1.Diagnostic Value of Detection of 16S rRNA Gene of Pathogens from Blood by PCR
Changfa YU ; Lijun YE ; Yingpeng REN ; Darong DUAN ; Ronghua RUAN ; Xiansen ZHANG
Chinese Journal of Nosocomiology 2009;0(19):-
OBJECTIVE To explore study a method for rapid detection of bacterial infection in clinic to diagnose septicemia early.METHODS 16S rRNA gene of ten bacterial species was amplified with PCR,by using human genome DNA,HBV-DNA and Candida albicans as comparison.The sensitivity test was done by the method of gradual dilution of Escherichia coli.RESULTS The bacterial species were amplified and the products were 371 bp,but human genome DNA,HBV-DNA and C.albicans showed no amplification products.Sensitivity test showed that it could detect as low as 1.5?104/L of E.coli.CONCLUSIONS The method is rapid and highly specific and sensitive in detecting the existence of bacterial 16S rRNA gene.
2.Risk factors for early recurrence of patients with single large hepatocellular carcinoma after hepatectomy
Yingpeng YE ; Yong YANG ; Xingchen CAI ; Hongda ZHU ; Caide LU ; Jiongze FANG
Chinese Journal of General Surgery 2023;38(1):1-6
Objective:To investigate the risk factors for postoperative early recurrence of patients with single large hepatocellular carcinoma (HCC) (tumor diameter≥5cm).Methods:Clinical data of 135 single large HCC patients who underwent radical resection from Jan 2015 to Sep 2020 in Ningbo Medical Centre Lihuili Hospital were analyzed.Results:Seventy-five HCC patients suffered recurrence,among those 42 patients had early recurrence(within 12 months). Multivariate analysis showed that alpha-fetoprotein (AFP)≥400 ng/ml ( OR=3.510,95% CI: 1.528-8.064; P=0.003) and tumor microvascular invasion (MVI) ( OR=2.769,95% CI: 1.143-6.706; P=0.024) were independent risk factors for early recurrence of single large hepatocellular carcinoma. Survival analysis showed that early recurrence risk factors significantly reduced recurrence free survival (RFS)(AFP≥400 ng/ml, χ 2=23.038, P<0.001; MVI positive , χ 2=10.554, P=0.001) and overall survival (OS) (AFP≥400 ng/ml, χ 2=14.336, P<0.001; MVI positive, χ 2=10.481, P=0.001) in single large hepatocellular carcinoma patients. Conclusion:AFP≥400 ng/ml and MVI positive are independent risk factors for postoperative early recurrence in single large hepatocellular carcinoma patients.
3.First hepatectomy beyond the Milan criteria affects the prognosis of salvage liver transplantation
Yingpeng YE ; Yong YANG ; Hongda ZHU ; Fei FENG ; Shengdong WU ; Caide LU ; Jiongze FANG
Chinese Journal of Hepatobiliary Surgery 2023;29(11):813-819
Objective:To analyze the prognostic factors affecting salvage liver transplantation (SLT).Methods:The clinical data of 97 patients undergoing liver transplantation in the Ningbo Medical Centre Lihuili Hospital from January 2012 to May 2022 were retrospectively analyzed, including 84 males and 13 females, aged (53.6±7.4) years. Among them, 33 patients underwent primary liver transplantation (PLT) and 64 underwent SLT. SLT patients were subdivided into the groups within the Milan criteria (SLT-A, n=35) and beyond the Milan criteria (SLT-B, n=29), according to whether the Milan criteria were met at first hepatectomy. Clinicopathological and prognostic data were subsequently analyzed. Results:The tumor number ( χ2=16.03, P<0.001), microvascular invasion (MVI) ( χ2=10.97, P=0.004), recurrence rate ( χ2=9.31, P=0.010), recurrence-free survival (RFS, F=14.05, P=0.001) and overall survival (OS, F=17.27, P<0.001) were significantly different among the three groups. RFS ( P=0.047) and OS ( P=0.012) in PLT group were better than those in SLT-B group. RFS ( P=0.007) and OS ( P=0.024) in SLT-A group were also better than those in SLT-B group. The multivariate analysis indicated that beyond the Milan criteria at first hepatectomy was an independent risk factor for RFS ( HR=4.378, 95% CI: 1.393-13.756, P=0.011) and OS ( HR=5.391, 95% CI: 1.428-20.352, P=0.013) in patients undergoing SLT, and MVI positive ( HR=4.042, 95% CI: 1.137-14.368, P=0.031) was an independent risk factor for RFS in patients undergoing SLT. Conclusion:Patients beyond the Milan criteria at first hepatectomy and MVI positive showed a poorer prognosis after SLT. Whether the Milan criteria should be the gold standard for SLT as well as for PLT needs further study.