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Article in Chinese | WPRIM | ID: wpr-745357


Objective To compare the safety and short-term efficacy of laparoscopic repeat hepatectomy (LRH) with open repeat hepatectomy (ORH) for recurrent hepatocellular carcinoma (rHCC).Methods The clinical data of 33 patients with rHCC who underwent hepatectomy at Nanfang Hospital,Southern Medical University from August 2015 to November 2017 were retrospectively analyzed.There were 24 males and 9 females.The patients were divided into LRH group (n=15) and ORH group (n=18).The preoperative clinical data,operative and postoperative data of the two groups were compared.Results No significant differences were observed in the preoperative clinical data of the two groups,including the extent of the previous hepatectomy,the interval between the two surgeries,the number of tumors,and the maximum diameter of tumors.No significant differences were observed in the liver resection method,portal occlusion time and operation duration between the two groups.Blood loss was significantly lower in the LRH group [(66.7±86.1) ml vs.(251.1±75.6) ml,P<0.05].The total hospitalization expenses,first postoperative white blood cell count,and hepatic insufficiency in the two groups were not significantly different (P>0.05).The postoperative diet recovery was significantly shorter (1.2±0.4) days vs.(2.9± 1.4) days,the inflammation indicator NEU% was significantly decreased (83.6±4.8)% vs.(88.2±3.7)%,and the length of postoperative hospital stay (6.3±2.9) days vs.(9.8± 3.7)days was significantly shorter in the LRH group (P<0.05).Conclusions LRH was safe and effective in the treatment of rHCC,LRH was superior in reducing intraoperative blood loss,promoting postoperative recovery and shortening hospital stay when compared to ORH.

China Journal of Endoscopy ; (12): 91-94, 2017.
Article in Chinese | WPRIM | ID: wpr-621125


Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.

Article in Chinese | WPRIM | ID: wpr-482374


Objective To determine the expression of CD38 and HLA -DR on CD +8 T cells in patients with chronic hepatitis B and HBV carriers,and to disscuss the relation between immune activation and disease progression of HBV infection.Methods Thirty -two chronic hepatitis B patients receiving adefovir dipivoxil treatment,31 HBV carriers and 28 normal controls were collected.The counts of CD +4 and CD +8 T cells and the percentage of CD +8 CD +38 and CD +8 HLA -DR +T cells were tested by flow cytometry.HBV DNA and liver function were tested in the central laboratory of our hospital.Results The percentage of CD +8 CD +38 T cells in CHB patients was (58.4 ±12.7)%,and was higher than that in HBV carriers (46.8 ±8.5)% and normal controls (46.8 ±8.5)%,and decreased after adefovir dipivoxil treatment (34.2 ±9.4%)(F =8.27,P =0.000).The percentage of CD +8 CD +38 T cells in HBV carriers was (43.3 ±12.5)%,and was much higher than that in normal controls (9.8 ±5.7)%(F =13.48,P =0.000).The percentage of CD +8 HLA -DR + T cells in CHB patients was higher than that in normal controls,but similar to that in HBV carriers (37.1 ±11.3)%.CD +8 HLA -DR + T cells in CHB patients also decreased after adefovir dipivoxil treatment (P <0.05 ).Conclusion Our study demonstrates that activation of CD +8 T cells is increased in HBV infection but decreased by adefovir dipivoxil treatment.The percentages of CD +8 CD +38 and CD8 +HLA -DR +T are good markers for disease progression of HBV infection.