【据Journal of Gastroenterology and Hepatology 2021年1月报道】题:自发性脾肾分流对肝硬化患者长期生存的影响(作者Yi F等)[JP]自发性脾肾分流(SSRS)是肝硬化门静脉高压的表现之一。然而,SSRS对肝硬化患者长期生存的影响尚不清楚。...【据Journal of Gastroenterology and Hepatology 2021年1月报道】题:自发性脾肾分流对肝硬化患者长期生存的影响(作者Yi F等)[JP]自发性脾肾分流(SSRS)是肝硬化门静脉高压的表现之一。然而,SSRS对肝硬化患者长期生存的影响尚不清楚。来自北部战区总医院消化内科的Yi等推测SSRS可能通过减少肝血流灌注使肝功能恶化,并增加肝硬化死亡的风险。展开更多
Objective Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma( GBM).Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor t...Objective Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma( GBM).Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue,facilitating safe maximal resection of GBM. In this study,the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing( CE) regions,where this relationship has been established,and into the nonCE( NCE),diffusely infiltrated margins. Methods Thirty-two patients received fluorescein sodium( 3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter.Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis,histopathological evaluation of localized biopsy specimens,and radiological volumetric assessment of the extent of resection.Results Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors,thus serving as a visual guide during resection. Gross-total resection( GTR) was achieved in 84% of the patients with an average resected volume of 95%,and this rate was higher among patients for whom GTR was the surgical goal( GTR achieved in 93. 1% of patients,average resected volume of 99. 7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions,with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. Conclusions Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findingssupport the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal.展开更多
文摘【据Journal of Gastroenterology and Hepatology 2021年1月报道】题:自发性脾肾分流对肝硬化患者长期生存的影响(作者Yi F等)[JP]自发性脾肾分流(SSRS)是肝硬化门静脉高压的表现之一。然而,SSRS对肝硬化患者长期生存的影响尚不清楚。来自北部战区总医院消化内科的Yi等推测SSRS可能通过减少肝血流灌注使肝功能恶化,并增加肝硬化死亡的风险。
文摘Objective Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma( GBM).Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue,facilitating safe maximal resection of GBM. In this study,the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing( CE) regions,where this relationship has been established,and into the nonCE( NCE),diffusely infiltrated margins. Methods Thirty-two patients received fluorescein sodium( 3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter.Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis,histopathological evaluation of localized biopsy specimens,and radiological volumetric assessment of the extent of resection.Results Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors,thus serving as a visual guide during resection. Gross-total resection( GTR) was achieved in 84% of the patients with an average resected volume of 95%,and this rate was higher among patients for whom GTR was the surgical goal( GTR achieved in 93. 1% of patients,average resected volume of 99. 7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions,with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. Conclusions Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findingssupport the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal.