ABSTRACT
Objective To evaluate the feasibility of splenectomy and pericardial devascularization in patients with Child-Pugh grade C cirrhosis,portal hypertension,and severe hypersplenism or after the first gastroesophageal variceal hemorrhage (GEV bleeding).Methods From January 2010 to January 2017,the clinical data from patients with Child-Pugh grade C cirrhosis,portal hypertension with a high risk of GEV bleeding were retrospectively analyzed.These patients underwent splenectomy and pericardial devascularization at the Huashan Hospital Affiliated to the Fudan University.The safety and effectiveness of surgery,postoperative complications and mortality were further explored.Results Liver protection treatment was given before surgery to improve the liver function.Of the 32 patients who underwent splenectomy and pericardial devascularization,the operation time was (2.2±0.3) hours.The blood loss was (208.0± 102.0) ml and the hospital stay after surgery was (11.8±2.8) d.Postoperative complications included fever,wound infection and ascites.One patient died of hypovolemic shock and acute renal failure.The incidence of postoperative PVT was 12.5％ (4/32).The rates of GEV rebleeding at 1 year,3 years,and 5 years after surgery were 6.3％ (2/32),6.3％ (2/32),and 9.4％ (3/32).The 5-year overall mortality rate was 12.5％ (4/32).Conclusions In the absence of obvious surgical contraindications and with a lack of donor livers for liver transplantation,aggressive perioperative management,splenectomy and pericardial devascularization are a feasible option for patients with Child-Pugh grade C cirrhosis,portal hypertension with a high risk of GEV bleeding.
ABSTRACT
Objective To evaluate the effect of sustained silencing Forkhead box Ml (F0XM1) gene by short-hairpin RNA (shRNA) expression vector on cell growth of hepatocelluar carcinoma (HCC) in vitro.Methods Four shRNA expression vectors targeting different sequences of human F0XM1 mRNA were constructed.The expression vector with the best interfering effect and the negative control plasmid were used to transfect HCC cell line QGY-7703, stably transfected cell clones were selected by neomycin (G418).Cell growth was evaluated by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay and colony formation was assessed by clonogenic assay.Cell apoptosis was detected by double staining with APC conjugated Annexin V and PI.Results F0XM1 protein was detected with different levels in all these studied human cell lines.The expression vector shRNA-1026 exhibited excellent interference effect after transient transfection, which showed 38.5% and 53.2% reduction of FOXM1 mRNA and protein level respectively.The growth of QGY-7703 cells was inhibited after stable inhibition of FOXM1 expression by shRNA-1026, which was indicated by decreased absorbance value of the test group after culture for 48, 72 and 96 h compared to control group (t = 10.830,3.578 and 5.734 respectively, P ＜ 0.05).Stable inhibition of F0XM1 also led to reduced colony formation ( t = 5.336, P ＜ 0.05 ) and increased apoptosis of QGY-7703 cells in comparison to control cells (t = 6.827, P ＜ 0.05 ).Conclusions Stable silencing F0XM1 gene by shRNA suppresses the growth of HCC cells in vitro.
