1.Postoperative adjuvant interferon therapy for hepatitis B virus infected hepatocellular carcinoma: a Meta-analysis
Jianbo XU ; Fuzhen QI ; Gang XU ; Guofeng CHEN ; Jianhuai ZHANG
Chinese Journal of Hepatobiliary Surgery 2014;20(2):81-85
Objective To assess the efficacy of postoperative adjuvant interferon (IFN) therapy on patients with hepatitis B virus (HBV) related hepatocellular carcinoma (HCC).Methods An electronic search for articles published from January 2000 to January 2013 was conducted to identify English language comparative studies evaluating IFN therapy on recurrence and survival after surgical treatment of HCC.Results A total of five trials consisting of 694 patients were included in the Meta-analysis.The estimated odds ratios (OR) for the 1-,2-,3-,and 5-year overall survival rates of HBV-related HCC were 3.37 (95%CI:1.18-6.27,P=0.000),2.36 (95% CI:1.45-3.83,P=0.001),1.81 (95% CI:1.21-2.72,P=0.004),and 1.93 (95% CI:1.35-2.75,P=0.000),respectively.The OR for the 1-,2-,3-,and 5-year recurrence rates were 0.63 (95% CI:0.44-0.91,P=0.014),0.84 (95% CI:0.60-1.18,P=0.322),0.88 (95% CI:0.63-1.22,P=0.431),and 0.78 (95% CI:0.56-1.07,P=0.120),respectively.Conclusion This Meta-analysis shows that IFN therapy had a significant clinical effect in improving overall survival rates but not in decreasing recurrence rates of HBV infected HCC patients postoperatively.
2.Application of amputation of secondary structures of splenic pedicle and self-made spleen-removing bag in laparoscopic splenectomy using 3-hole method
Guofeng CHEN ; Fuzhen QI ; Dianhua GU ; Jianhuai ZHANG ; Yebo WANG ; Ling LIU ; Yong CAI ; Gang XU
Chinese Journal of Hepatobiliary Surgery 2010;16(9):681-682
Objective To summarize the experience in application of amputation of secondary structures of splenic pedicle and self-made spleen-removing bag in laparoscopic splenectomy the using 3-hole method. Methods The clinical data of 11 patients receiving the procedure from June 2007 to April 2009 in our hospital were retrospectively analyzed. Results Advantages of the procedure were less bleeding, small wound, quick recovery and no occurrence of postoperative complications. Six cases had slight postoperative pain. All 11 patients were cured. Conclusion The technique of amputation of secondary structures of splenic pedicle is safe and feasible in laparoscopic splenectomy using the 3-hole method.
3.Application of Glissonean pedicle transection method for hepatic resection in hepatocellular carcinoma
Fuzhen QI ; Gang XU ; Yan SONG ; Dianhua GU ; Jianbo XU ; Guofeng CHEN ; Jianhuai ZHANG
The Journal of Practical Medicine 2016;32(1):65-68
Objective To investigate the clinical application of Glissonean pedicle transection method in hepatocellular carcinoma. Methods We analyzed the clinical data of 232 cases of hepatocellular carcinoma underwent hepatic resection in our department from April 2009 to April 2013. Eighty-nine cases underwent hepatic resection by Glissonean pedicle transection method, and 143 cases underwent Pringle maneuver. Results There was no significant differences in the operation time and blood loss between the two groups (P > 0.05). However, the postoperative hospital stay time and the postoperative complications in group A were better than those in group B(P<0.05). Levels of ALT and AST in group A increased significantly slowly than those in group B. The 1, 3-year disease-free survival rates in the two groups were 87.4%, 71.1% and 85.1%, 60.0%, respectively. The 1, 3-year survival rates were 93.3%, 73.5% and 93.4%, 65.0%, respectively, with no significant differences (P>0.05). Conclusion Glissonean pedicle transection method has many advantages including effectively preventing the intraoperative bleeding, maximally reserving the remaining of liver function, decreasing the rate of tumor spread and metastasis. Meanwhile, it is a safe and effective technique for hepatectomy without dissection of the hepatic artery, portal vein and bile duct in the hepatoduodenal ligament.
4.The primary explore of the damage of the executive control network in major depressive disorder:a dynamic causal model on magnetoencephalography
Lingling HUA ; Zhijian YAO ; Hao TANG ; Rui YAN ; Jianhuai CHEN ; Yinglin HAN ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2015;24(4):304-306
Objective To investigate the interconnection of the executive control network in major depressive disorder when they recognized the sad facial stimuli,and to discuss the aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteers participated in the experiment.The brain actions of all subjects were recorded by the magnetoencephalography (MEG) when they were required to distinguish the emotion face.Based on prior knowledge,the interested brain area consisted of the primary visual cortex (V1),the orbitofrontal cortex(OFC),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulated cortex (ACC).Then constructing three competing models to select an optimal model by the method of dynamic causal model(DCM),finally the differences of the effective connections of the optimal model between the depressed patients and healthy controls were analyzed.Results According to the results of Bayesian model selection (BMS),model 1 had the most exceedance probability of 0.80 with the features that there were bidirectional modulatory connections between the OFC,ACC and DLPFC.Given the best model,the parameters of effective connectivity of the optimal model were extracted,and then two-sample t-test over the model 1 was adopted.The modulatory effective connectivity from the OFC to the DLPFC in both hemisphere(t=-2.73,P=0.0096;t=-3.01,P=0.0046) and the OFC to the ACC (t=-2.93,P=0.0057) in the left hemisphere were significantly reduced in MDD.Conclusion There exists abnormal function of executive control network in depressed patients,the decreased effective connections between the OFC and the DLPFC,as well as the OFC and the ACC,may have correlation with the negative
5.A study on the correlation between the local topological properties of the brain structural networks in depression and the severity of the disease
Jianhuai CHEN ; Zhijian YAO ; Jiaolong QIN ; Rui YAN ; Lingling HUA ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2014;23(10):881-884
Objective To explore the differences of the connectivity strength,the clustering coefficient and the local efficiency of the nodes in the brain structural networks in the depression and healthy subjects and then analyze the mode of the local connections of the brain regions and their local efficiency of the transmission of information and their relationship with the severity of the disease in the depression.Methods The Diffusion Tensor Imaging data were obtained from 24 depression patients and 25 healthy controls.The whole cerebral cortex was parcellated into 90 regions by the anatomical label map.Tractography was performed in the whole cerebral cortex of each subject to reconstruct white matter tracts of the brain using the fiber assignment by continuous tracking (FACT) algorithm.And then the brain structural networks were constructed using the complex network theory.The local topological properties of the brain structural networks of the depression and healthy were examined by two sample t-test.Results The local efficiency of the nodes of the networks in depression decreased significantly (the left middle frontal gyrus (orbital part):0.64±0.30,the left hippocampus:0.57±0.07,the right parahippocampal gyrus:0.50±0.15) compared with the healthy (0.88±0.10,0.64±0.06,0.66±0.13 respectively,P=0.00098,0.00039,0.00017,survived critical FDR threshold for multiple comparisons) ; and the clustering coefficient of the nodes of the networks in depression (the left middle frontal gyrus (orbital part):0.14±0.07) decreased significantly when compared with the healthy (0.22±0.06,P=0.000030,survived critical FDR threshold for multiple comparisons).Significant negative correlation was found between the local efficiency of the left middle frontal gyrus (orbital part) and the total scores of HAMD-17 in the depression (r=-0.48,P=0.02).Conclusion The degree of the localization and the local efficiency of the information transmission of the frontal lobe are decreased.The local efficiency in the information transmission in the hippocampal is also decreased.And the local efficiency of the frontal lobe is negatively related with the severity of the disease in the depression.
6.The strength of the nodes of the brain white matter weighted networks and its relationship with the course of disease in male schizophrenia
Jianhuai CHEN ; Zhijian YAO ; Jiaolong QIN ; Ke ZHAO ; Rui YAN ; Lingling HUA ; Qing LU
Chinese Journal of Nervous and Mental Diseases 2014;(12):721-725
Objective To explore the differences in the strength of the nodes in the brain white matter weighted networks between the male patients with paranoid schizophrenia and male healthy controls, and to analysis the integrity of the white matter fiber tracts that connected to the different brain regions and its relationship with the course of disease. Methods Diffusion tensor imaging (DTI) data were obtained from 25 male patients with paranoid schizophrenia and 26 male healthy controls. The whole brain was parcellated into 90 regions by using the anatomical label map. Tractography was performed in the whole brain of each subject to reconstruct white matter tracts using the FACT algorithm. The brain white matter weighted networks were then constructed using the complex network theory. Results The strength of the nodes in the networks of schizophrenia significantly decreased in the right thalamus (P=0.03, corrected) and the right hes?chl gyrus (P=0.04, corrected). Negative correlation was found between the strength of the right thalamus and the course of disease (r=-0.45, P=0.03). Conclusion The integrity of the white matter fiber tracts connected to the thalamus and tem?poral lobes in the male paranoid schizophrenia is impaired. The lesion of fiber tracts connected to the thalamus is related with the course of disease.
7.The most optimal effective connections of prefrontal-amygdala during major depressive patients recognizing happy face
Lingling HUA ; Zhijian YAO ; Haoran LI ; Hao TANG ; Rui YAN ; Jianhuai CHEN ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2014;23(1):25-28
Objective To investigate whether there is exists optimal effective connections of prefrontal-amygdala in patients with major depressive disorder when they recognize dynamic positive face expressions with the technology of magnetoencephalograph (MEG),and discuss the possible aberrant mechanism of emotion processing.Methods Twenty major depressive patients and 20 well-matched healthy volunteer controls participated in the experiment.The regions of interested brain area included the primary visual cortex (V1),the precuneus (PQ),the dorsolateral prefrontal cortex (DLPFC),the anterior cingulate cortex (ACC),the amygdala (AMYG).After constructing three putative models,dynamic causal model was used to select an optimal model,then extracted all the effective connection parameters and conducted t-test under the overall optimal model between-group comparison.Results The bayesian model selection (BMS) indicated that model with top-down modulate connections between DLPFC-ACC,DLPFC-AMYG and ACC-AMYG was the most superior model,whose exceedance probability was 0.41.In the fight hemisphere of patient group,the endogenous connectivity from AMYG to ACC significantly decreased compared to healthy controls (t=-2.21,P=0.033),while the endogenous connectivity from ACC to DLPFC was enhanced significandy (t=2.50,P=0.017),which was the same with the endogenous connectivity from AMYG to DLPFC (t=2.10,P=0.040).Conclusion The effective connections of prefrontal-amygdala in major depressive disorder are exactly impaired,which may indicate that major depressive disorder have a bias toward negative.While depressed patients don' t show abnormality in the modulate connectivity under happy stimulus.
8.A preliminary study of the topological patterns of the brain structural networks and its relationship with the course in depression
Jianhuai CHEN ; Zhijian YAO ; Jiaolong QIN ; Hao TANG ; Rui YAN ; Lingling HUA ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2014;23(3):207-210
Objective To investigate the small-worldness and the betweenness centrality of the nodes in the brain structural networks and its relationship with the course and the central role of the brain regions in the transmission of information across the whole brain in depression.Methods The diffusion tensor imaging data were obtained from 27 depression patients and 33 healthy controls.The brain structural networks were constructed using the complex network theory.Results The brain structural networks had small-world properties in both groups.When compared with the healthy,the betweenness centrality of the nodes of the networks in depression significantly decreased in right superior frontal gyms (orbital part) (P=0.00035,region survived critical FDR threshold for multiple comparisons),and left putamen (P=0.00054,region survived critical FDR threshold for multiple comparisons).Significant negative correlation was found between the betweenness centrality of left hippocampus and the course in the depression(r=0.50,P=0.016).Conclusion Both of the brain structural networks in depression patients and normal people have the property of small-worldness.But the central role of orbit frontal cortex and putamen in the transmission of information across the whole brain is declined,and the betweenness centrality of hippocampus is negatively related with the course in the depression.
9.Amplitude of low frequency fluctuation in first-episode depression and its relationship with the separate symptom clusters: a resting-state fMRI study
Rui YAN ; Zhijian YAO ; Hao TANG ; Maobin WEI ; Jianhuai CHEN ; Lingling HUA ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2014;23(8):673-675
Objective To explore the relationship between energy feature of the spontaneous neural activity and separate symptom clusters in first-episode depression.Methods 22 first-episode depression patients and 26 age-,gender-matched healthy controls were scanned with 3.0 T MRI Scanner.The t-test was employed to compare the difference of amplitude of low frequency fluctuation (ALFF) between the two groups,and the correlation analyses were conducted between ALFF of brain regions with significant difference and the severity of depressive symptoms clusters.Results Compared with healthy group,the depression group showed significantly increased ALFF in the right middle frontal gyrus (9,45,-6; K =18) and the bilateral fusiform gyrus (-34,-19,-12; K =37 and 30,-33,-18 ; K =31,respectively),and decreased ALFF in the left precuneus (0,-72,42; K =19) (P<0.05,corrected by Alphasim).The ALFF of the the right middle frontal gyrus,the right fusiform gyrus,and the left precuneus were negative correlated with the scores of weight factor,retardation factor and sleep disturbance factor (r=-0.494,P=0.019; r=-0.486,P=0.022 and r=-0.484,P=0.023,respectively).Conclusion Abnormal energy feature of the spontaneous neural activity may be associated with severity of specific depressive symptoms clusters in first-episode depression patients during resting-state.
10.The aberrant effective connectivity of the limbic system to happy face in patients with depression
Xiaoxue LIU ; Zhijian YAO ; Lingling HUA ; Jianhuai CHEN ; Rui YAN ; Kun BI ; Qing LU
Chinese Journal of Behavioral Medicine and Brain Science 2015;24(11):993-995
Objective To investigate the effective connectivity of limbic circuit in patients with major depressive disorder when they recognized dynamic positive face expressions,aiming to discuss the possible mechanism of emotion processing in depressed patients.Methods Eighteen depressive patients and eighteen well-matched healthy control volunteers participated in the experiment.All subjects were asked to recognize the emotion face during the magnetoencephalograph (MEG) scanning.The regions of interested (ROI) brain areas included the orbital frontal cortex (OFC),the anterior cingulated cortex (ACC),the amygdala (AMYG),the hippocampus and the insula.The MEG data were preprocessed by the SPM8 software and further analyzed by the Granger casual model (GCM).The non-parameter permutation was used to compare the value of effective connectivity between the healthy controls and the depressed patients.Results Compared with healthy controls,the effective connectivity from the ACC to the AMYG (P=0.0052),from the OFC to the AMYG(P=0.0046),from the Hippocampus to the ACC (P=0.0016),and from the ACC to the Hippocampus (P=0.0042)was significantly reduced in depressed patients.Conclusion The depressed patients display decreased interaction of the limbic circuit during the happy facial emotion processing,indicating that the depressed patients are unable to deal with the positive stimuli,and to certain extent,explaining the abnormal neuropathophysiological mechanism of positive stimuli in MDD.