ABSTRACT
Objective:To investigate the efficacy and safety of ticagrelor and clopidogrel in patients with coronary atherosclerotic heart disease (CHD) and hyperhomocysteinemia (Hhcy).Methods:A total of 101 patients with CHD complicated with HHcy who had successfully undergone percutaneous coronary intervention (PCI) were enrolled. They were divided into ticagrelor group ( n=49) and clopidogrel group ( n=52) according to the different antiplatelet drugs used. The clinical data of the two groups were collected, and the incidence of major cardiovascular and cerebrovascular adverse events (MACCE) and bleeding events in one year were compared between the two groups. Results:There was no statistical difference in baseline datas and PCI datas between the clopidogrel and ticagrelor groups ( P>0.05). Compared with clopidogrel group, ticagrelor can reduce the total MACCE (8.16% vs 32.69%, P<0.05) and the incidence of unstable angina pectoris events (0 vs 13.46%, P<0.05) in patients with hyperhomocysteinemia PCI 1 year after operation. The incidences of ischemic stroke, unstable angina pectoris, recurrent myocardial infarction, and cardiogenic death were compared separately between the two groups, and the difference was not statistically significant ( P>0.05). The incidence of major bleeding events, minor bleeding events, and minimal bleeding events were similar between the two groups, and the difference was not statistically significant (4.08% vs 0; 4.08% vs 1.92%; 20.41% vs 9.62%; P>0.05). Conclusions:In patients with CHD and Hhcy, ticagrelor can play a better antithrombotic effect, reduce the incidence of ischemic events, and has good security, which is more worthy of clinical recommendation.
ABSTRACT
The hospital took the lead in the area to carry out stroke process improvement, including the accountability practice of the president, micro-videos for illness condition description, standardized language communication, CT-room thrombolysis, and interdisciplinary seamless corporation among others. The timespan from admission to thrombolysis ( door to needle time, DNT) has shortened significantly, scoring the median time of 25 minutes and the shortest of 8 minutes. The hospital is also the first in the area to initiate the program to bypass the emergency department and the thrombolytic treatment on the ambulance. Such bypass program keeps the DNT of emergency patients within 15 minutes.
ABSTRACT
Objective To analyze the clinical features and definitive repair strategies of bile duct strictures after hepatectomy.Methods The clinical data of patients undergoing definite repair for bile duct strictures after hepatectomy in the PLA General Hospital from 2000 to 2014 and Beijing Tsinghua Changgung Hospital from 2014 to 2017 were retrospectively collected.Results Twenty-one patients with bile duct stricture after hepatectomy were treated with reoperation.Among them,13 cases showed continuous bile leakage after operation.The types of hepatectomy include 10 cases of left or extended left hemihepatectomy,7 cases of right or extended right hemihepatectomy,2 cases of mesohepatectomy,and 2 cases of hepatic caudate labectomy.According to classification formulated by the Biliary Surgery Group of Chinese Medical Association,the types of injuries of the patients included four of Ⅱ 2,twelve of Ⅱ 3,and five of Ⅱ 4 respectively.19 of 21 patients underwent definitive repair with hepaticojejunostomy.The long-term follow-up success rate was 89.0％.Conclusions Biliary injury after hepatectomy in which the injury affects the secondary or below hepatic ducts requires surgical repair.Hepaticjejunostomy is an effective definitive repair method.Hepaticjejunostomy for bile duct stenosis after right hemihepatectomy always need to dissect the left intrahepatic bile duct by a hilar plate approach or UPV approach,due to the effect of hepatic portal transposition.Surgical repair for bile duct stenosis after the left hepatectomy,always need the incision of the right anterior and right posterior hepatic duct,due to extensive injuries of hepatic duct.
ABSTRACT
Objective To summarize the clinicopathological characteristic,diagnosis and treatment of iatrogenic biliary tree destruction.Methods The retrospective cross-sectional study was conducted.The clinical data of 11 patients with iatrogenic biliary tree destruction who were admitted to the Chinese PLA General Hospital (9 patients) between January 1990 and December 2013 and Beijing Tsinghua Changgung Hospital (2 patients) between December 2014 and May 2017 were collected.Observation indicators:(1) causes and parts of destruction;(2) clinical manifestation;(3) imaging performance;(4) treatment;(5) follow-up.Follow-up using outpatient examination and telephone interview was performed to detect long-term prognosis of patients up to April 2018.Measurement data with skewed distribution were described as M (range).Results (1) Causes and parts of iatrogenic biliary tree destruction:causes of iatrogenic biliary tree destruction in 11 patients:transcatheter arterial embolization for hepatic hemangioma was performed in 7 patients,high intensity focused ultrasound for hepatic hemangioma in 1 patient,arterial embolization for false aneurysm in 1 patient,sclerosant injection for hepatic echinococcosis in 1 patient,and cyberknife radiotherapy for hepatocellular carcinoma in 1 patient.Parts of biliary tree destruction of 11 patients:5,3,2 and 1 respectively involved bilateral biliary tree,right biliary tree,bilateral main biliary ducts in hepatic port and left biliary tree.(2) Clinical manifestation:11 patients had symptoms of recurrent chills and fever,and combined with different degrees of jaundice.The initial symptom occurred in 2 weeks to 3 months after iatrogenic biliary tree destruction.Of 11 patients,7 were complicated by different degrees of hepatic abscess,and abscess involving left and right half liver were detected in 4 patients,aggregating in right half liver in 2 patients and aggregating in left half liver in 1 patient.Eight patients had secondary biliary cirrhosis,portal hypertension,splenomegaly and hypersplenism during the late course of disease.(3) Imaging performance:magnetic resonanced cholangio-pancreatography (MRCP) and cholangiography examinations showed missing bile duct in necrosis area,beading-like stricture and dilation of damaged biliary tree,reducing proximal bile duct branches and associated gallbladder necrosis.CT and MRI examinations showed that structure of distribution area of damaged biliary tree disappeared or bile duct wall was thickened,and hepatic abscesses of patients were scattered and multiple.Five patients had significantly secondary liver atrophy-hypertrophic syndrome,showing atrophy of right liver and hyperplasia of left liver.Radiotherapy-induced biliary tree destruction showed a characteristic of continued progress,localized abnormality in the early stage and typical imaging changes after the damage stability in the late stage.(4) Treatment:of 11 patients,4 didn't undergo surgery,and 7 underwent 18 intentional and conclusive surgeries (1-4 times / per case).(5) Follow-up:11 patients were followed up for 2-132 months,with a median time of 73 months.During the follow-up,2,1 and 8 patients had respectively excellent,good and poor prognoses.Among 11 patients,4 died (2 died of severe infection and 2 died of biliary cirrhosis),and 7 survived.Conclusions Iatrogenic biliary tree destruction is easy to cause hepatic abscess,liver atrophy-hypertrophic syndrome or biliary cirrhosis,and it can be diagnosed by imaging examination.The definitive treatment should be followed by liver resection or liver transplantation of involving area according to the extent of damage.
ABSTRACT
Objective To explore clinical efficacy of new types of operation based on perihilar resection to cure hilar cholangiocarcinoma.Methods The retrospective descriptive study was conducted.The clinicopathological data of 4 patients with different Bismuth type of hilar cholangiocarcinoma who were admitted to the Beijing Tsinghua Chunggung Hospital from December 2014 to June 2016 were collected.After preoperative examinations and evaluations,single perihilar resection or combined with central liver segmentectomy were performed.Observation indicators included:(1) intraoperative situations;(2) postoperative pathological examinations;(3) postoperative situations;(4) follow-up.Patients were followed up using outpatient examination up to June 2017.Follow-up included abdominal pain,fever,routine blood test,tumor marker test and imaging examination which detected tumor recurrence and metastasis.Measurement data were represented as average (range).Results (1) Intraoperative situations:4 patients received successful operations,with an average operation time of 512 minutes (range,300-620 minutes).Portal vein was blocked continuously,with an average occlusion time of 70 minutes (range,57-80 minutes),an average volume of intraoperative blood loss was 537 mL (range,200-1 000 mL).Two patients received transfusion of 2 U plasma,4 U plasma + 4 U red blood cell (RBC),respectively.(2) Postoperative pathological examinations:results of postoperative pathological examinations in 4 patients showed that tumor size was respectively 1.5 cm× 1.2 cm× 1.1 cm,1.3 cm× 1.1 cm× 1.0 cm,2.0 cm× 1.7 cm× 1.5 cm and 2.0 cm×2.0 cm× 1.5 cm.Tumor differentiation:1 and 3 patients were respectively detected in moderate-differentiated cholangiocarcinoma and low-differentiated cholangiocarcinoma.Positive nerve plexus invasion was found in all 4 patients and 3 patients had regional lymph node metastasis.Four patients received R0 resection.TNM staging:T2aN1M0 and T2bN1M0 were found in 1 and 3 patients,respectively.(3) Postoperative situations:of 4 patients,1 complicated with biliary leakage was cured by conservative treatment and then discharged from hospital at 67 days;3 had good recovery and then discharged from hospital at day 21,14 and 14,respectively.Patients didn't receive postoperative adjuvant treatment,such as chemoradiotherapy.(4) Follow-up:4 patients were followed up for 12-31 months.During follow-up,4 patients were in good condition,and 1 with transient fever was relieved by conservative treatment.Levels of tumor marker in 4 patients were normal,results of enhanced CT scan showed no signs of tumor recurrence and intrahepatic bile duct dilatation.Conclusion After precisely evaluating the tumor extension among segmental bile duct,single perihilar resection or combined with central segmentectomy can effectively cure hilar cholangiocarcinoma.
ABSTRACT
Objective To explore clinical efficacy of new types of operation based on perihilar resection to cure hilar cholangiocarcinoma.Methods The retrospective descriptive study was conducted.The clinicopathological data of 4 patients with different Bismuth type of hilar cholangiocarcinoma who were admitted to the Beijing Tsinghua Chunggung Hospital from December 2014 to June 2016 were collected.After preoperative examinations and evaluations,single perihilar resection or combined with central liver segmentectomy were performed.Observation indicators included:(1) intraoperative situations;(2) postoperative pathological examinations;(3) postoperative situations;(4) follow-up.Patients were followed up using outpatient examination up to June 2017.Follow-up included abdominal pain,fever,routine blood test,tumor marker test and imaging examination which detected tumor recurrence and metastasis.Measurement data were represented as average (range).Results (1) Intraoperative situations:4 patients received successful operations,with an average operation time of 512 minutes (range,300-620 minutes).Portal vein was blocked continuously,with an average occlusion time of 70 minutes (range,57-80 minutes),an average volume of intraoperative blood loss was 537 mL (range,200-1 000 mL).Two patients received transfusion of 2 U plasma,4 U plasma + 4 U red blood cell (RBC),respectively.(2) Postoperative pathological examinations:results of postoperative pathological examinations in 4 patients showed that tumor size was respectively 1.5 cm× 1.2 cm× 1.1 cm,1.3 cm× 1.1 cm× 1.0 cm,2.0 cm× 1.7 cm× 1.5 cm and 2.0 cm×2.0 cm× 1.5 cm.Tumor differentiation:1 and 3 patients were respectively detected in moderate-differentiated cholangiocarcinoma and low-differentiated cholangiocarcinoma.Positive nerve plexus invasion was found in all 4 patients and 3 patients had regional lymph node metastasis.Four patients received R0 resection.TNM staging:T2aN1M0 and T2bN1M0 were found in 1 and 3 patients,respectively.(3) Postoperative situations:of 4 patients,1 complicated with biliary leakage was cured by conservative treatment and then discharged from hospital at 67 days;3 had good recovery and then discharged from hospital at day 21,14 and 14,respectively.Patients didn't receive postoperative adjuvant treatment,such as chemoradiotherapy.(4) Follow-up:4 patients were followed up for 12-31 months.During follow-up,4 patients were in good condition,and 1 with transient fever was relieved by conservative treatment.Levels of tumor marker in 4 patients were normal,results of enhanced CT scan showed no signs of tumor recurrence and intrahepatic bile duct dilatation.Conclusion After precisely evaluating the tumor extension among segmental bile duct,single perihilar resection or combined with central segmentectomy can effectively cure hilar cholangiocarcinoma.
ABSTRACT
Optimization of surgical treatment of biliary dilatation (BD) depends on reasonable clinical classification and standardized classification-based treatment strategy.Due to increasing limits and defects of classic Todani classification,a new classification named Dong-classification has been proposed,which was based on a large series analysis from a single referral center.Some important parameters including anatomical location and range of BD,pathogenic factors,and different surgical managements were main considerations in the new classification.After practical application and evaluation,Dong-classification has been improved step by step.It is believed that Dong-classification may contribute to improving surgical treatment decision and selecting reasonable operative plan.
ABSTRACT
Objective To observe the therapeutic effect of porcine myocardium against porcine myocardial infarction (MI) by porcine myocardial infarction model with connexin-43/zonula occludens-1 (CX43/ZO-1) double gene induced pluripotent stem cells (iPS) transplantation.Methods Porcine myocardial infarction model was established by balloon occlusion.One week later,1640 culture medium,CX43 gene ips cells and CX43/ZO-1 gene ips cells were injected into the different coronary arteries.After 3 months,electron microscopy and color Doppler ultrasonography were used to evaluate the curative effect.Results Compared to ips group of CX43 and 1640 culture group,in CX43/ZO-1 gene ips group,electron microscope showed a large number of island-like cardiomyocytes,blood vessels and intact intercalated discs in the infarct area and normal myocardial junction area structure,color Doppler echocardiography showed left ventricular end diastolic diameter reduced,and ejection fraction was significantly increased (P ＜ 0.05).Conclusions Transfection of CX43/ZO-1 double gene ips cells can promote cardiomyocyte regeneration and cardiac function recovery in porcine myocardial infarction model.
ABSTRACT
Objective To explore the feasibility of electromagnetic navigation for hepatic ducts exploration by choledochoscope based on a three-dimensional (3D) printing model.Methods The retrospective descriptive study was conducted.The clinical data of 1 patient with obstructive jaundice combined with secondary biliary tract dilation who was admitted to the Beijing Tsinghua Changgung Hospital in April 2016 were collected.Digital imaging and standardized format data of enhanced computed tomography (CT) scan were collected,3D reconstruction of liver and bile duct were done under a 3D printing model,and then a hollow model of bile duct was achieved.Choledochoscope with internal electromagnetic probe was inserted into the printed hepatic ducts.Four points of anatomical markers in left and right hepatic ducts and common hepatic duct were chosen as fiducial markers for calibration and registration.Results After registration,the scope can be tracked in main hepatic segmental bile ducts.The locations of choledochoscope matched precisely the navigation results.Conclusion Electromagnetic navigation may bring accurate tracking effectiveness for choledochoscopic examination.
ABSTRACT
The sphincter of Oddi is a valve that controls the biliopancreatic duct and plays an irreplaceable role in maintaining normal physiological functions of the biliopancreatic duct.However,sphincteroplasty and sphincterotomy may cause varying degrees of damage to the function of the sphincter of Oddi,which may further result in postoperative reflux of duodenal fluids and bacterial contamination in bile and increase the risks of recurrent common bile duct stones,reflux cholangitis,and even cholangiocarcinoma.Therefore,clinical physicians should protect the structure and function of the sphincter of Oddi.Based on our experience,under the premise that the extrahepatic bile duct can be preserved,patients with iatrogenic injury of the sphincter of Oddi can be treated with transduodenal sphincteroplasty to restore the structural integrity of the sphincter of Oddi and reduce biliopancreatic duct complications secondary to loss of function.
ABSTRACT
ObjectiveTo investigate the effects of bone marrow stem cells autologous transplantation after acute myocardial infarction on local mRNA expression of SDF-1,Kit ligand,E-selectin,ICAM-1and VCAM-1.Methods Acute myocardial infarction models were established in 10 swine,which were randomized divided into placebo group (5 swine) and transplantation group (5 swine).After six months,hearts of placebo group and early transplantation group were harvested and mRNA expression of SDF-1,Kit ligand,E-selectin,ICAM-1 and VCAM-1 in infarcted myocardial region was detected.Results The mRNAs of SDF-1,Kit ligand,E-selection,ICAM-1 and VCAM-1 were expressed in the infarcted myocardial region of transplantation group six months after myocardial infarction,but it was not found in the placebo group.ConclusionsBone marrow autologous transplantation after acute myocardial infarction can promote local mRNA expression of SDF-1,Kit ligand,E-selectin,ICAM-1 and VCAM-1,which may be due to the paracrine effects of stem cells.
ABSTRACT
ObjectiveTo compare the effects on left ventricular remodeling of bone marrow mononuclear cells transplantation one week and three months after acute myocardial infarction.MethodsAcute myocardial infarction models were successfully established in 15 swine,which were randomly divided into three groups:placebo group,early transplantation group and late trasplantation group.One week after model had been established,early transplantation group underwent bone marrow mononuclear cells transplantation,and then so did the late trasplantation group three months after acute myocardial infarction.B-ultrasound and single photon emission computed tomography (SPECT) examinations were performed to assess the left ventricular end diastolic dimension( LVd),left ventricular end diastolic volume(EDV) and left ventricular ejection fraction(EF) before and one week,three months,six months after acute myocardial infarction.ResultsThe LVd of late transplantation group [ (54.20:t:3.70) mm] was lower than placebo group [ (63.20 ±5.63)mm],but higher than early transplantation group [ (47.40 ± 1.14)mm].The EDV of late transplantation group [ ( 163.00 ±6.96)ml] was lower than placebo group [ (209.40 ± 18.69)ml],but higher than early transplantation group [ ( 135.40 ± 4.93 ) ml ].The EF of late transplantation group (0.25 ±0.02) was higher than placebo group (0.19 ±0.02),but lower than early transplantation group (0.37 ±0.02).ConclusionsBone marrow mononuclear cells transplantation can alleviate progressing ventricular remodeling,even it is performed three month after acute myocardial infarction,but its therapeutic effects are inferior to early transplantation's.
ABSTRACT
Objective To analyze the advantages of right hepatic resection using the anterior approach for large right hepatic tumors. Methods After initial control of the right liver hilum, liver parenchyma was transected along the ischemic plane down to the anterior surface of the inferior vena cava. All the small caval branches were individually ligated and divided. The right hepatic vein was then isolated, divided and sutured. Sequentially, the right hepatic lobe and tumor were mobilized from the right abdominal cavity in the usual manner and delivered. Results The anterior approach was used for right hepatic resection in 24 patients with huge right hepatic tumors from January 2000 to December 2006 in our hospital. The median size of the tumors was 15.7 cm. Intraoperative blood loss and blood transfusion volume were 734 ml and 620 ml, respectively. No major postoperative complications or hospital death occurred. Conclusion The anterior approach is a preferred technique for huge right hepatic tumors that are very difficult to resect in the conventional manner.
ABSTRACT
Objective To investigate the effects of established swine acute myocardial infarction and following ventricular remodeling model by occluding Coronary with balloon. Methods Ten healthy Domestic swine are enrolled. Each swine's left anterior descending coronary artery was occluded for three hours by dilated balloon, and then reperfusion was performed. During the whole course of operation, the electro-cardiogram was monitored. B-ultrasound and single -photon emission computed tomography examination (SPECT) were performed to detect left ventricular end diastolic dimension, left ventricular tip wall thickness, left ventricular end diastolic volume and left ventricula ejection fraction before operation and one week, three month, six month after acute myocardial infarction. Results Five swine died during the period of opera-tion for lack of experience, the remains survived. Electrocardiogram revealed significant ST-elevation and Q-wave formation. B-untrasound and SPECT witnessed deteriorating left ventricular end diastolic dimension expansion, left ventricular tip wall thickness thinning, left ventricular end diastolic volume expansion and left ventricular ejection fraction depression. Conclusions Coronary artery occlusion by balloon can successfully establish acute myocardial infarction and following left ventricular remodeling models.
ABSTRACT
BACKGROUND:Animal experiments have demonstrated that transplanted bone marrow stem cells (BMSCs)in the myocardial infarction region can directionally differentiate into myocardial cells with normal physiological function and promote neovascularization. Clinical studies have also showed that the cardiac function can be improved in myocardial infarction and cardiomyopathy patients after stem cell transplantation.OBJECTIVE: To observe the effect of autologous BMSCs transplantation on short-term cardiac function of patients with heart failure of ischemic cardiomyopathy.DESIGN: Self-control study.SETTING: Department of Cardiology, Xiangtan Central Hospital.PARTICIPANTS: Twenty-one patients with ischemic cardiomyopathy, including 13 males and 8 females, aged (64±6)years,who received treatment in the Department of Cardiology,Xiangtan Central Hospital of Hunan Province from March 2004 to January 2006 were retrieved. Inclusive criteria: with previous myocardial infarction at least once, B-mode ultrasonic cardiac examination showed that cardiac chamber was expanded, obvious cardiac inadequacy or stenocardia existed before stent implantation and hospitalized repeatedly, underwent percutaneous coronary artery intervention for restoring blood flow of infarcted vessel to TIMI3 degree over 3 months,but cardiac inadequacy existed to different degrees.Coronary arteriongraphy showed that no stenosis was found in the stent implanted in the coronary artery.Informed consents were obtained from all the patients.METHODS:After admission, all the patients received BMSCs transplantation based on routine drug treatment.Infarction-related arterial passage was established by percutaneous transluminal catheter technique and occluded by balloon.Isolated bone marrow stem cell suspension was injected into infarction-related arterial passage through the central cavity of catheter. ① Left ventricular ejection fractions (LVEF) and left ventricular end-diastolic diameter(LVDd)were measured before and 6 months after transplantation.② 24-hour dynamic electrocardiogram evaluation was conducted before and 6 months after transplantation under the precondition of not taking antiarrhythmic drugs. ③Clinical cardiac functional grading was conducted before and 6 months after transplantation by NYHA grading method: Grade Ⅰto Ⅳ: the higher grade, the severer symptom. ④ Adverse events and side effects were observed after operation.MAIN OUTCOME MEASURES:① LVEF and LVDd were measured before and 6 months after transplantation. ②24-hour dynamic electrocardiogram evaluation results. ③ Clinical cardiac functional grading evaluation results. ④ Post-operative adverse events and side effects.RESULTS:All the involved 21 patients participated in the result analysis.①The LVEF of patients 6 months after transplantation of BMSCs was more than that before transplantation [(54.4±6.2)％, (44.6±6.4)％,t = -5.946, P＜ 0.01], and LVDd of patients 6 months after transplantation was smaller than that before transplantation [(54.6±4.2), (60.2±4.4) mm,t = 5.306, P ＜ 0.01]. ② No new arrhythmic types appeared, and case of malignant serious cardiac arrhythmias were not increased. ③ Six months after transplantation of BMSCs, there were totally 9 patients with cardiac function of grade Ⅲ and Ⅳ, while there were 18 patients before transplantation. ④ The whole transplantation was safe.No patients were found to undergo re-examination of coronary arteriongraphy, which showed stent necrosis, due to chest pain, and no dead cases were either found.CONCLUSION:It is feasible to treat ischemic cardiomyopathy by percutaneous coronary transplantation of BMSCs,which can boost LVEF and improve cardiac function after transplantation.
ABSTRACT
BACKGROUND: Recent researches demonstrate that transplantation of bone marrow stem cells in the area of myocardial infarction can directionally differentiate into myocardial cells having normal physiological function and can promote newborn vascularization so as to repair infarction myocardium and improve injured cardiac function.OBJECTIVE: To observe short-term clinical effect of autologous bone marrow stem cell transplantation (ABMSCT) in percutaneous coronary artery on the treatment of acute myocardial infarction.DESIGN: Self-control study.SETTING: Department of Cardiology, Xiangtan Central Hospital.PARTICIPANTS: A total of 27 patients with acute myocardial infarction, including 16 males and 11 females, were selected from Department of Cardiology, Xiangtan Central Hospital from June 2004 to December 2006. Their ages coronary artery was finished after onset emergently; in addition, blood flow of infraction related vessels recovered to grade TIMI3. All patients provided the confirmed consent.METHODS: Operative procedure: All patients were performed with emergently interventional therapy of coronary artery after onset of acute myocardial infarction. One week later, percutaneous cavity tube technique was used to establish infarction related arterial pathway, and guiding filament was used to send micro-perfusion tube into stents. And then,separated bone marrow stem cell suspension was poured through central cavity of micro-tube into the distal end of infarction vessels. Operative evaluation: Dynamic electrocardiogram was evaluated for 24 hours before and after transplantation; in addition, left ventricular ejection fraction and myocardial perfusion defect scores were detected before and at 6 and 12 months after transplantation; otherwise, recovery state and complication were observed in follow up at 6 and 12 months after operation.defect scores: At 6 and 12 months after operation, left ventricular ejection fraction was higher than that before transplantation, and there was significant difference before and after transplantation (P＜0.05). While, myocardial perfusion defect scores were lower than those before transplantation, and there was significant difference before and arrhythmia were not found out, cardiac arrhythmia was not increased, and cardiac arrhythmia combining with malignancy not have any complications and in-stent constriction after operation.
ABSTRACT
Objective To study the expression of survivin and its relationship with the proliferative activity in hepatocellular carcinoma.Methods Using immunohistochemistry ABC methods, the expression of survivin and PCNA were evaluated in 31 hepatocellular carcinoma, 8 cirrhosis of liver and 4 normal livers tissues.Results No expression of survivin were detected in normal livers and cirrhosis of liver. In contrast, survivin protein was expressed in 19 of 31 patients with HCC(61.3%). When compared with normal livers and cirrhosis of liver, hepatocellular carcinoma had significantly more frequencies of survivin expression(P
ABSTRACT
0.05).Myocardial perfusion defect scores were decreased significantly from 14.8?3.0 to 10.5?1.8(P
ABSTRACT
Objective To investigate the selective killing effect of MDA/IL-24 on human hepatocellular carcinoma line HepG2 in vitro and provide a theoretical basis for gene therapy of hepatocellular carcinoma.Methods The MDA-7/IL-24 gene was transfected into human hepatocullular carcinoma cell line HepG2 and normal liver cell line L02 with a replication-incompetent adenovirus vector.The mRNA and protein expression of MDA7/IL-24 in HepG2 and L02 cells was examined by RT-PCR and ELISA assay respectively.MTT assay and flow cytometry were used to study tumor cell proliferation and cell cycle in vitro.Hoechst and Annexin-V and PI staining were studied to indicate the apoptosis.Results RT-PCR confirmed that the exogenous MDA-7/IL-24 gene was expressed in HepG2 and L02 cells.The protein product was confirmed by assay of the supernatant with ELISA.MTT and apoptosis test indicated MDA-7/IL-24 induced growth suppression and cell apoptosis of the HepG2 cell in vitro but not in cell line L02,and cell cycle test revealed MDA-7/IL-24 could block HepG2 cell in G2/M but not in L02.Conclusions MDA-7/IL-24 selectively induces growth suppression and apoptosis in lines HepG2 in vitro but not in L02 cell,which indicates that adenovirus mediated MDA-7/IL-24 can be an excellent tool for gene therapy in hepatocellular carcinoma.
ABSTRACT
Objective To explore a new molecular target for HSV-tk/GCV system in human liver cancer therapy.Methods The lactose and poly-L-lysine covalently linked compound(Lac-PLL) were prepared by using reductive amination methods and purified by using Sephadex G10 gel filtration.The value of n was determined by methods of phenol-vitriol colorimetry.The plasmid r-pAs16Dr was mixed with the conjugate to form a gene delivery complex named GlanPLL-r-pAs16Dr.The GlanPLL-r-pAs16Dr was transformed to different cell lines such as HepG2 and A549 to confirm the expression of RFP.The expression of HSV-tk was confirmed by RT-PCR.Cells with various concentrations of GCV were observed at different time points using MTT.Results The PLL modified by 34 Lac was obtained by using chemical synthesis.The RFP was expressed in HepG2 by 48h after transfection,and was not expressed in A549.The expression of HSV-tk was only detected in HepG2 using RT-PCR.The HepG2 transformed with GlanPLL-r-pAs16Dr was sensitive to GCV and the growth inhibiting rate was 70.5% with the treatment of low concentration of GCV(1mg/L) for 3 days.The A549 was not sensitive to GCV.Conclusion Lac-PLL,which is easy to prepare,is an efficient carrier for HSV-tk to be delivered to hepatoma cell lines by binding to ASGPR.