Clinical efficacy of entecavir in HBeAg-negative chronic hepatitis B with compensated cirrhosis / 临床肝胆病杂志

ObjectiveTo investigate the clinical efficacy of 96-week entecavir (ETV) treatment for HBeAg-negative chronic hepatitis B patients with compensated cirrhosis, as well as its effect on patients with different HBV DNA loads. MethodsA total of 118 chronic hepatitis B patients with compensated cirrhosis who visited Xiangyang Hospital of Traditional Chinese Medicine from January 2009 to June 2013 were enrolled and all had Child-Pugh class A cirrhosis. According to HBV DNA load, these patients were divided into high-load group (group A, HBV DNA≥105 copies/ml) and low-load group (group B, HBV DNA＜105 copies/ml). All the patients were treated with ETV 0.5 mg/d for 96 weeks. Child-Pugh score was used to evaluate liver function before and after treatment, and the changes in alanine aminotransferase (ALT), albumin (Alb), and total bilirubin (TBil) after treatment were observed. Hyaluronic acid (HA), α2-macroglobulin, and liver stiffness measurement (LSM) were used to evaluate liver fibrosis. The t-test was used for comparison between groups, and a repeated-measures analysis of variance was used for comparison within one group and between groups at different time points. Chisquare test was applied for comparison of categorical data between the two groups. ResultsThe two groups showed significant reductions in ALT, Alb, and TBil at weeks 12 and 24 of treatment (all P＜0.05), and the ALT normalization rate and HBV DNA clearance rate at weeks 24 and 48 of treatment showed significantly differences between the two groups (χ2=9241，6428，11134，5139，all P＜0.05). Both groups showed significant reductions in HA, α2-macroglobulin, and LSM after treatment (t=2648，1921，4018，3166，2136，3461，all P＜0.05). The incidence rates of complications such as variceal bleeding, ascites, and hepatocellular carcinoma showed no significant differences between the two groups (all P＞0.05). ConclusionIn HBeAg-negative chronic hepatitis B patients with compensated cirrhosis, ETV can significantly improve liver function, slow down the process of liver fibrosis and cirrhosis, and effectively reduce long-term complications.

Sensitized dendritic cells with apoptotic hepatoma cells induced by mitomycin / 中国组织工程研究

BACKGROUND: Dendritic cells play an important role in antigen present in vivo, and the mechanism of tumor cells in escaping the antigen presentation of dendritic cells existed in the patients with tumor.OBJECTIVE: To sensitize dendritic cells from human peripheral blood with apoptotic hepatoma cells induced by mitomycin.DESIGN: A randomized control trial by taking apoptotic hepatoma cell sensitized dendritic cells as the observed subjects.SETTINGS: Institute of Field Surgery, Daping Hospital, the Third Military Medical University of Chinese PLA; Institute of Radiation Medicine,Chinese PLA Academy of Military Medical Sciences.MATERIALS: The experiments were carried out in the Institute of Radiation Medicine, Chinese PLA Academy of Military Medical Sciences from April 1998 to May 1999. The cell strain was the QBC939 bile duct cancer cell strain, and mitomycin was used as the antitumor drug.METHODS: Mononuclear cells were isolated from the peripheral blood of normal people, 50μg/L granulocyte-macrophage colony stimulating factor(GM-CSF) and 1 000 U/mL interleukin-4 (IL-4) were added, once every other day for 4 times. On the 3rd day of culture, the apoptotic bile duct cancer cells induced by mitomycin was added, and then cultured in vitro for 4 days, finally the dendritic cells were collected.MAIN OUTCOME MEASURES: ① The identification of the cultured dendritic cells was observed; ② The dendritic cells were co-cultured with necrotic and normally cultured bile duct cancer cells respectively, and the phagocytized apoptotic body loaded antigens were observed; ③ The immunostimulatory activity of dendritic cells (1×103, 5×103 and 1×104/well)and that after loaded by antigen were detected, and the mononuclear cells were taken as controls.RESULTS: ① The cultured and amplified dendritic cells expressed high levels of costimulatory molecules of CD1a and B7, and there were typical irregular processes on the surface. ② The tumor cells formed apoptotic bodies when they were induced by mitomycin, which were arrested and phagocytized by dendritic cells. ③ The ability of the antigen loaded dendritic cells in stimulating the proliferation of allogenic lymphocyte T was further enhanced.CONCLUSION: The apoptotic tumor cells induced by mitomycin can induce the mononuclear cells from human peripheral blood differentiating into the dendritic cells with the concomitance of GM-CSF and recombinant IL-4 and amplify dendritic cells. Meanwhile, the dendritic cells can effectively present the antigens of apoptotic bile duct cancer cells, and it probably becomes a new effective approach for tumor antigen to sensitize dendritic cells.

Reduced-size orthotopic liver transplantation with different grade steatotic grafts in rats / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To explore the survival time, pathological change and liver regeneration in different kinds of reduced-size liver transplantation in rats using steatotic grafts.</p><p><b>METHODS</b>Macrovesicular and microvesicular steatotic rat liver models were established by feeding rats with a diet consisting of 79% standard chow, 20% lard and 1% cholesterol for different time periods. With modified two cuff vascular anastomoses and end-to-end sutures on the bile duct, reduced-size orthotopic rat liver transplantations were performed in an attempt to explore the ratio of graft weight to recipient body weight, recipient original liver weight and histological and electron-microscopic findings in comparison with whole rat liver transplantations.</p><p><b>RESULTS</b>A one-week survival rates for the rats undergoing whole liver transplantation, and those in the 70% reduced-size orthotopic liver transplantation (ROLT) group, the 60%ROLT group and the 50%ROLT group (grade I macrosteatotic grafts) were 91.67%, 75%, 75% and 25%. A 2-week survival rate was 83.33%, 75%, 58.33% and 0 respectively. And their graft recipient body weight (GRBW) values SD were 3.56% +/- 0.36%, 2.53% +/- 0.15%, 2.28% +/- 0.12% and 1.83% +/- 0.16%, respectively. In grade II macrosteatotic grafts, the one-week survival rate for those undergoing whole liver transplantation and those in the 70% ROLT group was 83.33% and 25%. In the microsteatosis grafts for whole liver transplantation, 70% ROLT, 60% ROLT and 50% ROLT, the one-week survival rate was 83.33%, 75%, 75% and 33.33%; and the 2-week survival rate was 75%, 66.67%, 66.67% and 0, respectively. The survival rate of the 50% ROLT group using grade I macrosteatotic grafts or grafts mainly with microsteatosis was significantly different from that of other groups. While using macrosteatotic grafts in grade II, the 1-week survival rate of the 70% ROLT group was very poor. Pathological findings after operation included liver regeneration and portal space with mild lymphocyte infiltration. Improvement in steatosis and dilation of the central vein and sinusoids was observed in some rats.</p><p><b>CONCLUSIONS</b>In the successful and long-term survival of rat reduced-size liver transplantation using grade Imacrosteatotic grafts or grafts with microsteatosis, the GRBW values should be over 2.28% +/- 0.12%, and the value of graft-recipient liver weight should be over 60%. Steatotic livers in grade II should not be used as grafts in ROLT. Steatosis was improved and even totally cured in some long-term survival rats.</p>

Experimental study of the reduced-size orthotopic liver transplantation in different steatotic rats / 第三军医大学学报

Objective To observe the survival time, pathological change and liver regeneration in different kinds of reduced size liver transplantation in steatotic rats. Methods Rat models of different kinds of reduced size orthotopic liver transplantation were performed by modified two cuff vascular anastomoses and end to end suture for bile duct to observe the recipient body weight, graft weight, recipient original liver weight, histological and pathological and electron microscopic findings in comparison with those of the whole rat liver transplantation. Results One week survival rate of the whole liver transplantation, 70% reduced size liver transplantation(ROLT), 60% ROLT and 50% ROLT group (grade Ⅰsteatotic donor) was 91.67%, 75%, 75% and 25%, respectively, and 2 week survival rate was 83.33%, 75%, 58.33% and 0, respectively. In grade Ⅱ steatotic donor, 1 week survival rate of the whole liver transplantation and 70% ROLT was 83.33% and 25%. As to donor livers with microvesicular steatosis, 1 week survival rate of the whole liver, 70% ROLT, 60%ROLT and 50% ROLT was 83.33%, 75%, 75% and 33.33% and the 2 week survival rate was 75%, 66.67% 66.67% and 0. The survival rates of 50% ROLT in grade Ⅰ steatotic donor and livers mainly with microvesicular steatosis were significantly different from those in other groups. The 1 week survival rate of 70% ROLT was very poor in steatotic donors in grade Ⅱ. Pathological findings after operation included liver regeneration and mild lymphocyte infiltration in portal space, the amelioration of the steatosis in some cases and dilation of the central vein and sinusoids. Conclusion To obtain long term survival of reduced size liver transplantation using steatotic donors, the GRBW should be over (2.28?0.12)(the ratio of graft to recipient liver weight over 60%). Steatotic livers in grade Ⅱ should not be used as donors in ROLT. The steatosis can be ameliorated after operation.

Regulation of the extracellular matrix synthesis and degradation in liver fibrotic rats by antisense TIMP_1 / 第三军医大学学报

Objective To investigate the effects of antisense TIMP 1 on the interstitial collagen synthesis of fibrotic liver in rats. Methods Fibrosis was induced in the liver of rats with the injection of 60% CCl 4 and 5% alcohol. Recombinant antisense TIMP 1 gene mammalian expression vectors were construct and infused into the fibrotic liver of rats. The expressions of TIMP 1 mRNA, ?1(Ⅲ) mRNA and protein were determined by RT PCR, ISH and immunohistochemistry. The serum levels of PCⅠ, PCⅢ in rats were determined by RIA. Results Antisense TIMP 1 gene could markedly suppress the expression of endogenous TIMP 1 mRNA in the transfected liver of rats( P

Immune isolation of diffusion chamber for hybridoma / 第三军医大学学报

Objective To determine the effect of diffusion chamber for immune isolation and the proliferation of allogenic hybridoma within diffusion chamber in mice. Methods The hybridoma cell strain was established from SP2/0 cells and the splenocytes of BALB/c mouse by PEG mediate technique. The cells were injected peritoneally into BALB/c ( n =5) and C57 BL/6 (B6, n =5) mice. Diffusion chambers with microporous membrane containing hybridoma cells were implanted peritoneally into 5 BALB/c and 5 B6 mice. Results Within two months after peritoneal injection of the cell strain, four BALB/c mice developed bloody ascites and one developed abdominal tumor, but the B6 mice developed neither ascites nor tumor. After 30 and 101 days of the chamber implantation, the chambers were coated by omentum or mesenterium in all the animals of both strain groups and freshly formed blood vessels to the chamber membrane could be observed. Within the chambers, tumor developed, but the tumor could not fully fill the inner space of the chamber during the whole observation period. Conclusion The hybridoma cells established from SP2/0 cells and the splenocytes of BALB/c mouse may carry BALB/c MHC antigen. The diffusion chambers can effectively isolate immune rejection. Freshly formed blood vessels to the chamber membrane can support the cells within the chambers.

Experimental study of the steatotic donor liver transplantation in rats / 第三军医大学学报

Objective To explore the effect of fatty liver on graft survival, especially with reference to macrovesicular and microvesicular steatosis and to evaluate the relationship between histological grading and inflammation activity. Methods Different degrees of rat fatty liver model were established by feeding rats a diet consisting of 79% standard diet, 20% lard and 1% cholesterol. By modified two cuff vascular anastomoses and end to end suture for bile duct, rat orthotopic liver transplantation was performed to evaluate the relationship between donor histological grading and survival rate. Results Low survival rate of macrosteatosis (grade Ⅲ) was found. Most rats died of liver failure in early days after transplantation. Pathological findings showed frequent hepatic necrosis. There was no significant difference between macrosteatosia(gradeⅠ) and the normal group. After transplantation, almost all of the fat was cleared by the end of the fourth week. Diminished steatosis and liver regeneration were found in macrosteatosis (gradeⅡ), while microsteatotic donors had higher survival rate than the other groups except the normal group. Conclusion Macrovesicular steatosis(grade Ⅲ) affects graft survival and these steatotic livers should not be used as donors. However, steatotic livers with mild macrovesicular steatosis (grade Ⅰ) and microvesicular steatosis(grade Ⅲ) do not influence recipient survival, so these livers can be used safely for liver transplantation. The ischemic damage should be considered when using livers of macrovesicular steatosis(gradeⅡ). Donors with numbering score more than 2.7 are correlated with the poor survival.

Ursodeoxycholic acid promotes liver regeneration after partial hepatectomy in bile duct obstructive rats / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the effect of ursodeoxycholic acid (UDCA) on liver regeneration after 70% partial hepatectomy (PH) in bile duct obstructive (BDO) rats.</p><p><b>METHODS</b>Wistar rats were randomly divided into N-PH group in which normal rats were operated with 70% PH, BDO-PH group in which 70% PH were operated after two week's BDO, and BDO-PH UDCA or sterile saline treatment group in which UDCA (15mg kg(-1) d(-1)) or saline was administrated during BDO and after 70% PH. The hepatic pathological changes were observed. BrdU labeling of hepatocytes, the mRNA expression of intrahepatic hepatocyte growth factor (HGF) and its receptor (Met gene) after 70% PH were measured by immunohistochemical analysis and RT-PCR, respectively.</p><p><b>RESULTS</b>Improvements of hepatic function and pathological changes were induced by UDCA administration after BDO. The expression of hepatic HGF/Met mRNA after 70% PH in BDO-PH UDCA treatment group rats was significantly increased compared with N-PH group rats (P<0.05), BrdU peak labelling of hepatocytes (59.39% +/- 10.82%) in BDO-PH UDCA treatment group rats was significantly higher than that (36.22% +/- 8.37%) in BDO-PH group rats (t=4.149, P<0.01) and without significance compared with N-PH group rats (68.64% +/- 11.26%, t=1.451, P >0.05).</p><p><b>CONCLUSIONS</b>UDCA promotes liver regeneration after 70% PH in BDO rats by remission of hepatic pathological changes and elevating hepatic mRNA expression of HGF and Met.</p>

Semi-quantitative analysis of MCT1 and MCT2 genes mRNA expression in human hepatocellular carcinoma / 中国普通外科杂志

Objective　To study the mRNA expression of MCT1 and MCT2 genes in human hepatocellular carcinoma (HCC) and paracarcinoma liver tissue (PCLT). Methods　The semi-quantitative analysis of MCT1 and MCT2 genes mRNA expression in human HCC and PCLT was conducted by RT-PCR method and electrophoresis band opacity density (OD) comparison analysis method in 25 patients with HCC. Results　The mRNA expression of MCT1 was significantly higher than MCT2 in HCC and PCLT, in HCC the mRNA expression of MCT1 and MCT2 genes were significant higher than that in PCLT. Conclusions　The high expression of mRNA of MCT1 and MCT2 genes in HCC indicates that these genes may take a significant role on lactate and other monocarboxylate transmembrane transportation and on pH regulation in tumor cells.

Expression of HGF/Met mRNA and TGF-α/EGFR mRNA in the liver/hepatocyte after partial hepatectomy in noncirrhotic obstructive rats / 第三军医大学学报

Objective　To investigate the expression of HGF and TGF-α and their receptor, Met (HGF receptor) and EGFR (TGF-αreceptor) mRNA, in the regenerative liver/hepatocytes after 70% partial hepatectomy (70% PH) in noncirrhotic biliary obstruction rats. Methods　Wistar rats were divided randomly into N-PH group, BDO-RBF-PH group and BDO-RBF group. The expression of HGF/Met mRNA and TGF-α/EGFR mRNA was measured by RT-PCR in the liver/hepatocytes at the time point of 0, 6, 12, 24, 48 and 72 h after 70% PH or RBF. Results　In N-PH group, the expression of HGF/Met mRNA increased sharply and peaked at 6 h, and maintained at a high level until 24 h after 70% PH. In BDO-RBF-PH group however, the expression of HGF/Met mRNA increased slowly and peaked at 12 h after 70% PH. The peak level was lower in BDO-RBF-PH group than in N-PH one. The expression of TGF-α/EGFR mRNA increased sharply and peaked at 24 h after 70% PH in N-PH group. However, the expression of TGF-α/EGFR mRNA elevated slowly and peaked at 48 h after 70% PH in BDO-RBF-PH group with a lower peak level than that in N-PH group. Conclusion　The expression of HGF/Met mRNA and TGF-α/EGFR mRNA in the regenerative liver/hepatocytes after 70% PH decreases significantly in noncirrhotic biliary duct obstruction rats. There is a tendency that the expression of HGF mRNA and TGF-α mRNA is less than Met mRNA and EGFR mRNA.

Expression of CD14 in Kupffer′s cells induced by Lipopolysaccharide / 第三军医大学学报

Objective　To investigate the expression of LPS receptor-CD14(CD14) on the membrane of Kupffer′s cells (KCs) induced by Lipopolysaccharide (LPS )and its role in activation of KCs and production of cytokines. Methods　KCs were isolated by collagenase perfused Wistar rats and routinely cultured in 24-well dishes for 12 h. Cells were harvested and adjusted to a concentration of 1×106/ml/well and were devided into two groups. Group of LPS: KCs were induced with different concentration of LPS (0, 100 ng/ml, 1 μg/ml and 100 μg/ml). Group of PI-PLC: KCs were pre-incubated for 30 min with one unit of phophatidy linositol specific phospholipase C (PI-PLC) before different concentrations of LPS were added. KCs were cultured for 30 and 60 min respectively. Supernatants were then collected for measuring the level of TNFα and IL-6. Cells were stained by indirect immunofluorescent method ( rabbit anti-CD14 antibody and goat anti-rabbit IgG conjugated with FITC ) and analyzed with flow cytometer (FCM). The percentage and mean fluorescence intensity (FI) of CD14-positive cells were taken as the indexes. Results　In LPS group, after incubation of cells with increasing concentration of LPS, a significant increase in the percentage of CD14 positive KCs were found and the mean FI was stronger when compared with the control points or the group of PI-PLC. The levels of TNFα and IL-6 in supernatant also increased (P<0.01). In group of PI-PLC, decreased percentage of CD14 positive KCs and weakened mean FI were found when compared with group of LPS. The increasing production of TNFα and IL-6 slowed down in the group of PI-PLC. Conclusion　CD14 expression of KCs might be up-regulated by LPS with increase of some cytokines. The production of cytokines in KCs induced by LPS is partially inhibited by PI-PLC.

Clinical significances of growth hormone and growth hormone binding pro tein determination in patients with obstructive jaundice / 第三军医大学学报

Objective　To evaluate the changes and clinical s ignificances of serum growth hormore (GH) and GH binding protein (GHBP) in patie nts with obstructive jaundice (OJ). Methods　Serum levels of GH, GHBP, insulin-like growth factor-Ⅰ (IGF-Ⅰ), endotoxin, prealbumin concentr ation and liver function in 60 male in patients with OJ were detected 1 d preope ratively and 1, 3, 7 d postoperatively. And 40 male patients with simple gallbla dder stone hospitalized in the same period were served as control. Resu lts　The levels of GH, GHBP and IGF-Ⅰ were significantly lower in pati ents with obstructive jaundice than in control group(P<0.01), which was corr elated with the levels of bilirubin, endotoxin and prealbumin (P<0.01). Conclusion　The obviously downregulation of GH/GHBP axis in patients with OJ probably results from the inbibition of expression of GH receptor due t o nutritional dysfunction and endotoxemia, and further aggravate the nutritional dysfuction and endoxemia, which may be one of the important factors in the path ophysiological changes of OJ.

The kinetic mechanism of gallstone formation / 中国普通外科杂志

Objective To probe into the kinetics of gallstone formation.Methods Fifty seven rabbits were divided into five groups: (1) normal control with standard fodder, (2)1 2% cholesterol was added into the fodder,(3)1 2% cholesterol plus indomethacin in the fodder,(4)1 2% cholesterol plus erythromycin,(5) 1 2% cholesterol plus Dong Li San, a Chinese herb compound. All animals were feed four weeks before measurement.Results Gallstone developed in 0 out of 13 in group 1, in 12 out of 14 rabbits in group 2, in 4 out of 10 rabbits in group 3, in 0 out of 10 in group 4, and in 2 out of 10 in group 5. Compared with that in group 1 rabbits in group 2 had higher level of cholesterol and mucin in bile,much higher common bile duct pressure and cystic duct resistance,much lower gallbladder emptying rate ( P

Degeneration of Dendritic Cells from Human Peripheral Blood and Acquirement Antigen from Apoptotic Hepatochlangioma Cells / 中国肿瘤临床

Objective:To eastablish the efficient presentation of antigen from apoptotic cells by human DC from peripheral blood. Methods: using recombinant human granulocyte/macrophage colonystimulating factor(GM- CSF) and interleukin 4 (IL- 4 ) we have established dendritic cells (DC)from peripheral blood monocyte that maintain the antigen capturing and processing capacity characteristic of immature dendritic cells in vivo. GM - CSF 50ng/ml , IL- 41 000ng/ml once two days(total four). on the 3 rd day of culture, immature DC and apoptotic hepatochlangioma cells were in coculture lasting 7 days. Results:these cells had typical dendritic morphology, express high levels of CD1a ,B7 and acquired antigen from apoptotic cells and induced an increased T cell stimulatory capacity in MLR. Conclusions:we have established DC from blood mononuclear tells using GM- CSF and IL- 4 and DC can be efficiently drived from apoptotic cells and can induce the increase of T cells obviously. It probably becomes an effective approach of antigen transduced with DC.

Effect of activated macrophages on glycoprotein secretion from gallbladder tissue of guinea pig / 中华肝胆外科杂志

Objective To study the effects of high cholesterol diet and activated macrophages (M) on glycoprotein secretion from the gallbladder tissue of guniea pig.Method Forty guniea pigs were randomized into group A fed with ordinary diet and group B fed with a diet containing 1.2% cholesterol for one week.Glycoprotein secretion from guinea pig gallbladder was observed in tissue culture using ~3H-glucesamine as a precursor,and in the meantime,with hydrocortisone and activated M to understand the effects on glycoprotein synthesis and secre- tion function of gallbladder epithelium.Results The activity of peritoneal M was significantly increased in guinea pigs fed with high cholesterol diet.High cholesterol diet induced significant release of ~3H-glucosamine-labeled gly- coprotein into the tissue culture medium as compared with the control level of guinea pig fed with normal diet.The gallbladder tissues were co-cultured for 16 hours with peritoneal M of guinea pig fed with high cholesterol diet. Mucin secretion had an evident increase compared with the controls (with the peritoneal M of guinea pig fed with normal diet at 10~4,10~6 cell/ml).Hydrocortisone (10~(-6),10~(-5),10~(-4)mol/l) caused a reversible dose-dependent inhibition on glycoprotein secretion from the gallbadder tissues of guinea pig fed with high cholesterol diet.Hydro- cortisone (10~(-4)mol/l) also inhibited the stimulatory effect of M activated by high cholesterol diet on glycoprotein hypersecretion in the gallbladder tissues of guinea pig fed with ordinary diet.Conclusion (1) High cholesterol diet can induce the increase of glycoprotein secretion from gallbladder tissues of guinea pig;(2) M can be actvi- ated by high cholesterol diet,which stimulates glycoprotein secretion from the gallbladder tissues of guinea pig. Considering the results of experiment using an animal gallbladder stone model,these findings suggest that the hy- persecretion of glycuprotein from guinea pig gallbladder tissue may be related to guinea pig M activated by high cholesterol diet and stimulated to release TNF,IL-I,etc.

The effect of reduced glutathione and venous systemic oxygen perfusion on apoptosis and ultrastructure of rat steatotic liver grafts / 中国普通外科杂志

Objective To explore the effect of reduced glutathione and venous systemic oxygen perfusion on apoptosis and ultrastructure of hepatocytes in rat steatotic liver grafts. Methods Before liver transplantation grade Ⅱ steatotic liver model was established by a diet consisting of 79% standard diet,20% lard and 1% cholesterol for 6 weeks. In pretreatment group, the donor received intraperitoneal injection of reduced glutathione at a dosage of 500 mg/kg/body weight 3 times a day for 2 days, and intrahepatic venous oxygen perfusion for 6 hours while kept in cold preservation. Results Preconditioning measures in steatotic liver grafts significantly decreased the hepatocytes necrosis (38?10)% vs (17?6)%, P

Semi-quantitative analysis of MCT1 and MCT2 genes mRNA expression in human hepatocellular carcinoma / 中国普通外科杂志

Objective To study the mRNA expression of MCT1 and MCT2 genes in human hepatocellular carcinoma (HCC) and paracarcinoma liver tissue (PCLT). Methods The semi-quantitative analysis of MCT1 and MCT2 genes mRNA expression in human HCC and PCLT was conducted by RT-PCR method and electrophoresis band opacity density (OD) comparison analysis method in 25 patients with HCC. Results The mRNA expression of MCT1 was significantly higher than MCT2 in HCC and PCLT, in HCC the mRNA expression of MCT1 and MCT2 genes were significant higher than that in PCLT. Conclusions The high expression of mRNA of MCT1 and MCT2 genes in HCC indicates that these genes may take a significant role on lactate and other monocarboxylate transmembrane transportation and on pH regulation in tumor cells.

Twenty year experience in surgical treatment of hilar cholangiocarcinoma / 中国普通外科杂志

Objective To summarize twenty year experience in the surgical treatment of hilar cholangiocarcinoma(H CC) and explore the effective measuers for increase in resectional rate and reducing operative morbidity and mortality of H CC. Methods Clinicopathological data of 201 patients with H CC treated surgically in our center between 1978 and 1997 were analysed retrospectively. The resection rate, operative morbidity and mortality of the patients before and after December 1990 were compared. Results Of the 201 patients, 97 underwent resection(redical resection in 51; palliative in 46), 84 subjected to internal or external drainage and 20 only laparotomy. In 75 followed up patients, the 1,3,5 year survival rate was 95.45%, 40.91%, 13.64% in radical resection group, and 55%, 10%, 0% in palliative resection group respectively; whereas in unresectional internal and external drainage group, 1 year survival rate was 36%, noone survived for more than 3 years. All the patients with only laparotomy died within 3 months after operation. Comparation of the two stages revealed that the resection rate had been increased from 34.95% before December 1990 to 62.24% after December 1990, and the radical resection rate from 15.53% to 35.71%, meanwhile the operative morbidity and mortality decreased from 39.80% and 17.84% to 18.37% and 6.12% respectively. Conclusions Radical resection plays an important role for improving long term survival rate in patients with H CC. Appropriately perioperative care can reduce the operative morbidity and mortality.

A sduty on changes of hepatic energy metabolism and their management in acute obstructive cholangitis in rats / 第三军医大学学报

:Mitochondrial respiratory rate,respiratory control rate(RCR),oxidative phospho-rylation efficiency(ADP/O),and hepatic ATP content were determined in rats under 5 conditions including acute obstructive cholangitis(AOC),bile duct ligation(BDL),verapamil pretreatment in AOC(VET),dexamethasone pretreatment in AOC(DET).and sham operation(SO).It was found that rnitochondrial respiratory rate especially its state 4 phase was significantly increased and RCR,ADP/O,and ATP were significantly decreased at 6th hour after AOC and at 24th after BDL.These changes occurred earlier and more dramatically in AOC than in BDL.Pretreatment with verapamil or dexamethasone in AOC could minimize the changes of RCR,ADP/O and ATP in varying intervals.The findings indicate that AOC and BDL can both result in severe functional impairment of the mitochondria of hepatocytes and verapamil and dexamethasone exert effective protection on the rnitochondrial functions of respiration and energy metablism.

An experimental study on hepatocyte mitochondrium damage during acute biliary sepsis / 第三军医大学学报

In order to elucidate the mechanism of liver damage due to acute biliary sepsis,the changes of hepatocyte mitochondria were observed during biliary sepsis in the rat.The accompanied liver function changes were also studied.Mitochondrial calcium content,and lysosome fragility of the hepatocytes,lipid peroxide (LPO) level of liver tissue,ornithine carbamoytransferase (OCT),mitochondrial glulamicoxloacetic transaminase (m-GOT),and hepa-toplastin were determined.It was found that there were overloading of calcium in mitochondria,increase of lysosome fragility,and accumulation of LPO in the liver.These events would result in adverse effects on mitochondrial function.The activity of serum OCT and m-GOT was significantly increased,which suggests that mitochondria are seriously damaged since the 2 enzymes mainly come from hepatocyte mitochondria.And the liver reserving function declined progressively.Our study indicates that mitochondrial damage does exist during acute biliary sepsis,which might play an important role in liver damage.