目的:评价文拉法新与舍曲林治疗抑郁症疗效的差异。方法:对6项符合纳入标准的研究应用循证医学方法评价文拉法新与舍曲林治疗抑郁症疗效有效率、以及症状学变化的差异。结果:文拉法新组的有效率(122/177 vs 128/179,OR=1.22,95%CI:0.77~...目的:评价文拉法新与舍曲林治疗抑郁症疗效的差异。方法:对6项符合纳入标准的研究应用循证医学方法评价文拉法新与舍曲林治疗抑郁症疗效有效率、以及症状学变化的差异。结果:文拉法新组的有效率(122/177 vs 128/179,OR=1.22,95%CI:0.77~1.93,Z=0.86,P>0.05)与曲林组相似,但是文拉法新组在第1周末(WMD:-1.57,95%CI:-2.98^-0.15,Z=2.17,P=0.03)和第2周末(WMD:-1.53,95%CI:-2.83^-0.23,Z=2.30,P=0.02)症状改善明显于舍曲林,而在第6周末相似(WMD:0.13,95%CI:-0.91~1.17,Z=0.25,P=0.81)。结论:文拉法新与舍曲林治疗抑郁症有效率相似,但前者症状改善前2周改善比较快。展开更多
Orthotopic liver transplantation as a successful treatment of end-stage liver disease is hampered by a persistent lack of cadaveric organs.Split liver transplantation,which was first successfully performed by Medical ...Orthotopic liver transplantation as a successful treatment of end-stage liver disease is hampered by a persistent lack of cadaveric organs.Split liver transplantation,which was first successfully performed by Medical School of Hannover in 1988,has become a mature surgical technique to expand the donor pool.Between 1993 and 1999,split liver transplantation activities have increased in Europe from 1.2%to 10.4%in all performed liver transplantations.Current data have strongly supported that the survival rate of patients after split liver transplantation is not significantly different from that of patients after whole-size orthotopic liver transplantation.The most important step of donor graft selection is surgeon's observation judged by the experience of individual transplant center.The paper aims to provide the guideline of donor selection,hepatic graft splitting,and recipient management as well.DATA SOURCES:Medical School of Hannover has accumulated plentiful experience of split liver transplantation for more than 10 cases ever since 1998.Besides that,we also reviewed a variety of literatures from other famous European and American centers specialized in this field for many years.RESULTS:According to our experience combined with the view points of others,the donor should meet the following criteria as well:(1)age less than 50 years;(2)hemodynamics stable;(3)ICU less than 5 days;(4)Na less than 170 mmol/L or better if less than 150 mmol/L.In 1996 and 1997,the Hamburg group and the UCLA group separately introduced a breakthrough technique performing split liver transplantation in situ.Evidently,the in situ technique has been limited by prolonged time of donor organ procurement,coordination with other organ procurement teams,and even extra burden on donor hospital.Some groups,therefore,have restored the ex situ or bench splitting technique,and fortunately the transplant outcomes of the ex situ technique are equivalent to those of the in situ one.Recently some new techniques have been introduced to split the liver for two adult patients,including the split-cava technique.CONCLUSIONS:It is clear that the most important factor for determining the prognosis of the patient is the time of receiving liver transplantation,not the type of liver transplantation.We still need to pay close attention to the graft to recipient weight ratio(GRWR)and the UNOS classification or MELD score before the patient is subjected to split liver transplantation.展开更多
AIM： To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS： From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe （segments ...AIM： To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS： From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe （segments Ⅱ and Ⅲ） and a right extended lobe （segments Ⅰ, Ⅳ-Ⅷ） in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 29 cases. The average age, weight and ICU slaying period of the donors were 32.7 years （25-52 years）, 64.5 kg（45-75 kg） and 2.4 d （2-8 d） respectively.RESULTS： The average weight of the whole graft and the left lateral lobe was 2 322.6 g （956-2 665 g） and 282.8 g （298-373 g） respectively, and the average ratio of left lateral lobe to the whole graft was 0.225 （0.278-0.274）.The average graft to recipient weight ratio （GRWR） of the left lateral lobe and the right extended lobe reached 2.44% （2.22-5.42%） and 2.73% （2.32-2.30%） respectively.On average it took approximately 205 min （85-235 rain）to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one case.CONCLUSION： Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.展开更多
In a recent study published in Nature,Ryu et al.1demonstrate the presence of metabolically distinct mitochondrial subpopulations within one cell.One mitochondrial subpopulation contains the FiFo-ATP synthase for oxida...In a recent study published in Nature,Ryu et al.1demonstrate the presence of metabolically distinct mitochondrial subpopulations within one cell.One mitochondrial subpopulation contains the FiFo-ATP synthase for oxidative phosphorylation(OXPHOS),while a second population performs reductive biosynthesis of proline and ornithine.The separation of mitochondria into two functionally distinct pools is reversible and depends on their fusion and fission.展开更多
文摘目的:评价文拉法新与舍曲林治疗抑郁症疗效的差异。方法:对6项符合纳入标准的研究应用循证医学方法评价文拉法新与舍曲林治疗抑郁症疗效有效率、以及症状学变化的差异。结果:文拉法新组的有效率(122/177 vs 128/179,OR=1.22,95%CI:0.77~1.93,Z=0.86,P>0.05)与曲林组相似,但是文拉法新组在第1周末(WMD:-1.57,95%CI:-2.98^-0.15,Z=2.17,P=0.03)和第2周末(WMD:-1.53,95%CI:-2.83^-0.23,Z=2.30,P=0.02)症状改善明显于舍曲林,而在第6周末相似(WMD:0.13,95%CI:-0.91~1.17,Z=0.25,P=0.81)。结论:文拉法新与舍曲林治疗抑郁症有效率相似,但前者症状改善前2周改善比较快。
基金This study was supported by a grant from Deutshcer Akademischer Austausch Dienst(DAAD)K.C.Wong Fellow-ships.
文摘Orthotopic liver transplantation as a successful treatment of end-stage liver disease is hampered by a persistent lack of cadaveric organs.Split liver transplantation,which was first successfully performed by Medical School of Hannover in 1988,has become a mature surgical technique to expand the donor pool.Between 1993 and 1999,split liver transplantation activities have increased in Europe from 1.2%to 10.4%in all performed liver transplantations.Current data have strongly supported that the survival rate of patients after split liver transplantation is not significantly different from that of patients after whole-size orthotopic liver transplantation.The most important step of donor graft selection is surgeon's observation judged by the experience of individual transplant center.The paper aims to provide the guideline of donor selection,hepatic graft splitting,and recipient management as well.DATA SOURCES:Medical School of Hannover has accumulated plentiful experience of split liver transplantation for more than 10 cases ever since 1998.Besides that,we also reviewed a variety of literatures from other famous European and American centers specialized in this field for many years.RESULTS:According to our experience combined with the view points of others,the donor should meet the following criteria as well:(1)age less than 50 years;(2)hemodynamics stable;(3)ICU less than 5 days;(4)Na less than 170 mmol/L or better if less than 150 mmol/L.In 1996 and 1997,the Hamburg group and the UCLA group separately introduced a breakthrough technique performing split liver transplantation in situ.Evidently,the in situ technique has been limited by prolonged time of donor organ procurement,coordination with other organ procurement teams,and even extra burden on donor hospital.Some groups,therefore,have restored the ex situ or bench splitting technique,and fortunately the transplant outcomes of the ex situ technique are equivalent to those of the in situ one.Recently some new techniques have been introduced to split the liver for two adult patients,including the split-cava technique.CONCLUSIONS:It is clear that the most important factor for determining the prognosis of the patient is the time of receiving liver transplantation,not the type of liver transplantation.We still need to pay close attention to the graft to recipient weight ratio(GRWR)and the UNOS classification or MELD score before the patient is subjected to split liver transplantation.
文摘AIM： To outline the surgical experience with donor liver splitting in split liver transplantation.METHODS： From March 1 to September 1 in 2004, 10 donor livers were split ex situ into a left lateral lobe （segments Ⅱ and Ⅲ） and a right extended lobe （segments Ⅰ, Ⅳ-Ⅷ） in Medical School of Hannover, and thereafter split liver transplantation was performed successfully in 29 cases. The average age, weight and ICU slaying period of the donors were 32.7 years （25-52 years）, 64.5 kg（45-75 kg） and 2.4 d （2-8 d） respectively.RESULTS： The average weight of the whole graft and the left lateral lobe was 2 322.6 g （956-2 665 g） and 282.8 g （298-373 g） respectively, and the average ratio of left lateral lobe to the whole graft was 0.225 （0.278-0.274）.The average graft to recipient weight ratio （GRWR） of the left lateral lobe and the right extended lobe reached 2.44% （2.22-5.42%） and 2.73% （2.32-2.30%） respectively.On average it took approximately 205 min （85-235 rain）to split the donor liver. Five donor organs showed anatomic variation including the left hepatic vein variation in two cases, the left hepatic artery variation in two cases and the bile duct variation in one case.CONCLUSION： Split liver transplantation has become a mature surgical technique to expand the donor pool with promising results. In the process of graft splitting, close attention needs to be paid to potential anatomic variations,especially to variations of the left hepatic vein, the left hepatic artery, and the bile duct.
文摘In a recent study published in Nature,Ryu et al.1demonstrate the presence of metabolically distinct mitochondrial subpopulations within one cell.One mitochondrial subpopulation contains the FiFo-ATP synthase for oxidative phosphorylation(OXPHOS),while a second population performs reductive biosynthesis of proline and ornithine.The separation of mitochondria into two functionally distinct pools is reversible and depends on their fusion and fission.
