1.Research progress of liver regeneration after partial hepatectomy
Long YANG ; Yamin ZHANG ; Zhongyang SHEN
Chinese Journal of Hepatobiliary Surgery 2013;19(10):786-789
Partial hepatectomy (PH) is widely used and the preferred method for the surgical treatment of hepatocellular carcinoma,and liver regeneration is directly related to the prognosis of the patients after the operation.Therefore,the specific mechanism and cytokines related to liver regeneration have become a hot topic in recent years.Currently,there is a wide variation of reported gene expressions and signal transduction pathways in the literature,but the mechanism and interactions are still unclear,especially for postoperative liver regeneration with hepatitis or cirrhosis.This review summarizes current research on the liver regeneration process,the mechanism of liver regeneration after partial hepatectomy,and the different mechanisms of hepatocirrhosis.
2.Influence of L-ornithine-L-aspartate on MELD score of patients with chronic liver failure.
Weilong ZOU ; Wei ZHANG ; Xinguo CHEN ; Yunjin ZANG ; Zhongyang SHEN
Clinical Medicine of China 2010;26(12):1307-1309
Objective To evaluate the influence of L-ornithine-L-aspartate (LOLA) on model for end stage liver disease(MELD) score and liver function of patients with chronic liver failure (CLF). Methods Sixty patients consecutively admitted to our hospital from May, 2002 and November, 2008 were enrolled into the study and randomly divided into low dose group (LD group, LOLA:10 g/d) and high dose group (HD group, LOLA :20 g/d)After treatment of LOLA, the clinical data ( serum NH3 , MELD score and liver function ) were compared between the two groups. Results Compared to serum NH3 level before treatment, serum NH3 decreased ( 62.59 + 27.87 )μmoL/L in the HD group and (49.36 + 27.34 ) μmol/L in the LD group, and both decreasements were statistical significant (Ps < 0. 05 ). Compared to MELD before treatment, MELD score decreased ( 8.38 ± 2. 24 ) and ( 14.57 + 7.68), respectively ( Ps < 0.05 ). Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group ( Ps < 0.05 ). Conclusions LOLA could significantly decrease serum NH3 and MELD score and improve liver function in CLF patients.
3.The experience in one case of adult-to-adult combined liver-kidney transplantation from the same living donor
Zhijun ZHU ; Zilin CUI ; Zhiping WANG ; Yamin ZHANG ; Zhongyang SHEN
Chinese Journal of Organ Transplantation 2013;(6):338-340
Objective To summarize the experience in one case of adult-to-adult combined liver-kidney transplantation.Method In Sep.2007,one case of adult-to-adult liver-kidney transplantation from the same living donor was performed on a patient with liver cirrhosis (liver failure decompensation) and chronic renal failure (uremia).There was a donation of the right liver with the middle hepatic vein and right kidney in the same time from the living donor.The piggyback liver transplantation and ectopic kidney transplantation were performed for the recipient.Basiliximab and methylprednisolone were given for immune induction therapy in operation.Tacrolimus,MMF and prednisone were given for anti-rejection.There were hepatoprotective treatment,anti-infection treatment and nutritional support for the donor and recipient after operation.The follow-up period has now been more than five years.Result The donor and the patient were smooth in the perioperative period.The liver and kidney function of the donor is well so far.There was no significant influence on quality of life of the donor.The transplanted liver and kidney function of the recipient is well so far.There were no significant complications for the recipient.Conclusion The living liver-kidney transplantation is an effective means for the treatment of liver and kidney failure.The safety can be ensured for the donors that donate the right liver and one kidney simultaneously.
4.MRI characteristics of pilomyxoid astrocytoma
Meirong LI ; Zhongyang ZHANG ; Yuhua LI ; Huimin LI ; Zhuqiang WU
Chinese Journal of Radiology 2014;(5):422-424
Objective To investigate the MRI features of pilomyxoid astrocytoma ( PMA ) in children.Methods MRI features of seven children with pathologically proven PMA in 2011-2013 were retrospectively analyzed.The ages of the patients ranged from 10 months to 32 months at initial diagnosis.Results All tumors were well-circumscribed masses.Six tumors were located in the hypothalamic-chiasmatic-third ventricular region , two tumor involved the bilateral temporal lobe , and one tumor was associated with NF-I.One occurred in the basal ganglia region.Four tumors were solid masses , whereas the other three showed cystic components.Six tumors were hypointense and one was isointense on T 1-weighted image.Five tumors were hyperintense and three were isointense on T 2-weighted image.Four tumors were hypointense , one was iso-hypointense and one was isointense on DWI.After contrast administration , four tumors enhanced homogenously and three tumors enhanced heterogeneously , with intratumoral irregular hypointense region in two tumors and rim enhancement in one tumor.Cerebrospinal fluid ( CSF ) dissemination, hydrocephalus and peritumor edema were observed in 2, 4 and 1 of cases, respectively.Proton magnetic resonance spectrum of two PMA showed elevated Cho /Cr ratios and decreased NAA/Cr ratios.Conclusions The imaging features of pilomyxoid astrocytoma include common origination from the midline of the neuroaxis in younger children about 2-3 years old.The CSF dissemination is common.The presence of hemorrhage and peritumor edema is not common.
5.Effect of CYP3A5 and CYP3A4 on pharmacokinetics of Tacrolimus in renal transplantation recipients
Ling LIN ; Wenli SONG ; Zhongyang SHEN ; Yi ZHANG
Chinese Journal of Organ Transplantation 2012;33(4):220-224
Objective To retrospectively investigate the effects of CYP3A5 * 3,CYP3A4 * 18B and CYP3A5-CYP3A4 phenotype on the C0,D and C0/D of tacrolimus (Tac) in renal transplantation recipients.Methods The CYP3A5 * 3 and CYP3A4 * 18B genotypes of the 61 patients were detected by DNA direct sequencing,and the C0 was detected by ELISA.The differences of C0,D and C0/D on the day 14,and month 1,2 and 3 after transplantation were compared among different genotypes of recipients treated with Tac.Results The frequency of the CYP3A5 * 3 and CYP3A4 * 18B was 74.6% and 26.2% respectively.When the D of the recipients with CYP3A5 * 1 ( * 1/* 1 + * 1/* 3)was 1.3-1.6 times to theCYP3A5*3/*3,theC0 of *3/*3 group was 1.1-1.5 times to the * 1group,and the C0/D was 1.8 2.4 times to the CYP3A5 * 1.For CYP3A4,the D of CYP3A4 * 18B group ( * 1/* 18B+ * 18B/* 18B) was 1.2-1.5 times to the CYP3A5 * 1/* 1,but the C0 of 1/* 1was 1.2-1.4 times to the * 18B,the C0/D was 1.5-1.8 times to the * 18B.For the CYP3A5 CYP3A4 phenotype,the D of the recipients with AAAA was 1.3-1.7 times to the GG-GG,the C0 of GG-GG was 1.5-2 times to the AA-AA,the C0/D of the recipients with G@GG was 2.5-3 times to the AA-AA.In the recipients with C0/D above or below the median of C0/D,the distribution of CYP3A5,CYP3A4 and CYP3A5-CYP3A4 phenotypes was different significantly.Conclusion There is a significant correlation between the CYP3A5,CYP3A4 and pharmacokinetics of Tac.It's more powerful evaluating the CYP3A5-CYP3A4 phenotype rather than just one genotype of the recipients.So detecting the CYP3A5 * 3 and CYP3A4 * 18B genotypes prior to transplantation is meaningful for us to determine an appropriate initial and long-time dosage of Tac.
6.Single center's experience of ABO-incompatible liver transplantation in 20 cases
Weiye ZHANG ; Yonglin DENG ; Jiancun HOU ; Zhijun ZHU ; Zhongyang SHEN
Chinese Journal of General Surgery 2012;27(8):609-612
ObjectiveTo summarize 20 ABO-incompatible liver transplantation cases in our hospital and explore the treatment strategy. MethodsFrom January 2009 to July 2011,20 cases donorrecipient ABO blood type not-identical liver transplantation was performed at our hospital. 16 cases were ABO-incompatible(ABO-Ⅰ) and 4 were ABO-compatible(ABO-C ).The median follow-up was (13.3 ± 9.2) months.ResultsExcept preoperative MELD score,there were no significant difference in other perioperative data,the incidence of postoperative complications and the cumulative survival rate between ABO-C and ABO-Ⅰ group.There were 5 deaths in 20 cases,2 cases in ABO-C group and 3 cases in ABO-Ⅰ group,survival rate was 75%.The cause of death was perioperative multiple organ failure in 2 cases,liver cancer recurrence in 2 cases and cerebral hemorrhage in 1 case.There were 2 cases of acute rejection,3 cases of biliary complications and 3 cases of portal vein thrombosis developing postoperatively. Eleven patients had increased serum creatinine after operation,preoperative high creatinine existed in 6 cases and it maintained posttransplant high level for more than 7 days,the serum creatinine level in other 7 patients was back to normal level in 7 days.ConclusionsA combination splenectomy before the portal vein reperfusion,the protocol of basiliximab,tacrolimus (TAC)/mycophenolate mofetil (MMF)/steroids immunosuppression treatment,postoperative peripheral vascular dilatation treatment by Alprostadil,help achieve favorable outcome in selected patients who underwent ABO-incompatible liver transplant.
8.Relationship between mycelium morphology and laccase production of Pleurotus ferulae in submerged cultivation.
Youzhi CHEN ; Lu WANG ; Lin PENG ; Zhongyang DING ; Liang ZHANG ; Zhenghua GU ; Guiyang SHI ; Kechang ZHANG
Chinese Journal of Biotechnology 2013;29(11):1701-1705
In this study, the relationship between mycelium morphology and laccase production was studied. The results indicated that the morphology of P. ferulae pellets was changed when glass beads were added. Laccase production showed higher with spherical mycelium than with filamentous or flocculent mycelium. In addition, the spherical mycelium with a diameter of 0.2-0.4 mm highly affected laccase production. Effect of the composition of culture medium on pellets was investigated and results indicated that various concentrations of glucose, corn meal and wheat bran were important to the formation of pellets in diameter of 0.2-0.4 mm. Besides nutrients, the addition of non-nutritional substrates influenced the distribution of P. ferulae pellets. However, the production of laccase was not promoted by non-nutritional substrates.
Culture Media
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Fermentation
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Glass
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chemistry
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Industrial Microbiology
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Laccase
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biosynthesis
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cytology
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growth & development
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Pleurotus
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cytology
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enzymology
9.Diagnostic value of MRI in axillary lymph node metastasis of early breast cancer
Yongnan WANG ; Anqin ZHANG ; Jian WAN ; Yan ZHANG ; Zhongyang CHEN ; Yugang JIANG ; Yijia LU
International Journal of Surgery 2013;(3):153-156
Objective To explore the diagnostic value of MRI special use of breast and uhrasonography in axillary lymph node metastasis of early breast cancer.Methods Clinical data of 136 Ⅰ-Ⅲ A breast cancer patients accepted MRI examination before surgery had been retrospectively studied,analysing diagnostic value of MRI and ultrasonography in axillary lymph node metastasis of early breast cancer.Results The sensitivity,specificity,and accuracy obtained by MRI were 83.3%,88.6% and 86.3%.And these data of ultrasonography were 73.1%,76.7% and 75.0%.The sensitivity,specificity,and accuracy obtained MRI were better than that of ultrasonography.The sensitivity,specificity,and accuracy of ≥ 50 years old patients were 70.0%,77.8% and 75.0%.And < 50 years old patients were 85.7%,92.3% and 88.9%.The sensitivity,specificity,and accuracy of < 50 years old patients were better than ≥ 50 years old patients.Conclusions The MRI special use of breast have an important value in axillary lymph node metastasis of early breast cancer,especially to gounger than 50 years old patients.It can provide a scientific basis of the clinical accurate treatment for early breast cancer patients.
10.Single-center experience of organ donation after cardiac death
Yonglin DENG ; Weiye ZHANG ; Yamin ZHANG ; Jinzhen CAI ; Ying ZHAO ; Ying ZHONG ; Zhongyang SHEN
Chinese Journal of Organ Transplantation 2012;33(2):109-112
Objective To summarize our experience of harvesting and using the organs of donors after cardiac death.MethodsForm March 2010 to October 2011,56 potential donors were diagnosed with cardiac death,who conformed to the classification of Maastricht Ⅲ criteria.There were 40 failure cases whose family refused to donate,and one failure case who suffered from serious infection.Finally,the success ratio of donation after cardiac death was 26.8% (15/56).Twelve livers and 22 kidneys were transplanted into 12 and 20 recipients respectively.ResultsTwelve cases of liver transplantations had acceptable outcomes. The grafts of 4 cases out of 20 cases of kidney transplantations were removed after transplantation,and other recipients had acceptable outcomes.ConclusionCitizens organ donation after cardiac death can expand the number of suitable organs,but we need to strictly control the criteria for potential donors.