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The occurrence and development of hepatic ischemia-reperfusion injury (HIR) has important clinical significance,while interleukin-6 (IL-6) is closely related to HIR and it plays an important role in the signaling pathway between downstream signal transducer and activator of transcription 3 (STAT3).IL-6 has been considered to be a typical proinflammatory cytokine.Activation of the gpl30 homodimer by IL-6 leads to the initiation of Janus kinase (JAK)-STAT path-way that is often constitutively switched on in inflammatory diseases.However,a plethora of studies in the last decade showed that only signaling via the soluble IL-6R (trans-signaling) accounts for the deleterious effects of IL-6,whereas the signaling via the membrane-bound receptor (classic signaling) is essential for the regenerative and anti-inflammatory effects of IL-6.In this paper,the latest progresses in the research field of the IL-6/STAT3 signaling pathway in HIR is discussed.
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Objective To compare the safety and feasibility of laparoscopic splenectomy and esophagogastric devascularization (LS + ED) versus open splenectomy and esophagogastric devascularization (OS + ED) in treating portal hypertension using Meta-analysis.Methods Controlled trials comparing LS + ED and OS + ED in treating portal hypertension were electronically searched from Wan Fang Data Knowledge Service Platform,Medalink,CNKI,PubMed,Elsevier,SpringerLink and CBM disc.The most recent search was conducted in April 2015.All the relevant data and references were retrieved and screened.RevMan 5.2 was used for data analysis.Results Eventually,7 randomized controlled trials (RCTs) or high-quality case-controlled studies involving 468 patients were included into this study.Meta-analysis showed LS reduced blood loss [WMD =214.67,95％ CI 198.74-230.60,P ＜ 0.01],shortened flatus time [WMD =17.72,95％ CI 12.39-23.04,P ＜ 0.01] and postoperative hospital stay [WMD =3.75,95％ CI 3.28-4.23,P ＜ 0.01],while the duration of surgery was shorter in OS (P ＞ 0.05).However,OS was comparable with LS in complication rates.Conclusions Comparing with OS,LS had the advantages of reducing intraoperative blood loss and shortening recovery time after operation.In patients with cirrhosis,portal hypertension and esophageal varices,laparoscopic splenectomy was safe and effective.
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Objective To systematically evaluate the storage effect and transplant outcomes of University of Wisconsin (UW) preservation solution and histidine-tryptophan-ketoglutarate (HTK) preservation solution on liver allografts.Methods Literatures were researched using PubMed,Embase (1980-),Ovid Medline (1948-),The Cochrane Library,Wanfang database,VIP database from the database establishement to October 2015 with the key words including organ preservation,storage solutions,Histidine-tryptophan-ketoglutarate or HTK,custodial,bretschneider,University of Wisconsin,UW solution,viaspan,cardiosol,belzer solution,hepatic transplantation,liver transplantation,viscera transplantation,liver grafts,hepatic grafts,liver allografts,hepatic allografts,器官移植,器官保存液,UW,HTK,肝移植and比较.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.All the patients using UW and HTK preservation solutions were respectively allocated into the UW group and HTK group.Count data were represented as the odds ratio (OR) and measurement data were represented as the standardized mean difference (SMD) and 95％ confidence interval (CI).The heterogeneity of the studies was analyzed using the I2 test.Results Eleven literatures were retrieved,and the total sample size were 34 475 patients including 25 248 in the UW group and 9 227 in the HTK group.The results of Meta analysis showed that there were no statistically significant differences in the primary transplants nonfunction,retransplant rate and 1-year grafts overall survival rate between the 2 groups (OR =1.18,0.84,0.97,1.02,95％ CI:0.55-2.57,0.47-1.50,0.66-1.42,0.66-1.58,P ＞0.05).There were also no statistically significant differences in the levels of alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil) at postoperative day 1 between the 2 groups (SMD =-0.19,-O.30,0.30,95％ CI:-0.62-0.23,-0.70-0.10,-0.01-0.61,P ＞0.05).There were no statistically significant differences in the postoperative prothrombin time(PT) and alkaline phosphatase(ALP) between the 2 groups (P ＞0.05) and in the incidence of postoperative biliary complications between the 2 groups (OR =1.49,95％ CI:0.97-2.30,P ＞ 0.05).Conclusion There is similar storage effect between UW and HTK preservation solutions on liver allografts,and no difference in the transplant outcomes.
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Objective To evaluate laparoscopic radical resection of liver hydatid cyst as compared with conventional open surgery.Methods From May 2006 to January 2013 clinical data of 41 patients undergoing laparoscopic radical resection of hepatic hydatid cyst were compared with those 112 cases treated by open surgery.Operation time,blood loss,conversion rate,length of hospitalization and recurrence rate were compared and analyzed.Results There was not statistical significant difference in operative time and blood loss between the two groups (t =1.97,P ＞ 0.05) (t =2.00,P ＞ 0.05).Five laparoscopic patients were converted to open surgery,conversion rate was 12.2 ％ (5/41),three due to inadequate exposure,and two for intraoperative bleeding.Postoperative hospital stay was significantly shorter in laparoscopic group than that in conventional group.The overall morbidity was 4.9％ (2/41) in laparoscopic and 16.0％ (18/112) in conventional group with statistical significance(x2 =3.92,P ＜ 0.05).Recurrence rate and mortality was 0 in both groups.Conclusions Laparoscopic radical resection of hydatid cyst is safe and effective in carefully selected patients and provides short hospital stay,good cosmetic result,fast recovery and fewer complications.