Research on clinical efficacy of liver transplantation for severe liver disease / 器官移植

@#Objective To explore the clinical efficacy of liver transplantation for severe liver disease. Methods The clinical data of 51 patients who underwent liver transplantation for severe liver disease were retrospectively analyzed. The general intraoperative conditions were observed, including operation duration, warm ischemia time, cold ischemia time, anhepatic phase, bleeding volume, blood transfusion volume, plasma transfusion volume and so on. The changes in indexes such as total bilirubin (TB), prothrombin time activity (PTA), and prothrombin time international normalized ratio (PT-INR) were observed before operation and at 3 d, 1 week and 2 weeks after operation. The postoperative survival and occurrence of complications were analyzed. The indexes that might affect the prognosis of patients with severe liver disease were analyzed by Cox regression analysis. Results For the 51 patients, operation duration, warm ischemia time and cold ischemia time was 8 (7, 9) h, 3 (2, 3) min and 6 (5, 8) h respectively, intraoperative anhepatic phase was 80 (70, 100) min, intraoperative bleeding volume was 1 000 (550, 1 500) mL, and intraoperative blood transfusion volume was 1 200 (200, 1 600) mL. Postoperative TB, PTA, PT-INR and other indexes improved significantly compared to those preoperatively. Among the 51 patients, 10 cases died, with the death causes of multiple organ failure and severe infection(7 cases), renal insufficiency (2 cases), and cardiovascular complications (1 case). Survival rates at 1 month and 1 year post-transplantation for patients with severe liver disease were 82% and 80%, respectively. Cox regression analysis suggested that abnormal preoperative PTA and PT-INR were the risk factors for post-transplantation death in patients with severe liver disease. Conclusions Liver transplantation significantly improves the survival rate for patients with severe liver disease, perioperative infection prevention and treatment as well as multiple organ function management play key roles in improving post-transplantation survival rate in patients with severe liver disease.

Review of survey method for human time-activity pattern and its application in the exposure assessment of air pollutants / 中华预防医学杂志

Time activity pattern refers to the time and behavior of people at different locations. The knowledge of time-activity pattern is essential for air pollution exposure assessment when direct personal exposure monitoring can't not be conducted, because air pollutant concentrations may vary significantly by location and activity. This review is focused on the survey method for human time-activity pattern and its application in the exposure assessment of air pollutants. After comparing the diary-reported trips and Global Positioning System (GPS) recording method, we believed that diary-reported trips were more reliable in describing comprehensive and detail records of the behavior and environmental circumstances while GPS-recorded trend to maintain sound information of time, location and transportations. Meanwhile, according to different subjects, the air pollution exposure model could be divided for population and individuals. There were great difference between two types of model in many areas, including the required information about time, activity and microenvironment.

Assessing the consistency of methods to measure travel behavior related to exposure to air pollution / 中华预防医学杂志

Objective@#To compare diary-reported trips and Global Positioning System (GPS) recording trips and identify the reasons for the discrepancies between two methods.@*Methods@#The survey was conducted in Jiangning district in Nanjing city during July to September and November to December, 2015. Both the diary records and GPS method were used to investigate the travel behavior of 33 retired adults for 5 consecutive days. The GPS traces were display in Google Earth and then split into trips to compare with the diary records according to time and location. χ2 test was used to analyze the influence of trip characteristics on misreporting rates of each method.@*Results@#A total of 1 087 trips in the survey can be compared between the diary (n=909) and the GPS method (n=912). 7.3% (79/1 087) of the trips were only recorded by GPS method, and 11.8% (128/1 087) were only reported in the diary. Of the remaining 880 trips recorded by the both methods, 86.7% (763/880) matched each other, while 13.3% (117/880) did not. For the matched trips, the difference between the trip durations recorded by diary and GPS method was 2.0 (quartile was 6.0) minutes and the diary method overestimated about 25.0% trip durations when compared with the GPS method. The accuracy rates were 84.8%(903/1 065) and 86.9%(925/1 065) for diary and GPS method, respectively. Both methods were more likely to misreport the trip under 5 minutes. The misreporting rates of diary method for trips under 5 minutes were 6.8 times higher than trips over 30 minutes (21.7% vs 3.2%). The reporting accuracy was also significantly different among trips by different travel mode (P<0.05) for both methods, diary method had the lowest accuracy in reporting vehicles recorders (69.3%, 133/192), while GPS method was more accuracy in both biking (91.9%, 136/148) and vehicles recorders(89.6%, 172/192). The main reasons for misreporting by diary method were forgetting or unwilling to record and failing to record trips according to travel mode, while forgetting to carry GPS device, bad GPS signal and failing to locate the position were the main reasons for misreporting by GPS method.@*Conclusion@#The majority of the trips reported in diary and GPS method are well consistent with each other. Both of the methods should be used simultaneously in the survey of time-activity pattern to improve the data quality.

Nicho ecológico e aspectos da história natural de Phyllomedusa azurea (Anura: Hylidae, Phyllomedusinae) no Cerrado do Brasil Central / Ecological niche and aspects of the natural history of Phyllomedusa azurea (Anura: Hylidae, Phyllomedusinae) in the Cerrado of Central Brazil

Aspectos da ecologia e da história natural de Phyllomedusa azurea foram estudados em uma área de cerrado do Brasil Central, entre abril de 2006 e fevereiro de 2007. As observações foram realizadas entre as 18:00 e 5:00 h. Os aspectos investigados são referentes aos nichos espacial, temporal e trófico, morfometria e reprodução. A maioria dos animais vocalizou em locais com predominância do estrato herbáceo e de dossel aberto. Os principais substratos utilizados foram arbustos e árvores. Com relação às alturas de empoleiramento, os animais foram encontrados principalmente em locais entre 0,50 e 1,00 m de altura. As amplitudes de nicho espacial (substrato e altura de empoleiramento) foram respectivamente 2,91 e 3,83. A maioria dos animais foi encontrada próxima a corpos d'água lênticos, normalmente até 0,50 m. É possível que essas características estejam primariamente relacionadas com a filogenia do gênero e secundariamente às necessidades particulares da espécie e à disponibilidade local de recursos. Os arbustos e árvores utilizados pela espécie servem como sítios de vocalização e ovoposição. Os espécimes de Phyllomedusa azurea foram localizados principalmente entre às 20:00 e 21:00 h. A largura de nicho temporal estimada (horário de atividade) foi de 4,68. Padrão reprodutivo prolongado foi também observado, predominando nos meses de maior temperatura e umidade (setembro a fevereiro). A dieta constituiu-se de 11 itens, sendo que o item mais importante para as fêmeas foi Orthoptera (IVI = 63) e para os machos Araneae (IVI = 43). As amplitudes numérica e volumétrica do nicho trófico foram respectivamente 1,80 e 1,16, para fêmeas, e 4,03 e 3,92, para machos. Machos e fêmeas diferiram em tamanho (CRC) e massa, com as fêmeas sendo maiores e mais pesadas. Os tamanhos dos menores indivíduos reprodutivos de machos e fêmeas foram 34,64 e 40,33 mm, respectivamente. Diferenças no tamanho podem estar relacionadas a distintos investimentos na reprodução...

Aspects of the ecology and natural history of Phyllomedusa azurea were investigated in an area of Central Brazilian Cerrado between April, 2006, and February, 2007. Observations were conducted between 6:00 PM and 5:00 AM. The study focused on spatial, temporal, and trophic niches, morphometry and reproduction. Most animals were recorded vocalizing in places dominated by herbaceous vegetation and an open canopy. The main substrates used were bushes and trees, and animals were seen perched most often between 0.5 and 1.0 m of height. Spatial niche breadth was 2.91 and 3.83 for substrate and perch height, respectively. Most animal were sighted close to lentic water bodies, usually up to 0.50 m. It is possible that these characteristics are related primarily to the phylogeny of the genus and secondarily to the specific needs of the species and the local availability of resources. The bushes and trees were used by the species mainly as sites of vocalization and oviposition. Specimens of Phyllomedusa azurea was sighted most frequently between 8:00 PM and 9:00 PM. Estimated temporal niche breadth (activity period) was 4.68. Prolonged reproductive pattern was also observed predominantly in the months with higher temperature and higher humidity (September to February). The diet consisted of eleven items. The most important prey taxon for the females was Orthoptera (IVI = 63), whereas for the males, it was Araneae (IVI = 33). The breadths numeric and volumetric of the trophic niche, was respectively 1.80 and 1.16, for females, and 4.03 and 3.92, for males. Males and females differed in size (SVL) and mass, with the females being larger and heavier. The sizes of smaller reproductive individuals males and females were 34.64 and 40.33 mm, respectively. Differences in size may be related to different investments in reproduction by the two sexes.

Time-activity budgets and behaviour of the Amazilia hummingbird, Amazilia amazilia (Apodiformes: Trochilidae) in an urban environment

This study deals with the time-activity budgets of Amazilia amazilia, a territorial hummingbird, and its preferences for different flower species and perches in the gardens of Lima (Peru) in September 2001. A. amazilia spent an important part of its time resting on perches (ca. 80%) and only 15.5% for foraging, devoted essentially to flower visitation and only 0.3% for hunting and drinking water. Territorial defence accounted for 2% of total time, mostly against Coereba flaveola, an introduced nectarivorous species that seem to be an important competitor of A. amazilia. Flower use is not directly related to flower abundance (chi(2)9, = 1,546, p<0.0001), with Justicia brandegeana and red-flowered Salvia splendens being selected and Impatiens balsamina being rejected. The large amount of time spent on the perches makes them an important element of the habitat. The perches selected are typically on trees, close to the flowers visited, and in a low vertical and middle horizontal position, surrounded by low foliage density, probably to minimize heat loss.

Se estudi¨® la distribuci¨®n del tiempo en las actividades de Amazilia amazilia, un colibr¨ª territorial, y sus preferencias por diferentes flores y perchas en los jardines de Lima (Per¨²), en septiembre de 2001. A. amazilia pasa una parte importante de su tiempo descansando en las perchas (ca. 80%) y s¨®lo un 15.5% aliment¨¢ndose, dedicado fundamentalmente a visitar flores y s¨®lo un 0.3% a cazar y a beber agua. La defensa del territorio ocup¨® un 2% del tiempo total, la mayor parte frente a Coereba flaveola, una especie nectar¨ªvora introducida que parece constituir un importante competidor de A. amazilia. El uso de las distintas especies de flores no se relaciona con su abundancia (¦Ö29 = 1546, p<0.0001), siendo Justicia brandegeana y Salvia splendens de flores rojas seleccionadas e Impatiens balsamina rechazada. La gran cantidad de tiempo que pasa en las perchas las convierte en un elemento importante del h¨¢bitat. Las perchas seleccionadas se encuentran t¨ªpicamente en ¨¢rboles, cercanas a las flores que visita y, se sit¨²an en posici¨®n baja y central rodeadas de baja densidad de follaje, probablemente para minimizar la p¨¦rdida de calor.

The Relation of Educational Level and Life-Style behaviors to Obesity in Adult Males

This study examined the relations of educational level and life-style behaviors to the obesity. A total of 507 male adults aged 30 - 50 years completed the self-reported questionnaires. Educational level was used for measuring socioeconomic status. Activity at work, leisure-time activity and TV watching were measured for life-style behaviors related to physical activity, and some demographic and family history of disease as well. Subjects were categorized as obese when BMI was equal to or over 25 kg/m2, in which 19.7% resulted obesity. Using multivariate logistic regression, the association between the measured factors and obesity was assessed. The odds ratios (OR) for risk of obesity did not differ with either age or monthly income. Subjects who completed high school (OR = 0.36; 95% CI = 0.20 - 0.66) or university (OR = 0.34; 95% CI = 0.16 - 0.71) had lower risk of obesity than those with education below middle school. Those with moderate activity level at work (OR = 0.41; 95% CI = 0.24 - 0.72) showed lower risk of obesity than in inactive ones. The subjects watching TV more than 3.5 hr/day presented higher risk of obesity (OR = 2.46; 95% CI = 1.28 - 4.74), compared with those watching TV less than 1.5 hr/day. The higher risk of obesity observed in high level of leisure time activity than in low one was considered due to that physical activity at work and leisure-time might counteract each other. Educational level and activity at work or leisure-time activity or TV watching were jointed and categorized, and then OR for obesity was estimated. The extent of obesity risk at a given level of each work activity or leisure-time activity or TV watching was different depending the educational level, which was significantly high when educational level was below middle school. Educational difference had no effect on activity level at work. However, higher educational attainment increased the leisure activity and reduced TV watching (p < 0.05), indicating that low education tended to contribute to more sedentary life-style. The findings of this study is concluded that low education was related to obesity in adult males, and its relation can partly be explained through acquiring inactive life-style behaviors. Individuals with low education might be more susceptible to the risk factors of obesity.

Development of Program for Renal Function Study with Quantification Analysis of Nuclear Medicine Image / 대한핵의학회잡지

PURPOSE: In this study, we developed a new software tool for the analysis of renal scintigraphy which can be modified more easily by a user who needs to study new clinical applications, and the appropriateness of the results from our program was studied. MATERIALS AND METHODS: The analysis tool was programmed with IDL5.2 and designed for use on a personal computer running Windows. For testing the developed tool and studying the appropriateness of the calculated glomerular filtration rate (GFR), 99mTc-DTPA was administered to 10 adults in normal condition. In order to study the appropriateness of the calculated mean transit time (MTT), 99mTc-DTPA and 99mTc-MAG3 were administered to 11 adults in normal condition and 22 kidneys were analyzed. All the images were acquired with ORBITOR, the Siemens gamma camera. RESULTS: With the developed tool, we could show dynamic renal images and time activity curve (TAC) in each ROI and calculate clinical parameters of renal function. The results calculated by the developed tool were not different statistically from the results obtained by the Siemens application program (Tmax: p=0.68, Relative Renal Function: p=1.0, GFR: p=0.25) and the developed program proved reasonable. The MTT calculation tool proved to be reasonable by the evaluation of the influence of hydration status on MTT. CONCLUSION: We have obtained reasonable clinical parameters for the evaluation of renal function with the software tool developed in this study. The developed tool could prove more practical than conventional, commercial programs.

Role of PET in Evaluating Indeterminate Solitary Pulmonary Nodule with CT / 대한핵의학회잡지

About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We performed FDG-PET studies in patients who ha radiologi- cally indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC). Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch- ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.

The Differentiation of Benign from Malignant Soft Tissue Lesions using FDG-PET: Comparison between Semi-quantitative Indices / 대한핵의학회잡지

The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.