Clinical study of standard residual liver volume and transient elastography in predicting poor prognosis of patients after hemihepatectomy

BACKGROUND Liver cancer resection,especially in patients with hemihepatectomy or extended hemihepatectomy,often leads to poor prognosis,such as liver insufficiency and even liver failure and death,because the standard residual liver volume(SRLV)cannot be fully compensated after surgery.AIM To explore the risk factors of poor prognosis after hemihepatectomy for hepatocellular carcinoma and evaluate the application value of related prognostic approaches.METHODS The clinical data of 35 patients with primary liver cancer in Nantong Third People's Hospital from February 2016 to July 2020 were retrospectively analyzed.The receiver operating characteristic curve was created using medcac19.0.4 to compare the critical values of the SRLV in different stages of liver fibrosis after hemihepatectomy with those of liver dysfunction after hemihepatectomy.It was constructed by combining the Child-Pugh score to evaluate its application value in predicting liver function compensation.RESULTS The liver stiffness measure(LSM)value and SRLV were associated with liver dysfunction after hemihepatectomy.Logistic regression analysis showed that an LSM value≥25 kPa[odds ratio(OR)=6.254,P<0.05]and SRLV≤0.290 L/m^(2)(OR=5.686,P<0.05)were independent risk factors for postoperative liver dysfunction.The accuracy of the new liver reserve evaluation model for predicting postoperative liver function was higher than that of the Child-Pugh score(P<0.05).CONCLUSION SRLV and LSM values can be used to evaluate the safety of hemihepatectomy.The new liver reserve evaluation model has good application potential in the evaluation of liver reserve function after hemihepatectomy.

Study on the Distribution Law of Horizontal Seismic Forces between Slab-Column and Shear Wall

In slab column-shear wall structures,both the whole structure′s seismic behavior and failure mode are greatly influenced by the distribution of horizontal seismic forces between slab-column and shear wall.In this paper,a pushover analysis of topical slab column-shear wall structure was carried out,the seismic shear force that the slab-column and shear wall should undertake was worked out,the influences of plastic internal force redistribution and structure stiffness characteristic value on horizontal seismic distribution were studied and the calculation formula was given.The analysis results showed that with the yield of the shear walls,the story shear force was undertaken by slab-columns correspondingly increased while with the decrease of characteristic value of stiffness of a structure,and the horizontal seismic force was undertaken by slab-columns correspondingly decreased.According to the code,the design of horizontal force distribution may be cause insecurity problems,so it is necessary to give the distribution law of horizontal seismic forces in slab-column shear wall structures as the supplement to the corresponding regulation of the Code.