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Objective To investigate the effect of ischemia/reperfusion(I/R) on tumor metastasis in a experimental mouse model of hematogenous metastasis after I/R; we also quantitated expression of matrix metalloproteinases-9 (MMP-9) during I/R.Methods An experimental mouse model of metastasis after partial hepatic I/R was designed to determine the effects of I/R on tumor metastasis to liver.Tumor loads were valued 7 days after operation.In addition,tissue analysis for alanine transaminase,aspartate transaminase (AST) and matrix metalloproteinases and 8 h reperfusion were performed.Results After 2 h hepatic reperfusion,ALT and AST in I 45 min group were higher than the sham group and I 30 min group (P ＜0.05).ALT and AST in the sham group were both a little higher than the normal.ALT and AST in the I 45 min group and I 30 min group at 8 h were both higher than those at 2 h reperfusion(P ＜0.05).The tumor load (valued by Hepatic replacement area) and the expression of MMP-9 in ischemic lobe in I 45 min group were greater than that after 30 min group and sham group.(P =0.013,P =0.007).There was no statistical difference on tumor load between the right lobe of sham operated mice and the right lobe (non-ischemic lobe) of mice subjected to I/R(P =0.089).Mouse survival were compared among the groups.Mice in Sham group lived longer than I 30 min group (P =0.041).And there were no statistical significance between I 45 min group and I 30 min group (P =0.055).MMP-9 expression in I 45 min group was higher than I 30 min group(P ＜ 0.001).Conclusion Hepatic I/R promotes liver hematogenic metastasis of hepatocellular carcinoma in mice through induction of MMP-9 expression.
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ObjectiveTo observe the effect of mesenchymal stem cells (MSCs) on enhancing rat islets viability and function in vitro by a pretransplant co-culture.Methods4-week-old Wistar rats were used as donors, bone mesenchymal stem cells were isolated and subcultured. Islets of Wistar rats were isolated and purified by one-step single-layer Histopaque-1077. Then islets were divided into four groups randomly, 2 groups co-cultured with mesenchymal stem cells (MSCs) (one using low-glucose medium; the other using high-glucose medium ); 2 groups were cultured alone (low-glucose medium; high-glucose medium), each group was further stratified into 3 subgroups(3, 7, 14 d); the survival and functionality of these islets were observed and evaluated. The amount of glucose stimulated secreted insulin were measured wth a rat/mouse insulin enzyme-linked immunosorbent assay (ELISA) kit and stimulation index was also calculated.ResultsCompared with those not co-cultured, islets co-cultured with MSCs demonstrated significantly higher survival rates and viability both in 3th, 7th and 14th day ( P ＜ 0. 01 ); furthermore, cocultured islets revealed higher levels of glucose stimulated insulin secretion and secretion indexes in 7th day (P＜0.01).ConclusionRat islet cells co-cultured with MSCs have longer in vitro survival and better functions.
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Objective:To investigate the feasibility and safety of a new method of natural orifice transluminal endoscopic surgery(NOTES) -totally transtracheal endoscopic thyroidectomy(TTET) .Methods:Three miniature swines and 6 beagle dogs were underwent TTET.Under general anesthesia,special designed endotracheal tube with 2-channel was used and endoscope and instruments were inserted through the respective channel.Incision of tracheal anterior wall was accomplished and partial or subtotal thyroidectomy was performed.Finally,the defects in the trachea were sutured with ENDO STITCH instrument.Results:Partial thyroidectomy was successfully accomplished on 3 pigs and subtotal thyroidectomy was done on 6 dogs.No serious complications such as anoxia,asphyxia,airway obstruction and death occurred during the operation.Animals were sacrificed 2h after the procedure and incision of trachea was found to be closely sutured.There were no subcutaneous emphysema and haematoma formation.Conclusion:Preliminary experimental results showed the feasibility and safety of TTET.Transtracheal access maintains the integrity of cervical tissues and achieves an optimal cosmetic outcome.TTET may open up a new field of NOTES on thyroid surgery.
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Objective To investigate the value of modified pancreatoduodenectomy in the treatment of ampullary carcinoma by comparing the efficacy of pancreatoduodenectomy with preservation of ascending portion of duodenum and that of Whipple procedure. Methods The clinical data of 133 patients with ampullary carcinoma who had been admitted to the Qilu Hospital from 1990 to 2006 were retrospectively analyzed. Of the 133 patients, 88 received Whipple procedure (group A) and 45 received pancreatoduedenectomy with preservation of ascending portion of duodenum (group B). The preoperative condition of the patients and short- and long-term efficacy of the 2 procedures were compared by Fisher exact probability, t test, chi-square test, Kaplan-Meier survival curve and Log-rank test, and the differences between the efficacy of the 2 procedures were compared. Results The operation time, time of gastrointestinal function recovery, hospital stay and ratio of patients with blood transfusion were (366±111) minutes, (7.4±1.4) days, (24±9) days and 76% (67/88) in group A, and (325±32)minutes, (4.3±1.4)days, (31±14)days, 42% (19/45) in group B, with significant difference between the 2 groups (t = 2.34, 2.08, 1.98 ; χ2 = 14.99, P < 0.05). The medium survival time of patients in groups A and B were (19.0±1.5)months and (16.9±1.7) months, with no significant difference between the 2 groups (χ2 = 0.46, P > 0.05). There was no significant difference in the occurrence of postoperative complications between the 2 groups (P > 0.05). Conclusions Pancreateduodenectomy with preservation of ascending portion of duodenum can be applied for patients with ampullary carcinoma.
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Objective To detect the effect of cell density off both integrin αγβ6 expression and matrix metalloproteinase-9(MMP-9)secretion in colon cancer cells. Methods Flow cytometry was applied to analyze αγβ6 expression in human WiDr colon cancer cell lines and human HaCaT keratinocyte cells, respectively,at high-and low-cell density culture.The MMP-9 aetivity level for various coloIl cancer cell lines, WiDr and SW480 cells at high-and low-cell density culture was analyzed using Biotrak MMP-9 activity assay and Gelatin Zymography assay, respectively. Results High cell density significantly enhances integrin αγβ6 expression for WiDr cells expressing αγβ6 compared with low density,but no increase was observed for human keratinocyte HaCaT cells. Biotrak MMP-9 assay indicated that the amount of MMP-9 secreted per cell for WiDr and SW480 B6 cells at high cell density culture was(3.3±1.2)×10-7ng/cell and(27.2±3.0)× 10-7ng/cell respectively; However,at low cell density it was(1.8±0.7)× 10-7ng/cell and(10.9±2.0)×10-7 ng/cell,respectively. It was 2-3-fold higher for WiDr and SW480 β6 cells at high cell density compared with that at low cell density, but no density-dependent increase observed for SW480 wild cells lack αγβ6 expression(t=0.47,P＞0.05),MMP-9 secretion for SW480 wild cells was(3.9±1.7)× 10-7 ng/cell at hish cell density and(3.8 ±0.7)×10-7 ng/cell at low eell density(P＞0.05),respectively. Gelatin zymography assay also indicated that the level of MMP-9 in SW480 B6 cells expressing αγβ6 was evidently higher at high density than at low density, however no density-dependent increase observed for SW480 wild cells and HaCaT cells. Conclusions High cell density induces integrin αγβ6 expression and promotes MMP-9 secretion in colon cancer cells, which constitutes the basis for a self-perpetuating system of tumor infiltrating growth in colon cancer progression.
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Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.
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Objective To evaluate the clinical significance of measuring angel of lesser pancreas(ALP) by ultrasound in diagnosis of neoplasm in the head of pancreas.Methods ALP was measured by ultrasound in 41 cases of pancreatic neoplasm,and in 52 normal cases as contrast.All of the cases were divided into three groups: group A,32 cases which were proven having mass in the head of pancreas by ultrasound; group B,9 cases which were discovered mass in the head of pancreas by CT or MRI,but not diagnosed by ultrasound; group C,52 cases as contract without presence of any mass in the head of pancreas.Results The mean value of ALP in group A,group B and group C was 83??9?,78??9?,and 43??5?, respectively.The angel in group A and group B was significantly wider than that in group C (P60?.Conclusions The widing of ALP by ultrasound is a sensitive sign for mass in the head of pancreas.
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Objective To investigate the diagnosis and treatment of patients with benign tumor of duodenum(BTD). Methods Clinico-pathological data of 24 patients with BTD treated by surgery in our department in recent 21 years were analyzed retrospectively. Among the 24 cases, 18 cases underwent local resection, 4 segmental duodenectomy, 1 subtotal gastrectomy and 1 pylorus-preserving pancreatoduodenectomy. Results Abdominal pain, digestive tract hemorrhage and duodenal obstruction were the common clinical manifestations of BTD. The correct diagnostic rates of air barium double contrast radiography and duodenoscopy were 82.4% and 93.3% respectively. The result of surgical treatment was satisfactory, except 1 patient who died of acute myocardial infarction 6 days after the operation. Of the 24 patients, the pathological examination showed as follows 8 had a villous adenoma, 6 gastrointestinal stromal tumor, 5 Brunner′s gland adenoma, 2 leiomyoma, 2 multiple adenomas in familial adenomatous polyposis, 1 hemangioma. Conclusions Air barium double contrast radiography and duodenoscopy are mainsteps for the diagnosis of BTD. The best treatment is surgical resection.
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Objective:To investigate the expression of costimulatory molecule B7-1 and B7-2 by warm ischemia/reperfusion(I/R)injury in rat liver and the meaning of immunology.Methods:Male Wistar rats were randomly divided into 3 groups:A(ischemia 30 mins,referfusion 24h),B(ischemia 60 mins,referfusion 24h),C(sham operation group).A model of hepatic warm I/R in rats was established according to the method of Ohmorid.The expression of B7-1 and B7-2 mRNA was analyzed by real-time reverse transcription polymerase chain reaction(RT-PCR).Results:Compared with the sham operation group,the expression of B7-1 and B7-2 mRNA increased significantly in the rats undergoing I/R procedure(P
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Objective:To study the effect of Cyclosporine A preconditioning on liver preservation and transplantation in rat.Methods:Rats were divided randomly into control group (group A,HTK solution preservation) and CsA precondioning group (groupB,HTK solution preservation+1?M CsA).The livers of two groups were had been all preservated for 12 hours before operation of orthotopic liver transplantation.The content of serum AST,ALT,LDH were all assayed during preservation in 0h,12h and 7d post liver transplantation,as well as determination of mitochondrial respiration function parameters (RCR and P/O).The change of cell morphology and apoptosis were also observed by TUNEL stain,and miclroscopes in two groups.Results:The content of serum ALT,AST and LDH in group B were less than in group A after presenvation for 12 hours.RCR and P/O parameters of mitochondrial respiration in group B on preservation for 12h.and for 30 min after operation were more than in group A.Cell morphology and apoptosis changed slingtly compared with group B.Conclusion:CsA preconditioning can relieve injury of donated liver during cold preseration and reperfusion.It protects mitochondrial fuction of liver cells and inlibits cell apoptosisa.
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Objective:We wanted to design an adequate method with which to cryopreserve rat aorta.Methods:Rat aorta were cryopreserved at 0.7℃/min,and kept frozen for 3 months.After being thawed,arteries were examined for contraction and vasodilation.Results:The mean contractions to KCL,PE,ET-1 and the relaxant ratio of SNP were better preserved in Group B than in Group C(P0.05).Conclusion:A modified cryopreservation technique can better preserves endothelial contractile function and endothelium independent vasodilation of the rat aorta than the conventional method,but the endothelium dependent vasodilation is badly preserved after the cryopreservation.
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Objective:To investigate the role of oxygen free radicals in renal dysfunction in rats with obstructive jaundice and the protective effect of Salvia Miltiorrhiae(SM) on renal mitochondria.Methods:The 54 Wistar rats were randomly divided into three groups:sham-operation control group(group A,n=18),obstructive jaundice group(group B,n=18),SM-treated group(group C,n=18).The model of obstructive jaundice in rats was established by common bile duct ligation(CBDL).In group C SM(5ml/kg?d) was given through abdominal cavity for 21 days.The rats were executed at 7th,14th,and 21th day after operation respectively.The contents of serum BIL,Cr,BUN and the contents of renal mitochondria MDA and cholesterol were determined respectively,and the changes of renal histopathology were observed.Results:The contents of renal mitochondria MDA and cholesterol in group B and group C were markedly higher than group A(P
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Objective:To evaluate the value of gastrointestinal endoscopy in patients with hepatic cell cancer.Methods:A retrospective analysis was made on 316 patients with hepatic cell cancer undergoing gastrointestinal endoscopy preoperatively from 1992 to 1998.Results:2 cases were accompanied with gastric cancer,62 cases with esophagogastric varices,58 cases with gastric or duodenal ulcer,218 cases with gastritis,Of them 30 cases with portal hypertension gastropathy,24 cases were normal.Conclusion:Hepatic cell cancer is usually accompanied with upper gastrointestinal lesions,It should be paied attention to treat perioperatively.
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Objective:To investigate the expression of lysozyme in ampullary carcinoma, and its relation with invasion, metastasis and prognosis. Methods: 36 cases were analyzed with immunohistochemistry of lysozyme. Results: The lysozyme-positive rate in patients with lymph node metastasis (30%) was significantly lower than that in patients without metastasis (71%), while that in patients with advanced cancer invading the pancreas (35%), was significantly lower than that in patients with cancer without invasion of the pancreas. The Survival rate of lysozyme-positive patients (66.7%) was significantly higher than that of lysozyme-negative patients (14.3%). Conclusion: The expression of lysozyme in carcinoma of ampulla is associated with invasion, metastasis and prognosis. Lysozyme is important in typing of cancer of ampulla.
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Objective : The patients with inguinal hernia were treated with plug mesh hernia repair. Methods:The hernia sacs were isolated and dissected back to the internal ring. The unoperated sacs were allowed to drop back through the internal ring into the abdominal cavity. A cone-shaped mesh hernia plug is inserted tapered end through ring and placed into position just beneath the crura. All our repairs were reinforced a second piece of flat was placed from the pubic tubercle, overlying the direct space. Results : Com-paired with conventional suture surgical techniques, a plug repair uses less disscection and ensures tenssion free hernioplusty. Conclusion : We believe that the two factors are the most important reseasons for greater patients confort, rapit rehabilitation, decreased recurrence and lessened overall complication rates with the mesh hernia plug techniques.
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Objective: To explore the effect of CO 2 pneumoperitoneum in laparoscopic surgery on the cardiovascular function of the geriatric cholelithiasis.Methods:Sixty aged patients undergone laparoscopic surgery were selected.During various stage of CO 2 insufflation,the heart rate(HR),blood pressure,oxygen saturation ,electrocardiogram(ECG),and myocardial enzymes were dected,and the clinical values of these changes were analyzed.Results: when CO 2 pneumoperitoneum established ,the HR and blood pressure were increased obviously .The incidence of arrhythmia was 36% and the incidence of changes of ST segment was 30%,10 minutes after pneumoperitoneum eliminated,these changes were restored. The myocardial enzymes and the oxygon saturation of blood had no distinct changes. Conclusion: The procedure of CO 2 pneumoperitoneum caused temporany changes of the HR ,SBP/DSP and ECG.The laparoscopic surgery is effective and safe for geriatric cholelithiasis.It suggests that the dynamic monitoring of electrocardiogram is necessary,especially for those with abnormal heart function.
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Objective: To set up the animal model of precancerous lesion of rats' pancreatic acinar cellular cancer,and to learn estrogen's effect on this lesion's biological feature and K-ras gene mutation. Methods: male Wistar rats were injected Azaser-ine 30mg/kg(ip). Some rats received Estradiol-17 P Valerate(0.18mg/100g/2weeks, im) .4 months later, rats'pancreas were autopsied and K-ras gene mutation were detected by PCR-SSCP method. Results : The incidence of AACN were very high. The incidence of K-ras gene mutation was 42.1% in rats without estrogen and 25.6% with estrogen. Conclusion: Azaserine could induce precancerous lesion of rats' pancreatic acinar cancer successfully, K-ras gene mutation was early change during this process Estrogen could inhibit this precancerous lesion's happen and development to some degree.