ABSTRACT
Objective:To study the learning curve in laparoscopic left lateral hepatic sectionectomy.Methods:The clinical data of 62 consecutive patients who underwent left lateral hepatic sectionectomy by a single operator from February 2015 to May 2022 in General Hospital of Northern Theater Command were retrospectively analyzed. There were 22 males and 40 females, with mean ±s.d. of (50.7±11.7) years. The learning curve was depicted and evaluated by using the cumulative summation test. The general information, operation and postoperative indicators of the growth level group and the master level group were compared.Results:The average operation time of the 62 consecutive subjects was (172.9±70.1) minutes. Intraoperative blood loss was 100 (50, 200) ml. Two patients were converted to open hepatectomy. Clavien-Dindo grade I postoperative complications occurred in 20 patients (32.3%), with grade Ⅱ in 1 patient (1.6%) and grade Ⅲb in another patient (1.6%). The learning curve reached its highest point on the 20th patient by using the cumulative summation test. The study subjects were then assigned into the growth level group (patient 1-20) and the master level group (patient 21-62). The master level group had a significantly wider spread of patient age [(52.9±11.0) years vs (46.1±11.9) years], decreased operation time [(146.8±55.6) min vs (227.9±66.7) min], shortened drainage tube removal time [4(3, 5) d vs 6(4, 7) d] and decreased postoperative hospital stay [5(5, 7) d vs 6.5(4, 9) d] (all P<0.05) when compared with the growth level group. Conclusion:Left lateral hepatic sectionectomy was safe and feasible, and a single operator went through a learning curve of 20 patients before he/she could master the operation more proficiently.
ABSTRACT
Compared with traditional statistical models, machine learning in artificial intelligence has certain advantages in establishing predictive models. Currently, a large amount of research has been conducted on the application of machine learning in liver diseases. However, there is still no unified approach for selection of machine learning algorithms and steps of training different machine learning algorithms. As research progresses, predictive models based on machine learning combined with various omics have great potential in improving the diagnosis, treatment, and efficacy evaluation of liver diseases.
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Objective To explore the effect and mechanism of Toll-like receptor 4 (TLR4) on cerebral ischemia/reperfusion injury. Methods Rats were divided into a sham group, MCAO group, and MCAO+TAK group. Cerebral cortices were removed on day 1, 3, 7, and 14 post surgery. Morphological staining and Western blotting were used to detect pathological changes and TLR4 and P-IKKα/β expression in brain tissues. Results The pathological changes in the MCAO+TAK group were more severe than in the MCAO group on day 1 post surgery. However, the MCAO group exhibited more severe damage at the other time points. TLR4 expression was lowest in the cerebral cortices of the sham group. On day 1 and 14 post surgery, TLR4 expression was lower in the MCAO group than in the MCAO+TAK group, while on day 3 and 7 post surgery, TLR4 expression was higher in the MCAO group than in the MCAO+TAK group. P-IKKα/β expression was highest in the cerebral cortices of the MCAO group at all time points except for day 1. Conclusion TLR4 may alleviate cerebral ischemia reperfusion injury in rats on day 1 post surgery; however, TLR4 may exacerbate ischemia repeifusion injury 3 to 14 days post surgery. The mechanism may be due to the effect of P-IKKα/β expression in the cerebral cortex.
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Aim To study the effect of novel AChE inhibitors, 2-phenoxy-indan-1-one derivatives (YKY-1~7), against glutamatic acid-induced neurotoxicity in PC12 cells and on learning & memory impairment in dementia model mice induced by A?25~35 icv Methods The PC12 cells were preincubated with different concentrations of YKY-1~7 for 24 h and subsequently treated by glutamatic acid, at the high concentration of 2 mmol?L-1 for 15 min to induce cytotoxicity. The cell viability was assessed with MTT method.. Dementia model mice were made by intracerebroventricular injection (icv) of aggregated A?25~35. From the next day, the model mice were administered YKY-7 (2.5, 5, 10 mg?kg-1, ig) for 10 consecutive days and sham control mice or A? model control mice received daily ig saline. After the final treatment, the passive avoidance learning was tested, regional cerebral blood flow at cerebral cortex was assessed, and the activity of AChE in the cerebral cortex, hippocampus and blood serum were determined. Results Six out of the seven YKY compounds appeared to be effective against glutamatic acid-induced neurotoxicity in PC12 cells, with YKY-7 demonstrating the most activity. YKY-7 significantly ameliorated the learning and memory ability in dementia model mice induced by A?25-35 icv, slightly and selectively inhibited the cortical and hippocampal AChE, and gently increased the blood flow at cerebral cortex. Conclusion Some of 2-phenoxy-indan-1-one derivatives reported here have protective effects against glutamatic acid induced neurotoxicity in PC12 cells, and improve the learning and memory impairment induced by A?25-35, which may be partly attributable to its selective inhibition of AChE activity in the cerebral cortex and hippocampus.