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| 1 | Necessity and indications of invasive treatment for Budd-Chiari syndrome显示文摘BACKGROUND:The development of collaterals in Budd-Chiari syndrome has been described and these collaterals play an important role in the presentation of this disease.These collaterals are diagnostic and their use in management strategy has never been evaluated.This study aimed to investigate the indications,feasibility and necessity of invasive treatment for patients with Budd-Chiari syndrome and to determine whether such a strategy is necessary for optimal management.METHODS:Twenty-nine patients who had been treated at our unit were enrolled in this study.Based on physical and biochemical examination,and hemodynamic compensation by collaterals,18 patients underwent radiological intervention (group A),while the other 11 had no invasive treatment (group B).The related hemodynamic parameters were acquired when percutaneous angiography was performed.RESULTS:In group A,all patients underwent successfully inferior vena cava (IVC) balloon angioplasty with or without stenting.Four patients also underwent hepatic vein angioplasty.In these patients,the mean IVC pressure before and after treatment was statistically different (29.3±9.2 vs 15.1±4.6 mmHg,P<0.01).The mean IVC pressure was much lower in group B than in group A (12.9±2.4 vs 29.3±9.2 mmHg,P<0.01),but there was no difference from that of the patients after radiological treatment (12.9±2.4 vs 15.1±4.6 mmHg,P>0.05).Median follow-up was 32.3 months (mean 21.3 months;range 3-61 months).In the course of follow-up,the patients in group A survived with good systemic status except for re-stenosis in one patient who underwent re-canalization of the IVC.In group B,10 patients had good systemic status except one patient who had a meso-caval shunt because of deterioration.CONCLUSIONS:The rationale of 'early diagnosis and early treatment' is not suitable for all patients with Budd-Chiari syndrome.Satisfactory survival can be achieved in some patients without invasive treatment,who are completely compensated by rich collaterals.Nonetheless,a positive treatment procedure should be performed if the patient's situation worsens in the course of regular follow-up. | Department of General Surgery (Fu Y,Sun YL,Ma XX,Xu PQ,Feng LS,Tang Z and Luo CH),Institute of Hepatic Vascular Disease (Sun YL),Department of Radiological Intervention (Guan S and Wang ZW),First Affiliated Hospital,Zhengzhou University School of Medicine,Zhengzhou 450052,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，3： | 10 |
| 2 | Survival factors after resection of small hepatocellular carcinoma显示文摘Early resection of hepatocellular carcinoma is a key measure to prolong the survival of patients. This study was designed to summarize our experience in surgical resection of small hepatocellular carcinoma (HCC), and to analyze the factors influencing the postoperative survival of patients. METHODS:The clinicopathologic data of 105 patients with small HCC after resection from 1986 through 2003 were analyzed ; the patients had been followed up for more than half a year (median 33 months). Nine clinicopathologic factors, preoperative α-fetoprotein (AFP) level, liver cirrhosis, Child-Pugh score, tumor size (>2cm vs.≤2 cm) and number (single vs. multiple), capsule formation, portal vein tumor thrombi (PVTT), Edmondson tumor grade and surgical method, were analyzed by the log-rank test and the Cox proportional harzards model analysis. RESULTS:The cumulative 1-,3- and 5-year survival rates after the operation were 86.5%, 70.3% and 55.2%, respectively, and the 1-, 3- and 5-year disease-free survival rates were 78%, 58. 9% and 45. 6%, respectively. One patient died from esophagogastric varices hemorrhage in 2 weeks after reoperation. Thirty-six patients had intrahepatic recurrence or metastasis postoperatively and 34 patients died. The Kaplan-Meier method and the Cox proportional harzards model analysis indicated that poor Child-Pugh score, tumor more than 2 cm in diameter, PVTT and multiple lesions (including satellitic lesions) were adverse factors affecting postoperative survival. The Cox proportional harzards model analysis indicated that tumor size, PVTT and multiple lesions were the factors influencing postoperative disease-free survival. CONCLUSIONS:Limited hepatectomy with a margin more than 1 cm is an appropriate surgical approach. Adverse preoperative Child-Pugh score and postoperative intrahepatic recurrences are the main factors leading to the death of patients with small HCC. | Departments of Surgical Oncology (Wu FS, Zhao WH, Ma ZM, Teng LS and Wang M) and General Surgery ( Liang TB and Zheng SS) , First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 5 |
| 3 | Rotavirus glyeoprotein NSP4 is a modulator of viral transcription in the infected cell 显示文摘 | Silvestri LS Tortorici MA Patton JT | 2005 | J Virol2005，79，15： | 1 |
| 4 | Pharyngeal airway vol- ume and shape from cone-beam computed tomography:relationshipto facial morphology显示文摘 | Grauer D Cevidanes LS Styner MA | 2009 | Am J Orthod Dentofacial Orthop2009，136，6： | 1 |
| 5 | Identification of an atyp- ical Grb2 carboxyl - terminal SH3 domain binding site in Gab docking proteins reveals Grb2 - dependent and - independent re- cruitment of Gabl to receptor tyrosine kinases显示文摘 | Lock LS Royal I Nanjokas MA | 2000 | J Biol Chem2000，275，31： | 1 |
| 6 | Gene expression in human neural stem cells: effects of leukemia inhibitory factor显示文摘 | Wright LS Li J Caldwell MA | 2003 | J Neurochem2003，86，1： | 1 |
| 7 | Na+-ATPase inspontaneous hypertensive rats:Possible AT(1) receptor target in thedevelopment of hypertension 显示文摘 | Queiroz-Madeira EP Lara LS Wengert MA | 2010 | Biochim Biophys Acta:Biomembranes2010，1798，3： | 1 |
| 8 | Cranial ultrasound in metabolic disorders presenting in the neonatal period:characteristic features and comparison with Mr imaging显示文摘 | Leijser LM de Vries LS Rutherford MA | 2007 | AJNR Am J Neuroradiol2007，28，7： | 1 |
| 9 | High - dose steroids, ursodeoxycholic acid, and chronic intravenous anti- biotics improve bile flow after Kasaiprocedure in infants with biliary atresia 显示文摘 | Meyers RL Book LS O' Gorman MA | 2003 | J Pediatr Surg2003，38，3： | 1 |
| 10 | Truncation by Glu180 nonsense mutation results in complete loss of slow skeletal muscle troponin T in a lethal nemaline myopathy显示文摘 | Jin JP Brotto MA Hossain MM Huang QQ Brotto LS Nosek TM | 2003 | J Biol Chem2003，278，26： | 1 |
| 11 | Identification of an atypical Grb2 earboxyl-terminal SH3 domain binding site in Gab docking proteins reveals Grb2-dependent and-independent recruitment of Gabl to receptor tyrosinekinases显示文摘 | Lock LS Royal I Naujokas MA | 2000 | J Biol Chem2000，275，31： | 1 |
| 12 | Quantitative analysis of retinal vessel attenuation in eyes with retinitis pigmentosa显示文摘 | Ma Y Kawasaki R Dobson LP Ruddle JB Kearns LS Wong TY | | 0，，7： | 1 |
| 13 | An osteoconductive col agen/hyaluronate matrix for bone regeneration显示文摘 | Liu LS Thompson AY Heidaran MA | | 0，，12： | 1 |
| 14 | Correlations of recognition memory performance with expression and methyla- tion of brain-derived neurotrophic factor in rats显示文摘 | Munoz PC Asp6 MA Contreras LS | 2010 | Biol Res2010，43，2： | 1 |
| 15 | The model of the clinical practice of emergency medicine 显示文摘 | Hockberger RS Binder LS Graber MA | 2001 | Annals of Emergency Medicine2001，37，： | 1 |
| 16 | The relationship between reduction in periodontal inflammation and diabetes control:A report of 9 cases 显示文摘 | Manwell MA Newbold D | 1992 | J Periodontol1992，63，： | 1 |
| 17 | Sex-based differences in serum cardiac troponin Ⅰ, a specific marker formyocardial injury, after cardiac surgery显示文摘 | Schwarzenberger JC Sun LS Pesce MA | 2003 | Crit Care Med2003，31，3： | 1 |
| 18 | Further development and validation of scoliosis research society (SRS) outcomes instrument显示文摘 | Asher MA Min LS Burton DC | 2000 | Spine2000，25，18： | 1 |
| 19 | Gene expression in human neural stem cells: effects of leukemia inhibitory factor显示文摘 | Wright LS Li J Cald well MA | 2003 | Neurochem2003，86，1： | 1 |
| 20 | Sesquiterpene lactones from lxeris sonchifolia显示文摘 | Ma JY Wang ZT Xu LS | 1998 | Phtochemistry1998，48，1： | 1 |
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