Paclitaxel ameliorates fibrosis in hepatic stellate cells via inhibition of TGF-beta/Smad activity.

AIM: To investigated if paclitaxel can attenuate hepatic fibrosis in rat hepatic stellate cells (RHSCs). METHODS: RHSCs were cultured in vitro and randomly assigned to four groups: normal control group (treated only with Dulbecco's Modified Eagle's Medium), Taxol group (200 nmol/L paclitaxel was added to the cell culture), transforming growth factor (TGF)-beta group (5 ng/mL recombinant human TGF-beta1 was added to the cell culture), and TGF-beta + Taxol group. TGF-beta signaling cascade and status of various extracellular matrix proteins were evaluated by real time reverse transcriptase polymerase chain reaction and Western blotting. RESULTS: The paclitaxel treatment markedly suppressed Smad2/3 phosphorylation. This was associated with attenuated expression of collagen I and III and fibronectin in RHSCs. CONCLUSION: These data indicate that 200 nmol/L paclitaxel ameliorates hepatic fibrosis via modulating TGF-beta signaling, and that paclitaxel may have some therapeutic value in humans with hepatic fibrosis.

[Study on correlation of JAK/STAT signal pathway with progression and prognosis in hepatocellular carcinoma].

AIM: To investigate the expression of JAK/STAT signal pathway in human hepatocellular carcinoma, and to evaluate its clinical significance in the progression and prognosis in hepatocellular carcinoma. METHODS: 196 patients with hepatocellular carcinoma were examined for the expression of JAK-1 protein and STAT-3 protein by SABC immunohistochemistry. RESULTS: The positive expression rates of JAK-1 protein and STAT-3 protein in patients with hepatocellular carcinoma were significantly higher than those in 20 cases of normal liver tissue (P=0.02 and 0.01, respectively). There was no significant relation between the positive expression rates of JAK-1 protein and STAT-3 protein and patients'sex, age, tumor size, and cirrhosis of the hepatocellular carcinoma tissues (all P>0.05). The JAK-1 protein and STAT-3 protein were expressed more frequently in hepatocellular carcinoma tissues with incomplete capsule (P=0.01 and 0.008, respectively), venous tumor emboli (both P=0.02), poorly differentiated (P=0.01 and 0.009, respectively) or clinical III-IV stage (P=0.02 and 0.008, respectively) than in those with complete capsule, no venous tumor emboli, maturely differentiated or clinical I-II stage. Cox proportional hazard regression model analysis indicated that the expression of JAK-1 protein and STAT-3 protein was significantly correlated with the prognosis of patients with hepatocellular carcinoma. CONCLUSION: The results suggest that the over-expression of JAK/STAT signal pathway may be an important feature of hepatocellular carcinoma.

[Highly-selective regional vascular exclusion for large liver tumor resection].

OBJECTIVE: To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor. METHODS: Short hepatic veins were ligated and divided followed by the dissection, and isolation of the inflow and outflow vessels of the tumor-bearing lobe, which were completely devascularized after the occlusion of these vessels. The blood loss volume, postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases. RESULTS: Main hepatic veins were dissected and isolated exo-hepatically in 65 cases. In the other 3 cases, the main hepatic veins were blocked by Satin skin clamp applied longitudely along the inferior vena cava. Hepatic pedicle was routinely excluded.The amount of blood loss was from 400 to 1200 (600+/-200) mL and 26 (65%) cases didn't receive transfusion.There was no operative mortality and liver function failure. Surgical complications included subphrenic abscess in 2 cases and bile leakage in 2 cases, which were cured conservatively. CONCLUSION: Highly-selective regional exclusion of hepatic blood flow during the risk hepatectomy is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.

[Preventive effect of 5-fluorouracil on post-ERCP pancreatitis].

OBJECTIVE: To investigate the preventive effect of 5-fluorouracil (5-FU) on post-ERCP (endoscopic retrograde cholangiopancreatography) hyperamy-lasemia and pancreatitis. METHODS: One hundred and sixty patients who underwent ERCP were divided at random into 2 groups: group A (n = 80) was given meglumine diatrizoate with 5-FU; and group B (n = 80) was used contrast medium without 5-FU. Blood was drawn in each group the day before, 6 hours and 24 hours following ERCP for amylase. RESULTS: Post-ERCP hyperamylasemia occurred in 9 patients in group A (11. 25%) and 45 in B (56.25%). The difference of both groups was notable. Pancreatitis ensued in 2 instances in group A (2.50%) and 8 in group B (10.00%). Their difference was significant. CONCLUSION: 5-FU added in meglumine diatrizoate is helpful to prevent post-ERCP hyperamylasemia and pancreatitis.

[Nanobacteria in serum, bile and gallbladder mucosa of cholecystolithiasis patients].

OBJECTIVE: To find the distribution of nanobacteria in the serum, bile and gallbladder mucosa of cholecystolithiasis patients. METHODS: The infection rate of nanobacteria was identified by ELISA in the serum samples from 338 healthy people and 76 patients with cholecystolithiasis (chi(2) = 0.89, P > 0.05). Nanobacteria were cultured from the bile samples in 57 patients with cholecystolithiasis and 18 non-cholelithiasis patients and identified by immunohistochemical staining and TEM (chi(2) = 29.80, P < 0.05). Forty samples of gallbladder mucosa randomly selected from the 57 cholecystolithiasis patients were identified by immunohistochemical staining and compared with the corresponding bile samples. RESULTS: The infection rate of nanobacteria was 8.0% and 31.6% for the serum samples of the healthy people and cholecystolithiasis patients, respectively. The positive rate of nanobacteria in the bile samples was 61.3% and there was no significant difference in the bile of the cholecystolithiasis patients and the control group (61.4% vs. 61.1%). Fourteen positive patients had infection of nanobacteria in the gallbladder mucosa, submucosa, and calcific field. CONCLUSIONS: The infection rate of nanobacteria was 8% in the serum samples from the healthy people. There are nanobacteria in the serum, bile, and gallbladder mucosa. The infection of the nanobacteria may result in calcification and fibrosis of the gallbladder.

[New techniques of postoperative cholelith endoscopy via the "T" tube fistula].

OBJECTIVE: to explore some new techniques of postoperative cholelith endoscopy via the fistula. METHODS: Netting, washing, clamping, pushing, and electrohydraulic techniques were used in 260 cases of postoperative cholelith endoscopy via the fistula and the clinical data were analyzed retrospectively. RESULTS: The stones in 257 cases (98.8%) were removed completely in an average of 2.7 times. Three patients were operated on again because of biliary stricture and huge stones. CONCLUSION: The application of some new techniques in postoperative cholelith endoscopy via the fistula favors the complete removal of stones.