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Yang Q, Yi SH, Fu BS, Zhang T, Zeng KN, Feng X, Yao J, Tang H, Li H, Zhang J, Zhang YC, Yi HM, Lyu HJ, Liu JR, Luo GJ, Ge M, Yao WF, Ren FF, Zhuo JF, Luo H, Zhu LP, Ren J, Lyu Y, Wang KX, Liu W, Chen GH, Yang Y. [Clinical application of split liver transplantation: a single center report of 203 cases]. Zhonghua Wai Ke Za Zhi 2024; 62:324-330. [PMID: 38432674 DOI: 10.3760/cma.j.cn112139-20231225-00297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Objective: To investigate the safety and therapeutic effect of split liver transplantation (SLT) in clinical application. Methods: This is a retrospective case-series study. The clinical data of 203 consecutive SLT, 79 living donor liver transplantation (LDLT) and 1 298 whole liver transplantation (WLT) performed at the Third Affiliated Hospital of Sun Yat-sen University from July 2014 to July 2023 were retrospectively analyzed. Two hundred and three SLT liver grafts were obtained from 109 donors. One hundred and twenty-seven grafts were generated by in vitro splitting and 76 grafts were generated by in vivo splitting. There were 90 adult recipients and 113 pediatric recipients. According to time, SLT patients were divided into two groups: the early SLT group (40 cases, from July 2014 to December 2017) and the mature SLT technology group (163 cases, from January 2018 to July 2023). The survival of each group was analyzed and the main factors affecting the survival rate of SLT were analyzed. The Kaplan-Meier method and Log-rank test were used for survival analysis. Results: The cumulative survival rates at 1-, 3-, and 5-year were 74.58%, 71.47%, and 71.47% in the early SLT group, and 88.03%, 87.23%, and 87.23% in the mature SLT group, respectively. Survival rates in the mature SLT group were significantly higher than those in the early SLT group (χ2=5.560,P=0.018). The cumulative survival rates at 1-, 3- and 5-year were 93.41%, 93.41%, 89.95% in the LDLT group and 87.38%, 81.98%, 77.04% in the WLT group, respectively. There was no significant difference among the mature SLT group, the LDLT group and the WLT group (χ2=4.016, P=0.134). Abdominal hemorrhage, infection, primary liver graft nonfunction,and portal vein thrombosis were the main causes of early postoperative death. Conclusion: SLT can achieve results comparable to those of WLT and LDLT in mature technology liver transplant centers, but it needs to go through a certain time learning curve.
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Affiliation(s)
- Q Yang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - S H Yi
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - B S Fu
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - T Zhang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - K N Zeng
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - X Feng
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - J Yao
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - H Tang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - H Li
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - J Zhang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - Y C Zhang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - H M Yi
- Organ transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - H J Lyu
- Organ transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - J R Liu
- Organ transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - G J Luo
- Anesthesia & Surgery Center, the Third Affiliated Hospital of Sun Yat-sen University ,Guangzhou 510630
| | - M Ge
- Anesthesia & Surgery Center, the Third Affiliated Hospital of Sun Yat-sen University ,Guangzhou 510630
| | - W F Yao
- Anesthesia & Surgery Center, the Third Affiliated Hospital of Sun Yat-sen University ,Guangzhou 510630
| | - F F Ren
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - J F Zhuo
- Organ transplant Intensive Care Unit, the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - H Luo
- Anesthesia & Surgery Center, the Third Affiliated Hospital of Sun Yat-sen University ,Guangzhou 510630
| | - L P Zhu
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - J Ren
- Ultrasound Department of the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - Y Lyu
- Ultrasound Department of the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630
| | - K X Wang
- Organ Donation Department of the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
| | - W Liu
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - G H Chen
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
| | - Y Yang
- Liver Surgery & Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Organ Transplantation, Sun Yat-sen University, Guangdong Organ Transplantation Research Center, Guangdong Transplantation Medical Engineering Laboratory, Guangdong Provincial Key Laboratory of Liver Diseases, Guangzhou 510630
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Zhong XF, Luo GJ, Li WB, Chen XH, Wu Y, Chen YH, Ye JW, Bai J, Mo ZW, Chen XM. A series of naphthalenediimide-based metal-organic frameworks: synthesis, photochromism and inkless and erasable printing. Dalton Trans 2022; 51:14852-14857. [PMID: 36177919 DOI: 10.1039/d2dt02290g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Three new three-dimensional metal-organic frameworks were synthesized based on a naphthalenediimide derivative ligand, all of which exhibit photochromic behaviour due to the presence of the naphthalenediimide core. Interestingly, two of them possess significant colour changes under light, excellent stability, and appropriate photochromic lifetimes, thus showing potential for application in inkless and erasable printing media.
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Affiliation(s)
- Xiao-Feng Zhong
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Guo-Jun Luo
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Wen-Bin Li
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Xiong-Hai Chen
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Ying Wu
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Yi-Hui Chen
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Jia-Wen Ye
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Jie Bai
- Analysis and Test Center, Guangdong University of Technology, Guangzhou 510006, China
| | - Zong-Wen Mo
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China.
| | - Xiao-Ming Chen
- School of Biotechnology and Health Sciences, Wuyi University, Jiangmen, Guangdong 529020, PR China. .,MOE Key Laboratory of Bioinorganic and Synthetic Chemistry, School of Chemistry, Sun Yat-Sen University, Guangzhou 510275, China
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Guan B, Li XH, Wang L, Zhou M, Dong ZW, Luo GJ, Meng LP, Hu J, Jin WY. Gastric fundus splenosis with hemangioma masquerading as a gastrointestinal stromal tumor in a patient with schistosomiasis and cirrhosis who underwent splenectomy: A case report and literature review. Medicine (Baltimore) 2018; 97:e11461. [PMID: 29979450 PMCID: PMC6076098 DOI: 10.1097/md.0000000000011461] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
RATIONALE Splenosis is the heterotopic auto-transplantation of the splenic tissues. Gastric splenosis in a rare location mimics a gastrointestinal stromal tumor (GIST). Gastric splenosis with hemangioma has not been reported throughout the literature. PATIENT CONCERNS We report a case of a 74-year-old schistosomiasis cirrhosis splenectomy woman diagnosed with gastric fundus mass. Preoperative computed tomography and endoscopic ultrasonography revealed findings suggestive of a GIST. DIAGNOSES The mass located in the gastric fundus muscularis propria, measuring 3.9 × 2.8 × 2.4 cm with a dark red color, was removed by surgery. In the mass, a 1 × 1-cm red-purple nodule was also found. On microscopic examination, a well-formed splenic tissue divided into two compartments-white pulp and red pulp-separated by an ill-defined interphase known as the marginal zone. However, a nodule in the heterotopic spleen was mainly composed of larger thin-walled muscular vessels. The final diagnosis was gastric splenosis with hemangioma. INTERVENTIONS After discussion in a multidisciplinary conference, the patient was considered for a GIST resection under gastroscopy. In the process of peeling, the surface of the mucosal, submucosal, muscle layers and the tumor surface were diffusely oozing. The effect of electrocoagulation and hemostasis was extremely poor. Therefore, endoscopic surgery was arrested. After dealing with the patient's family, a combination of laparoscopic-gastroscope double-mirror surgery was decided in accordance with the principle of minimally invasive surgery to preserve the stomach. Owing to several adhesions and concealed the location of tumor, we stopped the double-mirror combination surgery plan. Considering the great possibility of a malignant GIST, we still decided to continue the traditional surgical resection. The tumor was then removed via surgery OUTCOMES:: The patient was favorable with healing and discharged on postoperative day 10. LESSONS Gastric splenosis with an associated hemangioma is the first well-documented case. Its pathogenesis may be direct implantation. Appropriate medical history taking and Tc-99 m heat-denatured RBC spleen scintigraphy (Tc-99MHDRS) are valuable for its diagnosis; however, pathology is the gold standard. Surgery is a reasonable treatment for gastric splenosis with hemangioma.
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Affiliation(s)
| | | | | | | | | | | | | | - Jun Hu
- Department of Hepatobiliary Surgery
| | - Wei-Yun Jin
- Department of Hematologic Oncology, Shanghai 6th People's Hospital Jinshan Branch, Shanghai, PR China
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Luo GJ, Luo M, Chen XF, Wang J, Chen XF, Bian Z, Guo Y, Wu XP. [Prevalence and risk factors of hypertension among residents of 30 years or above years old in Pengzhou city of Sichuan province]. Zhonghua Yu Fang Yi Xue Za Zhi 2016; 50:404-10. [PMID: 27141895 DOI: 10.3760/cma.j.issn.0253-9624.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the prevalence and risk factors of hypertension among residents in Pengzhou city of Sichuan province. METHODS Among 20 townships in Pengzhou city of Sichuan Province, 14 townships were selected using a clustered sampling based on the economic level and distance. The registered residents in the selected townships aged 30-79 years were recruited for a comprehensive survey from 2004 to 2007. A total of 55 687 residents (21 315 males and 34 372 females) were selected based on a face to face questionnaire interview and physical examination; the patient group included 14 151 residents with hypertension and the control group had 41 536 residents without hypertension were selected. Multivariate logistic regression model was used to investigate the influence factors for hypertension. OR (95%CI) values were calculated. Different levels of risk exposure factors were transformed into the risk scores using a statistical model. RESULTS The prevalence rate of hypertension was 25.41% among residents aged 30 years or above in Pengzhou (14 151/55 687), 28.95% (6 170/21 315) for male residents and 23.22% (7 981/34 372) for female residents. Multivaraite logistic regression analysis showed that main risk factors for hypertension in male residents were age, low educational level, widower, low household income, no medical insurance, no fresh fruits intake, high body mass index (BMI), high waist to hip ratio, and low physical activity, which was less than 3 metabolic equivalent of task (MET) level, among which the highest three riskswere (not including the social demographic characteristics) BMI≥28 kg/m(2), waist to hip ratio ≥0.90, and not consuming fresh fruits. OR (95% CI) values for these three key factors were 3.74 (3.27-4.28), 1.34 (1.24-1.44), and 1.27 (1.14-1.41), respectively. The corresponding risk scores for these factors were 2.993, 1.102, and 1.237, respectively. Main risk factors for hypertension in female residents were age, working hours, no medical insurance, fewer number of family members, no fresh fruits intake, smoking, never drinking tea, no dairy products intake, high BMI, highwaist to hip ratio and low physical activity, among which the highest three risks were (not including the social demographic characteristics) BMI ≥28 kg/m(2), MET level, and waist to hip ratio ≥0.85. OR (95% CI) values for these three key factors were 3.30 (3.02-3.60), 1.35 (1.22-1.51), and 1.33 (1.23-1.44), respectively. The corresponding risk scores for these factors were 2.390, 1.263, and 1.051, respectively. CONCLUSION The prevalence rate of hypertension among the residents over 30 years of age in Pengzhou city was 25.41%. The main risk factors were age, not consuming fresh fruits, high BMI, high waist to hip ratio, and low MET level.
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Affiliation(s)
- G J Luo
- Department of Chronic Diseases and Health Education, Pengzhou Center for Disease Control and Prevention, Pengzhou 611930, China
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