China ; Death ; Humans ; Tissue and Organ Procurement

Evidence-based medicine emphasizes making project of diagnosis and therapy on the basis of the most objective research results. The current condition in which domestic medicine is dominant in hepatobiliary surgery and teaching needs to be changed urgently. The procedure of application of evidence-based medicine in teaching of hepatobiliary surgery is explained by an actual example. Evidence-based medicine plays an important role in teaching and quick progress in all of the hepatobiliary surgery.

AIM: To study the protective effect of bone marrow stromal cells (MSCs) on ischemia /reperfusion hippocampal slices. METHODS: Ischemia/reperfusion models of hippocampal slices from newborn rats were established. MSCs obtained from adult bone marrow were cultured, isolated and purified. Cell death was assessed using propidium iodide fluorescence. And brain-derived neurotrophic factor (BDNF) expression in MSCs was determined by immunocytochemistry and Western blot. RESULTS: Maximal dead cells appeared in hippocampal slices 3 to 7 days after reperfusion. When the slices were co-cultured with MSCs, only a few cells were dead. The protective effect of MSCs on the slices was diminished significantly when anti-BDNF antibody was added to the medium. The protein of BDNF was faintly expressed in MSCs under normal conditions. When MSCs were co-cultured with ischemia /reperfusion hippocampal slices, the expression of BDNF in MSCs was increased gradually especially when co-cultured for 3 to 7 days. However, MSCs co-cultured with normal hippocampal slices expressed BDNF at a lower level at any times of co-culture. CONCLUSIONS: In an in vitro model of simulated ischemia, MSCs reduce cell death. Ischemia/reperfusion hippocampal slices co-cultured with MSCs promote the expression of BDNF in MSCs, which in turn protect the ischemic neurons.

Objective To explore the significance of serum cystatin C (Cys C)and β2-microglobulin (β2-MG) levels in blood and urine samples in hypertension grading and risk stratifying. Methods One hundred and thirty six cases with primary hypertension were enrolled into the study and classified into three grades and four risk stratifications. The serum Cys C levels were determined by ELISA assay. The blood and urine β2-MG were measured by radioimmunoassay. The serum BUN, Cr concentration were measured by the automatic biochemical analyzer. Results The positive rates of urine β2-MG were the highest index in patients with grade 1 (32%) and low risk hypertension( 8% ) ,followed by serum Cys C levels( grade 1 hypertension 24% ) ,compared with other indices( Ps ＜ 0. 05 ). With the blood pressure elevating, as well as the risk stratification increasing,serum Cys C level and the blood, urine β2-MG levels increased gradually by grading and stratifications (Ps ＜0. 05 or Ps ＜0. 01 ). We also found linear regression relationship between serum Cys C ,urine β2-MG levels and the risk stratifications of hypertension( r =0. 851 and r =0. 469 respectively,Ps ＜0. 01 ). The significant changes of serum BUN,Cr were only found in patients with grade 3 or very high-risk hypertension. Conclusion Joint detection of serum Cys C and urine β2-MG may help to detect early glomerular and tubular dysfunction in primary hypertension patients. Serum Cys C and blood, urine β2-MG levels are also related with the occurrence and development of hypertension,which show clinical significance in hypertension prognosis.

Aerenchyrna formation has been described in depth in a number of species at a histological level. But large gaps remain in our understanding of its regulation as a developmental process. It is attempted to analyse essential mineral elements like K, Mg, Cu, Zn, Ca and P in the cell wall of aerenchyma cells in petioles ofS. trifolia at five different developmental stages by CSEM-EDX technique. At early stage, K and Cl concentrations in cell wall were high up to 36% and 4.3% of dry weight, respectively. It supported the hypotheses that aerenchyma spaces are filled with liquid at early developmental stages of aerenchyma in S. trifolia petiole. Mg concentration was high at stage 2, up to 0.86% of dry weight. Zinc and Cu were detected only at rapid expansion stages, during which the concentrations were up to 1.5% and 2.5%, respectively. Calcium was detected in the cell wall only at mature stages, the concentration was high up to 1.3% of dry weight at stages 4 and 5. These results confirmed that the element concentration of aerenehyma cell wall undergoes dynamic changes during different developmental stages, and a low Ca with high Zn and Cu concentration are needed for cell expansion. Copper and Zn deposition in the cell wall showed a significant positive linear correlation, suggesting that these two elements share same or similar uptake and transport mechanism in plants.

Objective: To discuss the way of early nutritional support in the patients after the liver transplantation. Methods: The nutritional support was used in 28 patients who had suffered the orthopetic liver transplantation (OLT).Parenteral nutrition was started as soon as possible after the operation. On the fourth day after the operation, enteral nutrition was also used. Results: 5 patients died from the postoperative complications. 23 patients survived and had been in better nutrition. Conclusion: The early nutrition support can play an important role in the patients recovery after OLT. EN should be administrated immediately when the gut functions.

Objective To investigate the role of survivin and P53 in apoptosis of gastric adeno- carcinoma,as well as its relationship with the clinicopathologic features and the prognosis.Methods The gas- tric tissue microarrays were composed of those from 100 cases of gastric cancer and 30 controls.At these tissue microarrays,expressions of survivin and P53 were investigated immunohistochemically,and tumor cell apoptosis index was examined by TUNEL method.Of the 100 cases,47 cases were followed-up from 14 months to 13 years,in which the survival was analyzed.Results Two paraffin-embedded gastric carcinoma tissue micro- arrays were successfully constructed,including 114 and 116 tissue spots,respectively.Immunohistochemical analysis showed that survivin was expressed in 78 cases (78%).No expression of survivin was detected in control tissue (P0.05).In the 47 cases with followed-up data,univariant analysis revealed that the survival was correlated with invading of vessel and nerve,TNM stages,and expression of survivin.The histological grades and expression of P53 were not related to prognosis.However,Cox stepwise proportional hazards analysis showed that only TNM staging and survivin status retained significant independently in prospecting prognosis.Conclusions The expression of survivin was associated with the pathologic features,TNM stages and prognosis in gastric carcinoma,indicating that overex- pression of survivin may be a poor prognosis factor for gastric carcinoma.

ObejectiveTo evaluate the efficacyofacupointthread embedding in easing painafterMilligan-Morgan(M-M)for mixed hemorrhoids.MethodSixty patients undergone M-M for mixed hemorrhoids were randomized into a treatment group of 30 cases and a control group of 30 cases. After M-M, patients in the treatment group received thread embedding at Changqiang (GV1) and bilateral Zhibian (BL54), while the control groupdidn’treceive any intervention. The onset time of post-operative pain, average pain index within a week, and pain index after defecation, electromyogram (EMG), change of anal canal pressure, patients’ satisfaction, and adverse-event rate were observed.ResultThe average pain index and pain index after defecation in the treatment group were significantly lower than that in the control group (P<0.05), and the onset of pain in the treatment group was significantly later than that in the control group (P<0.01); after surgery, the anal canal resting pressure in the treatment group was markedly lower than that in the control group (P<0.05); there wasno significant difference in comparing the squeeze pressure of anal canal between the two groups (P>0.05). According to the motor unit potential (MUP) analysis, there were significant differences in comparing the amplitude (Ampl) and Ar/Am of the restingphase between the two groups (P<0.05), while there were no significant differences in comparingthe Ampl, Area, Ar/Am, and Freq of the contraction phase between the two groups (P>0.05). There were significant differences in comparing the patients’satisfaction, adverse-event rate, and use of analgesics between the two groups (P<0.05). ConclusionAcupoint thread embedding can produce a content analgesic effect, and it’s safe and reliable.

The outcome of liver transplantation for end-stage liver disease secondary to hepatitis B is remarkably impacted by recurrent infection and subsequent allograft failure. Pre-operational viral replication, immunosuppression degree, and disease types play an important role in hepatitis B recurrence. This article summarizes the mechanisms, the influencing factors, and clinical diagnosis for recurrence of hepatitis B following liver transplantation, and discusses multiple strategies to prevent hepatitis B recurrence. Lamivudine in combination with low-dose hepatitis B immuno-globulin currently is the most effective therapy to prevent recurrent hepatitis B virus allograft infection. It is emphasized that effective prophylaxis approaches against hepatitis B virus recurrence should be adopted before, during, and after operation. Long-term and even life-long antiviral therapy is important for a better outcome.
Combined Modality Therapy ; Hepatitis B Antibodies ; therapeutic use ; Hepatitis B virus ; immunology ; Hepatitis B, Chronic ; prevention & control ; Humans ; Immunoglobulins ; therapeutic use ; Lamivudine ; therapeutic use ; Liver Transplantation ; Postoperative Complications ; prevention & control ; Secondary Prevention

Hepatitis C ; etiology ; prevention & control ; surgery ; Humans ; Liver Transplantation ; Secondary Prevention