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find Author "李川" 51 results
  • Progress and Prospect of Liver Transplantation Standard for Hepatocellular Carcinoma

    ObjectiveTo understand the progress and problems of liver transplantation standard for hepatocellular carcinoma. MethodsThe related articles regarding transplant criteria of hepatocellular carcinoma were reviewed and analyzed. ResultsSince Milan criteria were proposed by Mazzaferro in 1996, a number of criteria were porposed by many transplant centers. These criteria expanded Milan criteria. Compared with Milan criteria, these criteria expanded tumor size and (or) tumor number, or combined with some biological variables, or combined with some immunological variables. However, there are still some issues should be clarified. ConclusionDespite there are many transplant criteria of hepatocellular carcinoma, but a number of issues should be further investigated.

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  • 同种异体胸骨移植重建胸骨三例

    目的 探讨胸骨切除后同种异体胸骨移植,一期重建胸骨手术的可行性、手术方法与技巧。 方法 2008年 1月至2009年12月青岛大学医学院附属医院收治胸骨肿瘤患者3例,其中男2例,女1例;年龄分别为19岁、44岁和52岁;病程2个月~2年。3例患者均行胸骨部分切除,同期以同种异体胸骨重建。异体胸骨预先冻存;手术切除范围距病变边缘至少2 cm,包括病变胸骨、相应部分肋软骨、软组织;异体胸骨植入后用钢丝固定,残腔以大网膜填充。 结果 3例手术均获成功,手术效果满意;3例分别随访6个月~2年,无肿瘤复发,无明显排斥反应,患者生活良好。 结论 以同种异体胸骨重建胸骨临床效果满意,有良好的可行性。

    Release date:2016-08-30 05:56 Export PDF Favorites Scan
  • 颈胸交界部位严重损伤20例的救治经验

    目的 探讨颈胸交界部位严重损伤的早期救治手段,以提高救治成功率和救治水平。 方法 总结1998年1月至2007年1月共10年间收治的颈胸交界部位严重损伤(创伤、医源性损伤)患者20例,占同期全部胸部创伤住院患者的2.08%(20/960),包括气管裂伤5例,胸导管损伤5例,锁骨下动脉损伤7例,食管损伤3例;分析以手术治疗为主的早期救治方法,手术治疗19例,保守治疗1例。 结果 全部患者均救治成功,术后发生锁骨上切口感染1例(5.26%),经二次清创后愈合。随访6个月~9年,因尿毒症死亡1例,其余19例生存良好。 结论对颈胸交界部位严重创伤早期积极外科手术干预治疗是救治成功的主要手段。

    Release date:2016-08-30 06:05 Export PDF Favorites Scan
  • 同种异体主动脉片修补犬食管缺损的实验研究

    目的寻找临床中实用、安全有效、制作简便的食管修复材料或食管替代物。方法在无菌条件下手术切取犬降主动脉,制作成2cm×3cm的主动脉片低温保存;将3只成年健康杂种犬经手术制造颈段食管壁缺损,用预先低温保存的同种异体犬主动脉片修补缺损。结果动物全部存活,新生食管壁具有正常食管的各层结构和功能,局部管腔无狭窄,进食正常,术后无严重急性排斥反应。结论同种异体主动脉片可以诱导自体食管壁新生,用于食管壁缺损的修补。

    Release date:2016-08-30 06:25 Export PDF Favorites Scan
  • 血管内皮细胞生长因子在食管癌中的表达及意义

    目的 探讨食管癌血管内皮细胞生长因子(VEGF) 表达及其与肿瘤血管新生和病理学特点的关系。方法 对40例手术切除的原发性食管癌标本进行免疫组织化学染色,确定其VEGF的表达及微血管密度。结果 40例食管癌患者中27例VEGF蛋白表达阳性,阳性率为67.5%,微血管密度在食管癌VEGF表达阴性、弱阳性和强阳性者间比较差别具有显著性意义(Plt;0.05),有淋巴结转移者VEGF表达阳性率较无淋巴结转移者明显增高(Plt;0.01)。结论 食管癌VEGF表达水平与肿瘤血管新生强度、淋巴结转移有密切关系。

    Release date:2016-08-30 06:34 Export PDF Favorites Scan
  • Child-Pugh A Class Cirrhotic Patients with a Single Hepatocellular Carcinoma up to 5 cm in Diameter: Liver Transplantation versus Resection

    ObjectiveTo analyse the outcomes of patients with Child-Pugh A class cirrhosis and a single hepatocellular carcinoma (HCC) up to 5 cm in diameter who underwent liver transplantation versus resection. MethodsDuring 2007 to 2011, 263 Child-Pugh A class cirrhotic patients with a single HCC up to 5 cm in diameter either underwent liver resection (n=227) or received liver transplantation (n=36) in our centre. Patients and tumour characteristics and outcomes were analysed. ResultsThe 1-, 3-, and 5-year recurrence-free survival rates of patients who received liver transplantation and liver resection were 91.7%, 85.3%, 81.0% and 80.6%, 59.8%, 50.8%, respectively (P=0.003). The 1-, 3-, and 5-year overall survival rates of patients who underwent liver transplantation were 100%, 87.5%, and 83.1% versus 96.9%, 83.8%, and 76.1% for patients received liver resection (P=0.391). The 1-, 3-, and 5-year recurrence-free survival rates for patients with a diameter of HCC < 3 cm underwent liver transplantation were 92.3%, 92.3%, and 92.3% versus 80.2%, 62.5%, and 50.5% for live resection group (P=0.019). The 1-, 3-, and 5-year overall survival rates for patients with a diameter of HCC < 3 cm underwent liver transplantation and liver resection were 100%, 91.7%, 91.7% and 97.7%, 87.5%, 79.5%, respectively (P=0.470). ConclusionsAlthough more recurrences are observed in Child A class cirrhotic patients with a single HCC up to 5 cm in diameter after liver resection, but overall survival rates for patients with a single HCC up to 5 cm in diameter are similar after liver resection and transplantation.

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  • Expression and Clinical Significance of IQGAP1 in Hepatocellular Carcinoma Tissues

    ObjectiveTo investigate the expression of IQ motif-containing GTPase activating protein 1 (IQGAP1) in hepatocellular carcinoma (HCC) tissues, and to analyze the relationship of IQGAP1 and patient's clinical characteristics and prognosis after liver resection. MethodsData of 79 patients who received liver resection between 2007 and 2009 in our hospital were collected. The expression of IQGAP1 was examined by immunohistochemical tests. The clinical characteristics and prognosis were compared. ResultsIQGAP1 was detected in 43 patients (54.4%). Patients with IQGAP1 expression had more poor differentiation and microvascular invasion. The cumulative recurrence-free rate and overall survival rate in 1-, 3-, and 5-year after operation of patients with IQGAP1 expression (cumulative recurrencefree rate:67.4%, 39.5%, and 23.3%; cumulative overall survival rate:97.7%, 71.5%, and 53.3%) were poor than patients without IQGAP1 expression (cumulative recurrence-free rate:100%, 94.4%, and 83.3%; cumulative overall survival rate:1007%, 97.2%, and 88.9%), P < 0.001. ConclusionsHCC patients with IQGAP1 expression had a poor prognosis after liver resection. IQGAP1 may be a prognostic indicator for hepatocellular carcinoma.

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  • Research of The Expression of FOXA2 and Its Relationship with Prognosis in Intrahepatic Cholangiocarcinoma

    ObjectiveTo investigate the expression of forkhead box A2 (FXOA2) in intrahepatic cholangiocarcinoma (ICC), and to analyze the relationship between expression of FOXA2 and patient's prognosis after liver resection. MethodsData of 85 patients with ICC who underwent liver resection between 2009 and 2013 in our hospital were collected retrospectively. The expression of FOXA2 was examined by immunohistochemical method, and then the relationship between expression of FOXA2 and patient's prognosis/clinical characteristics was expplored. ResultsAmong the 85 patients, low expression of FOXA2 was detected in 50 patients, whereas high expression was observed in 35 patients. More advanced tumor (Ⅲ+Ⅳ staging) was found in patients with low expression of FOXA2 than patients with high expression of FOXA2 (P < 0.050). The median follow-up time was 15-month (3-73 months). During the follow-up period, 65 patients suffered from recurrence, whereas 64 patients died. The multivariate analysis suggested that, postoperative recurrence was associated with low expression of FOXA2, evaluated preoperative CA19-9, and presence of satellite nodes (P < 0.050). Low expression of FOXA2, evaluated preoperative CA19-9, nerves invasion, and presence of satellite nodes were predictive factors for postoperative prognosis (P < 0.050). ConclusionLow expression of FOXA2 was associated with poor prognosis for patients with ICC after liver resection, and FOXA2 may be a prognostic factor for ICC.

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
  • Reconsideration of Posthepatectomy Liver Failure

    ObjectiveTo summarize the definitions, risk factors, and preoperative evaluation methods of posthe-patectomy liver failure. MethodsDomestic and international publications involving posthepatectomy liver failure were retrieved and reviewed. ResultsThere was no uniform definition of posthepatectomy liver failure, however, the most approbatory definitions were "50-50 criteria" and "International Study Group of Liver Surgery (ISGLS) criteria". Risk factors of posthepatectomy liver failure included patient-related factors, liver-related factors, and surgery-related factors, and preoperative evaluation was mainly based on liver function and liver volume. ConclusionPosthepatectomy liver failure is the main cause of postoperative death, sufficient preoperative evaluation and effective measures to decrease intraoperative blood loss and shorten surgery duration are helpful to prevent and (or) reduce posthepatectomy liver failure.

    Release date:2016-12-21 03:35 Export PDF Favorites Scan
  • Influence of hepatic artery ligation on hepatocyte apoptosis and liver regeneration of rats with obstructive jaundice

    Objective To assess the influence of hepatic artery ligation on survival, hepatocyte apoptosis and regeneration of rats with obstructive jaundice. Methods Eighty adult male Wistar rats were divided into four groups: group A, suffered 70% hepatectomy+hepatic artery ligation+biliary drainage after 3 days of establishing obstructive jaundice model; group B, suffered 70% of hepatectomy+biliary drainage after 3 days of establishing obstructive jaundice model; group C, suffered 70% of hepatectomy+hepatic artery ligation after 3 days of sham operation; group D, suffered 70% of hepatectomy after 3 days of sham operation. Five rats of each group were sacrificed on 1, 2, 3, and 6 days after second operation. Liver function, hepatocyte apoptosis and liver regeneration were detected. Results Postoperative survival rates were not significantly different between group A and group B, similarly between group C and group D (allP>0.05). There was no significantly different in liver function of group Aversus group B, and group Cversus group D (P>0.05), but the synthesis of album on 1 d or 3 d after operation were significant difference (group Aversus group B,P<0.05; group Cversus group D,P<0.05). Both of the group A, group B and group C had the highest apoptotic index on 1 d after operation, whereas the group D had the lowest hepatic apoptotic index among four group after the surgery. The regeneration indexes were as follow: group D>group C>group B>group A (allP<0.05). On y 6 d after operation, the regeneration indexes of group A and group B did not increase, while those of group C and group D decreased remarkably. However, the regeneration indexes of four groups were lower than the mean level. Conclusions Hepatic artery ligation will increase hepatocyte apoptosis and weaken liver regeneration. However, for rats with obstructive jaundice, hepatic artery ligation didn't increase the risk of postoperative mortality.

    Release date:2017-01-18 08:04 Export PDF Favorites Scan
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