Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac...Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis (PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during follow-up is compared between the two groups. Additionally, subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.展开更多
BACKGROUND: The treatment for primary tumor in the caudate lobe of the liver is difficult because of its unique anatomical location. This study was undertaken to improve operative techniques and results by a new anato...BACKGROUND: The treatment for primary tumor in the caudate lobe of the liver is difficult because of its unique anatomical location. This study was undertaken to improve operative techniques and results by a new anatomical method of caudate lobectomy. METHODS: Clinical data of 16 patients who had had caudate lobectomy for the liver from January 1996 to November 2004 were retrospectively analyzed. The third porta hepatis anatomical method was performed in all 16 patients. Operative time, intraoperative blood loss, postoperative complications were recorded. The 1-, 3-, and 5-year survival rates of 13 patients with caudate lobe carcinoma were followed up. Anatomical status, operative routes, operative procedures, liver blood supply were evaluated. RESULTS: The operation was successful in the 16 patients. The operative time was 255±70 minutes and blood loss 740±402 ml. None of the patients died from massive bleeding during the operation, nor did complications such as biliary fistula and liver failure occurred. In 13 patients with malignant tumor, 7 died from recurrence and metastasis of the tumor and the other 6 are still alive at the end of follow-up. One patient has survived for 6 years. The 1-, 3-, and 5-year survival rates in the 13 patients were 83.9%, 58.7% and 39.2%, respectively. CONCLUSION: Caudate lobectomy by the third porta hepatis anatomical method can improve operative effect and increase the resection probability for solitary tumor in the caudate lobe.展开更多
OBJECTIVE: To study the correlation between human cholangiocarcinoma in the porta hepatis and the infection of hepatitis virus. METHODS: Immunohistochemistry was used to detect HBxAg and HCV-C protein in formalin-fixe...OBJECTIVE: To study the correlation between human cholangiocarcinoma in the porta hepatis and the infection of hepatitis virus. METHODS: Immunohistochemistry was used to detect HBxAg and HCV-C protein in formalin-fixed and paraffin-embedded samples taken from 68 patients with cholangiocarcinoma in the porta hepatis. The findings were reviewed against the clinical records of the patients. RESULTS: Six patients (8.8%) were positive for HBxAg and 24 (35%) for HCV-C protein, respectively. One patient was positive for both HBxAg and HCV-C protein. There were statistically differences in the extent of differentiation, invasion, lymph-node metastasis, and treatment between the patients with cholangiocarcinomas in the porta hepatis with HB(C) V infection and those without infection. CONCLUSIONS: HB(C) V infection is correlated to the development of cholangiocarcinoma in the porta hepatis. The tumor with HB(C) V infection may have a higher malignancy biologically and poorer prognosis. HBxAg and HCV-C protein may play an important role in the pathogenesis of cholangiocarcinoma in the porta hepatis.展开更多
BACKGROUND Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position:Anterolateral to the second,third,and fourth trac...BACKGROUND Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position:Anterolateral to the second,third,and fourth tracheal cartilages.An intemperate descent or a migration failure of the thyroid anlage results in sub-diaphragmatic thyroid ectopia,a sparse clinical entity.CASE SUMMARY This case portrays a 63-year-old female patient presenting with chronic abdominal discomfort at a local hospital whereby a computed tomography(CT)scan revealed a well-defined mass in the hepatic entrance.For further examination,the patient underwent a CT scan with contrast,magnetic resonance imaging(MRI),and CT-angiography(CTA)at our department.The CT scan showed a welldefined and high attenuated mass measuring 43 mm×38 mm in the hepatic entrance with calcification.The CTA revealed an additional finding:Blood supply to the mass from the right hepatic artery.MRI of the upper abdomen demonstrated a mass with mixed signal intensity on T1 and T2 weighted images in the hepatic entrance.The patient underwent surgery with resection of the mass which was sent for histopathology.Ectopic thyroid at the level of porta hepatis with nodules was the definitive diagnosis since histopathological report revealed presence of thyroid tissue in the resected liver mass.CONCLUSION This case delivers a rare insight of pre-operative radiological imaging of an ectopic thyroid located in the liver.These findings can aid in narrowing down potential differential diagnosis when managing a patient with those subsequent findings.展开更多
作为巴塞罗那L＇ Hospitalet市都市再开发项目的一部分,费拉Porta Fira双子塔伫立于欧洲广场内。该基地位于巴塞罗那市和ElPrat国际机场之间,距离巴塞罗那ElPrat国际机场仅为8km,并构成了Barcelona Gran Via Fair会场的延伸部分,营造出...作为巴塞罗那L＇ Hospitalet市都市再开发项目的一部分,费拉Porta Fira双子塔伫立于欧洲广场内。该基地位于巴塞罗那市和ElPrat国际机场之间,距离巴塞罗那ElPrat国际机场仅为8km,并构成了Barcelona Gran Via Fair会场的延伸部分,营造出一个引导人们进入活动区域的门户。展开更多
Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,her...Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022.In this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal malaise.Many patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen 125.Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients.Pathological examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing assays.All patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment.Pathological examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.展开更多
家族企业可以说是全世界最常见的组织类型（La Porta et a1．，1999），对全球经济有实质性的影响（Morck and Yeung，2004），并且在各行各业都存在（Anderson et a1．，2003）。在中国，由于社会低规范程度的信息特征，使得家族制的...家族企业可以说是全世界最常见的组织类型（La Porta et a1．，1999），对全球经济有实质性的影响（Morck and Yeung，2004），并且在各行各业都存在（Anderson et a1．，2003）。在中国，由于社会低规范程度的信息特征，使得家族制的组织比市场和科层制还更有效率（陈凌，1998），形成中国有别于西方的家族化、地方化和网络化的市场经济制度特征（Boisot ＆ Child，1996）。展开更多
文摘Currently, nonselective β-blockers (NSBBs) are commonly used for the prevention of variceal bleeding in liver cirrhosis. The beneficial effects of NSBBs are primarily attributed to the reduction in cardiac output by blockade of β1 receptors and vasoconstriction of the splanchnic circulation by the blockade of β2 receptors. The prognostic value of occlusive portal vein thrombosis (PVT) in cirrhotic patients has been increasingly recognized. The most important risk factor for the development of PVT in liver cirrhosis is the decreased portal vein inflow velocity. Collectively, we propose that the use of NSBBs potentially increases the development of portal vein thrombosis by reducing portal vein inflow velocity. The hypothesis should be confirmed by prospective cohort studies, in which cirrhotic patients without prior PVT treated with and without NSBBs are enrolled, and the development of PVT during follow-up is compared between the two groups. Additionally, subgroup analyses should be performed according to the dosage of NSBBs and the reduction of portal inflow velocity after use of NSBBs.
文摘BACKGROUND: The treatment for primary tumor in the caudate lobe of the liver is difficult because of its unique anatomical location. This study was undertaken to improve operative techniques and results by a new anatomical method of caudate lobectomy. METHODS: Clinical data of 16 patients who had had caudate lobectomy for the liver from January 1996 to November 2004 were retrospectively analyzed. The third porta hepatis anatomical method was performed in all 16 patients. Operative time, intraoperative blood loss, postoperative complications were recorded. The 1-, 3-, and 5-year survival rates of 13 patients with caudate lobe carcinoma were followed up. Anatomical status, operative routes, operative procedures, liver blood supply were evaluated. RESULTS: The operation was successful in the 16 patients. The operative time was 255±70 minutes and blood loss 740±402 ml. None of the patients died from massive bleeding during the operation, nor did complications such as biliary fistula and liver failure occurred. In 13 patients with malignant tumor, 7 died from recurrence and metastasis of the tumor and the other 6 are still alive at the end of follow-up. One patient has survived for 6 years. The 1-, 3-, and 5-year survival rates in the 13 patients were 83.9%, 58.7% and 39.2%, respectively. CONCLUSION: Caudate lobectomy by the third porta hepatis anatomical method can improve operative effect and increase the resection probability for solitary tumor in the caudate lobe.
文摘OBJECTIVE: To study the correlation between human cholangiocarcinoma in the porta hepatis and the infection of hepatitis virus. METHODS: Immunohistochemistry was used to detect HBxAg and HCV-C protein in formalin-fixed and paraffin-embedded samples taken from 68 patients with cholangiocarcinoma in the porta hepatis. The findings were reviewed against the clinical records of the patients. RESULTS: Six patients (8.8%) were positive for HBxAg and 24 (35%) for HCV-C protein, respectively. One patient was positive for both HBxAg and HCV-C protein. There were statistically differences in the extent of differentiation, invasion, lymph-node metastasis, and treatment between the patients with cholangiocarcinomas in the porta hepatis with HB(C) V infection and those without infection. CONCLUSIONS: HB(C) V infection is correlated to the development of cholangiocarcinoma in the porta hepatis. The tumor with HB(C) V infection may have a higher malignancy biologically and poorer prognosis. HBxAg and HCV-C protein may play an important role in the pathogenesis of cholangiocarcinoma in the porta hepatis.
基金Supported by The Key Research and Development Program of Zhejiang Province,No.2019C03064Program Cosponsored by Province and Ministry,No.WKJ-ZJ-1926。
文摘BACKGROUND Ectopic thyroid is defined as a rare developmental anomaly where thyroid tissues are atypically found in locations other than its normal anatomical position:Anterolateral to the second,third,and fourth tracheal cartilages.An intemperate descent or a migration failure of the thyroid anlage results in sub-diaphragmatic thyroid ectopia,a sparse clinical entity.CASE SUMMARY This case portrays a 63-year-old female patient presenting with chronic abdominal discomfort at a local hospital whereby a computed tomography(CT)scan revealed a well-defined mass in the hepatic entrance.For further examination,the patient underwent a CT scan with contrast,magnetic resonance imaging(MRI),and CT-angiography(CTA)at our department.The CT scan showed a welldefined and high attenuated mass measuring 43 mm×38 mm in the hepatic entrance with calcification.The CTA revealed an additional finding:Blood supply to the mass from the right hepatic artery.MRI of the upper abdomen demonstrated a mass with mixed signal intensity on T1 and T2 weighted images in the hepatic entrance.The patient underwent surgery with resection of the mass which was sent for histopathology.Ectopic thyroid at the level of porta hepatis with nodules was the definitive diagnosis since histopathological report revealed presence of thyroid tissue in the resected liver mass.CONCLUSION This case delivers a rare insight of pre-operative radiological imaging of an ectopic thyroid located in the liver.These findings can aid in narrowing down potential differential diagnosis when managing a patient with those subsequent findings.
文摘作为巴塞罗那L＇ Hospitalet市都市再开发项目的一部分,费拉Porta Fira双子塔伫立于欧洲广场内。该基地位于巴塞罗那市和ElPrat国际机场之间,距离巴塞罗那ElPrat国际机场仅为8km,并构成了Barcelona Gran Via Fair会场的延伸部分,营造出一个引导人们进入活动区域的门户。
基金supported by the National key research and development program(2021YFC2301800)。
文摘Porta hepatis tuberculous lymphadenopathy(TL)is rare,and the clinical and imaging manifestations often mimic tumors.To offer a bet-ter understanding of porta hepatis TL and thus improve its diagnosis and treatment,here,we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022.In this study,porta hepatis TL occurred predominantly in women(70%),with a mean age of 43.1 years(range,16-70 years).Among the patients,60%were initially suspected of malignancy(metastatic lymphadenopathy and lymphoma).The clinical manifestations were nonspecific,such as fever and weight loss,without overt abdominal malaise.Many patients showed high concentrations of serum C-reactive protein,erythrocyte sedimentation rate,alkaline phosphatase,γ-glutamyl transpeptidase and carbohydrate antigen 125.Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients.Pathological examination confirmed the diagnosis in 90%of patients with caseous granulo-matous inflammation and positive results of Xpert MTB/RIF,quantitative real-time PCR and/or metagenomic next-generation sequenc-ing assays.All patients underwent antituberculosis therapy with a median treatment duration of 13.5 months(range,1-43 months).They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment.Pathological examination by biopsy remains the primary diagnostic method.A combination of the characteristic epidemiologic,clinical,imaging fea-tures and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.
文摘家族企业可以说是全世界最常见的组织类型（La Porta et a1．，1999），对全球经济有实质性的影响（Morck and Yeung，2004），并且在各行各业都存在（Anderson et a1．，2003）。在中国，由于社会低规范程度的信息特征，使得家族制的组织比市场和科层制还更有效率（陈凌，1998），形成中国有别于西方的家族化、地方化和网络化的市场经济制度特征（Boisot ＆ Child，1996）。
