Management of postoperative chyle leak after surgery for digestive malignancies / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment of postoperative chyle leak after surgery for digestive malignancies.</p><p><b>METHODS</b>From December 2008 to February 2012, in the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, clinical data of 19 patients with chyle leak after digestive system cancer surgery were retrospective analyzed.</p><p><b>RESULTS</b>Nineteen cases of chyle leak were all identified between the second and the fourth postoperative day and were all initially managed with conservative treatment including early fasting, parenteral nutrition(PN), 24-hour continuous infusion of somatostatin, and low pressure suction drainage. Eight patients were treated successfully for 6 to 10 days with a significant reduction of the daily drainage volume. Ten patients had enteral nutrition(EN) and their drain tubes were repeatedly washed with 30 ml of compound meglumine diatrizoate injection every day until the drainage volume decreased to 200 ml/day. The time to resolution of chyle leak in these ten patients ranged from 12 to 24 days. One patient had no significant decrease in fluid drainage and developed abdominal distension after one week of conservative treatment. Surgical closure of chyle leak was performed on the 11th postoperative day, abdominal cavity drainage tube was removed on the 4th postoperative day. The patient was discharged home in good condition.</p><p><b>CONCLUSION</b>Most postoperative chyle leak after surgery for digestive malignancies can be successfully managed with conservative treatment. Somatostatin and the drainage are the main therapeutic approaches. When chyle leak is not resolved with conservative treatment, surgical treatment should be considered to prevent serious complications.</p>

Establishment of a heterotopic heart transplantation model in mice / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To establish a mouse model of heterotopic heart transplantation.</p><p><b>METHODS</b>In isotransplantation,BALB/c mice were used as both donors and recipients. In allotransplantation, C57 mice were used as donors and BALB/c mice as recipients. The hearts of donor mice were transplanted into the abdominal cavity of recipient mice, connecting aortic ascent artery of donor mice and abdominal aortic artery of recipient mice, main pulmonary artery of donor mice and inferior vena cava of recipient mice.</p><p><b>RESULTS</b>The mouse model of heterotopic heart transplantation was established successfully with a success rate of 90 %. The mean time of hot ischemia and cold ischemia were (0.9 +/-0.05) min and (34.8 +/-0.7) min, respectively. The survival time of isograft was more than 100 days and that of allograft was (7.7 +/- 0.3) days.</p><p><b>CONCLUSION</b>The operational procedure of donor heart and the quality of blood vessel anastomosis are two key points for successful heterotopic heart transplantation.</p>

Serum cytokine profiles in stable survivors with clinical liver transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To elucidate the profile of serum cytokines and adhesion molecules in stable survivors with clinical liver transplantation.</p><p><b>METHODS</b>Flow cytometric analysis was used to analyse the phenotype of T cell subsets in peripheral blood mononuclear cells (PBMCs) from group of liver transplantation (LTx) (n = 22), primary liver carcinoma (PLC) (n = 13) and healthy control (n = 12). Enzyme-linked immunoabsorbent assay (ELISA) was used to determine the serum cytokines and adhesion molecules profiles in stable survivors with clinical liver transplantation.</p><p><b>RESULTS</b>Percentage of CD3(+) T cell and CD8(+) T cell, as well as ratio of CD4(+) to CD8(+) revealed no difference among three groups. The percentage of CD3(+)CD25(+) T cells in LTx group was found higher than that in healthy group (P = 0.022). Th1 cytokines (IL-2, IFN-gamma) and Th2 cytokines (IL-4, IL-10), as well as TNF-alpha displayed no significant difference among three groups. The levels of IL-6, ICAM-1 and P-selectin in serum were not found any difference between LTx group and PLC group, while the levels of IL-6, ICAM-1 and P-selectin in serum shown significant difference between LTx and healthy groups (P = 0.048, 0.000 and 0.025, respectively).</p><p><b>CONCLUSIONS</b>Our data demonstrates that effector T-cells can also be activated and exert immunoresponse to grafts permanently under the treatment of immunosuppressant. Adhesion molecules (ICAM-1, P-Selectin) and pro-inflammatory cytokines (IL-6, TNF-alpha) might be involved in the process of chronic graft damage induced by allo-immunoresponse.</p>

The effect of pro-angiogenic factors and their receptors on angiogenesis in hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the effect of pro-angiogenic factors and their receptors on angiogenesis in hepatocellular carcinoma.</p><p><b>METHODS</b>Expression of VEGF/KDR and Angiopoietins/Tie2 was detected by RT-PCR and Western blot in 15 cases with hepatocellular carcinoma, 15 tumor adjacent tissues (<1 cm, >5 cm), 8 cirrhotic liver, and 4 normal liver. Immunohistochemistry (IHC) was used to detect CD34 expression, and the relationship between neovascular density and angiogenesis was analyzed.</p><p><b>RESULTS</b>The expression levels of VEGF and Ang2 were significantly higher in hepacellular carcinoma group than those in the other groups (P < 0.01), and so did the expression of CD34. The expressions of KDR and Ang1/Tie2 showed no significant difference in all groups, but they indeed increased to various levels in tumor and tumor adjacent tissues as compared with those in cirrhosis and normal liver.</p><p><b>CONCLUSION</b>VEGF/KDR and Angiopoietins/Tie2 may be the crucial signal pathways in the development of hepatocellular carcinoma.</p>