AIM To investigate serum mean platelet volume(MPV) levels in acute pancreatitis(AP) patients and assess whether MPV effectively predicts the disease severity of AP.METHODS We included 117 consecutive patients with AP ...AIM To investigate serum mean platelet volume(MPV) levels in acute pancreatitis(AP) patients and assess whether MPV effectively predicts the disease severity of AP.METHODS We included 117 consecutive patients with AP as the AP group and 34 consecutive patients with colorectal polyps(before endoscopic treatment) as the control group. Complete blood counts, liver function, platelet indices(MPV), coagulation parameters, lactate dehydrogenase(LDH) and C-reactive protein(CRP) were measured on days 1, 2, 3 and 7 after admission. Receiver operating characteristic curves were used to compare the sensitivity and specificity of MPV, white blood cell(WBC), LDH and CRP in predicting AP severity. The Modified Glasgow Prognostic Score(m GPS) and the 2012 revised Atlanta criteria were used to evaluate disease severity in AP.RESULTS MPV levels were significantly lower in the AP group than in the control group on day 1(P = 0.000), day 2(P = 0.029) and day 3(P = 0.001) after admission.In addition, MPV values were lower on day 1 after admission than on day 2(P = 0.012), day 3(P = 0.000) and day 7(P = 0.002) in all AP patients. Based on the m GPS, 78 patients(66.7%) were diagnosed with mild and 39 patients(33.3%) with severe AP. There was no significant difference in mean MPV levels between patients diagnosed with mild and severe AP based on the m GPS(P = 0.424). According to the 2012 revised Atlanta criteria, there were 98 patients(83.8%) without persistent organ failure(OF) [non-severe acute pancreatitis(non-SAP) group] and 19 patients(16.2%) with persistent OF(SAP group). MPV levels were significantly lower in the SAP group than in the non-SAP group on day 1 after admission(P = 0.002). On day 1 after admission using a cut-off value of 6.65 f L, the overall accuracy of MPV for predicting SAP according to the 2012 revised Atlanta criteria(AUC = 0.716) had a sensitivity of 91.8% and a specificity of 47.4% and was superior to the accuracy of the traditional markers WBC(AUC = 0.700) and LDH(AUC = 0.697).CONCLUSION MPV can be used at n展开更多
AIM To examine the effect of center size on survival differences between simultaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed patients.METHODS The United Network of Organ...AIM To examine the effect of center size on survival differences between simultaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed patients.METHODS The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Posttransplant survival was evaluated using stratified Cox regression with interaction between transplant type(LTA vs SLKT) and center volume.RESULTS During the study period, 393 of 4580 patients(9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients(180/393, 46%) than SLKT recipients(1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio(HR) = 2.85; 95%CI: 2.21, 3.66; P < 0.001] in centers performing 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction(HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs performed.CONCLUSION In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes.展开更多
Aims: 1) To establish the volume, weight and size of a normal pancreas, spleen and kidney in 114 adult male autopsies;2) To investigate the relationship between the volume, weight, and size of the pancreas, spleen, an...Aims: 1) To establish the volume, weight and size of a normal pancreas, spleen and kidney in 114 adult male autopsies;2) To investigate the relationship between the volume, weight, and size of the pancreas, spleen, and kidney with body mass index (BMI), body surface area (BSA), age, height, and weight. Methods: The normal pancreas, spleen, and kidney volume, weight, and size retrospectively gathered from 114 forensic autopsy cases between the ages of 25 and 88 years. The pancreas, spleen, and kidney volume, weight, and size were available. The parameters used for statistical correlation were the age, height, body weight, BMI, and BSA of the deceased. Results: The volume, weight, and size of all the organs were shown in correlation with the deceased’s height, body weight, BMI, and BSA but not age. The organ volume, weight, and size showed a better statistical correlation with the BSA, BMI, and body weight than the height. Conclusions: The normal reference ranges for organ volume, weight, and size given in this study can serve as a standard to judge atrophy or hypertrophy of organs in post-mortem diagnosis.展开更多
Objective:Port placement is a crucial pre-operative task in robot-assisted minimally invasive surgery.Due to the insufflation process,the abdominal shape is deformed while the internal organs are shifted in position.T...Objective:Port placement is a crucial pre-operative task in robot-assisted minimally invasive surgery.Due to the insufflation process,the abdominal shape is deformed while the internal organs are shifted in position.These changes need to be considered when determining the optimal port locations for the robotic manipulators.However,intra-operative medical image acquisition systems are not always available.In this study,we aim to estimate the shift extent of the abdominal organs in humans by measuring the changed volume and position of the abdominal organs before and after insufflation in three pigs.Methods:A 3D model of the abdomen and abdominal organs was reconstructed from 3D images of the pigs taken by an MRI scanner before and after insufflation.Position shift and shape changes of the abdominal organs after insufflation were determined.The corresponding shift in port location for the robotic manipulators was determined based on the abdominal model.Results:Organ movements as a result of insufflation ranged from 6.37±0.10 cm for the spleen,to 1.64±0.22 cm for the liver.Even a slight planar motion of the target organ(e.g.,1.33±0.06 cm,2.38±0.21 cm in X-Y plane for the left kidney)can shift the access port for the robot manipulator by about 1.6 cm on the abdominal surface.Conclusions:The target organs’motion due to insufflation is a critical factor in determining port locations in robot-assisted minimally invasive surgery.展开更多
目的评价三维立体超声容积测量功能(VOCAL)对胎儿小脑蚓部发育的监测价值。方法前瞻性地对730例孕18～35w胎儿应用腹部三维立体超声容积探头,在胎头小脑蚓部的正中矢状切面,测量胎儿小脑蚓部面积,储存在仪器上,由专人应用其三维立体超...目的评价三维立体超声容积测量功能(VOCAL)对胎儿小脑蚓部发育的监测价值。方法前瞻性地对730例孕18～35w胎儿应用腹部三维立体超声容积探头,在胎头小脑蚓部的正中矢状切面,测量胎儿小脑蚓部面积,储存在仪器上,由专人应用其三维立体超声的容积测量功能(Virtual Organ Computer aided analysis,VOCAL)测量胎儿小脑蚓部体积,获得不同孕周正常值,并发现异常儿。结果胎儿小脑蚓部体积随孕周增加而增大呈正相关(r=0.86,P<0.05),发现异常儿10例,其中小脑蚓部缺如9例(6例系Dandy-Walker综合征,3例系全前脑并多发畸形),小脑蚓部发育不良1例。结论三维立体超声VOCAL能够克服二维超声扫查难以获取的胎头小脑蚓部正中矢状切面,有助于揭示正常胎儿小脑蚓部的发育规律,并发现异常的小脑蚓部,使宫内评价胎儿小脑蚓部发育成为可能。展开更多
基金Supported by the Joint Foundation of Department of Science and Technology of Guizhou Province,China,No.[2016]7408
文摘AIM To investigate serum mean platelet volume(MPV) levels in acute pancreatitis(AP) patients and assess whether MPV effectively predicts the disease severity of AP.METHODS We included 117 consecutive patients with AP as the AP group and 34 consecutive patients with colorectal polyps(before endoscopic treatment) as the control group. Complete blood counts, liver function, platelet indices(MPV), coagulation parameters, lactate dehydrogenase(LDH) and C-reactive protein(CRP) were measured on days 1, 2, 3 and 7 after admission. Receiver operating characteristic curves were used to compare the sensitivity and specificity of MPV, white blood cell(WBC), LDH and CRP in predicting AP severity. The Modified Glasgow Prognostic Score(m GPS) and the 2012 revised Atlanta criteria were used to evaluate disease severity in AP.RESULTS MPV levels were significantly lower in the AP group than in the control group on day 1(P = 0.000), day 2(P = 0.029) and day 3(P = 0.001) after admission.In addition, MPV values were lower on day 1 after admission than on day 2(P = 0.012), day 3(P = 0.000) and day 7(P = 0.002) in all AP patients. Based on the m GPS, 78 patients(66.7%) were diagnosed with mild and 39 patients(33.3%) with severe AP. There was no significant difference in mean MPV levels between patients diagnosed with mild and severe AP based on the m GPS(P = 0.424). According to the 2012 revised Atlanta criteria, there were 98 patients(83.8%) without persistent organ failure(OF) [non-severe acute pancreatitis(non-SAP) group] and 19 patients(16.2%) with persistent OF(SAP group). MPV levels were significantly lower in the SAP group than in the non-SAP group on day 1 after admission(P = 0.002). On day 1 after admission using a cut-off value of 6.65 f L, the overall accuracy of MPV for predicting SAP according to the 2012 revised Atlanta criteria(AUC = 0.716) had a sensitivity of 91.8% and a specificity of 47.4% and was superior to the accuracy of the traditional markers WBC(AUC = 0.700) and LDH(AUC = 0.697).CONCLUSION MPV can be used at n
文摘AIM To examine the effect of center size on survival differences between simultaneous liver kidney transplantation(SLKT) and liver transplantation alone(LTA) in SLKT-listed patients.METHODS The United Network of Organ Sharing database was queried for patients ≥ 18 years of age listed for SLKT between February 2002 and December 2015. Posttransplant survival was evaluated using stratified Cox regression with interaction between transplant type(LTA vs SLKT) and center volume.RESULTS During the study period, 393 of 4580 patients(9%) listed for SLKT underwent a LTA. Overall mortality was higher among LTA recipients(180/393, 46%) than SLKT recipients(1107/4187, 26%). The Cox model predicted a significant survival disadvantage for patients receiving LTA vs SLKT [hazard ratio, hazard ratio(HR) = 2.85; 95%CI: 2.21, 3.66; P < 0.001] in centers performing 30 SLKT over the study period. This disadvantage was modestly attenuated as center SLKT volume increased, with a 3% reduction(HR = 0.97; 95%CI: 0.95, 0.99; P = 0.010) for every 10 SLKs performed.CONCLUSION In conclusion, LTA is associated with increased mortality among patients listed for SLKT. This difference is modestly attenuated at more experienced centers and may explain inconsistencies between smaller-center and larger registry-wide studies comparing SLKT and LTA outcomes.
文摘Aims: 1) To establish the volume, weight and size of a normal pancreas, spleen and kidney in 114 adult male autopsies;2) To investigate the relationship between the volume, weight, and size of the pancreas, spleen, and kidney with body mass index (BMI), body surface area (BSA), age, height, and weight. Methods: The normal pancreas, spleen, and kidney volume, weight, and size retrospectively gathered from 114 forensic autopsy cases between the ages of 25 and 88 years. The pancreas, spleen, and kidney volume, weight, and size were available. The parameters used for statistical correlation were the age, height, body weight, BMI, and BSA of the deceased. Results: The volume, weight, and size of all the organs were shown in correlation with the deceased’s height, body weight, BMI, and BSA but not age. The organ volume, weight, and size showed a better statistical correlation with the BSA, BMI, and body weight than the height. Conclusions: The normal reference ranges for organ volume, weight, and size given in this study can serve as a standard to judge atrophy or hypertrophy of organs in post-mortem diagnosis.
文摘Objective:Port placement is a crucial pre-operative task in robot-assisted minimally invasive surgery.Due to the insufflation process,the abdominal shape is deformed while the internal organs are shifted in position.These changes need to be considered when determining the optimal port locations for the robotic manipulators.However,intra-operative medical image acquisition systems are not always available.In this study,we aim to estimate the shift extent of the abdominal organs in humans by measuring the changed volume and position of the abdominal organs before and after insufflation in three pigs.Methods:A 3D model of the abdomen and abdominal organs was reconstructed from 3D images of the pigs taken by an MRI scanner before and after insufflation.Position shift and shape changes of the abdominal organs after insufflation were determined.The corresponding shift in port location for the robotic manipulators was determined based on the abdominal model.Results:Organ movements as a result of insufflation ranged from 6.37±0.10 cm for the spleen,to 1.64±0.22 cm for the liver.Even a slight planar motion of the target organ(e.g.,1.33±0.06 cm,2.38±0.21 cm in X-Y plane for the left kidney)can shift the access port for the robot manipulator by about 1.6 cm on the abdominal surface.Conclusions:The target organs’motion due to insufflation is a critical factor in determining port locations in robot-assisted minimally invasive surgery.
文摘目的评价三维立体超声容积测量功能(VOCAL)对胎儿小脑蚓部发育的监测价值。方法前瞻性地对730例孕18～35w胎儿应用腹部三维立体超声容积探头,在胎头小脑蚓部的正中矢状切面,测量胎儿小脑蚓部面积,储存在仪器上,由专人应用其三维立体超声的容积测量功能(Virtual Organ Computer aided analysis,VOCAL)测量胎儿小脑蚓部体积,获得不同孕周正常值,并发现异常儿。结果胎儿小脑蚓部体积随孕周增加而增大呈正相关(r=0.86,P<0.05),发现异常儿10例,其中小脑蚓部缺如9例(6例系Dandy-Walker综合征,3例系全前脑并多发畸形),小脑蚓部发育不良1例。结论三维立体超声VOCAL能够克服二维超声扫查难以获取的胎头小脑蚓部正中矢状切面,有助于揭示正常胎儿小脑蚓部的发育规律,并发现异常的小脑蚓部,使宫内评价胎儿小脑蚓部发育成为可能。
