[Objective] This study aimed to preliminarily select the plants with colored foliage adaptable to Zhengzhou area. [Method] An introduction trial on 42 varieties with colored foliage was conducted, in which major ornam...[Objective] This study aimed to preliminarily select the plants with colored foliage adaptable to Zhengzhou area. [Method] An introduction trial on 42 varieties with colored foliage was conducted, in which major ornamental characteristics, phenological phases and stress resistance of all the introduced plants with colored foliage were observed and the introduced plants were comprehensively evaluated. [Result] Golden-and Compound-leaved Maple, Red-leaved Sakura, Pink-and Compound-leaved Maple, Amur Maple, Purple-leaved Canadian Redbud with good performance were selected preliminarily, which can be applied for landscape in Zhengzhou area. Among them, Golden- and Compound-leaved Maple, Golden- and Silvery-leaved Maple and Purple-leaved Smoketree can either be planted separately, or in a line as boulevard trees, or in groups as ornamental forest; Red-leaved Sakura, Pink- and Compound-leaved Maple and Purple-leaved Canadian Redbud can be planted in groups or separately in gardens, parks or alongside streets or in front of buildings; Amur Maple with high adaptability is a excellent tree species for afforesting barren mountain. [Conclusion] This study has not only provided new excellent germplasm sources for the landscaping in Zhengzhou area, thus favoring the improvement of local landscaping level, but also provides examples and references for the introduction of plants with colored foliage in the other areas.展开更多
The development, distribution and features of one hundred and forty botanical gardens (BGs) in China are reported and their functions on research, conservation, display and utilization of biodiversity are summarized i...The development, distribution and features of one hundred and forty botanical gardens (BGs) in China are reported and their functions on research, conservation, display and utilization of biodiversity are summarized in this paper. The contributions to the social and economic development in the early stage of Chinese BGs with the researches of economic plant (tobacco), medicinal plant (yam) and wild fruit tree resources are evaluated. The theoretical and applied achievements in recent years in seed science, plant conservation, economic plant introduction, acclimatization and breeding are also described. A general scope of living plant collections in Chinese BGs is presented and the outstanding ones, including Magnoliaceae, Zingiberaceae, Cycadaceae, medicinal plants, Actinidia and Rhododendron are particularly mentioned. With special reference to Chinese penjing art garden and silicified wood garden, the development of scientific popularization and tourism in BGs is reviewed.展开更多
Spectral index methodology has been widely used in Leaf Area Index(LAI) retrieval at different spatial scales. There are differences in the spectral response of different remote sensors and thus spectral scale effect ...Spectral index methodology has been widely used in Leaf Area Index(LAI) retrieval at different spatial scales. There are differences in the spectral response of different remote sensors and thus spectral scale effect generated during the use of spectral indices to retrieve LAI. In this study, PROSPECT, leaf optical properties model and Scattering by Arbitrarily Inclined Layers(SAIL) model, were used to simulate canopy spectral reflectance with a bandwidth of 5 nm and a Gaussian spectral response function was employed to simulate the spectral data at six bandwidths ranging from 10 to 35 nm. Additionally, for bandwidths from 5 to 35 nm, the correlation between the spectral index and LAI, and the sensitivities of the spectral index to changes in LAI and bandwidth were analyzed. Finally, the reflectance data at six bandwidths ranging from 40 to 65 nm were used to verify the spectral scale effect generated during the use of the spectral index to retrieve LAI. Results indicate that Vegetation Index of the Universal Pattern Decomposition(VIUPD) had the highest accuracy during LAI retrieval. Followed by Normalized Difference Vegetation Index(NDVI), Modified Simple Ratio Indices(MSRI) and Triangle Vegetation Index(TVI), although the coefficient of determination R^2 was higher than 0.96, the retrieved LAI values were less than the actual value and thus lacked validity. Other spectral indices were significantly affected by the spectral scale effect with poor retrieval results. In this study, VIUPD, which exhibited a relatively good correlation and sensitivity to LAI, was less affected by the spectral scale effect and had a relatively good retrieval capability. This conclusion supports a purported feature independent of the sensor of this model and also confirms the great potential of VIUPD for retrieval of physicochemical parameters of vegetation using multi-source remote sensing data.展开更多
The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treat...The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection(RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease(IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhoodonset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.展开更多
Pancreatic fistula is a quite rare complication in patients who undergo living donor liver transplantation(LDLT).However,in the cases that show pancreatic fistula,the limited volume of the graft and the resultant inad...Pancreatic fistula is a quite rare complication in patients who undergo living donor liver transplantation(LDLT).However,in the cases that show pancreatic fistula,the limited volume of the graft and the resultant inadequate liver function may complicate the management of the fistula.As a result,the pancreatic fistula may result in the death of the patient.We present 2 cases in whichendoscopic treatment was effective against pancreatic fistulas that developed after LDLT.In case 1,a 61-yearold woman underwent LDLT for primary biliary cirrhosis.Because of a portal venous thrombus caused by a splenorenal shunt,the patient underwent portal vein reconstruction,and a splenorenal shunt was ligated on postoperative day(POD)7.The main pancreatic duct was injured during the manipulation to achieve hemostasis,thereby necessitating open drainage.However,discharge of pancreatic fluid continued even after POD 300.Endoscopic naso-pancreatic drainage(ENPD)was performed,and this procedure resulted in a remarkable decrease in drain output.The refractory pancreatic fistula healed on day 40 after ENPD.In case 2,a 58-year-old man underwent LDLT for cirrhosis caused by the hepatitis C virus.When the portal vein was exposed during thrombectomy,the pancreatic head was injured,which led to the formation of a pancreatic fistula.Conservative therapy was ineffective;therefore,ENPD was performed.The pancreatic fistula healed on day 38 after ENPD.The findings in these 2 cases show that endoscopic drainage of the main pancreatic duct is a less invasive and effective treatment for pancreatic fistulas that develop after LDLT.展开更多
The Poyang Lake is a Ramsar site and is the important over-wintering site for migratory waterbirds along the East Asian-Australasian Fly way. Examining the effects of water level fluctuations on waterbird abundance an...The Poyang Lake is a Ramsar site and is the important over-wintering site for migratory waterbirds along the East Asian-Australasian Fly way. Examining the effects of water level fluctuations on waterbird abundance and analyzing the influencing mechanism is critical to waterbird protection in the context of hydrological alteration. In this study, the effect of water level regime on wintering goose abundance was examined and the influencing mechanism was interpreted. Synchronous waterbirds survey data, hydro- logical data, Moderate Resolution Imaging Spectroradiometer-Normalized Difference Vegetation Index (MODIS-NDVI) data and habi- tat data derived from Landsat TNUETM data and HJ/CCD data were combined. The satellite-derived Green Wave Index (GWI) based on MODIS-NDVI dataset was applied to detect changes in goose food resources. It was found that habitat size and vegetation conditions are key factors determining goose abundance. Geese numbers were positively correlated with habitat area, while intermediate range of vegetation productivity might benefit the goose abundance. Water level affects goose abundance by changing available habitat areas and vegetation conditions. We suggested that matching hydrological regime and exposed meadows time to wintering geese dynamics was crucial in the Poyang Lake wetlands. Our study could provide sound scientific information for hydrological management in the context of waterbird conservation.展开更多
In this paper, based on the analysis of satellite measurements, the authors conclude that the continuous seasonal droughts intensify the browning of woody vegetation and that evergreen needleleaf forest(ENF) shows a l...In this paper, based on the analysis of satellite measurements, the authors conclude that the continuous seasonal droughts intensify the browning of woody vegetation and that evergreen needleleaf forest(ENF) shows a larger browning percentage than other woody vegetation types over Yunnan Province. Based on the Tropical Rainfall Measuring Mission(TRMM) precipitation standardized anomaly, in the dry season, which is from October to March, the 2010 drought affected an area of Yunnan Province 1.77 times larger than the 2012 drought, but in the post-drought months(April to June), the browning area of all woody vegetation in 2012 was 1.11 times larger than that in 2010 on the basis of the enhanced vegetation index(EVI) standardized anomaly. The reduction of vegetation greenness over large areas of Yunnan Province represents a photosynthetic capacity loss which will have an impact on carbon fluxes to the atmosphere.展开更多
This is an editorial comment on a recent publication reporting an increased rate of pyogenic liver abscesses(PLAs) after upper gastrointestinal panendoscopy. Its aim is to critically highlight the findings, limitation...This is an editorial comment on a recent publication reporting an increased rate of pyogenic liver abscesses(PLAs) after upper gastrointestinal panendoscopy. Its aim is to critically highlight the findings, limitations and potential clinical implications of this study. Issues of the mucosal barrier, the microbial flora, administration of antibiotics and underlying diseases are discussed. The probability of PLAs after endoscopies is not exactly known and the length of the "incubation period" remains unclear, but a possible causality should already suffice to make us think how to avoid them. Especially in patients with risk factors such as diabetes mellitus, end-stage renal disease, liver cirrhosis, biliary tract infection, and malignancies, the potential risk for PLAs should be considered. Unnecessary insufflation during endoscopy(causing mucosal stretching and microscopic tears) as well as mucosal damage(by direct abrasion with the scope) should be avoided in order to limit the invasiveness of the procedure as much as possible. And, in everyday routine, it should be kept in mind that in patients after endoscopy, especially in those with a breach of the mucosal barrier and significant comorbidities, PLAs can potentially develop and require timely administration of antibiotics as well as further diagnostic and therapeutic steps.展开更多
Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an is- sue. Benefit of oversizing strategies to prevent them isn't well established. We com...Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an is- sue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of con- secutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. Methods From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien~ or Corevalve devices~. Retrospectively, according to pre-procedural MSCT and the valve size, pa- tients were classified into three groups: normal, moderate and severe oversizing; depending on the ratio between the prosthesis area and the annulus area indexed and measured on MSCT. Main endpoint was mid-term mortality and secondary endpoints were the Valve Academic Research Consortium (VARC-2) endpoints. Results Two hundred and sixty eight patients had a MSCT and underwent TAVI procedure, with mainly Corevalve~. While all-cause and cardiovascular mortality rates were similar in all groups, post-procedural new pacemaker (PM) implantation rate was significantly higher in the severe oversizing group (P = 0.03), while we observed more in-hospital congestive heart-failure (P = 0.02) in the normal sizing group. There was a trend toward more moderate to severe aortic regurgitation (AR) in the normal sizing group (P = 0.07). Conclusions Despite a higher rate of PM implantation, oversizing based on this ratio reduces aortic leak with lower rates of post-procedural complications and a similar mid-term survival.展开更多
Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopi...Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopic retrograde cholangiopancreatography,cholecystectomy,biliary tract surgery,and liver transplantation.Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients.Hemobilia may also be caused by coagulation defects.It can form intracholedochal hematomas,causing obstructive jaundice.Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure.Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation,but in our case,percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot,with a good outcome.展开更多
AIM:To investigate the impact of different time points of secondary warm ischemia on bile duct in a rat autologous liver transplantation model with external bile drainage.METHODS:One hundred and thirty-six male inbred...AIM:To investigate the impact of different time points of secondary warm ischemia on bile duct in a rat autologous liver transplantation model with external bile drainage.METHODS:One hundred and thirty-six male inbred SD rats were randomly assigned to one of four groups(Ⅰ-Ⅳ) according to the secondary warm ischemia time of 0,10,20 and 40 min.A rat model of autologous liver transplantation with continuous external biliary drainage under ether anesthesia was established.Ten rats in each group were used to evaluate the one-week survival rate.At 6 h,24 h,3 d and 7 d after reperfusion of the hepatic artery,6 rats were killed in each group to collect the blood sample via the infrahepatic vena cava and the median lobe of liver for assay.Warm ischemia time of liver,cold perfusion time,anhepaticphase,operative duration for biliary external drainage and survival rates in the four groups were analyzed for the establishment of models.RESULTS:No significant difference was shown in warm ischemia time,anhepatic phase and operative duration for biliary external drainage among the four groups.Five of the 40 rats in this study evaluated for the one-week survival rate died,including three deaths of severe pulmonary infection in group Ⅳ.A significant decrease of one-week survival rate in group Ⅳ was noted compared with the other three groups.With the prolongation of the biliary warm ischemia time,the indexes of the liver function assessment were significantly elevated,and biliary epithelial cell apoptosis index also increased.Pathological examinations showed significantly aggravated inflammation in the portal area and bile duct epithelial cell injury with the prolonged secondary warm ischemia time.Microthrombi were found in the micrangium around the biliary tract in some sections from groups Ⅲ and Ⅳ.CONCLUSION:The relationship between secondary warm ischemia time and the bile duct injury degree is time-dependent,and 20 min of secondary warm ischemia time is feasible for the study of bile duct injury.展开更多
文摘[Objective] This study aimed to preliminarily select the plants with colored foliage adaptable to Zhengzhou area. [Method] An introduction trial on 42 varieties with colored foliage was conducted, in which major ornamental characteristics, phenological phases and stress resistance of all the introduced plants with colored foliage were observed and the introduced plants were comprehensively evaluated. [Result] Golden-and Compound-leaved Maple, Red-leaved Sakura, Pink-and Compound-leaved Maple, Amur Maple, Purple-leaved Canadian Redbud with good performance were selected preliminarily, which can be applied for landscape in Zhengzhou area. Among them, Golden- and Compound-leaved Maple, Golden- and Silvery-leaved Maple and Purple-leaved Smoketree can either be planted separately, or in a line as boulevard trees, or in groups as ornamental forest; Red-leaved Sakura, Pink- and Compound-leaved Maple and Purple-leaved Canadian Redbud can be planted in groups or separately in gardens, parks or alongside streets or in front of buildings; Amur Maple with high adaptability is a excellent tree species for afforesting barren mountain. [Conclusion] This study has not only provided new excellent germplasm sources for the landscaping in Zhengzhou area, thus favoring the improvement of local landscaping level, but also provides examples and references for the introduction of plants with colored foliage in the other areas.
文摘The development, distribution and features of one hundred and forty botanical gardens (BGs) in China are reported and their functions on research, conservation, display and utilization of biodiversity are summarized in this paper. The contributions to the social and economic development in the early stage of Chinese BGs with the researches of economic plant (tobacco), medicinal plant (yam) and wild fruit tree resources are evaluated. The theoretical and applied achievements in recent years in seed science, plant conservation, economic plant introduction, acclimatization and breeding are also described. A general scope of living plant collections in Chinese BGs is presented and the outstanding ones, including Magnoliaceae, Zingiberaceae, Cycadaceae, medicinal plants, Actinidia and Rhododendron are particularly mentioned. With special reference to Chinese penjing art garden and silicified wood garden, the development of scientific popularization and tourism in BGs is reviewed.
基金National Natural Science Foundation of China(No.41401002)Jilin Province Science Foundation for Youths(No.20160520077JH)
文摘Spectral index methodology has been widely used in Leaf Area Index(LAI) retrieval at different spatial scales. There are differences in the spectral response of different remote sensors and thus spectral scale effect generated during the use of spectral indices to retrieve LAI. In this study, PROSPECT, leaf optical properties model and Scattering by Arbitrarily Inclined Layers(SAIL) model, were used to simulate canopy spectral reflectance with a bandwidth of 5 nm and a Gaussian spectral response function was employed to simulate the spectral data at six bandwidths ranging from 10 to 35 nm. Additionally, for bandwidths from 5 to 35 nm, the correlation between the spectral index and LAI, and the sensitivities of the spectral index to changes in LAI and bandwidth were analyzed. Finally, the reflectance data at six bandwidths ranging from 40 to 65 nm were used to verify the spectral scale effect generated during the use of the spectral index to retrieve LAI. Results indicate that Vegetation Index of the Universal Pattern Decomposition(VIUPD) had the highest accuracy during LAI retrieval. Followed by Normalized Difference Vegetation Index(NDVI), Modified Simple Ratio Indices(MSRI) and Triangle Vegetation Index(TVI), although the coefficient of determination R^2 was higher than 0.96, the retrieved LAI values were less than the actual value and thus lacked validity. Other spectral indices were significantly affected by the spectral scale effect with poor retrieval results. In this study, VIUPD, which exhibited a relatively good correlation and sensitivity to LAI, was less affected by the spectral scale effect and had a relatively good retrieval capability. This conclusion supports a purported feature independent of the sensor of this model and also confirms the great potential of VIUPD for retrieval of physicochemical parameters of vegetation using multi-source remote sensing data.
文摘The role of fecal microbial transplant(FMT) in the treatment of pediatric gastrointestinal disease has become increasingly popular among pediatric practitioners, patients, and parents. The success of FMT for the treatment of recurrent Clostridium difficile infection(RCDI) has bolstered interest in its potential application to other disease states, such as inflammatory bowel disease(IBD). FMT has particular interest in pediatrics, given the concerns of patients and parents about rates of adverse events with existing therapeutic options, and the greater cumulative medication burden associated with childhoodonset disease. Published literature on the use of FMT in pediatrics is sparse. Only 45 pediatric patients treated for RCDI have been reported, and only 27 pediatric patients with pediatric IBD. The pediatric microbiome may uniquely respond to microbial-based therapies. This review will provide a comprehensive overview of fecal microbial transplant and its potential role in the treatment of pediatric inflammatory bowel disease. We will discuss the microbiome in pediatric inflammatory bowel disease, existing adult and pediatric literature on the use of FMT in IBD treatment, and pediatric FMT trials that are currently recruiting patients. This review will also discuss features of the microbiome that may be associated with host response in fecal transplant, and potential challenges and opportunities for the future of FMT in pediatric IBD treatment.
文摘Pancreatic fistula is a quite rare complication in patients who undergo living donor liver transplantation(LDLT).However,in the cases that show pancreatic fistula,the limited volume of the graft and the resultant inadequate liver function may complicate the management of the fistula.As a result,the pancreatic fistula may result in the death of the patient.We present 2 cases in whichendoscopic treatment was effective against pancreatic fistulas that developed after LDLT.In case 1,a 61-yearold woman underwent LDLT for primary biliary cirrhosis.Because of a portal venous thrombus caused by a splenorenal shunt,the patient underwent portal vein reconstruction,and a splenorenal shunt was ligated on postoperative day(POD)7.The main pancreatic duct was injured during the manipulation to achieve hemostasis,thereby necessitating open drainage.However,discharge of pancreatic fluid continued even after POD 300.Endoscopic naso-pancreatic drainage(ENPD)was performed,and this procedure resulted in a remarkable decrease in drain output.The refractory pancreatic fistula healed on day 40 after ENPD.In case 2,a 58-year-old man underwent LDLT for cirrhosis caused by the hepatitis C virus.When the portal vein was exposed during thrombectomy,the pancreatic head was injured,which led to the formation of a pancreatic fistula.Conservative therapy was ineffective;therefore,ENPD was performed.The pancreatic fistula healed on day 38 after ENPD.The findings in these 2 cases show that endoscopic drainage of the main pancreatic duct is a less invasive and effective treatment for pancreatic fistulas that develop after LDLT.
基金Under the auspices of National Natural Science Foundation of China(No.41171030,41471088)
文摘The Poyang Lake is a Ramsar site and is the important over-wintering site for migratory waterbirds along the East Asian-Australasian Fly way. Examining the effects of water level fluctuations on waterbird abundance and analyzing the influencing mechanism is critical to waterbird protection in the context of hydrological alteration. In this study, the effect of water level regime on wintering goose abundance was examined and the influencing mechanism was interpreted. Synchronous waterbirds survey data, hydro- logical data, Moderate Resolution Imaging Spectroradiometer-Normalized Difference Vegetation Index (MODIS-NDVI) data and habi- tat data derived from Landsat TNUETM data and HJ/CCD data were combined. The satellite-derived Green Wave Index (GWI) based on MODIS-NDVI dataset was applied to detect changes in goose food resources. It was found that habitat size and vegetation conditions are key factors determining goose abundance. Geese numbers were positively correlated with habitat area, while intermediate range of vegetation productivity might benefit the goose abundance. Water level affects goose abundance by changing available habitat areas and vegetation conditions. We suggested that matching hydrological regime and exposed meadows time to wintering geese dynamics was crucial in the Poyang Lake wetlands. Our study could provide sound scientific information for hydrological management in the context of waterbird conservation.
基金funded by the National Basic Research Program of China (Grant No. 2012CB956202)the Strategic Priority Research Program of the Chinese Academy of Sciences (Grant No. XDA05090200)
文摘In this paper, based on the analysis of satellite measurements, the authors conclude that the continuous seasonal droughts intensify the browning of woody vegetation and that evergreen needleleaf forest(ENF) shows a larger browning percentage than other woody vegetation types over Yunnan Province. Based on the Tropical Rainfall Measuring Mission(TRMM) precipitation standardized anomaly, in the dry season, which is from October to March, the 2010 drought affected an area of Yunnan Province 1.77 times larger than the 2012 drought, but in the post-drought months(April to June), the browning area of all woody vegetation in 2012 was 1.11 times larger than that in 2010 on the basis of the enhanced vegetation index(EVI) standardized anomaly. The reduction of vegetation greenness over large areas of Yunnan Province represents a photosynthetic capacity loss which will have an impact on carbon fluxes to the atmosphere.
文摘This is an editorial comment on a recent publication reporting an increased rate of pyogenic liver abscesses(PLAs) after upper gastrointestinal panendoscopy. Its aim is to critically highlight the findings, limitations and potential clinical implications of this study. Issues of the mucosal barrier, the microbial flora, administration of antibiotics and underlying diseases are discussed. The probability of PLAs after endoscopies is not exactly known and the length of the "incubation period" remains unclear, but a possible causality should already suffice to make us think how to avoid them. Especially in patients with risk factors such as diabetes mellitus, end-stage renal disease, liver cirrhosis, biliary tract infection, and malignancies, the potential risk for PLAs should be considered. Unnecessary insufflation during endoscopy(causing mucosal stretching and microscopic tears) as well as mucosal damage(by direct abrasion with the scope) should be avoided in order to limit the invasiveness of the procedure as much as possible. And, in everyday routine, it should be kept in mind that in patients after endoscopy, especially in those with a breach of the mucosal barrier and significant comorbidities, PLAs can potentially develop and require timely administration of antibiotics as well as further diagnostic and therapeutic steps.
文摘Background Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an is- sue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of con- secutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. Methods From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien~ or Corevalve devices~. Retrospectively, according to pre-procedural MSCT and the valve size, pa- tients were classified into three groups: normal, moderate and severe oversizing; depending on the ratio between the prosthesis area and the annulus area indexed and measured on MSCT. Main endpoint was mid-term mortality and secondary endpoints were the Valve Academic Research Consortium (VARC-2) endpoints. Results Two hundred and sixty eight patients had a MSCT and underwent TAVI procedure, with mainly Corevalve~. While all-cause and cardiovascular mortality rates were similar in all groups, post-procedural new pacemaker (PM) implantation rate was significantly higher in the severe oversizing group (P = 0.03), while we observed more in-hospital congestive heart-failure (P = 0.02) in the normal sizing group. There was a trend toward more moderate to severe aortic regurgitation (AR) in the normal sizing group (P = 0.07). Conclusions Despite a higher rate of PM implantation, oversizing based on this ratio reduces aortic leak with lower rates of post-procedural complications and a similar mid-term survival.
基金Supported by National Natural Science Foundation of China, No.81072029 and No.91029721Program for New Century Excellent Talents in University,Ministry of Education of China,No. NCET-09-0160
文摘Hemobilia is a rare biliary complication of liver transplantation.The predominant cause of hemobilia is iatrogenic,and it is often associated with traumatic operations,such as percutaneous liver intervention,endoscopic retrograde cholangiopancreatography,cholecystectomy,biliary tract surgery,and liver transplantation.Percutaneous transhepatic cholangiography and liver biopsy are two major causes of hemobilia in liver transplant recipients.Hemobilia may also be caused by coagulation defects.It can form intracholedochal hematomas,causing obstructive jaundice.Herein we describe a patient with an intracholedochal hematoma resulting in significant obstructive jaundice after liver transplantation for fulminant hepatic failure.Previous studies have shown that percutaneous transhepatic manipulation is a major cause of hemobilia after liver transplantation,but in our case,percutaneous transhepatic intervention was used to relieve the biliary obstruction and dissolve the biliary clot,with a good outcome.
基金Supported by Grants from Jiangsu Provincial Government,China,No. ZX200605
文摘AIM:To investigate the impact of different time points of secondary warm ischemia on bile duct in a rat autologous liver transplantation model with external bile drainage.METHODS:One hundred and thirty-six male inbred SD rats were randomly assigned to one of four groups(Ⅰ-Ⅳ) according to the secondary warm ischemia time of 0,10,20 and 40 min.A rat model of autologous liver transplantation with continuous external biliary drainage under ether anesthesia was established.Ten rats in each group were used to evaluate the one-week survival rate.At 6 h,24 h,3 d and 7 d after reperfusion of the hepatic artery,6 rats were killed in each group to collect the blood sample via the infrahepatic vena cava and the median lobe of liver for assay.Warm ischemia time of liver,cold perfusion time,anhepaticphase,operative duration for biliary external drainage and survival rates in the four groups were analyzed for the establishment of models.RESULTS:No significant difference was shown in warm ischemia time,anhepatic phase and operative duration for biliary external drainage among the four groups.Five of the 40 rats in this study evaluated for the one-week survival rate died,including three deaths of severe pulmonary infection in group Ⅳ.A significant decrease of one-week survival rate in group Ⅳ was noted compared with the other three groups.With the prolongation of the biliary warm ischemia time,the indexes of the liver function assessment were significantly elevated,and biliary epithelial cell apoptosis index also increased.Pathological examinations showed significantly aggravated inflammation in the portal area and bile duct epithelial cell injury with the prolonged secondary warm ischemia time.Microthrombi were found in the micrangium around the biliary tract in some sections from groups Ⅲ and Ⅳ.CONCLUSION:The relationship between secondary warm ischemia time and the bile duct injury degree is time-dependent,and 20 min of secondary warm ischemia time is feasible for the study of bile duct injury.