ABSTRACT
Prevention and treatment of complications after liver transplantation play a significant role in maintaining liver graft function and improving clinical prognosis of the recipients. Neutrophil extracellular trap (NET) are fibrous net-like structures composed of DNA as the skeleton and histones and granular proteins released by activated neutrophils. Studies have shown that the activation of neutrophils and the release of NET in donor liver after liver transplantation are involved in the incidence of multiple liver transplantation-related complications including ischemia-reperfusion injury, acute rejection, acute liver failure and recurrence of hepatocellular carcinoma, etc. In this article, the effect of NET on the complications after liver transplantation was mainly assessed, and research progress on NET as a potential target for the prevention and treatment of complications after liver transplantation was reviewed, aiming to provide reference for the prevention and treatment of complications after liver transplantation, enhance clinical efficacy of liver transplantation and improve clinical prognosis of the recipients.
ABSTRACT
Hepatocellular carcinoma cells interact with tumor microenvironment, and exhibits There are temporal and spatial heterogeneity of hepatocellular carcinoma which interacts with tumor microinvironment. In this paper, we summarized the characteristics of hepatocellular carcinoma heterogeneity, the mechanism of heterogeneity, and the impact of hepatocellular carcinoma heterogeneity on diagnosis and treatment, so as to provide a new thinking direction for the diagnosis and treatment of hepatocellular carcinoma.
ABSTRACT
The training of academic postgraduate students in critical care medicine emphasizes basic knowledge and underestimates the importance of clinical practice. Research objectives are innovative, but with a lack of practicability, and thus cannot meet the huge needs for clinical research in this major. Under the guidance of the concept of translational medicine , the training of academic postgraduate students should strengthen clinical observation and systematic learning of clinical knowledge, enhance the accumulation of clinical data, improve the quality of data statistics, reinforce the training on clinical research processes, standards, and methods, and emphasize interdisciplinary and multicenter communication and cooperation, so as to break the barrier between basic and clinical research, broaden scientific research thinking , and improve the comprehensive quality of academic postgraduate students in critical care medicine.
ABSTRACT
Objective To improve the mode of clinical medicine postgraduates for specialty degree by OSCE. Methods Clinical medicine postgraduates for specialty degree of Grade 2010 and 2011 were enrolled as research objects. The OSCE scores of the students of Grade 2010 were analyzed and the problems in clinical skills training were summarized. In the last year of clinical training for the clinical medical students of Grade 2011, the reform of clinical skills training was implemented with such improvement measures as publishing last year achievement, analyzing OSCE assessment, strength-ening the supervision of the department of clinical skill training, strengthening the examination as-sessment efforts and organizing collective training. And finally the OSCE scores of the students of Grade 2011 were compared with the scores of the students of Grade 2010. SPSS 19.0 was used to analyze the OSCE scores. Quantitative data were expressed as x±s. T test and Chi-squared test were em-ployed to do statistical analysis, with the inspection level of α=0.05. Result The graduate exami-nation OSCE scores of clinical medicine professional master's degree postgraduates of Grade 2010 display that the failure rate of SP, Physical, Surgical Operation, CPR and Case analysis are more than 5%. After the improvement of clinical skill training, using independent samples t test and chi square test, and contrasting grade 2010, the failure rate of the OSCE score of Grade 2011 in physical examination, surgical operation, site emergency station, CPR station, and case analysis station is significantly improved (P<0.05). Conclusions Improving the mode of clinical skill training by OSCE and performance analysis can effectively enhance clinical competence.
ABSTRACT
Objective To explore the postgraduate tutor assessment system in order to provide suggestions to improve the quality of postgraduate education. Methods Assessment indexes of post-graduate tutor were screened and assigned by methods of questionnaire investigation, interview, kruskal wallis H-test, taking a total of 109 students and professors in medical colleges in the south-western part as research objects. Results Different populations had different cognitions on the important degree of each index, P<0.05. Primary indexes of assessment system were determined based on the importance of indicators and the influence of different cognitive levels, including tutor personal accom-plishment, teaching ability, scientific research quality and guiding ability (P<0.05). Conclusions Assessment system and method fined by this study covers majority aspects of tutors and can provide feasible suggestions for tutor evaluation.
ABSTRACT
Objective To detect the expression of ARK5 in hepatocellular carcinoma (HCC)tissue and hepatoma SMMC-7721 cells,and to investigate its effect on the growth of hepatoma cells.Methods The expression levels of ARK5 mRNA and protein were determined by RT-PCR and Western blotting in 30 cases of HCC tissue, paracarcinoma tissue,SMMC-7721 cells,and hepatic cells LO2.The SiRNA of ARK5 and negative control (NC) siRNA were constructed and transfected into the SMMC-7721 cells,and used as experimental group and negative control group;at the same time blank control group was set up. The proliferation activity and apoptotic rate of transfected cells were detected by MTT assay and flow cytometry (FCM).Results The PCR and Western blotting results showed that the expression levels of ARK5 mRNA and protein in HCC tissue and SMMC-7721 cells were significantly higher than those in paracarcinoma tissue and LO2 cells (P<0.05 ). The MTT assay results demonstrated that the inhibitory rates of growth of transfected cells in experimental group at 24,48 and 72 h were (19.39±5.42)%, (23.19±0.53)%,and (20.74±1.23)%;there were significant differences compared with blank control group and negative control group (P<0.01).The FCM results indicated that the apoptotic rate of the transfected cells in experimental group was (15.017±0.945)%,there were significant differences compared with blank control group (8.770%± 0.656 )% and negative control group (8.763%± 1.201%) (P<0.05 ). Conclusion The ARK5 expression level is significantly increased in HCC tissue and hepatoma SMMC-7721 cells;the inhibition of ARK5 expression could suppress the growth of hepatoma cells and induce apoptosis. So ARK5 maybe act as a cancer-promoting gene and induce hepatocellular carcinogenesis.
ABSTRACT
Postgraduate education is the highest leveled education in the national education hierarchy and bears the historic task of providing top-notch innovative personnel for the country and conducting independent innovation. At present,the medical degree is divided into two types: clinical scientific degree and clinical professional degree. Clinical scientific degree is different from clinical professional degree due to its importance and peculiarities. Therefore,education for postgraduates with clinical scientific degree faces many problems in enrollment,research and clinical capacity develop-ment and evaluation system. Through reforming enrollment plan,strengthening capacity building and establishing sound clinical education evaluation system can further improve training quality for post-graduates with clinical scientific degree.
ABSTRACT
Objective To investigate the relationship between the maturity and function of dendritic cells (DC) and hepatitis B virus covalently closed circular DNA (HBV cccDNA) load in the peripheral blood mononuclear cells (PBMC)/monocyte-derived DC in patients with chronic hepatitis B (CHB). Methods The peripheral blood samples were collected from 29 patients with CHB and 10healthy controls. PBMC were isolated freshly and induced with granulocyte/macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4). A large amount of DC were harvested after seven days of culture. The expressions of CD209, CD80, CD86, human leucocyte antigen (HLA)-DR and CD1a of DC were analyzed by flow cytometry. The HBV cccDNA load in PBMC and DC were measured by real-time polymerase chain reaction (PCR). The interleukin-12 (IL-12) level in the culture supernatant of DC was determined by enzyme linked immunosorbent assay (ELISA). The effects on T lymphocyte proliferation induced by DC were tested by mixed lymphocyte reaction (MLR). The data was compared by t test and analysis of variance. Results HBV cccDNA could be detected in PBMC from 16 patients, but not in DC from all 29 patients. HBV cccDNA load was all negatively correlated with the expressions of CD209 (r= -0. 793, P＜0.01), CD80 (r= -0. 581,P＜0.05), CD86 (r=-0. 698, P＜0.01), HLA-DR (r=-0. 817, P＜0.01), CD1a (r=-0. 734, P＜0.01), IL-12 level (r=-0. 632, P＜0.05) and allogenic T lymphocyte proliferation induced by DC (r=-0. 617, P＜0.05). The expressions of CD209, CD80, CD86, CD1a and HLA-DR on DC,IL-12 level in culture supernatant of DC and the allogenic T lymphocyte proliferation induced by DC in patients with positive PBMC HBV cccDNA were all significantly lower compared to those in healthy controls, and the changes of the parameters mentioned above were greater in PBMC HBV cccDNA positive patients than those in PBMC HBV cccDNA negative patients (P ＜ 0. 05 or P ＜ 0. 01).Conclusions The function and maturity of DC are impaired in CHB patients. HBV cccDNA can be detected in PBMC from CHB patients. Moreover, the higher PBMC HBV cccDNA is, the worse DC function and maturity are, which could be one of the important mechanisms of HBV persistent infection.
ABSTRACT
Objective To evaluate Caspofungin for the treatment of fungous infection liver transplant patients. Methods From 2003 to 2008 clinical data of 27 cases of liver transplant patients with fungal infections were reviewed retrospectively. Before 2005 (control group) fungal infections were treated with amphotericin B or Fluconazole in 13 cases. After 2005, the infection was treated with Caspofungin (observation group) in 14 cases. Liver function (AST, ALT, TBIL) and renal function (BUN, Scr) were evaluated at one and two weeks respectively. Result of treatment was evaluated 7 ～ 14 d after the treatment as for the clinical cure rate, with or without acute rejection. Result The liver function of the observation group compared with that of the control group at one week was as AST(t =8. 03 ,P <0. 01), ALT(t =9. 09, P<0.01), TBIL(t =6.01,P<0.01), and at 2 week as AST(t=5.59,P<0.01), ALT(t =6.60,P< 0. 01), TBIL(t = 8.45,P <0. 01). The renal function of the observation group compared with that of the control group after one week as for BUN(t =6. 51 ,P <0. 01), Scr(t =5.66,P <0. 01). At 2 week,as BUN (t =7.61,P <0.01), Scr(t =6.91,P <0.01). The clinical cure rate of the control group was 7/13 (53%), that of the observation group was 12/14(86%) ; Two cases in the observation group and one in the control group had acute rejection which was successfully managed by methylprednisolone pulse therapy. Conclusion Caspofungin is an ideal alternative therapy for fungal infection after fiver transplantation.
ABSTRACT
Objective To explore the modified of methods and techniques to establish a rat model of or thotopic liver transplantion effectively by a single operator, and improve the stability. Methods On the basis of two-cuff technique of Kamada, we improved the techniques of perfusing, shearing, triming donor liver, the suturation of the superior and inferior eaval veins, and so on. Operation was performed in 80 rats with modified techniques (experiment group) and conventional techniques (control group), respectively, compare the survival rates of 48 h, 1 week, lmonth were compared between the two groups. Results In contrast to conventional teehniques, the modified techniques reduced the average time of donor operation, recipient operation and anhepatie phase (P < 0. 05), elevated 1-week, 1-month survival rates, remarkably (P < 0. 05 ).Between the Iwo groups, the survival rate of 48 hour had no statistical significance (P > 0. 05). Conclusions The modified techniques may reduce the operation time of donor and receptor effectively raise the quality of donor liver, elevated the survival rate of receptor. II is a stable, reliable and effective method to establish the rat urthotopic liver transplantation model.
ABSTRACT
Objective To observe the inhibitory effects of local co-transfection of tissue-type plasminogen activator(tPA) gene and proliferating cell nuclear antigen antisense oligodeoxynucleotides(PCNA-ASODN) on the intima proliferation and restenosis of autograft artery in rabbits. Methods One hundred and twenty male Zelanian rabbits were randomly divided into four groups(n=30, in each group): control group, PCNA-ASODN group, tPA group and tPA+PCNA-ASODN group. The left and right external iliac arteries (length 1.0 cm) were transplanted reciprocally. The transplanted arteries were respectively soaked in lipofection, PCNA-ASODN, pBudCE4.1/tPA and pBudCE4.1/tPA+PCNA-ASODN solution about 15 minutes. The transplanted arteries were sutured with 9-0 sutures soaked in PCNA-ASODN and pBudCE4.1/tPA solution. Each group were divided into five subgroups(n=6, in each subgroup) according to the sacrifice time (3 d, 7 d, 14 d, 28 d and 56 d after operation). On every sacrifice time point, the vascular specimens were harvested. The thrombocyte assembling and thrombus forming lining vessel wall were observed by scanning electron microscope. The pathological morphology of transplanted arteries were observed under microscope(HE). The intimal areas and stenosis ratio(%) of transplanted arteries were calculate and analyzed statistically among groups by computer system. The mRNA expression of tPA gene in transplanted ressel wall was detected with vevere transcription-PCR(RT-PCR). The number of PCNA positive cells in transplanted vessel wall was counted by SP immunochemisty. Results The mRNA expression of tPA gene in the transplan-ted vessel wall in tPA and tPA+PCNA-ASODN groups was higher than that of the other two groups (P
ABSTRACT
Objective To improve the method of orthotopic liver transplantation model in mice.Methods On the basis of "Qian SG" mothod,the techniques of perfusion,harvesting,and trimming of donor's liver,as well as the anastomosis of superior and inferior caval veins were improved.Operations were performed in 70 mice with improved technique(experiment group) and in 70 mice with conventional technique(control group),respectively.The operation time in both donors and recipients,and the survival rates of 48h,1 week and 1 month after operation were compared between the two groups.Results The operation time for both donors and recipients and the time of anhepatic phase were 37?2min,45?2min and 16?2min,respectively in experiment group,while they were 45?2min,54?2min and 23?2min,respectively,in control group,so that the average time for each procedure was significantly shorter(P0.05).Conclusions The improved technique may shorten the operation time and raise the survival rate,and is an ideal method for the establishment of orthotopic liver transplantation model in mice.
ABSTRACT
Objective To study the surgical technique of construction of orthopic liver transplantation model in mice by a single operator.Methods On the basis of two-cuff technique,running suture was used to reestablish the suprahepatic vena cava(SHVC),"two-cuff"technology to reestablish the portal vein(PV)and infrahepatic vena cava(IHVC),and"stent"to reestablish the bile duct.Operation was performed in 70 mice,the 24 h,1 week,1M postoperative survival rate were noted,and hepatic function and pathological change were observed.Results The 24 h,1 week and 1M survival rate was 95.7%,90.9%,85.1%,respectively.The ALT increased gradually in the first postoperative week,and dropped to normal level in the first month.Pathology showed the structure of liver tissue was fine.Conclusions The method is an ideal mothod to establish the orthotopic liver transplantation model in mice,because it has high survival rate,good stability and is easily replicated.
ABSTRACT
Objective To observe the effects of co-transfection of proto-oncogene c-myc antisense oligodeoxynucleotides(c-myc-AODN) and tissue-type plasminogen activator(tPA) gene on intimal hyperplasia of auto-transplantion artery in rabbit. Methods The left and right external iliac artery(length 1.0 cm) of rabbits were cross transplanted. The artery grafts and sutures were respectively soaked in Lipofection, c-myc-AODN, pBudCE4.1/tPA, c-myc-AODN and pBudCE4.1/tPA solution for 15 minutes. Each group were divided into five subgroups(n=5, in each subgroup) according to the sacrifice times(3, 7, 14, 28 and 56 d after operation). Specimens were harvested for pathology, chromogenic substrate test, 3H-TdR incorporation test and immunochemisty coloration study. Result The intimal area, stenosis ratio, 3H-TdR incorporation, PCNA positive cell in c-myc-AODN adding tPA co-transfection group were significantly lower than that of control group(P0.01), and that were lower than c-myc-AODN transfection group and tPA gene transfection group(P0.05). Conclusion Vascular local co-transfection of tPA gene and c-myc-AODN effectively inhibits the proliferation of vascular smooth muscle cell(VSMC) and hyperplasia of intima of the transplanted artery.
ABSTRACT
AIM: To observe the effects of local transfection of vascular endothelial growth factor 165 (VEGF165) gene on inhibiting intimal hyperplasia and restenosis of artery in rabbits after operation injury, and its possible mechanisms. METHODS: Microsurgery injury was used to establish the intimal injury model of right external iliac artery in rabbits. 105 male New Zealand rabbits were randomly divided into 3 groups (35 rabbits in each group). Group A was physiological saline control group, group B was pBudCE4.1-transfected group, group C was pBudCE4.1/VEGF165-transfected group. The physiological saline, pBudCE4.1 and pBudCE4.1/VEGF165 transfection solutions were injected into injured vessel walls of above-mentioned groups. The injured vascular specimen was harvested for pathologic examination, electric microscope observation, RT-PCR examining and immunohistochemical staining. RESULTS: Rabbit intimal thickness and area of vessel walls in group C at every time point after operation were significantly less than those in group A and group B (P
ABSTRACT
Objective To observe the co-expression plasmid of tissue plasminogen activator (tPA) and vascular endothelia growth factor165 (VEGF165) in vascular endothelial cell (VEC) and to study the effect of the product on the proliferation of VEC and fibrinolysis activity. Methods pBudCE4.1/tPA-VEGF165 was transfected into VECs by using lipofection. The expression of tPA and VEGF165 at mRNA level was detected by RT-PCR and expression at protein level was detected by Western blot. The fibrinolysis activity of VEC culture solution of transfecting tPA and VEGF165 genes were detected by fibrin plate technique. The VEC and VSMC were cultured with VEC culture solution of transforming tPA and VEGF165 genes, the proliferation of VEC and VSMC were evaluated with 3?H-TdR incorporation and flow cytometry (FCM). Results The expression of tPA and VEGF165 in the transfected VECs was detected. The fibrinolysis activity of transfected VEC culture solution was also detected. tPA and VEGF165 products in VECs elevated proliferation of VEC, while there was no effect on the proliferation of VSMC. Conclusion The tPA and VEGF165 eukaryotic co-expression plasmid could express in transfected VECs, and the expression products have biology activity.