Modified Procedures for ALPPS Based on a Risk-Reduced Strategy: Paralleled Clinical Evaluation at Multiple Institutions

Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.

Modified Procedures for ALPPS Based on a Risk-Reduced Strategy: Paralleled Clinical Evaluation at Multiple Institutions

Purpose@#We compared the clinical outcomes of modified procedures for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) based on a risk-reduced strategy with those of classic ALPPS procedures in treating large liver carcinoma. @*Materials and Methods@#Short-term outcomes, increases in future liver remnant (FLR) and functional FLR (FFLR), and overall survival (OS) were compared between 45 consecutive patients treated with modified ALPPS procedures and 34 patients treated with classic ALPPS procedures. @*Results@#Clinical outcomes after the 1st-stage operation markedly improved with the modified procedures. Although the proportions of liver cirrhosis and hepatocellular carcinoma were higher in the modified group, the mortality and incidence of severe complications did not increase. FLR and FFLR hypertrophy at 1 week after the 1st-stage operation were similar in both groups; however, kinetic growth rates in the modified group were lower. OS rates were similar. @*Conclusion@#Modified ALPPS procedures could be safely applied to provide long-term survival for patients with liver cirrhosis without sufficient FLR.

Allogeneic leukocyte immunization combined with IVF-ET for treatment of infertility induced by recurrent spontaneous abortion / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of allogeneic leukocyte immunization combined with in vitro fertilization-embryo transfer (IVF-ET) for treatment of infertility induced by habitual abortion.</p><p><b>METHODS</b>Allogeneic leukocyte immunization was performed in 9 patients with infertility induced by habitual abortion, with another 9 patients undergoing IVF-ET without habitual abortion as the control group. All the patients were treated with long GnRH-a protocols. The infertility patients with recurrent spontaneous abortion history were immunized with lymphocytes from the husband for before IVF-ET and after clinical pregnancy.</p><p><b>RESULTS</b>The fertilization rates of the immunotherapy group and control group were 81.3% and 82.2%, respectively, showing no significant difference (P>0.05). Five patients in each group had clinical pregnancy, and a twin pregnancy occurred in the control group. The embryo implantation rates were also comparable between the two groups (22.7% vs 28.6%, P>0.05). All the fetuses resulted from IVF-ET developed normally and were healthily delivered.</p><p><b>CONCLUSION</b>Allogeneic leukocyte immunotherapy along with IVF-ET is effective for treatment of infertility resulting from recurrent spontaneous abortion.</p>

Neonatal outcomes of pregnancy resulting from in vitro fertilization and embryo transfer: analysis of 1274 cases / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the neonatal outcomes of pregnancies resulting from in vitro fertilization and embryo transfer (IVF-ET) in relation to the occurrence of congenital malformations of the neonates.</p><p><b>METHODS</b>A total of 1274 infants born after IVF-ET were reviewed. The neonatal outcome was evaluated based on gestational weeks, body weight, congenital malformations, manner of spermatization, maternal age and multiple gestation.</p><p><b>RESULTS</b>IVF-ET resulted in 930 deliveries, giving birth to a total of 1274 newborns. Spontaneous delivery occurred in 115 cases (12.37%), with preterm birth in 224 cases (24.09%). Among these newborns, 363 (28.49%) had very low born weight (VLBW), 13 (1.02%) had congenital malformations, and neonatal mortality occurred in 15 cases (1.18%).</p><p><b>CONCLUSION</b>IVF increases the risks of twin pregnancies, preterm birth and VLBW, but does not increase the rate of congenital malformations and neonatal mortality. Intracytoplasmic sperm injection (ICSI) is at higher risk of congenital malformations. Maternal age and twin pregnancies are not associated with congenital malformations. IVF can be safe for treatment of infertility.</p>

Expression of imprinted genes related to Beckwith-Wiedemann syndrome in human oocytes and preimplantation embryos / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the expression of imprinted genes related to Beckwith-Wiedemann syndrome (BWS) in human oocytes and preimplantation embryos for understanding the relationship between assisted reproductive technology (ART) and BWS.</p><p><b>METHODS</b>Using nested reverse transcription-PCR to analyze the expression of P57KIP2, LIT1, TSSC3 in human oocytes and preimplantation embryos.</p><p><b>RESULTS</b>Transcripts of P57KIP2 were detected in human oocytes and at all stages of preimplantation embryos. LIT1 was expressed only in stages of 8-cell and blastocyst. Transcripts of TSSC3 could not be detected in human oocytes and preimplantation embryos.</p><p><b>CONCLUSION</b>Transcripts of P57KIP2 and LIT1, imprinted genes related to BWS, were detected in human preimplantation development; ART might affect the epigenetics of imprinted genes in early embryogenesis.</p>