improvement.
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Objective To research the influence of the thermoacoustic effect for the frequency of the magnetoacoustic signals in the magnetoacoustic tomography (MAT).Methods Some experiments were designed,and the magnetoacoustic signals and the thermoacoustic signals of several materials with different conductivities were analyzed and compared in the time domain and the frequency domain respectively,of which,copper and graphite were high-conductivity materials,and agar and pork were used as low-conductivity biological or similar tissue.Results The characteristics of the magnetoacoustic signals and the thermoacoustic signals of different materials were acquired.The results illustrated that there was a little drop in frequencies of acoustic signals of the materials with high conductivities while a big drop in frequencies of signals of the tissue-like materials comparing with the stimulant pulse.Furthermore,the main frequencies of acoustic signals were not accordant but much lower than the stimulant ones. Conclusion It is found that the thermoacoustic effect is related to the frequency of the acoustic signals. The drop in the center frequencies of the acoustic signals could be explained by the thermoacoustic effect of materials.The acoustic signals with lower main frequencies have the higher proportion of thermoacoustic signals.The studies could contributing to optimizing MAT method and improving MAT imaging quality.
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In this paper, we introduce a multiple electro-stimulative pulse generator based on IC555, which can produce continuous, discontinuous, frequency modulated and amplitude modulated modes, and thus multiple-output, independent adjustment & control are realized. The principle block diagram and a reference circuit are presented too. This design adds acusetor curing function to BME-500 series Chinese Acupuncture & Moxibustion Instrument, making it a multifunctional therapy device of electro-acupuncture, massage and drug permeation Moxibustion Instrument.