BMSCs protect against liver injury via suppressing hepatocyte apoptosis and activating TGF-ß1/Bax singling pathway.

Many factors cause liver injury, including chronic consumption of alcohol, irregular use of drugs, excessive levels of arsenic in water. This study aims to investigate role of bone marrow-derived mesenchymal stem cells (BMSCs) in liver injury recovery and to explore mechanism. BMSCs and primary hepatocytes were isolated, cultured and identified. Hepatocyte model and hepatic fibrosis (HF) model were established using carbon tetrachloride (CCL-4). The role of BMSCs were investigated in both in vitro and in vivo levels. Cell proliferation was examined using MTT assay. Transforming growth factor-ß1 (TGF-ß1), Bcl-2 and Bax expression were detected using western blot and real-time PCR, respectively. Results indicated that BMSCs and primary hepatocytes were successfully isolated and identified, and hepatocyte model was successfully established. BMSCs and HGF treatment enhance viability of normal hepatocytes and hepatocyte injury model. Cell viability in BMSCs treatment and Bax-1 inhibitor treatment group was higher significantly compared to normal hepatocyte control and injury hepatocyte model, respectively (P<0.05). Bax-1 expression was significantly lower and Bcl-2 was significantly higher in Bax-1 inhibitor treatment and BMSCs treatment group compared to normal hepatocyte control (normal rats) and injury hepatocyte model (HF model), respectively (P<0.05). BMSCs significantly decreased ALT and AST levels compared to Saline group (P<0.05). In conclusion, function of BMSCs in liver injury was triggered by inhibiting hepatocyte apoptosis and leading cell proliferation through TGF-ß1/Bax singling pathway. Our study proved protective role of BMSCs against liver injury via TGF-ß1/Bax pathway, which would enrich application of BMSC in clinical.

Autologous bone marrow stem cell transplantation attenuates hepatocyte apoptosis in a rat model of ex vivo liver resection and liver autotransplantation.

BACKGROUND: To investigate the efficacy of autologous bone marrow stem cell (BMSC) transplantation in the treatment of hepatic injury in ex vivo liver resection and liver autotransplantation (ELRLA). MATERIALS AND METHODS: Rat hepatic fibrosis was induced by intraperitoneal injection of 50% CCl4-olive oil solution at a dose of 2 mL/kg twice weekly for 4 wk. ELRLA was performed 3 d post the last injection of CCl4. Six rats in each group were killed 12, 24, 48, 72, and 168 h after the operation. Hepatocyte apoptosis was determined by TUNEL assay. The expression of Bcl-2, Bax, transforming growth factor (TGF) ß1, TGFß1 receptor1/2, and phosphorylated p38 MAPK were determined by Western blot. RESULTS: Autologous BMSC transplantation significantly inhibited the increase of alanine aminotransferease and aspartate aminotransferase at 12, 24, and 48 h post operation and attenuated ELRLA-induced hepatocyte apoptosis. In BMSC-treated rats, the expression of Bcl-2 was significantly upregulated, whereas there were no obvious changes in Bax level. The expression of TGFß1 was significantly upregulated in the rat liver after the surgery. Autologous BMSC transplantation significantly downregulated the TGFß1 levels at 48, 72, and 168 h post surgery. However, autologous BMSC transplantation showed little effect on the levels of TGFß receptor 1/2 at all the time points observed. Furthermore, autologous BMSC transplantation significantly inhibited the activation of p38 MAPK. CONCLUSION: Autologous BMSC transplantation may reduce ELRLA-induced liver injury and improve survival rates in hepatic fibrosis rats. Autologous BMSC transplantation may be useful to improve the outcome of patients who undergo ELRLA.

Primary leiomyosarcoma of the inferior vena cava: a case report.

Primary leiomyosarcoma of the inferior vena cava (IVC) is a rare malignant tumor originating from the vein smooth muscle. We present one case of primary leiomyosarcoma of the IVC. The patient benefited of surgical exploration at seventh day after admission. Tumor located in the junction of the anterior wall of the IVC and the left and right renal vein. We carried out the tumor resection, vena cava artificial vascular patch prosthetics. The patient did not take anticoagulant drugs after surgery and was discharged at 12 days after surgery. Currently, the patient had survived for nearly six months, repeated abdominal computed tomography examinations showed no clear recurrence.

Pancreas-sparing duodenectomy with regional lymphadenectomy for pTis and pT1 ampullary carcinoma.

BACKGROUND: The role of pancreas-sparing duodenectomy (PSD) in the treatment of ampullary carcinoma (Amp Ca) with local lymph node metastasis remains controversial. The aim of this study was to investigate the feasibility, safety, and long-term prognosis of PSD with regional lymphadenectomy in the treatment of early-stage (pTis/pT1) Amp Ca with or without regional lymph node metastasis. METHODS: Between May 2005 and November 2009, 31 consecutive patients with Amp Ca were enrolled in this study; 25 underwent PSD. A retrospective control group of 28 patients who underwent pancreatoduodenectomy (PD) for Amp Ca during the same period was established. These 2 groups were matched in terms of demographic data, tumor size, and TNM classification. RESULTS: In the PSD group, 9 patients (36%) had regional lymph node metastasis, and 23 patients (92%) had R0 resection. Patients who underwent PSD achieved favorable results in intraoperative blood loss, duration of hospital stay, and morbidity rate. The 3-year overall and disease-free survival in PSD group were 72% and 61%, respectively. There were no differences in hospital mortality and long-term survival between the 2 groups, even for patients with lymph node metastasis (N1). CONCLUSION: PSD with regional lymphadenectomy is feasible and safe in the treatment of pTis/pT1 Amp Ca with or without regional lymph node metastasis. Long-term survival and morbidity rates are also favorable. PSD can be performed as an alternative of PD in selected patients with Amp Ca.

[Treatment of focal bone defect in postoperative nonunion with autologous red bone marrow injection].

OBJECTIVE: To observe the clinical effect of autologous red bone marrow injection in treating focal bone defect in postoperative nonunion. METHODS: Thirteen patients with focal bone defect in postoperative nonunion (7 cases in tibia, 2 cases in femur, 4 cases in humerus), including 8 males and 5 females with the mean age of 32.5-years-old (ranging from 15 to 60 years). The bone defects were treated with autologous red bone marrow injection (1 time per 2 weeks, 5 times in total) and the X-rays of AP and LP were observed. RESULTS: Thirteen patients were followed up from 6 to 12 months with an average of 7.5 months. According to results of X-ray pictures, 13 cases obtained bone defect recovered completely, and the average time of union was 4 months. CONCLUSION: Autologous red bone marrow injection has ascendancy such as less wound and clear clinical effect, which can accelerate bone healing and promotes functional recovery of limb. It is a good method to treat focal bone defect in postoperative nonunion.