AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were ...AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.展开更多
Background and aims:Hepatocellular carcinoma is one of the most common cancers worldwide.Previous studies have reported he influence of various hepatic blood flow occlusions on tumor behavior,which is mainly mediated ...Background and aims:Hepatocellular carcinoma is one of the most common cancers worldwide.Previous studies have reported he influence of various hepatic blood flow occlusions on tumor behavior,which is mainly mediated by liver ischemia-reperfusion.Although some genes and pathways have been determined,the whole transcriptome after various hepatic blood flow occlusions is lacking.Methods:We systematically explored transcriptome changes after various hepatic blood flow occlusions,including sham operation(SO;n=10),occlusion of the portal triad(OPT;n=10),and occlusion of the portal vein(OPV;n=10),by RNA-sequencing.Results:HE sections and TUNEL assays showed different liver injury among groups.We identified the top altered genes and pathways.Compared with the SO group,96 genes were altered in OPV,with 81 upregulated and 15 downregulated genes.The top 5 upregulated genes were Pdk4,Serpina12,Depp1,Igfbp1,and Mup22.The top 5 downregulated genes were Sprr1a,Serpinb2,Tnc,Cdkn3,and Cenpu.Compared with the SO group,there were 20 differentially expressed genes in OPT,with 18 upregulated and 2 downregulated genes.The top 5 upregulated genes wereC7,Zbtb16,Gabrp,Pdk4,and Mmrn1.The top 2 downregulated genes were Krt20 and Sis.Compared with the OPV group,72 differentially expressed genes were in OPT,with 39 upregulated and 33 downregulated genes.The top 5 upregulated genes wereHspa1b,Hbb-bs,Phf19,Ddias,and Rad54b.The top 5 downregulated genes were Cish,Socs2,Slc25a30,Rgs3,and Hsd3b5.Conclusion:Various surgical methods have an obvious influence on the transcriptome of tumors.展开更多
Background The Pringle maneuver, which has been the standard for hepatic resection surgery for a long time, has the major flaw of ischemic damage in the liver. The aim of this research was to evaluate hepatic blood in...Background The Pringle maneuver, which has been the standard for hepatic resection surgery for a long time, has the major flaw of ischemic damage in the liver. The aim of this research was to evaluate hepatic blood inflow occlusion with/without hemihepatic artery control vs. the Pringle maneuver in hepatocellular carcinoma （HCC） resection. Methods Two hundred and eighty-one cases of resection of HCC with hepatic blood inflow occlusion （with/without hemihepatic artery control） and the Pringle maneuver from January 2006 to December 2008 in our hospital were analyzed and compared retrospectively; among them 107 were in group I （Pringle maneuver）, 98 in group II （hepatic blood inflow occlusion）, and 76 in group III （hepatic blood inflow occlusion without hemihepatic artery control）. The operation time, intraoperative blood loss, postoperative liver function and complications were used as the endpoints for evaluation. Results The operative duration and intraoperative blood loss of three groups showed no significant difference; alanine aminotransferase, total bilirubin and incidence of postoperative complications were significantly lower in groups II and Ill postoperation than those in group I. Conclusion Hepatic blood inflow occlusion without hemihepatic artery control is safe, convenient and feasible for resection of HCC, especially for cases involving underlying diseases such as cirrhosis.展开更多
AIM:To evaluate the changes in ocular blood flow with color Doppler ultrasonography(CDU) after intravitreal triamcinolone acetonide(IVTA) injection.METHODS:A total of 46 patients who underwent IVTA(4 mg/0.1 mL) inject...AIM:To evaluate the changes in ocular blood flow with color Doppler ultrasonography(CDU) after intravitreal triamcinolone acetonide(IVTA) injection.METHODS:A total of 46 patients who underwent IVTA(4 mg/0.1 mL) injection for diabetic macular edema(DME)(n =22), central retinal vein occlusion(CRVO)(n =12) and choroidal neovascular membrane(CNVM)(n =12) were included in the study. Peak systolic velocity(PSV), end diastolic velocity(EDV) and resistivity index(RI) were measured from the ophthalmic artery(OA), the central retinal artery(CRA) and the posterior ciliary artery(PCA)of each patient with CDU before, at the end of the first week and at the end of the first month following IVTA injection.RESULTS:In the DME group, PSV of OA at the first of the first month(mean ±SD)(37.48 ±10.87 cm/s) increased compared to pre-injection value(31.39 ±10.84 cm/s)(P =0.048). There was a statistically significant decrease(P =0.049) in PSV of CRA at the end of the first month(7.97±2.67 cm/s) compared to the pre-injection(9.47±3.37 cm/s).There was not any statistically significant difference onthe other parameters in the DME group. Also, there was not any statistically significant difference on the ocular blood flow values in the CRVO and CNVM groups.CONCLUSION:We observed that 4 mg/0.1 mL IVTA increased PSV of OA and decreased PSV of CRA in DME patients and did not have any effect on ocular blood flow values of CRVO and CNVM patients.展开更多
BACKGROUND Hepatic portal blood flow occlusion is a common technique for reducing hepatic hemorrhage during hepatectomy.We designed a novel Y-Z magnetic hepatic portal blocking band(Y-Z MHPBB)based on the principle of...BACKGROUND Hepatic portal blood flow occlusion is a common technique for reducing hepatic hemorrhage during hepatectomy.We designed a novel Y-Z magnetic hepatic portal blocking band(Y-Z MHPBB)based on the principle of magnetic compression technique.AIM To introduce the Y-Z MHPBB device and verify the feasibility of this device for hepatic portal blood flow occlusion in dogs.METHODS Ten beagles were randomly divided into the experimental group and control group.The operation time,intraoperative blood loss,the number of portal blood flow occlusions,the total time spent on adjusting the blocking band,and the average time spent on adjusting the blocking band were recorded.The surgeons evaluated the feasibility and flexibility of the two portal occlusion devices.RESULTS Laparoscopic hepatectomy was successfully performed in both the experimental group and control group.There was no statistical difference between the two groups in the operation time,intraoperative blood loss,and the number of hepatic portal blood flow occlusions.With respect to the total time spent on adjusting the blocking band and the average time spent on adjusting the blocking band,the experimental group showed significantly better outcomes than the control group,with a statistical difference(P<0.05).The operators found that the Y-Z MHPBB was superior to the modified T-tube in terms of operational flexibility.CONCLUSION The Y-Z MHPBB seems to be an ingenious design,accurate blood flow occlusion effect,and good flexibility;and it can be used for hepatic portal blood flow occlusion during laparoscopic hepatectomy.展开更多
目的探讨两种气囊压力带在辅助下肢深静脉血栓(DVT)溶栓治疗中阻断浅静脉的压力值范围,既能有效溶解血栓又能提高患者舒适度,为实施个体化、规范护理流程提供依据。方法 80例下肢DVT患者分为改良型气囊压力带组(研究组)和传统表式血压...目的探讨两种气囊压力带在辅助下肢深静脉血栓(DVT)溶栓治疗中阻断浅静脉的压力值范围,既能有效溶解血栓又能提高患者舒适度,为实施个体化、规范护理流程提供依据。方法 80例下肢DVT患者分为改良型气囊压力带组(研究组)和传统表式血压计袖带组(对照组),每组40例,两组均行输液泵持续泵入尿激酶经足背静脉顺行溶栓治疗,每日尿激酶用量相同。两组患者阻断下肢浅静脉血流的压力值在下肢静脉造影时测定,即下肢深静脉显影时的气囊压力值。对比分析两组患者的腿围消肿率、平均血栓清除率及舒适度等指标。结果研究组下肢浅静脉血流阻断压力为65~75 mm Hg,平均(70±5)mm Hg;对照组下肢浅静脉血流阻断压力值为60~85 mm Hg,平均值(70±10)mm Hg。两组患者的腿围消肿率、不同时间点的平均血栓清除率、舒适度评分均存在显著差异(P<0.05),研究组均优于对照组。结论与传统表式血压计袖带相比,应用改良型气囊压力带阻断下肢浅静脉血流可以获得较好的溶栓疗效,且治疗过程中患者舒适度较高。展开更多
基金Supported by The Inner Mongolia Science Foundation,Grant No.2009BS1103
文摘AIM:To investigate the clinical significance of hepatic blood inflow occlusion without hemihepatic artery control (BIOwHAC) in the treatment of hepatocellular carcinoma (HCC).METHODS:Fifty-nine patients with HCC were divided into 3 groups based on the technique used for achieving hepatic vascular occlusion:group 1,vascular occlusion was achieved by the Pringle maneuver (n=20);group 2,by hemihepatic vascular occlusion (HVO) (n=20);and group 3,by BIOwHAC (n=19).We compared the procedures among the three groups in term of operation time,intraoperative bleeding,postoperative liver function,postoperative complications,and length of hospital stay.RESULTS:There were no statistically significant differences (P > 0.05) in age,sex,pathological diagnosis,preoperative Child's disease grade,hepatic function,and tumor size among the three groups.No intraoperative complications or deaths occurrred,and there were no significant intergroup differences (P > 0.05) in intraoperative bleeding,hepatic function change 3 and 7 d after operation,the incidence of complications,and length of hospital stay.BIOwHAC and Pringle maneuver required a significantly shorter operation time than HVO;the difference in the serum alanine aminotransferase or aspartate aminotransferase levels before and 1 d after operation was more significant in the BIOwHAC and HVO groups than in the Pringle maneuver group (P < 0.05).CONCLUSION:BIOwHAC is convenient and safe;this technique causes slight hepatic ischemia-reperfusion injury similar to HVO.
基金supported by the Beijing Natural Science Foundation of China(7202235).
文摘Background and aims:Hepatocellular carcinoma is one of the most common cancers worldwide.Previous studies have reported he influence of various hepatic blood flow occlusions on tumor behavior,which is mainly mediated by liver ischemia-reperfusion.Although some genes and pathways have been determined,the whole transcriptome after various hepatic blood flow occlusions is lacking.Methods:We systematically explored transcriptome changes after various hepatic blood flow occlusions,including sham operation(SO;n=10),occlusion of the portal triad(OPT;n=10),and occlusion of the portal vein(OPV;n=10),by RNA-sequencing.Results:HE sections and TUNEL assays showed different liver injury among groups.We identified the top altered genes and pathways.Compared with the SO group,96 genes were altered in OPV,with 81 upregulated and 15 downregulated genes.The top 5 upregulated genes were Pdk4,Serpina12,Depp1,Igfbp1,and Mup22.The top 5 downregulated genes were Sprr1a,Serpinb2,Tnc,Cdkn3,and Cenpu.Compared with the SO group,there were 20 differentially expressed genes in OPT,with 18 upregulated and 2 downregulated genes.The top 5 upregulated genes wereC7,Zbtb16,Gabrp,Pdk4,and Mmrn1.The top 2 downregulated genes were Krt20 and Sis.Compared with the OPV group,72 differentially expressed genes were in OPT,with 39 upregulated and 33 downregulated genes.The top 5 upregulated genes wereHspa1b,Hbb-bs,Phf19,Ddias,and Rad54b.The top 5 downregulated genes were Cish,Socs2,Slc25a30,Rgs3,and Hsd3b5.Conclusion:Various surgical methods have an obvious influence on the transcriptome of tumors.
文摘Background The Pringle maneuver, which has been the standard for hepatic resection surgery for a long time, has the major flaw of ischemic damage in the liver. The aim of this research was to evaluate hepatic blood inflow occlusion with/without hemihepatic artery control vs. the Pringle maneuver in hepatocellular carcinoma （HCC） resection. Methods Two hundred and eighty-one cases of resection of HCC with hepatic blood inflow occlusion （with/without hemihepatic artery control） and the Pringle maneuver from January 2006 to December 2008 in our hospital were analyzed and compared retrospectively; among them 107 were in group I （Pringle maneuver）, 98 in group II （hepatic blood inflow occlusion）, and 76 in group III （hepatic blood inflow occlusion without hemihepatic artery control）. The operation time, intraoperative blood loss, postoperative liver function and complications were used as the endpoints for evaluation. Results The operative duration and intraoperative blood loss of three groups showed no significant difference; alanine aminotransferase, total bilirubin and incidence of postoperative complications were significantly lower in groups II and Ill postoperation than those in group I. Conclusion Hepatic blood inflow occlusion without hemihepatic artery control is safe, convenient and feasible for resection of HCC, especially for cases involving underlying diseases such as cirrhosis.
文摘AIM:To evaluate the changes in ocular blood flow with color Doppler ultrasonography(CDU) after intravitreal triamcinolone acetonide(IVTA) injection.METHODS:A total of 46 patients who underwent IVTA(4 mg/0.1 mL) injection for diabetic macular edema(DME)(n =22), central retinal vein occlusion(CRVO)(n =12) and choroidal neovascular membrane(CNVM)(n =12) were included in the study. Peak systolic velocity(PSV), end diastolic velocity(EDV) and resistivity index(RI) were measured from the ophthalmic artery(OA), the central retinal artery(CRA) and the posterior ciliary artery(PCA)of each patient with CDU before, at the end of the first week and at the end of the first month following IVTA injection.RESULTS:In the DME group, PSV of OA at the first of the first month(mean ±SD)(37.48 ±10.87 cm/s) increased compared to pre-injection value(31.39 ±10.84 cm/s)(P =0.048). There was a statistically significant decrease(P =0.049) in PSV of CRA at the end of the first month(7.97±2.67 cm/s) compared to the pre-injection(9.47±3.37 cm/s).There was not any statistically significant difference onthe other parameters in the DME group. Also, there was not any statistically significant difference on the ocular blood flow values in the CRVO and CNVM groups.CONCLUSION:We observed that 4 mg/0.1 mL IVTA increased PSV of OA and decreased PSV of CRA in DME patients and did not have any effect on ocular blood flow values of CRVO and CNVM patients.
基金Institutional Foundation of The First Affiliated Hospital of Xi’an Jiaotong University(to Yan XP),No.2022MS-07。
文摘BACKGROUND Hepatic portal blood flow occlusion is a common technique for reducing hepatic hemorrhage during hepatectomy.We designed a novel Y-Z magnetic hepatic portal blocking band(Y-Z MHPBB)based on the principle of magnetic compression technique.AIM To introduce the Y-Z MHPBB device and verify the feasibility of this device for hepatic portal blood flow occlusion in dogs.METHODS Ten beagles were randomly divided into the experimental group and control group.The operation time,intraoperative blood loss,the number of portal blood flow occlusions,the total time spent on adjusting the blocking band,and the average time spent on adjusting the blocking band were recorded.The surgeons evaluated the feasibility and flexibility of the two portal occlusion devices.RESULTS Laparoscopic hepatectomy was successfully performed in both the experimental group and control group.There was no statistical difference between the two groups in the operation time,intraoperative blood loss,and the number of hepatic portal blood flow occlusions.With respect to the total time spent on adjusting the blocking band and the average time spent on adjusting the blocking band,the experimental group showed significantly better outcomes than the control group,with a statistical difference(P<0.05).The operators found that the Y-Z MHPBB was superior to the modified T-tube in terms of operational flexibility.CONCLUSION The Y-Z MHPBB seems to be an ingenious design,accurate blood flow occlusion effect,and good flexibility;and it can be used for hepatic portal blood flow occlusion during laparoscopic hepatectomy.
文摘目的探讨两种气囊压力带在辅助下肢深静脉血栓(DVT)溶栓治疗中阻断浅静脉的压力值范围,既能有效溶解血栓又能提高患者舒适度,为实施个体化、规范护理流程提供依据。方法 80例下肢DVT患者分为改良型气囊压力带组(研究组)和传统表式血压计袖带组(对照组),每组40例,两组均行输液泵持续泵入尿激酶经足背静脉顺行溶栓治疗,每日尿激酶用量相同。两组患者阻断下肢浅静脉血流的压力值在下肢静脉造影时测定,即下肢深静脉显影时的气囊压力值。对比分析两组患者的腿围消肿率、平均血栓清除率及舒适度等指标。结果研究组下肢浅静脉血流阻断压力为65~75 mm Hg,平均(70±5)mm Hg;对照组下肢浅静脉血流阻断压力值为60~85 mm Hg,平均值(70±10)mm Hg。两组患者的腿围消肿率、不同时间点的平均血栓清除率、舒适度评分均存在显著差异(P<0.05),研究组均优于对照组。结论与传统表式血压计袖带相比,应用改良型气囊压力带阻断下肢浅静脉血流可以获得较好的溶栓疗效,且治疗过程中患者舒适度较高。
