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Objective To investigate the influence of pain on liver function recovery after hepatectomy Methods Clinical data of 257 patients with primary hepatocellular carcinoma were analyzed retrospectively. The patients were divided into effective analgesia group(NRS ≤ 3 points)and ineffective analgesia group(NRS > 3 points)according to the digital hierarchy(NRS). The serum liver function indexes including ALT,AST,TBiL, ALB and PT were compared in 2 groups. Results There was no significant difference in preoperative liver function between 2 groups but the levels of ALT ,AST ,PT and TBIL at 1st ,3rd ,5th and 7th days postoperatively were lower in effective analgesia group than those in ineffective analgesic group after surgery(P<0.05). The incidence of the delay of liver function was lower in effective analgesia group than that in ineffective analgesic group. Conclusion Effective analgesic treatment can reduce liver damage and accelerate liver function recovery.
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Objectives To evaluate the predictive value of the revised model for end-stage liver disease in the clinical early stage after liver transplantation.Methods The clinical data of 218 patients were retrospectively analyzed.After calculating the MELD score,ReFit MELD score and ReFit MELDNa score before transplantation,we compared the predictive accuracies of these scoring systems using the area under curve (AUC) of the receiver operating characteristic.The groups were categorized with the cut-offs of the MELD,ReFit MELD and ReFit MELDNa,and the early-stage complications and mortality in the different groups were analyzed.Results The AUC for the MELD,ReFit MELD and ReFit MELDNa were 0.737 (95％CI 0.621～0.854),0.727 (95％CI 0.663～0.785) and 0.735 (95％CI 0.671～0.792),respectively.There was no statistical difference is the AUC among the MELD,ReFit MELD and ReFit MELDNa.Elevated scores in the 3 models predicted higher rates of pulmonary infection,abdominal infection and acute renal dysfunction,as well as a higher mortality.Conclusions The ReFit MELD score and ReFit MELDNa score were relatively useful predictors of short-term survival rates after liver transplantation.The predictive accuracy was similar to the MELD score.Values of the score above the cutoff values indicated higher rates of complication and poorer prognosis.
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Objective To investigate the prognostic relevant factors of hepatocellular carcinoma (HCC) in recipients following liver transplantation (LT).Methods The clinical data of 147 cases of HCC undergoing LT between Aug. 2004 and Feb. 2011 in Nanfang Hospital were studied retrospectively.Those of significance in 14 relevant factors involving gender,age,blood-type,CTP,model of end-stage liver disease (MELD),alpha-fetoprotein (AFP),tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and microvascular invasion (MVI),HCC histology differentiation,which were based on univariate analysis with Log-Rank,were analyzed by means of Multivariate Cox proportional hazard regression model to screen out independently relevant ones.Results 143 cases were followed up.The follow-up duration ranged from 6 to 84 months.The 1- and 3-year cumulative survival rate was 75.2％ and 54.7％ respectively.The tumor free 1- and 3-year cumulative survival rate was 70％ and 59％ respectively.Univariate ananlysis revealed that age,AFP,tumor number,cumulative diameter of tumor,tumor occupying proportion of the liver,bilobar involvement,envelope invasion,macrovascular invasion,and MVI had significant difference, In a Cox model,MVI,macrovascular invasion and AFP≥ 400 μg/L were independent prognostic factors.Conclusion MVI,macrovascular invasion and AFP are the main prognostic risk fators.Intervention and non-tumor technique should be performed preoperatively and intraoperatively,respectively.
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Objective To explore the effects of adriamycin-loaded immuno-nanoparticles on multidrug resistance (MDR) of hepatoma cell line SMMC-7721/ADM. Methods The cytotoxicity of the adriamycin-loaded immuno-nanoparticles on the bepatoma cell line SMMC-7721/ADM in vitro and the tumor cell-binding ability of adriamycin-loaded immuno-nanoparticles were detected. Results The effect of the cytotoxicity of adriamycin-loaded immuno-nanoparticles on the hepatoma cell line SMMC-7721/ADM was significantly better than that of adriamycin-loaded nanoparticles. Adriamycin-loaded immuno-nanoparticles had the specific binding ability with the hepatoma cell line SMMC-7721/ADM. Conclusions Adriamycin-loaded immuno-nanoparticles can overcome the MDR of the tumor in vitro. The mechanism may be that immuno-nanoparticles could adhere to the tumor cell membrane, and the release of the loaded adriamycin creates a high local concentration in the extracellular medium. The increased concentration gradient improves the diffusion of adriamycin from the extracellular medium to the intracellular medium.
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Objective To study the preventive effect of hepatic metastasis from colorectal cancer and the immune function influence on postoperative patients with colorectal cancer treated by TIL, rIL-2 and cyclophosphamide by portal vein infusion. Methods One hundred and twenty-four patients with advanced colorectal cancer (Dukes B and Dukes C stage) were randomly divided into immunotherapy group and control group. The control group were treated with 5-Fu and MMC by intravenous injection after resection of colorectal cancer. The immunotherapy group were treated with TIL, rIL-2 and cyclophosphamide by portal vein infusion after resection of the tumor, then with chemotherapy as the control group. All cases were followed-up for 3 years. Results Eight cases (12.3%) had hepatic metastases from colorectal cancer in the immunotherapy group, but nineteen cases (33.2%) in the control group. There was significant difference between the two groups (P>0.05). The NK, IL-2 activity and CD3, CD4, CD4/CD8 levels in peripheral blood of the immunotherapy group increased significantly after treatment (P<0.05). Conclusions The TIL, rIL-2 and cyclophosphamide treatment after resection of colorectal cancer is effective in improving antitumorgenic immune function, and preventing hepatic metastases.
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AIM:To study the relationship between expression of p53 protein and AgNORs count and histological grade in pancreatic adenocarcinoma.METHODS:Fifty-six patients with pancreatic adenocarcinoma and 25 normal pancreatic tissue were examined for mutant P53 protein by immunohistochemistry,silver binding nucleolar organizer regions(AgNORs)were counted in cancer cells,and histological grade was observed in pancreatic adenocarcinoma.RESULTS:P53 protein positive expression was 50% in pancreatic adenocarcinoma,P53 protein expression was negative in all normal pancreatic tissue.There is a significant difference in P53 expression between normal pancreatic tissue and pancreatic adenocarcinoma tissue.The mean AgNORs count was 9.14?2.08 in group with P53 protein positive expression,and 5.99?1.84 in group with P53 protein negative expression group.The P53 expression was associated with AgNORs significantly.The P53 expression was significantly related with histological grade,and AgNORs count was also significantly related with histological grade.CONCLUSION:P53 may be closely related to carcinogenesis and development of pancreatic adenocarcinoma.P53 protein expression and AgNORs count might be a useful prognostic factor in pancreatic adenocarcinoma.