Strategy on timing of ALPPS stageⅡbased on increase in remnant liver volume / 中华肝胆外科杂志

Objective:To study the safety and efficacy on timing of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) stageⅡbased on increase in remnant liver volume.Methods:19 patients (male: female 13: 6; average age 53 years) with liver tumors treated by ALPPS from April 2014 to December 2020 were retrospectively studied. Patients with FLV/ESLV (future liver volume/ estimated standard liver volume) increase of more than 50% within 1 week followed by stageⅡALPPS were included into the rapid group ( n=8). Those who failed to have 50% increase in FLV/ESLV within 1 week were included into the control group ( n=11). The two groups were compared in the ALPPS stage II in operating time, blood loss, postoperative complications, mortality rate and hospital stay. Results:All 19 patients underwent ALPPS stage II uneventfully. One patient in the control group died from liver failure within 30 days of operation. The operation time (3.2±1.8)h, blood loss (554±227) ml and postoperative hospital stay (12.6±2.4) d in the rapid group were significantly better than those in the control group (4.7±2.2) h, [(760±314) ml, (18.2±6.4) d (all P<0.05)]. The two groups had similar complication rates in both post stageⅠ[37.5%(3/8) vs. 45.4%(5/11)] , or stageⅡ [37.5%(3/8) vs. 36.4%(4/11)] (both P>0.05). Conclusion:Rapid increase in FLR volume of more than 50% within a week was safe and feasible to proceed to ALPPS stage II. This conclusion needs to be confirmed by further studies using large sample sizes.

Puerarin induces angiogenesis in myocardium of rat with myocardial infarction.

Puerarin is a major effective ingredient extracted from the traditional Chinese medicine ge-gen (radix puerariae, RP). Recently, puerarin has been used to treat patients with coronary artery diseases (CAD). However, the mechanisms of puerarin on coronary artery diseases are still not very clear. In this study, we investigated the role of puerarin on angiogenesis in the non-ischemic and ischemic myocardium. We found that puerarin (120, 60 mg/kg, i.p.) could reduce infarct area in the heart of rat with myocardial infarction (MI). Puerarin (120 mg/kg) induced angiogenesis in the non-ischemic and ischemic myocardium, which was one of the mechanisms of curing coronary artery diseases. The gene expression or activation of vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1alpha (HIF-1alpha) and endothelial nitric oxide synthase (eNOS) that correlated with angiogenesis were also induced by puerarin. From these results, we suggested that puerarin may induce therapeutic angiogenesis in myocardium of rat with MI. The mechanism may be that puerarin can induce VEGF and eNOS expression.

House dust mite allergen (Derp1 and Blot5) levels in asthmatics' home in Hongkong / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To measure Derp1 and Blot5 allergen levels in asthmatics' homes in Hongkong.</p><p><b>METHODS</b>Seventy houses were enrolled for a mite indoor environment study. Dust samples were obtained from two sites of each patients' house: bed and floor. Derp1 and Blot5 levels were quantified by a two-site monoclonal antibody-based ELISA technique.</p><p><b>RESULTS</b>The levels of Derp1 allergens found in bed (geometric mean (GM) 3.43 microg/g of dust; 95%CI, 1.89-4.96 microg/g) and on the floor (GM 1.12 microg/g of dust; 95%CI, 0.71-1.53 microg/g) indicated significant differences (P=0.005). However, the levels of Blot5 allergens found in bed (GM 19.00 microg/g of dust; 95%CI, 0.89-38.90 microg/g) and on the floor (GM 6.14 microg/g of dust; 95%CI, 0.40-11.90 microg/g) showed no statistically significant difference. In addition, in regards to the exposure index for Derp1 and Blot5 allergens found in bed and on the floor, 17.6% in bed and 8.6% on the floor had levels of Blot5 > or = 10 microg/g of dust, higher than those obtained for Derp1 (7.2% and 0% in bed and on the floor respectively, P<0.05); higher percentages in bed and on the floor (25.0% and 35.7%) were observed for levels of Blot5 = 0 microg/g of dust as compared with Derp1 in bed and on the floor (4.3% and 14.5% respectively, P<0.05).</p><p><b>CONCLUSIONS</b>Derp1 and Blot5 are the major allergens found in this regional study, Blot5 is a more potent allergen in Hongkong, probably reflecting the high level of exposure to Blomia tropicalis (Bt). Bt and Dermatophagoides pteronyssinus (Dp) allergens should be included for precise diagnosis and effective immuno-therapeutic treatment of mite allergy in Hongkong.</p>

Lead poisoning in new immigrant children from the mainland of China / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To define the prevalence, severity and risk factors for lead poisoning in new immigrant children from the mainland of China to Hong Kong, China.</p><p><b>METHODS</b>New immigrant children from the mainland of China under 18 years of age were invited to join the study. Their growth parameters and venous blood lead levels (BLL) were measured within 7 days of arrival. Those with elevated BLL i.e. > 10 micrograms/dl (0.48 mumol/L) were assessed for signs, symptoms and risk factors of lead poisoning. Education on the prevention of lead poisoning and follow up BLL measurements were offered until their BLL normalized.</p><p><b>RESULTS</b>Four hundred and fifty-seven children were recruited. Among them, 18.1% and 2.6% had BLL > 0.48 and 0.71 mumol/L, respectively. None had BLL > 0.96 mumol/L. Possible risk factors included contaminated drinking water (19%), herb ingestion (17.5%), pica, playing in dumping grounds, residing near paint factories or highways, habitual inhalation of car exhaust and cooking with petroleum. Symptoms and signs included abdominal pain, headache, short stature, and learning difficulties but did not correlate with BLL. None required treatment except for counseling on the avoidance of risk factors. About 94.7% showed a reduction in BLL 2-3 months after arrival and before counseling. All had normalized BLL by 9 months except 1 who had an X-ray feature of lead line.</p><p><b>CONCLUSIONS</b>Lead poisoning is common in new immigrant children from the mainland of China. Environmental factors were most important while behavioral factors like regular herb ingestion might have contributed to the persistence of high BLL in the minority.</p>