Progress in the diagnosis and therapies of kidney injury after non-kidney solid organ transplantation / 中华器官移植杂志

The article provides a brief review of the risk factors, prevention, and management strategies for kidney injury after non-kidney solid organ transplantation, in order to optimize the management of kidney injury by the transplant team and further improve the life quality and survival of the recipients.

Risk factors for acute kidney injury after adult orthotopic liver transplantation / 中华肝胆外科杂志

Objective:To study the risk factors for acute kidney injury (AKI) after adult orthotopic liver transplantation.Methods:The clinical data of 232 recipients who underwent orthotopic liver transplantation at the First Affiliated Hospital of Zhengzhou University from January 2019 to April 2021 were retrospectively analyzed. There were 195 males and 37 females, aged (49.1±9.4) years old. The patients were divided into two groups according to whether AKI had occurred within 7 days of surgery into the AKI group ( n=112) and the non-AKI group ( n=120). Clinical data including basic information, preoperative hematological indexes, operation time and postoperative hospital stay were compared between the two groups. Factors associated with AKI after orthotopic liver transplantation were studied using univariate analysis and those factors with significant differences were included in multifactorial logistic regression analysis. Results:Among 232 patients who underwent orthotopic liver transplantation, 112 patients developed AKI after surgery, with an incidence of 48.3% (112/232). There were 64 patients with AKI stage 1 (57.1%, 64/112), 30 patients with AKI stage 2 (26.8%, 30/112), and 18 patients with AKI stage 3 (16.1%, 18/112). Logistic regression analysis showed that hypertension ( OR=5.874, 95% CI: 1.931-17.863, P=0.002) and high scores on the model for end-stage liver disease (MELD) ( OR=1.041, 95% CI: 1.010-1.074, P=0.010) were independent risk factors for AKI after orthotopic liver transplantation. Conclusion:Hypertension and MELD score were independent risk factors for postoperative AKI in orthotopic liver transplant recipients.

Expression of ENO3 and Its Effect on Sensitivity of Hepatocellular Carcinoma Cells to Oxaliplatin / 肿瘤防治研究

Objective To investigate the expression of ENO3 gene in hepatocellular carcinoma and its effect on the sensitivity of hepatocellular carcinoma cell lines to OXA, and to explore the possible mechanism. Methods qRT-PCR and immunohistochemical analysis were used to detect the expression of ENO3 in 48 pairs of hepatocellular carcinoma tissues and normal liver tissues.Overexpression plasmid was constructed and transfected into MHCC97H and HepG2 cells.The experiments were divided into empty group (Vector group), ENO3 overexpression group (ENO3 group), empty+OXA group (Vector+OXA group) and ENO3 overexpression+OXA group (ENO3+OXA group).The proliferation ability of MHCC97H and HepG2 cells were detected by CCK-8 assay and cell colony formation assay.The apoptosis rate was determined by flow cytometry assay.Protein expressions of Bcl-2, Bax and Caspase-3 were detected by Western blot assay. Results The expression of ENO3 was significantly decreased in hepatocellular carcinoma tissues, compared with normal liver tissues adjacent to the carcinoma.The expression of ENO3 gene in the ENO3 overexpression group was significantly higher than that in the empty group.Compared with the Vector+OXA group, cell viability was decreased, apoptosis rate was increased, Bcl-2 protein expression was decreased, Bax and Caspase-3 protein expression were increased in the ENO3+OXA group. Conclusion The expression of ENO3 is down-regulated in hepatocellular carcinoma tissues, and the overexpression of ENO3 can enhance the sensitivity of hepatocellular carcinoma cell lines to oxaliplatin by promoting cell apoptosis.

Influence of Multidisciplinary Combined Therapy on Curative Effect of Liver Cancer Treatment / 肿瘤防治研究

Liver cancer is one of the common malignant tumors in China, and the treatment effect is poor. The current treatment plan is still surgery-based comprehensive treatment, and multidisciplinary combined therapy is currently the main mode of liver cancer treatment. With the increased number of new technologies and methods of liver cancer treatment being applied clinically, the prognosis of liver cancer patients has significantly improved. This article explains the selection mechanism for optimal individualized combined treatment plans to improve the curative effect of liver cancer treatment based on the different conditions of liver cancer patients and types of liver cancer.

Research progress on the role of programmed cell death in hepatic ischemia-reperfusion injury / 器官移植

Liver transplantation is an effective treatment for the end-stage liver disease. However, hepatic ischemia-reperfusion injury (HIRI) will inevitably occur during liver transplantation, which might lead to early graft dysfunction or aggravate rejection. The underlying protective mechanism remains to be further elucidated. Programmed cell death is an important mechanism of HIRI, and multiple novel types of programmed cell death participate in the pathological process of HIRI. In-depth study of programmed cell death is expected to further improve the therapeutic effect of liver transplantation. In this article, research progresses on apoptosis, autophagy and autophagy-dependent cell death, ferroptosis, necroptosis, pyroptosis, pathanatos and other common programmed cell death patterns in HIRI were reviewed, aiming to provide reference for enhancing the success rate of liver transplantation and improving clinical prognosis of the recipients.

Analysis of treatment strategies for donor-derived infection: a report of 486 cases / 中华器官移植杂志

Objective:To explore the microbiological characteristics of donor blood culture and donor liver perfusion culture and summarize the clinical experiences to provide basic rationales for preventing donor-derived infections.Methods:From August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020 at First Affiliated Hospital, Zhengzhou University, culture results of donor blood and donor liver perfusate were retrospectively reviewed.According to whether or not donor liver was obtained without breaking diaphragm, removing gallbladder intraoperatively and flushing bile through cystic duct, two stages were assigned: before and after improvement measures of liver donor, i.e.August 1, 2018 to November 26, 2018 and November 27, 2018 to December 31, 2020.The culture results of donor blood samples and donor liver perfusion fluid samples in two stages of liver transplantation were statistically analyzed and infection preventing measures during donor liver maintenance and obtaining donor liver examined.Results:A total of 486 cases of blood culture from potential donors and 478 cases of liver perfusion culture were analyzed.The results showed that the incidence of blood culture infection was 4.5% and 4.3% before and after improvement measures( χ2=0.008; P=0.927)while the incidence of perfusion fluid infection was 56.8% and 46.2%( χ2=4.569; P=0.031); Klebsiella pneumoniae was a major pathogen cultured in perfusion solution before improvement measures and Staphylococcus epidermidis after improvement measures. Conclusions:Before organ donation, infection screening and prevention of potential donors and corresponding measures during donor liver acquisition can reduce donor source infection and effectively lower the mortality of recipients.

Strategies and outcomes of portal vein reconstruction of liver transplantation recipient with diffuse portal vein thrombosis / 中华器官移植杂志

Objective:To summarize the strategies and effects of portal vein reconstruction after liver transplantation in recipients with diffuse portal vein thrombosis(PVT).Methods:Clinical data were retrospectively reviewed for 10 PVT patients undergoing liver transplantation(LT)from January 2014 to June 2019. There were 8 males and 2 females with a age of (50.7±10.1)years. The follow-up period was (66.3±25.8)months. Diameter of portal vein anastomosis, diameter and flow velocity of portal vein and presence of ascites were evaluated by color Doppler ultrasound. And computed tomography(CT)was employed for assessing the presence of esophagogastric varices. And patency of portal vein blood flow, therapeutic outcomes of portal hypertension and survival status of recipients were evaluated.Results:Among 7 patients with diffuse PVT without enlarged collaterals, cavoportal hemitransposition( n=6) and renoportal anastomosis( n=1) were performed.Ascites subsided gradually and minimal ascites( n=4) perdisted.Variceal bleeding did not recur within 6 months.As of December 2021, portal vein blood flow remained unobstructed in 4 recipients and 3 patients died.One case of inferior vena cava thrombosis and renal injury at 3 months post operation died of multiple organ failuer at 8 months post-operation.Another patient died of recurrent hepatocarcinoma at 11 months post-operation.Another case died of stroke at 44 months post-operation.Among 3 patients with diffuse PVT complicated with enlarged collaterals, there were right gastric vein to portal vein anastomosis( n=1), gastric coronary vein to portal vein anastomosis( n=1) and pericholedochalvarix to portal anastomosis( n=1). Ascites gradually subsided within 2 months post-operation.Portal vein anastomosis thrombosis was formed 1 month after operation and racanalizated after anticogulation and thrombosis therapies in patient with gastric coronary vein to portal vein anastomosis.Upper gastroinstestinal hemorrhage occurred 36 months after operation and was relieved by endoscopic ligation and sclerotherapy.Blood flow of portal vein was unobstructed in patients with right gastric vein and pericholedochalvarix to portal vein anastomosis.During the last follow-up, velocity of portal vein surpassed 20 cm/s and liver function remained normal in 7 survivors. Conclusions:For patients with complex PVT, portal vein reconstruction may ensure sufficient portal vein blood flow of graft. After operation, portal hypertension disappears and liver function normalizes.

Effect of normothermic mechanical portal vein perfusion pressure on repairing donor liver injury induced by prolonged warm ischemia in rats / 中华器官移植杂志

Objective:To develop an ex vivo normothermic mechanical perfusion(NMP)and compare the effect of different portal perfusion pressures on attenuating hepatic injury from donor after cardiac death(DCD).Methods:All rat livers were subjected to in situ warm ischemia for 30 min after cardiac attest and thereafter stored for 8 h under cold preservation. Six livers were harvested and regarded as static cold storage(group CS, n=6). In experimental group, liver received an ex vivo dual NMP with oxygenated perfusion via hepatic artery for 2 h after cold storage. Hepatic injury was assessed and compared from perfused livers with full portal vein pressure(group M1, n=6)and low portal vein pressure(group M2, n=6). The evaluation parameters included perfusion flow, liver enzymes of perfusate, pathological changes by hematoxylin-eosin staining, Suzuki histological criteria, expression of activation markers of polymorphonuclear neutrophils and macrophages, myeloperoxidase (MPO)and CD68 by immunohistochemistry, level of malondialdehyde(MDA)and activity of superoxide dismutase(SOD). Results:In experimental group during NMP, perfusion flows tended to increase when portal pressures were stabilized in groups M1 and M2.Perfusion flow during NMP 60~120 min was significantly higher than during NMP 0~20 min.After NMP with full portal pressure, hepatic sinusoidal congestion, hepatocyte necrosis, steatosis and Suzuki criteria were lower in group M1 than those in group CS( P<0.05). Compared with group M1, lower hepatic injury was characterized with a lower change of liver enzymes in perfusate( P<0.05), a better histological evaluation( P<0.05), a lower level of MDA and a higher activity of SOD( P<0.05), lower expressions of CD68 and MPO ( P<0.05)and lower levels of TNF-α and IL-6( P<0.05)in perfused liver. Conclusions:The ex vivo dual NMP with oxygenated perfusion via hepatic artery mimics liver perfusion under the physiological conditions.NMP with a lower portal pressure can attenuate hepatic ischemia-reperfusion injury and confer a better protection against liver damage from DCD.

Effect of taurine on the antioxidant capacity and ATP activity of skeletal muscle in rats with exhaustive exercise / 中国基层医药

Objective@#To explore the effect of taurine on the activity of SOD, MDA, Na+ -K+ -ATP enzyme and Bax/Bcl-2 in skeletal muscle of rats after exhaustive exercise.@*Methods@#Thirty male SD rats(6 months old) were randomly divided into normal group, control group and taurine group, with 10 rats in each group.The normal group was given routine feeding for 1 week, adaptive training for 3 days, without applying other measures.The control group was given routine feeding for 1 week, after adaptive training for 3 days underwent exhaustive exercise for 2 days.The taurine group was given 200mg/kg taurine gavage daily on the basis of the control group.The activity of SOD, MDA, Na+ -K+ -ATP and Bax/Bcl-2 were measured in the skeletal muscle after 2 days exhaustive exercise.@*Results@#After 2 days exhaustive exercise, the SOD concentration in skeletal muscle of the control group was (146.58±13.42)U/mg prot, which was lower than that in the taurine group[(143.81±15.93)U/mg prot] (t=2.519, P<0.05). The MDA concentration in the skeletal muscle of the control group was (1.97±0.20)nmol/mg prot, which was higher than that in the taurine group [(1.22±0.19)nmol/mg prot] (t=2.356, P<0.05). The ratio of SOD/MDA in the control group was (60.86±20.38), which was lower than that in the taurine group [(120.87±23.51)] (t=4.071, P<0.05). The activity of Na+ -K+ -ATP in the control group was (2.42±0.67)U/mg prot, which was lower than that in the taurine group [(5.74±1.15)U/mg prot] (t=3.905, P<0.05). The ratio of Bax/Bcl-2 in the control group was (1.62±0.17), which was higher than that in the taurine group [(0.96±0.14)] (t=3.419, P<0.05).@*Conclusion@#Taking taurine before exhaustive exercise can increase the ability of scavenging free radicals, reduce the production of oxidative stress products and protect the activity of Na+ -K+ -ATP enzyme.It is benefit for maintain the stability of cell environment and prevent skeletal muscle injury.

Effect of taurine on the antioxidant capacity and ATP activity of skeletal muscle in rats with exhaustive exercise / 中国基层医药

Objective To explore the effect of taurine on the activity of SOD,MDA,Na +-K +-ATP enzyme and Bax/Bcl-2 in skeletal muscle of rats after exhaustive exercise.Methods Thirty male SD rats (6 months old) were randomly divided into normal group,control group and taurine group,with 10 rats in each group.The normal group was given routine feeding for 1 week,adaptive training for 3 days,without applying other measures.The control group was given routine feeding for 1 week,after adaptive training for 3 days underwent exhaustive exercise for 2 days.The taurine group was given 200mg/kg taurine gavage daily on the basis of the control group.The activity of SOD,MDA,Na+-K+-ATP and Bax/Bcl-2 were measured in the skeletal muscle after 2 days exhaustive exercise.Results After 2 days exhaustive exercise,the SOD concentration in skeletal muscle of the control group was (146.58 ± 13.42) U/mg prot,which was lower than that in the taurine group [(143.81 ± 15.93) U/mg prot] (t =2.519,P ＜0.05).The MDA concentration in the skeletal muscle of the control group was (1.97 ± 0.20) nmol/mg prot,which was higher than that in the taurine group [(1.22 ± 0.19) nmol/mg prot] (t =2.356,P ＜ 0.05).The ratio of SOD/MDA in the control group was (60.86 ±20.38),which was lower than that in the taurine group [(120.87 ±23.51)] (t =4.071,P ＜ 0.05).The activity of Na +-K +-ATP in the control group was (2.42 ± 0.67) U/mg prot,which was lower than that in the taurine group [(5.74 ± 1.15) U/mg prot] (t =3.905,P ＜ 0.05).The ratio of Bax/Bcl-2 in the control group was (1.62 ± 0.17),which was higher than that in the taurine group [(0.96 ±0.14)] (t=3.419,P ＜ 0.05).Conclusion Taking taurine before exhaustive exercise can increase the ability of scavenging free radicals,reduce the production of oxidative stress products and protect the activity of Na +-K +-ATP enzyme.It is benefit for maintain the stability of cell environment and prevent skeletal muscle injury.

Inducible nitric oxide synthase inhibitor 1 400W suppresses endoplasmic reticulum stress and alleviates ischemia-reperfusion injury in human intrahepatic bile duct epithelial cells / 中华器官移植杂志

Objective To explore the role and mechanism of inducible nitric oxide synthase inhibitor 1 400W in alleviating ischemia-reperfusion injury of human intrahepatic bile duct epithelial cells.Methods Human intrahepatic bile duct epithelial cells (HIBEC) in logarithmic phase were inoculated into culture plate at an appropriate density.The samples were randomly divided into control group (group C),ischemiareperfusion group (group I/R) and ischemia-reperfusion + 1 400W group (group I/R + 1 400W).Group C was cultured routinely;cells in I/R and I/R + 1 400W groups were placed in a three-gas incubator for 12h for simulating ischemia and then normal culture for 6h for simulating reperfusion.The I/R + 1 400W group had a final concentration of 100 μmol/L of 1 400W before ischemia and hypoxia.After reperfusion,cells and culture medium were collected,CCK 8 was used for detecting cell vitality,microplate method for detecting the content of lactate dehydrogenase (LDH) in culture medium,AnnexinV-FITC/PI double stain for detecting apoptosis level,Western blot for analyzing the expressions of endoplasmic reticulum stress (ERS)related protein cysteinyl aspartic acid protease 12 (caspase-12),glucose regulatory protein 78 (GRP78) C/EBP homologous protein (CHOP) and inducible nitric oxide synthase (iNOS).Results As compared with group C,cell viability significantly decreased in I/R and I/R+ 1 400W groups (53.8％ ± 2.3％ vs.100％,66.5 ％ ± 2.8 ％ vs.100 ％) (P＜0.05) while LDH increased markedly in cell culture medium (287.4 ±9.0U/L vs 120.2 ± 8.7U/L,212.0 ± 8.3U/L vs 120.2 ± 8.7U/L) (P＜0.05).Apoptosis accelerated markedly (41.5％±2.3％ vs5.2％±0.5％,32.7％± 1.8％ vs 5.2％±0.5％) (P＜0.05) and the expressions of caspase-12,GRP78,CHOP and iNOS spiked (P＜0.05);as compared with I/R group,cell viability of I/R+ 1 400W group rose while LDH,apoptosis level,caspase-12,GRP78 and CHOP declined in cell culture medium (P＜0.05).Conclusions 1 400W may alleviate ischemia-reperfusion injury of human intrahepatic bile duct epithelial cells and its mechanism may be correlated with a suppression of endoplasrnic reticulum stress.

Correlation between the main indicators of organ donation and donor liver and the early prognosis of transplant after the death of citizens / 中华器官移植杂志

Objective To explore the correlation between main indicators of donor liver and early prognosis after liver transplantation.Methods The clinical data of 166 donors and recipients of post-mortem organ donation (DD) from June 2017 to June 2018 were retrospectively analyzed.The effects of donor age,sex,body mass index,serum sodium level,total bilirubin,prothrombin time and international standardized ratio on early allograft dysfunction (EAD) in liver transplant recipients were investigated.According to the culture results of donor liver preservation solution,the results were divided into positive group and negative group.Combined with the culture results of blood,sputum and drainage fluid after liver transplantation,the early infection rate of recipients in the two groups was observed.Results Univariate analysis showed that preoperative donor bilirubin total ＞17.1 mmol/L and donor cold ischemia time ＞8 h were risk factors for postoperative EAD in transplant recipients.Multivariate analysis showed that donor cold ischemia time ＞8 h was an independent risk factor for postoperative EAD in liver transplant recipients;the incidence of EAD in the group with cold ischemia time ＞8 h was significantly higher than that in the group with cold ischemia time ≤8 h (26.3％ vs.7.0％;P =0.003).The positive rate of postoperative sputum culture and drainage fluid culture in the donors with positive donor culture was 43.9％ and 48.8％,respectively,which was significantly higher than that in the negative group (10.7％ and 13.1％).The difference was statistically significant (P =0.000,P =0.000).The positive rate of postoperative blood culture in the positive group and the negative group was 12.2％ and 6.0％ with the difference being not statistically significant (P =0.161).Conclusion Cold ischemia time of the donor ＞8 h is an independent risk factor for EAD in recipients after liver transplantation.Shortening the cold ischemia time of donor liver can reduce the incidence of postoperative EAD in recipients.The culture results of preservation solution have a certain guiding effect on the postoperative anti-infective treatment of the recipients.

Effect and mechanism of curcumin on proliferation and apoptosis of human hepatoma HCC-LM3 cells / 国际外科学杂志

Objective To investigate the effects of curcumin on the growth and apoptosis of human hepatoma HCC-LM3 cells and explore the molecular mechanisms.Methods The human hepatoma HCC-LM3 cells were treated with different concentrations of curcumin and the cell growth inhibition rate was detected by CCK-8.The effect of curcumin on human hepatoma HCC-LM3 cells was observed.Refer to the relevant literature,the human hepatoma HCC-LM3 cells were treated with the concentration of 2.5,5.0,10.0,15.0,20.0,40.0,60.0 μmol/L of curcumin for 48 hours,taking the 0 μmol/L curcumin as control group,and the cell growth inhibition rate was detected by CCK-8.According to the results of CCK-8,selecting the concentration of 0 μmol/L as control group and the concentration of 10.0,20.0,40.0 μmol/L as experimental groups,which has significant difference on growth inhibition rates.Cell cloning assay was used to detect cell cloning ability,Flow cytometry was used to detect apoptosis,and Western blotting to detect the protein expression levels of Mcl-1,Bax,Bcl-2 and Bcl-xL.The measurement data were expressed in ((x) ± s),and the single factor analysis of variance was used for comparison between groups.Results CCK-8 assay showed that with treated by the concentration of 2.5,5.0,10.0,15.0,20.0,40.0,60.0 μmol/L,the growth inhibition rates were(6.71 ± 3.45)％,(12.33 ± 5.02)％,(20.07 ± 5.60)％,(57.80 ±7.34)％,(78.37 ±6.53)％,(91.73 ±6.14)％ and (96.18 ±3.45)％,suggesting that curcumin could inhibit the growth of human hepatoma HCC-LM3 cells in a dose-dependent manner.Cell clone formation experiment showed that curcumin could inhibit the clone of the human hepatoma HCC-LM3 cells,and the clone of the cells was inhibited significantly when the concentration of the curcumin was over 20.0μmol/L.The result of Annexin V-FITC/PI double staining analysis showed that the apoptotic rates of experimental groups and control groups were (5.20 ± 1.44) ％,(9.90 ± 3.31) ％,(55.67 ± 5.29) ％,(79.63 ±4.71)％,with all the apoptotic rates of experimental group over the control groups (P ＜0.05),suggesting curcumin could induce the apoptosis of human hepatoma HCC-LM3 cells.The Westen blotting showed that curcumin increased the expression of Bax protein while decreasing expression of Mcl-1 protein significantly in concentration-dependent manner (P ＜ 0.05),but have no effect on the expression of Bcl-2 and Bcl-xL proteins.Conclusion Curcumin could inhibit the proliferation and clone of human hepatoma HCC-LM3 cells,and induce apoptosis in a dose dependent manner.

Influence of different anesthetic and analgesic methods on early cognitive function of elderly patients receiving non-cardiac surgery

Objective: To discuss over influence of two different anesthetic and analgesic methods on early cognitive function of elderly patients who received non-cardiac surgery

Methods: Two hundred and six elderly patients who underwent non-cardiac surgery were selected as research subjects. They were randomly divided into observation group [103 cases] and control group [103 cases]. Patients in observation group were given combined spinal and epidural anesthesia and epidural analgesia, while patients in control group adopted general anesthesia and intravenous analgesia. Neurological function test was carried out one day before surgery and on the 7[th] day after surgery. Moreover, changes of postoperative pain degree, neuropsychological function and cognitive function were observed and compared

Results: On the 7[th] day after surgery, incidence of cognition impairment in observation group and control group was 48.50% [50/103 cases] and 44.70% [46/103 cases], and difference between groups had no statistical significance. Visual Analogue Scale [VAS] Score of observation group was much lower than control group in the 12[th], 24[th] and 48[th] h after surgery [p < 0.05]. Logistic regression analysis suggested that, short education years and general surgery were independent risk factors for early cognition impairment

Conclusion: About 46.60% elderly patients undergoing non-cardiac surgery developed cognition impairment, but influence of different anesthetic and analgesic methods on incidence of postoperative cognition impairment of elderly patients had no significant difference

The associated complications analysis and treatment measures of high intensity focused ultrasound in the treatment of primary hepatic carcinoma / 国际外科学杂志

Objective To investigate the complications of High Intensity Focused Ultrasound (HIFU) in the treatment of primary hepatic carcinoma,looked forward to improving the safety of the treatment of HIFU.Methods Retrospectively analyzed the clinical data of 165 patients with primary liver cancer treated by High Intensity Focused Ultrasound in the First Affiliated Hospital of Zhengzhou University from September 2014 to December 2009,to summarise the complications of this therapeutic method and analysis the related treatment measures.Results HIFU treatment of primary liver cancer common complications included the treatment of skin soft tissue injury (118/165),a transient injury of liver function (83/165),postoperative fever (81/165),self-limiting pleural effusion (42/165) and postoperative pain (33/165);The severe complications included rib fractures(2 cases),organ perforation injury (1 case),Cancer rupture hemorrhage (1 case)and Skin 1Ⅱ(5 cases),Ⅲ(1 case) degree burn;Serious consequences were not caused by the complications which were actively treated.Conclusion The treatment of primary liver cancer by High Intensity Focused Ultrasound has less serious complications and high safety.

Arthroscopic 360° denervation for knee osteoarthritis: a report of 85 cases / 中华创伤杂志

Objective To compare the curative effect of 360° arthroscopic denervation and routine arthroscopic debridement in treatment of knee osteoarthritis.Methods A total of 85 patients were included in the study after excluding the 5 follow-up dropout among the 90 patients with knee osteoarthritis treated between May 2006 and May 2011.Subsequently,the odd and even quality of the mantissa of admission number was used to determine the groups:Group A,42 patients underwent routine arthroscopic debridement; Group B,43 patients underwent arthroscopic debridement plus 360 degree denervation.Traumatic and degenerative arthritis occurred in 30 and 55 patients respectively.There were 34 male and 51 female patients whose mean age was 63 years (range,52-73 years).Western Ontario and McMaster University Osteoarthritis Index (WOMAC),MOS item short from health survey (SF-36),and visual analogue score (VAS) were compared between the two groups before and after operation.Results WOMAC score and SF-36 score of the two groups improved after surgery.At postoperative 6 months,12 months,and 24 months,WOMAC in Group B scored 81.0,78.5,and 82.4 respectively,lower than 86.8,83.8,and 91.7 in Group A (P ＜ 0.05) ; SF-36 in group B scored 47.4,46.3,and 44.4 respectively,higher than 43.9,41.4,and 39.5 in group A (P ＜ 0.05).At postoperative 1 week,VAS of group B was 1.6 points,lower than 2.6 points in group A (P ＜ 0.05).There was no statistical difference between the two groups in postoperative swelling of joint (P ＞ 0.05).Conclusions According to the area involved in knee osteoarthritis and characteristics of innervation of knee joint synovium,arthroscopic 360° denervation provides thorough debridement and removes as many innervation of knee joint synovium.Arthroscopic 360° denervation is superior to the routine arthroscopic debridement in improvement and duration of the symptoms.

RNA interference targeting EphA7 inhibits growth of SMMC-7721 cell xenograft in nude mice / 中华肝胆外科杂志

Objective To investigate the effects of RNA interference targeting EphA7 gene on the growth of SMMC-7721 cell xenograft in nude mice.Methods Recombinant plasmid of EphA7 gene-targeting siRNA was transfected into hepatic cancer SMMC-7721 cells by LipofectamineTM2000,comparing with the empty vector transfected group,untransfected group and control group.The nude mice tumor model was established by subcutaneous injection of hepatic cancer cells in the left upper limb of the mice.Control group was injected with PBS as blank.Real-time PCR,immunohistochemistry and Western blot were employed to detect the mRNA and protein expressions of EphA7 in tumor tissues.The tumor formation time,tumor mass and weight of tumor were also considered in the analysis.Results About 9 ～ 12 days after the injection of tumor cells,the xenograft tumor formation can be observed around the injection site except the control group.35 days after tumor formation,there were obvious decreases in the tumor growth rate,tumor mass,as well as tumor weight in transfected group,comparing with empty vector transfected group and untransfected group (P ＜0.05).Transfection of RNA interference can inhibit the growth of xenograft tumor by 55％.Immunohistochemistry tests showed that there were less cells with positive staining of EPHA7 protein in transfected group,and the staining was lighter as pale yellow,in contrast with the untransfected group and the empty vector transfected group.Real-time PCR and Western blot revealed that the expression of EphA7 mRNA and EPHA7 protein of transfected group were significantly lower than those of untransfected group and empty vector trausfected group with statistically significance (P ＜ 0.05).Conclusion Silencing EphA7 gene with RNA interference can effectively inhibit the growth of SMMC-7721 cell in nude mice,which is expected to become a new target for gene therapy of hepatic cancer.

Gastritis cystica profunda in 15 cases / 中华普通外科杂志

Objective To investigate the clinical characteristics and summarize the experiences on the diagnosis and treatment of gastritis cystica profunda (GCP).Methods Clinical data of 15 GCP patients,who were treated in the First and Second Affiliated Hospital of Zhengzhou University from January 2006 to January 2013,were retrospectively analyzed.Results GCP may present clinically as abdominal pain,bloating,emaciation,and GI bleeding.CT,electronic gastroscope,or ultrasonic endoscope shows that GCP consists of multiple cysts within a thickened submucosal layer.The submucosal pathological features can not be obtained by ordinary biopsy and snares.Of the 15 cases,proximal gastrectomy was performed in 4 cases,distal subtotal gastrectomy in 3 cases,1 case was treated with gastric wedge resection,and total gastrectomy was performed in 7 cases.Postoperative recovery was uneventful.13 cases were followed up for 2 years,and there was no evidence of recurrence.Conclusions GCP is an uncommon disease with unknown origin,and has no clinical characteristics,and has malignant potential.Postoperative prognosis is satisfactory.

The preliminary results of high intensity focused ultrasound (HIFU) treatment for advanced pancreatic cancer / 中华普通外科杂志

Objective To study the efficacy and safety of high intensity focused ultrasound (HIFU) treatment for advanced pancreatic cancer.Methods In this study,25 patients with advanced pancreatic cancer received high-intensity focused ultrasound (HIFU) treatment.Liver and kidney function,CA19-9 levels,tumor size changes,pain relief,survival rate before and after treatment were evaluated.Results The blood routine test,liver and kidney function,blood amylase did not alter significantly after HIFU treatment in all patients.The CA19-9 level of 12 patients decreased.The appetite of 15 patients improved,5 patients with body weight gain after HIFU treatment.Pain was relieved after HIFU treatment in 18 cases,pain relief rate was 72％ (18/25).In 15 cases tumor ablation volume ＞ 90％ after HIFU treatment,5 patients with tumor ablation volume ＞ 50％,tumor ablation effective rate was 80％ (20/25).There were no major complications such as acute pancreatitis,gastrointestinal injury after HIFU treatment.After HIFU treatment,the median survival period was 8 months,1 year survival rate was 30％.Conclusions High-intensity focused ultrasound is a safe and effective method of palliative treatment for advanced inoperable pancreatic cancer.

A new unconventional HLA-A2-restricted epitope from HBV core protein elicits antiviral cytotoxic T lymphocytes

Cytotoxic T cells (CTLs) play a key role in the control of Hepatitis B virus (HBV) infection and viral clearance. However, most of identified CTL epitopes are derived from HBV of genotypes A and D, and few have been defined in virus of genotypes B and C which are more prevalent in Asia. As HBV core protein (HBc) is the most conservative and immunogenic component, in this study we used an overlapping 9-mer peptide pool covering HBc to screen and identify specific CTL epitopes. An unconventional HLA-A2-restricted epitope HBc141-149 was discovered and structurally characterized by crystallization analysis. The immunogenicity and anti-HBV activity were further determined in HBV and HLA-A2 transgenic mice. Finally, we show that mutations in HBc141-149 epitope are associated with viral parameters and disease progression in HBV infected patients. Our data therefore provide insights into the structure characteristics of this unconventional epitope binding to MHC-I molecules, as well as epitope specific CTL activity that orchestrate T cell response and immune evasion in HBV infected patients.