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Objective To investigate the changes in intestinal flora in patients with extrahepatic cholangiocarcinoma (ECC) and related influencing factors. Methods Fecal samples were collected from 16 patients with ECC who were hospitalized and treated in Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, from January to December 2020, and absolute quantitative bacterial 16S rRNA was used for sequencing. A comparison was made with 20 patients with common bile duct stones (CBDS group) and 10 healthy controls (normal group), and the three groups were compared in terms of the differences in intestinal flora and the association with clinical indices. A one-way analysis of variance was used for comparison of normally distributed data with homogeneity of variance between the three groups, the t -test was used for comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed data between the three groups, and the Nemenyi test was used for comparison between groups. The chi-square test or the Fisher's exact test were used for comparison of categorical data between the three groups, and a Spearman correlation analysis was used to investigate correlation. Results The ECC group had significantly higher levels of total bilirubin (TBil) and direct bilirubin (DBil) than the CBDS group and the normal group. The α diversity analysis showed that there were no significant differences in observed species, Chao1 Index, and Shannon Index between the three groups (all P > 0.05), while there were significant differences in Shannon Index and Simpson Index between the three groups. The ECC group had a similar species diversity to the normal group and a significantly greater species diversity than the CBDS group ( P < 0.05), and the CBDS group had a significantly greater species diversity than the normal group ( P < 0.05). The β diversity analysis showed that the structure of intestinal flora in the ECC group was significantly different from that in the normal group and the CBDS group ( P < 0.05). The analysis of the difference in bacterial composition showed that Prevotella , Lactobacillus , Megasphaera , and Sutterella were significantly enriched in the ECC group. The correlation analysis showed that Prevotella was negatively correlated with the use of antibiotics, acid inhibitors, and liver-protecting drugs, and Lactobacillus , Megasphaera , and Sutterella were positively correlated with TBil and DBil. Conclusion There is a significant change in intestinal flora in patients with ECC, which is closely associated with liver function and the use of drugs.
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Objective To analyze the relationship between preoperative serum sodium concentration and preoperative status of liver transplantation recipients and it's effect on early prognosis. Methods Retrospectively collected the clinical data of 281 patients underwent liver transplantation in First Affiliated Hospital of Zhengzhou University from January 2016 to September 2017. According to the preoperative serum sodium concentration, they were divided into hyponatremia group (< 130 mmol/L) 18 patients, normonatremia group (130-145 mmol/L)232 patients and hypernatremia group(> 145 mmol/L) 31 patients. The SPSS 21.0 statistical software was used to analyze the difference of preoperative MELD score, Child-Pugh score, postoperative survival rate and the incidence of graft dysfunction among three groups. Multivariate comparisons of measurement data were performed using analysis of variance. Pairwise comparisons between groups were performed using the LSD-t test. Chi-square tests were used to compare the count data sets. Results The preoperative MELD score was(19.27 ±7.35) scores, Child-Pugh score was(10.39±2.28) scores, serum creatinine concentration was(95.89 ± 49.40) μmol/L in hyponatremia group, the preoperative MELD score was(12.17土8.79) scores(P=0.001), Child-Pugh score was(8.50±2.68) scores (P =0.004) and serum creatinine was(66.07 ±24.13) μmol/L(P <0.05) in normonatremia group, the difference between two groups were statistically significant. There were no significant difference in the length of postoperative ICU stay and postoperative hospital stay among the three groups, there were no significant difference between the 30th and 90th postoperative survival rates and the incidence of graft dysfunction. Conclusions Hyponatremia is an indicator of poor preoperative status in liver transplantation recipients. Preoperative serum sodium concentration has no significant effect on early prognosis of liver transplantation.
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ObjectiveTo explore the role of HSP27 in hepatic ischemia-reperfusion (IR) injury and hepatic ischemic preconditioning (IP).MethodsMale C57BL/6 mice were randomly divided into 3 groups:control group (sham operation),IR group (only hepatic IR),rHSP27 + IR group (rHSP27 injection before IR).The extent of liver injury was evaluated among these 3 groups.Murine HSP27 was silenced by short hairpin RNA and mice were subjected to IR with or without IP after interfering succeeded.Serum ALT and AST levels,hepatic histological damages and mRNA expression levels of pro-inflammatory mediators (TNF-α,IL-1β and IL-6) were measured.Results Silencing hepatic HSP27 aggravated IR injury indicated by higher concentration of serum ALT and AST (P＜0.05),reinforced by severer histological damage and more expression of pro-inflammatory mediators (P＜0.05),while injection of rHSP27 or IP ameliorated hepatic IR injury.Western-blot showed HSP27 expression was significantly higher in IP group than sham group.Silencing HSP27 largely removed the IP-induced hepatoprotection,indicated by restoration of caspase-3 induction.ConclusionHSP27 is an essential endogenous defense of liver against IR injury.Hepatic ischemic preconditioning can improve subsequent IR injury via up-regulation of HSP27,which is related to HSP27-mediated reduction of apoptosis.
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ObjectiveTo investigate the possible mechanism of common bile duct ligation (CBDL) preconditioning alleviating subsequent renal ischemia/reperfusion injury.MethodsC57BL/6 mice was divided into 3 groups.In CBDL group,the common bile duct was transiently ligated at day 0 (d0),and recanalized after two days (d2) and two days later (d4). Unilateral renal ischemia/reperfusion injury was performed.Sham operation was done in Sham group at d0,then unilateral renal I/R was performed at d4. Control group was set as normal contrast. Total bilirubin (TB) was monitored.24 h after I/R (d5),we collected blood to detect creatinine (Cr),and the expression of heat-shock protein 27 (HSP-27) and endothelial nitric oxide synthase (eNOS) was monitored by Western blotting at d0,d2,d4,d5 four time points.ResultsAfter CBDL,TB fell to normal at d4.Cr levels in CBDL group were lower than in Sham group (P＜0.05),the protein expression levels of HSP-27 and eNOS were increased from d2 and sustained to d5 in CBDL group as compared with Sham group ( P ＜ 0.05 ).Conclusion CBDL preconditioning can obviously alleviate renal ischemia/reoerfusion injury in mice probably by up-regulating the expression of HSP-27 and eNOS.