Predictive value of the initial MELD score and its derivative scores for early survival rate after liver transplantation in patients with liver failure / 器官移植

Objective To explore the predictive values of the initial model for end-stage liver disease (MELD) score, MELD combined with serum sodium (MELD-Na) score and MELD combined with serum lactic acid (MELD-Lac) score for early survival rate after liver transplantation in patients with liver failure. Methods Clinical data of 135 recipients undergoing liver transplantation for liver failure were retrospectively analyzed. All patients were divided into the early survival group (n=110) and early death group (n=25) according to the survival at postoperative 28 d. Clinical data were compared between two groups. The optimal cut-off values of MELD, MELD-Na and MELD-Lac scores for predicting early survival rate after liver transplantation in patients with liver failure were determined by the receiver operating characteristic (ROC) curve. The predictive values of different scores for early survival rate after liver transplantation in patients with liver failure were evaluated. Results Significant differences were observed in the initial MELD, MELD-Na and MELD-Lac scores after liver transplantation between two groups (all P < 0.05). For the initial MELD, MELD-Na and MELD-Lac scores in predicting early survival rate after liver transplantation in patients with liver failure, the AUC were 0.653 [95% confidence interval (CI) 0.515-0.792], 0.648 (95%CI 0.514-0.781) and 0.809 (95%CI 0.718-0.900), the optimal cut-off values were 18.09, 18.09 and 19.97, Youden's indexes were 0.398, 0.380 and 0.525, the sensitivity was 0.680, 0.680 and 0.840, and the specificity was 0.720, 0.700 and 0.690, respectively. The AUC of MELD-Lac score was higher than those of MELD and MELD-Na scores, and the differences were statistically significant (both P < 0.05). Conclusions Compared with the initial MELD and MELD-Na scores after liver transplantation, the initial MELD-Lac score is a more reliable index for predicting early survival rate after liver transplantation in patients with liver failure.

Blood flow in intracranial aneurysms treated with Pipeline embolization devices: computational simulation and verification with Doppler ultrasonography on phantom models

PURPOSE: The aim of this study was to validate a computational fluid dynamics (CFD) simulation of flow-diverter treatment through Doppler ultrasonography measurements in patient-specific models of intracranial bifurcation and side-wall aneurysms. METHODS: Computational and physical models of patient-specific bifurcation and sidewall aneurysms were constructed from computed tomography angiography with use of stereolithography, a three-dimensional printing technology. Flow dynamics parameters before and after flow-diverter treatment were measured with pulse-wave and color Doppler ultrasonography, and then compared with CFD simulations. RESULTS: CFD simulations showed drastic flow reduction after flow-diverter treatment in both aneurysms. The mean volume flow rate decreased by 90% and 85% for the bifurcation aneurysm and the side-wall aneurysm, respectively. Velocity contour plots from computer simulations before and after flow diversion closely resembled the patterns obtained by color Doppler ultrasonography. CONCLUSION: The CFD estimation of flow reduction in aneurysms treated with a flow-diverting stent was verified by Doppler ultrasonography in patient-specific phantom models of bifurcation and side-wall aneurysms. The combination of CFD and ultrasonography may constitute a feasible and reliable technique in studying the treatment of intracranial aneurysms with flow-diverting stents.

Determination of notoginsenoside R1, ginsenoside Rg1 and Rb1 in Radix Notoginseng and its preparation by HPLC-ELSD / 中国中药杂志

<p><b>OBJECTIVE</b>To establish the quantitative method of notoginsenoside R1, ginsenoside Rg1 and Rb1 in Radix Notoginseng and its preparation Xuesaitong injection by HPLC-ELSD.</p><p><b>METHOD</b>The column was packed with 5 microm Diamonsil C18 stationary phase. The mobile phase consisted of acetonitrile-water, eluted in gradient mode. The temperature of drift tube was 105 degrees C and the nebulizer nitrogen flow rate was 2.9 L x min(-1).</p><p><b>RESULT</b>The linear ranges of the three components were 0.456-2.25 microg, 1.47-7.38 microg and 1.20-6.03 microg respectively. The average recoveries of the three components in Radix Notoginseng were 97.1% (RSD 1.9%), 96.8% (RSD 2.0%), 97.0% (RSD 2.2%) respectively; in Xuesaitong Injection were 98.7% (RSD 1.9%), 98.5% (RSD 1.8%), 98.1% (RSD 1.4%) respectively.</p><p><b>CONCLUSION</b>It was proved that the method was reliable, simple, and precise, that could be used for quality control.</p>