Objective: Hand-assisted laparoscopic liver resection has the advantages of open and laparoscopic surgeries.There is still lack of comparison of surgical outcomes between hand-assistied laparoscopic liver resection(HA...Objective: Hand-assisted laparoscopic liver resection has the advantages of open and laparoscopic surgeries.There is still lack of comparison of surgical outcomes between hand-assistied laparoscopic liver resection(HALLR)and open liver resection(OLR). This study compared the surgical outcomes of the two approaches between wellmatched patient cohorts.Methods: Patients who received liver resection during January 2014 and October 2017 in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were included in this retrospective study. Propensity score matching(PSM) was performed to reduce selection bias between the two groups. Operation and short-term surgical outcomes were compared between the well matched groups.Results: During this period, 232 patients with a median age of 55.1 years old received OLR, while 49 patients with a median age of 54.7 years old received HALLR. Compared with HALLR group, OLR group has a higher proportion in male patients(190/232, 81.9% vs. 34/49, 69.4%, P=0.048) and lower albumin(43.2±4.5 vs. 44.8±3.7,P=0.020). After PSM, 49 patients from each group were included in the following analysis. Two groups were well balanced in their baseline characteristics, liver functions, preoperative treatments, abdominal surgery history, and surgical difficulty. None perioperative mortality was observed in both groups. Operation time and postoperative complications were similar in two groups(P=0.935, P=0.056). The HALLR group showed less bleeding amount(177.8±217.1 mL vs. 283.1±225.0 mL, P=0.003) and shorter postoperative stay period(6.9±2.2 d vs. 9.0±3.5 d,P=0.001).Conclusions: We demonstrated that hand-assisted laparoscopic surgery is feasible and safe for liver resection,including some difficult cases. HALLR can provide better bleeding control and faster recovery after surgery.展开更多
Background: Postoperative radiotherapy (RT) is known to play an important role in the treatment of hepatocellular carcinomas (HCCs), but the specific role of intraoperative electron radiotherapy (IOERT) in HCCs remain...Background: Postoperative radiotherapy (RT) is known to play an important role in the treatment of hepatocellular carcinomas (HCCs), but the specific role of intraoperative electron radiotherapy (IOERT) in HCCs remains unclear. The aim of this study was to investigate the safety and efficacy of IOERT in centrally located HCCs treated with narrow-margin (<1 cm) hepatectomy. Methods: This was a single-center, phase 2, prospective non-randomized controlled study, including 268 patients with centrally located HCCs who underwent narrow-margin hepatectomy. The patients were subsequently allocated to the IOERT group (n=59) or to the control group (n=65). The primary outcome of the study was to compare recurrence-free survival (RFS) between the IOERT group and the control group, and the secondary outcome was to compare overall survival (OS) rate between the two groups. Results: Of 268 patients enrolled, a total of 124 were included in the study: 59 in IOERT group, 65 in control group. The 1-, 2-, 3-year RFS rates were 79.3%, 62.1% and 45.8% for patients in the IOERT group, and 47.6%, 28.6%, and 22.9% for patients in the control group, respectively (P=0.025). The 1-, 2-, and 3-year OS rates were 100.0%, 94.9%, and 83.7% for patients in the IOERT group, and 92.3%, 87.5%, and 79.4% for patients in the control group, respectively (P=0.314). Subgroup analysis of MVI (+) patients revealed that RFS and OS are significantly prolonged in the IOERT subgroup as compared to the control, whereas there was no significant difference of RFS and OS between the two groups in MVI (−) patients. Conclusions: IOERT for centrally located HCCs with concurrent narrow-margin hepatectomy was feasible and safe. Statistically better RFS rate was observed in the IOERT group compared to the control group. Subgroup analysis revealed that IOERT was more beneficial for postoperative survival of HCC patients with MVI. Trial Registration: ChiCTR-TRC-12002802;www.who.int/ictrp.展开更多
The South China Sea(SCS)is the largest semi-enclosed marginal sea in the western Pacific.The alternation of East Asian monsoon causes a significant seasonal pattern of chlorophyll,primary productivity,and export flux ...The South China Sea(SCS)is the largest semi-enclosed marginal sea in the western Pacific.The alternation of East Asian monsoon causes a significant seasonal pattern of chlorophyll,primary productivity,and export flux of sinking particles.However,the source and sink of dissolved organic carbon(DOC)pools with different bioavailability are less studied.Here we evaluated the seasonal production of DOC in labile,semi-labile and refractory forms using a coupled physical-biogeochemical model.This study aims to understand the dynamics and budgets of organic matters in the SCS.Model results show that the production of labile,semi-labile and refractory DOC is highly correlated with the net primary productivity(NPP)which is higher in winter and lower in summer,reflecting a dependence of DOC on the NPP.The seasonal variation in Pearl River discharge dominates the DOC production in the northern coastal region.In the northeast,the Kuroshio intrusion associated frontal system is attributed to cause high winter production.The DOC production in the southwest is controlled by both winter mixing and summer upwelling.The production of refractory DOC with the least bioavailability favors carbon sequestration.Its annual mean production is 1.8±0.5 mg C m^(−2) d^(−1),equivalent to 26%of the export flux of particulate organic carbon at 1000 m.展开更多
基金supported by PUMC Youth Fund/ Fundamental Research Funds for the Central Universities (No. 3332016031)National Key Research and Development Plan (No. 2016YFD0400604-03)
文摘Objective: Hand-assisted laparoscopic liver resection has the advantages of open and laparoscopic surgeries.There is still lack of comparison of surgical outcomes between hand-assistied laparoscopic liver resection(HALLR)and open liver resection(OLR). This study compared the surgical outcomes of the two approaches between wellmatched patient cohorts.Methods: Patients who received liver resection during January 2014 and October 2017 in Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College were included in this retrospective study. Propensity score matching(PSM) was performed to reduce selection bias between the two groups. Operation and short-term surgical outcomes were compared between the well matched groups.Results: During this period, 232 patients with a median age of 55.1 years old received OLR, while 49 patients with a median age of 54.7 years old received HALLR. Compared with HALLR group, OLR group has a higher proportion in male patients(190/232, 81.9% vs. 34/49, 69.4%, P=0.048) and lower albumin(43.2±4.5 vs. 44.8±3.7,P=0.020). After PSM, 49 patients from each group were included in the following analysis. Two groups were well balanced in their baseline characteristics, liver functions, preoperative treatments, abdominal surgery history, and surgical difficulty. None perioperative mortality was observed in both groups. Operation time and postoperative complications were similar in two groups(P=0.935, P=0.056). The HALLR group showed less bleeding amount(177.8±217.1 mL vs. 283.1±225.0 mL, P=0.003) and shorter postoperative stay period(6.9±2.2 d vs. 9.0±3.5 d,P=0.001).Conclusions: We demonstrated that hand-assisted laparoscopic surgery is feasible and safe for liver resection,including some difficult cases. HALLR can provide better bleeding control and faster recovery after surgery.
基金This work was supported by Beijing Municipal Science&Technology Commission(No.Z131107002213166)the Beijing Hope Run Special Fund of Cancer Foundation of China(No.LC2018A15)the PUMC Fund of the Funds for the Central Universities(No.3332018193).
文摘Background: Postoperative radiotherapy (RT) is known to play an important role in the treatment of hepatocellular carcinomas (HCCs), but the specific role of intraoperative electron radiotherapy (IOERT) in HCCs remains unclear. The aim of this study was to investigate the safety and efficacy of IOERT in centrally located HCCs treated with narrow-margin (<1 cm) hepatectomy. Methods: This was a single-center, phase 2, prospective non-randomized controlled study, including 268 patients with centrally located HCCs who underwent narrow-margin hepatectomy. The patients were subsequently allocated to the IOERT group (n=59) or to the control group (n=65). The primary outcome of the study was to compare recurrence-free survival (RFS) between the IOERT group and the control group, and the secondary outcome was to compare overall survival (OS) rate between the two groups. Results: Of 268 patients enrolled, a total of 124 were included in the study: 59 in IOERT group, 65 in control group. The 1-, 2-, 3-year RFS rates were 79.3%, 62.1% and 45.8% for patients in the IOERT group, and 47.6%, 28.6%, and 22.9% for patients in the control group, respectively (P=0.025). The 1-, 2-, and 3-year OS rates were 100.0%, 94.9%, and 83.7% for patients in the IOERT group, and 92.3%, 87.5%, and 79.4% for patients in the control group, respectively (P=0.314). Subgroup analysis of MVI (+) patients revealed that RFS and OS are significantly prolonged in the IOERT subgroup as compared to the control, whereas there was no significant difference of RFS and OS between the two groups in MVI (−) patients. Conclusions: IOERT for centrally located HCCs with concurrent narrow-margin hepatectomy was feasible and safe. Statistically better RFS rate was observed in the IOERT group compared to the control group. Subgroup analysis revealed that IOERT was more beneficial for postoperative survival of HCC patients with MVI. Trial Registration: ChiCTR-TRC-12002802;www.who.int/ictrp.
基金This work was supported by the Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)(Grant No.SML2020SP008)the National Key Research and Development Program of China(Grant No.2016YFA0601101)+4 种基金the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB42000000)the National Natural Science Foundation of China(Grant Nos.41876123,41890805,41876032)SOED research program(Grant No.SOEDZZ2104)State Key Laboratory of Marine Geology,Tongji University(Grant No.MGK202103)the Key Special Project for Introduced Talents Team of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(Grant No.GML2019ZD0305).
文摘The South China Sea(SCS)is the largest semi-enclosed marginal sea in the western Pacific.The alternation of East Asian monsoon causes a significant seasonal pattern of chlorophyll,primary productivity,and export flux of sinking particles.However,the source and sink of dissolved organic carbon(DOC)pools with different bioavailability are less studied.Here we evaluated the seasonal production of DOC in labile,semi-labile and refractory forms using a coupled physical-biogeochemical model.This study aims to understand the dynamics and budgets of organic matters in the SCS.Model results show that the production of labile,semi-labile and refractory DOC is highly correlated with the net primary productivity(NPP)which is higher in winter and lower in summer,reflecting a dependence of DOC on the NPP.The seasonal variation in Pearl River discharge dominates the DOC production in the northern coastal region.In the northeast,the Kuroshio intrusion associated frontal system is attributed to cause high winter production.The DOC production in the southwest is controlled by both winter mixing and summer upwelling.The production of refractory DOC with the least bioavailability favors carbon sequestration.Its annual mean production is 1.8±0.5 mg C m^(−2) d^(−1),equivalent to 26%of the export flux of particulate organic carbon at 1000 m.
