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( Li-yang Sun ),( Jiong-jie Yu ),( Ju-dong Li ),( Xin-fei Xu ),( Jia-he Wang ),( Bing Quan ),( Wen-tao Yan ),( Feng Shen ),( Chao Li ),( Lei Liang ),( Tian Yang ) 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Surgical site infection (SSI) is a common postoperative complication and associated with an increased morbidity, hospital stay, and overall cost. The aim of the present study was to identify risk factors for SSIs after hepatic resection based on a large single-center cohort. Methods: A retrospective study was conducted of 6,132 patients who underwent liver resection without concomitant biliary reconstruction or gastrointestinal procedures between 2014 and 2016 at the largest hepatic center in China. The occurrences of SSI, classified as incisional SSI and organ/space SSI within 30 days after operation were investigated. Patient- and surgical-related risk variables were collected using standardized data collection form. A likelihood ratio forward regression model was used to assess the independent association of risk factors with SSI. Results: SSI developed in 587 patients (9.6%), including superficial/deep incisional SSI in 357 patients (5.8 %), and organ/ space SSI in 304 patients (5.0 %). Multivariate logistic regression analysis showed that obesity, diabetes mellitus, ASA score ≥ 2, liver cirrhosis, re-hepatectomy, hepatoliathiasis, and intraoperative blood transfusion were independent risk factors of overall SSI. However, incisional and organ/space SSI differed from each other with respect to risk factors. Among a variety of risk factors, hepatolithiasis, liver cirrhosis, and intraoperative blood transfusion were consistently associated with both incisional and organ/space SSI. Conclusions: SSI is a common complication after liver resection, and more caution should be taken in patients with hepatolithiasis or liver cirrhosis. Prevention strategies focusing on factors associated with SSI is necessary in order to reduce SSI after liver resection.
( Ju-dong Li ),( Xin-fei Xu ),( Jiong-jie Yu ),( Jia-he Wang ),( Li- Yang Sun ),( Wen-tao Yan ),( Bing Quan ),( Jian-hong Zhong ),( Yi-sheng Huang ),( Ya-hao Zhou ),( Ting-hao Chen ),( Hong Wang ),( W 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: Serum prealbumin is more sensitive to profile nutritional status and liver function than albumin, which could hardly be affected by infusion supplement. This study aims: to identify the relationship between preoperative prealbumin level and the long-term prognosis after curative resection of hepatocellular carcinoma (HCC). Methods: Patients undergone HCC curative resection between 2001 and 2014 at six institutions in China were enrolled. By using 170 mg/dl as cut-off value of serum prealbumin level, these patients were divided into the low and normal preoperative prealbumin groups. The overall survival (OS) and recurrence-free survival (RFS) were analyzed and compared. Univariable and multivariable Cox-regression analyses were performed to identify predictive factors of OS and RFS. Results: Among 1,483 patients, 437 (29.5%) had a low prealbumin level within a week before surgery. The 1-, 3-, and 5-year OS and RFS rates of patients in the low prealbumin group were 83.8, 57.0, and 31.1%, and 67.0, 39.8, and19.9%, respectively, which was significantly poorer than those in the normal group (93.0, 75.5, and 42.6%, and 77.0, 56.4, and 28.4%, both P<0.001). Multivariable analyses revealed that preoperative prealbumin level, but not albumin level, was an independent predictor of OS (HR, 1.789; 95% CI: 1.544 -2.072, P<0.001) and RFS (HR, 1.420; 95% CI: 232-1.636, P<0.001). Conclusions: Preoperative prealbumin level is useful for predicting long-term prognosis in patients undergoing liver resection for HCC. Prealbumin may be suitable to displace albumin, yielding to an updated Child-Pugh grade for accessing liver function.
Ling-Ling Xie,Ren-Xi Gong,Hao-Ze Zhuo,Jiong-Quan Wei 대한전기학회 2011 Journal of Electrical Engineering & Technology Vol.6 No.4
An investigation of the mechanism of period-doubling bifurcation in a voltage mode controlled buck-boost converter operating in discontinuous conduction mode is conducted from the viewpoint of nonlinear dynamical systems. The discrete iterative model describing the dynamics of the close-loop is derived. Period-doubling bifurcation occurs at certain values of the feedback factor. Results from numerical simulations and experiments are provided to verify the evolution of perioddoubling bifurcation, and the results are consistent with the theoretical analysis. These results show that the buck-boost converters exhibit a wide range of nonlinear behavior, and the system exhibits a typical period-doubling bifurcation route to chaos under particular operating conditions.
Xie, Ling-Ling,Gong, Ren-Xi,Zhuo, Hao-Ze,Wei, Jiong-Quan The Korean Institute of Electrical Engineers 2011 Journal of Electrical Engineering & Technology Vol.6 No.4
An investigation of the mechanism of period-doubling bifurcation in a voltage mode controlled buck-boost converter operating in discontinuous conduction mode is conducted from the viewpoint of nonlinear dynamical systems. The discrete iterative model describing the dynamics of the close-loop is derived. Period-doubling bifurcation occurs at certain values of the feedback factor. Results from numerical simulations and experiments are provided to verify the evolution of perioddoubling bifurcation, and the results are consistent with the theoretical analysis. These results show that the buck-boost converters exhibit a wide range of nonlinear behavior, and the system exhibits a typical period-doubling bifurcation route to chaos under particular operating conditions.