1.Prevention and treatment for complications of radiofrequency ablation for hepatic malignancy
Zhijian ZHANG ; Mengchao WU ; Han CHEN
Chinese Journal of Minimally Invasive Surgery 2001;0(02):-
Objective To study the prevention and treatment of intra- or post- operative complications of radiofrequency ablation (RFA) for hepatic malignancy. Methods A series of 353 patients with primary hepatic carcinoma or secondary hepatic malignancy verified by pathological examinations and clinical manifestations underwent 452 times of RFA between October 1999 and March 2003, including 344 cases of percutaneous RFA and 9 cases of RFA during open surgery. There were 198 cases of primary hepatic carcinoma previously unoperated, 81 cases of recurrent hepatic carcinoma after surgery, and 74 cases of secondary hepatic malignancy. All the patients were followed up to make out short- or long-term surgical complications. Results Complications happened in 12 cases: skin burn by the electrode (2 cases), pneumothorax (1 case), right hydrothorax (1 case), vena cava thrombus (1 case), right bile duct injury and stricture (1 case), gastric external fistula (1 case), bile leakage in the left lateral lobe of the liver (1 case), hepatic abscess (1 case), external fistula of the ascending colon resulted from hepatic abscess (1 case), internal fistula of the duodenum, liver and right thorax resulted from hepatic abscess (1 case), and intra-abdominal hemorrhage (1 case). The incidence of complication was 2 65% (12/452) and the complication-related mortality was 8 33% (1/12). Conclusions RFA is a kind of minimally invasive procedure. But RFA especially percutaneous RFA may involve some risks for patients with the tumor located at the porta hepatic or the surface of the liver, or adhered to hollow organs, especially those who had a history of abdominal operation and adhesions of hollow viscera to the liver. Some complications can be prevented and effectively treated in the event of proper selection of patients, careful performance during the surgery, intensive postoperative care, effective hemostasia and efficient infection prevention.
2.Changes of cortical-limbic pathways in male recurrent unipolar major depressive disorder during attention control dysfunction
Li HAN ; Hao TANG ; Qing LU ; Haiteng JIANG ; Zhijian YAO
Chinese Journal of Behavioral Medicine and Brain Science 2012;21(5):417-420
ObjectiveTo study information transmission circumstances within the neural circuits related to the attentional controls of the mate depression patients.MethodsTwelve unipolar depression patients and twelve age- and education- matched healthy controls were involved in the Stroop word-color interference test to detect the variation of brain inhibitory function by Magnetoencephalography scanning.ResultsCompared with the healthy controls,the abnormally activities in depressed patients during in chronological order were separately as follow:decreased activation in the left postcentral gyrus ( t =3.10 ),the right superior frontal gyrus ( t =2.16 ),the left middle frontal gyrus (t=2.64),the left parietal lobe (t=2.89),the right middle temporal grus( t=1.92),the right superior temporal gyrus(t=2.84),the right insula(t=3.03),the right precuneus(t=2.98),the bilateral middle frontal gyros ( t =3.64,t =2.25 ),the right postcentral gyrus ( t =2.20),the right cingulate gyrus ( t =4.04 ),the bilateral precuneus ( t =2.79,t =1.87 ) ;increased activation in the left caudate body ( t =1.91 ),the left pulvinar ( t =2.56),the left middle temporal gyrus( t =1.89),the left precentral gyrus( t =2.02) (P < 0.05,uncorrected).ConclusionThe abnormal activation in the brain regions related with attentional control processing is detected in the male recurrent unipolar recurrent major depression,performances of limbic system increased and.cortex declined more in the recurrent depressed.
3.Mesenchymal stem cells modulate immune responses in a rat renal transplantation model
Chao QIN ; Wei ZHANG ; Zhijian HAN ; Dongliang XU ; Wei ZHANG
Chinese Journal of Organ Transplantation 2011;32(11):675-678
Objective To discuss the effect of mesenchymal stem cells (MSCs) in modulating immune responses in a rat renal transplantation model.Methods An in vivo trial of cytology was performed in one centre from March to December in 2008.Wistar rat donors and Lewis rat recipients in a renal transplantation model were randomly divided into 4 groups:MSCs (low dose,1 × 106 )therapy,MSCs (high dose,1 × 107) therapy,CsA monotherapy,and no therapy.Biochemistry methods were used to detect the levels of creatinine in serum.The survival time,renal grafting function and pathological changes of transplanted renal tissues were observed.Results Animal survival was significantly prolonged by MSCs (high dose) therapy and CsA monotherapy as compared with the no therapy group (both P<0.01).Animal survival in the MSCs (low dose) therapy group was prolonged as compared with no therapy group (P<0.01),but shortened as compared with MSCs (high dose) therapy group (P<0.05) and CsA monotherapy group (P<0.05).The MSCs (high dose) therapy and CsA therapy groups showed no special changes in histology,hut the control group showed acute rejection.Conclusion MSCs down-regulated immune responses,reduced production of some inflammatory mediators,preserved graft function in the initial stage after transplantation,and prolonged animal survival,and these effects were the same as those of CsA therapy with 1 × 107/day.
4.The gender differences of the magnetic source imaging during recognizing dynamically sad facial expression in depressed patients
Haiteng JIANG ; Yinglin HAN ; Qing LU ; Zhijian YAO ; Jing ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2011;20(3):234-237
Objective To explore the gender differences of brain activation between patients with depression in recognition of dynamically sad expression with magnetoencephalography (MEG) technology and the paradigm of expressional experiment,and further to examine its neurological basis. Methods Brain activities were detected using MEG during the recognition of dynamic facial video with 12 female depressed patients, 11 male depressed patients, and their corresponding normal controls matched by age and education. Results Compared with male depression,female depression showed increased activation during different time periods were in turn as follows: bilateral inferior frontal gyrus ( x, y, z = 58/- 60,12/22,20/20, T = 2.17,1.88 ), left anterior cingulate gyrus ( x, y, z = 64,12,4, T = 2.37 ), bilateral superior frontal gyrus ( x, y, z= 30/-24,64/- 4,0/50, T = 2.86,2.36 ),the left brainstem( x, y,z = - 12, - 16, - 18 ,T = 1.96) ,right middle frontal gyrus( x,y,z =40,60,4,T = 2.22 ),bilateral precentral gyrus(x,y,z = -62/56, 16/10, 10/8. T = 1.99,2.65 ) ,left hippocampus ( x,y,z = - 26,- 14, -20,T = 1.77) ,left parahippocampal gyrus(x,y,z = - 16, - 12, -20,T = 1.72) ,right middle occipital gyrus( x ,y ,z = 50, -76, -14 ,T = 1. 75 ),while the decreased brain activation were in turn in right superior temporal gyrus ( x, y, z = 68, - 18,2, T = 1.85 ), right parahippocampal gyrus ( x, y, z = 20, - 36, - 14, T = 1.92 ), left cuneus( x,y,z = -6, -98,14,T =2.46) ,bilateral temporal middle gyrus( x,y,z =52/-34, - 80/-62,20/28,T = 1.95,2.57 ), left pre-cuneus ( x, y, z = - 40, - 74,38, T = 2.58 ), right hippocampus( x, y, z = 24, - 32, - 18,T = 2.05 ) in recognition of dynamically sad expression. ( p < 0. 05, corrected). Conclusion The data suggest that there may be significant gender differences of functional network in depressed patients during recognizing dynamical sad facial expression.
5.Percutaneous radiofrequency ablation of hepatic malignancies guided by ultrasonography
Zhijian ZHANG ; Mengchao WU ; Jia GUO ; Yi CHEN ; Han CHEN
Chinese Journal of General Surgery 2001;10(2):102-105
Objective To study the value of B type ultrasonography guiding percutaneous radiofrequency ablation (PRFA) for hepatic cancer (HC). Methods 70 patients with primary or metastatic hepatic malignancies were treated by PRFA under ultrasound guidance through LeVeen multipolar array needle electrode and RF 2000. All patients were followed up by turnor marker, B type sounography and MRI monthly. Results PRFA were performed in 53 patients with hepatocellular carcinoma (HCC) and 17 cases with metastatic liver cancer. Liver function classfication was 53 cases in Child class A, 15 in class B and 2 in class C. In 21 patients with non-operated small HCC (≤5 cm), 12 of 17 patients with AFP positive were decreased to normal (70.6%) and decreased markedly in 4 (23.5%), and MRI showed the treated tumors were completely necrosis in 16 patients (76.2%). The 3, 6 month survival rates were 90.5%, 100% respectively in small HC groups, and 66.7% to 72.7% and 27.6% to 72.7% in large HC groups.Conclusions PRFA as a local thermal therapy is becoming a kind of new palliative treatment for hepatic malignancies, which not only is safe, minimally invasive, and effective for small ones; but also can be used with combination of TACE for larger ones.
6.The dynamic characteristics of the magnetic source imaging of recognizing expression in major depressive disorder
Yinglin HAN ; Zhijian YAO ; Haiteng JIANG ; Qing LU ; Jing ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2010;19(5):425-428
Objective To explore the features of functional networks about recognizing dynamically positive expression with using magnetoencephalography (MEG) technology and the paradigm of expressional experiment, and further to examine its neurological basis. Methods Twelve depressed patients and twelve age,education-matched healthy controls participated to recognize the dynamically positive expression in the MEG scans. Results In comparison with the healthy,the abnormally activities regions in depressed patients during different time periods were separately as follow;decreased activation in the right inferior parietal lobule(t = 3.94),the right su-pramarginal gyms(t = 3.59),the bilateral posterior cingulated(t = 5. 04, t = 4. 85) ,the bilateral precuneus(t = 3.84) ,the left cuneus(t = 3.58) and increased activation in the bilateral hippocampus(t = 2. 13, t = 2.56) ,the left amygdale(t = 2.41), the bilateral uncus gyrus(t = 2.33, t = 2.44) , the right anterior cingulated (t = 2. 15) , the left fusiform gyms (t = 3. 33) (P < 0. 05, unconnected). Conclusion The results indicate, compared with healthy controls,abnormal brain activities as the weakened function of the medial temporal cortex,parietal lobe and the enhanced function of limbic system were distributed extensively in depressed patients during recognizing dynamically positive expression. These abnormalities may prompt the dynamic characteristics of the magnetic source imaging about recognizing dynamically positive expression,and further reveals the mechanisms of emotional symptoms in depression.
7.Evidence for Central Neural Regulation of Pacing Strategies
So RAYMAND ; Zhijian HUANG ; Xiaobo JIANG ; Han XU ; Gangyan SI
Chinese Journal of Sports Medicine 2010;(1):8-13
Objective Based on the model of exercise induced central fatigue,we attempt to testify that the whole power output in time-counted sporting events was regulated by the central nervous system(CNS).Methods Eighteen national level rowers participated in the experiment.Each participant completed two successive 6 minutes maximal rowing exercise with an interval of 15 minutes.The power output(PO),heart rate(HR),blood lactate(BL),RPE and EMG were measured.Results It was demonstrated that the pacing strategies adopted by the rowers in the 2 successive 6-minute rowing tests were remarkably similar,and the rowers'PO and iEMG activities in the two tests were highly correlated,especially in the last minute of exercise.Conclusion It is concluded that the hypothesis of pacing strategy is controlled by CNS.
8.Research of preoperative D-dimer value in patients with gastric cancer in judging gastric cancer metastasis and assessing prognosis
Lixiang ZHANG ; Wenxiu HAN ; Zhijian WEI ; Aman XU
International Journal of Surgery 2017;44(2):99-103,封3
Objective To explore the value of preoperative D-dimer in patients with gastric cancer in judging gastric cancer metastasis and assessing prognosis.Methods Clinicopathological data of 132 patients with gastric cancer in the First Affiliated Hospital of Anhui Medical University between Jan.2010 and Jan.2011 was analyzed retrospectively in this study.All patients were divided into two groups according to the cutoff value (1.465 mg/L)of D-dimer and the relationships between D-dimer and clinicopathological data were determined by chi-square test.Moreover,the association of preoperative D-dimer and the prognosis was analyzed by Kaplan-Meier analysis and Log-rank test.Univariate and multivaritate Cox model were used to analyze the factors which might affect the survival of the patients and significant independent factors.Results A total of 132 patients were enrolled in this study in accordance with the inclusion criteria.D-dimer was positively correlated with the depth of invasion (x2 =4.996,P < 0.05),age (x2 =4.311,P < 0.05) and distant metastasis of gastric cancer (x2 =16.641,P <0.01),but not with thc gcndcr,lymph node metastasis,tumor size,the degree of differentiation and TNM stage (P > 0.05).The mean D-dimer level was (1.39 ± 0.7) mg/L in distant metastasis patients and (0.97 ±0.83) mg/L in non distant metastasis patients (P =0.023),the mean plasma D-dimer level in patients alive at the 5 years after the surgery was (0.78 ± 0.58) mg/L,which was significantly lower than the amounts determined for the deceased patients (0.75 ± 0.58) mg/L (P < 0.01).The Kaplan-Meier curves showed that the patients with gastric cancer had a longer time in the low D-dimer group than in the high D-dimer group,showing a significant difference between the two groups (P < 0.01).Univariate analysis showed that the overall survival rate was significantly correlated with the gender,D-dimer,tumor size,the depth of invasion,lymph node metastasis and TNM stage (P all < 0.05).The D-dimer was proved to be independent risk factor for the prognosis of gastric cancer by multivariate analysis(P < 0.05).Conclusion According to the analysis,D-dimer may be valuable biomarker for metastasis patients,besides,D-dimer was an independent prognostic factor for patients with gastric cancer.
9.Analysis of prognostic factors and influencing factors of lymph node ratio in patients with Siewert Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction
Lixiang ZHANG ; Wenxiu HAN ; Zhijian WEI ; Aman XU
Chinese Journal of Digestive Surgery 2017;16(5):490-495
Objective To investigate the prognostic factors and influencing factors of lymph node ratio (LNR) in patients with Siewert Ⅱ and Ⅲ adenocarcinoma of the esophagogastric junction (AEG).Methods The retrospective case-control study was conducted.The clinicopathological data of 444 patients with Siewert Ⅱ and Ⅲ AEG who were admitted to the First Affiliated Hospital of Anhui Medical University between January 2010 and January 2011 were collected.All the 444 patients underwent radical D2 lymph node dissection,extent of lymph node dissection was inferior mediastinum,around the esophageal hiatus and celiac lymph node.Follow-up usingtelephone interview and outpatient examination was performed to detect patients' prognosis once every 3 months within 2 years postoperatively,once every 6 months from 2 vears to 5 years postoperatively and once every 12 months after 5 years up to October 2016.Observation indicators:(1) follow-up and survival situations;(2) univariate and multivariate factors analysis affecting prognosis of patients with Siewert Ⅱ and Ⅲ[AEG;(3) univariate and multivariate factors analysis affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG.The survival curve and rate were respectively drawn and calculated by the Kaplan-Meier method.The univariate analysis and multivariate analysis were respectively done using the Log-rank test and the COX regression model.Results (1) Follow-up and survival situations:all the 444 patients were followed up for 1-81 months,with a median time of 52 months.The 1-,3-,5-year overall survival rates of 444 patients were respectively 93.2%,60.3% and 45.7%.(2) Factors analysis affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG:results of univariate analysis showed that tumor diameter,tumor differentiation,invasion depth of tumor,pN staging and staging of LNR were related factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG,with statistically significant differences (x2 =12.332,5.898,36.045,38.847,46.464,P<0.05).Results of multivariate analysis showed that invasion depth of tumor and staging of LNR were independent factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG [RR =1.393,1.411,95% confidence interval (CI):1.137-1.708,1.106-1.801,P<0.05].(3) Factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG:results of univariate analysis showed that tumor diameter,tumor differentiation and invasion depth of tumor were related factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG,with statistically significant differences (x2=20.077,12.618,36.586,P<0.05).Results of multivariate analysis showed that tumor diameter,tumor differentiation and invasion depth of tumor were independent factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG (OR=0.684,0.688,0.788,95% CI:0.485-0.965,0.505-0.936,0.687-0.903,P<0.05).Conclusions The invasion depth of tunor and staging of LNR are independent factors affecting prognosis of patients with Siewert Ⅱ and Ⅲ AEG.Tumor diameter,tumor differentiation and invasion depth of tumor are independent factors affecting LNR of patients with Siewert Ⅱ and Ⅲ AEG.
10.Application of S type incision modified double Kessler suture in the treatment of fresh achilles tendon rupture
Peizhang XU ; Xinming HAN ; Yuhua CHEN ; Zhijian YUAN
Journal of Regional Anatomy and Operative Surgery 2017;26(1):52-54
Objective To explore the clinical effect of the treatment for fresh achilles tendon rupture by modified double Kessler suture with S type incision .Methods Totally 21 cases of fresh achilles tendon rupture were admitted into our hospital from January 2012 to Decem-ber 2015, and they were treated by S type incision modified double Kessler suture within 7 days (averagely 4.1 days).Observed the postop-erative complications and evaluated the efficacy with Arner-Lindholm.Results All the 21 patients were followed for 6 to 24 months ( aver-agely 12 months).There was no incision infection ,necrosis, re-fracture of achilles tendon and other complications .There were 16 cases of excellent and 5 cases of good , with the excellent and good rate of 100% through the Arner-Lindholm evaluation criteria .Conclusion Modified double Kessler suture with S incision for the treatment of fresh achilles tendon rupture is conducive to early functional exercise ,and it can obtain satisfactory clinical efficacy .