Research progress on the protective effect and mechanism of puerarin on diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

Increasing prevalence and incidence of diabetes mellitus(DM)-the most common chronic consumptive disease worldwide-has a devastating impact on people's daily lives, particularly through the deterioration or complete loss of vision brought on by diabetic retinopathy(DR). Therefore, it is imperative to investigate the pathogenesis and effective treatment of DR. Meanwhile, Pueraria lobata is the extensively used dried root of kudzu or dried kudzu, also known as Pueraria flavonoids. Moreover, its roots are primarily composed of isoflavones, Pueroside ABC, triterpenes, and alkaloids, which can calm cardio-cerebrovascular smooth muscle and enhance microcirculation. Currently, it is widely employed for the treatment of cardio-cerebrovascular diseases, osteonecrosis, DM and its complications, neurodegenerative disorders, endometriosis and tumor diseases. Inhibiting retinal neovascularization, alleviating ischemia and hypoxia, decreasing advanced glycation end products in diabetes, raising insulin-like growth factor(IGF)expression while decreasing tumor necrosis factor-α(TNF-a)expression, decreasing vascular endothelial growth factor(VEGF)expression, reducing retinal nerve cell death, inhibiting the NOD-like receptor protein 3(NLRP3)inflammatory pathway and inhibiting ferroptosis are all mechanisms by which puerarin(Pue)has been found to protect the retina in recent studies. Thus, this article summarizes the current comprehension of the mechanism and protective effect of Pue on diabetic retina, serving as a guidepost for its future development and application.

Comparison of local immune microenvironment between liver-metastasis colorectal cancer and non-liver-metastasis colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the difference of local immune microenvironment in primary tumors between liver-metastasis and non-liver-metastasis cohort in stage III to IIII colorectal cancer patients.</p><p><b>METHODS</b>Tumor samples from 167 patients of colorectal cancer were harvested, who received tumor resection for the first time in The First Affiliated Hospital of Sun Yat-sen University from 2000 to 2005. Patients were divided into two groups according to liver metastasis or not. Expressions of 18 immune markers, including CD3, CD4 and CD8 were examined and quantified by immunohistochemistry staining.</p><p><b>RESULTS</b>No significant differences of gender, age, BMI, tumor differentiation, pathology type and preoperative CEA level were found between the two groups. The expressions of CD8, CD45RO, IL-17, tryptase and FAS were lower in liver-metastasis group as compared to non-liver-metastasis group (all P<0.05).</p><p><b>CONCLUSIONS</b>Decrease of the number of T lymphocyte and mast cell may play an important role in local infiltration of immune microenvironment of stage III to IIII colorectal cancer with liver metastasis.</p>

Curative effect analysis of radical surgery for colon cancer invading duodenum / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the clinicopathological characteristics and access the immediate- and long-term outcome of radical surgery in patients with colon cancer invading duodenum.</p><p><b>METHODS</b>A retrospective review of 19 patients with colon cancer invading duodenum underwent radical surgery between 1995 and 2010 was performed. There were 7 male and 12 female, age ranged from 36 to 73 years with an average of 56 years. The main manifestations were abdominal pain, loss of weight, change of stool frequency and so on. The tumors located at the hepatic flexure in 15 patients. All of the patients underwent radical surgery, and none of the patients had positive resection margins. One patient underwent pancreaticoduodenectomy combined with right hemicolectomy (RH). Two patients underwent pylorus preserving pancreaticoduodenectomy combined with RH. One patient underwent duodenectomy combined with RH. Four patients underwent RH. And the other 11 patients underwent lateral duodenectomy combined with RH.</p><p><b>RESULTS</b>There was no postoperative morbidity and mortality, and the 30-day mortality rate was 0. The median overall survival was 5.3 years. Overall 1 and 5 years survival rate were 94.4% and 70.4%, respectively. And 3 patients developed recurrence in 3 years.</p><p><b>CONCLUSIONS</b>The patients with colon cancer invading duodenum are lack of specific clinical manifestations. And the radical surgical procedure is safe, which could prolong the survival and improves the prognosis in these patients.</p>

Meta-analysis of efficacy and safety on neoadjuvant therapy for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To assess the value of neoadjuvant therapy for resectable rectal cancer and the impact on postoperative complications.</p><p><b>METHODS</b>Literature search was performed in PubMed, Ovid, Web of Science, Springer-Link and Elsevier ScienceDirect for randomized controlled trials published before May 2010 that compared neoadjuvant therapy with surgery alone or postoperative adjuvant therapy. The computer search was supplemented with hand search of reference lists for available primary studies. Inclusion criteria and quality assessment were performed.</p><p><b>RESULTS</b>Eleven studies including 7407 patients were enrolled for analysis. Neoadjuvant therapy group had significant advantages in local recurrence (OR=0.43, 95%CI:0.37-0.50, P<0.01), distant recurrence (OR=0.85, 95%CI:0.76-0.95, P<0.01), 5-year overall survival (RR=1.15, 95%CI:1.04-1.28, P<0.01), and sphincter-saving surgery (RR=1.48, 95%CI:1.17-1.87, P<0.01). There were no significant difference in postoperative mortality rate(OR=1.20, 95%CI:0.68-2.13, P=0.53) and anastomotic complications (OR=1.04, 95%CI:0.73-1.48, P=0.84).</p><p><b>CONCLUSION</b>Neoadjuvant therapy improves local control, distant recurrence and long-term survival without increasing postoperative complications.</p>

Efficacy and safety of domestic biofragmentable anastomotic ring in the intestinal anastomosis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the efficacy and safety of the domestic biofragmentable anastomotic ring (BAR) from Hangzhou in the intestinal anastomosis.</p><p><b>METHODS</b>A total of 134 patients who underwent intestinal anastomosis from February 2010 to April 2011 in the First Municipal People's Hospital of Guangzhou and the First Affiliated Hospital of Zhejiang University were randomized into two groups. The Valtrac BAR from USA was employed in the control group while the experimental group used domestic BAR. The operative performance of the BARs, as well as the patients vital signs and bowel function, complications, fragmentation status of the rings were compared between two groups.</p><p><b>RESULTS</b>No significant difference was found between two groups in the operative performance, the fragmentation status of the BARs, the temperature, blood pressure, heart rate, and bowel function (P>0.05).</p><p><b>CONCLUSION</b>The domestic BAR possesses similar safety and efficacy with the Valtrac BAR in intestinal anastomosis.</p>

Laparoscopic colorectomy versus open colorectomy for elderly patients over 80 years old: a meta-analysis of safety and efficacy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the clinical safety and efficacy of laparoscopic versus open colorectal resection in octogenarians. Methods Studies comparing laparoscopic colorectal resection with open colorectal resection in octogenarians were identified from the Medline, Embase, Ovid, and Cochrane databases from 1990 to 2012. The methodological quality of the selected studies was assessed to determine studies suitable for inclusion. Meta-analysis was performed by fixed or random effects model.</p><p><b>RESULTS</b>Five observational studies with a total of 685 patients (330 laparoscopic colorectal resections and 355 open colorectal resections) were identified. Laparoscopic colorectal resection was associated with a prolonged operative time (WMD=27.89, P<0.01) and a lower rate of overall complications (OR=0.58, P<0.01), wound infection (OR=0.50, P<0.05), cardiovascular complication(OR=0.53, P<0.05), quicker bowel function return (WMD=-0.83, P<0.01), and shorter length of hospital stay (WMD=-3.60, P<0.05). No differences were found with regard to anastomotic leak (OR=1.13, P>0.05), prolonged ileus (OR=0.71, P>0.05), respiratory complication (OR=0.59, P>0.05),mortality (OR=0.67, P>0.05), and reoperation (OR=0.85, P>0.05).</p><p><b>CONCLUSION</b>Laparoscopic colorectal resection is as safe as open colorectal resection, and is more favorable in terms of length of hospital stay and bowel function return in octogenarians.</p>

Meta-analysis of safety and efficacy on paraaortic lymphadenectomy in gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer with meta-analysis.</p><p><b>METHODS</b>Randomized controlled trial comparing D(2)/D(3) and D(2)/D(3) plus paraaortic lymphadenectomy in gastric cancer were identified by two investigators after search strategy was established. Seven randomized controlled trials with 1446 cases were included in this meta-analysis. Fixed effect model or random model was separately used to evaluate the safety and efficacy of paraaortic lymphadenectomy in gastric cancer.</p><p><b>RESULTS</b>Total complication rate in the D(2)/D(3) plus paraaortic lymphadenectomy group was significantly higher than that in the D(2)/D(3) group (RR 1.34, 95% CI 1.03-1.75, P=0.03), while surgery associated complication between the two groups was almost the same. Lymphorrhea and severe diarrhea was more common in the D(2)/D(3) plus paraaortic lymphadenectomy (RR 16.23 and 9.56, 95% CI 1.99-131.98 and 1.70-53.67, respectively). Anastomotic leak, pancreatic fistula, abdominal abscess, ileus, postoperative bleeding and wound infection were similar. There were no advantages in operating time, amount of blood transfusion, in-hospital stay, reoperation, recurrence and 5-year survival favoring the paraaortic lymphadenectomy group except intra-operative blood loss and rate of blood transfusion (WMD 202.95, 95% CI 116.80-289.10; RR 1.93, 95% CI 1.20-3.10).</p><p><b>CONCLUSIONS</b>Paraaortic lymphadenectomy is associated with increased total complication without altering postoperative recurrence and survival. Strict large-scale multicenter controlled trials with long-term follow-up are required.</p>

Systematic review on safety and efficacy of lateral node dissection in rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of lateral node dissection in rectal cancer.</p><p><b>METHODS</b>Data of safety and efficacy in 27 case-controlled studies comparing lateral node dissection and non-lateral node dissection in rectal cancer were meta-analyzed using fixed effect model or random effect model.</p><p><b>RESULTS</b>The increased operating time, blood loss and urinary dysfunction were more common in lateral node dissection group. The postoperative total complications, pelvic abscess, anastomotic leak, sexual dysfunction and defecation dysfunction were similar in both groups. There was no reasonably clear evidence in favor of lateral node dissection for recurrence, local recurrence, distal metastasis and 5-year survival.</p><p><b>CONCLUSION</b>Lateral node dissection can neither reduce recurrence nor improve survival in the current study, which is not recommended to be a routine procedure in rectal cancer surgery.</p>

Increased rate change over time of a sphincter-saving procedure for lower rectal cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Total mesorectal excision (TME) has increased the rate of sphincter-preservation (SP) for more patients with low-lying rectal cancer. Here, we analyze the change of sphincter preserving rates in lower rectal cancer and their related factors.</p><p><b>METHODS</b>We reviewed retrospectively the medical records of 316 patients with lower rectal cancers, 1 to 5 cm from the anorectal line, who had surgical resections from August 1994 to November 2005. The 12-year span was divided into 2 periods: period I (August 1994-December 1998) and period II (January 1999-November 2005), based on the date (January 1999) when standard total mesorectal excision (TME) was introduced. The patients were divided into two groups based on the operation: abdominoperineal resection (APR) or SP surgery. SP rates, leakage and other clinico-pathological characteristics were compared between the two time periods and between the two different groups.</p><p><b>RESULTS</b>The SP rate increased significantly over the 12 years, from 44.9% in period I to 76.2% in period II (P = 0.000). The factors significantly influencing SP included the distance of the tumor from the anorectal line, gender, time period, circumference of intramural spread and histological differentiation (P < 0.05). Significant differences were detected between the two time periods in gender, blood transfusion volume and Dukes' stage (P < 0.05). The leakage rate was 2.7% in period I and 1.3% in period II (P > 0.05).</p><p><b>CONCLUSIONS</b>Over the 12-year period of the study the SP rate in rectal cancers 1 - 5 cm from the anorectal line has increased significantly while the blood transfusion volume has decreased due to the introduction of TME. However, TME had no effect on operating time and leakage rates.</p>

Preoperative chemoradiotherapy with FOLFOX in low rectal cancer: a multicenter study / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the toxicity and safety of FOLFOX regimen concurrent with radiotherapy in neoadjuvant setting in patients with low rectal cancer.</p><p><b>METHODS</b>Fifty-six patients with stage T(3-4)N(0)M(0) and T(1-4)N(1-2)M(0) were eligible from Aug. 2004 to Jul. 2007. Upon entry the study, they received 4 cycles of chemotherapy with FOLFOX regimen. Radiotherapy was added from the second cycle of chemotherapy (CT). The total dose of radiotherapy (RT) was 46 Gy (2 Gy x 23). Total mesorectal excision (TME) was performed 4-8 weeks after RT.</p><p><b>RESULTS</b>Among them, 54 cases received 4 cycles of CT, 1 patient stopped CT after the second cycle of CT because of unrecovery from neutropenia. One patient stopped chemoradiotherapy(CRT) because of complicating with active pulmonary tuberculosis after 2 cycles of CT and 10 times of RT. Two occurred liver, lung and bone metastases after CT. Totally 220 cycles of CT were administrated. Fifty-two patients received operation after CRT, 50 with anal interior sphincter reservation, 19 with prophylactic ileac stoma. Anastomotic leakage occurred in 2 patients after operation, and rectal vaginal fistula in 2 patients 1 month after operation. According to the pathologic results, 7 patients achieved complete response, 41 partial response, 4 stable disease, and the objective response rate was 85.7%.</p><p><b>CONCLUSION</b>Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer was safe and tolerable, and it suggests that protective ileostomy for anastomotic leakage following anus-preserving operation should be performed.</p>

A comparison of the metabolic effect of postoperative analgesia with lornoxicam and morphine or morphine on patients undergoing gastrointestinal carcinoma operation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the metabolic effect of postoperative analgesia with lornoxicam/morphine or morphine on patients undergoing gastrointestinal carcinoma operation.</p><p><b>METHODS</b>One hundred patients, undergone gastrointestinal carcinoma operations, were randomly assigned into two groups: group A received postoperative analgesia with lornoxicam/morphine and Group B with morphine alone. Parenteral nutrition with limited nitrogen resource was given to both groups. Visual analog scale (VAS), temperature and postoperative nitrogen balance were monitored postoperatively. The concentration of plasma cortisol , epinephrine, tumour necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) were measured preoperatively and day 1, 3 postoperatively.</p><p><b>RESULTS</b>VAS of two groups at 24 th, 48 th, 72 th after operation were similar (P>0.05). The temperature of two groups on the third postoperative day increased as compared to that before operation, and the temperature of group B on 1st and 3rd postoperative day [(37.8+/-0.6),(37.5+/-0.8)degrees C] were significantly higher than those of group A[(37.3+/-0.5)degrees C,(37.0+/-0.8)degrees C](P<0.05). Nitrogen balance within 3 days after operation were -7.5+/-3.2, -5.2+/-4.2, -3.1+/-1.2 in group A and -16.7+/-7.3, -10.5+/-6.1, -9.1+/-2.1 in group B (P<0.05). The post-operative plasma concentrations of cortisol and epinephrine increased significantly in both groups as compared to those examined preoperatively(P<0.05), but there was no significant difference between the two groups. However, the plasma concentrations of TNF-alpha and IL-6 in group B were significantly higher than those in group A(P<0.05).</p><p><b>CONCLUSIONS</b>Postoperative analgesia with lornoxicam/morphine or morphine is able to produce an adequate postoperative analgesia to patients undergoing gastrointestinal carcinoma operation. Lornoxicam and morphine analgesia possesses a better metabolic intervention in decreasing the protein metabolism and improving the nitrogen balance.</p>

Safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis.</p><p><b>METHODS</b>A search of published studies in English and Chinese between January 1992 and May 2008 was performed. Nine hundred and twenty-three patients from 16 studies were recruited which met the inclusion criteria. Meta-analysis was performed through fixed effect model or random effect model dependent on heterogeneity.</p><p><b>RESULTS</b>Compared to open procedure, patients with ulcerative colitis undergone laparoscopic surgery were able to tolerate oral intake significantly earlier (P<0.01) with shorter hospital stay (P<0.01) and had lower total complication rate (P<0.01). But duration of laparoscopic surgery was significantly longer than that of open procedure(P=0.04). Laparoscopic procedure was no more superior to open procedure in recovery of bowel function, re-operation rate, intra-abdominal abscess, anastomotic leak, postoperative bowel obstruction, wound infection, blood loss and mortality. The conversion rate was 4.2% in this analysis.</p><p><b>CONCLUSION</b>Laparoscopic surgery for ulcerative colitis is safe and feasible with better recovery in short-term as compared to the open procedure.</p>

Observation on the long-term complications after esophageal replacement with colon / 中华外科杂志

<p><b>OBJECTIVE</b>To study the etiology and preventive measures of the long-term postoperative complication after esophageal replacement with colon for esophageal benign disease.</p><p><b>METHODS</b>To review the clinical data of 577 patients with esophageal replacement with colon our department, including 123 cases of esophageal benign disease. Of all, there were 25 cases-time for 11 cases following with severe complication: redundancy and dilated colon 12 cases-time, severe stricture of stoma 4, macrocyst esophagus 2, colon-stomach stoma expansion 4, mechanical obstruction of colon 3. The etiology included iatrogenic and functionality. The therapy included stricture form or resection, redundancy segment resection, obstructed segment solution and stoma resection and form.</p><p><b>RESULTS</b>Eight cases underwent once operation, 2 case twice, 1 case three times. After operation, 9 cases took food normally, 2 improved symptoms obviously.</p><p><b>CONCLUSIONS</b>The iatrogenic and functionality factor contributed to severe complication after esophageal replacement with colon for esophageal benign disease. The preventive measure is followed during operation: cervical esophageal-colon anastomosis exceed 2.5 centimeter, abdominal colon-stomach anastomosis reflux, channel width of colon passage, intestinal canal lay up straight. Re-operation is best choice to for local stricture, colon expansion, redundancy and dilated colon.</p>

Effect of postoperative analgesia with flurbiprofen axetil and sufentanyl on metabolism of surgical patients with intestinal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>T To evaluate the effect of postoperative analgesia with flurbiprofen axetil combined with sufentanyl in modulating the metabolism of patients undergoing operations for intestinal carcinoma.</p><p><b>METHODS</b>Eighty patients undergoing operations for intestinal carcinoma were randomly assigned into two groups, in group A, the patients received postoperative analgesia with flurbiprofen axetil combined with sufentanyl, and in group B, only sufentanyl was given. Parenteral nutrition with restricted nitrogen resource was given in both groups. The Visual Analog Scale (VAS), body temperature and postoperative nitrogen balance were monitored postoperatively, and the concentrations of plasma cortisol, epinephrine, tumour necrosis factor-alpha(TNF-alpha) and interleukin-6 (IL-6) were measured perioperatively.</p><p><b>RESULTS</b>VAS at 24, 48, 72 h after operation were similar between the two groups (P>0.05). The changes in body temperature, nitrogen balance, TNF-alpha and IL-6 after operation were more obvious in group B than in group A, but significantly improved on postoperative day 3 (P<0.05) in the two groups. Flurbiprofen did not result in postoperative increase in cortisol and epinephrine.</p><p><b>CONCLUSION</b>Postoperative analgesia with flurbiprofen axetil and sufentanyl or with sufentanyl alone produces similar postoperative analgesic effect in patients undergoing operation for intestinal carcinoma, but the former protocol offers better interventional effect on protein catabolism and promotes nitrogen balance.</p>

Changes of sphincter preserving rate in lower rectal cancer and analysis of their related factors / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To analyze the factors related to sphincter preserving(SP) operation for lower rectal cancer.</p><p><b>METHODS</b>Clinicopathological data of 316 patients with lower rectal cancer 1-5 cm from the anorectal line who underwent surgical resection from Aug. 1994 to Nov. 2005 were analyzed. The whole period was divided into two period based on the introduction of TME in Jan. 1999. The SP rates, leakage between the two period were compared.</p><p><b>RESULTS</b>The SP rate increased significantly from 44.9 % in period I (Aug. 1994-Dec. 1998) to 76.2 % in period II (Jan. 1999-Nov. 2005)(P=0.000). The factors significantly influencing SP were the distance from the anorectal line, sex, period, circumference of intramural spread, histological differentiation (P< 0.05). Significant differences were detected between the two period in sex, volume of blood transfusion, Dukes' stage (P< 0.05). The rate of leakage were 2.7 % and 1.3 % in the two period (P > 0.05).</p><p><b>CONCLUSIONS</b>Over 12 years, the SP rate of rectal cancers 1-5 cm from the anorectal line was significantly increased and volume of blood transfusion reduced obviously due to the introduction of TME. These surgical techniques, however, have no effect on the operating time and leakage rates.</p>

Surgery therapy of Crohn disease complicated with fistula / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the surgical treatment of Crohn disease(CD) complicated with perforation or fistula.</p><p><b>METHODS</b>The clinical data of 24 CD cases complicated with perforation or fistula treated in our department from Jan. 1980 to Apr. 2005 were analyzed retrospectively.</p><p><b>RESULTS</b>There were 24 cases of CD complicated with perforation or fistula among 181 CD patients,and the incidence of perforation or fistula was 13.3%. Steroid treatment before perforation was given in 8 patients, while not in 9 patients and unclear in 7 patients. Eighteen patients had single perforation, 4 patients two free perforations and 2 patients more than three extra-abdominal fistula. Emergency operation was performed in 8 cases and selective operation in 16 cases. Five cases had postoperative complications including incision infection in 2, intra-abdominal abscess in 2 and stomal fistula in one case, and were all cured by surgical drainage and anti-infection treatment. The morbidity rate was 20.8%. The postoperative mortality rate was 12.5% (3/24). Eighteen patients were followed up from 6 months to 18 years, and the 5-year recurrent rate was 16.7%. The 10-year reoperation rate was 33.3%.</p><p><b>CONCLUSIONS</b>Steroid use is not the main cause of perforation or fistula in CD. Perforation or fistula is the definite indication for surgical treatment.</p>

Application of new method for data processing in metabonomic studies / 药学学报

<p><b>AIM</b>To search for and application of new method for data processing in metabonomic studies.</p><p><b>METHODS</b>The paper proposed that in the processing of metabonomic data, robust PCA method can be used to diagnose outliers; and unstable variables judged by comparison between difference within class and difference among classes should be excluded before data analysis; moreover, the data should be properly scaled before further processing. The proposed methods were used to preprocess metabolomic data of four genotypes of the Arabidopsis thaliana plants.</p><p><b>RESULTS AND CONCLUSION</b>The outcome demonstrated that the application of these methods can obviously improve clustering and biomarker identifying results.</p>

Radical resection of gastric or colorectal carcinoma combined with liver transplantation for gastric or colorectal carcinoma with multiple hepatic metastases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To summarize the short-term outcomes of radical resection of gastric or colorectal carcinoma combined with liver transplantation for gastric or colorectal carcinoma with multiple hepatic metastases.</p><p><b>METHODS</b>Radical resection of gastric or colorectal carcinoma combined with liver transplantation were performed on one gastric carcinoma case and two rectal carcinoma cases with severe liver metastasis, and partial resection of left lung was performed in one of the two rectal cancer cases for pulmonary tuberculosis.</p><p><b>RESULTS</b>There was no perioperative death. The gastric cancer patient died of recurrence 5 months after operation. The rectal cancer patient with pulmonary tuberculosis died of hepatic function failure 7 months after operation without recurrence. Another rectal cancer patient recovered well with normal liver functions, blood cells, without recurrence signs, and was back to work.</p><p><b>CONCLUSION</b>Radical operation combined with liver transplantation may provide survival opportunity for some patients with gastric or colorectal carcinoma synchronous with severe liver metastasis, but the long-term outcome needs to be observed.</p>

Synergistic protective effect of testicular cells expressing Fas ligand and cyclosporine A on the survival of islet allografts / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the synergistic protective effect of co-transplanted testicular cells expressing FasL and CsA on survival of islet allografts.</p><p><b>METHODS</b>The allogeneic islets and testicular cells were co-transplanted into the renal subcapsular space of the diabetic recipients with or without CsA after operation. Allografts survival period and the testicular cells or islets function were analyzed.</p><p><b>RESULTS</b>The mean survival period of control group was 4.6 +/- 1.1 days. When CsA was administered after transplantation, the mean survival period of islet allografts, (21.8 +/- 4.7) days, was significantly longer than that of control group (P < 0.01). When islets were co-transplanted together with 1 x 10(7) testicular cells (group A), a significant prolongation of graft survival was found (more than 57.5 +/- 4.0 days; P < 0.01 vs. control). But if 1 x 10(7) testicular cells expressing FasL were cultured with FasL-mAb for 30 minutes before co-transplantation (group B), the mean survival period of islet allografts (5.8 +/- 2.6 days), was similar to that in control group, but significantly shorter than that in group A (P < 0.01). When islets and 1 x 10(5) testicular cells were co-transplanted separately into the bilateral renal subcapsular space with CsA (group C), the survival of islet allografts was significantly prolonged in comparison with control group (more than 55.0 +/- 6.5 days; P < 0.01 vs. control), and similar to islets co-transplanted together with 1 x 10(7) testicular cells (group A). When islets were co-transplanted separately with 1 x 10(6) testicular cells without CsA (group D), the mean survival period (11.5 +/- 3.1 days) was shorter than that in group C, but prolonged in comparison to control group (P < 0.05).</p><p><b>CONCLUSION</b>The co-transplanted testicular cells expressing FasL with administering CsA post-transplantation can jointly inhibit immune rejection of islet allografts by different mechanism and play a systemic and synergistic protective role to islet allografts.</p>