Drugs, Chinese Herbal ; pharmacology ; Embryo Implantation ; drug effects ; Endometrium ; drug effects ; physiology ; Female ; Humans

As placenta barrier controls material exchanges between mother and fetus during pregnancy, studies on the placental transport mechanism of drugs is of great importance to analyze the efficacy, safety and toxicity of drugs. BeWo cells are derived from human choriocarcinomas, which can form monolayer trophoblast cells to offers an efficient placenta barrier in vitro for estimating nutrient and drug intake, efflux and transport. This essay focuses on the establishment and characteristics of BeWo cell model, and the advance on studies on nutrient and drug intake, efflux and transport mechanism by applying the model.
Biological Transport ; Choriocarcinoma ; metabolism ; Female ; Humans ; Placenta ; metabolism ; Pregnancy ; Tumor Cells, Cultured ; metabolism ; Uterine Neoplasms ; metabolism

LPS stimulation of macrophages production of IFN-beta plays a key role in innate immunity defending the microbial invasion. In this study, the effect of S632A3 promoting LPS-induced IFN-beta production and the underlying mechanism were investigated, mRNA level was measured by real-time PCR, cytokine production was determined by ELISA, GSK-3beta activity was investigated by kinase assay, protein phosphorylation and expression were evaluated by Western blotting. The results revealed that S632A3 significantly augmented IFN-beta production by LPS-stimulated macrophages. S632A3 inhibition of the activation of GSK-3beta, reduced the threonine 239 phosphorylation of transcription factor c-Jun but increased the total level of c-Jun in LPS-stimulated macrophages. Moreover, small interfering RNA-mediated knockdown of c-Jun level abrogated the ability of S632A3 to augment IFN-beta. The study thus demonstrates S632A3 being a new anti-inflammation lead compound and provides a molecular mechanism by which S632A3 promoted LPS-induced IFN-beta production in macrophages through inhibiting the activation of GSK-3beta.
Animals ; Anti-Bacterial Agents ; pharmacology ; Cell Line ; Enzyme Activation ; drug effects ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Interferon-beta ; biosynthesis ; genetics ; Lipopolysaccharides ; pharmacology ; Macrophages ; cytology ; metabolism ; Mice ; Phosphorylation ; Piperidones ; pharmacology ; Proto-Oncogene Proteins c-jun ; metabolism ; RNA, Messenger ; metabolism ; RNA, Small Interfering ; genetics ; Transfection

OBJECTIVETo discuss the relevant factors of biliary complications after liver transplantation and to investigate the value of comprehensive management for the complications.

METHODSThe data of 366 patients undergoing liver transplantation from October 2000 to March 2012 was analyzed retrospectively, and the risk factors were analyzed by univariate analysis and Stepwise Logistic regression. The cases with biliary leak were administered thorough drainage. The cases with anastomotic biliary stricture were administered sacculus dilatation through percutaneous transhepatic cholangiography (PTC) and endoscopicretrograde cholangiopancreatography (ERCP). If necessary, some cases were placed biliary tract brackets. The patients with nonanastomotic biliary stricture were treated with PTC plus choledochoscope.

RESULTSAll the 366 patients were followed up for 58.5 (10 to 129) months. Biliary complications after liver transplantation were diagnosed in 42 cases among these patients. The incidence for biliary complications was 11.5%. The univariate analysis and multivariate Logistic regression analysis showed that the second warm ischemia period and the blood loss and the damage of blood supply and the diameter of biliary anastmosis were significantly associated with biliary complications after liver transplantations (Wald = 9.474 to 17.208, P < 0.05). Twelve cases with biliary leak were cured through abdominal and nasobiliary drainage. Twenty-two cases with anastomotic biliary stricture were administered sacculus dilatation through ERCP or PTC and were cured, including 6 cases were placed biliary tract brackets. Among 8 cases with nonanastomotic biliary stricture, 6 cases were cured through PTC associating with choledochoscope. One case was treated second liver transplantation and another case got worse.

CONCLUSIONSIschemic injury and the diameter of anastmosis are risk factors for biliary complications after liver transplantations. The interventional management of biliary stricture and bile leakage after liver transplantation is safe and effective.

Adolescent ; Adult ; Aged ; Biliary Fistula ; therapy ; Biliary Tract Diseases ; epidemiology ; therapy ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Humans ; Liver Transplantation ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; therapy ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo investigate the pathological feature of primary hepatic carcinoma and the clinical significance.

METHODSFrom August 2000 to December 2007, there were 89 patients with cirrhosis and carcinoma of liver who accepted whole liver resection. The whole liver was cut into 10 mm slices to examine the tumor size, number, distribution, capsule, satellite nodes, portal vein tumor thrombi (PVTT). The invaded adjacent tissue and lymph nodes were recorded, the distance from satellite to major tumor was measured, then histological examinations were carried out, and the final diagnosis was made by pathologists.

RESULTSThe total of 89 cases included hepatocellular carcinoma in 86 cases and cholangiocarcinoma in 3 cases; 53 cases with multiple tumors and 36 cases with solitary tumor; complete capsule only in 14 cases, no obvious margin in 11 cases, 13 cases had a major tumor in the right lobe and a small tumor in the left lobe; 8 of 25 cases with gross invaded tissue were confirmed by histological examination, 7 of 16 cases with swollen lymph nodes were infiltrated by cancer cells. There were 47 cases with PVTT (47.2%) and 39 cases with satellite nodes (43.8%). PVTT and satellite nodes increased with the increase of sizes and the numbers of the tumors. The distance from satellite node to major tumor mostly were 0.5 - 3.0 cm.

CONCLUSIONSThe whole explanted liver can completely reflect the characteristics of growth and infiltration of hepatic carcinoma. Attention must be paid to the small cancer lesions in another lobe, distal satellite nodes from major tumor, and tumor thrombi in a small branch of portal vein, which can not be found by imaging, and might influence the curative effectiveness after liver resection or transplantation.

Adult ; Carcinoma, Hepatocellular ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Young Adult

OBJECTIVETo analyze the risk factors for acute renal failure (ARF) early after liver transplantation.

METHODSThe data of 362 patients undergoing liver transplantation from August 2000 to December 2010 were retrospectively analyzed, including 71 patients with ARF (ARF group) and 291 without ARF (non-ARF group). Thirty-six variables, including clinical and experimental variables, were analyzed by t test for continuous variables and χ(2) test for discrete variables. The variables with significance (P < 0.05) were then analyzed with Stepwise logistic regression.

RESULTSTwelve variables, including pretransplant serum creatinine, hemoglobin, thrombinogen activity, total bilirubin, MELD scores, total operation time, intraoperative blood loss, intraoperative blood transfusion, preoperative urine output, preoperative hepatic encephalopathy, intraoperative low blood pressure and postoperative infection, had significant difference between two groups (F = 10.30 - 182.70, P = 0.000 - 0.041). The Stepwise logistic regression analysis for 12 variables demonstrated that the high level of pretransplant serum creatinine, the low pretransplant thrombinogen activity, the high MELD scores, the large volume of intraoperative blood loss, postoperative infection were the independent risk factors of ARF complicated to orthotopic liver transplantation (P < 0.05).

CONCLUSIONSEarly ARF is a key negative factor for the survivors after orthotopic liver transplantation. The reason for ARF complicated to OLT is multiple. The high level of pretransplant serum creatinine, the low pretransplant thrombinogen activity, the high MELD scores, the large volume of intraoperative blood loss, postoperative infection were the independent risk factors of ARF complicated to orthotopic liver transplantation.

Acute Kidney Injury ; etiology ; Adolescent ; Adult ; Aged ; Female ; Humans ; Liver Transplantation ; adverse effects ; Logistic Models ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Retrospective Studies ; Risk Factors ; Young Adult

OBJECTIVETo investigate the feasibility, reliability and therapeutic effectiveness of adjuvant chemotherapy for advanced hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).

METHODSThe clinical data of adjuvant chemotherapy after OLT in 10 advanced HCC patients were studied retrospectively. FAP chemotherapy regimen was adopted calcium folinate (CF) 200 mg/m(2) and 5-Fluorouracil 500 mg/m(2) iv on D1 to D5, and doxorubicin 40 mg/m(2), cisplatin 30 mg/m(2) iv on D1, with 28 days as a cycle. The opportune time of chemotherapy, chemotherapy regimen, synergistic action between cytotoxic agent and immunosuppressive agent on liver and kidney and side-effects were preliminarily evaluated.

RESULTS7/10 patients are surviving, with the longest survival of 32 months, and the shortest 9 months. Three patients died after operation, two at 13 months, one at 20 months after OLT, all died of metastasis. The incidence of one year survival was 9/9. During the period of chemotherapy, the side-effects of adjuvant chemotherapy were moderate.

CONCLUSIONChemotherapy which is able to prolong the life-span of patients with advanced HCC after orthotopic liver transplantation is feasible and effective, the side-effects were mild. The choice of opportune time of chemotherapy might influence the outcome.

Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Cisplatin ; administration & dosage ; Doxorubicin ; administration & dosage ; Drug Administration Schedule ; Female ; Fluorouracil ; administration & dosage ; Follow-Up Studies ; Humans ; Leucovorin ; administration & dosage ; Liver Neoplasms ; drug therapy ; pathology ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Retrospective Studies ; Survival Rate

OBJECTIVETo investigate the value of liver transplantation for late hepatocellular carcinoma.

METHODSThirty-six patients were treated by liver transplantation from August 2000 to February 2002, of which 15 patients had had advanced hepatocellular carcinoma and thirteen of these 15 patients were evaluated for results.

RESULTSThe 1-year survival rate was 86% (6/7). Only one patient died of recurrence within 6 months. The tumor-free survival was 5 to 19 months. Till February 2002, two patients have survived for 10 months and 19 months with recurrence.

CONCLUSIONIn our country, if the patients can afford liver transplantation, advanced hepatocellular carcinoma without extrahepatic metastasis is still indicated for liver transplantation, since some patients may survive relatively long.

Adult ; Carcinoma, Hepatocellular ; mortality ; surgery ; Female ; Humans ; Liver Neoplasms ; mortality ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Recurrence, Local

OBJECTIVETo compare the clinical effect of Chinese medicine (CM) and Western medicine (WM) for controlling the recurrence of pelvic endometriosis after a conservative operation.

METHODSThe study was a multi-center, randomized, parallel controlled and prospective clinical trial. Patients were randomly divided into two groups: CM group (106 cases) and WM group (102 cases). Drugs were given to patients during 1-5 days of the first menstruation after a conservative operation in both groups. Patients with stages I and II (revised American Fertility Society) were treated for 3 months, while the patients with stages III and IV were treated for 6 months. The patients in the CM group were treated using three types of Chinese herbal medicine based on syndrome differentiation. Patients in the WM group were treated using gonadotropin releasing hormone agonist (GnRH-a) or gestrinone. Patients treated with GnRH-a received add-back therapy of Tibolone Tablets once a day after 4 months of treatment. Any cases of dysmenorrheal chronic pelvic pain, menstruation and any adverse reactions of patients were recorded once a month during the preoperative and postoperative periods and once every 3 months during the follow-up period. During the preoperative, postoperative and the follow-up periods, patients underwent type B ultrasonography of the pelvis and measurements of serum CA125 levels, gynecologic examination, routine evaluations of blood, urine, hepatic function (glutamate pyruvate transaminase), renal function (blood urea nitrogen) and electrocardiograms. During the follow-up period they underwent type B pelvic ultrasonography, measurement of serum CA125 levels and further gynecologic examinations. The two treatments were compared for clinical recurrence rates, pregnancy rates and the incidence of adverse reactions.

RESULTSThe incidence and timing of recurrence of endometriosis were not significantly different between the two groups. The first pregnancy achieved by the patient in the CM group was significantly earlier than that in the WM group (P <0.05). Moreover, the incidence of adverse reactions in the WM group was significantly higher than in the CM group (P <0.01).

CONCLUSIONSTreatment with Chinese herbal medicines prevented the recurrence of endometriosis after a conservative operation, improved the conception rate and showed fewer and lighter adverse reactions than did treatment with WM therapy. Treatment with Chinese herbal medicine meets the need of patients wishing to have a child following endometriosis and is an appropriate form of clinical treatment.

Adult ; Demography ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Endometriosis ; drug therapy ; surgery ; Female ; Humans ; Pelvis ; surgery ; Pregnancy ; Recurrence

OBJECTIVETo investigate the effect of Chinese medicine (CM) and Western medicine (WM) on quality of life (QOL) after conservative surgery for endometriosis.

METHODSA total of 320 patients with endometriosis were randomized into two groups by using random block design, CM group (160 cases, activating blood circulation and removing blood stasis treatment based on syndrome differentiation) and WM group (160 cases, gonadotropin-releasing hormone agonist or gestrinone treatment) after conservative surgery. Treatment was given for 3-6 months (according to the revised American Fertility Society scoring system stage), and the World Health Organization QOL-BREF (WHOQOL-BREF) was applied to patients before and after treatment to assess QOL.

RESULTSThere were 136 cases in the CM group and 141 cases in the WM group completing therapy. In the CM group, the use of the WHOQOL-BREF showed that the physical, psychological and environmental scores posttreatment were significantly higher than those at pre-treatment (P < 0.05), and for 12 items (pain and discomfort, energy and fatigue, sleep and rest, mobility, activities of daily living, work capacity, negative feelings, health and social care: accessibility and quality, participation in and opportunities for recreation/leisure activities, appetite, QOL score, overall health status and QOL), the difference in scores was significant (P < 0.05). In the WM group, 4 items (pain and discomfort, opportunities for acquiring new information and skills, QOL score, overall health status and QOL) had significantly different scores post-treatment compared with those at pre-treatment (P < 0.05). Before treatment, the QOL in the two groups of patients showed no significant difference (P > 0.05). After treatment, the scores for physical health in the CM group were significantly higher than those of the WM group (P < 0.05) and the scores of 4 items (mobility, activities of daily living, sexual activity, QOL score) in the CM group were significantly higher than those in the WM group (P < 0.05).

CONCLUSIONSCM and WM treatment could improve the QOL of patients with endometriosis after conservative surgery. CM treatment is more effective than WM.

Adolescent ; Adult ; China ; Drugs, Chinese Herbal ; therapeutic use ; Endometriosis ; diagnosis ; surgery ; Female ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; antagonists & inhibitors ; therapeutic use ; Humans ; Middle Aged ; Pain Measurement ; Pain, Postoperative ; drug therapy ; physiopathology ; Patient Satisfaction ; statistics & numerical data ; Postoperative Care ; methods ; Prospective Studies ; Quality of Life ; Reference Values ; Risk Assessment ; Treatment Outcome ; Young Adult