ObjectiveTo summarize the current status and progress of surgical treatment for postoperative recurrent hepatocellular carcinoma (HCC).MethodThe literatures about studies of surgical treatment of postoperative recurrent HCC were reviewed.ResultsThe surgical operation was an effective method for the treatment of recurrent HCC. The operation methods included re-hepatectomy and salvage liver transplantation. There was no uniform standard for the indication of re-hepatectomy, but the basic principles were the same. At present, the indication of salvage liver transplantation was mainly based on Milan criteria. For patients with recurrent HCC who met the operation indications, surgical operation could improve the long-term survival rate of patients and benefit the patients.ConclusionIt migh prolong the survival time and improve the long-term survival rate of patients with recurrent HCC when the appropriate patients and reasonable surgical methods are chosen according to the surgical indications, the tumor situation of initial hepatectomy, postoperative recurrence time, and other factors.
Objective To observe the effects of cryopreservation and resuscitation on the biological characteristics of mesenchymal stem cells (MSCs) derived f rom human umbilical cord blood. Methods MSCs were isolated and cultured f rom human umbilical cord blood in vitro. The cells were passaged , and the third generation of MSCs were cryopreserved in－196 ℃ liquid nitrogen for 4 weeks with cryopreservation medium , which contained 10 % dimethyl sulfoxide (DMSO) and 90 % fetal calf serum ( FCS) . The morphology , proliferation and differentiation of MSCs were investigated and compared with those of MSCs before cryopreservation. Results There was no significant difference of morphology between pre-cryopreserved MSCs and the ones af ter resuscitation. It was observed that all MSCs were spindle-shaped and showed adherence growth characteristic before and af ter cryopreservation. The cell growth curves of MSCs were also similar before and af ter cryopreservation. Even though the curve of resuscitated MSCs descended a little as compared with that of pre-cryopreserved MSCs , there was no significant difference ( Pgt; 0. 05) . After 2-week adipocytic differentiation induction , fat drops could be found in the kytoplasm of MSCs and they were red when stained with oil-red O staining , which suggested that MSCs could be induced and differentiated into adipocytes. Af ter 4-week osteoblastic differentiation induction , MSCs could be induced and differentiated into osteoblasts , and calcium node showed black when stained with Von Kossa staining. There were no significant changes of the differentiating ability of MSCs into adipocyte and osteoblast before and after cryopreservation. Conclusion MSCs derived from human umbilical cord blood maintains their biological characteristics af ter cryopreservation and resuscitation.
Objective To systematically evaluate the efficiency of laparoscopic hepatectomy（LH） and conventionalopen hepatectomy （OH）in patients with hepatocellular carcinoma （HCC）. Methods The literatures about the therap-eutic effect of LH and OH on hepatocellular carcinoma were collected from PubMed， Chinese Journal Full-text Database （CJFD）， Wanfang Database， China Doctor/Master Dissertations Full-text Database （CDMD）， and China Proceedings of Conference Full-text Database （CPCD）from 2000 to 2011. RevMan 5.0 software was used for data analysis. Results Eleven controlled clinical trials were included in this analysis. These studies included a total of 781 patients：325 treated with LH and 456 treated with OH. The results of meta-analysis showed that LH group had shorter operation time〔WMD=-20.85， 95% CI （-29.54， -12.16）， P＜0.000 01〕， less operative blood loss 〔SMD=-0.42，95% CI（-0.65，-0.19）， P=0.000 4〕， a lower postoperative morbidity rate 〔OR=0.43，95% CI （0.28，0.65），P＜0.000 1〕， and shorter hospitalization days 〔WMD=-4.32，95％ CI （-6.29，-2.34），P＜0.000 1〕 than OH group. There was no significant difference in postoperative recurrence （P=0.80）， overall survival in 1-year （P=0.98）， 3-year （P=0.41）， and 5-year （P=0.12）， and in disease-free survival in 1-year （P=0.15）， 3-year （P=0.62）， and 5-year （P=0.99）between the two groups. Conclusions For the patients with hepatocellular carcinoma localized to the CouinaudⅡ，Ⅲ，Ⅳ，Ⅴ，and Ⅵ segments with a maximum lesion size of 5cm， as well as the tumor has no effect on the exposure of blood vessel of the first and second hepatic portal， and the liver functions are classified as Child B or A high grade， the laparoscopic liver resection is priority considered in the conditions allow.
Objective To investigate the optimal dosage of bone marrow mesenchymal stem cells （BMSCs） transplantations for treatment of hepatic ischemia-reperfusion injury in rats， and to provide prophase experimental basis for it. Methods BMSCs of Wistar rats were isolated and cultivated by bone marrow adherent culture method. BMSCs of the fourth generation were prepared for cell transplantation. Thrity hepatic ischemia-reperfusion injury models of maleWistar rats were successfully established， and then were randomly divided into blank control group， 5×105 group， 1×106group， 2×106 group， and 3×106 group， each group enrolled 6 rats. The 200 μL cell suspension of BMSCs were transfusedinto the portal vein with number of 5×105， 1×106， 2×106， and 3×106 separately in rats of later 4 groups， and rats of blank control group were injected with phosphate buffered saline of equal volume. At 24 hours after cell transplantation， blood samples were collected to test aspartate aminotransferase （AST） and alanine aminotransferase （ALT）， liver tissueswere obtained to test malonaldehyde （MDA）， superoxide dismutase （SOD）， and nuclear factor-κB （NF-κB） p65 protein.Liver tissues were also used to perform HE staining to observe the pathological changes. Results Compared with blank control group， 5×105 group， and 3×106 group， the levels of AST， ALT， and MDA were lower （P＜0.05） while activity levels of SOD were higher （P＜0.05） in 1×106 group and 2×106 group， and expression levels of NF-κB p65 protein were lower with the pathological injury of liver tissue improved， but there were no significant differences on levels of AST， ALT， MDA， and SOD （P＞0.05）， and both of the 2 groups had the similar pathological change. Conclusion The optimal dosage of the BMSCs transplantations after hepatic ischemia-reperfusion injury is 1×106.
【Abstract】ObjectiveTo evaluate the injury of common bile duct in immediate removal of the ligation in cholecystectomy. MethodsEighteen healthy Japanese rabbits were selected and divided into three groups randomly: A group treated with simple cholecystectomy, B group with cholecystectomy plus common bile duct crossligation and C group with cholecystectomy plus hepatic bile duct conjunction “Y”type ligation. The ligation was removed after 5 min in B and C groups. The levels of serum transaminase and bilirubin and pathological changes of bile duct and liver in each group were observed respectively. ResultsThere were no statistic difference in the levels of GPT, GOT, total bilirubin (TB), direct bilirubin (DB) and DB/TB on 12 hours before operation and the 1st and 7th day after operation between A and ligation groups (Pgt;0.05). But there were statistic difference in the those indexes and pathological changes of bile duct and liver between A and ligation groups on the 30th and 90th day after operation (Plt;0.05). ConclusionDuring cholecystectomy, immediate removal of common bile duct ligation doesn’t affect shortterm results, but the long-term results are bile duct stricture and obstruction.
Objective To summarize the treatment and prognosis of malignant tumors with hepatic metastasis. Methods Review and analysis of recent relevant literatures at home and abroad of malignant tumors with liver metastasis, according to the different treatments were summarized. Evaluation of the patients’ clinically curative effect and survival situation was performed under different treatments. Results With the development of imaging and surgical techniques, and deeply understanding of malignant tumor, many malignant tumors with liver metastasis could be found and treated, and previous concept of treatment for malignant tumors with liver metastasis was also fundamentally changed, and radical resection of the primary lesions and liver metastasis was the best way to get clinically curative effect for the patients with malignant tumors with liver metastasis. The treatments of malignant tumors with liver metastasis also included radio frequency ablation (RFA), transarterial chemoembolization (TACE), chemotherapy,125I seed implantation, cryotherapy, stereotactic body radiation therapy (SBRT), laser-induced interstitial thermotherapy (LITT), gene targeting therapy, and so on. Conclusion Now for malignant tumors with liver metastasis, positive surgery and (or) individualized comprehensive treatment are taken more often, and they play positive role to prolong the survival and improve the prognosis of malignant tumors patients with liver metastasis.
Objective To summarize the important role of sirtuin type 1 (SIRT1) in the development of gastrointestinal tumors. Methods Domestic and international publications related to biological functions of SIRT1 and its role in gastrointestinal tumors in recent years were collected and reviewed. Results SIRT1 had a significant high expression in esophageal cancer, gastric cancer, colorectal cancer, liver cancer, and pancreatic cancer tissues, by associating with long noncoding RNA (LncRNA), microRNA, and autophagy. It affected the occurrence and development of gastrointestinal tumors. Conclusions Abnormal expression of SIRT1 is closely related to the occurrence and development of gastrointestinal tumors.
ObjectiveTo investigate the application value of albumin-bilirubin (ALBI) score in the treatment and prognosis of hepatocellular carcinoma (HCC).MethodThe literatures related to studies on the relationship between the ALBI score and the HCC were searched. The sources of ALBI score and its role in predicting the survival of patients after the liver cancer resection, liver transplantation, and non-surgical treatment such as radiofrequency ablation, radiotherapy, sorafenib treatment, and other therapies were reviewed.ResultsThe ALBI score was the independent prognostic factor after the hepatectomy. As a risk factor for the early recurrence of HCC after the radical hepatectomy, the ALBI score might help to determine the appropriate treatment based on the patient’s liver function when the recurrence occurred. As an independent predictor of mortality after the liver transplantation, the ALBI level 3 might be helpful in optimizing individual risk assessment for the liver transplantation. The ALBI score could be used as the reference tool for the clinicians to choose between the hepatectomy and non-surgical treatment in the patients with HCC.ConclusionsRole of ALBI score in evaluating liver function is no less useful than that of Child-Pugh grade. It plays an important role in evaluating prognosis and recurrence of patients with HCC, and is conducive to selection of individualized treatment for them, and formulation of treatment plan that maximizes benefit of patients.
ObjectiveTo investigate the application progress of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in various treatment methods of hepatocellular carcinoma(HCC), aiming to fully understand the value of NLR and PLR in various treatments of HCC.MethodRetrieved and reviewed domestic and foreign literatures related to peripheral blood NLR and PLR and HCC in recent years.ResultsThe treatment of HCC mainly included liver resection, liver transplantation, transarterial chemoembolization, radiofrequency ablation, and sorafenib. Peripheral blood NLR and PLR were related to the survival of HCC patients after treatment. High NLR and PLR often indicated poor prognosis for HCC patients.ConclusionNLR and PLR play a certain role in various treatment methods of HCC, and have a certain value in judging tumor prognosis, recurrence, and metastasis.
ObjectiveTo systematically evaluate the risk factors for pulmonary infection after cardiac surgery. MethodsA computer search was performed to collect researches on risk factors for pulmonary infection in patients after cardiac surgery from the databases, including CNKI, Wanfang, VIP, CBM, PubMed, The Cochrane Library, EBSCO, CINAHL, Web of Science, EMbase from the inception to August 2023. Two researchers independently extracted data and assessed the literature according to the inclusion and exclusion criteria, and the quality of the literature was evaluated using the Newcastle-Ottawa Scale (NOS). The meta-analysis was performed using RevMan 5.4 software. ResultsA total of 23 studies covering 24348 patients were selected, including 21 case-control studies and 2 cohort studies. The NOS scores were≥6 points. The results of meta-analysis showed that age (OR=2.16, 95%CI 1.80 to 2.59, P<0.001), smoking history (OR=1.91, 95%CI 1.67 to 2.18, P<0.001), pulmonary disease (OR=1.61, 95%CI 1.40 to 1.85, P<0.001), diabetes mellitus (OR=1.62, 95%CI 1.26 to 2.08, P<0.001), operation time (OR=2.54, 95%CI 1.86 to 3.46, P<0.001), cardiopulmonary bypass (CPB) (OR=3.78, 95%CI 2.11 to 6.77, P<0.001), CPB time (OR=2.30, 95%CI 1.94 to 2.71, P<0.001), blood transfusion (OR=2.55, 95%CI 2.04 to 3.20, P<0.001), postoperative mechanical ventilation time (OR=2.78, 95%CI 2.34 to 3.30, P<0.001), tracheal intubation time (OR=3.93, 95%CI 2.45 to 6.31, P<0.001) and repeated tracheal intubation (OR=8.74, 95%CI 4.17 to 18.30, P<0.001) were independent risk factors for pulmonary infection in patients after cardiac surgery. ConclusionAge, smoking history, pulmonary disease, diabetes mellitus, operation time, CPB, CPB time, blood transfusion, postoperative mechanical ventilation time, tracheal intubation time, and repeated tracheal intubation are risk factors for pulmonary infection in patients after cardiac surgery. It can be used as a reference to strengthen perioperative evaluation and nursing of high-risk patients and reduce the incidence of pulmonary infection.