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ObjectiveObjective To investigate the value of pancreatic elasticity based on shear wave elastography (SWE) in predicting the risk of pancreatic fistula, to measure pancreatic hardness by determining the SWE level of the pancreatic body, and to reduce the development of pancreatic fistula after pancreaticoduodenectomy. MethodsA retrospective analysis was performed for the clinical data of 53 patients who were admitted to The Affiliated Hospital of Binzhou Medical University from October 2017 to February 2019 and underwent pancreaticoduodenectomy (PD). The 53 patients were divided into pancreatic fistula group with 10 patients who developed pancreatic fistula after PD and non-pancreatic fistula group with 43 patients who did not develop this disease after PD. The elasticity value of the pancreatic body measured by SWE was used to reflect the tissue elasticity of the pancreas and evaluate the hardness of the pancreas. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between groups. A logistic regression analysis was used for univariate analysis, and the Spearman’s correlation coefficient was used to investigate the correlation between SWE and other laboratory data. ResultsBody mass index (BMI) (t=1.321), preoperative total bilirubin (t=1.347), diameter of the main pancreatic duct (t=1.385), maximum SWE value (t=1.728), mean SWE value (t=1.634), and intraoperative pancreatic hardness (χ2=4.983) were risk factors for pancreatic fistula (all P＜0.05). Maximum SWE value and mean SWE value were negatively correlated with age and time of operation (maximum SWE value: r=-0.329 and -0.260, both P＜0.05; mean SWE value: r=-0.282, and -0.282, both P＜0.05) and positively correlated with BMI (r=0.275 and 0.350, both P＜0.05). ConclusionSWE level is an independent risk factor for pancreatic fistula after pancreaticoduodenectomy, and the SWE level of the pancreatic body has a high predictive value and guiding significance in surgical treatment.
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Objective To compare acoustic radiation force impulse(ARFI)and supersonic shear imaging (SWE) in diagnosis of liver fibrosis in patients with chronic hepatitis B. Methods Eighty patients with chronic hepatitis B having underwent ARFI and SWE examination were enrolled in this study.The elastic modulus E value(EI)was measured by SWE.The liver shear wave velocity(VTQ)was measured by ARFI.All patients underwent liver biopsy.The diagnostic values of SWE and ARFI for liver fibrosis were analyzed with Sperman correlation and the ROC curve.Results The values of EI and VTQ were increased with the pathological stage determined by liver biopsy and there were significantly differences(P<0.01).The correlation coefficient of SWE and ARFI was 0.651,P<0.01.The correlation coefficient of SWE, ARFI and pathological stage determined by liver biopsy were 0.784 and 0.683 and there were significant differences(P<0.01).The areas under ROC for diagnosing liver fibrosis≥S2,≥S3 and =S4 by using SWE were 0.912, 0.934 and 0.955 respectively and those by using ARFI were 0.870, 0.892 and 0.884. The sensitivity of ARFI in diagnosing liver fibrosis was similar with SWE, but SWE showed higher specificity (Z=8.756,P < 0.01; Z=10.802,P < 0.01; Z=15.871,P < 0.01). Conclusions Both SWE and ARFI can be effectively used in the evaluation of liver fibrosis in patients with chronic hepatitis B.The SWE technology has more advantages.
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BACKGROUND: The relationship between cellular morphosis and function is undetachable, but there is little investigation about ultrastructure of human umbilical cord mesenchymal stem cells (hUCMSCs).OBJECTIVE: To study the relationship between the functions of hUCMSCs and their ultrastructure obtained by atomic force microscope (AFM). METHODS: hUCMSCs were isolated, cultured, expanded after enzyme digestion. P3 cells were observed under AFM. Immunophenotype and cell cycle were analyzed by flow cytometry, as well as induction of the adipogenic, osteogenic differentiation of hUCMSCs were identified using Oil red O staining and alkaline phosphatase staining. RESULTS AND CONCLUSION: hUCMSCs at passage 3 were strongly positive for CD44 and CD29, weakly positive for CD106, but negative for hematopoietic marker CD34. Cells in G_0/G_1 phase accounted for 80%. Proliferation index was 19.9%. Following adipogenic induction, alkaline phosphatase staining demonstrated brown cytoplasm in cube and polygonal cells. AFM showed hUCMSCs were spindle shape, obvious cytoskeletal filament that connected into nets, which fit for the strong capacities for proliferation, migration and differentiation.
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BACKGROUND:Fibroblast growth factor can promote proliferation of mesenchymal stem cells (MSCs).grew along the wall.However,there are few reports on the differentiation of MSCs into hepatocytes following fibroblast growth factor induction.When mass concentration of hepatocyte growth factor was 1 μg/L,it can promote mitosis of hepatocytes,and is the strongest mitogenic agent for normal hepatocytes.OBJECTIVE:To explore the biological characteristics of human umbilical cord MSCs/n vitro and their differentiation ability to hepatocyte-like cells under the induction of chemical factors.DESIGN,TIME AND SETTING:The cytological in vitro study was conducted at the Institute of Blood,Jinan University from August 2008 to April 2009.MATERIALS:Umbilical cord was obtained from healthy full-term fetus,which was provided by the Guangzhou Huaqiao Hospital.The parturient signed informed consent.Hepatocyte growth factor and flbroblast growth factor were bought from Peprotech,USA.METHODS:The MSCs from human cord were isolated and cultured by type Ⅳ colagenase digestion+differential adherence.At the third passage,MSCs received cell surface antigen analysis and cell cycle determination to detect their ability to differentiate into adipocytes and osteoblasts.At the fifth passage,MSCs were adjusted into 5×10~9/L and assigned into 2 groups.BMSCs in the control group were incubated in DMEM/F12 containing 5% fetal bovine serum.BMSCs in the induction group were treated with above-mentioned medium supplemented with 20 μg/L hepatocyte growth factor and 10 μg/L flbroblast growth factor.MAIN OUTCOME MEASURES:The following parameters were measured:biological characteristics of human umbilical cord MSCs and differentiation of human umbilical cord MSCs into hepatocyte-like cells in vitro.RESULTS:At the third passage,MSCs derived from human cord expressed CD29,CD44,CD105,but not antigens of hematopoietic CD34,CD45,and 92.2% of them were in G_0/G_1 phase.Oil red O staining showed cytoplasm presented red granules.Alkaline phosphatase staining demonstrated that cytoplasm was black,with the differentiation ability into adipocytes and osteoblasts.Following 10 days of combined induction of hepstocyte growth factor and fibroblast growth factor,RT-PCR and Western blot results confirmed that cells expressed alpha fetoprotein and albumin.Negative expression was found in the control group.CONCLUSION:Human umbilical cord contained plenty of MSCs,with strong potential of multi-differentiation.Umbilical cord MSCs can differentiate into hepatocyte-like cells following combined induction of hepatocyte growth factor and fibroblast growth factor.