ABSTRACT
Objective To analyze the relationship of neurocognitive impairments and 1 H MRS changes of the thalamus in patients with chronic hepatitis B virus related cirrhosis (HBV-RC).Methods Totally 28 patients with HBV-RC (cirrhosis group) and 28 well-matched healthy subjects (control group) were enrolled.All subjects underwent number connection test A (NCT-A) and the digit symbol test (DST) before MRS scanning.The ratios of peak area to each metabolite,including N-acetylaminosuccinic acid (NAA),choline (Cho),glutamine and glutamate (Glx),myoinositol (mI) and creatine (Cr) were calculated,respectively.Results Compared with control group,patients in cirrhosis group showed lower Cho/Cr and mI/Cr,higher Glx/Cr,prolonged NCT-A time and decreased DST scores (all P＜0.001).NCT-A completion time was negatively correlated with Cho/Cr and mI/Cr (r=-0.477,P =0.001;r=-0.695,P＜0.001) and positively correlated with Glx/Cr (r=0.665,P＜0.001).DST scores were positively correlated with Cho/Cr and mI/Cr (r =0.478,P =0.001;r=0.632,P＜0.001),and negatively correlated with Glx/Cr (r=-0.572,P＜0.001).Conclusion The neurocognitive impairments may be related to metabolic changes of the thalamus in patients with HBV RC.
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Objective To determine the efficacy of liver cancer resection combined with splenectomy for patients with hepatocellular carcinoma with hypersplenism.Methods Among 35 patients with hepatocellular cancer and hypersplenism treated from March 2004 to January 2006 at our hospital,12 patients accepted simultaneous liver cancer resection and splenectomy (the splenectomy group)and 23 only accepted liver cancer resection (the non-splenectomy group).The liver function,platelets and white blood cells were analyzed retrospectively.Results All the operations were successfully carried out.Within 1 week after operation,the white blood cell count increased from (3.2 ± 1.7) × 109/L to (8.5±-5.3) × 109/L,the platelet count increased from (52.6±23.7) × 109/L to (245.3±94.6) ×109/L(P＜0.01) in the group of patients with combined splenectomy,while little change occurred in the non-splenectomy group.The liver function in the splenectomy group recovered to the preoperational value within 1 week.Two years after operation,7 (58.3％) patients were still surviving in the splenectomy group and the mean tumor-free survival was (16.4 ± 4.3) months compared with (14.3 ±5.2) months in 10 (43.5％) patients in the non-splenectomy group,(P＜0.005).Conclusion Liver cancer resection combined with splenectomy was efficacious to hepatocellular cancer with hypersplenism.
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Objective To investigate the surgical approach of the reasonable radical resection for carcino-mas of pancreatic head. Method 35 of 110 patients with carcinomas of pancreatic head underwent the surgical ap-proach of the posterior aspect of the radical resection for carcinomas of pancreatic head, and histopathological findings and prognosis were analyzed. Results The rate of curative resection rate was 31.82%. 3 patients underwent pancre-atoduodenectomy with partial resection of SMV for 9 patients with macroscopic suspicion of invasion of the SMV. The survival rate of the 5 years was 17.14% and the patients exceed 10 years. Conclusion Surgical approach of the reasonable radical resection for carcinomas of pancreatic head allows the reasonable radical resection,and may lead to increasing the resectability rate and the prognosis in the patients with carcinomas of pancreatic head.