Percutaneous transhepatic papillary ballon drainage(PTPBD)is a newly emerging interventional treatment modality for choledocholithiasis in China.Compared with other treatments,it has some advantages.Traditional Chines...Percutaneous transhepatic papillary ballon drainage(PTPBD)is a newly emerging interventional treatment modality for choledocholithiasis in China.Compared with other treatments,it has some advantages.Traditional Chinese medicine has been proven to have certain advantages in the treatment of choledocholithiasis,with reliable efficacy,few side effects,and a low recurrence rate.To standardize the clinical practice of choledocholithiasis,facilitate the application of PTPBD,and improve the diagnosis and treatment of integrative medicine,the Chinese College of Interventionalists organized multidisciplinary experts to discuss and formulate this consensus.This consensus aims to regulate the patient selection and technical process of PTPBD and the diagnosis and treatment scheme of integrative medicine.展开更多
Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to in...Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022.Methods:We investigated the overall status of HVPG technology in China-including hospital distribution,hospital level,annual number of cases,catheters used,average cost,indications,and current challenges by using online questionnaire.By counting the number and percentages of cases of these results,we hope to clarify the current status of HVPG measurements in China.Results:According to the survey,85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces.A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022,of which 2813 cases(56.4%)were measured alone.The average cost of HVPG measurement was 5646.8±2327.9 CNY.Of the clinical teams who performed the measurements(sometimes multiple per hospital),94.3%(82/87)used the balloon method,and the majority of the teams(72.4%,63/87)used embolectomy catheters.Conclusions:This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology.It is still necessary to continue promoting and popularizing this technology in the future.展开更多
Aims:Although the skeletal muscle index at the third lumbar vertebra(L3-SMI)is commonly utilized for the diagnosis of sarcopenia,the psoas muscle index at L3(L3-PMI)may serve as a reliable alternative indicator.This s...Aims:Although the skeletal muscle index at the third lumbar vertebra(L3-SMI)is commonly utilized for the diagnosis of sarcopenia,the psoas muscle index at L3(L3-PMI)may serve as a reliable alternative indicator.This study aims to investigate the application of the PMI in patients who have undergone transjugular intrahepatic portosystemic shunt(TIPS).Methods:This study included a cohort of 406 patients with cirrhosis who underwent TIPS between February 2016 and July 2022 across three medical centers in China.Clinical and imaging data,specifically L3-SMI and L3-PMI,were collected for these patients.The prognosis of the patients was assessed through re-examinations and telephone follow-ups,which extended up to 5 years.The diagnostic thresholds for sarcopenia,as defined by L3-PMI and L3-SMI,were established at 6.36 or 42.00 cm2/m2 for males and 3.92 or 38.00 cm2/m2 for females,respectively.Cox proportional hazards and Kaplan–Meier(K-M)analyses were employed to evaluate patient survival.Results:The findings indicated that both L3-PMI and L3-SMI before TIPS were independent risk factors for mortality.The results of the paired t-test demonstrated a significant increase in L3-PMI 1 month post-TIPS(5.11±1.81 vs.5.71±1.90 cm2/m2 ,p<0.001),whereas L3-SMI did not exhibit a significant increase until 6 months post-TIPS(45.45±9.41 vs.48.59±10.38 cm2/m2 ,p<0.001).Among these patients,191(47.0%)and 159(39.2%)were diagnosed with sarcopenia according to the L3-PMI and L3-SMI models,respectively.Patients identified as sarcopenic by both indicators demonstrated a significantly lower survival rate(L3-SMI model:hazard ratio[HR],1.913;95%confidence interval[CI],1.094–3.410;log-rank p=0.020;L3-PMI model:HR,1.867;95%CI,1.059–3.290;log-rank p=0.030).In sarcopenic patients,the reversal of sarcopenia associated with improved survival occurred 1 month after TIPS in the L3-PMI model(HR,2.675;95%CI,1.245–5.735;log-rank p=0.012),while a similar effect was not observed until 6 months post-TIPS in the L3-SMI model(HR,3.342;95%CI,1.477–7.560;logrank p=0.004).Conclusions:L3-PMI and L3-SMI demonstrate comparable efficacy in diagnosing cirrhosis-related sarcopenia.Furthermore,L3-PMI has the capacity to identify improvements in sarcopenia as early as 1 month following TIPS,thereby providing earlier insights into patient survival outcomes.展开更多
基金by the Program for Integrated Traditional Chinese and Western Medicine in Shandong Province of China(YXH2019ZXY007)Ji’nan Professionals Development Special Fund(20228118)+1 种基金Science and Technology Project of(Sinopec Group)Shengli Petroleum Administration Co.,Ltd(GKY2001)Science and Technology Project of Ji'nan Health Committee(2020-3-65).
摘要Percutaneous transhepatic papillary ballon drainage(PTPBD)is a newly emerging interventional treatment modality for choledocholithiasis in China.Compared with other treatments,it has some advantages.Traditional Chinese medicine has been proven to have certain advantages in the treatment of choledocholithiasis,with reliable efficacy,few side effects,and a low recurrence rate.To standardize the clinical practice of choledocholithiasis,facilitate the application of PTPBD,and improve the diagnosis and treatment of integrative medicine,the Chinese College of Interventionalists organized multidisciplinary experts to discuss and formulate this consensus.This consensus aims to regulate the patient selection and technical process of PTPBD and the diagnosis and treatment scheme of integrative medicine.
摘要Aims:Surveys and research on the applications of the hepatic venous pressure gradient(HVPG)are important for understanding the current status and future development of this technology in China.This article aimed to investigate the status of hepatic venous pressure gradient measurement in China in 2022.Methods:We investigated the overall status of HVPG technology in China-including hospital distribution,hospital level,annual number of cases,catheters used,average cost,indications,and current challenges by using online questionnaire.By counting the number and percentages of cases of these results,we hope to clarify the current status of HVPG measurements in China.Results:According to the survey,85 hospitals in China used HVPG technology in 2022 distributed across 29 provinces.A total of 4989 HVPG measurements were performed in all of the surveyed hospitals in 2022,of which 2813 cases(56.4%)were measured alone.The average cost of HVPG measurement was 5646.8±2327.9 CNY.Of the clinical teams who performed the measurements(sometimes multiple per hospital),94.3%(82/87)used the balloon method,and the majority of the teams(72.4%,63/87)used embolectomy catheters.Conclusions:This survey clarified the clinical application status of HVPG in China and confirmed that some medical institutions in China have established a foundation for this technology.It is still necessary to continue promoting and popularizing this technology in the future.
基金the approval of Ethics Committees of Union Hospital Tongji Medical College,Huazhong University of Science and Technology(No.2022-S207)The First Affiliated Hospital of Soochow University(No.2022412)The First Hospital of Shanxi Medical University(No.2022KK094).
摘要Aims:Although the skeletal muscle index at the third lumbar vertebra(L3-SMI)is commonly utilized for the diagnosis of sarcopenia,the psoas muscle index at L3(L3-PMI)may serve as a reliable alternative indicator.This study aims to investigate the application of the PMI in patients who have undergone transjugular intrahepatic portosystemic shunt(TIPS).Methods:This study included a cohort of 406 patients with cirrhosis who underwent TIPS between February 2016 and July 2022 across three medical centers in China.Clinical and imaging data,specifically L3-SMI and L3-PMI,were collected for these patients.The prognosis of the patients was assessed through re-examinations and telephone follow-ups,which extended up to 5 years.The diagnostic thresholds for sarcopenia,as defined by L3-PMI and L3-SMI,were established at 6.36 or 42.00 cm2/m2 for males and 3.92 or 38.00 cm2/m2 for females,respectively.Cox proportional hazards and Kaplan–Meier(K-M)analyses were employed to evaluate patient survival.Results:The findings indicated that both L3-PMI and L3-SMI before TIPS were independent risk factors for mortality.The results of the paired t-test demonstrated a significant increase in L3-PMI 1 month post-TIPS(5.11±1.81 vs.5.71±1.90 cm2/m2 ,p<0.001),whereas L3-SMI did not exhibit a significant increase until 6 months post-TIPS(45.45±9.41 vs.48.59±10.38 cm2/m2 ,p<0.001).Among these patients,191(47.0%)and 159(39.2%)were diagnosed with sarcopenia according to the L3-PMI and L3-SMI models,respectively.Patients identified as sarcopenic by both indicators demonstrated a significantly lower survival rate(L3-SMI model:hazard ratio[HR],1.913;95%confidence interval[CI],1.094–3.410;log-rank p=0.020;L3-PMI model:HR,1.867;95%CI,1.059–3.290;log-rank p=0.030).In sarcopenic patients,the reversal of sarcopenia associated with improved survival occurred 1 month after TIPS in the L3-PMI model(HR,2.675;95%CI,1.245–5.735;log-rank p=0.012),while a similar effect was not observed until 6 months post-TIPS in the L3-SMI model(HR,3.342;95%CI,1.477–7.560;logrank p=0.004).Conclusions:L3-PMI and L3-SMI demonstrate comparable efficacy in diagnosing cirrhosis-related sarcopenia.Furthermore,L3-PMI has the capacity to identify improvements in sarcopenia as early as 1 month following TIPS,thereby providing earlier insights into patient survival outcomes.