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Objective To investigate the mechanism of acute inflammatory response and tissue repair when rats accepted transplanted bone marrow mesenchymal stem cells (MSC) in severe acute pancreatitis (SAP).Methods A total of 40 rats were randomly divided into 4 groups which included the normal group (n=10),the model severe acute pancreatitis group (n=10),the transplanted bone marrow mesenchymal stem cells group (n =10),and the combination of bone marrow mesenchymal stem cells and granulocyte colony-stimulating factor (G-CSF) group (n=10).To cure the acute severe pancreatic injury caused by SAP,rats were injected with EDU-labeled MSCs and granulocyte colonystimulating factor (Gr-CSF).The conversion rate of MSCs to pancreatic cells or MSCs to endothelial cells was detected to assess the role of MSCs in tissue regeneration and repair.The expression of amylase,interleukin-6 (IL-6),and interleukin-10 (IL-10) in serum was detected to assess the role of MSCs in an acute inflammatory response.Results The concentrations of amylase and IL-6 were reduced and the concentration of IL-10 was increased in MSC and MSC+G-CSF groups after the onset of SAP.Flow cytometry showed a small amount of MSCs converting to endothelial or pancreatic cells,but the conversion rate was relatively low.Conclusions MSCs can play an important role in the antipre-release of inflammatory mediators,reducing acute immune response to control the acute inflammatory response in SAP.Moreover,MSCs can repair a damaged pancreas by converting into both pancreatic and endothelial cells.
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Objective To investigate effects of bone marrow mesenchymal stem cells (MSC) on severe acute pancreatitis (SAP) in rats.Methods A total of 60 rats were randomly divided into normal group (n =10),the model of SAP group (n =10),the transplantation of the MSC group (n =20),the combination of the MSC and the granulocyte colony-stimulating factor (G-CSF) group (n =20).The conversion rate of MSC was detected by using immunofluorescence methods,and the level of amylase in serum was assayed by using biochemical methods.Simultaneously,the level of interleukin-6 (IL-6) in serum was determined by using enzyme linked immunosorbent assay (ELISA).Results The conversion rates of the MSC increased,and consequently,the levels of amylases and interleukin-6 in serum were reduced (P ＜ 0.05).When a small amount of the G-CSF was added to MSC,the therapeutic effects of the two different kinds of cells were synergistically strengthened.In the contrary,when a large number of the G-CSF was added to MSC,the antagonism resulted between these two different kinds of cells gives rise to harmful effects on SAP.Conclusions The bone marrow mesenchymal stem cells have therapeutic effects on SAP.When the number of the bone marrow mesenchymal stem cells increases,the protective effects are enhanced.
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Objective To investigate the protective effects of bone marrow mesenchymal stem cells transplantation (MSCT) and mobilization on severe acute pancreatitis (SAP) with acute renal injury.Methods A total of 240 SD rats were randomly divided into sham operation group ( n =48 ),model control group ( n =48 ),MSCT group ( n =48),bone marrow mesenchymal stem cells mobilization (MSCM) group ( n =48) and MSCT +MSCM group ( n =48 ) according to the random number table.Rat models of SAP were made by peritoneal injection of L-arginine.Rats in the MSCT group were injected with 1.2 ml of bone marrow mesenchymai stem cells via femoral vein at 6 hours after SAP model establishment; rats in the MSCM group were subcutaneously injected with 40 μg/kg of granulocyte-colony stimulating factor (G-CSF) at 3 days before SAP model establishment; rats in the MSCT + MSCM group were injected with 1.2 ml of MSC and 40 μg/kg of G-CSF simultaneously; rats in the sham operation group were injected with equal volume of normal saline.According to different time points after operation,rats in each group were subdivided into 12 h,24 h,48 h and 72 h groups (n =12).At each time points after operation,the mortality rate,pathological changes of renal tissue,expression of Bax protein,Bcl-2 protein and apoptosis indexes of renal tubular epithelium cells were observed.The contents of tumor necrotic factor-α (TNF-α),interleukin-6 (IL-6),blood urea nitrogen (BUN),creatinine (Cr),lactate dehydrogenase (LDH) and C-reactive protein (CRP) were determined.All data were analyzed by using SNK-q test,Fisher exact probability and analysis of variance.Results All rats in the sham operation group were survived.The numbers of rats in the model control group survived at postoperative 48 hours and 72 hours were 11 and 8,respectively.No rat died at postoperative 48 hours in the MSCT group,MSCM group and MSCT + MSCM group.The numbers of rats survived at postoperative 72 hours in the MSCT group,MSCM group and MSCT + MSCM group were 11,10 and 11,which were not significantly different from the number of survived rats in the model control group (P ＞0.05).The pathological injuries of renal tissues were relieved in the MSCT group,MSCM group and MSCT + MSCM group when compared with model control group.The expression of Bax protein,Bc1-2 protein,renal tubular epithelium cell apoptosis indexes at 12-72 hours were 12.80 + 1.78-20.30 + 2.40,4.34 + 1.20-3.03 ± 1.06,12.65％ ±2.31％-35.10％ ± 5.54％ in the model control group,9.68 ± 2.11-17.01 ± 2.54,5.57 ± 1.35-4.13 + 1.05,6.20％ ± 1.53％- 17.50％ ± 2.80％ in the MSCT group,10.05 ± 2.17-16.81 ± 2.55,5.49 ± 1.48-4.19 ±1.05,6.41％± 1.64％-17.14％±2.27％ in the MSCM group,8.33 ±2.06-14.03 ±2.27,6.60 ±2.11-5.63 ±1.52,5.80％ ± 1.52％-12.30％ ±2.43％ in the MSCT + MSCT group.There were significant differences in the expressions of Bax protein at 24 and 72 hours,Bcl-2 protein at 48 and 72 hours,renal tubular epithelium cell apoptosis index at 24,48 and 72 hours between the MSCT group,MSCM group and MSCT + MSCM group ( P ＜0.05 ),but no significant difference was found between the MSCT group and the MSCM group ( P ＞ 0.05 ).The contents of TNF-α,IL-6,BUN,Cr,LDH,CRP in the MSCT group,MSCM group and MSCT + MSCM group were decreased when compared with those in the model control group,and a significant decrease of the 6 factors was observed in the MSCT + MSCM group.There were significant difference in the content of TNF-α at 72 hours,IL-6,BUN and Cr at 48 and 72 hours,LDH at 24,48 and 72 hours and CRP at 72 hours between the MSCT group,MSCM group and MSCT + MSCM group (P ＜0.05),while no significant difference was observed between the MSCT group and the MSCM group (P ＞ 0.05).Conclusion MSCT and MSCM can significantly protect acute renal injury in the progress of SAP,the probable mechanisms are pathological regeneration,anti-inflammatory effect and apoptosis inhibition of mesenchymal stem cells.
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Objective To evaluate the TriVex system in the treatment of varicose veins of lower extremities,focusing on postoperative complications and management.Methods Clinical data of 108 patients (146 legs) of varicose veins of the lower extremity undergoing TriVex procedure were retrospectively analyzed.Deep veinons patency was verified in all patients by preoperative sonography.Above knee stripping of the great saphenous vein was done first when necessary.The below knee phlebectomy of the side branches was done with the new system (Trivex System/Smith and Nephew).Postoperative patients were followed-up,and results were evaluated.Results Procedure was successful in all cases.98 cases were followed up for 1 ～ 24 months.The mean operation time per leg was (34±8) minutes.Complications were as following:26 legs (17.8%) developed postoperative hematoma which was healed by conservative therapy including two cases in which the tension seroma,which was successfully managed by puncture aspiration.Transien skin numbness or paraesthesia developed in 13.0% (19/146).Subcutaneous induration in 11.6%(17/146) cases.Residual varicose and recurrence in 3.4% (5/146).Incision related complications developed in 4.8% (7/149) cases.Conclusion Transilluminated powered phlebectomy (TriVex) is a safe and effective cosmetic procedure for less invasive varicose vein surgery.
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Objective To explore the causes and surgical management of acute gangrenous cholecvstitis(AGC)after endoscopic sphincterotomy(EST).Methods Clinical and pathological data of 1066 patients who underwent EST from June 2003 to January 2007 were analyzed retrospectively.ResultsAGC was complicated in 16 patients(16/1066,1.5%),who underwent emergency operations and no death occurred.During the follow-up period of 4 to 36 months,no infection or obstruction was found.Conclusion Difficuitv in EST manipulation and biliary obstrucion might play a leading role in AGC after EST,and early surgical intervention is effective.
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Objective To evaluate the clinical application of immediate breast reconstruction with the pedicle transverse rectus abdominus myocutaneons(TRAM)flap.Methods Ten breast cancer patients underwent immediate breast reconstruction with the pedicle TRAM flap after mastectomy,among which 4 cases used single pediele TRAM and 6 cases used bipedical TRAM.Polypropypene mesh were applied on all cases of patients to repair the abdominal defect. Results All the breast reconstructions were successful.Complications included grafting flap infection in one case and skin necrosis on partial abdominal skin flap in one case.The reconstructed breasts had a very good shape in 8 cases,and good in 2 cases.No local recurrence and distant metastasis occurred in the patients during the follow-up time ranging from 3 to 15 months. Conclutions Immediate breast reconstruction with the pedicle TRAM flap is an ideal breast reconstruction method for those patients undergoing mastectomy not only because it reconstructs the defective breast but for its cosmetic effect on the abdominal wall.
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Objective To observe the protective effects of autologous bone marrow mesenchymal stem cells transplantation alone with bone marrow stem cells mobilization on liver cells in rats with severe acute paucreatitis in order to explore their mechanism. Method After the establishment of severe acute pancreatitis in rats made by intraperitoneal injection of L-arginine, 240 SD rats were randomly divided into sham-operated group (n = 48), model control group (n = 48), bone marrow mesenchymal stem cell transplanted (MSC) group (n = 48), granu-lacyte-colony stimulating factor treated (G-CSF) group (n = 48) and MSC + G-CSF (n = 48). The rats of MSC group were prepared by injection of 1.2 mL MSC into femoral vein 6 hours after SAP. The rats of G-CSF group were prepared by subcutaneous injection of G-CSF 40 μg/kg for 3 days before SAP. The rats of MSC + G-CSF group received MSC and G-CSF together. The rats of sham-operated group were injected with equal volume of nor-real saline. The rats in each group were sabdivided into 12 h, 24 h, 48 h and 72 h sub-groups (n = 12) according to the examinations in different intervals after operation. Of different subgroups, the morality rate, pathological changes, expression levels of Bax, Bcl-2 proteins and apoptosis indexes of livers were observed respectively. The contents of serum TNF-α,IL-6,ALT,AST,LDH and CRP were simultaneously determined to compare the difference among subgroups by variance analysis. Results Compared to the respective model group, the mortality rates of all treated 72 h subgroups showed no difference (P > 0.05), and no rats died before 48 h. The pathological injuries of liver cells were rather attenuated in rats of treated group than in rats of control group. The liver cell apoptosis in-dexes of 48 h and 72 h MSC + G-CSF subgroups were 107.1 ± 7.0, 110.3 ± 8.6, respectively; the expression of Bax in livers of 24 h,48 h and 72 h subgroups was 5.60±0.Z5, 5.69±0.22, 5.73±0.27, respectively;Bcl-2 protein of 48 h,72 h subgroups was 4.61±0.28, 4.43±0.28, respectively; compared with MSC and G-CSF subgroups the differences were significant (P < 0.05). The serum TNF-α, IL-6, ALT, AST, LDH and CRP de-creased obviously in 24 h/48 h treated subgroups in comparison with control group (P < 0.05). The MSC + G-CSF group showed more significant effects on those biomarkers than MSC or G-CSF alone after 48 hours (P < 0.05). Conclusions Autologous bone marrow mesenchymal stem cells transplantation alonewith bone marrow stem cells mobilization can significantly protect livers from severe damage during the course of severe acute panere-atitis, and the probable mechanisms are likely associated with the pathological regeneration, anti-inflammatory ef-fect and apoptosis inhibition of MSC.
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Objective To observe the influence of Baicalin and Octreotide on lung injury of rat with severe acute pancreatitis(SAP) and discuss the therapeutic effect and mechanism of the two medicines on SAP.Methods The improved Aho(?)method was adopted to pre- pare SAP rat models via retrograde injection of 3.5% sodium taurocholate to the pancreatic duct.The 135 SAP rat models after being pre- pared were randomly divided into the model group,Baicalin treatment group and Octreotide treatment group with 45 rats in each group;an- other 45 were selected to be the sham operation group which only received abdomen opening surgery.The above - mentioned groups were then randomly divided into 3h,6h and 12h groups with 15 rats in each group.Observed respectively at 3h,6h and 12h after operation,the mortalities of all rat groups followed by batch execution of rats,and then observed the gross pathological and pathological changes of lung. The tissue microarrays technology was applied to prepare the lung tissue microarrays sections.The changes in Bax and bcl-2 protein ex- pression levels of lung tissue of each group were observed via immunohistochemical staining and meanwhile the TUNEL method was applied to observe the lung cell category and apoptotic index changes of lung tissue in each group.Results The 12h survival of model group was 66,67% while those of Baicalin treatment group and Octreotide treatment groups were both 100%,indicating a marked difference(P＜0.05).Comparison of lung pathological score disclosed:The model group and Baicalin treatment group obviously exceeded the sham oper- ation group at various time points(P＜0.01);at 6h and 12h the Baicalin treatment group was obviously less than the model group(P＜0.05)and the Oetreotide treatment group less than the model group(P＜0.01).Comparison of Bax protein of lung in each group dis- closed:The Baicalin treatment group and Octreotide treatment group obviously exceeded the sham operation group and model group at 3h (P＜0.05),meanwhile the Baicalin treatment group obviously exceeded the Octreotide treatment group(P＜0.01).Changes of lung bcl -2 protein expression level of all groups disclosed:The model group and Baicalin treatment group obviously exceeding the sham operation group(P＜0.01)as well as the Octreotide treatment group(P＜0.05)at different time points,the Baicalin treatment group was obviously less than the model group at 6h(P＜0.05).The peak of apoptosis occurred to the Baicalin treatment group at 6h,but statistics showed no obvious difference among all groups at different time points(P＞0.05).Conclusions(1)Both Baicalin and Octreotide have protecting effect on SAP lung injury and their therapeutic mechanism is possibly related to apoptosis.The application of tissue microarrays in SAP pathological examination can save manpower and material resources,cut down the experimental cost and improve the experimental efficien- cy,thus worth popularizing.
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Objective To evaluate the enhancement effect of SLC(secondary lymphoid tissue chemokine)gene mediated by a repli- cation deficient recombinant adenovirus(Ad)on human pancreatic cancer in vitro and vivo and to investigate the mechanism of action of SLC.Methods Human pancreatic carcinoma cell line ASPC-1 was infected with Ad-SLC and Ad-CFG,and compared with phosphate buffered saline(PBS).MTT(3,-[4,5-dimethyhhiazol-2-yl]-2,5-diphenyhetrazolium bromide)assay was used to estimate the proliferation of ASPC-1 cells;tube formation assay and choriallantoic membrane assay were used to evaluate angiogenesis in vivo and in vitro.Xenografted nude mice with pancreatic cancer were established to observe in vivo tumour growth suppression.Microvessel density re- vealed by CD34 immunohistochemical staining was measured and TIL in tumor region was also evaluated.Results Growth and tube forma- tion of ASPC-1 cells infected with Ad-SLC were suppressed significantly compared with cells infected with Ad-CFG or ceils treated with PBS.Neovascularisation in the Ad-SLC group was less than that in the PBS and Ad-CFG groups,based on chorioallantoic mem- brane results.Volumes of pancreatic tumours in the Ad-SLC group were significantly smaller than those in the PBS and Ad-CFG groups at the end of the treatment period.Microvessel density in the Ad-SLC group was significantly lower than that in the Ad-CFG and PBS groups and TILs in tumor region in the Ad-SLC group was significantly risen much more than that in the Ad-CFG and PBS groups when the mice transferd the same number of TILs from spleen of health mice.Conclusions The SLC gene mediated by adenovirus is efficient for gene therapy for pancreatic carcinoma.Suppression of SLC on proliferation of vascular endothelium cells,attracting TIL to tumor region and angiogenesis may account for its effect.
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Objective To study the short-term prognosis of laparoscopic splenectomy combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension.Methods The clinical data of 7 cases of portal hypertension treated by laparoscopic eplenectomy combined with lower esophagus transaction were retrospectively analysisd.Results Among of the patients,six cases were undertaken with total laparoscopic technique and only one case done with hand-assisted laparoscopic operation and one case turned to open surgery.Average operation time was 330 min and operation hemorrhage was 780 ml.None of cases died,bled or occurred pancreatical fistula.Mean time of bowel function recovery(70 h) and postoperative hospitalization(12.7 d).1 case complicated with hydrothorax recovered after conservative therapy.Conclusion Cincial short-term effects of patients treated with laparoscopic splenectomy combined with lower esophagus transection for hepatic cirrhosis induced portal hypertension is satisfied,so it is a safe and feasible way for future clinical practice if conducted by the skilled and competent surgeon.
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Objective To investigate the correlation between midkine(MK) and VEGF expression with angiogenesis and biological features in recurrent gastric carcinoma.Methods The expression of MK was examined using immunohistochemistry in 9 cases of gastric carcinoma and 9 cases of adjacent normal tissues.Microvessel density(MVD)was determined by VEGF immunohistochemical staining.Results Majority of recurrent gastric carcinoma tissues showed positive reaction to immunostaining,but no specific positivity was detected in adjacent normal tissue.Values of MVD and MK positive group(88.8%,79.75) was higher than those in the negative group(15.0%)(P
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Objective To explore the protective effect of Salvia miltiorrhiza on small intestinal ischemia reperfusion injury during intestinal transplantation induced by cytokines in rats.Methods Sixty Sprague Dawley rats were randomly divided into sham operation group,model group and low,mid,high doze treatment group,the superior mesenteric artery was occluded and then released to simulate the model of small intestinal ischemia reperfusion during intestinal transplantation.Tumor necrosis factor-?,interleukin-1?,interleukin-8 both in the plasm and small intestinal tissue were evaluated by ELISA 2 hours after reperfusion,changes of pathology in intestinal mucosa were observed.Results TNF-?,IL-1?,IL-8 were significantly higer(P
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Objective To investigate the correlation of chemokine interleukin-8(IL-8) and tumor infiltrating lymphocyte.neutrophil in gastric cancer.Study the effect of chemokine IL-8 on local region immunocompetence and the mechanism of IL-8 in gastric cancer. Methods The distribution and quantitation of the subpopulations of tumor infiltrating lymphocyte including T_3、T_4、T_8 and neutrophil were studied with SABC immunhistochemistry and myeloperoxidase (MPO) kits respectively. Results Interleukin-8 and T_4/T_8 has a negative correlations (?=-0.52,P
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Objective To evaluate the T cell subsets in peripheral blood of patients with gastric cancers after operation. Methods The T cell subsets of peripheral blood were determined by flow cytometry in 82 cases of gastric cancer before and after operation, and the data were compared with those of benign disease. Results Before operation CD69-positive T cell were significantly lower in cancer patients than those in control (P
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Objective To improve diagnosis and therapy of intussusception in adult.Methods The clinical datas of 57 hospitalized cases with intussusception in adult were collected from Jan.1997 to May. 2006.Results 19 cases were diagnosised preoperation37 of 57 cases wereoperated on ,among them ,11 cases benigh,26 cases with malgnent disease.2 cases died of serious condition,the others recovery smoothly, 43 cases followed up for 8 mon to 8 years without relapse one.Conclusions The key is to emphasis on the disease and the primary choice was to operat on.
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Objective To Investigate the expression of secondary lymphoid tissue chemokine (SLC) and its relationship with angiogenisis,pathological feature and prognosis of pancreatic cancer (PC).Methods SLC mRNA expression and microvessel density(MVD) were detected in 22 cases with PC with immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR) respectively and compared with its clinical features.Results Mean MVD of PC was 57?12 and enhanced expression of SLC mRNA was detected in 17 cases(77%),The positive rate of SLC mRNA was significantly lower in cases of without metastasis and at early clinical stage(stage Ⅰ+Ⅱ)than that with metastasis and at advanced stage(stage Ⅲ+Ⅳ).MVD was significant higher in SLC mRNA-enhanced PC than in SLC mRNA reduced PC(P
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Objective To investigate the effect of transabdominal gastroesophageal stapling in management of variceal bleeding in portal hypertension with Hassabi operation and sum up our clinical experience.Methods Retrospective analysis of 48 cases with portal hypertension operated by transabdominal gastroesophageal stapling between May,1998 and Oct.2005.The elimination of oesophagus venous、the rebleeding rate、the operation mortality、the stricture and the fistula rate and the index that influences the liver function were maily observed.Results No case suffered rebleeding and hepatal encephalopathy during the hospitaligation of the patients.Esophageal varices disappeared or reduced in all cases.One case resulted from stricture and one case died of multiple organ failure.Conclusions Transabdominal extensive oesophagogastric devascularization combined with gastrooesophageal stapling is an effective and safe procedure for control of acute variceal haemorrhage with satisfactory short-term control,but the long-term effect needs to be long follow-up for the patients.
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Objective To investigate and analyze the diagnosis and treatment of gerontal large intestinal carcinoma patients complicating with intestinal obstruction.Methods The perioperative medical care and treatments of 94 cases of gerontal large intestinal carcinoma patients admit in our hospital were retrospectively analyzed.Results 85 cases (90.4%) of patients fully recovered and 9 cases(9.4%)died.Conclusions Thinking highly of the perioperitive medical care of gerontal large intestinal carcinoma complicating with intestinal obstruction and handling the postoperative complications effectively are the key point to lower the mortality and elevate the achievement ratio.
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Objective To investigate and analyze the severe complications and their surgical managements after endoscopic sphincterotomy(EST).Method 36 patients with complications after EST such as severe hemorrhage, perforation and severe pancreatitis were analyzed,of them there were 16 cases of hemorrhage, 11 case of perforation, 6 cases of hemorrhage combined with perforation and 3 cases of severe pancreatitis combined with perforation. Results 14 cases of merely hemorrhage patients, 11 cases of merely perforation patients, 1 case of perforation combined with severe pancreatitis patient and 3 case of perforation combined with hemorrhage patient were survived while 2 case of merely hemorrhage patient, 3 cases of perforation combined with hemorrhage patients and 2 case of perforation combined with severe pancreatitis patients died.Conclusions Hemorrhage is the most common complication of EST and most complications can be healed well through expectant treatment. Once severe complications occurred, prompt operations are the keys to lower the mortality.
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Objective To analyze incidence of thyroid carcinoma and to explore and conclude the principle of its diagnosis and treatment.Methods One hundred and forty six patients of thyroid carcinoma in our hospital were analyzed and discussed with literature.Results 101 cases were diagnosed as thyroid carcinoma by pathological diagnosis of fast frozen sections,the positive ratio is approximately 93.5%.totle resection of affected lobe and isthmus was performed on 35 cases,total resection of affected lobe and isthmus and majority of opposite lobe was done on 37 cases.The lymph node metastasis was found by postoperative pathological diagnosis with a rate of 32.5%.Conclusions Preoperative diagnose of thyroid carcinoma is rarely available,diagnosis of thyroid carcinoma by fast frozen sections is optimal.total resection of affected lobe and isthmus or total resection of affected lobe and isthmus and majority of opposite lobe are the main operation patterns.