1.Effects of hepatic microcirculation using low dose HSS40 preoperation on the partial hepatectomy patients in induction of anesthesia
Yanqing CHEN ; Lin YUAN ; Youxian XU
International Journal of Surgery 2014;41(10):662-666
Objective To study effects of hepatic microcirculation and hepatic function using low dose HSS40 preoperation on the partial hepatectomy patients.Methods Sixty-five partial hepatectomy patients were randomly divided into study group (32 cases with HSS40,4 mL/kg,in 30 min) and control group (33 cases with RL,4 mL/kg,in 30 min).Patients of two groups were monitored in liver microcirculation,hepatic function parameters at different times before and after the infusion.Results Compared with the study group,the control group were more infusion (2400 ± 1650) mL and blood transfusion (550 ± 190) mL,the differences were statistically significant (P <0.05).Control group of nitric oxide (NO) T3 time(17.84 ± 6.26) μmol/L in the preexpansion compared with preoperative T0 time(38.06 ± 9.34) μmol/L and the study groupT3 time (36.37 ± 9.15) μmol/L was significantly decreased (P < 0.05),and endothelin (ET) (T3 time 185.16 ± 41.34 pg/mL) was significantly higher (P < 0.05),and the study group(T3 time 99.75 ± 30.31 pg/mL) than the control group variation amplitude,time later,the difference was statistically significant (P < 0.05) ; Control group ALT,AST,DBLI,TBLI rise after preexpansion (P < 0.05),and significantly higher than the study group (P < 0.01),and the study group than the control group variation amplitude,time later,differences were statistically significant (P < 0.05) ; while no significant changes in the concentration ALB two groups,the difference was not statistically significant difference (P > 0.05).Conclusion Using low dose HSS40 preoperation on the partial hepatectomy patients can improve cardiovascular stability,protective effect on ischemia-reperfusion injury of liver,can increase the tissue perfusion,and improve the hepatic microcirculation,better able to maintain the stability of the liver function.
2.To study expression and recurrence significance of uniting soluble E-cadherin and AFP pre-and postoperative in hepatocellular carcinoma
Lin YUAN ; Youxian XU ; Shiqiang SHEN ; Xin LU
China Oncology 2013;(6):447-451
Background and purpose: E-cadherin (EC) is a type of glycoprotein, which could maintain epithelial polarity and cell-cell junction. It is thought to be associated with the development and progression of hepatocellular carcinoma (HCC). The study aimed to detect expression of uniting detection sEC and AFP before and after operation in patients, and to monitor recurrence of postoperative. Methods:The levels of sEC and AFP in 105 HCC patients were tested by enzyme linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) before and after operation as well as in 70 healthy controls. Theirs correlation with clinical and pathological factors was analyzed. We analyzed the level of plasma sEC and AFP of 47 patients who had been suffered from the hepatocellular carcinoma operation and relapse. Results: The levels of sEC and AFP in HCC patients before operation were significantly higher than in controls, which declined significantly one week after operation. The sEC level before operation showed significant correlation with TNM staging (P<0.01), edmondson grade, the carcerous thrombi within the portal vein and the capsule of carcinoma (P<0.05), but not with age of patients or the tumor size (P>0.05). While AFP only correlation with TNM staging (P<0.05), not with others factors (P>0.05). When the recurrence was confirmed, the level of sEC was much higher significantly than the level postoperation (P<0.01). Conclusion:The levels of sEC in HCC patients before operation are closely related with prognosis and recurrence of HCC. The unites detection of sEC+AFP may be a predictive factor for recurrence of postoperation.