ABSTRACT
OBJECTIVE：To stud y the effects of different processed products of Whitmania pigra on hemorheology and coagulation indexes in acute blood stasis model rats. METHODS ：SD rats were randomly divided into blank group ，model group ， aspirin group ，W. pigra hang-dried product low- ，medium- and high-dose groups ，W. pigra talcum powder-ironed product low- ， medium- and high-dose groups ，W. pigra wine bran-processed product low- ，medium- and high-dose groups ，with 6 rats in each group. Except for blank group ，other groups received subcutaneous injection of epinephrine hydrochloride and ice water bath for 15 d to induce acute blood stasis model. From the 8th day of modeling ，rats in aspirin group were given aspirin 0.2 g/kg intragastrically. Rats in each dose group of W. pigra processed products were given relevant medicine 0.35，1.4，3.5 g/kg intragastrically（calculated by crude drug ）. Rats in blank group and model group were given constant volume of normal saline intragastrically， once a day ， for consecutive 8 days. Hemorheology indexes as whole blood viscosity （high， medium and low shearrate ），plasma viscosity ，erythrocyte com deformation index ，erythrocyte aggregation index ，hematocrit， and blood coagulation indexes as prothrombin time （PT）， mail：wcl19960125@163.com activated partial prothrombin time （APTT），thrombin time （TT）were determined. RESU LTS：Compared with blank group ，whole blood viscosity under different shear rates ，plasma viscosity ， erythrocyte aggregation index and hematocrit of model group were increased significantly ，while erythrocyte deformation index was significantly decreased ，PT，TT and APTT were significantly shortened （P＜0.01）. Compared with model group ，whole blood viscosity under different shear rates ，plasma viscosity ，erythrocyte aggregation index and hematocrit of aspirin group and W. pigra hang-dried product ，talcum powder-ironed product ，wine bran-processed product high-dose groups were decreased significantly ， while erythrocyte deformation index were significantly increased ，and PT （only W. pigra talcum powder-ironed products high-dose group），APTT（except for W. pigra hang-dried products high-dose group ）and TT were prolonged significantly. The whole blood viscosity of W. pigra hang-dried product medium-dose group under low shear rate ，and those of W. pigra talcum powder-ironed product low-dose ，wine bran-processed product medium-dose groups under low and medium shear rates were decreased significantly. Erythrocyte deformation index of W. pigra talcum powder-ironed product medium-dose group was increased significantly ，while erythrocyte aggregation index was decreased significantly ，and PT ，TT were prolonged significantly. APTT of W. pigra hang-dried product medium-dose group was prolonged significantly. Hematocrit of W. pigra wine bran-processed product low-dose group was decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ： W. pigra hang-dried， talcum powder-ironed and wine bran-processed product can effectively improve hemorheology indexes and prolong blood coagulation time.
ABSTRACT
Objective:To explore the clinical evaluation outcomes of COVID-19 risk assessment scale on organ donation and procurement during the pandemic of novel coronavirus pneumonia (NCP) and reduce the incidence of donor-derived infection and medical staff infection.Methods:From January 20 to February 29 in 2020, the organ procurement team adopted the COVID-19 risk assessment scale for evaluating 8 potential donors. They were classified into the levels of high/low/uncertain risk by analyzing the risk levels of donation hospitals, clinical characteristics and exposure history. The coordinators, organ evaluators and ward medical staff adopted essential protective measures. The infection status of 2019-nCoV in the above mentioned staff was examined and graft function in the corresponding recipients were observed.Results:Based upon the COVID-19 risk assessment results, the risk level was high (n=8), low (n=5) and uncertain (n=2) and underwent organ procurement. A total of 19 grafts including liver, kidney, pancreas and heart were harvested and successfully utilized for organ transplantation. During the observation period of 14 days, there was no suspected or confirmed infection of 2019-nCoV among coordinators and medical staff. No graft dysfunction or acute rejection was observed during a follow-up period of 4 to 30 days. No recipient was suspected or confirmed to be infected with 2019-nCoV and 6 of them were negative for 2019-nCoV nucleic acid testing after organ transplantation.Conclusions:During the COVID-19 pandemic, it is safe to proceed with donor organ evaluations and procurements according to the result with the COVID-19 risk assessment scale. Low-risk donor organ donation may be carried out, uncertain risk donor organ donation should be performed cautiously and high-risk donations discouraged.
ABSTRACT
Objective:To investigate the clinical evaluation effects of Corona Virus Disease 2019 (COVID-19) risk assessment scale on preoperative and surgical risk of liver transplantation during the COVID-19 outbreak.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 6 liver transplant recipients who were admitted to Southern Theater Command General Hospital of PLA between January 20 and March 27, 2020 were collected. There were 5 males and 1 female, aged from 42.0 to 62.0 years, with a median age of 53.0 years. There were 6 donors including 5 males and 1 female, aged from 24.0 to 60.0 years, with a median age of 41.5 years. All the donor livers were obtained through the China Organ Transplant Response System. Liver transplantation was performed in the fixed negative pressure operating room, and secondary protective measures were adopted for low-risk donors. Classic orthotopic liver transplantation or Piggyback liver transplantation was performed according to the specific situations of the recipients. Medical staffs in the ward were exposed to the secondary protective measures, and the three-grade protective measures were adopted for medical staffs when the liver transplant recipients had fever or suspected infection. Observation indicators: (1) risk assessment of COVID-19 on liver transplant recipients; (2) risk assessment of COVID-19 on medical staffs of liver transplantation; (3) treatment situations of liver transplant recipients; (4) postoperative situations of liver transplant recipients; (5) follow-up of liver transplant recipients; (6) infection of medical staffs of liver transplantation. Follow-up was performed using outpatient examination or telephone interview to detect whether liver transplant recipients had suspected or confirmed COVID-19 infection up to March 2020. Medical staffs who were involved in organ acquisition, transplantation surgery and ward management were followed up to detect whether they had suspected or confirmed COVID-19 infection within 14 days. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were described as M (range). Count data were expressed as absolute numbers. Results:(1) Risk assessment of COVID-19 on liver transplant recipients: all the 6 recipients and their related families were confirmed no contact with suspected COVID-19 patients or travel history in the epidemic area within 14 days. Of the 6 recipients, 1 was diagnosed with fever with body temperature of 38.1 ℃ and was tested negative for chest computer tomography (CT) examination and nucleic acid test for COVID-19; 1 was diagnosed with fever and hypoxemia with body temperature of 38.5 ℃ and was tested negative for nucleic acid test for COVID-19, and the results of chest CT examination showed large amount of pleural effusion in both lungs without invasive pneumonia; other 4 recipients had no clinical symptoms of COVID-19 with negative results of chest CT examination and nucleic acid test for COVID-19. Five of the 6 recipients had no history of contact with COVID-19 patients and 1 recipient had treatment history at hospital of risk level 1. The preoperative risk level of COVID-19 was low in all the 6 liver transplant recipients. (2) Risk assessment of COVID-19 on medical staffs of liver transplantation: of the 6 recipients, 5 had the waiting hospital of risk level 0 and 1 had the waiting hospital of risk level 1. Six recipients had the transplant hospital of risk level 0. (3) Treatment situations of liver transplant recipients: of the 6 recipients, 2 underwent classic orthotopic liver transplantation and 4 underwent piggyback liver transplantation. The cold ischemia time of liver, time of anhepatic phase, volume of intraoperative blood loss, operation time, treatment time at intensive care unit of the 6 recipients were (5.9±2.4)hours, (49±14)minutes, 1 500 mL(range, 800-1 800 mL), (8.9±2.1)hours, 2 days(range, 1-4 days), respectively. Of the 6 recipients, 2 required adjustment of the immunosuppression program, and 4 did not change the immunosuppression program. (4) Postoperative situations of liver transplant recipients: of the 6 recipients, 5 had no postoperative serious infection and 1 had postoperative serious infection. The 5 recipients without postoperative serious infection had the range of the highest temperature as 37.8-38.5 ℃, and returned to normal temperature within postoperative 3 days. All of the 5 recipients who had no postoperative serious infection received chest CT examination with no obvious manifestation of viral pneumonia and were tested negative for nucleic acid test for COVID-19 at 1 week postoperatively, and then were discharged from hospital. One recipient who had postoperative serious infection had gastrointestinal fistula and repeated fever at postoperative 7 days with the highest temperature as 39.2 ℃. This recipient had body temperature returned to normal and good function of the graft after treatment in the isolation ward with active drainage, and was transferred back to local hospital for further rehabilitation treatment. The duration of hospital stay of the 6 recipients were 30 days(range, 15-74 days). (5) Follow-up of liver transplant recipients: all the 6 recipients were followed up for 31.5 days(range, 12.0-64.0 days) with the normal body temperature, and they had negative results of viral pneumonia for chest CT examination and nucleic acid test for COVID-19. (6) Infection of medical staffs of liver transplantation: surgeons, nurses, anesthetists, medical staffs at ICU and medical staffs at liver transplantation center who participated in liver transplantation had good health within postoperative 14 days, without suspected or confirmed cases of COVID-19 infection.Conclusions:The COVID-19 risk assessment scale has good safety for liver transplant recipients during the COVID-19 outbreak. It is suggested that organ transplantation can be carried out in low-risk recipients and cautiously carried out in recipients of uncertain risk, but organ transplantation should not be carried out in high-risk recipients.
ABSTRACT
Objective To establish a quality standard of yinqiao xiaozhen mixture. Methods Preparation of Forsyth-ia,Arctium lappa L.,and Honeysuckle were identified by TLC method.The concentration of baicalin in yinqiao xiaozhen mixture was determined by HPLC method. Results The qualitative identification method can detect Forsythia,Arctium lappa L.,and Honeysuckle.TLC spots were clear.TLC method has strong specificity.The linear range of baicalin was 0.122 5-1.531 2 μg,r=0.999 9,the average sample recovery rate was 99.42%,RSD was 2.19%,respectively. Conclusion The method is simple,ac-curate and repeatable,which can be used for quality control of Qinqiao xiaozhen mixture.
ABSTRACT
Objective To explore the efficiency of the ABC-HOME in the rapid identification and assessment of potential donors.Methods We developed a submit system and a rapid assessment method of ABC-HOME for potential donors at 2013.They were on trial in service area hospitals of Guangzou General Hospital Organ Procurement Organization (GHOPO) from February,2015.We reviewed medical records of potential donors occurring in the intensive unit at 2014,from February to December 2015 and 2016,respectively.We examined data on the number of potential donors,actual donors and beds of ICU,and calculated the number of potential donors and actual donors per bed per year.The reasons for donation failure were analyzed.Results 19,38 and 50 organ donations were realized in 243,474 and 513 potential donors in 2014,from February 2015 to December 2015 and 2016,respectively.The growth rate of organ donation and the number of actual donors per bed per year was 95.0%,8.2% and 0.45,0.89 and 0.96,respectively.The conversion rate in these potential donors was 8.92% from February 2015 to December 2016.The reasons for donation failure included the family and social factors,doctor-patient relationship and communication factor and illness condition of donors' factors.Conclusion ABC-HOME is a convenient assessment method for potential donors,which can help to promote the identification of potential donors and to increase the number of potential donor information.
ABSTRACT
OBJECTIVE:To discuss the expression of voltage-gated potassium channel(KV1.3)and calcium activated potassi-um channel(KCa3.1)in peripheral monocyte from patients with coronary artery disease(CAD)and the regulatory effect of simvas-tatin. METHODS:20 patients with CAD and 8 control patients without CAD diagnosed by percutaneous coronary intervention but correlated to risk factor of CAD were enrolled. The expression of KV1.3 mRNA and KCa3.1 mRNA were measured by RT-PCR in 2 groups,and those of CAD group were measured by RT-PCR after 1 month of simvastatin treatment. RESULTS:Compared with control group,mRNA expression of KV1.3 [(1.54±0.08)vs.(0.77±0.06),P<0.01] and KCa3.1 [(1.32±0.08)vs.(1.06±0.06), P<0.05] were significantly increased in CAD group. mRNA expression of KV1.3 was significantly correlated to the concentration of C reactive protein (CRP)(P=0.003)and was decreased by simvastatin for one month [(1.54 ± 0.08)vs.(1.14 ± 0.05),P<0.01]. However,mRNA expression of KCa3.1 was not correlated to the concentration of CRP and simvastatin didn’t affect it’s expression. CONCLUSIONS:KV1.3 and KCa3.1 in peripheral monocytes may be two new markers of CAD. Regulating KV1.3 may be one of mechanisms of statin’s pleiotrophic effect.
ABSTRACT
Objective To summarize the experiences and protocol of extracorporeal membrane oxygenation (ECMO) technique in donors with brain death and unexpected cardiac arrest.Method We described here the organ donation of one case of brain death complicated with hemodynamic instability and cardiac arrest,and the corresponding recovery of the receptor liver.A 50-year old female developed brain death due to brain aneurysmal hemorrhage.He was given two kinds of high-dose vasopressor,but hemodynarnic instability was not improved.After ECMO support,the hemodynamics turned to stable,but unexpected cardiac arrest happened.The total operating time of ECMO was 5 h,including 4 h after cardiac arrest.The liver was transplanted into a 65-year old female with hepatocellular carcinoma (diagnosed by Hangzhou Criteria) by classic orthotopic liver transplantation with end-to-end anastomosis.Result One liver and two kidneys were obtained successfully,and all the receptors recovered uneventfully.The post-operative ALT and AST levels reached the peak at 169 U/L and 365 U/L respectively,and returned to normal two weeks later.Conclusion ECMO can be used to support brain death complicated with hemodynamic instability and unexpected cardiac arrest.It can save precious time for organ donation,and preserve the function of liver and kidney as well.
ABSTRACT
Objective To evaluate the clinical value of minimally invasive methods for non-anastomotic biliary stricture (NABS) after orthotopic liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation during recent 10 years in Liver Transplantation Center at General Hospital of Guangzhou Military Commanmol were analyzed retrospectively,and 13 patients with NABS were selected.The outcomes of 3 types of NABS patients treated by endoscopic retrograde cholangiopancreatography(ERCP) or percutaneous transhepatic cholangial drainage(PTCD) were compared and the indication for re-transplantation was identified.Results PTCD treatments of 4 patients were proved ineffective.The shortterm curative rate of minimally invasive treatments was 8/13.Five patients eventually required surgical treatments (re-transplantation in 4,Roux-en-Y anastomosis in 1).According to cholangiography results,NABS were divided into 3 types,namely hepatic bile duct strictures (n =4,type Ⅰ),multiple extra-hepatic and intrahepatic biliary strictures (n =7,type Ⅱ),intrahepatic biliary strictures (n =2,type Ⅲ).The success rates of minimally invasive treatment in 3 types of NABS were 3/4,4/7 and 1/2,respectively.Nearly half of type Ⅱ and type Ⅲ patients needed re-transplantation,which was more likely for those patients with hepatic artery stenosis (2/3).Conclusion NABS treated with minimally invasive methods are preferred.Based on the appearance of biliary stricture,type Ⅰ patients had the best prognosis.For those type Ⅱ and type Ⅲ patients who failed minimally invasive treatment,especially combined with hepatic arterial stenosis,surgical treatment should be timely,so as not to lose a chance for re-transplantation.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the effects and related mechanisms of exogenous fibroblast growth factor (FGF) 21 on atherosclerosis in apolipoprotein E deficient (apoE-/-) mice.</p><p><b>METHODS</b>Male 17-week-old C57BL/6J mice and apoE-/- mice were randomly divided into three groups (n = 12 each): blank control group (C vehicle), atherosclerosis group without FGF21 (apoE-/- vehicle) and apoE-/- plus FGF21 (100 µg × kg⁻¹ × d⁻¹ subcutaneously treatment) . All mice were fed with high-fat diet for 4 weeks. After 4 weeks treatments, atherosclerotic lesions in aortic arch and inner diameter of abdominal aorta were measured by ultrasonography. Plasma lipid profiles, CRP and TNFα were measured. The whole aorta and aortic root were prepared for HE and oil red O staining to analyze lesion areas.</p><p><b>RESULTS</b>There was no evident plaque in C vehicle group. TC/HDL-C, LDL-C/HDL-C, non-HDL-C, expression of CRP and TNFα were significantly higher in apoE-/- vehicle group than in C vehicle group (all P < 0.05). IMT of aorta [(156.4 ± 17.6)µm vs. (57.8 ± 7.4)µm] were significantly higher in apoE-/- vehicle group than in C vehicle group (all P < 0.05). While FGF21 significantly reduced the lesion area in aorta arch [(1.42 ± 0.16) mm² vs. (2.30 ± 0.10) mm², P < 0.05] and the inner diameter of abdominal aorta [(0.97 ± 0.03) mm vs. (0.75 ± 0.18) mm, P < 0.05] compared to apoE-/- vehicle group. Similarly, TC/HDL-C(5.11 ± 0.70), LDL-C/HDL-C(3.90 ± 0.76), non-HDL-C[(6.33 ± 1.22)mmol/L], plasma CRP[(4.20 ± 1.03)mmol/L] and plasma TNFα[(1.29 ± 0.47)mmol/L] were also reduced by FGF21( all P < 0.05 vs. apoE-/- vehicle). Moreover, FGF21 decreased the IMT[(107.2 ± 33.5)µm vs. (156.4 ± 17.6)µm], lesion area of aorta [(14.26 ± 3.5)%] vs. [(23.06 ± 4.16)%] and plaque size of aorta root [(21.75 ± 7.14)% vs. (38.03 ± 5.76)%] (all P < 0.05 vs. apoE-/- vehicle).</p><p><b>CONCLUSIONS</b>FGF21 can protect apoE-/- mice from atherosclerosis by modifying lipid profiles and downregulating CRP and TNFα expressions.</p>
Subject(s)
Animals , Male , Mice , Aorta , Pathology , Apolipoproteins E , Genetics , Atherosclerosis , Blood , Pathology , C-Reactive Protein , Metabolism , Disease Models, Animal , Fibroblast Growth Factors , Pharmacology , Lipids , Blood , Mice, Inbred C57BL , Mice, Knockout , Plaque, Atherosclerotic , Pathology , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To investigate the application and clinical value of donation after citizens death (DCD) in salvage liver transplantation (SLT).Method The clinical data of 12 recipients who underwent SLT from DCD of 12 donors at the Guangzhou General Hospital of Guangzhou Military Area from October 2010 to December 2013 were retrospectively analyzed.Of the donors,there was one case of type of China-Ⅰ,2 cases of the type of China-Ⅱ and 9 cases of the type of China-Ⅲ.Extracorporeal membrane oxygenation (ECMO) was applied to donation after brain and cardiac death to avoid warm ischemia.Of the recipients,6 met the Milan criteria,3 UCSF(The University of California,San Francisco) criteria and 3 Hangzhou criteria respectively.Orthotopic liver transplantation was performed on recipients.Eleven recipients received end-to-end anastomosis of the bile duct and followed up regularly.Result Liver transplantation was successfully performed on all recipients.No mortality during operation,no recovering delay and non-function of the transplanted liver occurred.Postoperative complications occurred in 4 cases,2 patients died,and 2 patients recovered and discharged after the second surgery.Ten recipients had a long-term survival.Two cases of hepatocellular carcinoma (HCC) recurrence were still alive after active treatment.The longest survival time was 42 months.All of them had no long-term complications such as biliary stricture.Conclusion The role and status of SLT in the treatment of HCC has become increasingly,and there will be more and more use of DCD donor in SLT.To ensure the DCD donors safely and effectively applied in SLT,we should grasp the characteristics of SLT,choose the appropriate DCD donor according to recipients,and rationally use the ECMO to protect the graft quality.
ABSTRACT
Objective To study the diagnosis and treatment of non-anastomotic biliary stricture (NABS) after liver transplantation.Methods The clinical data of 403 patients who underwent liver transplantation in the past 10 years in our department were analyzed retrospectively,compared different methods to find out the most appropriate method in the diagnosis and management of NABS.Results NABS occurred in 13 out of 403 patients (3.2％),almost the same incidence as in patients who received DCD donor livers (4.16％,2/48).The clinical signs of NABS were frequent cholangitis and high TBil,r-GT and AKP (P ＜0.01).All these cases were finally diagnosed by cholangiography and they could be classified into 3 types:hepatic bile duct stricture (4 patients,type Ⅰ),multiple extrahepatic and intrahepatic biliary strictures (7 patients,type Ⅱ),intrahepatic biliary strictures (2 patients,type Ⅲ).NABS were mainly treated by interventional therapy,Roux-en-Y anastomosis and retransplantation in our centre.All type Ⅰ patients were successfully managed with interventional therapy/ERCP and Roux-en-Y anastomosis,but 44.4％ (4/9) of type Ⅱ and Ⅲ patients required retransplantation.The TBIL,r-GT and AKP decreased significantly in 12 patients (P ＜ 0.05) and the total curative rate of NABS was 92.3％ (12/13) with one patient who died after retransplantation.Conclusions Cholangiography was an effective way to diagnose NABS which is common among patients after liver transplantation.Interventional therapy/ERCP,Roux-en-Y anastomosis and retransplantation were our 3 ways to treat this problem.We proceeded from easy to difficult and chose a suitable way to deal with NABS according to the different types of biliary stricture from cholangiography.Type Ⅰ patients had much better prognosis than Type Ⅱ and Ⅲ patients who should receive retransplantation if interventional therapy/ERCP failed.
ABSTRACT
The donated organ after cardiac death would undergo warn ischemia injury inevitably,and the incidences of primary non-function of donated organs,transplanted organ loss and ischemic-type biliary lesions were increased.It is a paramount research dilemma to devise how to avert,lessen and recover the warm ischemia organs after donation of cardiac death (DCD).Since February 2009,the Liver Transplantation Center of Guangzhou General Hospital of Guangzhou Military Command of PLA has applied the extracorporeal membrane oxygenation (ECMO) to protect the organs of DCD.The mechanism of recovering the donors from warm ishemia by ECMO has good prospects in the field of international organ donation,and it is an important method to solve the problem of donor shortage in China.Spreading the application range of ECMO in DCD and establishing the standard procedures and techniques in China is of great importance.
ABSTRACT
ObjectiveTo summarize the early clinical experience of the extracorporeal membrane oxygenation (ECMO) for protecting the liver donation after cardiac death (DCD).Methods Review and analysis the clinical data of 17 cases of liver transplantation with the donors from Chinese citizen after cardiac death from July 2009 to May 2011 in our liver transplantation center,and comprehend the primary diseases and the relevant index of the donors,the flow-sheet of donation and obtain of the organs from the donation after cardiac death,and the apply methods of extracorporeal membrane oxygenation during those processes.ResultsAll 17 cases had been diagnosed as brain death before,and waited for cardiac death,so all were clearly the donation of brain death plus cardiac death(DBCD).During the processes waiting for cardiac death,extracorporeal membrane oxygenation were introducted in every case,and the using time were 51-380 (mean 187)min.The donation after brain death plus cardiac death (DBCD) were all harvested liver donors and were transplanted to 17 receivers respectively.In our center,there was no operational death in liver transplantation in this series.The post-operation liver function recovered satisfactory,without transplant liver non-function or recovering delay.One case died of the pulmonary infection one month later after operation,and the other 16 cases all survived and were followed up to now.The longest survival time was 29 months.ConclusionThe donation after brain death plus cardiac death (DBCD) was the special donation type for citizen in China.The extracorporeal membrane oxygenation (ECMO) could well control the warm ischemia for protecting the liver donor just without ethics dispute.So,the using of the extracorporeal membrane oxygenation (ECMO) for the liver donation after cardiac death(DCD)of citizen in our China have very important contribution.
ABSTRACT
Objective To summarize the clinical experiences in liver transplantation from donation after cardiac death donors. Methods The clinical data of 20 recipients who underwent liver transplantation from donation after cardiac death of 20 donors at the Guangzhou General Hospital of Guangzhou Military Area from July 2006 to May 2011 were retrospectively analyzed.Extracorporeal membrane oxygenation (ECMO) was applied to donors with brain and cardiac death to avoid warm ischemia.Donors in type Ⅲ according to the Maastricht classification did not receive ECMO.Liver grafts were obtained 5 minutes after the stop of heartbeat of the donors.Orthotopic liver transplantation was performed on recipients.Seventeen recipients received end-to-end bile duct anastomosis and 3 received cholangioenterostomy.All the recipients were followed up regularly.The survival curve was drawn by Kaplan-Meier method.Results Of the 20 donors,2 ( 10％ ) were in the type of Maastricht Ⅲ and 18 (90％) were donation after brain and cardiac death donors.Liver transplantation was successfully performed on all recipients,and the mean operation time,duration of anhepatic phase,mean volume of blood loss and duration of postoperative intensive care unit stay were (6.2 ± 2.7 ) hours,( 54 ± 13 ) minutes,( 2305 ± 1311 ) ml and (44 ±35) hours,respectively.There was no mortality during operation,and no recovering delay and non-function of the transplanted liver occurred.One recipient died of sepsis and 1 died of pulmonary infection at 1 month after operation,the other 18 recipients all survived.The longest survival time was 58 months.Conclusions Donation after cardiac death is the main source of liver grafts in China currently,and donation after brain and cardiac death is the main type.Establishment of rational flow-sheets of the donation after cardiac death and liver transplantation,rational application of ECMO for protecting the liver grafts are helpful for the work of organ donation after brain and cardiac death.
ABSTRACT
Objective To investigate the expression and genetic alterations of KLF6 in hepatocellular carcinoma (HCC) and explore their functional mechanisms in the oncogenesis and development of HCC. Methods Real-time quantitative-PCR, direct sequencing and LOH approaches were used to detect KLF6 genetic abnormalities in HCC. The experiment had 2 groups, an experimental group and a control group. In the experimental group, the transfected plasmid pcDNA3.0 was recombined with KLF6 and tranfected into HCC HepG2 cells. MTT, flow cytometry and Western blotting were used to observe the effect of anti-oncogene wild type KLF6 on HepG2 cells by transgenic method for 48 h.Results Expression levels of KLF6 were significantly downregulated in HCCs(P＜0. 01), as detected by qRT-PCR. LOH occurred in 11 (52%) of the 21 tumors, and all the samples with LOH showed KLF6 down-regulation. The mutational frequency was 29%, and sequence changes located in activation domain of KLF6. Meanwhile, MTT assay showed a significant antiproliferative effect of the transfected wtKLF6 on HepG2 cells(42.7%, P＜0.05). Fluorescence-activated cell sorting analysis revealed that KLF6 induced apoptosis. Conclusion The deregulation of KLF6 together with genetic abnormalities of allelic imbalance and mutations may play an important role in HCC pathogenesis.
ABSTRACT
ObjectiveTo study the impact of primary PCI in culprit artery on epicardial blood flow of nonculprit artery in patients with STEMI. MethodsEnrolled 117 patients with anterior wall STEMI were treated with primary PCI in the culprit artery, left anterior descending artery (LAD, as study group.Another 100 patients with normal coronary artery evidenced by angiography were enrolled as control group.The differences in CTFC (corrected TIMI frame count measured by using digital subtraction arteriography,TIMI =thrombolysis in myocardial infarction) and MBG (myocardium blood flow perfusion grading)between pre and post primary PCI in both culprit artery and nonculprit artery ( left circumflex artery, LCX),and CTFC and MBG were also detected in the subjects of control group. Blood samples were collected and the levels of CRP (C-reactive protein) were assayed. Clinical and angiographic features were analyzed.ResultsThe CTFC of nonculprit artery (LCX) and the level of MBG in patients with anterior wall STEMI were different from the level of MBG and CTFC in control group ( P＜0. 05) before primary PCI. The level of MBG and CTFC in nonculprit artery (LCX) were improved (P ＜ 0. 05 ) after primary PCI, but they did not resume to normal level. Patients without reflow in culprit artery had higher incidence of no reflow in nonculprit artery than patients with re-flow (78％ vs. 8％, P ＜ 0. 01 ), and the level of CRP in patients without reflow in nonculprit artery were higher than those in patients with re-flow ( P ＜ 0. 05). Conclusions The perfusion of nonculprit artery may be impaired in patients with STEMI. Although the perfusion of nonculprit artery may be improved after primary PCI in culprit artery, but it was still lower than those in the control group, and inflammation mechanism might contribute to it.
ABSTRACT
Objective To study the expression of matrix metalloproteinase 9 (MMP-9) and microvessel density (MVD) in prostatic cancer (PCa) and correlation with their metastasis. Methods The expression of MMP-9 and CD34(marked MVD) was detected by immunohistochemistry in 70 cases of prostatic diseases,including PCa (42 cases) and benign prostatic hyperplasia (BPH)(28 cases), compared clinical-stage and pathology and studied their results by statistical methods. Results The positive rate of MMP-9 in BPH and PCa was 10.7% (3/28) and 54.8% (23/42), the positive rate of MMP-9 was significantly higher in PCa than that in BPH (P< 0.05). The positive rate of MMP-9 in PCa metastasis group (C+D phase) and situ group (A+B phase) was 76.9% (20/26) and 18.8% (3/16),there was statistically significant difference between PCa metastasis group and situ group (P < 0.01). The concentration of MVD in PCa metastasis group and situ group was (69.47 ± 11.86), (51.09 ± 11.98) points each view, there was statistically significant difference between PCa metastasis group and situ group(P< 0.01) ,and all of MVD in PCa was significantly higher than that in BPH (27.92 ± 8.41) points each view (P < 0.01). The higher MMP-9 expression was positively correlated with increased MVD in PCa (r = 0.325,P< 0.05). Conclusion MMP-9 and MVD can be as indicator to pridict the metastasis of PCa.
ABSTRACT
Kruppel-like factor 6 (KLF6) was reported as tumor suppressor in multiple cancers. However, loss of chromosomal locus spanning KLF6 is relatively infrequent in previous published studies. To explore the role of KLF6 in hepatocellular carcinoma (HCC), we examined the gene for expression change, loss of heterozygosity (LOH) and mutation in 26 HCC samples. The expression levels of KLF6 were significantly down-regulated in HCCs, as detected by qRT-PCR. LOH occurred in 11 (52%) of 21 tumors, and all the samples with LOH showed KLF6 down-regulation. The mutational frequency was 24%, and sequence changes located in activation domain of KLF6. Furthermore, MTT assay showed a significant antiproliferative effect of the wt KLF6 transfected in HepG2 hepatoblastoma cells. Fluorescence-activated cell sorting analysis revealed that KLF6 could induce apoptosis. These findings indicate that deregulation of KLF6, together with genetic abnormalities of allelic imbalance and mutations, may play a role in HCC pathogenesis.
ABSTRACT
Objective To study the abnormalities of motor evoked potentials(MEPs)obtained from obese subjects induced by magnetic stimulation at T12 to L1. Methods A total of 90 healthy subjects without any neuro-muscular system abnormalities were divided into 3 groups according to the body mass index(BMI).The control group consisted of 30 normal somatotype males(BMI<23),while the obese somatotype group(BMI>30)and weight-reduc-ing group(BMI>30)consisted of 30 obese somatotype males,respectively.The subjects in the control group and obese somatotype group maintain their usual lifestyle as before,while those in the weight-reducing group were reques-ted to lose weight by all means.MEPs were induced by using magnetic stimulation of 70%and 90%the output of the stimulator,respectively,at T12 to L1 and recorded from all the anbjcots at the time of admission to the study and one year later. Results At admission,the amplitude and conduction time of MEPs in obese somatotype group and weight-reducing group were significantly different from those in control group(P<0.05),when the magnetic stimula- tion of 70%the stimulator output was employed.but all the indexes were not difierent when 90%the stimulator uot- put were adopted(P>0.05).One year later,the amplitude and conduction time of MEPs in obese somatotype group were significantly different from those in control group and weight-reducing group(P<0.05),but all the indexes were not different within 3 groups when 90%the stimulator output was adopted(P>0.05). Conclusion Supra-maximal magnetic stimulation should be used for recording the MEPs from the obese subjects,or false positive result would be obtained.
ABSTRACT
Objective To study the effectiveness and safety of methods of transurethral bipolar plasmakinetie prostatectomy for benign prostatic hyperplasia with large volume.Methods The transurethral bipolar plasmakinetic prostatectomy with Nesbit (Nesbit group,45 cases)and prying-up technique (pryhag-up group,60 cases)were performed in 105 patients of the prostatic volume of more than 60 g.The results could be obtained by comparing operative time,intraoperative and postoperative blood loss and the time of postoperative sustained washing of the bladder between the two groups.Results In Nesbit group,the efficiency of average cutting gland was (0.79±0.17)g/min,the average intraoperative blood loss was (3.87± 1.09)ml/g,the decrease in postoperative Hb within 24 hours was (6.84±3.96)g/L,the average time of postoperative continuous washing of the bladder was 72 hours,8 patients were given by blood transfusion.In prying-up group,the corresponding data were(1.16±0.20) g/min,(1.60±0.64)ml/g,(3.87±2.33 )g/L,36 hours respectively,none of patients was given by blood transfusion.There were statistically significant in two groups(P＜0.05).Conclusions The adoption of prying-up is more favorable compared with Nesbit method in the aspects such as less blood loss,shorter operating time,less lotion,more thorough resection of the gland,higher security.It is conducive to delivering lecture,and it enables the standard operational procedure available.