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Pancreatic cancer: open or minimally invasive surgery?

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World Journal of Gastroenterology 2016年第32期22卷 7301-7310页

作者： Yu-Hua Zhang Cheng-Wu Zhang Zhi-Ming Hu de-fei hong Division of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery Zhejiang Provincial People’s Hospital

Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the shortand long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures. We collected comparative data about minimally invasive and open pancreatic surgery. The available evidence suggests that minimally invasive pancreaticoduodenectomy(MIPD) is as safe and feasible as open PD(OPD), and shows some benefit, such as less intraoperative blood loss and shorter postoperative hospital stay. despite the limited evidence for MIPD in pancreatic cancer, most of the available data show that the short-term oncological adequacy is similar between MIPD and OPD. Some surgical techniques, including superior mesenteric artery-first approach and laparoscopic pancreatoduodenectomy with major vein resection, are believed to improve the rate of R0 resection. Laparoscopic distal pancreatectomy is less technically demanding and is accepted in more pancreatic centers. It is technically safe and feasible and has similar short-term oncological prognosis compared with open distal pancreatectomy.

关键词： Laparoscopic Minimally invasive Robotic Pancreaticoduodenectomy Distal pancreatectomy Pancreatic cancer

Indocyanine green retention is a potential prognostic indicator after splenectomy and pericardial devascularization for cirrhotic patients

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Hepatobiliary & Pancreatic Diseases International 2016年第4期15卷 386-390页

作者： Yuan-Biao Zhang Yi Lu Wei-Ding Wu Cheng-Wu Zhang Guo-Liang Shen de-fei hong department of Hepatopancreaticobiliary Surgery&Laparoscopic Minimally hwasive Surgery Zhejiang Provincial People's HospitalHangzhou 310014China

BACKGROUND：Splenectomy and pericardial devascularization（SPD）is an effective treatment of upper gastrointestinal bleeding and hypersplenism in cirrhotic patients with portal *** green retention at 15 minutes（ICGR15）was reported to offer better sensitivity and specificity than the Child-Pugh classification in hepatectomy,but few reports describe ICGR15 in *** present study was to evaluate the prognostic value of ICGR15 for cirrhotic patients with portal hypertension who underwent ***：From January 2012 to January 2015,43 patients with portal hypertension and hypersplenism caused by liver cirrhosis were admitted in our center and received *** ICGR15,Child-Pugh classification,model for end-stage liver disease（MELD）score,and perioperative characteristics were analyzed ***：Preoperative liver function assessment revealed that 34 patients were Child-Pugh class A with ICGR15 of13.6%-43.0%and MELD score of 7-20;8 patients were class B with ICGR15 of 22.8%-40.7%and MELD score of 7-17;1patient was class C with ICGR15 of 39.7%and MELD score of *** optimal ICGR15 threshold for liver function compensation was 31.2%,which offered a sensitivity of 68.4%and a specificity of 70.8%.Univariate analysis showed preoperative ICGR15,MELD score,surgical procedure,intraoperative blood loss,and autologous blood transfusion were significantly different between postoperative liver function compensated and decompensated *** regression analysis revealed that ICGR15 was an independent risk factor of postoperative liver function recovery（P=0.020）.CONCLUSIONS：ICGR15 has outperformed the Child-Pugh classification for assessing liver function in cirrhotic patients with portal ***15 may be a suitable prognostic indicator for cirrhotic patients after SPD.

关键词： indocyanine green liver function test liver cirrhosis splenectomy pericardial devascularization

Laparoscope resection of retroperitoneal ectopic insulinoma: A rare case

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World Journal of Gastroenterology 2015年第14期21卷 4413-4418页

作者： Jie Liu Cheng-Wu Zhang de-fei hong Jia Wu hong-Guo Yang Yuan Chen Da-Jian Zhao Yu-Hua Zhang department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery Zhejiang Provincial People’s Hospital department of General Surgery Haining Branch of Zhejiang Provincial People’s Hospital department of Pathology Zhejiang Provincial People’s Hospital

Ectopic insulinoma is a very rare and dormant *** we report the case of a 79-year-old female who presented with repeated episodes of hypoglycemia and was diagnosed with insulinoma based on laboratory and imaging *** tomography and positron emission tomography revealed a tumor in the retroperitoneum under and left of the hepatoduodenal ligament, which was resected successfully using a laparoscopic *** results revealed an ectopic insulinoma, which was confirmed *** insulinomas are accompanied by hypoglycemia that can be misdiagnosed as drug- or *** tumors are difficult to diagnose and locate, particularly in atypical cases or for very small *** or targeted examinations, including low blood glucose, elevated insulin, proinsulin, and C-peptide levels, 48-h fasting tests, and relevant imaging methods should be considered for suspected cases of *** is the treatment of choice for patients with insulinoma, and laparoscopic resection is a feasible and effective method for select ectopic insulinoma cases.

关键词： Diagnosis Ectopic insulinoma Hypoglycemia Laparosc

Primary hepatic epithelioid angiomyolipoma: A malignant potential tumor which should be recognized

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World Journal of Gastroenterology 2016年第20期22卷 4908-4917页

作者： Jie Liu Cheng-Wu Zhang de-fei hong Ran Tao Yuan Chen Min-Jie Shang Yu-Hua Zhang department of Hepatopancreatobiliary Surgery and Minimally Invasive Surgery Zhejiang Provincial People’s Hospital department of Pathology Zhejiang Provincial People’s Hospital

AIM: To improve the clinical diagnosis and recognition of hepatic epithelioid angiomyolipoma(HEAML).METHODS: Four cases of primary HEAML were confirmed based on the pathology archive system in our hospital from January 2009 to November 2015. The general state, clinical symptoms, imaging manifestations, histological results and immunohistochemistry of these patients were retrospectively reviewed and analyzed. Studies of HEAML published in the last 15 years were collected from Pub Med and MEDLINE to summarize the clinical symptoms, imaging characteristics, pathological features and management of ***: Four cases of primary HEAML were retrieved from our archives. These included three female patients and one male patient, with a mean age of 41.8 ± 11.5 years(ranging from 31 to 56 years). The meantumor size was 7.3 ± 5.5 cm(ranging from 3.0 to 15 cm). In the contrast-enhanced imaging, the tumor was obviously enhanced in the arterial phase, but enhanced continuously or exhibited a slow-density masse during the venous and delayed phases. Histologically, the tumors mainly consisted of epithelioid cells that comprised approximately 95% of the total neoplastic mass. Although no metastases occurred in our patients, pathological studies revealed necrosis, mitotic figures and liver invasion in two patients, which indicates aggressive behavior. Immunohistochemical staining revealed that human melanoma black 45(HMB-45) and Melan-A were positive in 4 cases. We only identified 81 cases with primary HEAML, including our present patients, from 26 articles available from Pub Med and MEDLINE. The majority of the papers were published as case reports. Only 5(5/75, 6%) cases were associated with tuberous sclerosis complex(TSC). More than half(35/66) were discovered incidentally upon physical examination. Approximately 65%(22/34) of the patients were misdiagnosed with HCC or other tumors before surgery. Approximately 10%(8/81) of the patients with HEAML had recurrence or metastasi

关键词： Epithelioid angiomyolipoma Imaging Liver Immunohistochemical staining Human melanoma black 45

Better surgical treatment method for hepatocellular carcinoma with portal vein tumor thrombus

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World Journal of Gastroenterology 2018年第40期24卷 4527-4535页

作者： Shu-You Peng Xu-An Wang Cong-Yun Huang Jiang-Tao Li de-fei hong Yi-Fang Wang Bin Xu department of Hepatobiliary and Pancreatic Surgery The Second Affiliated Hospital of Zhejiang University School of Medicine department of General Surgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine department of General Surgery Yuebei People's Hospital Affiliated to Shantou University School of Medicine department of Hepatobiliary and Pancreatic Surgery Sir Run Run Shaw Hospital Affiliated Hospital of Zhejiang University School of Medicine

Hepatocellular carcinoma(HCC) with portal vein tumor thrombus(PVTT) is a disease that is not uncommon, but the treatments vary drastically between Eastern and Western countries. In Europe and America, the first line of treatment is systemic therapy such as sorafenib and the surgical treatment is not a recommend option. While an increasing number of studies from China and Japan have suggested that surgical treatment results in better outcomes when compared to transcatheter arterial chemoembolization(TACE), sorafenib, or other nonsurgical treatments, and two classification systems, Japanese Vp classification and Chinese Cheng's classification, were very useful to guide the surgical treatment. We have also found that surgical treatment may be more effective, as we have performed surgical treatment for HCC-PVTT patients over a period of approximately 15 years and achieved good results with the longest surviving time being 13 years and onward. In this study, we review the efficacy and principles of current surgical treatments and introduce our new, more effective surgical technique named "thrombectomy first", which means the tumor thrombus in the main portal vein, the bifurcation or the contralateral portal vein should be removed prior to liver resection. Thus, compression and crushing of PVTT during the operation could be avoided and new intrahepatic metastases caused by tumor thrombus to the remnant liver minimized. The new technique is even beneficial to the prognosis of Cheng's classification Types Ⅲ and Ⅳ PVTT. The vital tips and tricks for the surgical approach are described.

关键词： Portal vein tumor thrombus Thrombectomy first Surgery Hepatocellular carcinoma

Evolution of associating liver partition and portal vein ligation for staged hepatectomy: Simpler, safer and equally effective methods

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World Journal of Gastroenterology 2017年第23期23卷 4140-4145页

作者： Shu-You Peng Xu-An Wang Cong-Yun Huang You-Yong Zhang Jiang-Tao Li de-fei hong Xiu-Jun Cai department of Hepatobiliary and Pancreatic Surgery The Second Affiliated Hospital of Zhejiang University School of Medicine department of General Surgery Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine department of General Surgery Yuebei People’s Hospital Affiliated to Shantou University School of Medicine department of Radiology Yuebei People’s Hospital Affiliated to Shantou University School of Medicine department of Hepatobiliary and Pancreatic Surgery Zhejiang Provincial People's Hospital department of Hepatobiliary and Pancreatic Surgery Sir Run Run Shaw HospitalZhejiang University

Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) has been recently demonstrated as a method to induce rapid and extensive hypertrophy within a short time and has been employed for a variety of primary and metastatic liver tumors. However, controversies remain due to its high morbidity and mortality. To enable safer surgery, liver surgeons have searched for better technical modifications, such as partial ALPPS, mini-ALPPS, minimally invasive ALPPS, and Terminal branches portal vein Embolization Liver Partition for Planned hepatectomy(TELPP). It seems that TELPP is very promising, because it has the main advantage of ALPPS-the rapid increase of future liver remnant volume, but the morbidity and mortality are much lower because only one surgical operation is required.

关键词： Associating liver partition and portal vein ligation for staged hepatectomy Terminal branches portal vein embolization Terminal branches portal vein embolization liver partition for planned hepatectomy Transarterial chemoembolization

Transcatheter arterial chemoembolization after percutaneous microwave ablation and portal vein embolization for advanced hepatocellular carcinoma

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Hepatobiliary & Pancreatic Diseases International 2023年第2期22卷 213-216页

作者： Jian Cheng de-fei hong Cheng-Wu Zhang Xiao-Ming Fan Zu-Yan Luo Wei-Feng Yao Li-Ming Jin General Surgery Cancer CenterDepartment of Hepatobiliary&Pancreatic Surgery and Minimally Invasive SurgeryZhejiang Provincial People’s HospitalAffiliated People’s Hospital of Hangzhou Medical CollegeHangzhou 310014China department of General Surgery Sir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310020China

To the Editor: Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) promotes the future liver remnant(FLR) rapid proliferation in the short term, which in turn provides an opportunity for... 详细信息

关键词： hepatocellular liver microwave

Review on synergistic damage effect of irradiation and corrosion on reactor structural alloys

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Nuclear Science and Techniques 2024年第3期35卷 109-141页

作者： Hui Liu Guan-hong Lei He-fei Huang Shanghai Institute of Applied Physics Chinese Academy of SciencesShanghai 201800China School of Nuclear Science and Technology University of Chinese Academy of SciencesBeijing 100049China

The synergistic damage effect of irradiation and corrosion of reactor structural materials has been a prominent research *** paper provides a comprehensive review of the synergistic effects on the third-and fourth-generation fission nuclear energy structural materials used in pressurized water reactors and molten salt *** competitive mechanisms of multiple influencing factors,such as the irradiation dose,corrosion type,and environmental temperature,are summarized in this *** approaches are proposed to alleviate the synergistic damage caused by irradiation and corrosion,thereby promoting in-depth research in the future and solving this key challenge for the structural materials used in reactors.

关键词： Irradiation and corrosion Synergistic effect Austenitic stainless steels Nickel-based alloys Reactors

Fast charge transfer kinetics in Sv-ZnIn_(2)S_(4)/Sb_(2)S_(3)S-scheme heterojunction photocatalyst for enhanced photocatalytic hydrogen evolution

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Rare Metals 2024年第2期43卷 533-542页

作者： Wei Li Jia-Jun Li Zhi-fei Liu hong-Yu Ma Peng-fei Fang Rui Xiong Jian-hong Wei Key Laboratory of Artificial Micro-and Nano-Structures of Ministry of Education School of Physics and TechnologyWuhan UniversityWuhan430072China

Constructing a S-scheme heterojunction with tight interface contact and fast charge transfer is beneficial to improving the photocatalytic hydrogen evolution ***,a unique one-dimensional(1D)/two-dimensional(2D)S-scheme heterojunction containing 1D Sb_(2)S_(3) nanorods and 2D ZnIn_(2)S_(4) with affluent sulfur vacancies(denoted as Sv-ZnIn_(2)S_(4)@Sb_(2)S_(3)) was *** introduced sulfur vacancy can promote the effective adsorption of H+for the following interfacial hydrogen-evolution ***,the larger contact area and stronger electron interaction between Sb_(2)S_(3) and ZnIn_(2)S_(4) effectively inhibits the recombination of photo-generated electron–hole pairs and abridges the migration distance of *** a result,the optimal Sv-ZnIn_(2)S_(4)@Sb_(2)S_(3) sample achieves H_(2) evolution activity of 2741.3 mol·h^(−1)·g^(−1),which is 8.6 times that of pristine ZnIn_(2)S_(4) and 3.0 times that of the Sv-ZnIn_(2)S_(4) *** on the experimental result,the photo-reactivity S-scheme mechanism of hydrogen evolution from water splitting with Sv-ZnIn_(2)S_(4)@Sb_(2)S_(3) is *** work provides an effective method for developing S-scheme heterojunction composites of transition metal sulfide with high hydrogen evolution performance.

关键词： ZnIn_(2)S_(4) nanosheets S-scheme heterojunction Sulfur vacancy Charge transfer and separation Photocatalytic H_(2)evolution