BACKGROUND:The number of loco-regional therapies(LRTs)for hepatocellular carcinoma(HCC)has increased dramatically during the past decade.Many patients with HCC who were beyond the Milan criteria were allowed to receiv...BACKGROUND:The number of loco-regional therapies(LRTs)for hepatocellular carcinoma(HCC)has increased dramatically during the past decade.Many patients with HCC who were beyond the Milan criteria were allowed to receive a liver transplantation(LT)once the HCC was successfully down-staged.This retrospective study aimed to analyze the outcomes of LRTs prior to LT in patients with HCC beyond the Milan criteria.METHODS:We analyzed 56 patients treated from June 2006 to March 2010:22 met the Milan criteria(T1+T2,39.3%),16 had T3 tumors(28.6%),and 11 had T4a tumors(19.6%),while 7 were suspected of tumor vascular invasion(T4b,12.5%).All patients underwent preoperative LRTs,including transcatheter arterial chemoembolization,radiofrequency ablation,percutaneous ethanol injection,liver resection,and/or microwave coagulation therapy.The number of the patients who were successfully down-staged before LT,the types of LRTs used before LT,and their outcomes after LT were recorded.RESULTS:Eleven patients had necrotic tumors(pT0,19.6%);6 had pT1 tumors(10.7%),22 had pT2 tumors(39.3%),6 had pT3 tumors(10.7%),5 had pT4a tumors(8.9%),and 6 had pT4b tumors(10.7%).The histopathologic tumors of 39 patients(69.6%)were down-staged and met the established Milan criteria(pT0-2).Imaging-proven under-staging was present in 5 HCC patients(8.9%)who had tumors involving the intrahepatic venous system.Twenty-three patients(41.1%)had stable HCC and 10(17.9%)died.The 1-,3-and 4-year survival rates were 96%,73%and 61%,respectively,with a mean survival time of 22.29±1.63 months.Six patients died of tumorrecurrence.The 1-,3-and 4-year recurrence-free survival(RFS)rates were 88%,75%and 66%,respectively.The 3-year RFS of patients with pT0-2 tumors was 82%,which was markedly greater than that of patients with pT3 tumors(63%,P=0.018)or pT4 tumors(17%,P=0.000).Although the 3-year RFS of patients with pT3 tumors was greater than that of patients with pT4 tumors,the difference was not significant.CONCLUSIONS:Successful down-staging of HCCs can be achieved in the majority of carefully selected patients by LRTs.Importantly,patients who are successfully down-staged and undergo LT may have a higher RFS rate.展开更多
BACKGROUND:Acute hepatic failure(AHF)is a devastating clinical syndrome with a high mortality rate.The outcome of AHF varies with etiology,but liver transplantation(LT)can significantly improve the prognosis and survi...BACKGROUND:Acute hepatic failure(AHF)is a devastating clinical syndrome with a high mortality rate.The outcome of AHF varies with etiology,but liver transplantation(LT)can significantly improve the prognosis and survival rate of such patients.This study aimed to detect the role of LT and artificial liver support systems(ALSS)for AHF patients and to analyze the etiology and outcome of patients with this disease.METHODS:A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center.We analyzed and compared the etiology,outcome,prognosis,and survival rates of patients between the transplantation(LT)group and the non-transplantation(N-LT)group.RESULTS:AHF was due to viral hepatitis in 25 patients(52.1%;hepatitis B virus in 22),drug or toxic reactions in 14(29.2%;acetaminophen in 6),Wilson disease in 4(8.3%),unknown reasons in 3(6.3%),and miscellaneous conditions in 2(4.2%).In the LT group,36 patients(7 underwent living donor LT,and 29 cadaveric LT)had an average model for endstage liver disease score(MELD)of 35.7.Twenty-eight patients survived with good graft function after a follow-up of 27.3±4.5 months.During the waiting time,6 patients were treated with ALSS and 2 of them died during hospitalization.The 30-day,12-month,and 18-month survival rates were 77.8%,72.2%,and 66.7%,respectively.In the N-LT group,12 patients had an average MELD score of 34.5.Four patients were treated with ALSS and all died during hospitalization.The 90-day and 1-year survival rates were only 16.7%and 8.3%,respectively.CONCLUSIONS:Hepatitis is the most prominent cause of AHF at our center.Most patients with AHF,who fulfill the Kings College Criteria for LT,did not survive longer without LT.ALSS did not improve the prognosis of AHF patients,but may extend the waiting time for a donor.Currently,LT is still the most effective way to improve the prognosis of AHF patients.展开更多
Precision measurement tools are compulsory to reduce measurement errors or machining errors in the processes of calibration and manufacturing.The laser interferometer is one of the most important measurement tools inv...Precision measurement tools are compulsory to reduce measurement errors or machining errors in the processes of calibration and manufacturing.The laser interferometer is one of the most important measurement tools invented in the 20th century.Today,it is commonly used in ultraprecision machining and manufacturing,ultraprecision positioning control,and many noncontact optical sensing technologies.So far,the state-of-the-art laser interferometers are the ground-based gravitational-wave detectors,e.g.the Laser Interferometer Gravitational-wave Observatory(LIGO).The LIGO has reached the measurement quantum limit,and some quantum technologies with squeezed light are currently being tested in order to further decompress the noise level.In this paper,we focus on the laser interferometry developed for space-based gravitational-wave detection.The basic working principle and the current status of the key technologies of intersatellite laser interferometry are introduced and discussed in detail.The launch and operation of these large-scale,gravitational-wave detectors based on space-based laser interferometry is proposed for the 2030s.展开更多
文摘BACKGROUND:The number of loco-regional therapies(LRTs)for hepatocellular carcinoma(HCC)has increased dramatically during the past decade.Many patients with HCC who were beyond the Milan criteria were allowed to receive a liver transplantation(LT)once the HCC was successfully down-staged.This retrospective study aimed to analyze the outcomes of LRTs prior to LT in patients with HCC beyond the Milan criteria.METHODS:We analyzed 56 patients treated from June 2006 to March 2010:22 met the Milan criteria(T1+T2,39.3%),16 had T3 tumors(28.6%),and 11 had T4a tumors(19.6%),while 7 were suspected of tumor vascular invasion(T4b,12.5%).All patients underwent preoperative LRTs,including transcatheter arterial chemoembolization,radiofrequency ablation,percutaneous ethanol injection,liver resection,and/or microwave coagulation therapy.The number of the patients who were successfully down-staged before LT,the types of LRTs used before LT,and their outcomes after LT were recorded.RESULTS:Eleven patients had necrotic tumors(pT0,19.6%);6 had pT1 tumors(10.7%),22 had pT2 tumors(39.3%),6 had pT3 tumors(10.7%),5 had pT4a tumors(8.9%),and 6 had pT4b tumors(10.7%).The histopathologic tumors of 39 patients(69.6%)were down-staged and met the established Milan criteria(pT0-2).Imaging-proven under-staging was present in 5 HCC patients(8.9%)who had tumors involving the intrahepatic venous system.Twenty-three patients(41.1%)had stable HCC and 10(17.9%)died.The 1-,3-and 4-year survival rates were 96%,73%and 61%,respectively,with a mean survival time of 22.29±1.63 months.Six patients died of tumorrecurrence.The 1-,3-and 4-year recurrence-free survival(RFS)rates were 88%,75%and 66%,respectively.The 3-year RFS of patients with pT0-2 tumors was 82%,which was markedly greater than that of patients with pT3 tumors(63%,P=0.018)or pT4 tumors(17%,P=0.000).Although the 3-year RFS of patients with pT3 tumors was greater than that of patients with pT4 tumors,the difference was not significant.CONCLUSIONS:Successful down-staging of HCCs can be achieved in the majority of carefully selected patients by LRTs.Importantly,patients who are successfully down-staged and undergo LT may have a higher RFS rate.
文摘BACKGROUND:Acute hepatic failure(AHF)is a devastating clinical syndrome with a high mortality rate.The outcome of AHF varies with etiology,but liver transplantation(LT)can significantly improve the prognosis and survival rate of such patients.This study aimed to detect the role of LT and artificial liver support systems(ALSS)for AHF patients and to analyze the etiology and outcome of patients with this disease.METHODS:A retrospective analysis was made of 48 consecutive patients with AHF who fulfilled the Kings College Criteria for LT at our center.We analyzed and compared the etiology,outcome,prognosis,and survival rates of patients between the transplantation(LT)group and the non-transplantation(N-LT)group.RESULTS:AHF was due to viral hepatitis in 25 patients(52.1%;hepatitis B virus in 22),drug or toxic reactions in 14(29.2%;acetaminophen in 6),Wilson disease in 4(8.3%),unknown reasons in 3(6.3%),and miscellaneous conditions in 2(4.2%).In the LT group,36 patients(7 underwent living donor LT,and 29 cadaveric LT)had an average model for endstage liver disease score(MELD)of 35.7.Twenty-eight patients survived with good graft function after a follow-up of 27.3±4.5 months.During the waiting time,6 patients were treated with ALSS and 2 of them died during hospitalization.The 30-day,12-month,and 18-month survival rates were 77.8%,72.2%,and 66.7%,respectively.In the N-LT group,12 patients had an average MELD score of 34.5.Four patients were treated with ALSS and all died during hospitalization.The 90-day and 1-year survival rates were only 16.7%and 8.3%,respectively.CONCLUSIONS:Hepatitis is the most prominent cause of AHF at our center.Most patients with AHF,who fulfill the Kings College Criteria for LT,did not survive longer without LT.ALSS did not improve the prognosis of AHF patients,but may extend the waiting time for a donor.Currently,LT is still the most effective way to improve the prognosis of AHF patients.
基金the National Natural Science Foundation of China(Grant Nos.11655001,11654004,91836104).
文摘Precision measurement tools are compulsory to reduce measurement errors or machining errors in the processes of calibration and manufacturing.The laser interferometer is one of the most important measurement tools invented in the 20th century.Today,it is commonly used in ultraprecision machining and manufacturing,ultraprecision positioning control,and many noncontact optical sensing technologies.So far,the state-of-the-art laser interferometers are the ground-based gravitational-wave detectors,e.g.the Laser Interferometer Gravitational-wave Observatory(LIGO).The LIGO has reached the measurement quantum limit,and some quantum technologies with squeezed light are currently being tested in order to further decompress the noise level.In this paper,we focus on the laser interferometry developed for space-based gravitational-wave detection.The basic working principle and the current status of the key technologies of intersatellite laser interferometry are introduced and discussed in detail.The launch and operation of these large-scale,gravitational-wave detectors based on space-based laser interferometry is proposed for the 2030s.
