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Routine utilization of machine perfusion in liver transplantation:Ready for prime time?
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作者 Alessandro Parente Keyue Sun +2 位作者 Philipp Dutkowski AM James Shapiro Andrea Schlegel 《World Journal of Gastroenterology》 SCIE CAS 2024年第11期1488-1493,共6页
The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver preservation.Robust evidence from numerous randomized controlled trials has been pooled by ... The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver preservation.Robust evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ preservation.This editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes. 展开更多
关键词 Liver transplantation Machine perfusion Viability assessment Hypothermic oxygenated perfusion Normothermic machine perfusion
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Early peripheral perfusion index predicts 28-day outcome in patients with septic shock
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作者 Cheng Chi Hao Gong +2 位作者 Kai Yang Peng Peng Xiaoxia Zhang 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第5期372-378,共7页
BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking Univers... BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock. 展开更多
关键词 Peripheral perfusion index Septic shock PROGNOSIS Predictive value
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Hemoperfusion and continuous veno-venous hemodiafiltration for eliminating chlorfenapyr in poisoning patients
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作者 Yanqing Liu Xiaoxia Lu +6 位作者 Haochun Wang Ming Niu Renzheng Zhang Zhongying Liu Limei Han Xiaobo Peng Xigang Zhang 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第3期235-237,共3页
Chlorfenapyr is a liposoluble insecticide belonging to the pyrrole family.Chlorfenapyr is activated when the N-ethoxymethyl side chain breaks,forming a toxic metabolite,which uncouples oxidative phosphorylation in the... Chlorfenapyr is a liposoluble insecticide belonging to the pyrrole family.Chlorfenapyr is activated when the N-ethoxymethyl side chain breaks,forming a toxic metabolite,which uncouples oxidative phosphorylation in the mitochondria,inhibits the production of adenosine triphosphate (ATP),and leads to the death of cells and targe organisms.[1] Symptoms of chlorfenapyr poisoning in patients are mild and atypical in the early stage,especially in patients receiving low dose exposure;however,such cases are rare and may be ignored by physicians,often leading to delayed treatment.[2,3]. 展开更多
关键词 PATIENTS perfusion eliminating
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New strategy for distal limb perfusion in veno-arterial extracorporeal membrane oxygenation treatment: application of continuous renal replacement therapy tubing
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作者 Zhaokun Fan Zhirong Zhang 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第4期311-312,共2页
Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported inc... Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed. 展开更多
关键词 ACUTE TREATMENT perfusion
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Matched pair analysis of the effect of longer hypothermic machine perfusion time on kidney transplant outcomes
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作者 Carlos Verdiales Luke Baxter +2 位作者 Hyun Ja Lim Gavin Beck Michael A Moser 《World Journal of Transplantation》 2024年第3期95-101,共7页
BACKGROUND Hypothermic machine perfusion(HMP)has demonstrated benefits in terms of early kidney transplant function compared to static cold storage.While longer preservation times have shown detrimental effects,a prev... BACKGROUND Hypothermic machine perfusion(HMP)has demonstrated benefits in terms of early kidney transplant function compared to static cold storage.While longer preservation times have shown detrimental effects,a previous paired study indicated that longer pump times(the second kidney in a pair)might lead to improved outcomes.AIM To revisit the prior paired study's somewhat unexpected results by reviewing our program's experience.METHODS A total of 61 pairs of transplant recipients who received kidneys from the same donor(2012-2021)were analyzed.Patients were divided into two groups depending on whether they were transplanted first(K1)or second(K2).Therefore,the patients in each pair had identical donor characteristics,except for time on the pump.Statistical analyses included Kaplan-Meyer analysis and paired tests,including McNemar's test,student's paired t-test,or Wilcoxon's test,as appropriate.RESULTS The two groups of recipients had similar demographics(age,body mass index,diabetes,time on dialysis,sensit-ization and retransplants).Cold ischemic times for K1 and K2 were 8.9(95%CI:7.9,9.8)and 14.7 hours(13.7,15.8)(P<0.0001),respectively.Overall,K2 had a higher rate of freedom from biopsy-proven acute rejection at 1 year(P=0.015).Delayed graft function was less common in K2,12/61(20%)than in K1,20/61(33%)(P=0.046).Finally,K2 showed a higher graft survival than K1(P=0.023).CONCLUSION Our results agree with a previous study that suggested possible advantages to longer pump times.Both studies should encourage further research into HMP's potential anti-inflammatory effect. 展开更多
关键词 Hypothermic machine perfusion Paired kidney study Early acute rejection
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Machine perfusion and the prevention of ischemic type biliary lesions following liver transplant:What is the evidence? 被引量:2
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作者 Manuel Durán Rafael Calleja +9 位作者 Angus Hann George Clarke Ruben Ciria Anisa Nutu Rebeca Sanabria-Mateos María Dolores Ayllón Pedro López-Cillero Hynek Mergental Javier Briceño M Thamara P R Perera 《World Journal of Gastroenterology》 SCIE CAS 2023年第20期3066-3083,共18页
The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft injury.Damage to the cholangiocytes during the liver donation,preservation,or earl... The widespread uptake of different machine perfusion(MP)strategies for liver transplant has been driven by an effort to minimize graft injury.Damage to the cholangiocytes during the liver donation,preservation,or early posttransplant period may result in stricturing of the biliary tree and inadequate biliary drainage.This problem continues to trouble clinicians,and may have catastrophic consequences for the graft and patient.Ischemic injury,as a result of compromised hepatic artery flow,is a well-known cause of biliary strictures,sepsis,and graft failure.However,very similar lesions can appear with a patent hepatic artery and these are known as ischemic type biliary lesions(ITBL)that are attributed to microcirculatory dysfunction rather than main hepatic arterial compromise.Both the warm and cold ischemic period duration appear to influence the onset of ITBL.All of the commonly used MP techniques deliver oxygen to the graft cells,and therefore may minimize the cholangiocyte injury and subsequently reduce the incidence of ITBL.As clinical experience and published evidence grows for these modalities,the impact they have on ITBL rates is important to consider.In this review,the evidence for the three commonly used MP strategies(abdominal normothermic regional perfusion[A-NRP],hypothermic oxygenated perfusion[HOPE],and normothermic machine perfusion[NMP])for ITBL prevention has been critically reviewed.Inconsistencies with ITBL definitions used in trials,coupled with variations in techniques of MP,make interpretation challenging.Overall,the evidence suggests that both HOPE and A-NRP prevent ITBL in donated after circulatory death grafts compared to cold storage.The evidence for ITBL prevention in donor after brain death grafts with any MP technique is weak. 展开更多
关键词 Liver transplant Ischemic type biliary lesions Hypothermic oxygenated machine perfusion Normothermic machine perfusion Abdominal normothermic regional perfusion Donation after circulatory death
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In vivo solid phase microextraction for therapeutic monitoring and pharmacometabolomic fingerprinting of lung during in vivo lung perfusion of FOLFOX 被引量:1
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作者 Nikita Looby Anna Roszkowska +5 位作者 Miao Yu German Rios-Gomez Mauricio Pipkin Barbara Bojko Marcelo Cypel Janusz Pawliszyn 《Journal of Pharmaceutical Analysis》 SCIE CAS CSCD 2023年第10期1195-1204,共10页
In vivo lung perfusion(IVLP)is a novel isolated lung technique developed to enable the local,in situ administration of high-dose chemotherapy to treat metastatic lung cancer.Combination therapy using folinic acid(FOL)... In vivo lung perfusion(IVLP)is a novel isolated lung technique developed to enable the local,in situ administration of high-dose chemotherapy to treat metastatic lung cancer.Combination therapy using folinic acid(FOL),5-fluorouracil(F),and oxaliplatin(OX)(FOLFOX)is routinely employed to treat several types of solid tumours in various tissues.However,F is characterized by large interpatient variability with respect to plasma concentration,which necessitates close monitoring during treatments using of this compound.Since plasma drug concentrations often do not reflect tissue drug concentrations,it is essential to utilize sample-preparation methods specifically suited to monitoring drug levels in target organs.In this work,in vivo solid-phase microextraction(in vivo SPME)is proposed as an effective tool for quantitative therapeutic drug monitoring of FOLFOX in porcine lungs during pre-clinical IVLP and intravenous(IV)trials.The concomitant extraction of other endogenous and exogenous small molecules from the lung and their detection via liquid chromatography coupled to high resolution mass spectrometry(LC-HRMS)enabled an assessment of FOLFOX's impact on the metabolomic profile of the lung and revealed the metabolic pathways associated with the route of administration(IVLP vs.IV)and the therapy itself.This study also shows that the immediate instrumental analysis of metabolomic samples is ideal,as long-term storage at80℃ results in changes in the metabolite content in the sample extracts. 展开更多
关键词 In vivo lung perfusion Solid-phase microextraction CHEMOTHERAPY Metabolomics Therapeutic drug monitoring
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Whole-brain CT Perfusion at Admission and During Delayed Time-window Detects the Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage 被引量:1
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作者 Feng YOU Wen-juan TANG +3 位作者 Chao ZHANG Ming-quan YE Xing-gen FANG Yun-feng ZHOU 《Current Medical Science》 SCIE CAS 2023年第2期409-416,共8页
Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP p... Objective To evaluate the utility of computed tomography perfusion(CTP)both at admission and during delayed cerebral ischemia time-window(DCITW)in the detection of delayed cerebral ischemia(DCI)and the change in CTP parameters from admission to DCITW following aneurysmal subarachnoid hemorrhage.Methods Eighty patients underwent CTP at admission and during DCITW.The mean and extreme values of all CTP parameters at admission and during DCITW were compared between the DCI group and non-DCI group,and comparisons were also made between admission and DCITW within each group.The qualitative color-coded perfusion maps were recorded.Finally,the relationship between CTP parameters and DCI was assessed by receiver operating characteristic(ROC)analyses.Results With the exception of cerebral blood volume(P=0.295,admission;P=0.682,DCITW),there were significant differences in the mean quantitative CTP parameters between DCI and non-DCI patients both at admission and during DCITW.In the DCI group,the extreme parameters were significantly different between admission and DCITW.The DCI group also showed a deteriorative trend in the qualitative color-coded perfusion maps.For the detection of DCI,mean transit time to the center of the impulse response function(Tmax)at admission and mean time to start(TTS)during DCITW had the largest area under curve(AUC),0.698 and 0.789,respectively.Conclusion Whole-brain CTP can predict the occurrence of DCI at admission and diagnose DCI during DCITW.The extreme quantitative parameters and qualitative color-coded perfusion maps can better reflect the perfusion changes of patients with DCI from admission to DCITW. 展开更多
关键词 aneurysmal subarachnoid hemorrhage delayed cerebral ischemia ADMISSION time window computed tomography perfusion
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Cardiovascular outcomes and mortality after abnormal myocardial perfusion scans in the elderly:a retrospective study at a tertiary care institution
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作者 Shishir Gupta Sohum Sheth +2 位作者 Sujay Kamisetty Marco Foreman David Winchester 《Journal of Geriatric Cardiology》 SCIE CAS CSCD 2023年第10期760-761,共2页
While the diagnostic and prognostic utility of single photon emission computed tomography(SPECT)myocardial perfusion scan(MPS)has been well established,[1,2]there is a paucity of literature evaluating SPECT MPS in eld... While the diagnostic and prognostic utility of single photon emission computed tomography(SPECT)myocardial perfusion scan(MPS)has been well established,[1,2]there is a paucity of literature evaluating SPECT MPS in elderly populations.Specifically,it is unclear whether the prognostic value of MPS diminishes as patients get older.We conducted this study to evaluate the role of SPECT MPS in risk-stratifying a large sample of elderly patients with or without known coronary artery disease(CAD)and hypothesized that abnormal MPS in patients over 75 years would be associated with a greater risk of all-cause mortality and major adverse cardiac events. 展开更多
关键词 MORTALITY perfusion CORONARY
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Computed tomography perfusion in differentiating portal hypertension: A correlation study with hepatic venous pressure gradient
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作者 Jian Dong Yu Zhang +5 位作者 Yi-Fan Wu Zhen-Dong Yue Zhen-Hua Fan Chun-Yan Zhang Fu-Quan Liu Lei Wang 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第4期664-673,共10页
BACKGROUND Hepatic venous pressure gradient(HVPG)is the gold standard for diagnosis of portal hypertension(PH),invasiveness and potential risks in the process of measurement limited its widespread use.AIM To investiga... BACKGROUND Hepatic venous pressure gradient(HVPG)is the gold standard for diagnosis of portal hypertension(PH),invasiveness and potential risks in the process of measurement limited its widespread use.AIM To investigate the correlation of computed tomography(CT)perfusion parameters with HVPG in PH,and quantitatively assess the blood supply changes in liver and spleen parenchyma before and after transjugular intrahepatic portosystemic shunt(TIPS).METHODS Twenty-four PH related gastrointestinal bleeding patients were recruited in this study,and all patients were performed perfusion CT before and after TIPS surgery within 2 wk.Quantitative parameters of CT perfusion,including liver blood volume(LBV),liver blood flow(LBF),hepatic arterial fraction(HAF),spleen blood volume(SBV)and spleen blood flow(SBF),were measured and compared before and after TIPS,and the quantitative parameters between clinically significant PH(CSPH)and non-CSPH(NCSPH)group were also compared.Then the correlation of CT perfusion parameters with HVPG were analyzed,with statistical significance as P<0.05.RESULTS For all 24 PH patients after TIPS,CT perfusion parameters demonstrated decreased LBV, increased HAF, SBV and SBF, with no statistical difference in LBF. Compared withNCSPH, CSPH showed higher HAF, with no difference in other CT perfusion parameters. HAFbefore TIPS showed positive correlation with HVPG (r = 0.530, P = 0.008), while no correlation wasfound in other CT perfusion parameters with HVPG and Child-Pugh scores.CONCLUSIONHAF, an index of CT perfusion, was positive correlation with HVPG, and higher in CSPH thanNCSPH before TIPS. While increased HAF, SBF and SBV, and decreased LBV, were found afterTIPS, which accommodates a potential non-invasive imaging tool for evaluation of PH. 展开更多
关键词 Portal hypertension Transjugular intrahepatic portosystemic shunt Hepatic vein pressure gradient perfusion Computed tomography
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Intraoperative pancreas stump perfusion assessment during pancreaticoduodenectomy:A systematic scoping review
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作者 Francis P Robertson Harry V M Spiers +3 位作者 Wei Boon Lim Benjamin Loveday Keith Roberts Sanjay Pandanaboyana 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第8期1799-1807,共9页
BACKGROUND Post-operative pancreatic fistula(POPF)is the primary cause of morbidity following pancreaticoduodenectomy.Rates of POPF have remained high despite well known risk factors.The theory that hypoperfusion of t... BACKGROUND Post-operative pancreatic fistula(POPF)is the primary cause of morbidity following pancreaticoduodenectomy.Rates of POPF have remained high despite well known risk factors.The theory that hypoperfusion of the pancreatic stump leads to anastomotic failure has recently gained interest.AIM To define the published literature with regards to intraoperative pancreas perfusion assessment and its correlation with POPF.METHODS A systematic search of available literature was performed in November 2022.Data extracted included study characteristics,method of assessment of pancreas stump perfusion,POPF and other post-pancreatic surgery specific complications.RESULTS Five eligible studies comprised two prospective non-randomised studies and three case reports,total 156 patients.Four studies used indocyanine green fluorescence angiography to assess the pancreatic stump,with the remaining study assessing pancreas perfusion by visual inspection of arterial bleeding of the pancreatic stump.There was significant heterogeneity in the definition of POPF.Studies had a combined POPF rate of 12%;intraoperative perfusion assessment revealed hypoperfusion was present in 39%of patients who developed POPF.The rate of POPF was 11%in patients with no evidence of hypoperfusion and 13%in those with evidence of hypoperfusion,suggesting that not all hypoperfusion gives rise to POPF and further analysis is required to analyse if there is a clinically relevant cut off.Significant variance in practice was seen in the pancreatic stump management once hypoperfusion was identified.CONCLUSION The current published evidence around pancreas perfusion during pancreaticoduodenectomy is of poor quality.It does not support a causative link between hypoperfusion and POPF.Further well-designed prospective studies are required to investigate this. 展开更多
关键词 Pancreatico-duodenectomy Post-operative pancreatic fistula perfusion Indocyanine green Post pancreatectomy pancreatitis
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Effects of cytoreductive surgery combined with hyperthermic perfusion chemotherapy on prognosis of patients with advanced gallbladder cancer
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作者 Jin-Xiu Wu Rong Hua +2 位作者 Xiang-Ji Luo Feng Xie Li Yao 《World Journal of Gastrointestinal Surgery》 SCIE 2023年第11期2413-2422,共10页
BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatme... BACKGROUND Gallbladder cancer(GC)is a common malignant tumor and one of the leading causes of cancer-related death worldwide.It is typically highly invasive,difficult to detect in the early stages,and has poor treatment outcomes,resulting in high mortality rates.The available treatment options for GC are relatively limited.One emerging treatment modality is hyperthermic intraperitoneal chemotherapy(HIPEC).HIPEC involves delivering heated chemotherapy directly into the abdominal cavity.It combines the strategies of surgical tumor resection and localized chemotherapy administration under hyperthermic conditions,aiming to enhance the concentration and effectiveness of drugs within the local tumor site while minimizing systemic toxicity.AIM To determine the effects of cytoreductive surgery(CRS)combined with HIPEC on the short-term prognosis of patients with advanced GC.METHODS Data from 80 patients treated at the Punan Branch of Renji Hospital,Shanghai Jiao Tong University School of Medicine between January 2018 and January 2020 were retrospectively analyzed.The control group comprised 44 patients treated with CRS,and the research group comprised 36 patients treated with CRS combined RESULTS The baseline data of the research and control groups were similar(P>0.05).Six days after surgery,the alanine aminotransferase,aspartate aminotransferase,total bilirubin,and direct bilirubin levels significantly decreased compared to the preoperative levels in both groups(P<0.05).However,the values did not differ between the two groups six days postoperatively(P>0.05).Similarly,the postoperative creatinine and blood urea nitrogen levels were significantly lower than the preoperative levels in both groups(P<0.05),but they did not differ between the groups six days postoperatively(P>0.05).Furthermore,the research group had fewer postoperative adverse reactions than the control group(P=0.027).Finally,a multivariate Cox analysis identified the tumor stage,distant metastasis,and the treatment plan as independent factors affecting prognosis(P<0.05).The three-year survival rate in the study group was higher than that in the control group(P=0.002).CONCLUSION CRS combined with HIPEC lowers the incidence of adverse reactions and improves survival in patients with advanced GC. 展开更多
关键词 Gallbladder diseases Chemotherapy Cancer Regional perfusion Gallbladder neoplasms PROGNOSIS Regression analysis Survival rate
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Progress of mechanical perfusion in split liver transplantation
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作者 SUN Jiang-bo PAN Sheng-hui +1 位作者 CHEN Wei-jia XU Jian 《Journal of Hainan Medical University》 CAS 2023年第18期75-80,共6页
Split liver transplantation is an essential means which expand the donor pool currently and the two livers obtained after splitting are marginal donor livers.The adoption of Static Cold Storage during allocation and p... Split liver transplantation is an essential means which expand the donor pool currently and the two livers obtained after splitting are marginal donor livers.The adoption of Static Cold Storage during allocation and preservation leads to a higher cold ischemia time,thus increasing the occurrence of related postoperative complications,which limits the further development of split-liver transplantation.Mechanical perfusion as a complement to split liver transplantation can minimize the damage to the marginal donor liver during preservation and reduce the occurrence of ischemia-reperfusion.At present,mechanical perfusion has achieved better efficacy in other types of marginal donor liver transplantation such as DCD,elderly donor liver,fatty liver,and so on.In recent years,mechanical perfusion has also shown great potential for application in split-liver transplantation,and limited clinical studies have shown outstanding therapeutic effects.Therefore,this paper will summarize the research progress and mechanisms related to the application of mechanical perfusion in split liver transplantation in order to promote the application of mechanical perfusion in split liver transplantation and reduce the damage of the organ during preservation. 展开更多
关键词 Split liver transplantation Mechanical perfusion Cold ischemia time Ischemia reperfusion
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Role of pulmonary perfusion magnetic resonance imaging for the diagnosis of pulmonary hypertension:A review
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作者 Miriam Lacharie Adriana Villa +3 位作者 Xenios Milidonis Hadeer Hasaneen Amedeo Chiribiri Giulia Benedetti 《World Journal of Radiology》 2023年第9期256-273,共18页
Among five types of pulmonary hypertension,chronic thromboembolic pulmonary hypertension(CTEPH)is the only curable form,but prompt and accurate diagnosis can be challenging.Computed tomography and nuclear medicine-bas... Among five types of pulmonary hypertension,chronic thromboembolic pulmonary hypertension(CTEPH)is the only curable form,but prompt and accurate diagnosis can be challenging.Computed tomography and nuclear medicine-based techniques are standard imaging modalities to non-invasively diagnose CTEPH,however these are limited by radiation exposure,subjective qualitative bias,and lack of cardiac functional assessment.This review aims to assess the methodology,diagnostic accuracy of pulmonary perfusion imaging in the current literature and discuss its advantages,limitations and future research scope. 展开更多
关键词 Pulmonary perfusion MRI Pulmonary hypertension Dynamic contrast enhanced magnetic resonance imaging Chronic thromboembolic pulmonary hypertension Computed tomography pulmonary angiography Chronic thromboembolic disease
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Efficacy of continuous arterial perfusion chemotherapy combined with transarterial chemoembolization regional arterial thermal perfusion in the treatment of pancreatic cancer with liver metastases
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作者 Zhuo Zhong Jian Yang +3 位作者 Jing-Zi Luo Xiong Xie Zhi-Mei Huang De Long 《Oncology and Translational Medicine》 2023年第4期176-183,共8页
Background:The aim of the study was to investigate the efficacy of continuous transcatheter arterial infusion chemotherapy combined with transarterial chemoembolization(TACE)for the treatment of advanced pancreatic ca... Background:The aim of the study was to investigate the efficacy of continuous transcatheter arterial infusion chemotherapy combined with transarterial chemoembolization(TACE)for the treatment of advanced pancreatic cancer with liver metastasis.Methods:Sixty patients with advanced pancreatic cancer and liver metastases were enrolled in this study.In the treatment group,31patients underwent continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial thermal perfusion,whereas 29 patients included in the control group received intravenous chemotherapy with gemcitabine and S-1.All patients received maintenance chemotherapy with S-1 after 4 cycles of the study regimen.Treatment efficacy,quality of life,survival,and toxicity were evaluated.Results:Efficacy was better in the treatment group than in the control group,as reflected by the objective remission,partial remission,and disease progression rates(all P<0.05).The Eastern Cooperative Oncology Group and Numerical Rating Scale pain scores were also higher in the treatment group(both P<0.05).In survival analysis,the 1-year overall survival rates in the treatment and control groups were64.516%and 10.345%,respectively,whereas the median overall survival times were 16 and 6 months,respectively(both P<0.05).The6-month progression-free survival rates in the treatment and control groups were 77.419%and 13.790%,respectively,and the median progression-free survival times were 12 and 3 months,respectively(both P<0.05).The rates of hematological and nonhematological toxicological adverse effects were also lower in the treatment group(both P<0.05).Although the rate of liver dysfunction was higher in the treatment group,this finding had no adverse effects on prognosis.Conclusions:Continuous transcatheter arterial infusion chemotherapy combined with TACE regional arterial perfusion chemotherapy resulted in better efficacy and safety outcomes in patients with pancreatic cancer and liver metastasis,suggesting its utility as a reference method for the clinical treatment of advanced pancreatic cancer. 展开更多
关键词 Advanced pancreatic cancer Liver metastasis Continuous transcatheter arterial infusion chemotherapy(cTAI) Transcatheter arterial chemoembolization(TACE) Arterial perfusion chemotherapy EFFICACY
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输入动脉选择对CT Perfusion 3.0软件包肺灌注成像的影响 被引量:3
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作者 王欣 于丽娟 +2 位作者 刘瑞宝 张修石 尚乃舰 《放射学实践》 2008年第12期1298-1300,共3页
目的:探讨输入动脉的选择对CT Perfusion 3.0软件包肺灌注成像的影响。方法:健康新西兰白兔2只,非离子型对比剂优维显5ml,对比剂的注射流率分别为0.1、0.3、0.5和0.8ml/s。所得数据传输到工作站,经Perfusion 3.0软件包以三种不同的灌注... 目的:探讨输入动脉的选择对CT Perfusion 3.0软件包肺灌注成像的影响。方法:健康新西兰白兔2只,非离子型对比剂优维显5ml,对比剂的注射流率分别为0.1、0.3、0.5和0.8ml/s。所得数据传输到工作站,经Perfusion 3.0软件包以三种不同的灌注成像方案处理。结果:以主动脉为输入动脉的体部肿瘤方案组所计算的血容量(BV)、血流量(BF)分别与以肺动脉为输入动脉组和肝脏肿瘤方案组所得数值间差异存在显著性意义(t=4.376、t=2.779);以肺动脉为输入动脉组和肝脏肿瘤方案组所得数值组间差异无显著性意义(t=1.5)。结论:应用CT Perfusion 3.0软件包,选择不同的输入动脉会对肺灌注成像结果产生影响,其实际应用有待进一步研究。 展开更多
关键词 体层摄影术 X线计算机 对比剂 灌注成像 动物实验
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Plasma perfusion治疗对HBV相关性肝衰竭患者T淋巴细胞亚群及炎性因子表达水平影响的相关性分析 被引量:1
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作者 任亮 喻雪琴 +3 位作者 陈星 陈芳 梅怡晗 敬雪明 《川北医学院学报》 CAS 2020年第3期505-508,共4页
目的:探讨血浆灌流(PP)治疗对肝衰竭患者循环血中T淋巴细胞亚群及炎性因子水平表达的影响及临床意义。方法:以112例肝衰竭患者作为治疗组,选取同期HBsAg(-)的健康体检者25例为对照组,检测在PP治疗前后循环血中CD4+T、CD8+T及炎性因子中... 目的:探讨血浆灌流(PP)治疗对肝衰竭患者循环血中T淋巴细胞亚群及炎性因子水平表达的影响及临床意义。方法:以112例肝衰竭患者作为治疗组,选取同期HBsAg(-)的健康体检者25例为对照组,检测在PP治疗前后循环血中CD4+T、CD8+T及炎性因子中的肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-10、γ-干扰素(IFN-γ)的水平表达。结果:治疗组患者在采用PP治疗后,TBIL、ALT、PTA、CRP的表达水平较治疗前明显下降(P<0.05)。治疗组患者采用PP治疗前,CD4+T、CD8+T水平较对照组低表达,CD4+T/CD8+T比值高表达,差异有统计学意义(P<0.05)。治疗组患者在PP治疗后,CD4+T、CD8+T水平较治疗前明显上调,CD4+T/CD8+T比值明显下调,差异有统计学意义(P<0.05);CD4+T、CD8+T水平较对照组明显下调,CD4+T/CD8+T比值明显上调,差异有统计学意义(P<0.05)。治疗组患者在PP治疗前,TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较治疗前明显下调,差异有统计学意义(P<0.05);治疗组患者在PP治疗后TNF-α、IFN-γ、IL-6、IL-10水平较对照组明显上调,差异有统计学意义(P<0.05)。结论:PP治疗肝衰竭患者可显著调控循环血中T淋巴细胞亚群的失衡状态,调节紊乱的炎性因子水平,促进肝功能复常,提高肝衰竭患者存活率。 展开更多
关键词 血浆灌流 炎性细胞因子 T淋巴细胞 乙肝病毒 肝衰竭
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Chemotherapy with laparoscope-assisted continuous circulatory hyperthermic intraperitoneal perfusion for malignant ascites 被引量:50
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作者 Ba, Ming-Chen Cui, Shu-Zhong +4 位作者 Lin, Sheng-Qu Tang, Yun-Qiang Wu, Yin-Bing Wang, Bin Zhang, Xiang-Liang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第15期1901-1907,共7页
AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritone... AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers. 展开更多
关键词 Intraperitoneal hyperthermic perfusion LAPAROSCOPY CHEMOTHERAPY Gastric cancer Malignant ascites
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Intraperitoneal perfusion of cytokine-induced killer cells with local hyperthermia for advanced hepatocellular carcinoma 被引量:21
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作者 Xiao-Pu Wang Meng Xu +2 位作者 Hong-Fei Gao Jian-Fu Zhao Ke-Cheng Xu 《World Journal of Gastroenterology》 SCIE CAS 2013年第19期2956-2962,共7页
AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carc... AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients. 展开更多
关键词 Cytokine-induced KILLER cell Radio frequency HYPERTHERMIA Primary HEPATOCELLULAR carcinoma INTRAPERITONEAL perfusion Clinical observation
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Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction 被引量:27
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作者 Qifeng Gui Yunmei Yang +1 位作者 Shihong Ying Minming Zhang 《Neural Regeneration Research》 SCIE CAS CSCD 2013年第9期792-801,共10页
A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus... A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion. 展开更多
关键词 neural regeneration traditional Chinese medicine XUESHUANTONG cerebral perfusion lacunarinfarction Panax notoginseng saponins cerebrovascular disease neuroprotection grants-supported paper photographs-containing paper NEUROREGENERATION
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