This concise review summarizes recent advancements in theoretical studies of vortex quantum droplets(VQDs)in matter-wave fields.These are robust self-trapped vortical states in two-and three-dimensional(2D and 3D)Bose...This concise review summarizes recent advancements in theoretical studies of vortex quantum droplets(VQDs)in matter-wave fields.These are robust self-trapped vortical states in two-and three-dimensional(2D and 3D)Bose–Einstein condensates(BECs)with intrinsic nonlinearity.Stability of VQDs is provided by additional nonlinearities resulting from quantum fluctuations around mean-field states,often referred to as the Lee–Huang–Yang(LHY)corrections.The basic models are presented,with emphasis on the interplay between the mean-field nonlinearity,LHY correction,and spatial dimension,which determines the structure and stability of VQDs.We embark by delineating fundamental properties of VQDs in the 3D free space,followed by consideration of their counterparts in the 2D setting.Additionally,we address stabilization of matter-wave VQDs by optical potentials.Finally,we summarize results for the study of VQDs in the single-component BEC of atoms carrying magnetic moments.In that case,the anisotropy of the long-range dipole-dipole interactions endows the VQDs with unique characteristics.The results produced by the theoretical studies in this area directly propose experiments for the observation of novel physical effects in the realm of quantum matter,and suggest potential applications to the design of new schemes for processing classical and quantum information.展开更多
AIM To perform a meta-analysis on laparoscopic hepatectomy VS conventional liver resection for treating hepatolithiasis.METHODS We conducted a systematic literature search on Pub Med,Embase,Web of Science and Cochrane...AIM To perform a meta-analysis on laparoscopic hepatectomy VS conventional liver resection for treating hepatolithiasis.METHODS We conducted a systematic literature search on Pub Med,Embase,Web of Science and Cochrane Library,and undertook a meta-analysis to compare the efficacy and safety of laparoscopic hepatectomy V S conventional open liver resection for local hepatolithiasis in the left or right lobe. Intraoperative and postoperative outcomes(time,estimated blood loss,blood transfusion rate,postoperative intestinal function recovery time,length of hospital stay,postoperative complication rate,initial residual stone,final residual stone and stone recurrence) were analyzed systematically.RESULTS A comprehensive literature search retrieved 16 publications with a total of 1329 cases. Meta-analysis of these studies showed that the laparoscopic approach for hepatolithiasis was associated with significantly less intraoperative estimated blood loss [weighted mean difference(WMD): 61.56,95% confidence interval(CI): 14.91-108.20,P = 0.01],lower blood transfusion rate [odds ratio(OR): 0.41,95%CI: 0.22-0.79,P = 0.008],shorter intestinal function recovery time(WMD: 0.98,95%CI: 0.47-1.48,P = 0.01),lower total postoperative complication rate(OR: 0.52,95%CI: 0.39-0.70,P < 0.0001) and shorter stay in hospital(WMD: 3.32,95%CI: 2.32-4.32,P < 0.00001). In addition,our results showed no significant differences between the two groups in operative time(WMD: 21.49,95%CI: 0.27-43.24,P = 0.05),residual stones(OR: 0.79,95%CI: 0.50-1.25,P = 0.31) and stone recurrence(OR: 0.34,95%CI: 0.11-1.08,P = 0.07). Furthermore,with subgroups analysis,our results proved that the laparoscopic approach for hepatolithiasis in the left lateral lobe and left side could achieve satisfactory therapeutic effects. CONCLUSION The laparoscopic approach is safe and effective,with less intraoperative estimated blood loss,fewer postoperative complications,reduced length of hospital stay and shorter intestinal function recovery time than with conventional approaches.展开更多
AIM: To investigate whether microvessel density (MVD) is related with prognosis in gastric cancer patients, and the expression of cyclooxygenase-2 (COX-2) and vessel endothelial growth factor (VEGF) so as to determine...AIM: To investigate whether microvessel density (MVD) is related with prognosis in gastric cancer patients, and the expression of cyclooxygenase-2 (COX-2) and vessel endothelial growth factor (VEGF) so as to determine the possible role of COX-2 and VEGF in gastric cancer angiogenesis.METHODS: Forty-seven formalin-fixed paraffin-embedded tissue samples of gastric cancer were evaluated for COX-2, VEGF by immunohitochemical staining. To assess tumor angiogenesis, MVD was determined by immunohitochemical staining of endothelial protein factor Ⅷ-related antigen. The relationship among COX-2 and VEGF expression, MVD, and clinicopathologic parameters was analyzed. RESULTS: Among the 67 samples, high MVD was significantly associated with lymph node metastasis and poor survival. Multivariate survival analysis showed that MVD value and lymph node metastasis were independent prognostic factors. The expression rate of COX-2 and VEGF was significantly higher than that of the adjacent tissues. COX-2 and VEGF expression in gastric cancer was significantly correlated with tumor differentiation and depth of invasion, but not with survival. The mean MVD value of COX-2 or VEGF positive tumors was higher than that of COX-2 or VEGF negative tumors. A significant correlation was found between the expressions of COX-2and VEGF. CONCLUSION: MVD may be one of the important prognostic factors for gastric cancer patients. COX-2 and VEGF may play an important role in tumor progression by stimulating angiogenesis. VEGF might play a main role in the COX-2 angiogenic pathway. The inhibition of angiogenesis or COX-2, VEGF activity may have an important therapeutic benefit in the control of gastric cancer.展开更多
Liver transplantation is an effective treatment for patients with end-stage liver disease. Accurate imaging evaluation of the transplanted patient is critical for ensuring that the limited donor liver is functioning a...Liver transplantation is an effective treatment for patients with end-stage liver disease. Accurate imaging evaluation of the transplanted patient is critical for ensuring that the limited donor liver is functioning appropriately. Ultrasound contrast agents(UCAs), in combination with contrastspecific imaging techniques, are increasingly accepted in clinical use for the assessment of the hepatic vasculature, bile ducts and liver parenchyma in pre-, intra- and posttransplant patients. We describe UCAs, their technical requirements, the recommended clinical indications, image interpretation and the limitations for contrastenhanced ultrasound applications in liver transplantation.展开更多
AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B...AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B and underwent orthotopic liver transplantation (OLT) before and 2, 4, 8 wk after surgery. After being cultured in vitro for 72 h, the levels of INF-γ and TNF-α in culture supernatants were detected with ELISA. At the same time, the quantities of HBV DNA in serum and PBMCs were measured by real time PCR.RESULTS: The levels of INF-γ and TNF-α in PBMC culture supernatants decreased before and 2, 4 wk after surgery in turns (INF-γ 155.52±72.32 ng/L vs14.76±9.88 ng/L vs 13.22±10.35 ng/L, F= 6.946, P = 0.027<0.05; TNF-α80.839±46.75 ng/L vs 18.59±17.29 ng/L vs9.758±7.96 ng/L,F= 22.61, P= 0.0001<0.05). The levels of INF-γ and TNF-α were higher in groups with phytohemagglutinin (PHA) than in those without PHA before surgery. However,the difference disappeared following OLT. Furthermore,INF-γ and TNF-α could not be detected in most patients at wk 4 and none at wk 8 after OLT. The HBV detection rate and virus load in PBMlC before and 2, 4 wk after surgery were fluctuated (HBV detected rate: 51.4%, 13.3%, 50% respectively; HBV DNA: 3.55±0.674 log(10) copies/mL vs 3.00±0.329 log(10) copies/mL vs 4.608±1.344 log(10) copies/mL, F= 7.582, P= 0.002<0.05). HBV DNA in serum was 4.48±1.463 log(10) copies/mL before surgery and <103 copies/mL after OLT except for one with 5.72×106 copies/mL 4 wk after OLT who was diagnosed as HBV recurrence.The levels of INF-γ, and TNF-α were lower in patients with a high HBV load than in those with a low HBV load (HBV DNA detected/undetected in PBMCs: IFN-γ 138.08±72.44 ng/L vs 164.24±72.07 ng/L, t = 1.065, P = 0.297>0.05, TNF-α 80.75±47.30 ng/L vs74.10±49.70 ng/L, t= 0.407, P= 0.686>0.05; HBV DNA positive/negative: IFN-γ 136.77±70.04 ng/L vs 175.27±71.50 ng/L, t= 1.702, P= 0.097>0.05; TNF-α 75.37±43.02 ng/L vs 81.53±52.46 ng/L, t = 0.402,P = 0.690>0.05).CONCLUSION: The yielding of INF-γ and TNF-α from PBMCs is inhibited significantly by immunosuppressive agents following OLT with HBV load increased, indicating that the impaired immunity of host is associated with HBV recurrence after OLT.展开更多
OBJECTIVES: To investigate the changing patterns of functional and histological status, observe the posttransplantation survival of liver graft under different warm ischemia time (WIT) in rats, and determine the maxim...OBJECTIVES: To investigate the changing patterns of functional and histological status, observe the posttransplantation survival of liver graft under different warm ischemia time (WIT) in rats, and determine the maximum limitation of liver graft to warm ischemia. METHODS: According to WIT, the rats were randomized into 7 groups, with WIT of 0, 10, 15, 20, 30, 45, 60 minutes respectively. Serum concentrations of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were measured at 1, 2, 3 and 5 days after orthotopic liver transplantation respectively. Liver graft specimens were observed histopathologically at the same interval. The rats' survival in each subgroup was observed. RESULTS: In terms of graft survival, there was no significant difference between subgroups within 30-minute WIT. In the group with 30-minute WIT, the recipient rats' survival rate was 83.3% (10/12) at one week, 58.3% (7/12) at one month, and 50.0% (6/12) at 3 months. In the group with 45-minute WIT, the recipient rats' survival rate was 66.7% (8/12) at one week, 33.3% (4/12) at one month, and 8.3% (1/12) at 3 months, whereas only 8.3% (1/12) of the rats had one-week survival in the group with 60-minute WIT. CONCLUSIONS: These results indicate that rat liver graft could be safely subject to warm ischemia within 30 minutes. When WIT is prolonged to 45 minutes, the recipients long-term survival is severely insulted, and both function and histological structure of liver graft may develop irreversible damage when WIT is prolonged to 60 minutes.展开更多
AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane...AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy(CLDH).Intraoperative and postoperative outcomes(operative time,estimated blood loss,postoperative liver function,length of hospital stay,analgesia use,complications,and survival rate)were analyzed in donors and recipients.Articles were included if they:(1)compared the outcomes of MILDH and CLDH;and(2)reported at least some of the above outcomes.RESULTS Of 937 articles identified,13,containing 1592 patients,met our inclusion criteria and were included in the meta-analysis.For donors,operative time[weighted mean difference(WMD)=20.68,95%CI:-6.25-47.60, =0.13]and blood loss(WMD=-32.61,95%CI:-80.44-5.21, =0.18)were comparable in the two groups.In contrast,analgesia use(WMD=-7.79,9 5%C I:-1 4.0 6-1.8 7, =0.0 1),posto pera tive complications[odds ratio(OR)=0.62,95%CI:0.44-0.89, =0.009],and length of hospital stay(W M D):-1.2 5,9 5%C I:-2.3 5-0.1 4, =0.0 3)significantly favored MILDH.No differences were observed in recipient outcomes,including postoperative complications(OR=0.93,95%CI:0.66-1.31, =0.68)and survival rate(HR=0.96,95%CI:0.27-3.47, =0.95).Funnel plot and statistical methods showed a low probability of publication bias.CONCLUSION MILDH is safe,effective,and feasible for living donor liver resection with fewer donor postoperative complications,reduced length of hospital stay and analgesia requirement than CLDH.展开更多
AIM: To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver transplantation (OLT)-associated hepatic artery stenosis (HAS) and non-anastomosis bile duct stricture. ME...AIM: To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver transplantation (OLT)-associated hepatic artery stenosis (HAS) and non-anastomosis bile duct stricture. METHODS: Nine cases were diagnosed as HAS and non-anastomosis bile duct stricture. Percutaneous transluminal angioplasty (PTA) was performed in four HAS cases, and expectant treatment in other fi ve HAS cases; percutaneous transhepatic bile drainage, balloon dilation, stent placement were performed in all nine cases. RESULTS: Diffuse intra-and extra-bile duct stricture was observed in nine cases, which was associated with bile mud siltation and biliary infection. Obstruction of the bile duct was improved obviously or removed. Life span/ follow-up period was 13-30 mo after PTA of four HAS cases, 6-23 mo without PTA of other fi ve cases. CONCLUSION: Progressive, non-anastomosis, and diffuse bile duct stricture are the characteristic manifestations of HAS and non-anastomosis bile duct stricture after OLT. These are often associated with bile mud siltation, biliary infection, and ultimate liver failure. Interventional therapy is signifi cantly benefi cial.展开更多
Biliary stenosis is a common complication after liver transplantation,and has an incidence rate ranging from4.7%to 12.5%based on our previous study.Three types of biliary stenosis(anastomotic stenosis,nonanastomotic p...Biliary stenosis is a common complication after liver transplantation,and has an incidence rate ranging from4.7%to 12.5%based on our previous study.Three types of biliary stenosis(anastomotic stenosis,nonanastomotic peripheral stenosis and non-anastomotic central hilar stenosis)have been identified.We report the outcome of two patients with anastomotic stricture after liver transplantation who underwent successfulcutting balloon treatment.Case 1 was a 40-year-old male transplanted due to subacute fulminant hepatitis C.Case 2 was a 57-year-old male transplanted due to hepatitis B virus-related end-stage cirrhosis associated with hepatocellular carcinoma.Both patients had similar clinical scenarios:refractory anastomotic stenosis after orthotopic liver transplantation and failure of balloon dilation of the common bile duct to alleviate biliary stricture.展开更多
BACKGROUND Mesenchymal tumors such as perivascular epithelioid cell neoplasm(PEComa)and inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDC sarcoma)are relatively uncommon in the liver and are...BACKGROUND Mesenchymal tumors such as perivascular epithelioid cell neoplasm(PEComa)and inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDC sarcoma)are relatively uncommon in the liver and are particularly rare in the caudate lobe.The clinical manifestations and available imaging tests lack specificity for hepatic mesenchymal tumors.To the best of our knowledge,no caudate PEComa or IPT-like FDC sarcoma has been completely resected by laparoscopy.The standard laparoscopic technique,surgical approaches,and tumor margins for potentially malignant or malignant caudate mesenchymal tumors are still being explored.AIM To assess both the safety and feasibility of laparoscopic resection for rare caudate mesenchymal neoplasms.METHODS Eleven patients who underwent isolated caudate lobe resection from 2003 to 2017 were identified from a prospective database.Three consecutive patients with rare caudate mesenchymal tumors underwent laparoscopic resection.Patient demographic data,intraoperative parameters,and postoperative outcomes were assessed and compared with the open surgery group.RESULTS All procedures for the three resection patients with caudate mesenchymal tumors were completed using a total laparoscopic technique by two different approaches.The average operative time was 226 min,and the estimated blood loss was 133 mL.The average length of postoperative hospital stay was 6.3±0.3 d for the laparoscopy group and 15.5±2.3 d for the open surgery group(P<0.05).There were no perioperative complications or patient deaths in this series.CONCLUSION Laparoscopic isolated caudate lobe resection for rare mesenchymal neoplasms is a feasible and curative surgical option in selected patients.展开更多
BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not...BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS: The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years(older group,n60) and those younger than 60 years(younger group, n305).Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS: Except for age and preexisting chronic disease(P0.05),no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence(P0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group(P0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group(odds ratio=3.615, P0.014).CONCLUSIONS: Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.展开更多
We theoretically study the existence and stability of optical solitons in saturable nonlinearity with a two-dimensional parity–time(PT) symmetric Bessel potential.Besides the fundamental solitons,a novel type of dr...We theoretically study the existence and stability of optical solitons in saturable nonlinearity with a two-dimensional parity–time(PT) symmetric Bessel potential.Besides the fundamental solitons,a novel type of dressed soliton,whose intensity looks like a ring dressed on an intensity hump,are presented.It is found that both the fundamental solitons and dressed solitons can exist when the propagation constant is beyond a certain critical value.The propagation stability is investigated with a linear stability analysis corroborated by a beam propagation method.All the fundamental solitons are stable,while dressed solitons are unstable for low values of saturable parameter.As the value of saturable parameter increases,the dressed solitons tend to be stable at high powers.展开更多
Background: Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this...Background: Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features. Methods: One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t-test was obtained to analyze continuous variable. Results: No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P 〉 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ2 = 40.34, P〈 0.001; OR = 39.87). Conclusions: Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.展开更多
We study fundamental modes trapped in a rotating ring with a saturated nonlinear double-well potential. This model, which is based on the nonlinear Schrodinger equation, can be constructed in a twisted waveguide pipe ...We study fundamental modes trapped in a rotating ring with a saturated nonlinear double-well potential. This model, which is based on the nonlinear Schrodinger equation, can be constructed in a twisted waveguide pipe in terms of light propagation, or in a Bose-Einstein condensate (BEC) loaded into a toroidal trap under a combination of a rotating π-out-of-phase linear potential and nonlinear pseudopotential induced by means of a rotating optical field and the Feshbach resonance. Three types of fundamental modes are identified in this model, one symmetric and the other two asymmetric. The shape and stability of the modes and the transitions between different modes are investigated in the first rotational Brillouin zone. A similar model used a Kerr medium to build its nonlinear potential, but we replace it with a saturated nonlinear medium. The model exhibits not only symmetry breaking, but also symmetry recovery. A specific type of unstable asymmetric mode is also found, and the evolution of the unstable asymmetric mode features Josephson oscillation between two linear wells. By considering the model as a configuration of a BEC system, the ground state mode is identified among these three types, which characterize a specific distribution of the BEC atoms around the trap.展开更多
Background:We investigated the prognostic value of preoperative fibrinogen levels in hepatocellular carcinoma patients receiving liver transplantation by building a scoring model for predicting tumor recurrence.Method...Background:We investigated the prognostic value of preoperative fibrinogen levels in hepatocellular carcinoma patients receiving liver transplantation by building a scoring model for predicting tumor recurrence.Methods:Cox regression analysis was used to identify factors that predicted tumor recurrence,and a scoring model was generated by assigning a value of 0 or 1 to each independent risk factor.The cut-off value for fibrinogen was determined by receiver operating characteristic curve analysis.Results:Preoperative fibrinogen concentration was significantly higher in patients with vs.without tumor recurrence(3.27 g/L vs.2.34 g/L,P<0.001),with vs.without macrovascular invasion(3.54 g/L vs.2.82 g/L,P?0.007),and with>400 vs.400 ng/mL plasma alpha-fetoprotein concentration(3.43 g/L vs.2.76 g/L,P?0.007).The 5-year disease-free survival rate was significantly lower for patients with elevated(2.68 g/L)vs.normal(<2.68 g/L)fibrinogen concentration(37.2%vs.78.4%,P?0.001).Macrovascular invasion,>3 tumor nodules,and elevated fibrinogen concentration were independent risk factors for tumor recurrence.A scoring model based on these risk factors predicted recurrence with a sensitivity of 68.3%and a specificity of 87.5%.Conclusions:Elevated preoperative plasma fibrinogen concentration is associated with tumor recurrence in HCC patients after liver transplantation.A new scoring model predicted recurrence with good sensitivity and specificity.展开更多
基金supported by Dongguan Science and Technology of Social Development Program (Grant No. 20231800940532)Songshan Lake Sci-Tech Commissioner Program (Grant No. 20234373–01KCJ-G)supported, in part, by the Israel Science Foundation (Grant No. 1695/22)
文摘This concise review summarizes recent advancements in theoretical studies of vortex quantum droplets(VQDs)in matter-wave fields.These are robust self-trapped vortical states in two-and three-dimensional(2D and 3D)Bose–Einstein condensates(BECs)with intrinsic nonlinearity.Stability of VQDs is provided by additional nonlinearities resulting from quantum fluctuations around mean-field states,often referred to as the Lee–Huang–Yang(LHY)corrections.The basic models are presented,with emphasis on the interplay between the mean-field nonlinearity,LHY correction,and spatial dimension,which determines the structure and stability of VQDs.We embark by delineating fundamental properties of VQDs in the 3D free space,followed by consideration of their counterparts in the 2D setting.Additionally,we address stabilization of matter-wave VQDs by optical potentials.Finally,we summarize results for the study of VQDs in the single-component BEC of atoms carrying magnetic moments.In that case,the anisotropy of the long-range dipole-dipole interactions endows the VQDs with unique characteristics.The results produced by the theoretical studies in this area directly propose experiments for the observation of novel physical effects in the realm of quantum matter,and suggest potential applications to the design of new schemes for processing classical and quantum information.
基金Supported by National Natural Science Foundation of China,No.81372243,No.81570593 and No.81370575Key Scientific and Technological Projects of Guangdong Province,No.2014B020228003 and No.2014B030301041+2 种基金Natural Science Foundation of Guangdong Province,No.2015A030312013Science and Technology Planning Project of Guangzhou,No.201400000001-3,No.201508020262 and No.2014J4100128Science and Technology Planning Project of Guangdong Province,No.2017A020215178
文摘AIM To perform a meta-analysis on laparoscopic hepatectomy VS conventional liver resection for treating hepatolithiasis.METHODS We conducted a systematic literature search on Pub Med,Embase,Web of Science and Cochrane Library,and undertook a meta-analysis to compare the efficacy and safety of laparoscopic hepatectomy V S conventional open liver resection for local hepatolithiasis in the left or right lobe. Intraoperative and postoperative outcomes(time,estimated blood loss,blood transfusion rate,postoperative intestinal function recovery time,length of hospital stay,postoperative complication rate,initial residual stone,final residual stone and stone recurrence) were analyzed systematically.RESULTS A comprehensive literature search retrieved 16 publications with a total of 1329 cases. Meta-analysis of these studies showed that the laparoscopic approach for hepatolithiasis was associated with significantly less intraoperative estimated blood loss [weighted mean difference(WMD): 61.56,95% confidence interval(CI): 14.91-108.20,P = 0.01],lower blood transfusion rate [odds ratio(OR): 0.41,95%CI: 0.22-0.79,P = 0.008],shorter intestinal function recovery time(WMD: 0.98,95%CI: 0.47-1.48,P = 0.01),lower total postoperative complication rate(OR: 0.52,95%CI: 0.39-0.70,P < 0.0001) and shorter stay in hospital(WMD: 3.32,95%CI: 2.32-4.32,P < 0.00001). In addition,our results showed no significant differences between the two groups in operative time(WMD: 21.49,95%CI: 0.27-43.24,P = 0.05),residual stones(OR: 0.79,95%CI: 0.50-1.25,P = 0.31) and stone recurrence(OR: 0.34,95%CI: 0.11-1.08,P = 0.07). Furthermore,with subgroups analysis,our results proved that the laparoscopic approach for hepatolithiasis in the left lateral lobe and left side could achieve satisfactory therapeutic effects. CONCLUSION The laparoscopic approach is safe and effective,with less intraoperative estimated blood loss,fewer postoperative complications,reduced length of hospital stay and shorter intestinal function recovery time than with conventional approaches.
基金Supported by the Major State Basic Research Development Program (973 Program) of China (No. 2003CB515507) and Science and Technology Fund by Department of Education of Anhui Province
文摘AIM: To investigate whether microvessel density (MVD) is related with prognosis in gastric cancer patients, and the expression of cyclooxygenase-2 (COX-2) and vessel endothelial growth factor (VEGF) so as to determine the possible role of COX-2 and VEGF in gastric cancer angiogenesis.METHODS: Forty-seven formalin-fixed paraffin-embedded tissue samples of gastric cancer were evaluated for COX-2, VEGF by immunohitochemical staining. To assess tumor angiogenesis, MVD was determined by immunohitochemical staining of endothelial protein factor Ⅷ-related antigen. The relationship among COX-2 and VEGF expression, MVD, and clinicopathologic parameters was analyzed. RESULTS: Among the 67 samples, high MVD was significantly associated with lymph node metastasis and poor survival. Multivariate survival analysis showed that MVD value and lymph node metastasis were independent prognostic factors. The expression rate of COX-2 and VEGF was significantly higher than that of the adjacent tissues. COX-2 and VEGF expression in gastric cancer was significantly correlated with tumor differentiation and depth of invasion, but not with survival. The mean MVD value of COX-2 or VEGF positive tumors was higher than that of COX-2 or VEGF negative tumors. A significant correlation was found between the expressions of COX-2and VEGF. CONCLUSION: MVD may be one of the important prognostic factors for gastric cancer patients. COX-2 and VEGF may play an important role in tumor progression by stimulating angiogenesis. VEGF might play a main role in the COX-2 angiogenic pathway. The inhibition of angiogenesis or COX-2, VEGF activity may have an important therapeutic benefit in the control of gastric cancer.
基金Supported by National Natural Science Foundation of ChinaNo.81371554+1 种基金Science and Technology Planning Project of Guangdong Province of ChinaNo.2013B021800092
文摘Liver transplantation is an effective treatment for patients with end-stage liver disease. Accurate imaging evaluation of the transplanted patient is critical for ensuring that the limited donor liver is functioning appropriately. Ultrasound contrast agents(UCAs), in combination with contrastspecific imaging techniques, are increasingly accepted in clinical use for the assessment of the hepatic vasculature, bile ducts and liver parenchyma in pre-, intra- and posttransplant patients. We describe UCAs, their technical requirements, the recommended clinical indications, image interpretation and the limitations for contrastenhanced ultrasound applications in liver transplantation.
基金Supported by the Technology Program of Guangdong Province, No. 2004B35001001
文摘AIM: To study the association between host immunity and hepatitis B virus (HBV) recurrence after liver transplantation.METHODS: Peripheral blood mononuclear cells (PBMC) were isolated from 40 patients with hepatitis B and underwent orthotopic liver transplantation (OLT) before and 2, 4, 8 wk after surgery. After being cultured in vitro for 72 h, the levels of INF-γ and TNF-α in culture supernatants were detected with ELISA. At the same time, the quantities of HBV DNA in serum and PBMCs were measured by real time PCR.RESULTS: The levels of INF-γ and TNF-α in PBMC culture supernatants decreased before and 2, 4 wk after surgery in turns (INF-γ 155.52±72.32 ng/L vs14.76±9.88 ng/L vs 13.22±10.35 ng/L, F= 6.946, P = 0.027<0.05; TNF-α80.839±46.75 ng/L vs 18.59±17.29 ng/L vs9.758±7.96 ng/L,F= 22.61, P= 0.0001<0.05). The levels of INF-γ and TNF-α were higher in groups with phytohemagglutinin (PHA) than in those without PHA before surgery. However,the difference disappeared following OLT. Furthermore,INF-γ and TNF-α could not be detected in most patients at wk 4 and none at wk 8 after OLT. The HBV detection rate and virus load in PBMlC before and 2, 4 wk after surgery were fluctuated (HBV detected rate: 51.4%, 13.3%, 50% respectively; HBV DNA: 3.55±0.674 log(10) copies/mL vs 3.00±0.329 log(10) copies/mL vs 4.608±1.344 log(10) copies/mL, F= 7.582, P= 0.002<0.05). HBV DNA in serum was 4.48±1.463 log(10) copies/mL before surgery and <103 copies/mL after OLT except for one with 5.72×106 copies/mL 4 wk after OLT who was diagnosed as HBV recurrence.The levels of INF-γ, and TNF-α were lower in patients with a high HBV load than in those with a low HBV load (HBV DNA detected/undetected in PBMCs: IFN-γ 138.08±72.44 ng/L vs 164.24±72.07 ng/L, t = 1.065, P = 0.297>0.05, TNF-α 80.75±47.30 ng/L vs74.10±49.70 ng/L, t= 0.407, P= 0.686>0.05; HBV DNA positive/negative: IFN-γ 136.77±70.04 ng/L vs 175.27±71.50 ng/L, t= 1.702, P= 0.097>0.05; TNF-α 75.37±43.02 ng/L vs 81.53±52.46 ng/L, t = 0.402,P = 0.690>0.05).CONCLUSION: The yielding of INF-γ and TNF-α from PBMCs is inhibited significantly by immunosuppressive agents following OLT with HBV load increased, indicating that the impaired immunity of host is associated with HBV recurrence after OLT.
文摘OBJECTIVES: To investigate the changing patterns of functional and histological status, observe the posttransplantation survival of liver graft under different warm ischemia time (WIT) in rats, and determine the maximum limitation of liver graft to warm ischemia. METHODS: According to WIT, the rats were randomized into 7 groups, with WIT of 0, 10, 15, 20, 30, 45, 60 minutes respectively. Serum concentrations of alanine aminotransferase, aspartate aminotransferase, and lactate dehydrogenase were measured at 1, 2, 3 and 5 days after orthotopic liver transplantation respectively. Liver graft specimens were observed histopathologically at the same interval. The rats' survival in each subgroup was observed. RESULTS: In terms of graft survival, there was no significant difference between subgroups within 30-minute WIT. In the group with 30-minute WIT, the recipient rats' survival rate was 83.3% (10/12) at one week, 58.3% (7/12) at one month, and 50.0% (6/12) at 3 months. In the group with 45-minute WIT, the recipient rats' survival rate was 66.7% (8/12) at one week, 33.3% (4/12) at one month, and 8.3% (1/12) at 3 months, whereas only 8.3% (1/12) of the rats had one-week survival in the group with 60-minute WIT. CONCLUSIONS: These results indicate that rat liver graft could be safely subject to warm ischemia within 30 minutes. When WIT is prolonged to 45 minutes, the recipients long-term survival is severely insulted, and both function and histological structure of liver graft may develop irreversible damage when WIT is prolonged to 60 minutes.
基金Science and Technology Planning Project of Guangzhou,No.201604020001
文摘AIM To perform a systematic review and meta-analysis on minimally vs conventional invasive techniques for harvesting grafts for living donor liver transplantation.METHODS Pub Med,Web of Science,EMBASE,and the Cochrane Library were searched comprehensively for studies comparing MILDH with conventional living donor hepatectomy(CLDH).Intraoperative and postoperative outcomes(operative time,estimated blood loss,postoperative liver function,length of hospital stay,analgesia use,complications,and survival rate)were analyzed in donors and recipients.Articles were included if they:(1)compared the outcomes of MILDH and CLDH;and(2)reported at least some of the above outcomes.RESULTS Of 937 articles identified,13,containing 1592 patients,met our inclusion criteria and were included in the meta-analysis.For donors,operative time[weighted mean difference(WMD)=20.68,95%CI:-6.25-47.60, =0.13]and blood loss(WMD=-32.61,95%CI:-80.44-5.21, =0.18)were comparable in the two groups.In contrast,analgesia use(WMD=-7.79,9 5%C I:-1 4.0 6-1.8 7, =0.0 1),posto pera tive complications[odds ratio(OR)=0.62,95%CI:0.44-0.89, =0.009],and length of hospital stay(W M D):-1.2 5,9 5%C I:-2.3 5-0.1 4, =0.0 3)significantly favored MILDH.No differences were observed in recipient outcomes,including postoperative complications(OR=0.93,95%CI:0.66-1.31, =0.68)and survival rate(HR=0.96,95%CI:0.27-3.47, =0.95).Funnel plot and statistical methods showed a low probability of publication bias.CONCLUSION MILDH is safe,effective,and feasible for living donor liver resection with fewer donor postoperative complications,reduced length of hospital stay and analgesia requirement than CLDH.
基金Organ Transplantation Center, The Third Affi liated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
文摘AIM: To analyze the clinical manifestations and the effectiveness of therapy in patients with orthotopic liver transplantation (OLT)-associated hepatic artery stenosis (HAS) and non-anastomosis bile duct stricture. METHODS: Nine cases were diagnosed as HAS and non-anastomosis bile duct stricture. Percutaneous transluminal angioplasty (PTA) was performed in four HAS cases, and expectant treatment in other fi ve HAS cases; percutaneous transhepatic bile drainage, balloon dilation, stent placement were performed in all nine cases. RESULTS: Diffuse intra-and extra-bile duct stricture was observed in nine cases, which was associated with bile mud siltation and biliary infection. Obstruction of the bile duct was improved obviously or removed. Life span/ follow-up period was 13-30 mo after PTA of four HAS cases, 6-23 mo without PTA of other fi ve cases. CONCLUSION: Progressive, non-anastomosis, and diffuse bile duct stricture are the characteristic manifestations of HAS and non-anastomosis bile duct stricture after OLT. These are often associated with bile mud siltation, biliary infection, and ultimate liver failure. Interventional therapy is signifi cantly benefi cial.
基金Key Scientific and Technological Projects of Guangdong Province,No.2014B020228003,No.2014B030301041 and No.2015B020226004the Natural Science Foundation of Guangdong Province,No.2015A030312013the Science and Technology Planning Project of Guangzhou,No.201400000001-3 and No.158100076
文摘Biliary stenosis is a common complication after liver transplantation,and has an incidence rate ranging from4.7%to 12.5%based on our previous study.Three types of biliary stenosis(anastomotic stenosis,nonanastomotic peripheral stenosis and non-anastomotic central hilar stenosis)have been identified.We report the outcome of two patients with anastomotic stricture after liver transplantation who underwent successfulcutting balloon treatment.Case 1 was a 40-year-old male transplanted due to subacute fulminant hepatitis C.Case 2 was a 57-year-old male transplanted due to hepatitis B virus-related end-stage cirrhosis associated with hepatocellular carcinoma.Both patients had similar clinical scenarios:refractory anastomotic stenosis after orthotopic liver transplantation and failure of balloon dilation of the common bile duct to alleviate biliary stricture.
基金Supported by the National Natural Science Foundation of China,No.81600505Medical Scientific Research Foundation of Guangdong Province,No.A2017370
文摘BACKGROUND Mesenchymal tumors such as perivascular epithelioid cell neoplasm(PEComa)and inflammatory pseudotumor-like follicular dendritic cell sarcoma(IPT-like FDC sarcoma)are relatively uncommon in the liver and are particularly rare in the caudate lobe.The clinical manifestations and available imaging tests lack specificity for hepatic mesenchymal tumors.To the best of our knowledge,no caudate PEComa or IPT-like FDC sarcoma has been completely resected by laparoscopy.The standard laparoscopic technique,surgical approaches,and tumor margins for potentially malignant or malignant caudate mesenchymal tumors are still being explored.AIM To assess both the safety and feasibility of laparoscopic resection for rare caudate mesenchymal neoplasms.METHODS Eleven patients who underwent isolated caudate lobe resection from 2003 to 2017 were identified from a prospective database.Three consecutive patients with rare caudate mesenchymal tumors underwent laparoscopic resection.Patient demographic data,intraoperative parameters,and postoperative outcomes were assessed and compared with the open surgery group.RESULTS All procedures for the three resection patients with caudate mesenchymal tumors were completed using a total laparoscopic technique by two different approaches.The average operative time was 226 min,and the estimated blood loss was 133 mL.The average length of postoperative hospital stay was 6.3±0.3 d for the laparoscopy group and 15.5±2.3 d for the open surgery group(P<0.05).There were no perioperative complications or patient deaths in this series.CONCLUSION Laparoscopic isolated caudate lobe resection for rare mesenchymal neoplasms is a feasible and curative surgical option in selected patients.
基金supported by grants from the Major State Basic Research Development Program of China(973 Program)(2009CB522404)Science Technology Research Development Program of Guangdong Province(2011B031800060)Science Technology Research Development Program of Guangzhou(2011Y1000332)
文摘BACKGROUND: Hepatitis B virus(HBV)-related end-stage liver disease is the leading indication for liver transplantation in China, but long-term results of liver transplantation in patients aged over 60 years are not clear. The present study was to reveal the natural history of liver recipients with hepatitis B older than60 years.METHODS: The recipients who had received liver transplantation between December 2003 and December 2005 were divided into two groups: those equal or older than 60 years(older group,n60) and those younger than 60 years(younger group, n305).Risk factors for poor long-term outcome in patients aged over 60 years were also analyzed.RESULTS: Except for age and preexisting chronic disease(P0.05),no significant differences were observed in perioperative characteristics between the two groups. There was also no significant difference in HBV and hepatocellular carcinoma recurrence(P0.05). The actuarial 1-, 3-, 5- and 8-year survival rates were 81.6%, 71.6%, 66.7% and 63.3% respectively for the older group vs 84.9%, 77.7%, 70.8% and 65.6% for the younger group(P0.05). Multivariate analyses showed that pre-liver transplant renal insufficiency was a risk factor for poor outcome in the older group(odds ratio=3.615, P0.014).CONCLUSIONS: Liver transplantation is safe and feasible for patients with HBV-related end-stage liver disease aged over 60years. Older patients with renal insufficiency should undergo transplantation earlier than younger patients.
基金Project supported by the National Natural Science Foundation of China(Grant No.61308019)the Guangdong Provincial Natural Science Foundation,China(Grant Nos.2015A030313650 and 2014A030310262)the Guangdong Provincial Science and Technology Planning Program,China(Grant No.2017A010102019)
文摘We theoretically study the existence and stability of optical solitons in saturable nonlinearity with a two-dimensional parity–time(PT) symmetric Bessel potential.Besides the fundamental solitons,a novel type of dressed soliton,whose intensity looks like a ring dressed on an intensity hump,are presented.It is found that both the fundamental solitons and dressed solitons can exist when the propagation constant is beyond a certain critical value.The propagation stability is investigated with a linear stability analysis corroborated by a beam propagation method.All the fundamental solitons are stable,while dressed solitons are unstable for low values of saturable parameter.As the value of saturable parameter increases,the dressed solitons tend to be stable at high powers.
基金This work was supported by the grants from Guangzhou Programs for Natural Science Foundation of Guangdong Province (No. 201707010282), Scientific Research Project of Guangzhou (No. 2017A030310286), the National Natural Science Foundation of China (No. 81670071 ), and Science and Technology Planning Project of Guangdong Province (No. 2014A020212627).
文摘Background: Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features. Methods: One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t-test was obtained to analyze continuous variable. Results: No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P 〉 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ2 = 40.34, P〈 0.001; OR = 39.87). Conclusions: Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.
基金This study was supported by grants from the National Natural Science Foundation of China[No.81572726]the Natural Science Foundation of Guangdong Province[No.2018A030313641 and No.2016A030313848]+1 种基金the Science and Technology Planning Project of Guangdong Province[No.2014A020212122 and No.2016A020212004]the Medical Research Foundation of Guangdong Province[No.A2016312].
基金Acknowledgements G. Chen appreciates the useful discussions with Yongyao Li (SCAU Univ.). This work was supported by the National Natural Science Foundation of China (Grant No. 61308019), Guangdong Natural Science Foundation (Grant No. 2015A030313650), and the Foundation for Distin- guished Young Talents in Higher Education of Guangdong (Grant No. Yq2013157).
文摘We study fundamental modes trapped in a rotating ring with a saturated nonlinear double-well potential. This model, which is based on the nonlinear Schrodinger equation, can be constructed in a twisted waveguide pipe in terms of light propagation, or in a Bose-Einstein condensate (BEC) loaded into a toroidal trap under a combination of a rotating π-out-of-phase linear potential and nonlinear pseudopotential induced by means of a rotating optical field and the Feshbach resonance. Three types of fundamental modes are identified in this model, one symmetric and the other two asymmetric. The shape and stability of the modes and the transitions between different modes are investigated in the first rotational Brillouin zone. A similar model used a Kerr medium to build its nonlinear potential, but we replace it with a saturated nonlinear medium. The model exhibits not only symmetry breaking, but also symmetry recovery. A specific type of unstable asymmetric mode is also found, and the evolution of the unstable asymmetric mode features Josephson oscillation between two linear wells. By considering the model as a configuration of a BEC system, the ground state mode is identified among these three types, which characterize a specific distribution of the BEC atoms around the trap.
基金supported by Science and Technology Planning Project of Guangdong Province,China(2017B020209004)Major State Research Development Program of China(2017ZX10203205-006-001,2017ZX10203205-001-003).
文摘Background:We investigated the prognostic value of preoperative fibrinogen levels in hepatocellular carcinoma patients receiving liver transplantation by building a scoring model for predicting tumor recurrence.Methods:Cox regression analysis was used to identify factors that predicted tumor recurrence,and a scoring model was generated by assigning a value of 0 or 1 to each independent risk factor.The cut-off value for fibrinogen was determined by receiver operating characteristic curve analysis.Results:Preoperative fibrinogen concentration was significantly higher in patients with vs.without tumor recurrence(3.27 g/L vs.2.34 g/L,P<0.001),with vs.without macrovascular invasion(3.54 g/L vs.2.82 g/L,P?0.007),and with>400 vs.400 ng/mL plasma alpha-fetoprotein concentration(3.43 g/L vs.2.76 g/L,P?0.007).The 5-year disease-free survival rate was significantly lower for patients with elevated(2.68 g/L)vs.normal(<2.68 g/L)fibrinogen concentration(37.2%vs.78.4%,P?0.001).Macrovascular invasion,>3 tumor nodules,and elevated fibrinogen concentration were independent risk factors for tumor recurrence.A scoring model based on these risk factors predicted recurrence with a sensitivity of 68.3%and a specificity of 87.5%.Conclusions:Elevated preoperative plasma fibrinogen concentration is associated with tumor recurrence in HCC patients after liver transplantation.A new scoring model predicted recurrence with good sensitivity and specificity.