BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Ne...BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Nevertheless,the choice of surgical procedure is controversial after successful conversion therapy.We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization.CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/discomfort and nausea/vomiting for more than 1 mo.Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors(the largest was≥10 cm in diameter)located in the right liver and left medial lobe,and the left lateral lobe was normal.The future remnant liver(FRL)of the left lateral lobe accounted for only 18%of total liver volume after virtual resection on the three-dimensional liver model.Conversion therapy was adopted after orally administered entecavir for antiviral treatment.First,the right portal vein was embolized.Then tumor embolization was performed via the variant hepatic arteries.After 3 wk,the FRL of the left lateral lobe accounted for nearly 30%of the total liver volume.Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia.The in situ resection was performed via an anterior approach.The operating time was 240 min.No clamping was required during the surgery,and the intraoperative blood loss was 300 mL.There were no postoperative complications such as bile leakage,and the incision healed well.The patient was discharged on the 8th postoperative day.During the 3-mo follow-up,there was no recurrence and obvious hyperplasia of residual liver was observed.Alpha-fetoprotein decreased significantly and tended to be normal.CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs,the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver.Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.展开更多
In the process of formulating the General Provisions of the Civil Law of P. R. China, the attribute of virtual property rights has changed from real rights to non-real rights. Article No. 127 thereof does not clarify ...In the process of formulating the General Provisions of the Civil Law of P. R. China, the attribute of virtual property rights has changed from real rights to non-real rights. Article No. 127 thereof does not clarify the nature of virtual property rights after all, and the place where virtual property is put in the "Civil Rights" chapter of General Provisions of the Civil Law makes the concept even more complex and confusing. The "relationships paradigm" protection of virtual property does not have a definite classification criterion, nor stands opposite to the "rights paradigm." There are two different ways to justify the "theory of virtual property as a real right" under the "rights paradigm" protection, namely, essentialism and consequentialism. The former resulted from utilizing features in a demonstration and identifying disposal rights with real rights, while the latter resulted from adherence to the dichotomy system of property rights comprising real rights and creditor's rights. From the perspective of larceny in Criminal Law and virtual property insurance in The Social Insurance Law, the attribute of virtual property rights is irrelevant to creditor's rights. The attribute of virtual property rights shall be defined as virtual property rights so that it can be included in the system of civil rights. The uniqueness of virtual property is enough to become an object of emerging civil rights; intangible property rights as a superordinate theoretical concept cannot reflect the essence of virtual property rights. The legislative frame of virtual property rights shall be comprised of the subject, object, exercise, publication and change of the rights.展开更多
In this paper,we prove the converse of gem is right equivalent is also true in[1] and[2],obtain the necessary and sufficient conditions of equivalence of a class gems of C∞ function on Banach spaces.
基金Supported by the Inner Mongolia Autonomous Region Grassland Talent Cultivation Program,No.CYYC2012040.
文摘BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Nevertheless,the choice of surgical procedure is controversial after successful conversion therapy.We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization.CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/discomfort and nausea/vomiting for more than 1 mo.Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors(the largest was≥10 cm in diameter)located in the right liver and left medial lobe,and the left lateral lobe was normal.The future remnant liver(FRL)of the left lateral lobe accounted for only 18%of total liver volume after virtual resection on the three-dimensional liver model.Conversion therapy was adopted after orally administered entecavir for antiviral treatment.First,the right portal vein was embolized.Then tumor embolization was performed via the variant hepatic arteries.After 3 wk,the FRL of the left lateral lobe accounted for nearly 30%of the total liver volume.Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia.The in situ resection was performed via an anterior approach.The operating time was 240 min.No clamping was required during the surgery,and the intraoperative blood loss was 300 mL.There were no postoperative complications such as bile leakage,and the incision healed well.The patient was discharged on the 8th postoperative day.During the 3-mo follow-up,there was no recurrence and obvious hyperplasia of residual liver was observed.Alpha-fetoprotein decreased significantly and tended to be normal.CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs,the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver.Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.
基金a phase achievement of Research on the Legal Problem of Third Party Infringing Contract Conclusion Interestsa general item under the national social sciences foundation(item number:16BFX1l0)Research on Expansion of Non-normative Provisions in Civil Legislation,one of the national subjects on rule of law and legal theory(item number:16SFB3031)
文摘In the process of formulating the General Provisions of the Civil Law of P. R. China, the attribute of virtual property rights has changed from real rights to non-real rights. Article No. 127 thereof does not clarify the nature of virtual property rights after all, and the place where virtual property is put in the "Civil Rights" chapter of General Provisions of the Civil Law makes the concept even more complex and confusing. The "relationships paradigm" protection of virtual property does not have a definite classification criterion, nor stands opposite to the "rights paradigm." There are two different ways to justify the "theory of virtual property as a real right" under the "rights paradigm" protection, namely, essentialism and consequentialism. The former resulted from utilizing features in a demonstration and identifying disposal rights with real rights, while the latter resulted from adherence to the dichotomy system of property rights comprising real rights and creditor's rights. From the perspective of larceny in Criminal Law and virtual property insurance in The Social Insurance Law, the attribute of virtual property rights is irrelevant to creditor's rights. The attribute of virtual property rights shall be defined as virtual property rights so that it can be included in the system of civil rights. The uniqueness of virtual property is enough to become an object of emerging civil rights; intangible property rights as a superordinate theoretical concept cannot reflect the essence of virtual property rights. The legislative frame of virtual property rights shall be comprised of the subject, object, exercise, publication and change of the rights.
基金Supported by the National Science Foundation of China(60802045) Supported by the Science and Technology Foundation of Guizhou(20052004) Supported by the Science Foundation of Qiannan Normal College for Nationalities
文摘In this paper,we prove the converse of gem is right equivalent is also true in[1] and[2],obtain the necessary and sufficient conditions of equivalence of a class gems of C∞ function on Banach spaces.