Formation and rupture of liver hematomas caused by intrahepatic gallbladder perforation:A case report and review of literature

BACKGROUND Gallbladder perforation is a serious complication of acute cholecystitis.Such perforation is a rare but life-threatening situation that can lead to the formation and rupture of liver hematomas.Here,we report a case of a ruptured intrahepatic hematoma caused by intrahepatic gallbladder perforation,and we present a literature review.CASE SUMMARY A 70-year-old male was admitted to the hospital with a complaint of right upper quadrant abdominal pain,flustering and dizziness.The preoperative diagnosis was a ruptured malignant liver tumor,and the patient’s medical images and increased level of carbohydrate antigen-199 suggested that the gallbladder had been invaded.However,the tumor was proven to be a liver hematoma secondary to gallbladder perforation after surgery.The patient was discharged uneventfully on the fifteenth postoperative day.CONCLUSION Intrahepatic gallbladder perforation is difficult to diagnose preoperatively.Radiological examinations play a crucial role in the diagnosis but only for partial cases.Early diagnosis and appropriate surgery are key to managing this rare condition.

微生物增产煤层气作用机理研究

通过向煤层产出液中添加营养剂激活内源菌群,与高阶煤相互作用,开展了煤层内源菌与高阶煤相互作用机理的研究。分别利用气相色谱仪、元素分析仪、傅里叶变换红外光谱仪等仪器设备对微生物作用后气体组分、煤组分、煤样品官能团、煤样品的微晶结构以及煤样品孔隙度进行测定。实验结果表明:反应过程中产生了氮气、甲烷等生物气体;微生物作用后煤样品中的中C、S元素含量平均降低18.99%、20.17%;N、H元素平均含量升高119.76%、70.84%;煤样中芳烃含量下降,醚基、羟基含量上升;微生物作用后煤样品孔隙度平均增加31.4%。

A combined pre- and intra-operative nomogram in evaluation of degrees of liver cirrhosis predicts post-hepatectomy liver failure: a multicenter prospective study

Background:Adequate evaluation of degrees of liver cirrhosis is essential in surgical treatment of hepatocellular carcinoma(HCC)patients.The impact of the degrees of cirrhosis on prediction of post-hepatectomy liver failure(PHLF)remains poorly defined.This study aimed to construct and validate a combined pre-and intra-operative nomogram based on the degrees of cirrhosis in predicting PHLF in HCC patients using prospective multi-center’s data.Methods:Consecutive HCC patients who underwent hepatectomy between May 18,2019 and Dec 19,2020 were enrolled at five tertiary hospitals.Preoperative cirrhotic severity scoring(CSS)and intra-operative direct liver stiffness measurement(DSM)were performed to correlate with the Laennec histopathological grading system.The performances of the pre-operative nomogram and combined pre-and intra-operative nomogram in predicting PHLF were compared with conventional predictive models of PHLF.Results:For 327 patients in this study,histopathological studies showed the rates of HCC patients with no,mild,moderate,and severe cirrhosis were 41.9%,29.1%,22.9%,and 6.1%,respectively.Either CSS or DSM was closely correlated with histopathological stages of cirrhosis.Thirty-three(10.1%)patients developed PHLF.The 30-and 90-day mortality rates were 0.9%.Multivariate regression analysis showed four pre-operative variables[HBV-DNA level,ICG-R15,prothrombin time(PT),and CSS],and one intra-operative variable(DSM)to be independent risk factors of PHLF.The pre-operative nomogram was constructed based on these four pre-operative variables together with total bilirubin.The combined pre-and intra-operative nomogram was constructed by adding the intra-operative DSM.The pre-operative nomogram was better than the conventional models in predicting PHLF.The prediction was further improved with the combined pre-and intra-operative nomogram.Conclusions:The combined pre-and intra-operative nomogram further improved prediction of PHLF when compared with the pre-operative nomogram.

Diagnosis and Treatment of Cholangiocarcinoma: A Consensus from Surgical Specialists of China

Cholangiocarcinoma refers to malignant tumors that develop in epithelial lining of biliary system, and it is divided into two categories according to tumor location, intrahepatic cholangiocarcinoma （ICC） and extrahepatic cholangiocarcinoma （ECC）. ICC occurs from the epithelial cells of the intrahepatic bile duct, its branches and interlobular biliary tree; and ECC is divided into hilar cholangiocarcinoma and distal cholangiocarcinoma by the circumscription at the confluence of cystic duct and the common hepatic duct.

新型冠状病毒院内感染调研与分析工具的开发与验证

目的制定2019-nCoV院内感染调研与分析工具,并行初步验证。方法研究小组基于前期循证制定的"新型冠状病毒医护感染过程及防控调研问卷",主要通过细化问卷调研目的、建立问卷条目池、评估问卷的效度三个步骤进行改编。结果形成了新型冠状病毒院内感染调研与分析工具,包括行政后勤感染组、医护对照组、行政后勤对照组3个问卷。问卷内容与研究目标具有较高的一致性。行政后勤感染组问卷包括"确诊前"、"确诊后"2个领域的调查,其中,"确诊前"涉及感染原因分析、确诊前防控方案、确诊前防控知识、确诊前心理上对疫情的应对状态4个部分,共计16个条目;"确诊后"包括确诊后症状、确诊后治疗、感染后对周围环境和人造成的影响、确诊后心理、感染后防护认识5个方面,共计21个条目。医护对照组问卷涉及与是否感染有关的工作或生活行为、防控相关行为、防控相关知识、心理上对疫情的应对状态4个方面,共计29个条目。行政后勤对照组问卷涉及的领域与医护对照组问卷相同,共计20个条目。结论本研究完成了2019-nCoV院内感染调研与分析工具的制定,共涉及2019-nCoV感染医院非医护工作人员感染过程及防控调研——行政、后勤人员专用,2019-nCoV感染医护感染对照组调研问卷——医护对照组,2019-nCoV感染医护感染对照组调研问卷——行政后勤对照组3个问卷,问卷的信度和效度均可靠、可行性良好。

一株可乳化降解原油的Compostibacillus的分离及特性

【背景】通过实施多轮次微生物采油,华北油藏产出液菌浓达到了106个/mL以上,油藏内部已经形成了较稳定的微生物发酵场,从其中筛选出能够乳化降解原油的微生物,并在地面对其进行扩大培养,然后再应用到微驱油藏,以进一步提高微生物采油实施效果。【目的】筛选乳化降解原油性能良好的菌株,对其进行多相分类学鉴定和性能评价。【方法】利用原油为底物筛选乳化降解性能良好的菌株,通过形态特征观察、生理生化测定、16S rRNA基因序列分析等确定菌株的分类地位。通过乳化能力、降解率等方法确定菌株的原油乳化降解特性。【结果】从华北油田采集的地层水样品中分离得到一株乳化原油的菌株BLG74,经多相分类鉴定表明其是土壤堆肥芽孢杆菌(Compostibacillus humi)的新菌株,亲源性99.6%。该菌株的生长温度为30?60℃(最适温度45℃),pH 6.5?9.5(最适pH 7.0),NaCl浓度0%?7%(质量体积比)。菌株BLG74在玉米浆培养基中培养,其发酵液的表面张力为56.3 mN/m,乳化力约95%,在初始原油质量浓度0.5%、温度45℃的条件下培养20 d,对原油的降解率可达40.8%。【结论】菌株BLG74是可乳化降解原油的新成员,其在热盐条件下乳化降解原油的特性在石油开采中有一定的潜力。