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Hepatocellular carcinoma (HCC) is a common malignant tumor and patients with HCC often have liver cirrhosis, with an extremely high 5-year recurrence rate and poor prognosis even after curative treatment. In recent years, sarcopenia has attracted more and more attention as a poor prognostic factor for various malignant tumors; however, there is still a lack of studies on the association between skeletal muscle index and prognosis of HCC in China. Evidence in foreign countries has shown that sarcopenia may be an a negative prognostic factor for HCC patients. This article reviews the etiology and possible pathogenesis of HCC-related sarcopenia and related intervention measures including nutritional supplementation, appropriate physical exercise, and medication, in order to provide a reference for related studies in China.
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Objective To compare the clinical efficacy of laparoscopic vs open choledocholithotomy plus T tube drainage for the treatment of extra-and intrahepatic cholangiolithiasis.Methods 300 patients with cholangiolithiasis undergoing surgical treatment in the Department of Hepatobiliary Surgery,Guizhou Provincial People's Hospital,from January 2012 to December 2016 were evaluated.Patients were divided into laparoscopic lithotomy of common bile duct plus T tube drainage group (n =120)and open surgery (n =180).Results The difference was not statistically significant in operation time (237 ±32) min,(t =0.671,P =0.504),operation success rate (100％),primary cure rate (81.7％),(x2 =0.400,P =0.531),residual stone rate (18.3％),(x2 =0.400,P =0.531),hospitalization costs (26 ±4) × 103 RMB,(t =0.981,P =0.329),perioperative complications including bile leakage(0),biliary bleeding (0),abdominal hemorrhage (0),acute cholangitis (0),(x2 =0.669,P =1.000),abdominal infection (0) and incisional infection (0),(x2 =1.342,P =0.518) and late complications including biliary stricture(0) and stone recurrence (11.7％),(x2 =0.022,P =1.000) between the two groups.While intraoperative blood loss (25 ± 14)ml,(t =-7.191,P =0.000),postoperative recovery time of gastrointestinal function (1.8 ± 0.6) d,(t =-5.847,P =0.000),postoperative hospital stay (10.1 ± 0.3) d,(t =-3.145,P =0.000),postoperative incision liquefaction (0),(x2 =26.415,P =0.000) were in favor of laparoscopy group with statistically significant difference.Conclusions For the treatment of extra-and intrahepatic cholangiolithiasis,it was feasible and effective for laparoscopic lithotomy of common bile duct plus T tube drainage.
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Objective To explore the value of Artis zeego robot imaging system endoscopic retrograde cholangiopancreatography (ERCP) for biliary calculi. Methods ERCP was performed on 12 patients with biliary tract dilation, diagnosed by B ultrasonography. Artis zeego robot was used simultaneously to acquire 3D images and biliary system reconstruction. The diagnostic consistency was assessed based on endoscopy and surgery if necessary. Results 3D rotating acquisition and biliary reconstruction were performed in the 12 patients. All diagnosis coincided with those of surgery and ERCP findings, achieving a consistency rate of 100%. Patients with extrahepatic bile duct stones of uncertain number (n = 2), with suspected biliary duct calculi ( n = 1 ) and with suspected intrahepatic bile duct stones ( n = 2) under ERCP were all diagnosed by the robot imaging system. Conclusion During ERCP, 3D rotating image acquisition and biliary reconstruction with Artis zeego robot is helpful for precise diagnosis of biliary tract stones.
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BACKGROUND: Because of the specificity and complexity of hepatic portal, carcinoma of bile duct of the hepatic portal is a difficulty in the surgical treatment. OBJECTIVE: To evaluate the safety and feasibility of simultaneous pancreaticoduodenectomy and liver transplantation for the end-stage hilar cholangiocarcinoma. RESULTS AND CONCLUSION: Pathology demonstrated a middle or low differentiation of hilar cholangiocarcinoma, and left, right hepatic duct, together with lobus quadratus were invaded. The tumor metastasized to hilar and posterior pancreatic lymphonodes, without involving the head of pancreas, duodenum and stomach. The function of transplanted liver recovered smoothly, and the endocrine and exocrine functions of pancreas were kept well. CA19-9 dropped to the normal levels. The patient recovered and discharged at 1 month after surgery, and still survived after one year follow up. These suggest that simultaneous pancreaticoduodenectomy and liver transplantation as a treatment of hilar cholangiocarcinoma are safe and feasible.
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【Objective】Finding the relative factors that influence the effect of electronic burn therapy in chronic cervicitis.【Methods】Some pathogens have been detected in 176 cases of patients with chronic cervicitis who have underwent electronic burn therapy.Some possible relative factors that influence the effect of electronic therapy in chronic cervicitis have been analysed.【Results】The relative factors include the degree of cervical erosion,character of cervical grume,degree of vaginal cleanness;puriform cervical grume,poor vaginal cleanness have higher positive rate of all kinds of pathogens.【Conclusion】Some relative pathogens should be detected and eliminated before electronic burn therapy in patients with chronic cervicitis.At least,those patients who present higher degree of cervical erosion,puriform cervical grume,poor vaginal cleanness should be treated with drug until these indexes improve before electronic burn therapy.
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Objective To assess the efficacy of laparoscopic salpingostomy in infertile women with distal tube obstruction. Methods 109 women with infertility underwent laparoscopic salpingostomy and the results were retrospectively analyzed. Results The total cumulative pregnancy rate was 32.9%.The cumulative pregnancy rate was 44.4% in the unilateral distal tube obstruction group after laparoscopic salpingostomy,while it was 20% in the bilateral distal tube obstruction patients(p
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After the dogs were inflicted with blast injury,high velocity shell fragment injury on one extremity,and blast-fragment combined injury,the morphological changes of the lungs were examined under gross inspection and with optical and transmission electron microscopes,and the lung/body weight index and lung water ratio were determined.It was found that high velocity shell fragment injury on one extremity could intensify the blast injury on the lungs by one grade.
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The changes of mean pulmonary arterial pressure (PAP) and 6-keto-PGF1a and TXB2 in the plasma and lung tissues of 3 groups of dogs (7 in each group) with blast injury (group Ⅰ),high velocity shell fragment injury on one of the extremities (group Ⅱ),and combined injury of the both (group Ⅲ) were investigated.It was found that PAP and TXB2 in the plasma and lung tissues increased after all the 3 kinds of injuries.The changes of PAP was most marked in group Ⅰ while those of TXB2 was more marked in groups Ⅲ and Ⅲ than in group Ⅰ.6-kcto-PGF1a increased in the plasma and lung tissues after blast and shell fragment injury but decreased in the plasma and showed no changes in the lung tissues after combined injury.The significance of these changes of 6-keto-PGF1a and TXB2 in the 3 kinds of injuryies were discussed.