clinical trials of new drugs,organ transplants involving ethical issues were explored

Heart Failure ; therapy ; Humans ; Practice Guidelines as Topic

Objective To investigate the impact of cavoplasty on the piggy back liver transplantation and on the prevention of hepatic outflow block. Methods Three patients received modified piggy back liver transplantation with venacavoplasty under single veno venous bypass. Results All the recipients had stability of dynamic circulation, short anhepatic phase and decreased hemorrhage during operation. Postoperatively all the patients recovered quickly with good liver function without any complications. Conclusions Venacavoplasty may overcome outflow block in piggy back liver transplantation and the technique can shorten anhepatic phase and decrease complications.

5 cases of orthotopic live transplantation (OLTX) were performed in unresectable hepatic cellular carcinoma(3),Wilson's disease(1)and hepatitis B(1).The donor livers were harvested by the technique of rapid multiple organ harvesting,flushed and preserved with UW solution.The veno-venous bypass was introduced during the anhepatic phase in the operation.The double or triple-drug immunosuppressive regimen was used and three episodes of acute rejection were controlled in two patients.One patient died of CMV infection and another,of upper gastrointestinal hemorrhage on the 92nd and 58th postoperative day respectively.The other three are still alive for 35,150 and 210 days.

AIM: To investigate whether hepatocyte apoptosis is contributed to liver ischemia-reperfusion (I/R) injury and the relationship between liver caspase-3 activity and hepatocyte apoptosis in cirrhotic rats. METHODS: Liver ischemia-reperfusion is induced by Pringle maneuver. The cirrhotic rats were randomized into two groups: Group A: simple hepatic blood inflow occlusion (HBIO); Group B: HBIO + inhibitor, before HBIO, ZVAD-fmk 15 mg/kg was injected via dorsal penis vein; Group C: healthy rat, simple HBIO. The ischemia time was 30 min in these groups. Serum aspartate aminotransferase(AST), liver caspase-3 activity, and apoptotic hepatocytes were examined in the three groups. RESULTS: After 6 h of reperfusion, the liver caspase-3 activity was markedly elevated and reached its peak, which was statistically higher than that of before I/R ［(18.1±1.8 ) μmol*h-1*g-1 (tissue) vs (6.6±2.0) μmol*h-1*g-1 (tissue), P＜0.01］. The same change occurred in hepatocyte apoptosis between 6 h of reperfusion and before I/R (20.9%±4.9% vs 0.5%±0.3%, P＜0.01). As the reperfusion prolonged, the caspase-3 activity and apoptotic hepatocyte decreased gradually. The 7th-day survival rate was 62.5% in group A. The serum AST, liver caspase-3 activity and apoptotic hepatocytes were significantly higher in group A than those in group B and C, representing the most severe liver injury among the three groups. CONCLUSION: Hepatocyte apoptosis is the major form of cell death in liver ischemia-reperfusion injury in cirrhotic rats. Hepatoctye apoptosis induced by I/R is caspase-3 dependent, and inhibiting caspase-3 can alleviate liver injury. The caspase-3 dependent hepatocyte apoptosis is highly contributed to the pathological phenomenon that the ischemic sensitivity of cirrhotic liver is higher than normal liver.

AIM:To investigate the role of 1,4,5-trisphosphate inositol(IP3)and Fas gene expression in apoptosis of HepG2 cells induced by quercetin.METHODS:HepG2 cells were treated with quercetin at different concentrations(including 20,40,60,80 ?mol/L)for 72 h and treated with 60 ?mol/L quercetin for 6 h,12 h,24 h,48 h and 72 h.IP3,Fas mRNA,Fas protein and apoptosis rate were assayed by IP3-3H Birtrak assay,RT-PCR,Western blotting and flow cytometry,respectively.RESULTS:When HepG2 cells were incubated with different concentrations of quercetin for 72 h,the IP3 content was lower than those in control.Fas mRNA expression,Fas protein expression and the apoptosis rate were higher than those in control.When HepG2 cells were incubated with quercetin for 6 h,12 h,24 h,48 h,72 h,the IP3 contents were lower than those in control incubated with 60 ?mol/L quercetin for 12 h.Fas mRNA expression was higher than that in control incubated with 60 ?mol/L quercetin for 12 h.Fas protein expression was higher than that in control.The apoptosis rate was significantly higher than that in control incubated with 60 ?mol/L quercetin for 24 h(P

AIM: To probe into the role of 1,4,5-trisphosphate inositol(IP3) and bcl-2 gene expression in inhibiting hepatocellular carcinoma of nude mice by genistein.METHODS: Animals with hepatocellular carcinoma were treated with genistein 1 mg?kg-1?d-1(ip) for 3 weeks.The volume and weight of tumaor were measured.IP3,bcl-2 mRNA,Bcl-2 protein were assayed by IP3- Birtrak assay,RT-PCR,Western blotting,respectively.RESULTS: The tumor volume and weight of animals treated with genistein were lower than those in control(42.7mm3?27.8mm3 vs 52.3mm3?26.5mm3,42.7mg?27.8 mg vs 91.3mg?31.4 mg).IP3 content was lower than that in control [(13.4?1.4)nmol/g protein vs(35.3?6.6)nmol/g protein].bcl-2 mRNA expression was lower in group treated with genistein than that in control(RI which was the gray degree multiply area of bcl-2 / the gray degree multiply area of ?-actin 0.48?0.02 vs 0.56?0.15).Bcl-2 protein expression was lower in group treated with genistein than that in control(RI 1.69?0.52 vs 1.37?0.48).CONCLUSION: Genistein inhibits growth of transplanted hepatocellular carcinoma in nude mouse liver by reducing IP3 production and down-regulating bcl-2 gene expression.

AIM: To probe into the role of 1, 4, 5-trisphosphate inositol (IP_3) and survivin protein in apoptosis of HepG2 cells induced by genistein. METHODS: HepG2 cells were treated with 60 ?mol/L genistein for 12 h, 24 h, 48 h and 72 h. IP_3, survivin and apoptosis rate were assayed by IP_3-[~3H] Birtrak assay, Western blotting and flow cytometry, respectively. RESULTS: IP_3 in groups incubated for 12 h, 24 h, 48 h and 72 h with 60 ?mol/L genistein were significantly lower than that in control (P

AIM: To investigate whether hepatocyte apoptosis is contributed to liver ischemia-reperfusion (I/R) injury and the relationship between liver caspase-3 activity and hepatocyte apoptosis in cirrhotic rats. METHODS: Liver ischemia-reperfusion is induced by Pringle maneuver. The cirrhotic rats were randomized into two groups: Group A: simple hepatic blood inflow occlusion (HBIO); Group B: HBIO + inhibitor, before HBIO, ZVAD-fmk 15 mg/kg was injected via dorsal penis vein; Group C: healthy rat, simple HBIO. The ischemia time was 30 min in these groups. Serum aspartate aminotransferase(AST), liver caspase-3 activity, and apoptotic hepatocytes were examined in the three groups. RESULTS: After 6 h of reperfusion, the liver caspase-3 activity was markedly elevated and reached its peak, which was statistically higher than that of before I/R [(18.1?1.8 ) ?mol?h -1 ?g -1 (tissue) vs (6.6?2.0) ?mol?h -1 ?g -1 (tissue), P

Objective To summerize the experience in diagnosis and surgical treatment for hilar cholangiocarcinoma in recent years.Methods 86 consecutive cases of hilar cholangiocarcinoma were surgically treated in this hospital from Jan. 1992 to Oct. 1998. Results The tumor resection rate was 37%(32/86) in this series. The postoperative morbidity and mortality rate were 47% and 7% respectively. The median survival time in palliative resection group was 16 months and the 1-year, 3- year, 5-year survival rate was 63%,21%,15% respectively. For curative resection,the median survival time was 19 months and the 1-year, 3- year, 5-year survival rate was 80%,35%,25% respectively( P =0 038). For drainage group, the median survival time was 5 months and the 1-year, 3- year, 5-year survival rate was 28%,8 4%,5% respectively.Conclusion Early diagnosis, improvement of patients′ general preoperative condition and the surgical expertise may help in increasing the curative resection rate and reducing postoperative morbidity and mortality rate, which are keys to prolong patients′ survival.