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Organ Transplantation ; (6): 465-2021.
Article in Chinese | WPRIM | ID: wpr-881532


Objective To evaluate the role of multi-disciplinary team (MDT) in improving the diagnosis and treatment of human herpes virus-6B (HHV-6B) encephalitis after liver transplantation. Methods MDT consultation was delivered for one rare case of HHV-6B encephalitis after liver transplantation to establish an effective individualized treatment regime. Results On the 16 d after liver transplantation, the patient developed headache, and suddenly presented with unresponsiveness, unconsciousness, coma complicated with involuntary limb twitching on the 18 d. Blood ammonia level was increased. Brain CT scan showed cerebral ischemic changes. Electroencephalography prompted the epileptic seizure. After MDT consultation, the possibility of nervous system infection after liver transplantation was considered, and medication therapy was given to control the epileptic seizure. Cerebrospinal fluid examination via lumbar puncture hinted increased intracranial pressure. Real-time fluorescent quantitative polymerase chain reaction (RT-qPCR) of the cerebrospinal fluid demonstrated that the patient was tested positive for HHV-6B nucleic acid, which confirmed the diagnosis of HHV-6B encephalitis. The immunosuppressant regime was adjusted, intravenous ganciclovir was given for antiviral treatment, and active interventions were delivered to prevent and treat relevant complications. Epileptic seizure disappeared after 4 d, and neurological symptoms were significantly alleviated after 2 weeks. After 4-week antiviral treatment, the patient was tested negative for virology testing, and the neurological function was restored to normal. Conclusions HHV-6B encephalitis rarely occurs after adult liver transplantation, which is primarily associated with the virus reactivation after use of immunosuppressant. MDT pattern may be employed to deepen the understanding of the patient's condition, formulate more effective individualized treatment regime, and enhance the clinical efficacy and safety.

Article in Chinese | WPRIM | ID: wpr-733552


Medical ethics has a long history and rich connotations.It has developed from the simple "medical morality" of ancient times to the modem medical ethics.The basic principles of medical ethics include autonomy,non-maleficence,beneficence,justice,and so on.Researchers often conduct clinical researches in the balance between achievements and ethical norms.Clinical researchers of surgery should have a deep understanding of medical ethical principles and strictly abide by medical ethics.Ethics committee should strictly perform their duties and play the role of inspection and supervision.Modem medical knowledges should be popularized throughout the society to make clinical research correctly understood.Adhering principles of ethics first,people orientation and cooperation practice,with patients' benefit as evaluation criteria,balance of surgical "Dao" and "Shu" can be achieved.

Practical Oncology Journal ; (6): 385-390, 2016.
Article in Chinese | WPRIM | ID: wpr-504345


Objective To investigate whether overexpression of VHL can inhibit the growth and metasta-sis of colon cancer .Methods Adenovirus vectors containing VHL were used to overexpress VHL protein in vitro and in vivo.The proliferation,apoptosis and migration of colon cancer cells CT 26 were examined in vitro.The ex-pressions of related proteins were detected by Western blot analysis .Subcutaneous and liver metastasis of colon cancer models were established and the therapeutic effects were evaluated .Results Overexpression of VHL pro-tein inhibited the proliferation and invasion of CT26,and promoted the apoptosis of CT26 via the regulation of COX-2,Bcl-2 and MMP-9.Overexpression of VHL protein inhibited the growth of subcutaneous colon cancer and liver metastasis in vivo .Conclusion Overexpression of VHL protien can inhibit the growth and metastasis of colon cancer ,and enhance the apoptosis of colon cancer ,indicating that VHL can be used as a potential target for colon cancer therapy .

Article in Chinese | WPRIM | ID: wpr-501972


Objective To explore the hotspots and developing direction of splenic surgery in China.Methods The biliometric analysis was adopted.Database including Chinese Database of Literature on Biomedicine were searched with “脾,外科,移植”.The time for retrieving was from January 1984 to December 2013.Chinese articles on splenic surgery which were published by academic journals were retrieved,and data were analyzed and evaluated by 2 independent researchers,including published year,distribution of journals,key words,authors and publication type.The P-value was calculated according to P =2Ln(eE × Y),and Euler's number =0.577 2 and Y was maximum amount of published articles in each journal.Results (1) Published year:1 977 articles were retrieved.There were 168 articles from 1984 to 1993,and number of articles in every year was less than 30.There were 562 articles from 1994 to 2003 and increasing number of articles in every year,with a maximum number of 88.There were 1 247 articles from 2004 to 2013,and average number of articles in every year was 125,with a maximum number of 165 in 2009.(2) Distribution of journals:all the articles have been published in 489 journals,including 9 surgical journals in the core journal such as Chinese Journal of Hepatobiliary Surgery and 7 journals from Chinese Science Citation Database.The maximum number of published articles of each journal was 54,and literature number in the core journals P≈9.(3) Distribution of key words:occurrence frequencies of “脾破裂”and“脾切除术”were very high in 3 periods (from 1984 to 1993,from 1994 to 2003,from 2004 to 2013) and percentages of occurrence frequencies were respectively 9.524%,24.911%,51.163% and 12.500%,19.217%,38.813%,showing an increasing trend.Occurrence frequencies of“回顾性研究”“手术后期间”“胰腺切除术”and“脾动脉”reached the top 20 of key words from 1994 to 2003 and then continued to increase from 2004 to 2013,and occurrence frequency of“回顾性研究”was significantly increased witha growth rate of 23.742%.The percentages of occurrence frequencies of“回顾性研究”“手术后期间”“胰腺切除术”and“脾动脉”were respectively 3.203%,8.185%,4.448%,3.559% from 1994 to 2003 and 26.945%,16.279%,7.939%,6.496% from 2004 to 2013.“创伤和损伤”and“腹腔镜”first appeared on the top 20 of key words from 2004 to 2013,with percentages of occurrence frequencies of 15.958% and 11.307%.Occurrence frequencies of“胰腺”and“肝”were gradually increased in 3 periods,with the percentages of 2.976%,3.915%,10.906% and l.786%,4.804%,6.496%.The percentage of occurrence frequency of“移植,自体”in 3 periods was respectively 15.476%,20.107%,8.821%.Conclusions The Chinese articles of splenic surgery are rising obviously in the past 30 years.The splenic injury and splenectomy have always been research hotspots in splenic surgery.The preservation of spleen function and minimal invasive surgery are the developing direction of splenic surgery.

Article in English | WPRIM | ID: wpr-158014


Nonspecific inflammatory response is the major cause for failure of islet grafts at the early phase of intraportal islet transplantation (IPIT). Bilirubin, a natural product of heme catabolism, has displayed anti-oxidative and anti-inflammatory activities. The present study has demonstrated that bilirubin protected islet grafts by inhibiting nonspecific inflammatory response in a syngeneic rat model of IPIT. The inflammation-induced cell injury was mimicked by exposing cultured rat insulinoma INS-1 cells to cytokines (IL-1beta, TNF-alpha and IFN-gamma) in in vitro assays. At appropriate lower concentrations, bilirubin significantly attenuated the reduced cell viability and enhanced cell apoptosis induced by cytokines, and protected the insulin secretory function of INS-1 cells. Diabetic inbred male Lewis rats induced by streptozotocin underwent IPIT at different islet equivalents (IEQs) (optimal dose of 1000, and suboptimal doses of 750 or 500), and bilirubin was administered to the recipients every 12 h, starting from one day before transplantation until 5 days after transplantation. Administration of bilirubin improved glucose control and enhanced glucose tolerance in diabetic recipients, and reduced the serum levels of inflammatory mediators including IL-1beta, TNF-alpha, soluble intercellular adhesion molecule 1, monocyte chemoattractant protein-1 and NO, and inhibited the infiltration of Kupffer cells into the islet grafts, and restored insulin-producing ability of transplanted islets.

Animals , Apoptosis/drug effects , Bilirubin/administration & dosage , Cell Line, Tumor , Cytokines/immunology , Diabetes Mellitus, Experimental/drug therapy , Inflammation , Inflammation Mediators/immunology , Islets of Langerhans/drug effects , Islets of Langerhans Transplantation , Male , Oxidative Stress/drug effects , Rats , Rats, Inbred Lew