Temporal lobe epilepsy is a multifactorial neurological dysfunction syndrome that is refractory,resistant to antiepileptic drugs,and has a high recurrence rate.The pathogenesis of temporal lobe epilepsy is complex and...Temporal lobe epilepsy is a multifactorial neurological dysfunction syndrome that is refractory,resistant to antiepileptic drugs,and has a high recurrence rate.The pathogenesis of temporal lobe epilepsy is complex and is not fully understood.Intracellular calcium dynamics have been implicated in temporal lobe epilepsy.However,the effect of fluctuating calcium activity in CA1 pyramidal neurons on temporal lobe epilepsy is unknown,and no longitudinal studies have investigated calcium activity in pyramidal neurons in the hippocampal CA1 and primary motor cortex M1 of freely moving mice.In this study,we used a multichannel fiber photometry system to continuously record calcium signals in CA1 and M1 during the temporal lobe epilepsy process.We found that calcium signals varied according to the grade of temporal lobe epilepsy episodes.In particular,cortical spreading depression,which has recently been frequently used to represent the continuously and substantially increased calcium signals,was found to correspond to complex and severe behavioral characteristics of temporal lobe epilepsy ranging from gradeⅡto gradeⅤ.However,vigorous calcium oscillations and highly synchronized calcium signals in CA1 and M1 were strongly related to convulsive motor seizures.Chemogenetic inhibition of pyramidal neurons in CA1 significantly attenuated the amplitudes of the calcium signals corresponding to gradeⅠepisodes.In addition,the latency of cortical spreading depression was prolonged,and the above-mentioned abnormal calcium signals in CA1 and M1 were also significantly reduced.Intriguingly,it was possible to rescue the altered intracellular calcium dynamics.Via simultaneous analysis of calcium signals and epileptic behaviors,we found that the progression of temporal lobe epilepsy was alleviated when specific calcium signals were reduced,and that the end-point behaviors of temporal lobe epilepsy were improved.Our results indicate that the calcium dynamic between CA1 and M1 may reflect specific epileptic behaviors corresponding to different grades.Furthermore,the selective regulation of abnormal calcium signals in CA1 pyramidal neurons appears to effectively alleviate temporal lobe epilepsy,thereby providing a potential molecular mechanism for a new temporal lobe epilepsy diagnosis and treatment strategy.展开更多
Partial epilepsies, originating in a specific brain region, affect about 60% of adults with epilepsy. Temporal lobe epilepsy (TLE) is the most prevalent subtype within this category, often necessitating surgical inter...Partial epilepsies, originating in a specific brain region, affect about 60% of adults with epilepsy. Temporal lobe epilepsy (TLE) is the most prevalent subtype within this category, often necessitating surgical intervention due to its refractoriness to antiepileptic drugs (AEDs). Hippocampal sclerosis, a common underlying pathology, often exacerbates the severity by introducing cognitive and emotional challenges. This review delves deeper into the cognitive profile of TLE, along with the risk factors for cognitive disorders, depression, and anxiety in this population.展开更多
Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as th...Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as the hippocampus,and many of these patients being refractory to treatment with anti-epileptic drugs.Temporal lobe epilepsy is the most common childhood neurological disorder and,compared with adults,the symptoms are greatly affected by age and brain development.Diagnosis of temporal lobe epilepsy relies on clinical examination,patient history,electroencephalographic recordings,and brain imaging.Misdiagnosis or delay in diagnosis is common.A molecular biomarker that could distinguish epilepsy from healthy subjects and other neurological conditions would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Among possible biomarkers of pathological changes as well as potential therapeutic targets in the epileptic brain are micro RNAs.Most of the recent studies had performed micro RNA profiling in body fluids such as blood plasma and blood serum and brain tissues such as temporal cortex tissue and hippocampal tissue.A large number of micro RNAs were dysregulated when compared to healthy controls and with some overlap between individual studies that could serve as potential biomarkers.For example,in adults with temporal lobe epilepsy,possible biomarkers are miR-199a-3p in blood plasma and miR-142-5p in blood plasma and blood serum.In adults with mesial temporal lobe epilepsy,possible biomarkers are miR-153 in blood plasma and miR-145-3p in blood serum.However,in many of the studies involving patients who receive one or several anti-epileptic drugs,the influence of these on micro RNA expression in body fluids and brain tissues is largely unknown.Further studies are warranted with children with temporal lobe epilepsy and consideration should be given to utilizing mouse or rat and non-human primate models of temporal lobe epilepsy.The animal models could be used to confirm micro RNA findings in human patients and to test the effects of targeting specific micro RNAs on disease progression and behavior.展开更多
Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have ...Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have been reported to be a potential target for controlling epileptic seizures in tempo ral lobe epile psy.However,their role in the cognitive impairment of temporal lobe epilepsy remains unclear.In this study,we found that patients with temporal lobe epile psy with hippocampal sclerosis had a low memory quotient and severe impairment in verbal memory,but had no impairment in nonverbal memory.The cognitive impairment was slightly correlated with reduced medial septum volume and medial septum-hippocampus tra cts measured by diffusion tensor imaging.In a mouse model of chronic temporal lobe epilepsy induced by kainic acid,the number of medial septum choline rgic neurons was reduced and acetylcholine release was reduced in the hippocampus.Furthermore,selective apoptosis of medial septum cholinergic neurons mimicked the cognitive deficits in epileptic mice,and activation of medial septum cholinergic neurons enhanced hippocampal acetylcholine release and restored cognitive function in both kainic acid-and kindling-induced epile psy models.These res ults suggest that activation of medial septum cholinergic neurons reduces cognitive deficits in temporal lobe epilepsy by increasing acetylcholine release via projections to the hippocampus.展开更多
Leaf is a vital organ of plants that plays an essential role in photosynthesis and respiration.As an important agronomic trait in leaf development,leaf shape is classified into lobed,entire(no-lobed),and serrated in m...Leaf is a vital organ of plants that plays an essential role in photosynthesis and respiration.As an important agronomic trait in leaf development,leaf shape is classified into lobed,entire(no-lobed),and serrated in most crops.In this study,two-lobed leaf watermelon inbred lines WT2 and WCZ,and a no-lobed leaf watermelon inbred line WT20 were used to create two F_(2)populations.Segregation analysis suggested that lobed leaves were dominant over the no-lobed leaves,and it was controlled by a signal gene.A locus on watermelon chromosome 4 controlling watermelon lobed/no-lobed leaves was identified through BSA-seq strategy combined with linkage analysis.The candidate gene was fine-mapped to a 61.5 kb region between 21,224,481 and 21,285,957 bp on watermelon chromosome 4 using two F_(2)populations.Four functional genes were annotated in the candidate region,while sequences blast showed that there was a single-base deletion(A/-)only in the exon of Cla018360,which resulted in premature termination of translation in the no-lobed leaf lines.Function prediction showed that Cla018360 encodes an HD-Zip protein that has been reported to regulate the development of leaf shape.The single-base deletion also occurred in the HD-Zip domain.We inferred that the Cla018360 gene is the candidate gene for regulating the development of lobed/no-lobed leaves in watermelon.Gene expression analysis showed that Cla018360 was highly expressed in young leaves.Phylogenetic analysis showed that Cla018360 had a close genetic relationship with AtHB51,which had been reported to regulate the formation of leaf shape in Arabidopsis.Furthermore,transcriptome analysis showed that a total of 333 differentially expressed genes were identified between WT2 and WT20,of which 115 and 218 genes were upregulated and downregulated in no-lobed leaved watermelon WT20.This study not only provides a good entry point for studying leaf development but also provides foundational insights into breeding for special plant architecture in watermelon.展开更多
Background: Improving the mechanical properties and angiogenesis of acellular scaffolds before transplantation is an important challenge facing the development of acellular liver grafts. The present study aimed to eva...Background: Improving the mechanical properties and angiogenesis of acellular scaffolds before transplantation is an important challenge facing the development of acellular liver grafts. The present study aimed to evaluate the cytotoxicity and angiogenesis of polyethylene glycol(PEG) crosslinked decellularized single liver lobe scaffolds(DLSs), and establish its suitability as a graft for long-term liver tissue engineering. Methods: Using mercaptoacrylate produced by the Michael addition reaction, DLSs were first modified using N-succinimidyl S-acetylthioacetate(SATA), followed by cross-linking with PEG as well as vascular endothelial growth factor(VEGF). The optimal concentration of agents and time of the individual steps were identified in this procedure through biomechanical testing and morphological analysis. Subsequently, human umbilical vein endothelial cells(HUVECs) were seeded on the PEG crosslinked scaffolds to detect the proliferation and viability of cells. The scaffolds were then transplanted into the subcutaneous tissue of Sprague-Dawley rats to evaluate angiogenesis. In addition, the average number of blood vessels was evaluated in the grafts with or without PEG at days 7, 14, and 21 after implantation. Results: The PEG crosslinked DLS maintained their three-dimensional structure and were more translucent after decellularization than native DLS, which presented a denser and more porous network structure. The results for Young’s modulus proved that the mechanical properties of 0.5 PEG crosslinked DLS were the best and close to that of native livers. The PEG-VEGF-DLS could better promote cell proliferation and differentiation of HUVECs compared with the groups without PEG cross-linking. Importantly, the average density of blood vessels was higher in the PEG-VEGF-DLS than that in other groups at days 7, 14, and 21 after implantation in vivo. Conclusions: The PEG crosslinked DLS with VEGF could improve the biomechanical properties of native DLS, and most importantly, their lack of cytotoxicity provides a new route to promote the proliferation of cells in vitro and angiogenesis in vivo in liver tissue engineering.展开更多
In this research work,we present the evolution of Coulomb failure stress(CFS)in the Sulaiman Lobe and its implications for seismic hazard assessment.The Chaman transform fault,~1,000 km long,is the major active fault ...In this research work,we present the evolution of Coulomb failure stress(CFS)in the Sulaiman Lobe and its implications for seismic hazard assessment.The Chaman transform fault,~1,000 km long,is the major active fault that marks the western boundary between Pakistan and Afghanistan on the Indian Plate.To date,few studies have been conducted to unveil the interactions among earthquakes and the implications of these interactions for seismic hazard assessment in the region.We thoroughly investigated the published and online catalog to construct a sequence of major earthquakes that occurred in this region during the past.The final earthquake sequence was composed of 15 earthquakes of M_(w)≥6.0,beginning with the 1888 earthquake.We used the stress-triggering theory to numerically simulate the evolution of CFS caused by these earthquakes.The numerical results revealed that 8 out of 15earthquakes were triggered by the preceding earthquakes.The earthquakes in 1908,1910,1935,1966,and 1997 were rather independent earthquakes in this sequence.Although the epicenters of the 1975a and 1975b earthquakes were in the stress shadow zone,the partial rupture segments of both these earthquakes were in high-CFS regions.The CFS induced by the 1935 earthquake was notable,as it later triggered the 2008 doublet.Moreover,our results revealed that the northern segment of the Chaman Fault,the southern segment of the Ghazaband Fault,and the northwestern segment of the Urghargai Fault demonstrated a high change in CFS that could trigger seismicity in these regions.The necessary arrangements must therefore be made to mitigate any possible seismic hazards in the region.展开更多
Background:Current reports on robotic hepatic caudate lobectomy are limited to Spiegel lobectomy.This study aimed to compare the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectom...Background:Current reports on robotic hepatic caudate lobectomy are limited to Spiegel lobectomy.This study aimed to compare the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectomy.Methods:Clinical data of 32 patients who underwent robotic resection of the hepatic caudate lobe in our department from May 2016 to January 2020 were retrospectively analyzed.The patients were divided into three groups according to the lobectomy location:left dorsal segment lobectomy(Spiegel lobectomy),right dorsal segment lobectomy(caudate process or paracaval portion lobectomy),and complete caudate lobectomy.General information and perioperative results of the three groups were compared and analyzed.Results:Among the 32 patients,none had conversion to laparotomy,three received intraoperative blood transfusion(9.38%),and none had complications of Clavien-Dindo gradeⅢor higher or died in the perioperative period.Among them,17 patients(53.13%)underwent Spiegel lobectomy,7(21.88%)underwent caudate process or paracaval portion lobectomy,and 8(25.00%)underwent complete caudate lobectomy.The operative time and blood loss in the left dorsal segment lobectomy group were significantly better than those in the right dorsal segment lobectomy and complete caudate lobectomy groups(operative time:P=0.010 and P=0.005;blood loss:P=0.005 and P=0.017,respectively).The postoperative hospital stay in the left dorsal segment lobectomy group was significantly shorter than that in the complete caudate lobectomy group(P=0.003);however,there was no difference in the postoperative hospital stay between the left dorsal segment lobectomy group and right dorsal segment lobectomy group(P=0.240).Conclusions:Robotic isolated partial and complete caudate lobectomy is safe and feasible.Spiegel lobectomy is relatively straightforward and suitable for beginners.展开更多
在机床各种形式的振动中,再生颤振具有最小的稳定极限切削宽度,换言之,机床抵抗再生颤振的能力最差。品质系数(Coefficient of Merit,COM)是切削力和切削表面法向相对位移之间的交叉频响函数最小负实部的函数,其大小直接反映机床抵抗再...在机床各种形式的振动中,再生颤振具有最小的稳定极限切削宽度,换言之,机床抵抗再生颤振的能力最差。品质系数(Coefficient of Merit,COM)是切削力和切削表面法向相对位移之间的交叉频响函数最小负实部的函数,其大小直接反映机床抵抗再生颤振的能力。此外,在机床的连续使用过程中,品质系数COM会逐渐减小,进而影响机床再生颤振抗振能力。基于相对激振方法和四自由度立铣加工过程动力学模型,重点分析了机床相对动柔度劣化过程中品质系数COM的变化趋势,以及对加工过程稳定性Lobe图的影响。研究表明:随着机床相对动柔度的劣化,轴向极限切深ap逐渐减小,并有加速递减的趋势,这和机床品质系数的劣化趋势一致。因此,考虑机床相对动柔度对稳定性Lobe图的影响,才能确定更合适的工艺参数,保证切削过程的稳定性,提高加工效率。展开更多
BACKGROUND Caudate lobe hemangioma of the liver is relatively rare.Due to the unique anatomical location of the caudate lobe,the caudate lobectomy accounts for only 0.5%to 4%of hepatic resection,which is difficult to ...BACKGROUND Caudate lobe hemangioma of the liver is relatively rare.Due to the unique anatomical location of the caudate lobe,the caudate lobectomy accounts for only 0.5%to 4%of hepatic resection,which is difficult to operate and takes a long time,and even has many postoperative complications.CASE SUMMARY A 34-year-old female presented with a 1 year history of intermittent pain in the right side of the waist without obvious inducement.All laboratory blood tests were within normal limits.Indocyanine green 15 min retention was rated 2.9%,and Child-Pugh was rated A.Computed tomography and magnetic resonance imaging diagnosed giant hemangioma of the caudate lobe with hemangioma of left lobe of liver.After discussion,surgical treatment was performed,which lasted 410 min,with intraoperative bleeding of about 600 mL and postoperative pathological findings of cavernous hemangioma.There were no obvious postoperative complications,and the patient was discharged 10 d after surgery.CONCLUSION Caudate lobectomy is difficult due to its special anatomical location.Under the condition of fully exposing the anatomy of the first porta hepatis,the second porta hepatis,the third porta hepatis,the fourth porta hepatis and middle hepatic vein and combining with the Pringle maneuver,caudate lobectomy can be performed in a precise and safe process.展开更多
AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lo...AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival.展开更多
BACKGROUND:Left liver graft from a small donor will not meet the metabolic demands of a larger adult recipient. To overcome the problem of graft size insufficiency,living donor liver transplantation(LDLT) using the ri...BACKGROUND:Left liver graft from a small donor will not meet the metabolic demands of a larger adult recipient. To overcome the problem of graft size insufficiency,living donor liver transplantation(LDLT) using the right lobe has become a standard method for adult patients. As the drainage of the median sector(segments Ⅴ,Ⅷ and Ⅳ) is mainly by the middle hepatic vein(MHV),the issue of whether the MHV should or should not be taken with the graft or whether the MHV tributaries(Ⅴ5,Ⅴ8) should be reconstructed in the recipient remains to be settled. DATA SOURCES:An English-language literature search was conducted using MEDLINE(1985-2006) on right lobe living donor liver transplantation,middle hepatic vein,vein graft,hepatic venoplasty and other related subjects. RESULTS:Some institutions had proposed their policy for the management of the MHV and its tributaries. Dominancy of the hepatic vein,graft-to-recipient weight ratio,and remnant liver volume as well as the donor-to-recipient body weight ratio,the volume of the donor's right lobe to the recipient's standard liver volume and the size of MHV tributaries are the major elements for the criteria of inclusion of the MHV,while for the policy of MHV tributaries reconstruction,the proportion of congestive area and the diameter of the tributaries are the critical elements. Optimal vein grafts such as recipient's portal vein and hepatic venoplasty technique have been used to obviate hepatic congestion and venous drainage disturbance.CONCLUSIONS:Taking right liver grafts with the MHV trunk(extended right lobe grafts) or performing the MHV tributaries reconstruction in modified right lobe grafts,according to the criteria proposed by the institutions with rich experience,can solve the congestion problem of the right paramedian sector and help to improve the outcomes of the patients. The additional use of optimal vein grafts and hepatic venoplasty also can guarantee excellent venous drainage.展开更多
BACKGROUND:Caudate lobectomy has long been considered technically difficult.This study aimed to elaborate the significance of early control of short hepatic portal veins(SHPVs) in isolated hepatic caudate lobectomy or...BACKGROUND:Caudate lobectomy has long been considered technically difficult.This study aimed to elaborate the significance of early control of short hepatic portal veins(SHPVs) in isolated hepatic caudate lobectomy or in hepatic caudate lobectomy combined with major partial hepatectomy,and to describe the anatomical characteristics of SHPVs.METHODS:The data of 117 patients who underwent either isolated or combined caudate lobectomy by the same team of surgeons from 2005 to 2009 were retrospectively analyzed.From 2005 to 2007(group A,n=55),we carried out early control of short hepatic veins(SHVs) only;from 2008 to 2009(group B,n=62),we carried out early control of both SHVs and SHPVs.The two groups were compared to evaluate which surgical procedure was better.A detailed anatomical study was then carried out on the last 25 consecutive patients in group B to study the number and distribution of SHPVs during surgery.RESULTS:Patients in group B had less intra-operative blood loss,less impairment of liver function,shorter postoperative hospital stay,fewer postoperative complications and required less blood transfusion(P<0.05).The number of SHPVs in the 25 patients was 183,with 7.3±2.7 per patient.The diameters of SHPVs were 1 to 4 mm.On average,3.4 SHPVs/patient came from the left portal vein,2.2 from the bifurcation,1.4 from the right portal vein,and 0.3 from the main portal vein.On average,3.3 SHPVs/patient supplied segment I of the liver,0.4 for segment II,2.1 for segment IV,1.4 for segment V and 0.1 for segment VI.CONCLUSION:Early control of SHPVs in isolated or combined hepatic caudate lobectomy may be a useful method to decrease surgical risk and improve postoperative recovery.展开更多
BACKGROUND:Because of the shortage of deceased donors with livers fit for transplantation,living donor liver transplantation(LDLT)is becoming an attractive alternative.Attention should be paid to the donors,especially...BACKGROUND:Because of the shortage of deceased donors with livers fit for transplantation,living donor liver transplantation(LDLT)is becoming an attractive alternative.Attention should be paid to the donors,especially to those of the right lobe.In this study,we evaluated the risks faced by donors of the right lobe for adult-to-adult LDLT.METHODS:The perioperative data from 105 consecutive living donors of the right lobe performed in West China Hospital from January 2002 to December 2007 were retrospectively studied.Preoperative evaluation included CT,MRCP,and intraoperative cholangiography,showing liver volume,hepatic vasculature and the biliary system.The standard liver volume(SLV)and the ratio of left lobe volume to SLV were calculated.The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein without inflow vascular occlusion,using an ultrasonic dissector.After operation the donors were monitored in the Intensive Care Unit for about three days.Each donor was followed up for at least 6 months.RESULTS:There was no donor mortality.Major complications occurred in 14 donors(13.3%),of whom 3 received conservative treatment,8 required invasive paracentesis,and 3 required further surgery.All donors were recovered well and resumed their previous occupations.CONCLUSIONS:Donors of the right lobe face low risks.The preoperative evaluation,especially evaluation of the volume of the remnant liver,should be exact.During the operation,the patency of the remnant hepatic vasculature and bile duct must be preserved,and the extent of injury to the remnant liver should be limited as much as possible.The detection and treatment of postoperative complications should be diligently performed.展开更多
Background: The efficacy and necessity of middle hepatic vein(MHV) reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT) remain controversial. The present study aimed to evaluate the sur...Background: The efficacy and necessity of middle hepatic vein(MHV) reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT) remain controversial. The present study aimed to evaluate the survival beneficiary of MHV reconstructions in LDLT. Methods: We compared the clinical outcomes of liver recipients with MHV reconstruction( n = 101) and without MHV reconstruction( n = 43) who underwent LDLT using right lobe grafts at our institution from January 2006 to May 2017. Results: The overall survival(OS) rate of recipients with MHV reconstruction was significantly higher than that of those without MHV reconstruction in liver transplantation( P = 0.022; 5-yr OS: 76.2% vs 58.1%). The survival of two segments(segments 5 and 8) hepatic vein reconstruction was better than that of the only one segment(segment 5 or segment 8) hepatic vein reconstruction( P = 0.034; 5-yr OS: 83.6% vs 67.4%). The survival of using two straight vascular reconstructions was better than that using Y-shaped vascular reconstruction in liver transplantation with two segments hepatic vein reconstruction( P = 0.020; 5-yr OS: 100% vs 75.0%). The multivariate analysis demonstrated that MHV tributary reconstructions were an independent beneficiary prognostic factor for OS(hazard ratio = 0.519, 95% CI: 0.282–0.954, P = 0.035). Biliary complications were significantly increased in recipients with MHV reconstruction(28.7% vs 11.6%, P = 0.027). Conclusions: MHV reconstruction ensured excellent outflow drainage and favored recipient outcome. The MHV tributaries(segments 5 and 8) should be reconstructed as much as possible to enlarge the hepatic vein anastomosis and reduce congestion.展开更多
Modals of the machine/tool and machine/part system are the principal factors affecting the stability of a milling process. Based on the modeling of chatter stability of milling process,the influence of modal parameter...Modals of the machine/tool and machine/part system are the principal factors affecting the stability of a milling process. Based on the modeling of chatter stability of milling process,the influence of modal parameters on chatter stability lobes independently or jointly has been analyzed by simulation. Peak-to-valley specific value,lobe coefficient and the corresponding calculation formula have been put forward. General laws and steps of modal simplification for multimodality system have been summarized.展开更多
BACKGROUND:Caudate lobectomy is now considered to be the most appropriate surgical treatment for benign tumors in the caudate lobe.But how to resect the caudate lobe safely is a major challenge to current liver surger...BACKGROUND:Caudate lobectomy is now considered to be the most appropriate surgical treatment for benign tumors in the caudate lobe.But how to resect the caudate lobe safely is a major challenge to current liver surgery and requires further study.This research aimed to analyze the perioperative factors and explore the surgical technique associated with liver resection in hepatic caudate lobe hemangioma.METHODS:Eleven consecutive patients with symptomatic hepatic hemangiomas undergoing caudate lobectomy from November 1990 to August 2009 at our hospital were investigated retrospectively.All patients were followed up to the present.RESULTS:In this series,9 were subjected to isolated caudate lobectomy and 2 to additional caudate lobectomy(in addition to left lobe and right lobe resection,respectively).The average maximum diameter of tumors was 9.65±4.11 cm.The average operative time was 232.73±72.16 minutes.Five of the 11 patients required transfusion of blood or blood products during surgery.Ascites occurred in l patient,pleural effusion in the perioperative period in 1,and multiple organ failure in l on the 6th day after operation as a result of massive intraoperative blood loss,who had received multiple transcatheter hepatic arterial embolization preoperatively.The alternating left-right-left approach produced the best results for caudate lobe surgery in most of our cases.All patients who recovered from the operation are living well and asymptomatic.CONCLUSIONS:For large hemangioma of the caudate lobe,surgery is only recommended for symptomatic cases.Caudate lobectomy of hepatic hemangioma can be performed safely,provided it is carried out with optimized perioperative management and innovative surgical technique.展开更多
基金supported by the National Natural Science Foundation of China,Nos.62027812(to HS),81771470(to HS),and 82101608(to YL)Tianjin Postgraduate Research and Innovation Project,No.2020YJSS122(to XD)。
文摘Temporal lobe epilepsy is a multifactorial neurological dysfunction syndrome that is refractory,resistant to antiepileptic drugs,and has a high recurrence rate.The pathogenesis of temporal lobe epilepsy is complex and is not fully understood.Intracellular calcium dynamics have been implicated in temporal lobe epilepsy.However,the effect of fluctuating calcium activity in CA1 pyramidal neurons on temporal lobe epilepsy is unknown,and no longitudinal studies have investigated calcium activity in pyramidal neurons in the hippocampal CA1 and primary motor cortex M1 of freely moving mice.In this study,we used a multichannel fiber photometry system to continuously record calcium signals in CA1 and M1 during the temporal lobe epilepsy process.We found that calcium signals varied according to the grade of temporal lobe epilepsy episodes.In particular,cortical spreading depression,which has recently been frequently used to represent the continuously and substantially increased calcium signals,was found to correspond to complex and severe behavioral characteristics of temporal lobe epilepsy ranging from gradeⅡto gradeⅤ.However,vigorous calcium oscillations and highly synchronized calcium signals in CA1 and M1 were strongly related to convulsive motor seizures.Chemogenetic inhibition of pyramidal neurons in CA1 significantly attenuated the amplitudes of the calcium signals corresponding to gradeⅠepisodes.In addition,the latency of cortical spreading depression was prolonged,and the above-mentioned abnormal calcium signals in CA1 and M1 were also significantly reduced.Intriguingly,it was possible to rescue the altered intracellular calcium dynamics.Via simultaneous analysis of calcium signals and epileptic behaviors,we found that the progression of temporal lobe epilepsy was alleviated when specific calcium signals were reduced,and that the end-point behaviors of temporal lobe epilepsy were improved.Our results indicate that the calcium dynamic between CA1 and M1 may reflect specific epileptic behaviors corresponding to different grades.Furthermore,the selective regulation of abnormal calcium signals in CA1 pyramidal neurons appears to effectively alleviate temporal lobe epilepsy,thereby providing a potential molecular mechanism for a new temporal lobe epilepsy diagnosis and treatment strategy.
文摘Partial epilepsies, originating in a specific brain region, affect about 60% of adults with epilepsy. Temporal lobe epilepsy (TLE) is the most prevalent subtype within this category, often necessitating surgical intervention due to its refractoriness to antiepileptic drugs (AEDs). Hippocampal sclerosis, a common underlying pathology, often exacerbates the severity by introducing cognitive and emotional challenges. This review delves deeper into the cognitive profile of TLE, along with the risk factors for cognitive disorders, depression, and anxiety in this population.
文摘Temporal lobe epilepsy is the most common form of focal epilepsy in adults,accounting for one third of all diagnosed epileptic patients,with seizures originating from or involving mesial temporal structures such as the hippocampus,and many of these patients being refractory to treatment with anti-epileptic drugs.Temporal lobe epilepsy is the most common childhood neurological disorder and,compared with adults,the symptoms are greatly affected by age and brain development.Diagnosis of temporal lobe epilepsy relies on clinical examination,patient history,electroencephalographic recordings,and brain imaging.Misdiagnosis or delay in diagnosis is common.A molecular biomarker that could distinguish epilepsy from healthy subjects and other neurological conditions would allow for an earlier and more accurate diagnosis and appropriate treatment to be initiated.Among possible biomarkers of pathological changes as well as potential therapeutic targets in the epileptic brain are micro RNAs.Most of the recent studies had performed micro RNA profiling in body fluids such as blood plasma and blood serum and brain tissues such as temporal cortex tissue and hippocampal tissue.A large number of micro RNAs were dysregulated when compared to healthy controls and with some overlap between individual studies that could serve as potential biomarkers.For example,in adults with temporal lobe epilepsy,possible biomarkers are miR-199a-3p in blood plasma and miR-142-5p in blood plasma and blood serum.In adults with mesial temporal lobe epilepsy,possible biomarkers are miR-153 in blood plasma and miR-145-3p in blood serum.However,in many of the studies involving patients who receive one or several anti-epileptic drugs,the influence of these on micro RNA expression in body fluids and brain tissues is largely unknown.Further studies are warranted with children with temporal lobe epilepsy and consideration should be given to utilizing mouse or rat and non-human primate models of temporal lobe epilepsy.The animal models could be used to confirm micro RNA findings in human patients and to test the effects of targeting specific micro RNAs on disease progression and behavior.
基金National Natural Science Foundation of China,Nos.82003 729 (to Ying W),82022071 (to YiW)Natural Science Foundation of Shandong Province of China,No.ZR2020QH357 (to Ying W)Public Welfare Technology Research Program of Zhejiang Province,No.LGF20H09001 1 (to JF)。
文摘Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have been reported to be a potential target for controlling epileptic seizures in tempo ral lobe epile psy.However,their role in the cognitive impairment of temporal lobe epilepsy remains unclear.In this study,we found that patients with temporal lobe epile psy with hippocampal sclerosis had a low memory quotient and severe impairment in verbal memory,but had no impairment in nonverbal memory.The cognitive impairment was slightly correlated with reduced medial septum volume and medial septum-hippocampus tra cts measured by diffusion tensor imaging.In a mouse model of chronic temporal lobe epilepsy induced by kainic acid,the number of medial septum choline rgic neurons was reduced and acetylcholine release was reduced in the hippocampus.Furthermore,selective apoptosis of medial septum cholinergic neurons mimicked the cognitive deficits in epileptic mice,and activation of medial septum cholinergic neurons enhanced hippocampal acetylcholine release and restored cognitive function in both kainic acid-and kindling-induced epile psy models.These res ults suggest that activation of medial septum cholinergic neurons reduces cognitive deficits in temporal lobe epilepsy by increasing acetylcholine release via projections to the hippocampus.
基金This research was supported by the National Natural Science Foundation of China(32102389,32172602)the Zhongyuan Youth Talent Support Program(ZYQR201912161)+3 种基金the Program for Science&Technology Innovation Talents in Universities of Henan Province(21HASTIT038)the Funding of Joint Research on Agricultural Varietie Improvement of Henan Province(2022010503)the Major Science and Technology Project of Henan Province(221100110400)the Science and Technology Innovation Fund of Henan Agricultural University(KJCX2021A14).
文摘Leaf is a vital organ of plants that plays an essential role in photosynthesis and respiration.As an important agronomic trait in leaf development,leaf shape is classified into lobed,entire(no-lobed),and serrated in most crops.In this study,two-lobed leaf watermelon inbred lines WT2 and WCZ,and a no-lobed leaf watermelon inbred line WT20 were used to create two F_(2)populations.Segregation analysis suggested that lobed leaves were dominant over the no-lobed leaves,and it was controlled by a signal gene.A locus on watermelon chromosome 4 controlling watermelon lobed/no-lobed leaves was identified through BSA-seq strategy combined with linkage analysis.The candidate gene was fine-mapped to a 61.5 kb region between 21,224,481 and 21,285,957 bp on watermelon chromosome 4 using two F_(2)populations.Four functional genes were annotated in the candidate region,while sequences blast showed that there was a single-base deletion(A/-)only in the exon of Cla018360,which resulted in premature termination of translation in the no-lobed leaf lines.Function prediction showed that Cla018360 encodes an HD-Zip protein that has been reported to regulate the development of leaf shape.The single-base deletion also occurred in the HD-Zip domain.We inferred that the Cla018360 gene is the candidate gene for regulating the development of lobed/no-lobed leaves in watermelon.Gene expression analysis showed that Cla018360 was highly expressed in young leaves.Phylogenetic analysis showed that Cla018360 had a close genetic relationship with AtHB51,which had been reported to regulate the formation of leaf shape in Arabidopsis.Furthermore,transcriptome analysis showed that a total of 333 differentially expressed genes were identified between WT2 and WT20,of which 115 and 218 genes were upregulated and downregulated in no-lobed leaved watermelon WT20.This study not only provides a good entry point for studying leaf development but also provides foundational insights into breeding for special plant architecture in watermelon.
基金supported by grants from Natural Science Foundation of Zhejiang Province (LY20H180011)National Natural Science Foundation of China (81970653)Medical and Health Science and Technology project of Zhejiang (2016KYA061)
文摘Background: Improving the mechanical properties and angiogenesis of acellular scaffolds before transplantation is an important challenge facing the development of acellular liver grafts. The present study aimed to evaluate the cytotoxicity and angiogenesis of polyethylene glycol(PEG) crosslinked decellularized single liver lobe scaffolds(DLSs), and establish its suitability as a graft for long-term liver tissue engineering. Methods: Using mercaptoacrylate produced by the Michael addition reaction, DLSs were first modified using N-succinimidyl S-acetylthioacetate(SATA), followed by cross-linking with PEG as well as vascular endothelial growth factor(VEGF). The optimal concentration of agents and time of the individual steps were identified in this procedure through biomechanical testing and morphological analysis. Subsequently, human umbilical vein endothelial cells(HUVECs) were seeded on the PEG crosslinked scaffolds to detect the proliferation and viability of cells. The scaffolds were then transplanted into the subcutaneous tissue of Sprague-Dawley rats to evaluate angiogenesis. In addition, the average number of blood vessels was evaluated in the grafts with or without PEG at days 7, 14, and 21 after implantation. Results: The PEG crosslinked DLS maintained their three-dimensional structure and were more translucent after decellularization than native DLS, which presented a denser and more porous network structure. The results for Young’s modulus proved that the mechanical properties of 0.5 PEG crosslinked DLS were the best and close to that of native livers. The PEG-VEGF-DLS could better promote cell proliferation and differentiation of HUVECs compared with the groups without PEG cross-linking. Importantly, the average density of blood vessels was higher in the PEG-VEGF-DLS than that in other groups at days 7, 14, and 21 after implantation in vivo. Conclusions: The PEG crosslinked DLS with VEGF could improve the biomechanical properties of native DLS, and most importantly, their lack of cytotoxicity provides a new route to promote the proliferation of cells in vitro and angiogenesis in vivo in liver tissue engineering.
文摘In this research work,we present the evolution of Coulomb failure stress(CFS)in the Sulaiman Lobe and its implications for seismic hazard assessment.The Chaman transform fault,~1,000 km long,is the major active fault that marks the western boundary between Pakistan and Afghanistan on the Indian Plate.To date,few studies have been conducted to unveil the interactions among earthquakes and the implications of these interactions for seismic hazard assessment in the region.We thoroughly investigated the published and online catalog to construct a sequence of major earthquakes that occurred in this region during the past.The final earthquake sequence was composed of 15 earthquakes of M_(w)≥6.0,beginning with the 1888 earthquake.We used the stress-triggering theory to numerically simulate the evolution of CFS caused by these earthquakes.The numerical results revealed that 8 out of 15earthquakes were triggered by the preceding earthquakes.The earthquakes in 1908,1910,1935,1966,and 1997 were rather independent earthquakes in this sequence.Although the epicenters of the 1975a and 1975b earthquakes were in the stress shadow zone,the partial rupture segments of both these earthquakes were in high-CFS regions.The CFS induced by the 1935 earthquake was notable,as it later triggered the 2008 doublet.Moreover,our results revealed that the northern segment of the Chaman Fault,the southern segment of the Ghazaband Fault,and the northwestern segment of the Urghargai Fault demonstrated a high change in CFS that could trigger seismicity in these regions.The necessary arrangements must therefore be made to mitigate any possible seismic hazards in the region.
文摘Background:Current reports on robotic hepatic caudate lobectomy are limited to Spiegel lobectomy.This study aimed to compare the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectomy.Methods:Clinical data of 32 patients who underwent robotic resection of the hepatic caudate lobe in our department from May 2016 to January 2020 were retrospectively analyzed.The patients were divided into three groups according to the lobectomy location:left dorsal segment lobectomy(Spiegel lobectomy),right dorsal segment lobectomy(caudate process or paracaval portion lobectomy),and complete caudate lobectomy.General information and perioperative results of the three groups were compared and analyzed.Results:Among the 32 patients,none had conversion to laparotomy,three received intraoperative blood transfusion(9.38%),and none had complications of Clavien-Dindo gradeⅢor higher or died in the perioperative period.Among them,17 patients(53.13%)underwent Spiegel lobectomy,7(21.88%)underwent caudate process or paracaval portion lobectomy,and 8(25.00%)underwent complete caudate lobectomy.The operative time and blood loss in the left dorsal segment lobectomy group were significantly better than those in the right dorsal segment lobectomy and complete caudate lobectomy groups(operative time:P=0.010 and P=0.005;blood loss:P=0.005 and P=0.017,respectively).The postoperative hospital stay in the left dorsal segment lobectomy group was significantly shorter than that in the complete caudate lobectomy group(P=0.003);however,there was no difference in the postoperative hospital stay between the left dorsal segment lobectomy group and right dorsal segment lobectomy group(P=0.240).Conclusions:Robotic isolated partial and complete caudate lobectomy is safe and feasible.Spiegel lobectomy is relatively straightforward and suitable for beginners.
文摘在机床各种形式的振动中,再生颤振具有最小的稳定极限切削宽度,换言之,机床抵抗再生颤振的能力最差。品质系数(Coefficient of Merit,COM)是切削力和切削表面法向相对位移之间的交叉频响函数最小负实部的函数,其大小直接反映机床抵抗再生颤振的能力。此外,在机床的连续使用过程中,品质系数COM会逐渐减小,进而影响机床再生颤振抗振能力。基于相对激振方法和四自由度立铣加工过程动力学模型,重点分析了机床相对动柔度劣化过程中品质系数COM的变化趋势,以及对加工过程稳定性Lobe图的影响。研究表明:随着机床相对动柔度的劣化,轴向极限切深ap逐渐减小,并有加速递减的趋势,这和机床品质系数的劣化趋势一致。因此,考虑机床相对动柔度对稳定性Lobe图的影响,才能确定更合适的工艺参数,保证切削过程的稳定性,提高加工效率。
基金Supported by National Natural Science Foundation of China,No.81660398Hospital Key Program of National Scientific Research Cultivation Plan,No.19SYPYA-12.
文摘BACKGROUND Caudate lobe hemangioma of the liver is relatively rare.Due to the unique anatomical location of the caudate lobe,the caudate lobectomy accounts for only 0.5%to 4%of hepatic resection,which is difficult to operate and takes a long time,and even has many postoperative complications.CASE SUMMARY A 34-year-old female presented with a 1 year history of intermittent pain in the right side of the waist without obvious inducement.All laboratory blood tests were within normal limits.Indocyanine green 15 min retention was rated 2.9%,and Child-Pugh was rated A.Computed tomography and magnetic resonance imaging diagnosed giant hemangioma of the caudate lobe with hemangioma of left lobe of liver.After discussion,surgical treatment was performed,which lasted 410 min,with intraoperative bleeding of about 600 mL and postoperative pathological findings of cavernous hemangioma.There were no obvious postoperative complications,and the patient was discharged 10 d after surgery.CONCLUSION Caudate lobectomy is difficult due to its special anatomical location.Under the condition of fully exposing the anatomy of the first porta hepatis,the second porta hepatis,the third porta hepatis,the fourth porta hepatis and middle hepatic vein and combining with the Pringle maneuver,caudate lobectomy can be performed in a precise and safe process.
文摘AIM:To evaluate the short-and long-term outcomes of liver resection for caudate lobe hepatocellular carcinoma (HCC).METHODS:We retrospectively analyzed 114 consecutive patients with HCC,originating from the caudate lobe,who underwent resection between January 2001 and January 2007.Univariate and multivariate analyses were performed on several clinicopathologic variables to determine the factors affecting long-term outcome and intrahepatic recurrence.RESULTS:Overall mortality and morbidity were 0% and 18%,respectively.After a median follow-up of 31 mo (interquartile range,11-66 mo),tumor recurrence had occurred in 76 patients (66.7%).The 1-,3-,and 5-year disease-free survival rates were 65.7%,38.1%,and 18.4%,respectively.The 1-,3-,and 5-year overall survival rates were 76.1%,54.7%,and 31.8%,respectively.Univariate analysis showed that subsegmental location of the tumor (45.7% vs 16.2%,P=0.01),liver cirrhosis (12.3% vs 47.9%,P=0.03),surgical margin (18.5% vs 54.6%,P=0.04),vascular invasion (37.9% vs 23.2%,P=0.04) and extended caudate resection (42.1% vs 15.4%,P=0.04) were related to poorer long-term survival.Multivariate analysis showed that only subsegmental location of the tumor,liver cirrhosis and surgical margin were significant independent prognostic factors.CONCLUSION:Hepatectomy was an effective treatment for HCC in the caudate lobe.The subsegmental location of the tumor,liver cirrhosis and surgical margin affected long-term survival.
基金This study was supported by a grant from the National Key Basic Research Program (973) of China (No. 2003 CB515501) Important Project from Science and Technology Department of Zhejiang Province (No. 021103699).
文摘BACKGROUND:Left liver graft from a small donor will not meet the metabolic demands of a larger adult recipient. To overcome the problem of graft size insufficiency,living donor liver transplantation(LDLT) using the right lobe has become a standard method for adult patients. As the drainage of the median sector(segments Ⅴ,Ⅷ and Ⅳ) is mainly by the middle hepatic vein(MHV),the issue of whether the MHV should or should not be taken with the graft or whether the MHV tributaries(Ⅴ5,Ⅴ8) should be reconstructed in the recipient remains to be settled. DATA SOURCES:An English-language literature search was conducted using MEDLINE(1985-2006) on right lobe living donor liver transplantation,middle hepatic vein,vein graft,hepatic venoplasty and other related subjects. RESULTS:Some institutions had proposed their policy for the management of the MHV and its tributaries. Dominancy of the hepatic vein,graft-to-recipient weight ratio,and remnant liver volume as well as the donor-to-recipient body weight ratio,the volume of the donor's right lobe to the recipient's standard liver volume and the size of MHV tributaries are the major elements for the criteria of inclusion of the MHV,while for the policy of MHV tributaries reconstruction,the proportion of congestive area and the diameter of the tributaries are the critical elements. Optimal vein grafts such as recipient's portal vein and hepatic venoplasty technique have been used to obviate hepatic congestion and venous drainage disturbance.CONCLUSIONS:Taking right liver grafts with the MHV trunk(extended right lobe grafts) or performing the MHV tributaries reconstruction in modified right lobe grafts,according to the criteria proposed by the institutions with rich experience,can solve the congestion problem of the right paramedian sector and help to improve the outcomes of the patients. The additional use of optimal vein grafts and hepatic venoplasty also can guarantee excellent venous drainage.
基金supported by grants from the Research Fund of Shanghai Science and Technology Commission(10495810400)the Youth Research Fund of Shanghai Health Bureau (2009Y065)
文摘BACKGROUND:Caudate lobectomy has long been considered technically difficult.This study aimed to elaborate the significance of early control of short hepatic portal veins(SHPVs) in isolated hepatic caudate lobectomy or in hepatic caudate lobectomy combined with major partial hepatectomy,and to describe the anatomical characteristics of SHPVs.METHODS:The data of 117 patients who underwent either isolated or combined caudate lobectomy by the same team of surgeons from 2005 to 2009 were retrospectively analyzed.From 2005 to 2007(group A,n=55),we carried out early control of short hepatic veins(SHVs) only;from 2008 to 2009(group B,n=62),we carried out early control of both SHVs and SHPVs.The two groups were compared to evaluate which surgical procedure was better.A detailed anatomical study was then carried out on the last 25 consecutive patients in group B to study the number and distribution of SHPVs during surgery.RESULTS:Patients in group B had less intra-operative blood loss,less impairment of liver function,shorter postoperative hospital stay,fewer postoperative complications and required less blood transfusion(P<0.05).The number of SHPVs in the 25 patients was 183,with 7.3±2.7 per patient.The diameters of SHPVs were 1 to 4 mm.On average,3.4 SHPVs/patient came from the left portal vein,2.2 from the bifurcation,1.4 from the right portal vein,and 0.3 from the main portal vein.On average,3.3 SHPVs/patient supplied segment I of the liver,0.4 for segment II,2.1 for segment IV,1.4 for segment V and 0.1 for segment VI.CONCLUSION:Early control of SHPVs in isolated or combined hepatic caudate lobectomy may be a useful method to decrease surgical risk and improve postoperative recovery.
文摘BACKGROUND:Because of the shortage of deceased donors with livers fit for transplantation,living donor liver transplantation(LDLT)is becoming an attractive alternative.Attention should be paid to the donors,especially to those of the right lobe.In this study,we evaluated the risks faced by donors of the right lobe for adult-to-adult LDLT.METHODS:The perioperative data from 105 consecutive living donors of the right lobe performed in West China Hospital from January 2002 to December 2007 were retrospectively studied.Preoperative evaluation included CT,MRCP,and intraoperative cholangiography,showing liver volume,hepatic vasculature and the biliary system.The standard liver volume(SLV)and the ratio of left lobe volume to SLV were calculated.The right lobe grafts were obtained by transecting the liver on the right side of the middle hepatic vein without inflow vascular occlusion,using an ultrasonic dissector.After operation the donors were monitored in the Intensive Care Unit for about three days.Each donor was followed up for at least 6 months.RESULTS:There was no donor mortality.Major complications occurred in 14 donors(13.3%),of whom 3 received conservative treatment,8 required invasive paracentesis,and 3 required further surgery.All donors were recovered well and resumed their previous occupations.CONCLUSIONS:Donors of the right lobe face low risks.The preoperative evaluation,especially evaluation of the volume of the remnant liver,should be exact.During the operation,the patency of the remnant hepatic vasculature and bile duct must be preserved,and the extent of injury to the remnant liver should be limited as much as possible.The detection and treatment of postoperative complications should be diligently performed.
基金supported by a grant from the National Science and Technology Major Project of China(2017ZX100203205)
文摘Background: The efficacy and necessity of middle hepatic vein(MHV) reconstruction in adult-to-adult right lobe living donor liver transplantation(LDLT) remain controversial. The present study aimed to evaluate the survival beneficiary of MHV reconstructions in LDLT. Methods: We compared the clinical outcomes of liver recipients with MHV reconstruction( n = 101) and without MHV reconstruction( n = 43) who underwent LDLT using right lobe grafts at our institution from January 2006 to May 2017. Results: The overall survival(OS) rate of recipients with MHV reconstruction was significantly higher than that of those without MHV reconstruction in liver transplantation( P = 0.022; 5-yr OS: 76.2% vs 58.1%). The survival of two segments(segments 5 and 8) hepatic vein reconstruction was better than that of the only one segment(segment 5 or segment 8) hepatic vein reconstruction( P = 0.034; 5-yr OS: 83.6% vs 67.4%). The survival of using two straight vascular reconstructions was better than that using Y-shaped vascular reconstruction in liver transplantation with two segments hepatic vein reconstruction( P = 0.020; 5-yr OS: 100% vs 75.0%). The multivariate analysis demonstrated that MHV tributary reconstructions were an independent beneficiary prognostic factor for OS(hazard ratio = 0.519, 95% CI: 0.282–0.954, P = 0.035). Biliary complications were significantly increased in recipients with MHV reconstruction(28.7% vs 11.6%, P = 0.027). Conclusions: MHV reconstruction ensured excellent outflow drainage and favored recipient outcome. The MHV tributaries(segments 5 and 8) should be reconstructed as much as possible to enlarge the hepatic vein anastomosis and reduce congestion.
基金Supported by the Fundamental Research Project of COSTI ND(K1203020507)
文摘Modals of the machine/tool and machine/part system are the principal factors affecting the stability of a milling process. Based on the modeling of chatter stability of milling process,the influence of modal parameters on chatter stability lobes independently or jointly has been analyzed by simulation. Peak-to-valley specific value,lobe coefficient and the corresponding calculation formula have been put forward. General laws and steps of modal simplification for multimodality system have been summarized.
文摘BACKGROUND:Caudate lobectomy is now considered to be the most appropriate surgical treatment for benign tumors in the caudate lobe.But how to resect the caudate lobe safely is a major challenge to current liver surgery and requires further study.This research aimed to analyze the perioperative factors and explore the surgical technique associated with liver resection in hepatic caudate lobe hemangioma.METHODS:Eleven consecutive patients with symptomatic hepatic hemangiomas undergoing caudate lobectomy from November 1990 to August 2009 at our hospital were investigated retrospectively.All patients were followed up to the present.RESULTS:In this series,9 were subjected to isolated caudate lobectomy and 2 to additional caudate lobectomy(in addition to left lobe and right lobe resection,respectively).The average maximum diameter of tumors was 9.65±4.11 cm.The average operative time was 232.73±72.16 minutes.Five of the 11 patients required transfusion of blood or blood products during surgery.Ascites occurred in l patient,pleural effusion in the perioperative period in 1,and multiple organ failure in l on the 6th day after operation as a result of massive intraoperative blood loss,who had received multiple transcatheter hepatic arterial embolization preoperatively.The alternating left-right-left approach produced the best results for caudate lobe surgery in most of our cases.All patients who recovered from the operation are living well and asymptomatic.CONCLUSIONS:For large hemangioma of the caudate lobe,surgery is only recommended for symptomatic cases.Caudate lobectomy of hepatic hemangioma can be performed safely,provided it is carried out with optimized perioperative management and innovative surgical technique.
