1.Clinical applications and analysis of pure laparoscopic left hemihepatectomy
Clinical Medicine of China 2008;24(11):1152-1154
Objective To study the clinical experience of pure laparoacopic left hemihepatectomy. Methods Pure laparoscopic left hemibepatectomy was attempted in 10 patients including 3 cases of primary hepatic carcino-mma,3 cases of cavernous hemangioma of liver,2 cases of hepatic cyst,and 2 cases of calculus of intrahepatic duct. Results Fully pure laparoscopic left hemihepatectomy was accomplished for all 10 cases. Operation time was 190-340(253.0±51.2) min,blood loss was 200-800(342.0 ± 191.7) ml,and hospital stay was(5.2 ± 1.3) d . No com-plicatious occurred. Conclusion Laparoscopic left bemibepatectomy is safe and feasible, which can be considered asan excellent choice for selected cases.
2.Expression of integrin ?V?3 in gastric cancers and its clinical significance
Shoujiang YU ; Gang TAN ; Shangha PAN
Chinese Journal of Current Advances in General Surgery 2004;0(05):-
Objective:The study aims to investigate the expression of integrin ?V?3 and its relationship in gastric cancers.Methods:The tumoral and normal tissues were collected from 65 cases of gastric cancer patients and 40 controls.The clinical phasing and pathological staging of the patients were recorded,and immunohistochemical analysis was used to detect the expression of integrin ?V?3 and microvessel density(MVD)in gastric cancers.Results:The positive rate of integrin ?V?3 expression was significantly higher in gastric cancer tissues than normal mucosal tissues(72.38% vs 22.86%,?2=8.35,P=0.032).There was a significant difference in integrin ?V?3 expression or MVD between tumors of infiltrating and expanding growth patterns(?2=14.97,P=0.002;t=10.150,P=0.001,respectively),cancers in T3~T4 and T1~T2 stages(?2=15.21,P=0.015;t=5.961,P=0.001,respectively).The positive rate of integrin ?V?3 expression and MVD also showed corelationship with lymph node invasion and metastases.Conclusion:Tumoral expression of integrin?V?3 was closely related with biological behavior of gastric cancers,suggesting that detection of integrin ?V?3 expression may present a potential tool to evaluate the clinical and pathological staging,lymph node status and metastases.
3.Development and validation of a dynamic nomogram predicting futile recanalization after thrombectomy in acute ischemic stroke
Shuai YU ; Qianmei JIANG ; Zhiliang GUO ; Shoujiang YOU ; Zhichao HUANG ; Jie HOU ; Huaishun WANG ; Guodong XIAO
Chinese Journal of Neurology 2022;55(10):1118-1127
Objective:To establish and verify a dynamic web-based nomogram for predicting futile recanalization after thrombectomy in acute ischemic stroke.Methods:Three hundred and four acute ischemic stroke patients admitted to the Second Affiliated Hospital of Soochow University from May 2017 to April 2021 were retrospectively enrolled. All these patients underwent mechanical thrombectomy and obtained successful recanalization. The eligible patients were randomly divided into training group ( n=216) and test group ( n=88) by 7∶3. The nomogram was established and internally validated with the data of the training group, and externally validated with the data of the test group. For the training group, multivariate Logistic regression analysis was performed by including all variables with P<0.05 in univariate analysis, and the independent predictors of futile recanalization were screened out to construct a nomogram. In the training group and the test group, the performance of the nomogram was verified by C-index, calibration chart and decision curve analysis respectively. Results:No significant difference was detected between the training group and the test group in futile recanalization [134/216 (62.0%) vs 56/88 (63.6%), χ 2=0.07, P=0.794]. Multivariate Logistic regression analysis showed that age ( OR=1.04,95% CI 1.00-1.08, P=0.033), National Institutes of Health Stroke Scale (NIHSS) score on admission ( OR=1.11,95% CI 1.04-1.19, P=0.001), neutrophil to lymphocyte ratio ( OR=1.19,95% CI 1.07-1.32, P=0.001), glycated hemoglobins ( OR=2.02,95% CI 1.34-3.05, P<0.001), poor collateral status ( OR=10.87,95% CI 4.08-29.01, P<0.001), postoperative high density ( OR=11.38,95% CI 4.56-28.40, P<0.001) were independent risk factors for futile recanalization. The C-index of this nomogram in the training group and the test group was 0.92 (95% CI 0.877-0.954, P<0.001) and 0.93 (95% CI 0.87-0.98, P<0.001), respectively. Conclusion:This web-based nomogram, including age, NIHSS score on admission, neutrophil to lymphocyte ratio, glycated hemoglobin, poor collateral status and postoperative high density, predicted individual probability of futile recanalization after mechanical thrombectomy with good discrimination and clinical utility.