Background Budd-Chiad syndrome （BCS） is a posthepatic portal hypertension caused by the obstruction of the lumen of the hepatic veins or the proximal inferior vena cava （IVC）. This study aimed to evaluate the clin...Background Budd-Chiad syndrome （BCS） is a posthepatic portal hypertension caused by the obstruction of the lumen of the hepatic veins or the proximal inferior vena cava （IVC）. This study aimed to evaluate the clinical experience of interventional therapy for Budd-Chiari syndrome. Methods IVC venography was carried out first, the obliteration or stenosis in the IVC was opened or dilated with the hard guided wire or Rupsl00 puncture needle and balloon, then a stent was routinely implanted for the type of obliteration or stenosis. Results The procedure was successful in 821 out of 903 cases including IVC intervention in 760 cases, and hepatic vein intervention in 61 cases. An IVC stent was used in 517 cases and hepatic vein stent in 19 cases. There were no pulmonary embolisms, but acute renal failure occurred in eight cases, hepatic coma in two cases and acute heart failure in 43 cases. Two patients died in this group and five cases were complicated with acute IVC thrombosis. Follow up of 7 to 124 months was made in 679 cases with recurrence found in 59 cases. Conclusions Interventional therapy is safe and effective with a fast recovery for most types of BCS. It is gradually becomine the first therapeutic choice.展开更多
AIM:To assess the efficacy of tenofovir disoproxil fumarate(TDF) in lamivudine(LAM)-resistant patients with a suboptimal response to LAM plus adefovir(ADV).METHODS:We retrospectively analyzed the efficacy of switching...AIM:To assess the efficacy of tenofovir disoproxil fumarate(TDF) in lamivudine(LAM)-resistant patients with a suboptimal response to LAM plus adefovir(ADV).METHODS:We retrospectively analyzed the efficacy of switching to tenofovir disoproxil fumarate in suboptimal responders to lamivudine plus adefovir.Charts were reviewed for LAM-resistant chronic hepatitis B(CHB) patients who visited the Zhejiang Province People's Hospital and The First Affiliated Hospital,College of Medicine,Zhejiang University,from June 2009 to May 2013.Patients whose serum hepatitis B virus(HBV) DNA remained detectable despite at least 6 mo of LAM plus ADV combination therapy were included.Patients with a suboptimal response to LAM plus ADV were randomized to switch to TDF monotherapy(300 mg/d orally; TDF group) or to continuation with LAM(100 mg/d orally) plus ADV(10 mg/d orally; LAM plus ADV group) and were followed for 48 wk.Serum HBV DNA was determined at baseline and weeks 4,12,24,36,and 48.HBV serological markers and biochemistry were assessed at baseline and weeks 12,24,and 48.Resistance surveillance and side effects were monitored during therapy.RESULTS:Fifty-nine patient were randomized to switch to TDF(n =28) or continuation with LAM plus ADV(n =31).No significant differences were found between the groups at baseline.Prior to TDF therapy,all patients had been exposed to LAM plus ADV for a median of 11 mo(range:6-24 mo).No difference was seen in baseline serum HBV DNA between the two groups [5.13 ± 1.08 log10 copies/m L(TDF) vs 5.04 ± 31.16 log10 copies/m L(LAM +ADV),P =0.639].There was no significant difference in the rates of achieving complete virological response(CVR) at week 4 between the TDF and LAM +ADV groups(17.86% vs 6.45%,P =0.24).The rate of achieving CVR in the TDF and LAM plus ADV groups was 75% vs 16.13% at week 12,82.14% vs 22.58% at week 24,89.29% vs 25.81% at week 36,and 96.43% vs 29.03% at week 48,respectively(P < 0.001).The rate of alanine aminotransferase normalization was significantly higher in the TDF than 展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths worldwide,but there is a shortage of effective biomarkers for its diagnosis.AIM To explore blood exosomal micro ribonucleic...BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths worldwide,but there is a shortage of effective biomarkers for its diagnosis.AIM To explore blood exosomal micro ribonucleic acids(miRNAs)as potential biomarkers for HCC diagnosis.RESULTS The principal component analysis suggested that daily alcohol consumption could alter the blood exosomal miRNA profiles of hepatitis B virus positive non-HCC patients through miR-3168 and miR-223-3p.The miRNA profiles also revealed the tumor stages of HCC patients.High expression of miR-455-5p and miR-30c-5p,which significantly correlated with better overall survival in tumor tissues,could also be detected in blood exosomes.Two pairs of miRNAs(miR-584-5p/miR-106-3p and miR-628-3p/miR-941)showed a 94.1%sensitivity and 68.4%specificity to differentiate HCC patients from non-HCC patients.The specificity of the combination was substantially influenced by alcohol consumption habits.CONCLUSION This study suggested that blood exosomal miRNAs can be used as new noninvasive diagnostic tools for HCC.However,their accuracy could be affected by tumor stage and alcohol consumption habits.展开更多
Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study ai...Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index （HARt）, and to observe pathological changes and morphology of biliary casts. Methods： Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks I, 2, 3 shown by color Doppler flow imaging. The compositions ofbiliary casts were analyzed by pathological examination and scanning electron microscopy. Results： HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 （P 〈 0.05）. Odds ratio （OR） analysis of HARI 1, HARI 2, HARI 3 following the operation was 〉1 （OR = 1.300： 1.223 and 1.889, respectively）. The OR of HARI 3 was statistically significant （OR - 1.889; 95% confidence interval - 1.166-7.490; P - 0.024）. The compositions of biliary casts were different when bile duct stones wcrc present. Furthermore, vascular epithelial cells were found by pathological examination in binary casts. Conclusions： HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of binary casts and bile duct stones are different.展开更多
The NIM5 fountain clock is the second fountain clock built at NIM(National Institute of Metrology,China),and has been operating stably and sub-continually since 2008.The fountain operates with a simple one-stage optic...The NIM5 fountain clock is the second fountain clock built at NIM(National Institute of Metrology,China),and has been operating stably and sub-continually since 2008.The fountain operates with a simple one-stage optical molasses to collect cold atoms,which reduces the collisional frequency shift dramatically.The fractional frequency uncertainty is estimated to be 2×10^(-15).The typical frequency instability of 2.5×10^(-14) is obtained at 10 s.Comparisons with other fountain frequency standards worldwide demonstrate agreement within the stated uncertainties.展开更多
BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC).Nevertheless,long-term survival rate ...BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC).Nevertheless,long-term survival rate and postoperative complications are far from ideal,mainly since the majority of patients treated with ALPPS surgery have large or multiple lesions and microvascular tumor thrombus.CASE SUMMARY We present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver,who was successfully treated with ALPPS surgery and apatinib.Postoperative pathology revealed HCC with several significant microvascular embolisms.Twenty months after operation,no tumor reoccurrence was observed.CONCLUSION Our case indicated that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.展开更多
Desertification is an environmental issue in the world. The salt-alkalization desertification land area formed by both primary and secondary salt-alkalization has extended in a large scale, which has become a signific...Desertification is an environmental issue in the world. The salt-alkalization desertification land area formed by both primary and secondary salt-alkalization has extended in a large scale, which has become a significant eco-environmental problem. Based on the characteristics of eco-environment and the situation of desertification in westem Songnen plain, this paper reports the analyzes of its formation in background and cause. An early waming system on the salt-alkalization desertification is established and the GIS technology is used to abstract the information of desertification evaluation index. Supported by the integrated technology of the GIS and ANN, the orientation and quantitative result of desertification are gained, which is helpful to the eco-environment protection and resource development in westem Songnen Plain.展开更多
文摘Background Budd-Chiad syndrome （BCS） is a posthepatic portal hypertension caused by the obstruction of the lumen of the hepatic veins or the proximal inferior vena cava （IVC）. This study aimed to evaluate the clinical experience of interventional therapy for Budd-Chiari syndrome. Methods IVC venography was carried out first, the obliteration or stenosis in the IVC was opened or dilated with the hard guided wire or Rupsl00 puncture needle and balloon, then a stent was routinely implanted for the type of obliteration or stenosis. Results The procedure was successful in 821 out of 903 cases including IVC intervention in 760 cases, and hepatic vein intervention in 61 cases. An IVC stent was used in 517 cases and hepatic vein stent in 19 cases. There were no pulmonary embolisms, but acute renal failure occurred in eight cases, hepatic coma in two cases and acute heart failure in 43 cases. Two patients died in this group and five cases were complicated with acute IVC thrombosis. Follow up of 7 to 124 months was made in 679 cases with recurrence found in 59 cases. Conclusions Interventional therapy is safe and effective with a fast recovery for most types of BCS. It is gradually becomine the first therapeutic choice.
文摘AIM:To assess the efficacy of tenofovir disoproxil fumarate(TDF) in lamivudine(LAM)-resistant patients with a suboptimal response to LAM plus adefovir(ADV).METHODS:We retrospectively analyzed the efficacy of switching to tenofovir disoproxil fumarate in suboptimal responders to lamivudine plus adefovir.Charts were reviewed for LAM-resistant chronic hepatitis B(CHB) patients who visited the Zhejiang Province People's Hospital and The First Affiliated Hospital,College of Medicine,Zhejiang University,from June 2009 to May 2013.Patients whose serum hepatitis B virus(HBV) DNA remained detectable despite at least 6 mo of LAM plus ADV combination therapy were included.Patients with a suboptimal response to LAM plus ADV were randomized to switch to TDF monotherapy(300 mg/d orally; TDF group) or to continuation with LAM(100 mg/d orally) plus ADV(10 mg/d orally; LAM plus ADV group) and were followed for 48 wk.Serum HBV DNA was determined at baseline and weeks 4,12,24,36,and 48.HBV serological markers and biochemistry were assessed at baseline and weeks 12,24,and 48.Resistance surveillance and side effects were monitored during therapy.RESULTS:Fifty-nine patient were randomized to switch to TDF(n =28) or continuation with LAM plus ADV(n =31).No significant differences were found between the groups at baseline.Prior to TDF therapy,all patients had been exposed to LAM plus ADV for a median of 11 mo(range:6-24 mo).No difference was seen in baseline serum HBV DNA between the two groups [5.13 ± 1.08 log10 copies/m L(TDF) vs 5.04 ± 31.16 log10 copies/m L(LAM +ADV),P =0.639].There was no significant difference in the rates of achieving complete virological response(CVR) at week 4 between the TDF and LAM +ADV groups(17.86% vs 6.45%,P =0.24).The rate of achieving CVR in the TDF and LAM plus ADV groups was 75% vs 16.13% at week 12,82.14% vs 22.58% at week 24,89.29% vs 25.81% at week 36,and 96.43% vs 29.03% at week 48,respectively(P < 0.001).The rate of alanine aminotransferase normalization was significantly higher in the TDF than
文摘BACKGROUND Hepatocellular carcinoma(HCC)is one of the leading causes of cancer-related deaths worldwide,but there is a shortage of effective biomarkers for its diagnosis.AIM To explore blood exosomal micro ribonucleic acids(miRNAs)as potential biomarkers for HCC diagnosis.RESULTS The principal component analysis suggested that daily alcohol consumption could alter the blood exosomal miRNA profiles of hepatitis B virus positive non-HCC patients through miR-3168 and miR-223-3p.The miRNA profiles also revealed the tumor stages of HCC patients.High expression of miR-455-5p and miR-30c-5p,which significantly correlated with better overall survival in tumor tissues,could also be detected in blood exosomes.Two pairs of miRNAs(miR-584-5p/miR-106-3p and miR-628-3p/miR-941)showed a 94.1%sensitivity and 68.4%specificity to differentiate HCC patients from non-HCC patients.The specificity of the combination was substantially influenced by alcohol consumption habits.CONCLUSION This study suggested that blood exosomal miRNAs can be used as new noninvasive diagnostic tools for HCC.However,their accuracy could be affected by tumor stage and alcohol consumption habits.
基金Source of Support： This study was supported by grants from Science and Technology, Development Plan of Shandong Province （No. 2011GSF 11836）, Natural Science Foundation of Shandong Province （No. ZR2012HM029）, Science and Technology Development Plan of Jinan City （No. 20140821 ）. Conflict of Interest： None declared.ACKNOWLEDGMENTS We thank Prof. Cong Cheng for all statistical analyses, who is director of the teaching and research section of statistics of Taishan Medical University.
文摘Background： BiNary cast syndrome （BCS） was a postoperative complication of orthotopic liver transplantation （OLT）, and the reason for BSC was considered to relate with ischemic type biliary lesions. This study aimed to evaluate the relationship between BCS following OLT and the hepatic artery resistance index （HARt）, and to observe pathological changes and morphology of biliary casts. Methods： Totally, 18 patients were diagnosed with BCS by cholangiography following OLT using choledochoscope or endoscopic retrograde cholangiopancreatography. In addition, 36 patients who did not present with BCS in the corresponding period had detectable postoperative HARI on weeks I, 2, 3 shown by color Doppler flow imaging. The compositions ofbiliary casts were analyzed by pathological examination and scanning electron microscopy. Results： HARI values of the BCS group were significantly decreased as compared with the non-BCS group on postoperative weeks 2 and 3 （P 〈 0.05）. Odds ratio （OR） analysis of HARI 1, HARI 2, HARI 3 following the operation was 〉1 （OR = 1.300： 1.223 and 1.889, respectively）. The OR of HARI 3 was statistically significant （OR - 1.889; 95% confidence interval - 1.166-7.490; P - 0.024）. The compositions of biliary casts were different when bile duct stones wcrc present. Furthermore, vascular epithelial cells were found by pathological examination in binary casts. Conclusions： HARI may possibly serve as an independent risk factor and early predictive factor of BCS. Components and formation of binary casts and bile duct stones are different.
基金Supported by the National Basic Research Program of China under Grant No 2010CB922902the National Natural Science Foundation of China(11174260)。
文摘The NIM5 fountain clock is the second fountain clock built at NIM(National Institute of Metrology,China),and has been operating stably and sub-continually since 2008.The fountain operates with a simple one-stage optical molasses to collect cold atoms,which reduces the collisional frequency shift dramatically.The fractional frequency uncertainty is estimated to be 2×10^(-15).The typical frequency instability of 2.5×10^(-14) is obtained at 10 s.Comparisons with other fountain frequency standards worldwide demonstrate agreement within the stated uncertainties.
文摘BACKGROUND Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has becoming ever more recognized in the treatment of hepatocellular carcinoma (HCC).Nevertheless,long-term survival rate and postoperative complications are far from ideal,mainly since the majority of patients treated with ALPPS surgery have large or multiple lesions and microvascular tumor thrombus.CASE SUMMARY We present the case of a 47-year-old male patient with a huge right hepatic mass and an estimated insufficient residual liver,who was successfully treated with ALPPS surgery and apatinib.Postoperative pathology revealed HCC with several significant microvascular embolisms.Twenty months after operation,no tumor reoccurrence was observed.CONCLUSION Our case indicated that combined targeted drug therapy with ALPPS can lead to long-term survival for patients with large HCC.
基金the National Natural Science Foundation of China
文摘Desertification is an environmental issue in the world. The salt-alkalization desertification land area formed by both primary and secondary salt-alkalization has extended in a large scale, which has become a significant eco-environmental problem. Based on the characteristics of eco-environment and the situation of desertification in westem Songnen plain, this paper reports the analyzes of its formation in background and cause. An early waming system on the salt-alkalization desertification is established and the GIS technology is used to abstract the information of desertification evaluation index. Supported by the integrated technology of the GIS and ANN, the orientation and quantitative result of desertification are gained, which is helpful to the eco-environment protection and resource development in westem Songnen Plain.
