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Functional assessment of liver regeneration after major hepatectomy

Hepatobiliary Surgery and Nutrition 2022年第4期11卷 530-538页

作者： Fadi Rassam Pim B.Olthof Bart Takkenberg Marc G.Besselink Olivier R.Busch Joris I.Erdmann Rutger-Jan Swijnenburg Krijn Pvan Lienden Ulrich H.Beuers Roelof J.Bennink Thomas Mvan Gulik Department of Surgery Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamThe Netherlands Department of Gastroenterology&Hepatology Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands Departments of Radiology and Nuclear Medicine Cancer Center AmsterdamAmsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands

Background: Liver regeneration is crucial to restore the functional liver mass after liver resection. The aim of this study was to evaluate the early postoperative changes in remnant liver function, volume and liver stiffness after major liver resection and their correlation with postoperative outcomes. Methods: Patients undergoing major liver resection (≥3 segments) between February and November 2018 underwent both functional assessment using technetium-99m mebrofenin hepatobiliary scintigraphy (HBS) and CT-volumetry of the (future) remnant liver on preoperative day 1, the 5th postoperative day, and 4-6 weeks after resection. At the same time points, patients underwent transient elastography (TE) for the assessment of liver stiffness. Severe postoperative complications (Clavien-Dindo ≥ 3A) and mortality were correlated with the functional and volumetric increases of the remnant liver. Liver failure was graded according to the International Study Group of Liver Surgery (ISGLS) criteria. Results: A total of 18 patients were included of whom 10 (56%) had severe complications and one patient (5%) developed liver failure. Function and volume of the remnant liver had increased by the 5th postoperative day from 6.9 (5.4-10.9) to 9.6 (6.7-13.8) %/min/m2, P=0.004 and from 795.5 (538.3-1,037.5) to 1,080.0 (854.0-1,283.3) mL, Pfrom 1,080.0 (854.0-1,283.3) to 1,222.0 (1,016.0-1,380.5) mL, P=0.035], however, liver function did not show any significant, further increase [from 9.6 (6.7-13.8) to 10.9 (8.8-13.6) %/min/m2, P=0.177]. Liver elasticity of the future remnant liver (FRL) increased [from 10.8 (5.7-18.7) to 17.5 (12.4-22.6) kPa, P=0.018] and gradually recovered after 4-6 weeks to a median of 10.9 (5.7-18.8) kPa (T3 vs. T4, P=0.079). Patients who had severe postoperative complications did not show a significant increase in liver function on the 5th postoperative day (P=0.203), despite increas

关键词： Hepatobiliary scintigraphy(HBS) liver resection liver regeneration posthepatectomy liver failure liver function test

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腕踝针联合电针对缺血性中风患者神经功能及肢体运动的影响

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针灸推拿医学:英文版 2023年第5期21卷 368-374页

作者：周茜盛姝薇张娇翟丹彤李娜娜解霞于杰夫 The First Affiliated Hospital of China Medical University Shenyang 110001China

目的:观察腕踝针联合电针对缺血性中风患者神经功能及肢体运动功能的影响。方法:将106例合格受试者根据随机数字表法分为治疗组与对照组,每组53例。对照组患者采用常规康复治疗方案。治疗组在对照组的基础上加用腕踝针和电针治疗。比较... 详细信息

目的:观察腕踝针联合电针对缺血性中风患者神经功能及肢体运动功能的影响。方法:将106例合格受试者根据随机数字表法分为治疗组与对照组,每组53例。对照组患者采用常规康复治疗方案。治疗组在对照组的基础上加用腕踝针和电针治疗。比较两组患者的NIHSS评分、Fugl-Meyer评定量表评分、Berg平衡量表评分、下肢主要神经传导速度和总有效率。结果:治疗组的总有效率高于对照组(P<0.05)。治疗后两组患者的NIHSS评分、Fugl-Meyer评定量表评分和Berg平衡量表评分均较治疗前改善(P<0.05),且治疗组明显优于对照组(P<0.05)。治疗后,对照组仅股神经的传导速度优于治疗前(P<0.05),治疗组的股神经、胫神经、腓肠神经和腓总神经的传导速度优于治疗前(P<0.05),且优于对照组(P<0.05)。结论:常规康复治疗基础上加用腕踝针和电针治疗可以显著改善缺血性脑卒中患者神经、肌肉功能,提高患者的运动和生活能力,其疗效优于单独常规康复治疗。

关键词：针刺疗法电针腕踝针缺血性中风神经传导日常生活活动

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A simple scoring system to estimate perioperative mortality following liver resection for primary liver malignancy-the Hepatectomy Risk Score(HeRS)

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Hepatobiliary Surgery and Nutrition 2021年第3期10卷 315-324,I0001,I0002页

作者： Dimitrios Moris Brian I.Shaw Cecilia Ong Ashton Connor Mariya L.Samoylova Samuel J.Kesseli Nader Abraham Jared Gloria Robin Schmitz Zachary W.Fitch Bryan M.Clary Andrew S.Barbas Department of Surgery Duke University Medical CenterDurhamNCUSA

Background:Selection of the optimal treatment modality for primary liver cancers remains complex,balancing patient condition,liver function,and extent of *** individuals with preserved liver function,liver resection remains the primary approach for treatment with curative intent but may be associated with significant *** purpose of this study was to establish a simple scoring system based on Model for End-stage Liver Disease(MELD)and extent of resection to guide risk assessment for liver ***:The 2005-2015 NSQIP database was queried for patients undergoing liver resection for primary liver *** first developed a model that incorporated the extent of resection(1 point for major hepatectomy)and a MELD-Na score category of low(MELD-Na=6,1 point),medium(MELD-Na=7-10,2 points)or high(MELD-Na>10,3 points)with a score range of 1-4,called the Hepatic Resection Risk Score(HeRS).We tested the predictive value of this model on the dataset using logistic *** next developed an optimal multivariable model using backwards sequential selection of variables under logistic *** performed K-fold cross validation on both *** operating characteristics were plotted and the optimal sensitivity and specificity for each model were calculated to obtain positive and negative predictive ***:A total of 4,510 patients were *** was associated with increased odds of 30-day mortality[HeRS=2:OR=3.23(1.16-8.99),P=0.025;HeRS=3:OR=6.54(2.39-17.90),P<0.001;HeRS=4:OR=13.69(4.90-38.22),P<0.001].The AUC for this model was *** AUC for the optimal multivariable model was higher at *** K-fold cross validation,the positive predictive value(PPV)and negative predictive value(NPV)of these two models were similar at PPV=6.4%and NPV=97.7%for the HeRS only model and PPV=8.4%and NPV=98.1%for the optimal multivariable ***:The HeRS offers a simple heuristic for estimating 30-day mortality after resectio

关键词： Hepatocellular carcinoma(HCC) cholangiocarcinoma liver resection Model for End-stage Liver Disease(MELD) outcomes

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Sequencing of 231 forensic genetic markers using the MiSeq FGxTM forensic genomics system-an evaluation of the assay and software

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Forensic Sciences Research 2018年第2期3卷 111-123页

作者： Christian Hussing Christina Huber Rajmonda Bytyci Helle S.Mogensen Niels Morling Claus Bφrsting Section of Forensic Genetics Department of Forensic MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark

The MiSeq FGx^(TM) Forensic Genomics System types 231 genetic markers in one multiplex polymerase chain reaction (PCR) *** markers include core forensic short tandem repeats (STRs) as well as identity,ancestry and phenotype informative short nucleotide polymorphisms (SNPs).In this work,the MiSeq FGx^(TM) Forensic Genomics System was evaluated by analysing reproducibility,sensitivity,mixture identification and forensic phenotyping capabilities of the ***,the genotype calling of the ForenSeq^(TM) Universal Analysis Software was verified by analysing *** files from the MiSeq FGx^(TM) platform using the softwares STRinNGS and ***,the performance of the MiSeq FGx^(TM) Forensic Genomics System was ***,locus and allele drop-outs were relatively frequent at six loci (two STRs and four human identification SNPs) due to low read depth or skewed heterozygote balances,and the stutter ratios were larger than those observed with conventional STR genotyping *** risk of locus and allele drop-outs increased dramatically when the amount of DNA in the first PCR was lower than 250 ***-person 50∶1 mixtures were identified as mixtures,whereas 100∶1 and 1000∶1 mixtures were not.Y-chromosomal short tandem repeats (Y-STRs) alleles were detected in the 100∶1 and 1000∶1 female/male *** ForenSeq^(TM) Universal Analysis Software provided the data analyst with useful alerts that simplified the analysis of the large number of *** of the alerts were due to user-defined,locus-specific *** results shown here indicated that the default settings should be altered for some ***,recommended changes to the assay and software are discussed.

关键词： Forensic science forensic genetics next generation sequencing short tandem repeats single nucleotide polymorphisms ForenSeq^(TM)DNA Signature Prep Kit MiSeq FGx^(TM)Forensic Genomics System

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