ABSTRACT
Objective To investigate the distribution of traditional Chinese medicine (TCM) syndrome types and elements in liver cirrhosis patients with dysplastic nodules (DN), and to provide a basis for exploring the connotation and pattern of TCM syndrome types of DN in liver cirrhosis. Methods A total of 138 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from March 2013 to January 2021 and were diagnosed with liver cirrhosis and DN were enrolled. General data such as age of onset and sex were collected, as well as the data on etiology, TCM syndrome types, and Child-Pugh class for liver function, and the distribution characteristics of TCM syndrome types and elements were summarized. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results The liver and the spleen were the main syndrome elements of disease location in liver cirrhosis patients with DN, accounting for 97.83% and 94.93%, respectively, followed by the kidney (23.91%); Qi deficiency and Qi stagnation were the main syndrome elements reflecting the nature of disease, accounting for 73.91% and 58.70%, respectively, followed by dampness (34.78%). The main TCM syndrome types included stagnation of liver Qi and spleen deficiency, damp-heat internal excess syndrome, blood stasis and toxin accumulation syndrome, and water-dampness retention syndrome, among which stagnation of liver Qi and spleen deficiency was more common and accounted for 58.70% ( P 0.05). There was a significant difference in Child-Pugh class between the liver cirrhosis DN patients with different TCM syndrome types ( χ 2 =34.320, P < 0.05), and Child-Pugh class A was more common in the patients with stagnation of liver Qi and spleen deficiency (59.8%), while Child-Pugh class C was more common in the patients with damp-heat internal excess syndrome (39.1%). Conclusion This article summarizes the distribution characteristics of common TCM syndrome types and elements of DN in liver cirrhosis, which provides a reference for the syndrome differentiation-based TCM treatment of DN in liver cirrhosis.
ABSTRACT
In recent years, the existence of the Laennec′s capsule has been histologically confirmed and contributes to the Laennec′s approach based on Laennec′s capsule for anatomic hepatectomy. With the deep understanding of liver surgery, the importance of Laennec′s approach based on Laennec′s capsule could be recognized. Better use of Laennec′s capsule would be beneficial to the standardization of surgical technique, facilitate safe and precise anatomical liver resection.The application of Laennec′s capsule in hepatic inflow occlusion and intrahepatic segmentation was summarized in this study. The natural gap between Laennec′s capsule, the liver pedicle and hepatic veins can reduce the destruction of liver parenchyma and intraoperative hemorrhage, simplify surgical steps, shorten the time of Hilar occlusion and surgery.
ABSTRACT
Hilar cholangiocarcinoma (HCCA) is a common malignant tumor of the extrahepatic bile duct and has the features of special anatomical location, tumor growth along the bile duct, high degree of malignancy, and easy involvement of liver parenchyma. At present, the treatment methods for HCCA include surgical resection, non-surgical biliary drainage, neoadjuvant chemoradiotherapy, and photodynamic therapy, but surgical resection is still the preferred method. There are still controversies over the need for preoperative biliary drainage, portal vein thrombosis, and extent of surgical resection. This article elaborates on the research advances in the clinical typing of HCCA, preoperative examination and diagnosis, and treatment methods.
ABSTRACT
In this study, the rapid resolution liquid chromatography-quadrupole time-of-flight mass spectrometry (RRLC-QTOF/MS) was used to profile the metabolites of urine samples from chronic heart failure (CHF) patients and healthy controls to find the differential metabolites which could provide the scientific evidence to explain the pathogenesis of the disease and supply a better therapy plan.Urine samples from 15 CHF patients (age (62.27±3.14) years) and 15 healthy controls (age (65.41±4.63) years) were analyzed by RRLC-QTOF/MS.After processing the data, the multivariate statistical analysis (principal component analysis, PCA) was performed to find the potential biomarkers.Result showed that urine samples of CHF patients were successfully distinguished from those of healthy controls.Two significantly differentially expressed metabolites, uridine and alanyltryptophan, were found and identified as potential biomarkers.The result showed that the LC-MS based metabolomics approach had good performance to identify potential biomarkers, and the disorder of uracil metabolism and Tryptophan metabolism may play an important role in the mechanism of CHF.
ABSTRACT
Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.
ABSTRACT
Hilar cholangiocarcinoma (HCCA) is a common malignant tumor of the extrahepatic bile duct and has the features of special anatomical location, tumor growth along the bile duct, high degree of malignancy, and easy involvement of liver parenchyma. At present, the treatment methods for HCCA include surgical resection, non-surgical biliary drainage, neoadjuvant chemoradiotherapy, and photodynamic therapy, but surgical resection is still the preferred method. There are still controversies over the need for preoperative biliary drainage, portal vein thrombosis, and extent of surgical resection. This article elaborates on the research advances in the clinical typing of HCCA, preoperative examination and diagnosis, and treatment methods.