Biliary atresia(BA), a chronic progressive cholestatic disease of infants, is the leading cause for liver transplant in children, especially in patients under two years of age. BA can be successfully treated with the ...Biliary atresia(BA), a chronic progressive cholestatic disease of infants, is the leading cause for liver transplant in children, especially in patients under two years of age. BA can be successfully treated with the Kasai portoenterostomy; however most patients still require a liver transplant, with up to one half of BA children needing a transplant by age two. In the current pediatric end-stage liver disease system, children with BA face the risk of not receiving a liver in a safe and timely manner. In this review, we discuss a number of possible solutions to help these children. We focus on two general approaches:(1) preventing/delaying need for transplantation, by optimizing the success of the Kasai operation; and(2) expediting transplantation when needed, by performing techniques other than the standard deceased-donor, whole, ABO-matched organ transplant.展开更多
Despite the new and ever expanding array of medications for the treatment of inflammatory bowel disease (IBD), there are still clear indications for operative management of IBD and its complications. We present an ove...Despite the new and ever expanding array of medications for the treatment of inflammatory bowel disease (IBD), there are still clear indications for operative management of IBD and its complications. We present an overview of indications, procedures, considerations, and controversies in the surgical therapy of IBD.展开更多
目的探讨脑血运重建术治疗缺血性烟雾病的最佳手术时机。方法回顾性分析武汉大学人民医院2016年7月—2018年5月收治的41例缺血性烟雾病患者的临床资料。所有患者均行颞浅-大脑中动脉搭桥+颞肌贴敷术,依据缺血性卒中发生时间与手术之间...目的探讨脑血运重建术治疗缺血性烟雾病的最佳手术时机。方法回顾性分析武汉大学人民医院2016年7月—2018年5月收治的41例缺血性烟雾病患者的临床资料。所有患者均行颞浅-大脑中动脉搭桥+颞肌贴敷术,依据缺血性卒中发生时间与手术之间的时间间隔,将患者分为早期组(1~3个月,17例)和晚期组(>3个月,24例)。分析比较两组患者术后3个月脑灌注改善率及神经功能缺损恢复状况;以及术后并发症(脑出血、脑梗死、过度灌注)的发生率。结果与晚期组相比,早期组患者术后3个月的脑灌注改善率更高,美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分明显降低,差异均有统计学意义(P<0.001,P=0.01)。术后总的并发症(包括过度灌注、脑出血、脑梗死)发生率,早期组为52.9%,晚期组为54.2%,两组的差异无统计学意义(P>0.05)。结论 缺血性烟雾病患者卒中事件后1~3个月内行脑血运重建术,对于改善患者脑灌注和神经功能恢复更有效,并且不增加术后并发症发生的风险。展开更多
文摘Biliary atresia(BA), a chronic progressive cholestatic disease of infants, is the leading cause for liver transplant in children, especially in patients under two years of age. BA can be successfully treated with the Kasai portoenterostomy; however most patients still require a liver transplant, with up to one half of BA children needing a transplant by age two. In the current pediatric end-stage liver disease system, children with BA face the risk of not receiving a liver in a safe and timely manner. In this review, we discuss a number of possible solutions to help these children. We focus on two general approaches:(1) preventing/delaying need for transplantation, by optimizing the success of the Kasai operation; and(2) expediting transplantation when needed, by performing techniques other than the standard deceased-donor, whole, ABO-matched organ transplant.
文摘Despite the new and ever expanding array of medications for the treatment of inflammatory bowel disease (IBD), there are still clear indications for operative management of IBD and its complications. We present an overview of indications, procedures, considerations, and controversies in the surgical therapy of IBD.
文摘目的探讨脑血运重建术治疗缺血性烟雾病的最佳手术时机。方法回顾性分析武汉大学人民医院2016年7月—2018年5月收治的41例缺血性烟雾病患者的临床资料。所有患者均行颞浅-大脑中动脉搭桥+颞肌贴敷术,依据缺血性卒中发生时间与手术之间的时间间隔,将患者分为早期组(1~3个月,17例)和晚期组(>3个月,24例)。分析比较两组患者术后3个月脑灌注改善率及神经功能缺损恢复状况;以及术后并发症(脑出血、脑梗死、过度灌注)的发生率。结果与晚期组相比,早期组患者术后3个月的脑灌注改善率更高,美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分明显降低,差异均有统计学意义(P<0.001,P=0.01)。术后总的并发症(包括过度灌注、脑出血、脑梗死)发生率,早期组为52.9%,晚期组为54.2%,两组的差异无统计学意义(P>0.05)。结论 缺血性烟雾病患者卒中事件后1~3个月内行脑血运重建术,对于改善患者脑灌注和神经功能恢复更有效,并且不增加术后并发症发生的风险。
