Objective To study the expressions of Livin, Caspase-3 and Bcl-2 in lung tissue of nonsmall cell lung cancer ( NSCLC) , and their relationship with the clinicopathological features and prognosis of NSCLC. Methods The expressions of Livin, Caspase-3 and Bcl-2 proteins were evaluated by immunohistochemical method in 87 NSCLC samples and 40 lung benign tissues. The relationship of their expressions with the clinicopathological features and prognosis of NSCLC were analyzed by Spearman’s Rank correlation and COX Regression. Results More NSCLC tissues showed expression of Livin than lung benign tissues( 72. 41% vs 0. 0% , P = 0. 000 ) , and the expression of Caspase-3 was significantly decreased ( 67. 82% vs 87. 5%, P lt; 0. 05 ) . The proteins of Livin, Caspase-3 and Bcl-2 were detected in the endochylema but none was detected in nucelus. There was no relationship between the expression of each of these proteins and the clinicopathological features of NSCLC such as histologic type, tumor differentiation,lymph node metastasis, TNM stage, the size of tumor, and tumor site. The expression of Livin was correlated with Caspase-3 and Bcl-2 expressions ( r1 = - 0. 260, P = 0. 015; r2 = 0. 351, P = 0. 001) . Livin, Caspase-3 and Bcl-2 were not independent prognostic factors of NSCLC. Conclusions The expression of Livin and Bcl-2 are up-regulated in NSCLC. The expression of Livin is positively correlated with that of Caspase-3 and Bcl-2, they might interact with each other in the carcinogenesis and development of NSCLC. The levels of Livin, BCl-2 and Caspase-3 proteins are not independent factors affecting the prognosis of lung cancer patients.
ObjectiveTo study the expression of inhibitor of apoptosis proteins (Livin) and aspartate-specific cysteine protease-3 (Caspase-3) in patients with middle ear cholesteatoma and its clinical significance. MethodWe selected 51 patients with cholesteatoma of the middle ear treated between April 2013 and March 2014 in our department to be our study subjects. Streptaridin-perosidase immunohistochemical method was adopted to detect the expression of Livin and Caspase-3 in the middle ear cholesteatoma epithelium and normal skin of external acoustic meatus. SPSS 17.0 software package was used for statistical analysis. ResultsThe expression of Livin in cholesteatoma epithelium was significantly higher than that in the normal skin tissue of the external auditory canal (P<0.05), and the expression of Caspase-3 in cholesteatoma epithelium was significantly higher than the normal skin tissue in the external auditory canal (P<0.05). The expression of Livin and Caspase-3 in cholesteatoma epithelium was positively correlated (r=0.49, P<0.05). ConclusionsThere is a balance between apoptosis and inhibition of apoptosis in normal tissues, and when there is abnormal expression of Livin and Caspase-3 in normal tissues, it will cause cell apoptosis and apoptosis-inhibitory balance disorders, which causes middle ear cholesteatoma.
Abstract: Objective To investigate the expression of inhibitor of apoptosis gene Livin and its relationship with expression of P53,Bcl-2 in esophageal carcinoma tissues. Methods The expression of Livin messenger ribonucleic acid (mRNA) in 36 esophageal carcinoma tissues and 18 paracancerous tissues were measured by reverse transcriptionpolymerase chain reaction (RT-PCR) combined with silver staining technique. The expression of Livin, P53 and Bcl-2 proteins were detected by immunohistochemical method (streptavidin-peroxidase). Results RT-PCR results: Livin mRNA positive expression of esophageal carcinoma tissues was more evident than that of paracancerous tissues, the expression of both variants was simultaneous basically. Immunohistochemical results: the Livin protein positive expression rate of esophageal carcinoma tissues was higher evidently than that of paracancerous tissues(Plt;0.01). Livin protein positive expression rate of external coat of esophagus invaded by carcinoma was higher than that of tunica muscularis esophagi invaded by carcinoma(Plt;0.05); Livin protein positive expression rate of lymph node metastasis was higher than that of normal lymph node (Plt;0.05). The expression of Livin protein was not related to the expression of P53 protein（χ2=1.00,P=0.505）,but it was positively related to the expression of Bcl-2 protein（χ2=10.60，P=0.003）. Conclusion Aberrant expression of Livin may be a new target for diagnosis and gene treatment of esophageal carcinoma.The aberrant expression of Livinand apoptosis related gene Bcl-2 may play synergetic roles in process of carcinogenesis of esophageal carcinoma.
Objective To evaluate the effect of sensory disturbance after the sagittal split ramus osteotomy (SSRO）on quality of life. Methods From September2004 to September 2005, 21 patients undergoing SSRO were studied by using questionnaires. There were 12 males and 9 females, aging 1927 years(mean 22.6 years).The patients were followed up at 4 weeks and 24 weeks after operation. The subjective questionnaire was completed by patient to evaluate the degree of living quality descending. Results At 4 weeks,19(90.48%) patients’ living quality descended because of postoperative sensory disturbance. Among them, 7(33.33%) patients had severe descending of living quality. The average effecting time of living accounted for total time 26.9%(about 6.5 h/d). At 24 weeks, 12(6316%) patients’ living quality descended because of postoperative sensory disturbance, 7(36.84%) patients could achieve preoperative living quality. The average effecting time of living accounted for total time 15.5%(about 3.7 h/d). Conclusion Most patients have descending of living quality after SSRO because of sensory disturbance. However, this condition can be improved during the followup and more than 1/3 patients canachieve their preoperative living quality.
Objective To analyze the effectiveness and effect on pregnant outcome about living preparation of lactobacillus versus metronidazole in the treatment of bacterial vaginosis in pregnancy. Methods We searched PubMed, The Cochrane Library, VIP, CNKI, Wangfang, CBM, FMJS, and FEBMT to identify randomized controlled trials (RCT) of living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy. The quality of the included trials was assessed. RevMan 5.0.24 software was used for meta-analysis. Results Eight trials involving 1 687 patients were included. The results of meta-analysis showed: no significant difference was found in the effectiveness between the two groups (RR=1.04, 95%CI 1.00 to 1.08, P=0.08); living preparation of lactobacillus had lower recurrence rate and lower premature delivery rate compared with metronidazole (RR=0.16, 95%CI 0.06 to 0.43, P=0.0004; RR=0.56, 95%CI 0.33 to 0.94, P=0.03); no significant differences were found in premature rupture of membrane, puerperal infection, infant of low-birth weight, infant infection, and infant jaundice between the two groups. Conclusion The effectiveness about living preparation of lactobacillus versus metronidazole for bacterial vaginosis in pregnancy is similar, but living preparation of lactobacillus has lower recurrence rate and lower premature delivery rate, the others of effect on pregnant outcome are similar.
Objective To summarize the changes of serum ceruloplasmin levels and urinary copper excretion in Wilson’s disease （WD） after living-related liver transplantation(LRLT) and orthotopic liver transplantation(OLT). Methods From September 2000 to November 2003, 140 cases liver transplantation were performed in our Liver Transplantation Center, LRLT and OLT were carried out in 26 patients with WD, three of them had fulminant hepatic failure and the others had end-stage hepatic insufficiency. All the recipients had low serum ceruloplasmin levels 〔(124.8±22.8) mg/L〕 and high urinary copper excretion 〔(1 524.8±328.6) μg/24h〕 before transplantation. The serum ceruloplasmin levels and urinary copper excretion were within normal limits in 22 donors 〔(230.4±29.6) mg/L〕 and ＜50 μg/24h〕. Results All recipients recovered satisfactorily. After operation 1, 3, 6,12 months, in OLT group, serum ceruloplasmin level and urinary copper excretion were (320.2±36.8) mg/L, (380.4±45.6) mg/L, (360.5±37.6) mg/L, (356.2±27.6) mg/L and (240.4±22.8) μg/24h, (86.5±10.6) μg/24h, (54.2±6.8) μg/24h, (46.8±3.4) μg/24h; While in LRLT group, serum ceruloplasmin levels and urinary copper excretion were (216.8±20.4) mg/L, (248.5±32.6) mg/L, (285.4±44.3) mg/L, (260.2±36.6) mg/L and (380.8±37.6) μg/24h, (150.6±24.5) μg/24h, (75.5±9.6) μg/24h, (60.3±5.8) μg/24h. Conclusion OLT and LRLT are curative procedure in WD manifested as fulminant hepatic failure and/or end-stage hepatic insufficiency. After liver transplantation, the serum ceruloplasmin level can increase to its normal range while urinary copper excretion decreases.
Objective To research anesthetic management, pathophysiologic variation of adult-to-adult living donor liver transplantation (A-ALDLT) and to probe how to improve anesthetic quality of A-ALDLT. Methods The clinical data of 47 donors from Sep. 2005 to Jan. 2007 in West China Hospital were reviewed. Intraoperative vital signs, anesthetic management, perioperative serum levels of HGB， Alb， ALT， AST, TBIL， APTT， PT were measured， and complications were assessed. Results The physical condition of all donors were good before operations and were all in grade Ⅰaccording to ASA. Under general anesthesia of intravenous and inhalation, electrocardiogram, O2 saturation, blood pressure and body temperature were continuously monitored. A radial arterial catheter and a central venous catheter were placed. Blood lavement was utilized intraoperatively in all patients. All donors maintained stable life signs intraoperatively. The average intraoperative blood losses was （603.13±317.00） ml, and donors were transfused with autologous blood 〔(381.25±171.15) ml〕, with only 4 donors required homologous blood transfusion. HR and mean arterial blood pressure (MAP) showed no significantly variations intraoperatively (Pgt;0.05). Compared with controlled central venous pressure (CVP) before and right after hepatectomy, CVP increased significantly (P＜0.05) when intubation and abdomen-closing were carried. After hepatectomy and on the first day after operation, HGB and Alb decreased significantly (P＜0.05); ALT, AST and TBIL increased significantly (P＜0.05). Right after hepatectomy, PT increased instantly and significantly (P＜0.05); On the first day after operation, APTT began to increase significantly (P＜0.05). All donors came around completely and were extubated in the liver transplantation intensive care unit on the first day after operation. There were 3 cases (6.38%) of postoperative complication, which were biliary leakage, portal vein thrombosis and serious pleural effusion. Those 3 donors were cured after treatment. Conclusion Inhalation and intravenous general anesthesia of propofol, remifen-tanil and isoflurane can maintain stable life signs and reduce liver injury. Steady anesthesia, sufficient oxygenation and effective blood protection measures, for example, by decreasing CVP to prevent bleeding and by reclaiming autologous blood to avoid transfusing homologous blood, are keys for the safety of the donor and the prevention of complications.
【Abstract】Objective To investigate the result of liver transplantation for end stage liver disease. Methods A retrospective analysis was made for 7 cases orthotopic liver transplantation(OLT) and 4 cases living related liver transplantation (5 patients with hepatitis B cirrhosis and 6 with Wilson’s disease),cirrhosis group was treated with lamivudine plus low dose anti-HBV-Ig. Results Ten patients were completely recovered discharged(including 4 cases LRLT) and only 1 died of ARDS.The complications after operation were: 2 cases of abdominal hemorrhage,3 cases of acute respiratory distress syndrome; and 4 cases of hepatitis B cirrhosis were HBV-DNA(-) after operation.Copperoxidase in all with Wilson’s disease became normal. Conclusion Liver transplantation is effective measure for end stage liver disease and living related liver transplantation is suitable for the present medical condition in China.Surgical technique is crucial for reducing perioperative complications.
ObjectiveTo evaluate and summarize the perioperative management experience of living related liver transplantation (LRLT). MethodsA retrospective analysis was made in perioperative management of 13 cases undergoing LRLT (15 times operation, including 2 cases of liver retransplantation) in our department from January 2001 to December 2002. ResultsAll the operations were successful. All the 13 donors were followed up regularly, 12 donors were uneventfully recovered after operation and 1 donor suffered from bile leakage due to T tube. The survival rate of recipients, who achieved longterm survival at 2 months to 2 years, was 92.3%(12/13); the survival rate of graft was 86.7%(13/15). One adult recipient with Wilson’s disease died of serious rejection on the 72nd day postoperatively. Two cases suffered from embolism of hepatic artery, one case received reduced size cadaveric liver retransplantation, the other case received liver retransplantation from cadaver, and they both achieved longterm survival after retransplantation. The other complications included: 1 case of serious rejection, 2 cases of ARDS, 6 cases of infection of microbe, 7 cases of serious hydrothorax, 1 cases of leakage of biliary tract, and so on. ConclusionPerfect preoperative management, which composes one of the key parts of LRLT, is critically important for both donor and recipient.
【Abstract】ObjectiveTo report the author’s experience with the first case of an adult-to-adult living donor liver transplantation (LDLT) for Budd-Chiari syndrome (BCS) using cryopreserved vena cava graft in postheptic vena cava reconstruction. MethodsA 35-year-old male patient with a diagnosis of BCS complicated with inferior vena cava (IVC) obstruction received medical treatment and radiologic intervention for nine months, no relief of the symptoms could be achieved. Finally, the patient underwent LDLT, which required posthepatic vena cava reconstructed using cryopreserved vena cava graft. ResultsThe patient has had an uneventful course since the LDLT. ConclusionWe believe that LDLT combined with posthepatic IVC reconstruction using cryopreserved vena cava graft is considered to be a sound modality for IVC obstructed BCS.