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.

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.

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.

Objective To investigate the selection of the types of anastomosis of bilioenterostomy and evaluate the therapeutic effects.Methods From 1990 to 2000,536 patients with obstructive jaundice underwent bilioenterostomy in our hospital.The patients included 279 cases(52%) of hilar strictures with hepatolithiasis,108 cases(20%) of end stage periampullary tumors,96 cases(17%) of proximal cholangiocarcinoma and 53 cases(12%) of congenital choledochus cyst.The types of anastomosis included extra or hilar hepatic bilioenterostomy in 302 cases(56%),intra hepatic duct anastomosis with different type of hepatectomy in 222 cases(42%),of which 44 cases(8%) were anastomosed by roud ligament approch,27 cases(5%) through gallbladder fossa.Results The short term and 1～9 years long term follow up indicated that the jaundice of different patients can be completed relieved by suitable type of bilioenterostomy.Conclusions The good therapeutic effects of bilioenterostomy come from the correct selection of the anastomosis methods.

0.05). The positive expression rate of p21 and p53 in gallbladder carcinoma was 62.5%(25/40) and 65.0%(26/40) respectively. The expression values of p21 and p53 in chronic cholecystitis was 2.5%(1/40) and 5.0%(2/40) respectively, which was significantly different from that of gallbladder carcinoma ( P

Objective To evaluate the effect of preoperative transcatheter arterial chemoembolization on proliferation of hepatocellular carcinoma cells. Methods A total of 136 patients with hepatocellular(HCC) underwent liver resection and pathologic confirmation. One to five courses of TACE prior to liver resection were performed in 79 patients (TACE group); with one to four courses of chemotherapy alone were performed in 11 patients (Group A); one to five courses of chemotherapy combined with iodized oil were performed in 33 patients (Group B); one to three courses of chemotherapy combined with iodized oil and gelation sponge were performed in 23 patients (Group C); one to three courses of chemotherapy combined with iodized oil, ethanol and gelatin sponge were performed in 12 patients (Group D). The other 57 patients only received liver resection (non-TACE group). The expressions of Ki-67 and proliferating cell nuclear antgen(PCNA) protein were detected by immunohistochemical method. Results The Ki-67 and PCNA protein expressions were significantly lower in Groups C and D than those in the non-TACE group (P

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.