Prediction of liver transplantation prognosis by transient elastography / 中华器官移植杂志

Objective To investigate the clinical value of transient elastography in adult after liver transplantation,by means of evaluating the correlation of liver stiffness measured by FibroScan with liver/renal functions.Method Forty-three patients received orthotopic liver transplant in our hospital during Dec.10,2013 and Mar.19,2014 were included in this study.Liver stiffness measurement (LSM) was performed after transplantation.Clinical data and laboratory tests including liver function and renal function were collected and analyzed.Result Bivariate correlation showed that body mass index (BMI),MELD score,graft-to-recipient weight ratio (GRWR) and warm ischemia time had no correlation with LSM.LSM at the 1st day after transplantation (LSM-1) showed no correlation with cold ischemia time,but LSM at the 7th day after transplantation (LSM-7) did,with R =0.335,P =0.028.LSM-1 showed positive correlation with the ICU time (R =0.488,P =0.001),but LSM-7 didn't.There was significantly positive correlation between LSM and aspartate aminotransferase,bile acid and creatinine,but no significant correlations were found between LSM and alanine arninotransferase,alkaline phosphatase,cholinesterase,gamma-glutamyl transferase,total bilirubin,direct bilirubin,indirect bilirubin,urea nitrogen and uric acid.The group with higher LSM-1 had longer ICU time than the lower group (9 d vs,7 d,P =0.013),and so was the hospital stay (34 d vs.23 d,P =0.023).For the LSM-7,there was no significant difference in ICU time and hospital stay between the two groups.The group with higher LSM-1 had higher serious complication incidence than the lower group (78.57％ vs.27.59％,P =0.002),but the two groups in LSM-7 showed no significant difference in serious complication incidence.Conclusion The LSM partially correlates with the liver function and renal function of liver transplantation recipient,and may have its clinical value for assessing the early prognosis after liver transplantation.

Hepatic artery resection and reconstruction in radical resection of hilar cholangiocarcinoma / 中华普通外科杂志

Objective To evaluate hepatic artery resection and microsurgical reconstruction in radical resection of Klatskin's tumor.Methods We retrospectively reviewed clinical data of 7 patients with advanced hilar cholangiocarcinoma (Klatskin's tumor) who underwent left hemihepatectomy combined with right hepatic artery resection and microsurgical reconstruction with or without portal vein reconstruction from August 2008 to March 2012.Results Right hepatic artery was reconstructed with end-to-end anastomosis,using the reserved left hepatic artery (n =1),the remanent right hepatic artery (n =1),the hepatic artery proper (n =4) and the gastroduodenal artery (n =1),among those 2 patients underwent concomitant portal vein reconstruction.Post-operative pathology showed middle to low differentiated adenocarcinoma in 2 patients,low differentiated adenocarcinoma in 3 and papillary adenocarcinoma in 2.R0 resection was achieved in 6 patients.There was no post-operative liver failure,biliary-enteric anastomotic leakage or perioperative deaths.Conclusions Hepatic artery resection and microsurgical reconstruction increases the radical resection rate of advanced hilar cholangiocarcinoma and decreases postoperative complications.

Clinical study of laparoscopic conservative surgery combined with medicine on prevention of persistent ectopic pregnancy / 中国医师进修杂志

Objective To investigate the efficacy of methotrexate combined with mifepristone prophylaxis for persistent ectopic pregnancy (PEP) after laparoscopic conservative surgery. Methods One hundred and twenty cases of tubal pregnancy were randomly divided into two groups by admission number, the study group (60 cases) were treated by mifepristone before laparoscopic conservative surgery and methotrexate combined with mifepristone after laparoscopic conservative surgery, but the control group (60 cases) were treated by laparoscopic conservative surgery, the bleeding was observated in the surgery,concentration of β-human chorionic gonadotrop ( β-hCG) was detected before operation and 1,3,7,12 d after operation. Results There were significant differences in β-hCG after operation 3,7,12 d between two groups(P<0.05). The bleeding was (21.8 ?.2) ml in study group,and (38.1 ?3.1) ml in control group, there was significant difference between two groups (P<0.05). In study group, the incidence of PEP was 0, and 3.33%(2/60) in control group. Conclusion Preoperative mifepristone and postoperative mifepristone combined with methotrexate in preventing PEP after laparoscopic conservative surgery is efficacy, and it can be chosen in clinic.

Effect of obstructive sleep apnea- hypopnea syndrome on hypertension and metabolism disorder / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#We investigated the influence of obstructive sleep apnea -hypopnea syndrome (OSAHS) on hypertension and metabolism.@*METHOD@#There were two groups in this research; they were the research group including 115 patients who were diagnosed with polysomnography and the control group of 122 healthy persons. The blood pressure in the morning, plasmas glucose (GLU), total cholesterol (TC), triglyceride (TG), and uric acid (UA) were measured. There were 32 moderate or severe OSAHS patients and 20 healthy persons were selected to be measured the mitochondrial coupling factor 6 (CF6) with radio-immunity method. The results were analyzed with statistic method. The P < 0.05 means the significant difference.@*RESULT@#The patients' blood pressure in the morning was significantly higher than the control healthy persons. The plasmas glucose, total cholesterol, triglyceride, and uric acid of the OSAHS patients were all in a higher level than those of the control group healthy persons. There were significant differences between the two groups. The mitochondrial coupling factor 6 (CF6) of moderate OSAHS patients or severe OSAHS patients was more than that of the healthy persons (P < 0.05).@*CONCLUSION@#OSAHS is a potential risk factor on the cardiovascular diseases and the metabolism disorders. The mitochondrial coupling factor 6 (CF6) may play an important role in the procedure of X syndrome.

Research of bone bridge-like on plasma sprayed HA coating / 生物医学工程学杂志

Bone formation on hydroxyapatite (HA) coating in the presence of gaps is important for clinical application. Pure Ti and hydroxyapatite coated by plasma sprayed samples were implanted in dog respectively. The implants were surrounded by gaps of 2 mm, and the follow-up period was 12 weeks. Histological examination and histomorphometry revealed that gaps could be bridged by bone provided the hydroxyapatite coating was applied, and that pure Ti implants were surrounded by fibrous tissue with no bone contact at all.

The Clinical Observations of the Treatment of Non-small Cell Lung Cancer with CT-guided Percutaneous Embedding of ~(125)I Particles in Combination with Chemotherapy / 昆明医科大学学报

Objective To observe the clinical effectiveness and adverse side effects of percutaneous embedding of ~(125)I particles in combination with chemotherapy for advanced non-small cell lung cancer(NSCLC).Methods Twenty-one patients with advanced NSCLC(IIIa-IIIb phase) received percutaneous embedding of ~(125)I particles in combination with concurrent chemotherapy.The chemotherapy was conducted in accordance with TP regime(paclitaxel at 135 mg/m~2 and cisplatin at 30 mg/m~2 were administered on day 1 and on day 2 to 4,respectively with 28 days as a cycle).12～75 ~(125)I particles were embedded with CT-guided percutaneous puncture one week after chemotherapy.The radioactivity quantum was 22～33 MBq per particle.The overall radioactivity quantum of embedded particles was 264-1650 MBq with one or more puncture points.Chemotherapy was then continued for two cycles.Results All the 21 patients completed the therapy,among whom,23.80% got complete response(CR),66.67% got partial response(PR) and 9.53% had stable or progressive disease(NC+PD) with an overall response(CR+PR) of 90.48%.The complications included hemopneumothorax(33.34%),hemorrhage(4.77%),particle migration(4.77%).The incidence rates of radiation esophagitis and radiation pneumonia with grade 1～2 were 4.77%(1/21) and 4.77%(1/21) respectively.No radiation esophagitis or radiation pneumonia with grade 3～4 was found.The incidence rate of grade 3～4 acute myelosuppression comprises 52.38% leucocytopenia,9.53% thrombocytopenia,28.58% decrease of hemoglobin,grade III-IV nausea and 42.86%vomiting,38.10% grade III-IV alopecia.The 1-year survival rate was 80.96%.The 12-month local control rate was 85.72%. Conclusion The results have shown that CT-guided percutaneous embedding of ~(125)I particles in combination with chemotherapy was effective and well-tolerable with few complications and good compliance.