1.Perioperative and long-term outcomes of laparoscopic versus open hepatectomy for hepatocellular carcinoma at specific sites of liver
Conglong SHEN ; Tingfeng HUANG ; Hongzhi LIU ; Liming HUANG ; Yongyi ZENG ; Kecan LIN
Chinese Journal of Hepatobiliary Surgery 2023;29(7):499-504
Objective:To compare the clinical efficacy of laparoscopic and open surgery in the treatment of hepatocellular carcinoma (HCC) at specific sites of liver.Methods:Data of patients with HCC undergoing hepatectomy in Mengchao Hepatobiliary Hospital of Fujian Medical University from September 2014 to May 2019 were retrospective analyzed. A total of 205 patients were enrolled, including 174 males and 31 females, aged (56.7±11.3) years. According to the surgical methods, patients were divided into laparoscopic group ( n=105) and open group ( n=100). The Child-Pugh score, maximum tumor diameter, tumor location, intraoperative blood loss, postoperative complication rate, liver function(glutamate transaminase, alanine transaminase, etc.) and length of hospital stay were compared between the two groups. Postoperative survival and recurrence were followed up. Survival curves and rates were analyzed by Kaplan-Meier and log-rank test. Results:There were no significant differences in Child-Pugh score, maximum tumor diameter, tumor location between the two groups. Compared to the open group, the laparoscopic group had a decreased blood loss [100 (50, 200) ml vs 150 (100, 200) ml], a lower incidence of postoperative complications[7.6%(8/105) vs 17.0%(17/100)], and a shorter hospital stay [(8.6±1.9) days vs (13.0±3.4) days](all P<0.05). The postoperative glutamate transaminase and alanine transaminase levels were lower in the laparoscopic group than those in the open group. The 1, 3, 5-year overall survival and recurrence-free survival were not significantly different between the two groups (χ 2=0.56, 0.21, P=0.456, 0.648). Conclusion:Laparoscopic surgery in the treatment of HCC at specific sites of liver is a safe, feasible and effective procedure.
2.Effect of mesenchymal stem cells combined with immunosuppressants on immune rejection in a rat model of liver transplantation
Haitao LI ; Saihua YU ; Lihong CHEN ; Zisen LAI ; Haiyan LIU ; Hongzhi LIU ; Conglong. SHEN
Journal of Clinical Hepatology 2024;40(6):1209-1214
ObjectiveTo investigate the effect of mesenchymal stem cells (MSCs) combined with immunosuppressants (IS) on immune rejection in a rat model of liver transplantation. MethodsF344 rats were divided into Normal group (without any intervention), PS group (injected with an equal volume of normal saline), MSC group (injected with MSC), IS group (injected with IS), and MSC+IS group (injected with MSC and IS), with 8 rats in each group. For all rats except those in the Normal group, the Kamada’s double-cuff method was used to establish a model of orthotopic liver transplantation, without reconstruction of the hepatic artery. HE staining and Masson staining were performed for rat liver tissue, and the degree of liver fibrosis was analyzed; immunohistochemical experiments were used to measure the infiltration of T cells and NK cells, and immunofluorescence assay was used to analyze macrophage M2 polarization. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for survival analysis. ResultsCompared with the PS group, the MSC+IS group had a significantly prolonged survival time (P<0.01), and the MSC group, the IS group, and the MSC+IS group had a significant improvement in the histological structure of the liver and a significant reduction in the degree of liver fibrosis (all P<0.000 1), as well as a significant reduction in the infiltration of NK and T cells (all P<0.000 1) and a significant increase in the degree of macrophage M2 polarization (all P<0.000 1). The MSC+IS group had a significantly better effect than the MSC group and the IS group. ConclusionMSCs combined with IS can improve liver histopathology, reduce inflammatory cell infiltration, promote macrophage M2 polarization, and exert an immunosuppressive effect in rats after liver transplantation.