Abdominal drainage systems in modified piggyback orthotopic liver transplantation

To the Editor:Whether orthotopic liver transplantation requires the placement of an abdominal drainage system is a controversial topic.A number of studies have suggested that prophylactic placement of abdominal drainage systems do not improve the diagnostic rate of complications such as bile leakage and hemorrhage after liver transplantation,even increased the risk of infection[1–3].However,there is no uniform standard for the selection of drainage tube and how to place the drainage tube in orthotopic liver transplantation.The types and placement modes of the drainage tubes used in each center are different.If adequate drainage is not possible,it may affect the drainage efficiency,which may lead to the misunderstanding that“it is unnecessary to place the drainage tube”.Herein we aimed to explore the most efficient abdominal drainage in modified piggyback orthotopic liver transplantation,based on the types and placement modes of drainage tubes in our clinical practice.

基于复杂网络的针刺治疗三叉神经痛选穴规律研究

Objective:To explore the acupoint selection rules of acupuncture for trigeminal neuralgia(TN) based on complex network.Methods:The articles on clinical research of acupuncture for TN published up to March 2019 were searched from the databases,i.e.CNKI,Wanfang,VIP,PubMed,Web of Science and Science Direct.A prescription database of acupuncture for TN was established.Using complex network,the core acupoints and acupoint selection rules were analyzed for TN treated with acupuncture.Results:A total of 304 articles,including 272 acupoint prescriptions were obtained.The complex network constructed for TN treated with acupuncture was in compliance with the small world effect.Using k-core analytic hierarchy process,36 acupoints were screened,and the total frequency of acupoints is1175.Regarding the meridian distribution,the points of yangming meridians of hand and foot were predominated,accounting for 50.21% of the overall(590/1175).In terms of acupoint location,the acupoints on the head and face were predominated,accounting for 52.51%(617/1175).For the types of acupoint,the specific acupoints were predominated,accounting for 71.32%(838/1175) and the majority was the intersecting points,accounting for 33.87%(398/1175).Based on community structure partition,the treatment of TN with acupuncture was divided into the treatment for symptoms,etiological treatment,and mind regulation.Besides,the supplementary acupoints based on the involved nerve branches of TN and those based on syndrome differentiation were recommended.Conclusion:The core acupoints of acupuncture for TN are Hégu(合谷LI4),Xiaguan(下关ST7),Tàichong(太冲LR3),Fēngchí(风池GB20) and Sìbái(四白ST2).In clinical treatment,the main therapeutics include the local analgesia for the symptoms and etiological treatment,associated with mind regulation.