Role of vascular cell adhesion molecule-1 in the mouse model of hepatic ischemia/reperfusion and the hematogenic metastasis / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effect of ischemia/reperfusion (I/R) on tumor metastasis in a experimental mouse model of hematogenous metastasis after I/R and to quantify expression of vascular cell adhesion molecule-1 (VCAM-1) during I/R.</p><p><b>METHODS</b>An experimental mouse model of metastasis after partial hepatic I/R was designed to determine the effects of I/R on tumor metastasis to liver. Tumor loads were valued 14 days after operation. In addition, the expressions of alanine transaminase (ALT), aspartate transaminase (AST), and VCAM-1 were detected.</p><p><b>RESULTS</b>Two hours after hepatic reperfusion, ALT and AST levels in ischemia 45-minute group and ischemia 30-minute group were significantly higher than in the sham group (all P < 0.05). Also, the changes of ALT and AST were more obvious in the ischemia 45-minute group than in ischemia 30-minute group (all P < 0.05). In the sham group, both ALT and AST slightly and transiently increased. ALT and AST in the ischemia 45-minute group and ischemia 30-minute group at 8 hours were both significantly higher than those at 2 hours reperfusion (P<0.05). The tumor load (valued by hepatic replacement area) and the expression of VCAM-1 in ischemic lobe were significantly larger in the ischemia 45-minute group than in the ischemia 30-minute group and sham group (P = 0.013, P = 0.007). However, there was no statistical difference on tumor load between the right lobe of sham operated mice and the right lobe (nonischemic lobes) of mice subjected to I/R (P = 0.089). Mouse survivals were significantly longer in the sham group than in the ischemia 30-minute group (P = 0.041) but were not significantly different between the ischemia 45-minute group and ischemia 30-minute group (P = 0.055). VCAM-1 expression in ischemia 45-minute group was significantly higher than in ischemia 30-minute group and sham group(P = 0.003, P < 0.001), and it was positively correlated with the hepatic replacement area (r = 0.491, P = 0.045).</p><p><b>CONCLUSION</b>Hepatic I/R promotes liver hematogenic metastasis of hepatocellular carcinoma in mice and at least in part, through the induction of VCAM-1 expression.</p>

Clinical application of vacuum pack system for temporary abdominal closure / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical application of a new temporary abdominal wound closure,vacuum system for temporary management of the open abdomen.</p><p><b>METHODS</b>Vacuum pack system consisted of polyethylene sheet,surgical towel,silicone drain, adhesive plastic drape. Clinical data of the patients undergoing exploratory celiotomy were recorded,and the indications for such temporary abdominal closure and its complications were reviewed.</p><p><b>RESULTS</b>Thirteen trauma patients underwent such vacuum abdominal closure for 15 times, including 5 times (33.3%) for increased intra- abdominal pressure so that tension-free fascial closure was unable to achieve, 4 times (26.7%) for reexploration, 2 times (13.3%) for damage control, and 4 times (26.7%) for combined factors. Finally, seven patients (53.8%) received direct closure and 5 patients (38.5%) received skin grafting after granulation because the defect could not be closed directly. One patient (7.7%) died before abdominal closure was attempted. None of the patients developed enterocutaneous fistula and evisceration. Three patients (23.1%) developed intra-abdominal abscess.</p><p><b>CONCLUSIONS</b>The vacuum pack is a better temporary abdominal wound closure device, and primary closure can be achieved in most of the patients. The technique is simple and easily mastered with a low complication rate.</p>

Relationship of vascular endothelial growth factor-C and lymphangiogenesis with the development and prognosis of colon cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the correlation of vascular endothelial growth factor-C (VEGF- C) expression and lymphatic microvessel density (LMVD) with clinicopathological features and prognosis in colon cancer.</p><p><b>METHODS</b>The expression of VEGF-C and VEGFR-3 was detected by immunohistochemical staining with monoclonal antibodies against VEGF-C and VEGFR-3 in 44 cases with primary colon cancer. LMVD was calculated.</p><p><b>RESULTS</b>VEGF-C positive rate was 43.2% (19/44). VEGF-C expression was associated with tumor (P=0.003), lymph node metastasis (P=0.002), Dukes stage (P=0.001). The mean LMVD was 10.14+/- 4.19. LMVD was associated with lymph node metastasis (P=0.002), Dukes stage (P=0.001). LMVD in VEGF-C(+) group was (11.34+/- 4.83) higher than (9.24+/- 3.48) in VEGF-C(-) group, but there was no statistically significance between the two groups (P=0.105). The survival rate of the patients with positive VEGF-C was lower than that with negative VEGF-C (P=0.0225). The median survival time of the patients with LMVD(+) group was shorter than that with LMVD(-) (P=0.0036). Distant metastasis (P=0.0004), lymphatic metastasis (P=0.021) and LMVD (P=0.0469) were independent prognostic factors.</p><p><b>CONCLUSIONS</b>VEGF-C and LMVD appear to be new prognostic factors for colon cancer. Furthermore, LMVD may be a new independent prognostic factor.</p>