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Common marginal donor liver mainly consists of fatty donor liver, elderly donor liver, small volume donor liver and liver graft from donation after cardiac death (DCD), etc. The application of marginal donor liver may resolve the severe shortage of donor liver to certain extent. Nevertheless, marginal donor liver yields a higher risk of ischemia-reperfusion injury (IRI) and causes more severe IRI than normal donor liver, which is a main cause for the failure of transplantation. In addition, oxidative stress is a major risk factor causing IRI of marginal donor liver. Therefore, how to mitigate oxidative stress and alleviate IRI of marginal donor liver has become a hot spot in clinical practice. Reactive oxygen species (ROS)-mediated oxidative stress occurs throughout the whole process of IRI. In this article, the role of oxidative stress in IRI of marginal donor liver transplantation and the ROS-targeted prevention and treatment were reviewed, aiming to provide reference for clinical practice.
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Objective:To explore the predictive factors of intestinal necrosis in acute mesenteric ischemia.Methods:This retrospective study enrolled 81 patients diagnosed as acute mesenteric vascular occlusive diseases in Zhongshan Hospital, Fudan University between Nov 2012 to May 2017. Univariate analysis and multivariate logistic regression analysis were used to identify predictive factors for intestinal necrosis.Results:In univariate analysis, the predictive factors of intestinal necrosis were peritoneal irritation sign ( P<0.001), white blood cell count ( P<0.001), serum albumin ( P=0.028), blood creatinine ( P=0.025), serum lactic acid ( P=0.008), D-dimer ( P=0.037), intestinal pneumatosis ( P=0.017), decreased or disappeared enhanced bowel wall ( P<0.001) and bowel loop dilation>2.5 cm ( P=0.01) on CT scan. According to multivariate logistic regression analysis, white blood cells ( OR=3.60, 95% CI: 1.51-5.47, P=0.007), lactic acid ( OR=4.80, 95% CI: 1.36-9.89, P=0.032), reduced or disappeared enhanced bowel wall ( OR=10.57, 95% CI: 1.82-61.10, P=0.008) were independent predictive factors of intestinal necrosis in patients with acute mesenteric ischemia. Conclusions:The predicted risk factors for intestinal necrosis in mesenteric ischemic diseases are increased white blood cells, elevated serum lactate levels, and reduced or disappeared enhanced bowel wall on CT scan.
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Hepatic ischemia-reperfusion injury (HIRI) is the main cause of liver damage and even multiple organ failure after complex liver surgery.When liver ischemia reperfusion occurs,the non-coding RNAs in the liver tissue is dysregulated and part of the non-coding RNAs with abnormal expression is involved in HIRI regulation.Non-coding RNAs to may be the intervention target for reducing HIRI.This article summarized the types and related functions of non-coding RNAs,the role of different non-coding RNAs in HIRI,and the interconnections between various non-coding RNAs in HIRI.
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Objective To explore the etiology and treatment of acute intestinal obstruction.Methods Clinical data of patients who underwent operation for acute intestinal obstruction in Zhongshan Hospital from May 2012 to May 2017 were collected and retrospectively analyzed.Results 721 patients were included and the ratio of males to females was 1.55 ∶ 1.There were 48.8％ in old-aged group and 51.1％ in young-middle-aged group.The most common causes of ileus included tumor in 376 cases (51.5％),adhesion in 168 cases (23.3％),hernia in 70 cases (9.7％),intraluminal obstruction in 42 cases (5.8％) and others in 79 cases.There was a significant difference between incarcerated hernia in elderly group and middle-young-aged group (4.6％ vs.15.1％,x2 =22.4,P ＜ 0.01).The length of hospitalized days in patients with tumor and incarcerated hernia in elderly group were significantly longer than young-middle-aged patients [(15.3±8.6)d vs.(13.4±6.3)d,t =-2.5,P＜0.05;(10.1 ± 6.7) d vs.(6.4 ± 2.9) d,t =-2.2,P ＜ 0.05].The length of hospitalized days by limited operation in patients with tumor were significantly shorter than those by emergency operation [(16 ± 12)d vs.(18 ± 24) d,t =-0.3,P ＞ 0.05].Conclusion Tumor and adhesion are the main causes of acute intestinal obstruction.Neoplastic bowel obstruction from small intestine or proximal colon requires emergency surgery.
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Cholangiocarcinoma is a malignant tumor originating from the epithelial cells of the bile duct, and its incidence and mortality rates keep increasing year by year. Unknown pathogenesis of this disease has led to the difficulties in early diagnosis and treatment. With the development of genetic engineering and bioinformatics, more and more studies have found that long non-coding RNA (lncRNA) is closely associated with the pathophysiological process of cholangiocarcinoma. This article summarizes the research advances in the role of lncRNA in mediating the biological behaviors of cell proliferation, apoptosis, metastasis, invasion, epithelial-mesenchymal transition, and drug resistance in cholangiocarcinoma, as well as the association of lncRNA with clinical features and prognosis.
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High-mobility group box B1 (HMGB1) is a DNA-binding protein widely distributed in eukaryotic cells. When tissue damage occurs, HMGB1 acts as an endogenous risk signal to activate the body’s immune system and mediate aseptic inflammatory response. Current research findings have shown that HMGB1 plays a key role in hepatic ischemia-reperfusion injury. This article summarizes the recent research advances in the proinflammatory role of HMGB1 in hepatic ischemia-reperfusion and HMGB1 as a target for the treatment of hepatic ischemia-reperfusion injury.
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High-mobility group box B1 (HMGB1) is a DNA-binding protein widely distributed in eukaryotic cells. When tissue damage occurs, HMGB1 acts as an endogenous risk signal to activate the body’s immune system and mediate aseptic inflammatory response. Current research findings have shown that HMGB1 plays a key role in hepatic ischemia-reperfusion injury. This article summarizes the recent research advances in the proinflammatory role of HMGB1 in hepatic ischemia-reperfusion and HMGB1 as a target for the treatment of hepatic ischemia-reperfusion injury.
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Objective To investigate the long-term effects of xanthine oxidase inhibitor,oxypurinol on myocardial contractility of post-ischemic heart failure in mice,and explore the underlying mechanism. Methods One hundred and twenty SV120 mice were randomly assigned into myocardial infarction control group,sham operation group and Oxy treatment group.Post-ischemic heart failure were induced by left anterior descending coronary artery ligation in myocardial infarction control group and Oxy treatment group,and mice in Oxy treatment group and sham operation group were orally administered with 0.5 mmol/L Oxy each day.Nine to eleven months after treatment,echocardiography was performed in all groups.Trabeculae from the right ventricle of mice were dissected for assessment of changes in excitation-contraction coupling.Sarcomere length was measured by laser diffraction.Intracellular free Ca~(2+) concentration([Ca~(2+)]_I)was detected with fluorescent dye Fura-2,which was microinjected iontophoretically into cells. Steady-state force-[Ca~(2+)]_I was achieved by addition of ryanodine and increasing the stimulus frequency to induce tetanization,and the relationship between myocardial contractility and intracellular Ca~(2+) transients was analysed.Besides,Western blotting was performed to determine the oxidation of myofilament proteins. Results Long-term oral administration of oxypurinol significantly improved myocardial contraction function and reduced ventricular wall thickness.Programming of excitation-contraction coupling was significantly improved,and maximal Ca~(2+) activated force(F_(max))in steady-state wag also significantly increased.Western blotting revealed the oxidative modification of actin in mice of Oxy treatment group was significantly inhibited compared with that of myocardial infarction control group. Conclusion Long-term treatment with Oxy improves the cardiac contraction function and boosts the cardiac force dramatically in post-ischemia heart failure.The increase in contraction is the result of increased myofilament Ca~(2+) responsiveness.Thus,antioxidant oxypurinol,by preventing oxidative damage to contractile proteins,can augment contraction with little changes in[Ca~(2+)]_I,represents new class of inotropic agents with advantages of reducing Ca~(2+) overload,and offers new promises in management of heart failure in the future.
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This study inquired into the formation of the "overlapping growth" of hepatoma cells through quantitative characterization on the growth of hepatoma cells in situ by means of morphological observation, Image Tool computer analytic system, statistical analysis as well as the experimental methods of cell mechanics and biochemistry. The results were as follows: (1) The ability of hepatoma cells to regulate cell morphological deformation was better than that of hepatic cells; (2) While we were using micropipette aspiration technique to suck the "overlapping growth plaque" of hepatoma cells, the "overlapping growth plaque" fell off from the substrate, leaving a blank area; (3) Integrin expression of hepatoma cells was more obvious than that of hepatic cells; (4) Fibronectin (Fn) down-regulated the integrin expression in the hepatoma cells cultured on the Fn coated surface, enhanced the cells' adhesion ability and morphological stability, but reduced the formation and aggregation of the round cells. These results indicated (1) The so-called overlapping growing area was actually formed by many closely arrayed and piled round cells; (2) The production of round cells may be caused by integrin abnormal expression and the effect on the hepatoma cells adhesion stability; (3) The formation of "overlapping growth plaque" in hepatoma cells is related to the round cells' congregation induced by the high frequency morphological transformation.
Subject(s)
Humans , Carcinoma, Hepatocellular , Metabolism , Pathology , Cell Adhesion , Cell Proliferation , Fibronectins , Metabolism , Image Processing, Computer-Assisted , Integrin beta Chains , Genetics , Liver Neoplasms , Metabolism , Pathology , Tumor Cells, CulturedABSTRACT
OBJECTIVE:To study whether Radix Inulae can replace Radix Aristolochiae as medicinal material.METHO_ DS:Comparison was made between Radix Inulae and Radix Aristolochiae in terms of plant resources,functions and indications,chemical compositions,pharmacologic actions,clinical applications,etc.by reviewing literature.RESULTS&CONCLUSIONS:Radix Inulae and Radix Aristolochiae were different in every aspect,thus the two can’t be replaced by each other as medicinal material.
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Objective To evaluate the value of endoscopy in etiological diagnosis and treatment of post - cholecystectomy syndrome. Methods Three hundred and twenty - six patients with post -cholecystectomy syndrome received ERCP. To reveral the etiology of post - cholecystectomy syndrome. For those with choledocholithiasis and those with papillary inflammatory stricture EST or EPBD were given those with papillary diverticulum and SOD EPBD were given, those with papillary tumor and hepatobiliary carcinoma EMBE were given and for those with bililary stricture in middle part of bile duct, purulent cholangitis, chloedocholithiasis(stones not excluded in one time)and bile leakage ENBD were used. Results ERCP was succeeded in 315 cases(96. 6%), 24 cases had no abnormal endoscopic findings view. 191 cases of choledocholithiasis 186 were totally get rid of stone after one to three times of opretion EST or EPBD was successfully given to 39 cases of 39 had papillary inflammatory stricture. Nine had papillary diverticulum which oppressed the papillary orifice, 7 had SOD, all of them were dealt with EPBD. Sixteen had stricture in the middle portion of bile duct, 11 of which were treated with ENBD. In 6 cases of papillary tumor and 5 hepatobiliary carcinoma patients jaundice improved significantly after received EMBE. Residual stones in cholecystic duct were seen in 4 cases. In 2 cases of bile leakage after cholecystectomy, ENBD was successfully carried out to avoid another operation. Complications were noted in 15 cases(4. 8%) of them. pancreatitis 11 cases, cholangitis 3 eases and hemorrhage of upper gastrointestinal tract one ease. Conclusion ERCP can find out the defenite cause of post - cholecystectomy syndrome at early stage and take corresponding endoscopic therapeutic measures. The complications of ERCP can be avoided by skillful operator.
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Objective To evaluate the feasibility and clinical value of endoscopic decompression with metal stent and colorectal tube for acute malignant colorectal obstruction. Methods With the aid of fluoroscopy, 26 cases with acute malignant colorectal obstruction were treated. Their obstructive sites consisted of rectum(n=14), sigmoid colon(n=8), descending colon(n=2) and transverse colon(n=1). Results In 18 of 26 patients, metal stents were successfully inserted (18/20, 90%), in 6 cases colorectal tube were successfully inserted(6/6, 100%), the total technical success rate was 92. 3% (24/26). Thereafter, 1 patient has no effect, 23 patients showed relief of obstructive symptoms within 1-2 days, the clinical success rate was 88.5% (23/26). Permanent metal stent placements were performed in 13 cases for palliative treatment, 10 underwent subsequent elective surgical resection after 7 ~ 10 days, without complications, such as anastomotic leakage and intraperitoneal infection. One case was failed in recurrent rectal carcinoma after resection, one case with widespread metastatic sigmoid colon carcinoma occurred colon perforation and received immediate Hartmann operation. Recurrent obstruction was detected in one patient with distal stent migration within 6 weeks, and second stent were placed to solve the problems. Stent occlusion from stool impaction was found in one patient 1 month after stent insertion, and was solved by endoscpic interventions. Conclusion Endoscopic decompression with metal stent and colorectal tube can alleviate the acute malignant colorectal obstructive sympotoms with high success rate. It is a simple, safe, effective and well tolerated method, and can obviate colostomy, prominently reduce trauma and agony, and increase the living quality of patients.
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Objective To improve the successful rate of endoscopic biliary drainage. Methods The experience of biliary drainage with duodenoscope for biliary obstruction from January 1998 to September 2001 was reviewed retrospectively. Endoscopic naso -biliary drainage (ENBD) , endoscopic retrograde biliary drainage (ERBD) and endoscopic metal biliary endoprothesis (EMBE) were performed in 242 cases, 43 cases and 35 cases respectively. Results Of 320 cases with biliary obstruction, 305 received successful drainage under endoscopy and 15 cases failed. Ten cases with ENBD failed but got successful drainage after modulating the site of naso-biliary tube or reinserting another tube. For 3 cases failed with ERBD, we chose plastic stents with appropriate length for 2 cases to achieve fluent drainage and percutaneous transhepatic biliary drainage (PTBD) was managed for another case after endoscopic management failed. For 2 cases with EMBE failed, one stent couldn' t exceed the tumor stricture site and one was obstructed by tumor implantion at one month after EMBE. Either a metal stent or a plastic stent was replaced through previous prothesis in these two failed cases. Conclusions The effect of endoscopic biliary drainage for biliary obstruction is definite. Mostly the drainage failure can be avoided as early as possible by analyzing the causes and taking some corresponding measures to correct it.
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AIM:To establish a HPLC fingerprint of Stellera chamaejasme L. from Inner Mongolia Region. METHODS: The RP-HPLC method was used with Akzonobel Kromasil C_ 18 (250 mm?4.6 mm, 5 ?m) the acetonitrile-0.5% phosphoric acid (gradient elution) was used as mobile phase, analytic time was 60 min, and detective wavelength was at 297 nm, the column temperature of 15℃ were adopted. RESULTS: The HPLC fingerprint of Stellera chamaejasme L. set up showed that 14 peaks were co-possessing in different sources. The results of method validation met technical standard of fingerprint, the similarities of Stellera chamaejasme L. were 0.9 to 1.0. CONCLUSION: The method is stable and reliable with a good reproducibility and provides a reference standard for the quality control of Stellera chamaejasme L. from Inner Mongolia Region.
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Objective To study the morphological changes of lymphatics in transplant tumor of mice. Methods H22 cells were inoculated under the armpit skin of KM mice. Tumor was obtained two weeks after inoculation. HE staining was used to observe the development of tumor. 5'-nase-alpase double staining was performed to observe blood vessels and lymphatics. Ultrastructures of lymphatics were observed with electron-microscopy. Results Tumor occurred in all the mice. Under microscope there was none of lymphatics in the center of the tumor, a few lymphatics and a lot of blood vessels could be seen in periphery of tumor. Under TEM damage of the organelles could be seen in the endothelial cell of lymphatics. Conclusion Neonatal lymphatics can be seen in transplant tumor caused by H22.