Puerarin alleviates lipopolysaccharide-induced acute kidney injury in mice by modulating the SIRT1/NF-κB pathway / 南方医科大学学报

OBJECTIVE@#To investigate the role of the SIRT1/NF-κB pathway in mediating the effect of puerarin against lipopolysaccharide (LPS)-induced acute kidney injury (AKI).@*METHODS@#Fifteen BALB/C mice were randomized into control group, LPS group and puerarin treatment group, and in the latter two groups, the mice were given an intraperitoneal injection of LPS (5 mg/kg), followed by daily injection of normal saline for 3 days or injection of puerarin (25 mg/kg) given 1 h later and then on a daily basis for 3 days. On day 5 after modeling, the kidney tissues were taken for histological observation and detection of cell apoptosis. The renal function indexes including urea nitrogen (BUN), serum creatinine (Scr) and kidney injury molecule 1 (KIM-1) and the levels of tumor necrosis factor (TNF-α) and interleukin 1β (IL-1β) were measured, and the expressions of SIRT1 and NF-κB-p65(acetyl K310) in the renal tissues were detected.@*RESULTS@#Intraperitoneal injection of LPS caused obvious glomerular capillary dilatation, hyperemia, renal interstitial edema, and renal tubular epithelial cell swelling and deformation in the mice. The mouse models of LPS-induced AKI also showed significantly increased renal tubular injury score and renal cell apoptosis (P < 0.01) with increased serum levels of BUN, Scr, KIM-1, TNF-α and IL-1β (P < 0.01), enhanced renal expressions of TNF-α, IL-1β and NF-κB p65(acetyl K310) (P < 0.01) and lowered renal expression of SIRT1 (P < 0.05). Treatment with puerarin effectively alleviated LPS-induced renal interstitial edema and renal tubular epithelial cell shedding, lowered renal tubular injury score (P < 0.01) and renal cell apoptosis rate (P < 0.01), and decreased serum levels of BUN, Scr, KIM, TNF-α and IL-1β (P < 0.01). Puerarin treatment significantly reduced TNF-α, IL-1β and NF-κB p65 (acetyl K310) expression in the renal tissue (P < 0.05) and increased SIRT1 expression by 17% (P < 0.05) in the mouse models.@*CONCLUSION@#Puerarin can effectively alleviate LPS-induced AKI in mice possibly by modulating the SIRT1/NF-κB signaling pathway.

FOLFIRINOX in treatment of pancreatic cancer: a single-institutional experience / 中华肝胆外科杂志

Objective:To review the clinical efficacy and safety of the FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, fluorouracil) regimen in treatment of pancreatic cancer.Methods:The clinical data of 31 patients with pancreatic cancer who were treated with the FOLFIRINOX regimen from July 2016 to December 2019 at the Department of General Surgery, China-Japan Friendship Hospital were retrospectively analyzed. For the 20 males and 11 females who were enrolled into this study, their age ranged from 29 to 80 years (mean 56.9 years). The FOLFIRINOX regimen was used as neoadjuvant therapy in 12 patients, postoperative therapy in 10 patients with liver-metastases, and postoperative adjuvant therapy in 9 patients (as second-line chemotherapy in 7 patients and as first-line chemotherapy in 2 patients). The clinical efficacy and adverse reactions of chemotherapy were evaluated.Results:In this study, 8 patients received the modified FOLFIRINOX regimen. Of the remaining 23 patients who received the standard FOLFIRINOX regimen, 10 (43.3%) were converted to the modified regimen because of adverse events. On clinical efficacy evaluation after neoadjuvant therapy: 5 patients achieved partial remission (PR), 3 stable disease (SD) and 4 progression disease (PD). The disease control rate (DCR) was 66.7% (8/12). For 10 patients got remission of abdominal pain, 5 patients underwent surgical resection. For the 10 patients with liver-metastases, 6 achieved PR, 1 SD, 3 PD. For 7 patients got disease control. For 8 patients had remission of abdominal pain, 1 patient underwent surgical resection. For the 7 patients who received second-line chemotherapy, 2 achieved PR and 5 PD. No tumor recurrence or metastases were found in the two patients after the first-line chemotherapy. Adverse events above grade three in all the patients included neutropenia in 12 patients (38.7%), leukopenia in 7 patients (22.6%) and thrombocytopenia in 1 patient (3.2%).Conclusions:The FOLFIRINOX regimen was efficacious with a high DCR rate and controllable adverse events. Balancing its efficacy and safety showed this regimen to be beneficial to patients with pancreatic cancer.

Laparoscopic partial splenectomy for splenic solid lesions / 中华普通外科杂志

Objective To analyze the safety and clinical effects of laparoscopic partial splenectomy for splenic solid benign lesions.Methods Retrospective analysis was made on patients with splenic solid benign tumor admitted from Jan 2015 to Feb 2017.Results 6 patients (4 males,2 females) underwent successful partial splenectomy for splenic tumors.Mean patient age was 44.7 years (range,28-58 years).5 patients were diagnosed by wellness examinations,1 patient had abdominal discomfort.The diameter of tumors ranged from 5.0 to 8.3 cm.Tumors were located in the superior lobes in 2 cases and the others were located in the inferior lobes.The operation times were 120-240 min and intraoperative blood loss was 50-1 400 ml (mean,375 ml).Laparoscopic procedure was successful in all patients without major complications.Postoperative pathology showed hemangioma in 5 cases and hemangioendothelioma in one patient.After 3 to 28 months follow-up no patients experienced recurrence.Conclusions Laparoscopic partial splenectomy is safe and effective in patients with focal benign splenic lesion that was located at the edge of the spleen or in the upper or lower pole of the spleen.

Surgical treatment for giant liver hemangioma: an expeience on 119 cases / 中华普通外科杂志

Objective To summarize the experience of surgical treatments for giant liver hemangioma.Methods A retrospective study was made on the clinical data of patients with liver hemangioma larger than 10 cm in diameter,which were divided into two groups (10-＜ 20 cm,88 cases,≥ 20 cm,31 cases).Data included age and gender,presentation,treatment methods,peri-operative indexes,and complications.Results All patients complained symptoms,the average diameter was (16 ± 7) cm.There were 23,7,and 17 cases respectively with anemia,thrombocytopenia and hypofibrinogenemia,all were more often seen in ≥20 cm group (P ＜ 0.001).Five patients were diagnosed as Kasabach-Merritt syndrome in ≥20 cm group.Patients in ≥20 cm group also had greater rates of compression of the porta hepatis (P ＜ 0.001).Patients in ≥ 20 cm group were treated more often by hepatic resections,while enucleations was often done in 10-＜20 cm group.The ≥20 cm group had more blood loss (P ＜0.001)and autologous transfusion (P ＜ 0.001),greater rates of blood transfusion (P ＜ 0.001).There was no significant difference on morbidity between the two groups (P =0.194).Conclusions For giant liver hemangioma both enucleation and hepatic resection could be completed safely in experienced hands.

Laparoscopic surgery for giant liver hemangiomas: a report of 40 patients / 中华肝胆外科杂志

Objective To analyze the clinical experience of laparoscopic surgery for giant liver hemangiomas.Methods The clinical data of 40 patients who underwent laparoscopic surgery for giant liver hemangiomas from August 2012 to January 2018 in the China-Japan Friendship Hospital were retrospectively analyzed.The diameters of the liver hemangiomas were more than 10 cm for all the patients.The liver functions of all the patients were Child-Pugh class A.The follow-up was up to the end of February 2018.Results Laparoscopic treatment of giant liver hemangioma was successfully performed in 37 patients.Three patients were converted to open hepatectomy.The mean diameter of the giant liver hemangiomas was (10.8± 1.3) cm (ranged 10.0～15.0 cm).The mean operative time for laparoscopic therapy was (154.7±68.0) min (range 70～ 390 min).The mean intraoperative blood loss was 200 (100 ～ 400) ml.20 patients received autologous blood transfusion.Of these 2 patients received in addition allogeneic blood transfusion.The postoperative hospital stay was (6.9t2.0) days (range 4～14 days).Postoperative complications occurred in 3 patients (8.1％).Two patients developed postoperative pleural effusion and one pelvic effusion.Two patients responded well to puncture drainage and one to conservation management.There was no postoperative hemorrhage,bile leakage or air embolism.All patients were followed-up and no liver hemangioma recurrence was detected.Conclusion Laparoscopic surgery was a safe and efficacious procedure in selected patients with giant liver hemangioma.

Analysis of primary site and pathology on 903 patients with neuroendocrine neoplasms / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the primary site and pathological feature of neuroendocrine neoplasm (NEN), especially the NEN of digestive system.</p><p><b>METHODS</b>Clinicopathological data of NEN patients at China-Japan Friendship Hospital from January 2012 to December 2016 were retrospectively analyzed. Tumor primary sites were summarized. Association between tumor site and pathological grading in gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN) was examined.</p><p><b>RESULTS</b>There were a total of 903 cases of NEN. Sites of primary tumor included the digestive system in 699 cases(77.4%), the thorax(including lung, thymus and mediastinum) in 87 cases(9.6%), other sites in 60 cases (6.6%), unknown in 57 cases(6.3%). Among 699 GEP-NEN cases, the primary sites included the stomachin in 207 cases (29.6%), pancreas in 201 (28.8%), rectumin in 185 (26.5%), duodenum in 43(6.2%), jejunum and ileum in 18(2.6%), appendix in 15 (2.1%), gallbladder in 11(1.6%), esophagus in 10(1.4%), and the colon in 9 cases (1.3%). Pathologically, the tumor grading was neuroendocrine tumor (NET) G1 in 336 cases(48.1%), NET G2 in 203 cases (29.0%), neuroendocrine carcinoma (NEC) G3 in 139 cases (19.9%). All the esophagus NEN(10/10), most gallbladder NEN(9/11) and colon NEN(6/9) were poorly-differentiated NEC (G3), while all appendix NEN(15/15), most stomach NEN(147/207, 71.0%), pancreas NEN (156/201, 77.6%), rectum NEN (169/185, 91.4%), duodenum NEN (31/43, 72.1%), jejunum and ileum NEN(16/18, 88.9%) were well-differentiated NET G1 or G2.</p><p><b>CONCLUSIONS</b>The most common primary site of NEN is the digestive system. The stomach, pancreas and rectum are most common primary sitesof GEP-NEN. Difference in pathological grading is quite greatin different primary sites of GEP-NEN. Most NENs fromesophagus, colon and gallbladder are poorly-differentiated NEC.</p>

Risk factors of massive blood loss during resection of giant liver hemangioma / 中华肝胆外科杂志

Objective To evaluate the risk factors of massive blood loss in resection of giant liver hemangioma.Method The clinical data of 141 patients who underwent giant liver hemangioma resection were retrospectively studied.These data included general physical condition,laboratory tests,radiologic findings,and various surgical parameters.The patients were divided into the massive blood loss group (＞ 1 000 ml,n =27) and the minor blood loss group (≤1 000 ml,n =114).Logistic regression was performed to determine the risk factors of intraoperative massive blood loss.Results The average diameter of the liver hemangioma was significantly greater in the massive blood loss group than that in the minor blood loss group [(21.7 ± 8.5) cm vs.(14.1 ± 5.3) cm,P ＜ 0.05].The incidences of preoperative leukopenia,anemia,thrombocytopenia and prolonged prothrombin time were higher in the massive blood loss group than that in the minor blood loss group (48.1％ vs.16.7％,37.0％ vs.11.4％,25.9％ vs.3.5％,22.2％ vs.3.5％,respectively,all P ＜ 0.05).Hepatic hemangioma with compressed hepatic veins,inferior vena cava and porta hepatis were more frequently found in the massive blood loss group than in the minor blood group (55.6％ vs.14.9％,44.4％ vs.14.0％,55.6％ vs.12.3％,respectively,all P＜0.05).Logistic regression analysis demonstrated a diameter of hemangioma greater than 15 cm was a risk factor of intraoperative massive blood loss during surgical resection.Conclusions Giant hepatic hemangioma may cause disorders in the hematological and coagulation systems.Compression of major hepatic vessels raised technical difficulty and risks in surgery.Hemangioma with a diameter greater than 15 cm was recognized as a high-risk factor of intraoperative massive blood loss.

Differential diagnosis of asymptomatic patients with pancreatic small cystic lesions / 中华普通外科杂志

Objective To analyze the differences between benign and potential malignant small pancreatic cystic lesions.Methods We retrospectively analyzed the clinical and pathological data of asymptomatic patients with pancreatic small cystic lesions and divided them into benign group (including serous cystic neoplasms,lymphoepithelial cyst and pseudocyst) and potential malignant group (including mucinous cystic neoplasms,intraductal papillary mucinous neoplasms and solid pseudopapillary neoplasms).Comparison of clinical data was made between the two groups.Results 46 patients with pathological results were included (22 cases in benign group and 24 cases in potential malignant group).No difference was detected on demographic data and lab results between the two groups.Compared with benign patients,patients in the potential malignant group were more likely to show thicken wall (P =0.000),mural nodule (P =0.000),solid constituents inside the cyst (P =0.001),wall enhancement (P =0.003) and uneven wall on CT scan (P =0.024).The diagnostic sensitivity,specificity and accuracy of the combination of above mentioned CT features for potential malignant diseases were 91.7％,77.3％ and 84.8％,respectively.Conclusions Pancreatic cystic lesions with thicken wall,mural nodule,wall enhancement,solid parts inside the cyst and uneven wall on CT were more likely of potential malignant entities.

Regulatory effects of the bile acid membrane receptor TGR5 on FN and TGF-β1 in rat glomerular mesangial cells cultured under high glucose condition / 中国药理学通报

Aim To investigate the expression of G protein-coupled receptor TGR5 and its effects on FN and TGF-β1 expression cultured under high glucose condition in rat glomerular mesangial cells , and then to explore the role of TGR5 in diabetic nephropathy. Methods INT-777 and TGR5 plasmid were used to activate TGR5 under high glucose(HG,30 mmol·L - 1 glucose ) condition, and anti-TGR5 small interfering RNA(TGR5 siRNA) was used to knock down TGR5. The protein expression of FN and TGF-β1 in rat me-sangial cells was detected by Western blot. Results TGR5 could be detected in rat glomerular mesangial cells. Both FN and TGF-β1 protein levels could be in-creased by high glucose compared with control group(P < 0. 05),and be inhibited by activiation of TGR5(P <0. 05). On the other hand,knockdown of TGR5 could increase FN and TGF-β1 protein to abnormal levels(P< 0. 01,P < 0. 05). Conclusion TGR5 suppresses HG-induced FN and TGF-β1 expression in rat glomer-ular mesangial cells,suggesting a protective role in the process of diabetic nephropathy.

Effect of fast acupuncture at Zusanli (ST36) on the recovery of gastrointestinal function after ;abdominal non-gastrointestinal surgery / 国际中医中药杂志

Objective To observe the effect of fast acupuncture at Zusanli(ST36) on the recovery of gastrointestinal function after abdominal non-gastrointestinal surgery. Methods In this randomised placebo-controlled single-blind clinical trial, patients received abdominal non-gastrointestinal surgery were assigned to a treatment group and a control group. The treatment group received fast acupuncture and the control group received superficial conciliative acupuncture. The acupuncture was taken at both sides of Zusanli (ST36) for 1 minute respectively during 7-8 a.m. and 7-8 p.m..We began from the first postoperative day and stopped when the patients got initial postoperative flatus or stool, or at the end of the fifth postoperative day. Results 37 controlled patients were assigned to the treatment group (18 patients) and the control group (19 patients) randomly. There were no differences on general information between the two groups. The treatment group had stronger feeling than the control group on the comparison of the acupuncture sensation level (5.7 ± 3.0 vs. 2.7 ± 2.2;t=-3.471, P=0.001). For the treatment group, the initial postoperative flatus or stool time is 19 hours earlier than the control group (65.9 ± 18.1 h vs. 85.0 ± 24.5 h; t=2.682, P=0.011). And the treatment group patients’ postoperative abdominal distension is lesser than the control group (P=0.006). Conclusion Fast acupuncture at Zusanli(ST36) can promote the recovery of gastrointestinal function after abdominal non-gastrointestinal surgery, and can also lighten the patients’ postoperative abdominal distension.

Molecular mechanism of nontypeable Haemophilus influenzae stimulated MUC5AC production in NCI-H292 cells / 中国病理生理杂志

AIM:To investigate the molecular mechanism of nontypeable Haemophilus influenzae ( NTHi)-in-duced MUC5AC expression in the human airway NCI-H292 cells.METHODS:Bronchial epithelial NCI-H292 cells were cultured in vitro.The production of MUC5AC and matrix metalloproteinase 9 (MMP-9) after stimulation with NTHi was analyzed by enzyme-linked immunosorbent assay (ELISA).The enzymatic activity of MMP-9 was detected by gelatin zy-mography.In addition, the cells were pretreated with different inhibitors such as AG 1478, LY294002, DPI, NAC and GM6001 before stimulation, which specifically inhibit epidermal growth factor receptor (EGFR), phosphatiadylinositol 3-ki-nase (PI3K), NADPH oxidase, reactive oxygen species (ROS) and MMP-9, respectively, and then the production of MUC5AC or MMP-9 was determined.RESULTS:NTHi-stimulated NCI-H292 cells exhibited a time-dependent increase in MMP-9 secretion and activity .NTHi also increased the activity of Rac 1 and the production of ROS .Pretreatment of AG1478 and LY294002 decreased the Rac1 activity, and preincubation of DPI or Rac 1 inhibitor significantly abrogated ROS production.In addition, secretion of MMP-9 and the enzymatic activity was decreased by treatment of NAC and NSC23766.Furthermore, inhibition of the MMP-9 activity by GM6001 significantly inhibited MUC5AC production.CON-CLUSION:EGFR/PI3K/Rac1/NADPH oxidase/ROS/MMP-9 regulates MUC5AC production in NTHi-challenged NCI-H292 cells.

GPI-PLD inhibits the growth of hepatoma cells by down-regulation of PI3K-Akt signaling pathway / 中南大学学报(医学版)

OBJECTIVE@#To clarify the effect of glycosylphosphatidylinositol-specific phospholipase D (GPIPLD) on hepatoma cells HepG2 and the possible molecular mechanism.@*METHODS@#MTT, fluorescent staining and Western blot were applied to analyze the effect and molecular mechanism of GPI-PLD on hepatoma cells by transfected high expression GPI-PLD model. We inoculated HepG2 in nude mice models to further clarify the effect of GPI-PLD on hepatoma cells in vivo.@*RESULTS@#Compared with the control groups, PI3K-Akt signaling pathway activity and proliferation of hepatoma cells were significantly inhibited in the GPI-PLD group. Nude mice models showed that the tumor growth and tumor weight [(1.87 ± 0.09) g] of the GPI-PLD group were significantly less than those of the blank control group [(2.20 ± 0.17) g] and the negative control group [(2.15 ± 0.09) g]. AST, ALT and AFP serum concentration in the GPI-PLD group were significantly lower than those of the control groups (P<0.05).@*CONCLUSION@#GPI-PLD can inhibit the proliferation of hepatoma cells and growth in vivo, and promote the apoptosis of hepatoma cells by reducing the activity of PI3K-Akt signaling pathway.

Effect of PFT-α on apoptosis of spermatogenic cells caused by enorchia / 中南大学学报(医学版)

OBJECTIVE@#To determine the molecular mechanism of germ cell apoptosis via investigating the effect of PFT-α on the expression of p53 and bcl-2/bax during experimental cryptorchid cell apoptosis.@*METHODS@#Male Sprague-Dawley rats were assigned into 4 groups: a sham-operated group, a cryptorchid group, a cryptorchid+p53 inhibitor (p53 inhibitor-alpha, PFT-α) group, and a cryptorchid+dissolvent of PFT-α [dimethyl sulphoxide (DMSO)] group. Unilateral cryptorchidism was surgically induced in the rats of the cryptorchid group, PFT-α group, and cryptorchid+dissolvent of PFT-α group. The rats in the PFT-α group and cryptorchid+dissolvent of PFT-α group were intra-peritoneally injected PFT-α and dissolvent of PFT-α, respectively, once a day. The rats were killed on the 7th day after the surgery. The morphology of spermatogenic epithelium at the side of surgery in the rats was observed under light microscope. The apoptosis of spermatogenic cells in the unilateral cryptorchidism was evaluated by TUNEL and flow cytometry (FCM). The protein expression levels of p53, bcl-2, and Bax were detected by Western blot and immunohistochemical assay in turn.@*RESULTS@#Compared with the cryptorchid groups and the cryptorchid+dissolvent of PFT-α group, the seminiferous epithelium of the cryptorchid+p53 inhibitor group appeared orderly, with thicker cell layers and lower apoptosis index, weak protein expression level of p53/Bax and strong protein expression level of bcl-2.@*CONCLUSION@#PFT-α inhibits the germ cell apoptosis caused by the experimental cryptorchidism via increasing the expression of bcl-2 and decreasing the expression of p53 and bax.

Localized primary sclerosing cholangitis mimicking as a Klatskin tumour: report of three cases / 中华肝胆外科杂志

Objective To report three cases of localized primary sclerosing cholangitis (PSC) mimicking a hilar cholangiocarcinoma (Klatskin tumor) and to summarize their clinical characteristics and the ways to differentiate them through a literature review.Method The clinical data of three patients with localized PSC mimicking a hilar cholangiocarcinoma were retrospectively analyzed.The characteristics of laboratory tests and imaging examination were reviewed,and therapy and prognosis were discussed.Results The three patients were all diagnosed to have a hilar cholangiocarcinoma preoperatively,but the diagnosis of PSC was confirmed by histopathology post-operatively.All the three patients had elevated CA19-9,2 patients had elevated anti-nuclear antibody (ANA) and 2 patients had elevated IgG.All the three patients underwent surgical resection and histopathological study showed chronic inflammation of the hilar bile ducts and cholangitis of the intrahepatic portal area.The three patients were followed up from 7 months to 8 years with no symptoms.Conclusions Localized PSC is rare and it can casily be misdiagnosed as a hilar cholangiocarcinoma.Biopsy before surgery is helpful for the differential diagnosis but it is difficult to get a good biopsy sample.Surgical resection is an effective treatment.

Effect of apigenin on proliferation and apoptosis of human lung cancer NCI-H460 cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of apigenin on the proliferation and apoptosis of human lung cancer cell line NCI-H460.</p><p><b>METHODS</b>NCI-H460 cells were cultured with different concentrations of apigenin, and MTT assay was used to evaluate the cell inhibition rates. Apoptosis of NCI-H460 cells was observed under a fluorescence microscope with Hoechst 33258 staining and quantified by flow cytometry using annexin V-FITC/PI stain. The expressions of apoptosis-related proteins Bax, Bcl-2 and caspase-3 were analyzed by Western blotting.</p><p><b>RESULTS</b>Apigenin causes concentration- and time-dependent inhibition of the proliferation of the cells. NCI-H460 cells treated with apigenin showed significant morphological changes of apoptosis, and the cell apoptotic rates increased as apigenin concentration increased. Western blotting demonstrated that apigenin increased the protein levels of Bax and caspase-3 and reduced the protein expression of Bcl-2.</p><p><b>CONCLUSION</b>Apigenin can inhibit the proliferation and induce apoptosis of NCI-H460 cells possibly by up-regulating expression of Bax and caspase-3 and down-regulating the expression of Bcl-2.</p>

Nodular regenerative hyperplasia of the liver: a report of 18 cases / 中华普通外科杂志

Objective To summarize the clinical diagnosis and treatment of nodular regenerative hyperplasia of the liver. Methods Retrospective analysis was made on the clinical manifestations,imagings, laboratory tests, diagnosis, treatment and prognosis of 18 consecutive cases finally established as NRH during the past 26 years. Results 15 of the 18 cases showed portal hypertension, 4 cases showed mono or multiple occupations of the liver, 8 cases suffered from concurrent autoimmune diseases, 3 cases were suspected of blood diseases. Preoperatively, 13 cases were diagnosed as cirrhosis, 2 cases were diagnosed as liver cancer or focal nodular hyperplasia ( FNH). All cases were diagnosed by operative wedging biopsy. 3 cases received splenectomy, 4 cases received disconnection /Phemister surgery, 3 cases received liver occupation/liver lobe resection, 1 case received partial small bowel resection, and 1 case received spleen artery restrictive surgery. Postoperatively, symptoms of portal hypertension relieved obviously. Follow-up study showed most of the patients were stable and prognosis of the NRH was good.Conclusions NRH may relate to the disturbance of liver blood supply, and most common clinical manifestation is portal hypertension, and can combine with immune diseases, hematopathy also can present single or multiple liver occupations. Differential diagnoses include liver cirrhosis, FNH, idiopathic portal hypertension. Diagnosis of NRH relies on liver wedging biopsy. Surgery can relive concurrent portal hypertension.

Effect of natural killer cells treated by serum of severe preeclampsia patient on apoptosis and endothelin-1 secretion of endothelial cells / 中华围产医学杂志

Objective To investigate the effect of natural killer (NK) cells treated by serum of severe preeclampsia patient on the function of endothelial cells.Methods Fifteen patients with severe preeclampsia and 15 normal pregnant women from the Obstetrics department,Shengjing Hospital,China Medical University were admitted into this case-control study from January 1,2006 to December 31,2008.NK cells from healthy non-pregnant woman were incubated with 20% serum from severe preeclampsia patients or normal pregnant women for 20 hours.Then,human umbilical vein endothelial cells ( HUVEC) and serum-treated NK cells were co-incubated for 24 hours.Apoptosis of HUVEC was checked by flow cytometry and electronic microscope.Endothelin-1 (ET-1) levels in the supernatants of HUVEC and NK cells were examined by radioimmunologic method.Results In severe preeclampsia group,the percentage of early apoptosis cell (Annexin V-FITC+ /PI+ ) was (23.81±4.79)%,that of late apoptosis cell (AnnexinV-FITC+/PI+ ) was (3.29±1.04) %,while those were (16.59±5.13)% and (2.24±0.72)% respectively in normal pregnant group (P＜0.01).There was no significant difference in dead cells (Annexin V-FITC- /PI+ ).Under electronic microscope,typical morphologic changes of apoptosis were shown in severe preeclampsia group.Level of ET-1 in

Impact of hepatic vascular inflow exclusion on postoperative arterial lactate level in patients undergoing hepatectomy / 中华普通外科杂志

Objective To investigate the impact of vascular inflow occlusion of the liver on arterial lactate level and pH value. Methods In this study, 68 patients who underwent hepatectomy from January 2006 to December 2008 were retrospectively studied. The patients were assigned to one of the three study groups according the vascular inflow status: clamping of portal vein and hepatic artery in the hepatic pedicle (n = 20), hemihepatectomy under total hemihepatic vascular exclusion (THVE, n = 22), and non-vascular occlusion (n = 26). Postoperative arterial blood gas analysis including systemic arterial lactate concentration, and liver and renal function tests were performed. Results Systemic arterial blood lactate levels significantly elevated in the portal clamping and THVE groups (5.53 ±2. 31 mmol/L and 5.62 ±2.52mmol/L, respectively), compared to the non-occlusion group (3. 37 ± 1.56 mmol/L, P < 0. 05) ;significant increase in arterial HCO3- level was observed in the THVE group in comparison to the nonocclusion group (19. 68 ± 3. 82) mmol/L vs. (21.65 ± 2. 48) mmol/L, (P < 0. 05). There were no significant differences as to the changes of pH values, liver and renal function tests between the three groups. Conclusions Vascular inflow deprivation may result in significantly increased arterial lactate level. Thus, intense surveillance of blood lactate level with prompt treatment is necessary to prevent postoperative hyperlactatemia and metabolic acidosis.

Hepatectomy for hepatolithiasis: an analysis of 98 eases / 中华普通外科杂志

Objective To investigate the effect and long-term prognosis of patients who underwent hepatectomy for hepatolithiasis. Methods We retrospectively analyzed the medical records of 98 patients with hepatolithiasis who were treated by hepatectomy in Peking Union Medical College Hospital.Results Male/femah:1/1.7;median age:55 years old.58 cases(59.2%)had been treated before;among them.50 by surgery.In 88 cages(89.8%)hepatolithiasis involved the left lobe only,in 2(2.0%) only the right lobe involved.and in 8(8.2%)both left and right lobe were involved.51(52.0%)had extrahepatic biliary stones,30(30.6%)had biliary duct strictures,28(28.6%)had a history of biliary ascariasis.and 5(5.1%)had a concurrent biliary tract malignancy.All received partial hepatectomy according to the stone location;for the 8 bilaterally involved patients,left hepatectomy and right lithotomy were performed.Postoperative complications occurredin 14 cases(14.3%),and there were2perioperative deaths(2.0%).Seventy-eight patients(79.6%)have beenfollowedupfor over1 yearwith no tumors;the results were excellent or good in 91.0%;the stone residue and recurrence rate were both 2.0%.Conclusions Hepatectomy not only eliminates calcuci,but also removes diseased biliary tracts,with advantages of low residue stone and recurrence rate.

Expression and clinical implications of hMSH2 gene in sporadic insnlinomns / 中华胰腺病杂志

Objective To investigate the role of hMSH2 in the pathogenesis of sporadic insulinomas and to determine whether the expression of hMSH2 could be used to differentiate benign sporadic insulinomas from malignant ones. Methods Fifty-five sporadic insulinomas (40 benign and 15 malignant tumors) resected from 50 patients were obtained. Expression of hMSH2 was detected by immunohistochemistry staining. DNA was obtained from micradissected tissue. Loss of heterozygnsity (LOH) of hMSH2 gene was detected by PCR-LOH. 6 microsatellite markers were selected on 3 chromosomes, and microsatellite instability (MSI) status of tumor tissue were detected by PCR. The findings were analyzed in relation to the clinicopathological characteristics. Results Down-regulation of hMSH2 expression was found in 13% of 55 sporadic insulinomas. LOH of the hMSH2 gene was not present in 55 insulinomas. High frequency MSI (MSI-H, MSI occurred in at least 2 out of 6 sites) was present in 36% (20/55) of all the insulinomas. Down-regulation of hMSH2 expression was found in 33% of the 15 malignant tumors, while it was 5% in benign tumors (P < 0. 05). Conclusions Down-regulation of mismatch repair gene hMSH2 may be correlated with the degree of tumor malignancy. The expression of hMSH2 could be used as a potential marker for distinguishing benign insulinoma from malignant ones.