Combination of electronic bronchoscope and narrow band imaging (NBI) in diagnosis of carcinomatous hydrothorax / 中国内镜杂志

Objective To evaluate the value of the electron bronchoscopy in diagnosis of carcinothoracic fluid in the case of replacing medical thoracoscopy and combining narrow-band imaging (NBI). Methods 89 cases of suspected cancerous pleural effusion patients, used electronic bronchoscope Olympus BF-1T 260 in place of medical thoracoscopy to enter pleural cavity in the usual way. First observed by white light bronchoscopy (WLB), then by narrow-band imaging (NBI) and take 5 pieces of tissue out respectively on the pleura of the lesion for pathological examination. Then compare the sensitivity and specificity of WLB and NBI methods, and the bleeding after biopsy. Result Among 89 cases of suspected cancerous pleural effusion patients, 85 cases found positive by white light bronchoscopy (WLB) , negative in 4 cases, 6 cases bleeding after biopsy (6.70%). Compared with the pathological results, WLB sensitivity 97.50%, specificity 22.22%. 68 cases found positive by NBI, negative 21 cases, no active bleeding after biopsy. Compared with the pathological results, the sensitivity of the NBI 86.67%, specificity 78.57%. Compared WLB with NBI, the former's sensitivity is superior to the latter, the latter's specificity is superior to the former. Both comparisons about sensitivity diagnosis of the and specificity are statistically significant (P < 0.05). Conclusion Electronic bronchial in place of medical thoracoscopy has high diagnostic rate in the carcinothoracic fluid, and the combination of NBI can improve the accuracy and security of the biopsy.

Cause and treatment in dififcult decannulation of tracheotomy patients / 中国内镜杂志

Objective To observe the value of flexible bronchoscopy (fiberoptic bronchoscopy/electronic bron choscopy, abbreviation bronchoscopy) in the diagnosis and treatment of patients with decannulation dififcult after tracheotomy. Methods 17 cases with decannulation difficult after tracheotomy which were diagnosed and treated by lfexible bronchoscopy were reviewed and evaluated. Result Among the 17 patients with decannulation dififcult, except one failure in decannulation because of upper airway scar contracture with atresia after brain injury, the rest was successful, and decannulation rate was 94.1%. Except one patient with displacement of metal stents, and one patient with breathing dififculty after the decannulation, there was no other adverse reactions and deadly complications. Conclusion Flexible bronchoscope plays an important part in the diagnosis and treatment of the patients with decannulation dififcult after tracheotomy. It is safe and reliable, so it is worthy of clinical promotion.

Relationship of extrahepatic metastasis of primary hepatocellular carcinoma between circulative tumor cells in the blood of hepatoma patients / 中华外科杂志

<p><b>OBJECTIVE</b>To study the relationship between extrahepatic metastasis of primary hepatocellular carcinoma and circulative tumor cells in the blood of hepatoma patients.</p><p><b>METHODS</b>The immunomagnetic bead technique was employed to enrich and separate the hepatoma cells in the peripheral blood of preoperative and postoperative hepatoma patients. The relationship between postoperative extrahepatic metastasis and hepatoma cells in peripheral blood cancer cells were analyzed. The circulative tumor cells in the peripheral blood of hepatoma patients were enriched and separated by immunomagnetic bead technique. They were identified as hepatoma cells by AFP immunohistochemistry. Among 30 cases of hepatoma patients, the positive rate of hepatoma cells in the peripheral blood of preoperation and postoperation were 53.3% and 83.3% respectively. There was difference significantly in positive cases before operation and after operation (P<0.05).</p><p><b>CONCLUSIONS</b>Extrahepatic metastasis of primary hepatocellular carcinoma is obviously correlated to the positive tumor cells and the concentration in the peripheral blood of preoperative patients.</p>

Effects of Astragalus Membranaceus Injection on TNF-alpha-induced release of inflammatory factors from HUVECs and the molecular mechanisms / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the protective effect of Astragalus Membranaceus Injection on human umbilical vein endothelial cells (HUVECs) against tumor necrosis factor alpha (TNF-alpha).</p><p><b>METHODS</b>Cultured passage 2 HUVECs were stimulated with TNF-alpha with or without a 2-h Astragalus Membranaceus Injection treatment. The expression of nuclear factor-kappaB (NF-kappaB) subunit p65 were evaluated by immuncytochemistical method, and the levels of p65 in the nuclei and the protein Ikappabetaalpha in the cytoplasm were evaluated by Western blotting. The levels of interleukin-6 (IL-6) and soluble intracellular adhesion molecule-1 (sICAM-1) in the cell culture were determined with ELISA.</p><p><b>RESULTS</b>TNF-alpha induced the activation of NF-kappaB and increased the expressions of IL-6 and sICAM-1 in HUVECs. The activation of NF-kappabeta by TNF-alpha was suppressed by Astragalus Membranaceus Injection in a dose-dependent manner.</p><p><b>CONCLUSION</b>Astragalus Membranaceus Injection can inhibit the TNF-alpha-induced expression of IL-6 and sICAM-1 by suppressing NF-kappabeta activation, suggesting its protective effect on the endothelial function.</p>

Study of mesenchymal stem cells transfected with oncogenes differentiate into hepatocellular carcinoma of rats / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of rat mesenchymal stem cells (MSCs) transfected with different oncogenes differentiate into hepatocellular carcinoma (HCC) in vitro.</p><p><b>METHODS</b>MSCs, transfected with different oncogenes c-myc, K-ras, c-myc and K-ras and amplified in vitro, were infused into rats via vena portae. The recipient rats were divided into the hepatic impairment group, which were fed with tetrachloromethane and the healthy control group. At day 7, 14, 21, 28 and 42 following grafting, the complete livers were obtained and examined using fluorescence detection, conventional pathology and immunohistochemistry detection of GFP, c-kit and AFP to study the colonization and distribution of stem cells in rat liver.</p><p><b>RESULTS</b>No immunological rejection occurred after grafting of allogenic MSCs. The infused MSCs colonized in the recipient rat liver. Liver tumors were present in 6 rats grafted with MSCs that were transfected with K-ras, K-ras and c-myc, and the protein expression of AFP was detected using immunocytochemistry at day 7. Rats grafted with MSCs that were transfected with c-myc gene had no obvious tuberosity or tumor. Small oval cells were found microscopically in the periphery of vena portae, and immunohistochemistry staining of AFP was negative. Immunohistochemical staining of c-kit was positive in all livers of rats that were transfected with MSCs.</p><p><b>CONCLUSIONS</b>Hepatocellular carcinoma may derive from genetically mutated MSCs.</p>

Antisense oligonucleotide against survivin induces apoptosis and enhances adriamycin sensitivity of SMMC-7721/ADM cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the effects of survivin-specific antisense oligonucleotide (ASODN) delivered via liposome on the growth and apoptosis of drug-resistant human hepatic cancer cell line SMMC-7721/ADM and the sensitivity of the cells to adriamycin (ADM).</p><p><b>METHODS</b>SMMC-7721/ADM cells were divided into 6 groups and treated with liposome, ADM, sense oligonucleotide (SODN), SODN+ADM, 400 ng/ml ASODN, and 400 ng/ml ASODN+ADM group, respectively. MTT assay was used to calculate the relative survival rates of the cells, and the changes in cell apoptosis and cycle were detected with flow cytometry. RT-PCR and Western blotting were performed to detect the expressions of survivin mRNA and protein, respectively.</p><p><b>RESULTS</b>The apoptotic rate of ASODN-treated cells was much higher than that of the control cells. survivin protein expression showed no significant variation between cells treated with liposome, ADM, SODN, and SODN+ADM (P>0.05), whereas compared with these 4 groups, cells treated with 400 ng/ml ASODN and 400 ng/ml ASODN+ADM had significantly lowered survivin mRNA expression (P<0.05), without significant differences between the latter two groups (P>0.05). SMMC-7721/ADM cells cultured in the presence of ASODN and adriamycin showed significant growth inhibition in comparison with ASODN group and ADM group.</p><p><b>CONCLUSION</b>survivin-specific ASODN can enhance the sensitivity of SMMC-7721/ADM cells to ADM by depressing survivin expression in the cells, thus improves the effect of ADM chemotherapy for liver cancer.</p>

A study of rat mesenchymal stem cells (MSCs) differentiating into liver cells when co-cultured with rat hepatocytes / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To explore whether rat mesenchymal stem cells (MSCs) can be induced to develop into hepatocytes and the role of the microenvironment of hepatocytes growth in inducing MSCs differentiating into hepatocytes in vitro.</p><p><b>METHODS</b>Mesenchymal stem cells were collected from the aspirates from femurs of SD rats by density gradient centrifugation and identified by flow cytometric analysis and alkaline phosphatase (ALP) staining. Rat hepatocytes were isolated by the modified two-step method described by Seglen. Two 6-well culture plates were piled up after the chambers' bottoms of the upper plate was removed. Then the upper and lower chambers were separated by a semi-permeable membrane. MSCs and hepatocytes of rats were plated separately in the upper and lower chambers of the two 6-well culture plates for co-culturing. MSCs cultured alone without co-culturing with hepatocytes served as controls. On days 1, 3, 7, 14, 21 and 28, mRNA of cytokeratin 18 (CK-18), alpha-fetoprotein (AFP) and albumin were detected by reverse transcriptase-polymerase chain reaction (RT-PCR), and immunocytochemistry staining of CK-18 AFP and albumin were also examined.</p><p><b>RESULTS</b>The shapes of MSCs co-cultured with hepatocytes changed and their sizes and numbers increased in the course of the culturing. When MSCs were co-cultured with hepatocytes for 2 weeks, colonies composed of polygonal cells resembling mature hepatocytes were found. In the controls, shapes of cells also changed and their sizes and numbers increased, but colonies composed of polygonal cells resembling mature hepatocytes were not found. Of the MSCs co-cultured with hepatocytes, on day 7, the mRNA of AFP was detected by RT-PCR, and it increased on day 14, and then decreased on day 21. mRNA of albumin and CK-18 were detected by RT-PCR from day 14 to day 28 in the co-cultured cells, but mRNA of AFP and CK-18 and albumin were not detected in the controls in the course of the culturing. Immunocytochemical analysis for CK-18, albumin, and AFP, showed positive staining reaction for AFP on day 7, for CK-18 and AFP on day 14 in the co-cultured cells but not in the controls.</p><p><b>CONCLUSIONS</b>Rat MSCs co-cultured with hepatocytes can differentiate into hepatocytes.</p>

Hepatocyte growth factor induces differentiation of adult rat mesenchymal stem cells into a hepatocyte lineage in vitro / 中华外科杂志

<p><b>OBJECTIVE</b>To explore whether the mesenchymal stem cells (MSCs) of rats can be induced into hepatocytes and the condition of differentiation in vitro.</p><p><b>METHODS</b>Mesenchymal stem cells were collected from the femora of SD rats by density gradient centrifugation and identified by flow cytometric analysis and alkaline phosphatase (AKP) staining. MSCs were divided into 4 groups to induce differentiation with the different concentration of hepatocyte growth factor (HGF) in culture medium. The concentration of each group was group A 0 ng/ml, group B 10 ng/ml, group C 20 ng/ml and group D 40 ng/ml, respectively. The morphological changes of MSCs were observed by phase-contrast microscope. On day 1, 3, 7, 14, 21 and 28, mRNA of albumin, AFP and CK18 of MSCs of each group were examined by reverse transcription polymerase chain reaction (RT-PCR), and the expressions of them were also detected with immunohistochemistry technique.</p><p><b>RESULTS</b>Mesenchymal stem cells collected from the femora of SD rats expressed antigens of CD29, CD44 and CD90, but not CD34 and CD45. AKP staining was negative for all of MSCs. On day 7, AFP mRNA of MSCs in group C and D could be detected by RT-PCR, and increased on day 14, and then directed on day 21. Albumin and CK18 mRNA of MSCs in group C and D could also be detected from day 14 to day 28 by RT-PCR. On the contrary, mRNA of AFP, CK18 and albumin was not detected in group A and B of culture. Immunocytochemical analysis for CK18, albumin and AFP showed positive staining reaction for AFP on day 7, for CK18 and albumin on day 14 in group C and D, and negative staining reaction both in group A and B of culture.</p><p><b>CONCLUSION</b>MSCs of adult rats cultured in high concentration of HGF can differentiate into hepatocytes.</p>

Study of three-dimensional reconstruction of digitized virtual hepatic images / 中华外科杂志

<p><b>OBJECTIVE</b>To study the methods of three-dimensional reconstruction of digitized virtual hepatic.</p><p><b>METHODS</b>Images of DSCF 2511-2520 were taken from the database of digitized Virtual Chinese Human female No. 1 (VCH-F1). Method of insertion value algorithm of three-dimensional reconstruction was used to make three-dimensional block diagram. In ordering to auto-judge the position of hepatic solid and hepatic ducts, these images were shown with different colors according to the character of color and location of every spot.</p><p><b>RESULTS</b>Stereo image of hepatic solid could be shown satisfactorily. Every shape of stereo image and the structure of hepatic duct could be shown by revolving the three-dimensional image with different direction.</p><p><b>CONCLUSIONS</b>The image of hepatic database of digitized Virtual Chinese female No. 1 was exact. The three-dimensional image of the liver and hepatic duct made by insertion value algorithm of three-dimensional reconstruction were distinct, and it was a ideal method of three-dimensional reconstruction.</p>

Study of three-dimensional computerized reconstruction and CT scanning with thin slice after filling hepatic duct system / 中华外科杂志

<p><b>OBJECTIVE</b>To establish the modal of perfusing and casting in hepatic duct system and explore the methods of three dimensional reconstruction with CT scanning image after filling hepatic duct.</p><p><b>METHODS</b>All canal of livers with integral porta hepatic were perfused with various filling material after pretreatment, then fixed and casted. Hepatic preparations that had been perfused were put into the model of modelling abdominal cavity and scanned with thin slice. The three dimensional duct structures of hepatic with three methods of MIP, SSD and computerized treatment.</p><p><b>RESULTS</b>Fourteen hepatic samples were filled and casted. Nine hepatic samples were scanned with slice height 1.0 mm, all 2514 slice images and average 279 images. Five hepatic samples were scanned with slice height 3.0 mm, all 512 slice images and average 102 images. Intrahepatic vein and portal vein system of three dimensional reconstruction were seen clearly with MIP method. The three dimensional established three dimensional images with SSD method was shown much stronger than that of MIP method. The three dimensional images of hepatic solid and hepatic vein system were established with method of comperized treatment. Vary three dimensional shape of hepatic solid and hepatic vein was obtained through different direction rotational.</p><p><b>CONCLUSIONS</b>The modal filled and casted hepatic duct system were practise. The images established three dimensional with methods of MIP, SSD and comperized treatment were seen clearly. The modal and images of thin slice CT scanning are a better method for researching hepatic duct system.</p>