BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the prim...BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outcomes(prothrombin time/international normalised ratio,total bilirubin,complication,post-hepatectomy liver failure,hospital stay,90-d,and mortality)compared with the not-marginal group.CONCLUSION Functional evaluation of the remnant liver enabled safe hepatectomy and may extend the indication for hepatectomy after PVE treatment.展开更多
Affinity dye-ligand Cibacron Blue F3GA（CB F3GA） was covalently coupled with poly（vinyl alcohol）（PVA） coated on the inner surface of microporous poly（tetra-fluoroethylene）（MPTFE） membranous capillary. The PVA...Affinity dye-ligand Cibacron Blue F3GA（CB F3GA） was covalently coupled with poly（vinyl alcohol）（PVA） coated on the inner surface of microporous poly（tetra-fluoroethylene）（MPTFE） membranous capillary. The PVA-coated PTFE capillary surface was characterized by XPS and FESEM. The grafting degree of PVA and the amount of CB F3GA immobilized onto the membranous capillary were 23.5 mg/g and 89.6 pmol/g, respectively. These dyed membranous capillaries were chemically and mechanically stable, and could be reproducibly prepared. Human serum albumin（HSA） was selected as model protein. The saturation adsorbance of the dye attached membranous capillary was 85.3 mg HSA/g, while the capacity of non-specific adsorption for HSA was less than 0.3 mg/g.展开更多
Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Metho...Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.展开更多
目的建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法选取2017年1～1...目的建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法选取2017年1～12月遂宁市中心医院健康管理中心14 639例20～79岁的表观健康成年人作为研究对象,其中男性4 811例,女性9 828例,通过问卷调查、体格检查、超声及实验室检查排除呼吸系统、血液系统、内分泌系统、炎症和肿瘤等疾病,检测其血浆FMN、总蛋白(total protein,TP)和清蛋白(albumin,ALB)的浓度并计算该人群FMN/TP及FMN/ALB的浓度水平。根据性别和年龄将研究对象分组(男女各6组:20～29岁组,30～39岁组,40～49岁组,50～59岁组,60～69岁组和70～79岁组),对各组检测结果进行统计学分析,浓度水平差异无统计学意义的各组数据进行合并后,呈正态分布则以均值±1.96标准差■建立该地区表观健康人群血浆中FMN,FMN/TP及FMN/ALB的参考区间;呈偏态分布以百分位数法(P_(2.5)～P_(97.5))建立其参考区间。结果男性血浆FMN,FMN/TP及FMN/ALB浓度水平依次为1.7(1.6～1.8)mmol/L,22.0(20.7～23.5)μmol/g和37.1(34.5～39.8)μmol/g;女性则依次为1.7(1.6～1.8)mmol/L,22.4(21.1～23.9)μmol/g和38.5(36.2～41.2)μmol/g。男性和女性血浆FMN,FMN/TP及FMN/ALB浓度水平均呈偏态分布(P<0.05),且两组间比较差异均具有统计学意义(P<0.01)。进一步分析,男性和女性各年龄组血浆FMN,FMN/TP及FMN/ALB浓度水平的中位数与其总体区间中位数的差异均<25%,故不建议按年龄段分组建立参考区间,可仅按性别分组建立其参考区间。FMN的参考区间:男性为1.4～2.0 mmol/L,女性为1.5～2.0 mmol/L;FMN/TP的参考区间:男性为18.2～26.4μmol/g,女性为18.9～26.8μmol/g;FMN/ALB的参考区间:男性为30.4～46.1μmol/g,女性为32.1～46.9μmol/g。结论初步建立了遂宁地区20～79岁表观健康人群血浆FMN,FMN/TP及FMN/ALB的参考区间,为临床应用其作为糖尿病患者的诊断及疗效评估指标提供依据。展开更多
【目的】系统评价益气养阴法联合西药治疗肾病综合征的有效性及安全性。【方法】检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wangfang)、维普(VIP)、PubMed、Web of Science、Cochrane Library、Embase等国内外主要文献数...【目的】系统评价益气养阴法联合西药治疗肾病综合征的有效性及安全性。【方法】检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wangfang)、维普(VIP)、PubMed、Web of Science、Cochrane Library、Embase等国内外主要文献数据库,筛选其中有关益气养阴法联合西药(试验组)对比单纯西药(对照组)治疗肾病综合征的临床随机对照试验(RCTs),采用Cochrane手册中的偏倚风险工具进行文献的质量评价,运用RevMan 5.3软件进行Meta分析。【结果】共纳入18个RCTs,包含1334例患者。Meta分析结果显示,益气养阴法联合西药在提高临床有效率(RR=1.24,95%CI[1.16,1.32],P<0.00001),改善24 h尿蛋白定量(24hUPRO)(MD=-0.92,95%CI[-1.09,-0.75],P<0.00001)、血清白蛋白(ALB)(MD=7.06,95%CI[4.73,9.39],P<0.00001)、尿素氮(BUN)(MD=-1.57,95%CI[-2.01,-1.13],P<0.00001)、血肌酐(SCr)(MD=-12.23,95%CI[-16.58,-7.88],P<0.00001)、总胆固醇(TC)(MD=-1.06,95%CI[-1.69,-0.43],P=0.0009)、甘油三酯(TG)(MD=-0.58,95%CI[-0.94,-0.21],P=0.002)水平,以及降低不良反应发生率(RR=0.50,95%CI[0.40,0.64],P<0.00001)方面优于单纯西药治疗。【结论】益气养阴法联合西药治疗肾病综合征在提高临床疗效及改善24hUPRO、ALB、BUN、SCr、TC、TG方面优于单纯西药治疗,且能降低激素产生的不良反应。因纳入文献较少,文献质量较低,潜在疗效需更多的高质量研究进行验证。展开更多
文摘BACKGROUND Preoperative evaluation of future remnant liver reserves is important for safe hepatectomy.If the remnant is small,preoperative portal vein embolization(PVE)is useful.Liver volume analysis has been the primary method of preoperative evaluation,although functional examination may be more accurate.We have used the functional evaluation liver using the indocyanine green plasma clearance rate(KICG)and 99mTc-galactosyl human serum albumin single-photon emission computed tomography(99mTc-GSA SPECT)for safe hepatectomy.AIM To analyze the safety of our institution’s system for evaluating the remnant liver reserve.METHODS We retrospectively reviewed the records of 23 patients who underwent preoperative PVE.Two types of remnant liver KICG were defined as follows:Anatomical volume remnant KICG(a-rem-KICG),determined as the remnant liver anatomical volume rate×KICG;and functional volume remnant KICG(frem-KICG),determined as the remnant liver functional volume rate based on 99mTc-GSA SPECT×KICG.If either of the remnant liver KICGs were>0.05,a hepatectomy was performed.Perioperative factors were analyzed.We defined the marginal group as patients with a-rem-KICG of<0.05 and a f-rem-KICG of>0.05 and compared the postoperative outcomes between the marginal and not marginal(both a-rem-KICG and f-rem-KICG>0.05)groups.RESULTS All 23 patients underwent planned hepatectomies.Right hepatectomy,right trisectionectomy and left trisectionectomy were in 16,6 and 1 cases,respectively.The mean of blood loss and operative time were 576 mL and 474 min,respectively.The increased amount of frem-KICG was significantly larger than that of a-rem-KICG after PVE(0.034 vs 0.012,P=0.0273).The not marginal and marginal groups had 17(73.9%)and 6(26.1%)patients,respectively.The complications of Clavian-Dindo classification grade II or higher and post-hepatectomy liver failure were observed in six(26.1%)and one(grade A,4.3%)patient,respectively.The 90-d mortality was zero.The marginal group had no significant difference in postoperative outcomes(prothrombin time/international normalised ratio,total bilirubin,complication,post-hepatectomy liver failure,hospital stay,90-d,and mortality)compared with the not-marginal group.CONCLUSION Functional evaluation of the remnant liver enabled safe hepatectomy and may extend the indication for hepatectomy after PVE treatment.
基金Supported by the National Natural Science Foundation of China(No29405038)
文摘Affinity dye-ligand Cibacron Blue F3GA（CB F3GA） was covalently coupled with poly（vinyl alcohol）（PVA） coated on the inner surface of microporous poly（tetra-fluoroethylene）（MPTFE） membranous capillary. The PVA-coated PTFE capillary surface was characterized by XPS and FESEM. The grafting degree of PVA and the amount of CB F3GA immobilized onto the membranous capillary were 23.5 mg/g and 89.6 pmol/g, respectively. These dyed membranous capillaries were chemically and mechanically stable, and could be reproducibly prepared. Human serum albumin（HSA） was selected as model protein. The saturation adsorbance of the dye attached membranous capillary was 85.3 mg HSA/g, while the capacity of non-specific adsorption for HSA was less than 0.3 mg/g.
基金Supported by a grant from the Sichuan Health and Family Planning Commission(No.16PJ041)
文摘Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.
文摘目的建立四川省遂宁地区表观健康成年人群血浆果糖胺(fructosamine,FMN)、果糖胺/总蛋白比值(fructosamine to total protein ratio,FMN/TP)及果糖胺/清蛋白比值(fructosamine to albumin ratio,FMN/ALB)的参考区间。方法选取2017年1～12月遂宁市中心医院健康管理中心14 639例20～79岁的表观健康成年人作为研究对象,其中男性4 811例,女性9 828例,通过问卷调查、体格检查、超声及实验室检查排除呼吸系统、血液系统、内分泌系统、炎症和肿瘤等疾病,检测其血浆FMN、总蛋白(total protein,TP)和清蛋白(albumin,ALB)的浓度并计算该人群FMN/TP及FMN/ALB的浓度水平。根据性别和年龄将研究对象分组(男女各6组:20～29岁组,30～39岁组,40～49岁组,50～59岁组,60～69岁组和70～79岁组),对各组检测结果进行统计学分析,浓度水平差异无统计学意义的各组数据进行合并后,呈正态分布则以均值±1.96标准差■建立该地区表观健康人群血浆中FMN,FMN/TP及FMN/ALB的参考区间;呈偏态分布以百分位数法(P_(2.5)～P_(97.5))建立其参考区间。结果男性血浆FMN,FMN/TP及FMN/ALB浓度水平依次为1.7(1.6～1.8)mmol/L,22.0(20.7～23.5)μmol/g和37.1(34.5～39.8)μmol/g;女性则依次为1.7(1.6～1.8)mmol/L,22.4(21.1～23.9)μmol/g和38.5(36.2～41.2)μmol/g。男性和女性血浆FMN,FMN/TP及FMN/ALB浓度水平均呈偏态分布(P<0.05),且两组间比较差异均具有统计学意义(P<0.01)。进一步分析,男性和女性各年龄组血浆FMN,FMN/TP及FMN/ALB浓度水平的中位数与其总体区间中位数的差异均<25%,故不建议按年龄段分组建立参考区间,可仅按性别分组建立其参考区间。FMN的参考区间:男性为1.4～2.0 mmol/L,女性为1.5～2.0 mmol/L;FMN/TP的参考区间:男性为18.2～26.4μmol/g,女性为18.9～26.8μmol/g;FMN/ALB的参考区间:男性为30.4～46.1μmol/g,女性为32.1～46.9μmol/g。结论初步建立了遂宁地区20～79岁表观健康人群血浆FMN,FMN/TP及FMN/ALB的参考区间,为临床应用其作为糖尿病患者的诊断及疗效评估指标提供依据。
