Objective To explore the liver transplantation in end stage liver disease with portal vein thrombosis (PVT). Methods Computer Tomography and color Doppler examinations were performed on the recipients to be subject to liver transplantation. Four male cases were found having PVT, received orthotopic liver transplantation and thrombectomy. Cell Saver auto transfusion blood and venous by-pass was also conventionally used. By reason of one case with residual thrombosis, a catheter with heparin cap was inserted into the branch of superior mesentery vein, followed by perfusion of urokinase for thrombus dissolution. Anti-coagulation treatments with low molecule heparin and Prostaglandtin E1 after operation were carried on in all of the patients. Results Surgical management of PVT were successful only one time in 3 patients. One patient with PVT extending over the entrance of spleen vein and left and right portal vein branches had portal vein residual thrombosis postoperation. After dissolution and anti-coagulation for 28 days, the residual thrombus disappeared. One cured patient with PVT died 48 days after operation from lung infection due to multiocular effusion resulting from chest cavity bleeding after pleuracentesis, and other 3 patients were cured in 2 months. Conclusion The PVT is not an absolute contraindication to liver transplantation; Thrombectomy combined with thrombus dissolution and anticoagulation can cure PVT; Prevention of bleedings in the patients with PVT is very importance postoperation.

Objective To observe the effects of basic fibroblast growth factor (bFGF) on osteogenic differentiation abili?ty and cell proliferation of human gingival fibroblasts (HGFs), and to explore the role of bFGF on the process of osteogenic differencitiaion in vitro. Methods HGFs were cultured in vitro until the 3rd passage when they were divided into four groups:normal medium as group 1, normal medium with 10μg/L bFGF as group 2, osteogenic medium as group 3 and osteo?genic medium with 10μg/L bFGF as group 4. MTT assay was used to evaluate the proliferation of HGFs. Alkaline phospha?tase (ALP) staining and Alizarin red staining were applied to investigate osteogenic potential of HGFs under different culture conditions. Results bFGF at concentration of 10 μg/L could increase HGFs proliferation in both normal and osteogenic medium (P<0.01). HGFs could be induced towards osteogenic differentiation and form mineralized nodule in osteogenic me?dium. However, 10μg/L bFGF had no effects on ALP activity and mineralized nodule formation of HGFs during osteogenic differentiation. Conclusion bFGF could promote the proliferation of HGFs but show no effects on osteogenic differentiation of HGFs at concentration of 10μg/L.

Objective To investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide (ASODN) on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P 0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth.Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.

Objective To summarize the experience in hepatic artery reconstruction in adult-to-adult living donor liver transplantation(ALDLT).Methods Fifty patients underwent ALDLT in our hospital from January 2002 to July 2006.All the hepatic a~ery reconstructions were done under surgical microscope.ResultsTwo patients(4%)presented with hepatic artery thrombosis.All the patients were followed up for 2 to 52 months (median,9 months),and no hepatic artery stenosis nor hepatic artery pseudoaneurysm occurred.The 1-year survival rate was 92%(46/50).Conclusions Systematic evaluation of hepatic artery reconstruction and use of microsurgical technique are key to the reduction of complications of hepatic artery reconstruction in ALDLT.

Objective To investigate the clinical effects of liver transplantation including living related liver transplantation for Caroli's disease (CD). Methods Seven consecutive patients with diffused type of Caroli's disease had undergone liver transplantation (LT) from September 1999 to February 2007 in our single center. The clinical characteristics and survival of these patients were retrospectively reviewed. Results All 7 patients were diagnosed as Caroli's disease with diffused type which manifested recurrent cholangitis in clinical symptoms. Among them, 4 were female and 3 male.The mean age was 16 years old (ranging from 10 to 31 years old). Six patients were subjected to conservative therapy and only one patient had previously undergone cholecystectomy and T tube drainage before transplantation. In types of surgery, 4 patients accepted split liver transplantation with right liver lobe, two got whole liver transplantation and only one underwent living related liver transplantation. In two patients venovenous bypass was done during the operation. The mean duration of surgery was 9. 1 h. Post-transplant complications included pulmonary infection (3 cases), acute rejection (2 cases), pleural effusion (2 cases) and biliary leakage in the split section of donor liver (1 case). One patient died within 19 days caused by acute renal failure and multiple organs dysfunction.The rest six patients are alive without any signs of recurrence of protopathy and the longest survival time is 7 years. Conclusion Liver transplantation is a valuable treatment to Caroli's disease with diffused type. Due to the organ shortage, living related liver transplantation may own identical effects on LT.

Objective To discuss the influence of anatomical variations of the cystic duct on preoperative diagnosis and operational scheme for cholecystectomy. Methods A 47-year-old woman was admitted to our hospital with diagnosis of cholecystolithiasis. Ultrasonography suggested minimal intra- and extrahepatic ductal dilatation. Laboratory tests showed that serum levels of alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase were 189 IU/L, 366 IU/L and 144 IU/L, respectively. In order to make a certain diagnosis, the patient received both magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). Results MRCP showed the bile duct slightly dilated with a shuttle shape figure and a lower signal with a strip form in it. MRCP could not confirm the quality of this signal and was doubtful of choledochus diaphragma. Subsequently, ERCP was applied to demonstrate that the cystic duct was collateral with the common hepatic duct when arriving into its left side and converged into the bile duct with a lower position, which was the reason for why MRCP misjudged the formation of choledochus diaphragma in the bile duct. Finally, the patient underwent open cholecystectomy. Conclusion There are some kinds of variations in the cystic duct including course, appearance and location of confluence. Combing MRCP with ERCP can significantly elevate the diagnostic accuracy of the cystic duct before operation, especially in those patients with doubtful diagnosis upon admission. To avoid biliary injury as much as possible, open cholecystectomy is superior to the laparoscopic cholecystectomy (LC)with regard to the patients suffering from cholecystolithiasis complicated with variation of the cystic duct.

OBJECTIVETo investigate the fetotoxicity of retrorsine.

METHODMouse whole embryo culture (WEC) was applied. Post-implantation (8.5 d) mouse embryos were isolated from their mothers and put into the medium of immediately centrifuged serum (ICS) prepared from rats. Different concentrations of retrorsine (12.5, 25, 50, 100 mg x L(-1)) were added into the WEC culture. Development (yolk sac diameter, crown-rump length, head length, somite number) and organic morphodifferentiation (yolk sac circulation, allantois, embryonic flexion, heart, brain, optic-otic-olfactory organ, branchial arch, maxillary, mandible, bud) of embryos were observed at 48 h after treatment.

RESULTObvious fetotoxicity could be observed in various retrorsine treatment groups in a dose-dependent manner. Development of embryos was delayed significantly at dose 12.5-100 mg x L(-1). Malformations were shown in all organic morphodifferentiation indexes, especially in otic-olfactory organ, branchial arch, maxillary, mandible, bud.

CONCLUSIONRetrorsine had obvious fetotoxicity in vitro WEC culture, indicating that exposure of pregnant mice to retrorsine may have potential risk on fetals.

Animals ; Dose-Response Relationship, Drug ; Embryo, Mammalian ; drug effects ; Female ; Male ; Mice ; Pregnancy ; Pyrrolizidine Alkaloids ; toxicity ; Rats ; Toxicity Tests ; methods

The purpose of this study is to evaluate the embryotoxicity of alkaloids in Senecionis Scandentis Hebra on in vitro cultured mouse embryos. Mouse whole embryo culture (WEC) was applied in this study. Post-implantation (8.5 d) mouse embryos were isolated from their mothers, and cultured in medium of immediately centrifuged serum (ICS) with different concentrations of seneciphylline (target concentrations were 100, 50, 25 and 12.5 μg x mL(-1)) or senkirkine (target concentrations were 50, 25 and 12.5 μg x mL(-1)) for 48 h. After culturing completed, the development and organic morphodifferentiation of the cultured embryos were evaluated microscopically. Treatment with seneciphylline and senkirkine had adverse effects on the development and organic morphodifferentiation of embryos. The effect also had clear dose-response. Alkaloidals in Senecionis Scandentis Hebra had embryotoxicity on cultured embryos, which indicated that pregnant people exposed to Senecionis Scandentis Hebra may get potential risk on fetus.

BACKGROUND:Previous studies have demonstrated that simvastatin that can promote osteogenic differentiation of bone marrow stromal stem cel s in vitro, is likely to be a new osteogenic drug. While it is stil unknown whether there is time-dependent stimulation of simvastatin on the expressions of bone morphogenetic protein 2 and col agen type I. OBJECTIVE:To investigate the expressions of bone morphogenetic protein 2 and col agen type I in rat bone marrow stromal stem cel s in vitro stimulated by simvastatin at different time points. METHODS:Passage 1 bone marrow stromal cel s were divided into control and simvastatin group, fol owed by cultured in osteogenic differetiation medium with or uithout 10-7 mol/L simvastatin. After 7-day intervention, expression of alkaline phosphatase was detected in passage 3 cel s. Passage 4 cel s were divided and cultured as described above, and afterwards, RNA and proteins were extracted at 12 and 36 hours to detect the expressions of bone morphogenetic protein 2 and col agen type I using real-time PCR and western blot assay. RESULTS AND CONCLUSION:Both two groups could express alkaline phosphatase, while the rate of positive cel s significantly increased in the simvastatin group compared with the control group (P<0.05);at 12 and 36 hours after intervention, mRNA expressions of bone morphogenetic protein 2 and col agen type I in the simvastatin group were significantly higher than those in the control group (P<0.05). Besides, western blot assay showed:at both 12 and 36 hours, simvastatin significantly enhanced the expression of bone morphometric protein 2, while the expression of col agen type I significantly increased at 12 hours (P<0.05), but not at 36 hours. In conclusion, simvastatin can promote the expressions of bone morphometric protein 2 and col agen type I in rat bone marrow stromal cel s, with more favorable outcomes after 12-hour treatment.

Objective To investigate the effect of Terpinen-4-ol on the proliferation of lung adenocarcinoma A-549 cells and its related mechanism. Methods A-549 cells were treated with different concentrations of Terpinen-4-ol. The inhibitory effect of Terpinen-4-ol on A-549 cells was tested by MTT method. Cell grow ability was determined by CCK-8 colorimetry. The ultrastructure of A549 cells were observed by transmission electron microscopy before and after Terpinen-4-ol treatment. The changes of cell cycle, apoptosis, and the level of intracel-lular calcium were inspected by flow cytometry. Inoculated the lung adenocarcinoma A-549 cells on the nude mice to form transplantation tumor. The experimental nude mice with transplantation tumors were divided into three groups:negative control group,high dose positive con-trol group and low dose positive control group. The mice were given continuously intraperitoneal injection for 10 days, and then the transplan-tation tumors were taken and the size and weight of them were detected. Results After Terpinen-4-ol treatment for 24 h,MTT assay showed that the IC50 value of A549 cells was 0. 067% v/v. The growth curves of positive control groups were significantly smooth than the negative control group. The formation of autophagosome increased after treatment with Terpinen-4-ol. The results of flow cytometry showed that the cell cycle was arrested in S phase,Terpinen-4-ol could induce apoptosis of A549 cell, The intracellular calcium concentrations in positive control groups were significantly higher than the negative control group(P<0. 05). Low dose group and high dose group restrained the growth of the transplantation tumor obviously, and the tumor inhibitory rate were 53. 33% and 77. 76% respectively. Conclusion Terpinen-4-ol has inhibitory effect on the proliferation of A-549 cells in vitro and in vivo.