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Ischemia.reperfusion injury of the liver consists of two distinct phases.The early phase occurs within 2 to 4 hours after reperfusion,which may be mainly induced by the increased production of oxygen radical species.The late phase results from inflammatory responses at 6 hours or more after reperfusion,leading to the progression of liver damage.The mechanism of IRIof the liver is a complex and muhifactorial process.The review outlines the current progress in the understanding of hepatic IRI from microcirculation,cellular,andmolecular levels,respectively.
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Objective To evaluate the prognostic value of plasma D dimer level in cancer thrombosis and vascular invasion assessment and to analyze the correlation between plasma D dimer level and the Pittsburgh modified TNM staging in patients with hepatocellular carcinoma for orthotopic liver transplantation. Methods The plasma D dimer level was quantitated using Golden method in 120 patients with hepatocellular carcinoma for orthotopic liver transplantation. Cancer thrombosis in trunk vein and microvascular invasion was diagnosed by pathology. The relationship between plasma D dimer level in different Child pugh’s classification patients and vascular invasion as well as the Pittsburgh modified TNM staging was analyzed with ? 2 test, factorial analysis of variance and q test by microsoft SPSS 9.0.Results In Child Pugh’s A, B and C patients, the difference of plasma D dimer level between patients with trunk vein cancer thrombosis and patients without vascular invasion was significant ( P 0.05). The differences of plasma D dimer level between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅲ tumor, and between patients with the Pittsburgh modified TNM Ⅰand Ⅱ tumor and patients with TNM Ⅳ tumor were significant ( P 0.05). Conclusion Plasma D dimer level, which increasing as upgrade of the Pittsburgh TNM staging, is useful in the vascular invasion and cancer thrombosis assessment in patients with hepatocellular carcinoma for liver transplantation, and the correlation was more significant as progression of vascular invasion and upgrade of Child pugh’s classification.
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Objective To observe the development of endotoxemia and its treatment during swine orthotopic liver transplantation (OLT). Methods Blood perfusion was carried out in 12 swine OLT cases during anhepatic period. Results It was 0 18 EU/ml in anhepatic period and 0 48 EU/ml in reperfusion period in control group compared to 0 13 EU/ml and 0 13 EU/ml,respectively in activated charcoal perfusion group( P
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Objective To investigate the clinical significance of c-myc、Bcl-2 protein expression, DNA ploidy and their relationship in breast cancer. MethodsWT5”BZ The expression of c-myc、Bcl-2 protein in 146 breast tumor tissues was examined by using immunohistochemical methods(S-P)and DNA ploidy in 72 cases of breast carcinoma by flow cytometry. ResultsKG1 Nuclear expression of c-myc protein was detected in 9 6% of tumors, and it was related to the DNA aneuploidy and prognosis. Cytoplasmic expression of c-myc protein was present in 91 8% of the carcinomas. Moderate to strong c-myc protein expression in cytoplasmic was associated with the positive status of ER. Bcl-2 protein was positive in 78 8% of cancers. Overexpression of Bcl-2 protein was associated with ER(+) status and the lack of axillary lymph node metastasis. DNA aneuploidy was found in 51 4% of 72 cancers, it was related to nuclear expression of c-myc protein and prognosis.WT5”HZConclusion Nuclear expression of c-myc protein and DNA ploidy are important prognostic factors.
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In the course of the establishment of the basic medical insurance system, medical and health institutions at various levels are going to face the readjustment of functional orientation and transformation of the current pattern of medical setups will produce a far reaching effect on medical institutions. While “reducing burdens”, big hospitals must try actively to suit the needs of the medical market under the new circumstances, give full play to their strong points, such as high concentration of talents, knowledge and resources, and provide quality, high efficiency and high value added medical service. It must also be brought to peoples awareness that third tier hospitals are not just the supplement and extension of community medical service but should also serve as its guarantee and backing.