Objective: To analyze the relationship of hepatic transit time and portal vein pressure in the patients with portal hypertension and esophagogastric varices, and to clarify its clinical significance. Methods: A total of 50 hospitalized patients underwent esophagogastric venous embolization due to portal hypertension and esophagogastric varices were selected as observation group, and 50 patients without history of liver disease and clinical manifestations of liver disease (hospitalized or out-patient) were selected as control group. All patients underwent liver contrast enhanced ultrasound. The free portal pressure (FPP) was measured by ultrasound guided portal vein puncture for operating pathways in the patients in observation group. The hepatic artery-hepatic vein transit time (HA-HVTT), the hepatic portal vein-hepatic vein transit time (PV-HVTT), the liver parenchyma- hepatic vein transit time (PA-HVTT) of the patients were compared between two groups. The correlations between HA-HVTT, PV-HVTT, PA-HVTT and FPP of the patients in observation group were analyzed. Results: The HA-HVTT, PV-HVTT and PA-HVTT of the patients in observation group were significantly shorter than those in control group 0=5.078, P<0. 01; t=\2. 163, P<0. 01; t=2. 649, PC0.01). The HA-HVTT, PV-HVTT and PA-HVTT had negative correlations with FPP in observation group ( r= 0.799, P

ObjectiveTo investigate the effects of cardioplegic solution enriched with different doses of glutathione on myocardial injury in children undergoing cardiac surgery under cardiopulmonary bypass (CPB).MethodsForty-eight ASA [Ⅱ or Ⅲ patients aged 2-5 yr undergoing repair of ventricular septal defect under CPB were randomly divided into 4 groups (n ＝ 12 each):control group (group C) and cardioplegic solution containing 3 different-dose of glutathione groups ( group G1-3 ).Glutathione 50,75,100 mg/kg were added to cardioplegic solution in group G1-3 respectively.Blood samples were collected before operation (T0),at 30 min after release of aortic cross-clamp (T1),at 6,12,24 h after termination of CPB (T2-4) for determination of plasma cTnI concentration.Myocardial specimens were obtained from right auricle before aortic cross-clamp and 15 min after release of aortic cross-clamp.The ultrastructure of myocardium was examined with scanning electron microscope.A mitochondrial FlaMeng semiquantitative analysis was done.ResultsThe plasma concentration of cTnI at T3,4 were significantly lower in groups G1,2 than in group C.The plasma concentration of cTnI at T1-4 were significantly lower in group G3 than in group C and group G1,2.The quantization score of myocardial mitochondria at 15 min after release of aortic cross-clamp were significantly lower in group G3 than in group C and group G1,2.Micorscopic examination showed that the injury to myocardial ultrastructure was attenuated in group G3 compared with group C.Conclusion Cardioplegic solution enriched with glutathione can reduce myocardial injury induced by CPB in a dose dependent manner.Glutathione 100 mg/kg can exert a visibly protective effect on myocardium.

Objective:To analyze the relationship of hepatic transit time and portal vein pressure in the patients with portal hypertension and esophagogastric varices, and to clarify its clinical significance.Methods:A total of50hospitalized patients underwent esophagogastric venous embolization due to portal hypertension and esophagogastric varices were selected as observation group, and 50patients without history of liver disease and clinical manifestations of liver disease (hospitalized or out-patient) were selected as control group, All patients underwent liver contrast enhanced ultrasound.The free portal pressure (FPP) was measured by ultrasound guided portal vein puncture for operating pathways in the patients in observation group.The hepatic artery-hepatic vein transit time (HA-HVTT) , the hepatic portal vein-hepatic vein transit time (PV-HVTT) , the liver parenchymahepatic vein transit time (PA-HVTT) of the patients were compared between two groups.The correlations between HA-HVTT, PV-HVTT, PA-HVTT and FPP of the patients in observation group were analyzed.Results:The HA-HVTT, PV-HVTT and PA-HVTT of the patients in observation group were significantly shorter than those in control group (t=5.078, P＜0.01;t=12.163, P＜0.01;t=2.649, P＜0.01) .The HA-HVTT, PV-HVTT and PA-HVTT had negative correlations with FPP in observation group (r=-0.799, P＜0.01;r=-0.554, P＜0.01;r=-0.735, P＜0.01) .The linear relationship between HA-HVTT and FPP was Y=-0.410X+7.254;the linear relationship between PV-HVTT and FPP was Y=-0.355X+4.983;the linear relationship between PA-HVTT and FPP was Y=-0.566X+4.997.Conclusion:Liver transit time can be used as an effective index to judge the portal vein pressure, and it can provide the theroretical basis for the diagnosis and treatment of portal hypertension in the patients.

Objective Stereotactic body radiotherapy(SBRT)and radiofrequency ablation(RFA)are primary treatments for hepatocellular carcinoma(HCC)at present.However,the effect of these treatments in clinical trails are rather controversial.The purpose of this paper is to conduct a meta-analysis on the clinical effect and related complications of SBRT and RFA for HCC.Methods A computerized retrieval of academic papers concerning the treatment effect of SBRT and RFA for HCC from the databases of PubMed,Embase,Cochrane Library,Scopus,Web of Science,CBM,CNKI,Wanfang database,VIP was conducted.The retrieval time period was from the establishment of the database to June 2022.Stata14.0 software was used to make meta-analysis.Results A total of 14 retrospective studies including 6 806 patients were included in this analysis.The results of combined hazard ratio(HR)based on overall survival(OS)showed that the OS rate of SBRT was lower than that of RFA(HR=1.25,95％CI=1.10-1.43,12=0％,P=0.000 9),while the results of combined HR of local control(LC)rate indicated that SBRT had a better therapeutic effect(HR=0.61,95％CI=0.47-0.78,I2=0％,P=0.000 1).Subgroup analysis revealed that the combined HR of LC rate favored the performance of SBRT for patients with tumor diameter larger than 2 cm(HR=2.64,95％CI=1.56-4.48,I=0％,P=0.000 3).No statistically significant difference in the incidence of late serious adverse reactions existed between SBRTgroup and RFA group(OR=1.01,95％CI=0.59-1.73,I2=30％,P=0.97).Conclusion SBRT is superior to RFA in controlling local HCC lesions,especially in patients whose tumor diameter is larger than 2 cm,although it does not show certain advantages in the survival benefit.(J Intervent Radiol,2023,32:1233-1241)

Objective:To investigate the differences of white matter diffusion properties between vulnerable and resistant individuals to continuous attention after sleep deprivation.Methods:According to the psychomotor vigilance test performance before and after sleep deprivation, the participants were divided into the vulnerable group( n=24) and resistant group( n=25). All participants underwent diffusion tensor imaging (DTI) scans.Tract based spatial statistics(TBSS) was used to compare fractional anisotropy(FA), mean diffusivity(MD), axial diffusivity(AD), radial diffusivity(RD) maps between the two groups.Spearman correlation analysis was conducted by SPSS 24.0 to investigate the relationships between the altered DTI metrics and PVT task performance. Results:(1) Compared with resistant group, FA value of vulnerable group decreased in the body of corpus callosum(x, y, z=-8, 9, 25, t=-7.855), right superior longitudinal fasciculus(x, y, z=-39, -7, 26, t=-6.252), bilateral anterior limb of internal capsule(x, y, z=-13, 8, 13, t=-5.235; x, y, z=12, 8, 3, t=-5.024) and right posterior thalamic radiation(x, y, z=-26, -56, 17, t=-5.469)(TFCE corrected, P<0.05, cluster size≥50 voxel). (2) Compared with resistant group, MD value of vulnerable group increased in the body of corpus callosum(x, y, z=-3, -6, 26, t=7.613), right superior longitudinal fasciculus(x, y, z=-31, -19, 38, t=5.314), bilateral anterior limb of internal capsule(x, y, z=-16, 7, 8, t=6.898; x, y, z=15, 5, 7, t=6.652), splenium of corpus callosum(x, y, z=27, -53, 17, t=6.541), and AD value increased in the right superior longitudinal fasciculus(x, y, z=-33, -19, 39, t=4.892), splenium of corpus callosum(x, y, z=-22, -49, 21, t=5.450), genu of corpus callosum(x, y, z=4, 26, 0, t=4.332), as well as RD value increased in the right superior corona radiata(x, y, z=-17, 1, 33, t=7.558), body of corpus callosum(x, y, z=4, -8, 26, t=6.699), right anterior limb of internal capsule(x, y, z=-12, 7, 3, t=5.212) (TFCE corrected, P<0.05, cluster size≥50 voxel). (3) Correlational analysis revealed that the negative correlations were found between PVT task performance and the FA value in the right superior longitudinal fasciculus( r=-0.492, P<0.001), right anterior limb of internal capsule( r=-0.510, P<0.001), right posterior thalamic radiation( r=-0.502, P<0.001) and body of corpus callosum( r=-0.464, P<0.001). The positive correlations were found between PVT task performance and the MD value in the body of corpus callosum( r=0.500, P<0.001), right superior longitudinal fasciculus( r=0.499, P<0.001), splenium of corpus callosum( r=0.462, P<0.001), right anterior limb of internal capsule( r=0.471, P<0.001), and AD value in right superior longitudinal fasciculus( r=0.643, P<0.001), as well as RD value in right superior corona radiate( r=0.498, P<0.001) (Bonferroni corrected, P<0.003). Conclusion:Differences in the microstructural characteristics of white matter fiber tracts in specific brain regions may constitute the potential neuropathological basis for the phenotypes of vulnerable and resistant individuals to continuous attention after sleep deprivation.

Objective     To investigate the risk factors for postoperative complications Clavien-Dindo classification≥grade Ⅱ after lung cancer surgery. Methods     The patients who underwent lung cancer surgery in a multicenter observational study from November 2017 to January 2020 were included. The Clavien-Dindo classification of postoperative complications was analyzed. Logistic regression was used to identify the risk factors for complications≥ gradeⅡ. Results     A total of 388 patients were enrolled, including 203 males and 185 females with a mean age of 56.14±10.36 years. The incidence of postoperative complications was 25.52% (99/388) after lung cancer surgery and the incidence of complications≥gradeⅡ was 20.10% (78/388). The five most common postoperative complications were pneumonia (6.96%), prolonged pulmonary air leak (>7 days, 5.67%), incision dehiscence (4.64%), arrhythmia (3.87%), and postoperative pleural effusion (3.35%). Multivariate analysis showed that open surgery [reference: uniportal thoracoscopic surgery, OR=2.18, 95%CI (1.01, 4.70), P=0.047], extended resection [reference: sublobar resection, OR=2.86, 95%CI (1.11, 7.19), P=0.030; reference: lobectomy, OR=2.20, 95%CI (1.10, 4.40), P=0.026] and operative time≥3 h [OR=2.07, 95%CI (1.12, 3.85), P=0.021] were independent risk factors for postoperative complications≥gradeⅡ after lung cancer surgery. Conclusion     Surgical approach, extent of resection and operative time are independent influencing factors for postoperative complications≥gradeⅡ after lung cancer surgery.