BACKGROUND:Hepatocyte transplantation can improve biochemical parameters and survival of animals with acute liver failure.However,cell sources.immunological rejection,distribution and histomorphological alternation of transplanted hepatocytes are important issues for its wide application in clinic.OBJECTIVE:To observe early-stage histomorphological and ultrastructural changes of SV40LT antigen gene transfected hepatocytes after transplanted into rat spleen.DESIGN,TIME AND SETTING:Randomized controlled animal trial was performed at Laboratory of National Hepatobiliary and Enteric Surgery Research Center.Ministry of Health from March to December 2001.MATERIALS:Sixty male Wistar rats were selected for hepatocyte transplantation.METHODS:Sixty rats were randomly divided into 4 groups(n=15).Primary cell group and primary cell plus cyclosporine A group were intrasplenically transplanted with primarily cultured hepatocytes;SV40LT antigen gene group and SV40LT antigen gene plus cyclosporine A group were intrasplenic transplanted with SV40LT antigen gene transfected hepatocytes.Twenty-four hours before and 14 days after transplantation,the rats in primary cell group and SV40LT antigen gene group were injected with 0.5 mL normal saline through tail vein daily,while the other groups were injected with cyclosporine A (10mg/kg per day).MAIN OUTCOME MEASURES:The spleen of one rat was harvested every day postoperatively for light microscopic and electron microscopic examinations to observe survival rate,histomorphological and ultrastructural features of transplanted hepatocytes for 14 days.RESULTS:Compared with primary cell group and SV40LT antigen gene group,the survival rate of transplanted hepatocytes in the other groups was significantly increased(P<0.05),but the histomorphological and ultrastructural changes were minor.There were no significant differences in the survival rate between SV40LT zntigen gene transfected hepatocytes and primarily cultured hepatocytes during the first week after transplantation(P>0.05),while the survival rate in SV40LT antigen gene transfected hepatocytes was significantly higher than primarily cultured hepatocytes 8-14 days postoperatively(P<0.01).CONCLUSION:Under treatment of cyclosporine A,the SV40LT antigen gene transfected hepatocytes can maintain a stable ultrastructure and a long survival rate.

BACKGROUND: Hepatocyte transplantation can improve biochemical parameters and survival of animals with acute liver failure. However, cell sources, immunological rejection, distribution and histomorphological alternation of transplanted hepatocytes are important issues for its wide application in clinic. OBJECTIVE: To observe early-stage histomorphological and ultrastructural changes of SV40LT antigen gene transfected hepatocytes after transplanted into rat spleen. DESIGN, TIME AND SETTING: Randomized controlled animal trial was performed at Laboratory of National Hepatobiliary and Enteric Surgery Research Center, Ministry of Health from March to December 2001. MATERIALS: Sixty male Wistar rats were selected for hepatocyte transplantation. METHODS: Sixty rats were randomly divided into 4 groups (n=15). Primary cell group and primary cell plus cyclosporine A group were intrasplenically transplanted with primarily cultured hepatocytes; SV40LT antigen gene group and SV40LT antigen gene plus cyclosporine A group were intrasplenic transplanted with SV40LT antigen gene transfected hepatocytes. Twenty-four hours before and 14 days after transplantation, the rats in primary cell group and SV40LTor antigen gene group were injected with 0.5 mL normal saline through tail vein daily, while the other groups were injected with cyclosporine A (10 mg/kg per day). MAIN OUTCOME MEASURES: The spleen of one rat was harvested every day postoperatively for light microscopic and electron microscopic examinations to observe survival rate, histomorphological and ultrastructural features of transplanted hepatocytes for 14 days. RESULTS: Compared with primary cell group and SV40LT antigen gene group, the survival rate of transplanted hepatocytes in the other groups was significantly increased (P 0.05), while the survival rate in SV40LT antigen gene transfected hepatocytes was significantly higher than primarily cultured hepatocytes 8-14 days postoperatively (P

Objective To investigate the effects of captopril on intubation response and the mechanism. Methods Thirty ASA Ⅰ - Ⅱ patients aged 25-60 yr, weighing 45-70 kg, scheduled for elective surgery under general anesthesia with tracheal intubation and mechanical ventilation were randomly divided into 2 groups: captopril group ( n = 15) and control group ( n = 13) . Premedication consisted of intramuscular phenobarbital 0.2 g and atropine 0.5 mg. In captopril group, captopril 0.3-0.35 mg?kg-1 was injected intravenously 10 min before induction while in control group normal saline 10 ml was given instead. Anesthesia was induced with droperidol 0.05 mg?kg-1 , fentanyl 1 ?g?kg-1 , thiopentone 5-6 mg?kg-1 . Intubation was facilitated with succinylcholine 1.5 mg ? kg-1 . Laryngoscopy and tracheal intubation was successfully performed within 30 seconds. Mechanical ventilation was started and enflurane inhalation was begun and maintained at 2.1 % , SBP, DBF, HR, EGG and SpO2 were continuously monitored. Blood samples were taken from peripheral vein before induction (T0 ) , at intubation (T1 ), 1-1.5 min (T2) and 5 min (T3) after intubation for determination of plasma concentrations of angiotensin- Ⅰ (A 1 ), angiotensin- Ⅱ (A Ⅱ ), aldosterone (ALD), noradrenaline (NE), adrenaline (E), atrial natriuretic polypeptide (ANP) and thromboxane B2(TXB2) .Results (1) In captopril group SBP, DBF, HR, and heart rate-systolic BP product (RPP) remained unchanged at intubation, while in control group the parameters were significantly increased at T1 or T2 as compared with the baseline values ( P

Objective To evaluate the efficacy and safety of an acne-clearing device in treating acne vulgaris.Methods A bicenter,randomized,single-blinded,placebo-controlled,parallel-group study was conducted.Seventy-three patients with mild to moderate acne vulgaris were enrolled for the trial.Two similar,clinically matched inflammatory papules were selected from each patient,and divided into a test group and a control group to be treated with an acne-clearing device with an output temperature of 46-50 ℃ and a control device without heat source respectively,for three sessions with the interval varying from 1 to 12 hours between the first two sessions and from 18 to 48 hours between the last two sessions.Every treatment lasted three minutes.Lesional color and size were recorded before and on day 1,5 and 14 after the first treatment.Side effects were also recorded for the evaluation of safety.Results Clinical improvement was observed in 66 (90.4％),73 (100.0％) and 72 (98.6％) patients,and marked improvement in 27 (37.0％),64 (87.7％) and 72 (98.6％) patients on day 1,5 and 14 after the first treatment,respectively.Significant differences existed between the control and test group in improvement rate on day 1 and 5,and in marked improvement rate on all the three time points (all P ＜ 0.01).The average time taken for erythematous swelling to begin to subside and time for lesions to completely heal were 19.51 hours and 7.15 days respectively in the test group,significantly shorter than those in the control group by 82.41 hours and 5.07 days respectively.Conclusions The acne-clearing device proves to be effective and safe for the treatment of mild to moderate acne vulgaris,which can rapidly relieve the inflammation in acne,shorten the time required for erythematous swelling to subside and for lesions to completely heal.

Objective To explore the factors influencing the patients' treatment compliance infected with chronic hepatitis B virus, and provide some useful advices to improve patients compliance. Methods Data were collected through deep interviews with 9 patients and analyzed using a phenomenological hermeneutic method. Results Using generic analysis, the factors influencing patients' compliance fell in-to three themes: (1) The enforceability of the doctor's advice; (2)The factors of the patients their own, in-cluding the disease-related knowledge, the realization of how harmful the disease is, and past behavior habits; (3)The social factors, including economic situation, pressure of life, family care, and the supervision and guidance of health care workers. Conclusions In order to make the patients consciously adopt the doctor's advice, health workers should pay more attention to strengthen the enforceability of the doctor's ad-vice and health education, and focus on the impact of cognitive, psychological and social factors on pa-tients' compliance.

Objective To investigate the clinical value of improved percutaneous tramhepatic cholangiographic drainage(PTCD)and percutaneous placement of biliary metallic stents on the treatment of malignant obstructive jaundice.Methods Thirty three patients with malignant biliary obstruction were treated by the improved PTCD guided by ultrasound followed by pereutaneous placement of biliary tract metallic stcnts 1～3 weeks later.Results Improved PTCD WaS succeeded in all the patients,30 patients(90.9%)accepted percutaneous placement of biliary metallic stents successfully,3 patients who failed in stents placement accepted PTCD again for palliative management of iallndice.Thofle who failed in stent placement were found to have bleeding from the PTCD tube,but recovered several days later.Jaundice alleviated in all the patients.The patients were followed up for 1～29 months,medium follow-up period is 14.8 months.Six cases were found lever and jaundice,among that,two ageepted improved PTCD again,one recovered after antibioic treatment,the remaining 3 patients failed in further treatment due to the metastasis of the tumor.Condusion Pereutaneous placement of biliary metallic stents after improved PTCD is a safe and effeetive method to relieve malignant biliary obstruction,it can improve life quality,prolong survival time.This method could be a good choice for treating the patients with mnlignant biliary obstruction without operation.

Objective To explore the efficacy difference of biliary stent combined with 125I seed intracavity irradiation and palliative biliary drainage in the treatment of obstructive jaundice caused by pancreatic head cancer. Methods The clinic date of 95 patients with pancreatic head cancer who underwent palliative surgery from June 2010 to June 2015 were analyzed retrospectively. 46 of the cases were treated with percutaneous biliary metal stent implantation combined with 125I seed intracavity irradiation (stent group), and the other 49 cases were treated with palliative biliary enterostomy (surgery group). The levels of jaundice, liver function, tumor size, survival time and hospitalization cost were compared between the patients before and after treatment. Paired t-test was applied for statistical analysis. Results Both the two treatment coulel effectively relieve jaundice and improve liver function. The mean TBIL of surgery group and stent group was (29.4±9.6) and (21.0±8.0)μmol/L after three months treanment, (40.3±11.0) and (24.4±9.6)μmol/L after six months treatment, respectively. Tumor maximum diameter of the two groups were (37.9 ± 4.5) mm and (33.5 ± 6.0)mm after three months treatment, (45.9 ± 5.0) mm and (37.0 ± 6.5) mm after six months, respectively. Each time point between them had statistical significance (t=-4.235,-5.476,-3.654,-6.702, P<0.05). The mean survival time was (12.83 ± 0.80) months in the stent group and (9.06±0.49) months in the surgery group, the difference was statistically significant (t=-3.49, P<0.01). The mean hospitalization cost of the stent group was (38 453.0 ± 7 282.0) yuan and the surgery group was (43 057.0 ± 7 667.4) yuan, the difference was statistically significant (t= 2.759, P<0.05). Conclusion For inoperable pancreatic head cancer patients, compared with palliative biliary enteric drainage, percutaneous biliary stent placement combined with 125I seed intracavity irradiation can effectively relieve biliary obstruction, improve liver function, inhibit tumor growth and prolong survival time.

Objective To summarize the experience of diagnosis and treatment of solid-pseudopapillary tumor of pancreas (SPTP).Methods The clinical data of 15 patients with SPTP who were treated in our hospital from March,2003 to March,2006 were analyzed retrospectively.Results The 15 cases were all women, and the average age was 29.4 years.The chief manifestations were abdominal mass, abdominal pain or other abdominal discomfort. None of the 15 cases had history of pancreatitis or abdominal trauma, and no long history of drinking or smoking. Six cases were negative for CEA,CA50,CA199,CA125 and other tumor markers.Solid and solid-cystic masses in pancreas or solid and solid-cystic tumors in retroperitoneum were found both by B-mode ultrasonography and CT examinations. Preoperative fasting blood sugar was within normal limits. The tumor in 8 cases was located in the pancreatic head, in 6 cases was in the body and tail of pancreas, and in 1 case was in the neck of pancreas. The diameter of the tumors was 2.5-10 cm. No metastasis was found in the abdominal cavity or liver. Local excision was performed in 6 cases, distal pancreatectomy was performed in 5 cases, including 2 cases combined with splenectomy, and pancreaticoduodenectomy was performed in 3 cases, segmental pancreatectomy was performed in one patient with tumor in the neck of pancreas. The 15 cases showed typical pathologic manifestation of SPTP by microscopy. At followed up for 16-52 months, no evidence of recurrence or metastasis in these cases was found.Conclusions Solid-pseudopapillary tumor of pancreas primarily affects young women, and it may be located in any part of pancreas. Surgical resection is recommended as the treatment of choice, and the prognosis is good.

Objective To evaluate the clinical application of the treatment on malignant obstructive jaundice by combination of percutaneous biliary stent placement and 125 I particles intraluminal implanation.Methods As a prospective study , 32 patients with malignant obstructive jaundice who either have no opportunity for radical operations or unwilling to be surgically treated were enrolled to be treated with percutaneous biliary stent placement and 125 I particles intraluminal implanation.Biochemical routine tests , blood routine tests , tumor markers , coagulation function , color ultrasound , CT and magnetic resonance cholangiopancreatography were conducted prior to the operation to obtain general information of the clinical status of the patients and the tumor and the site of obstruction.Percutaneous transhepatic cholangial drainage was performed first under the B -type ultrasound system.After one week , biliary stents were placed under DSA.According to the stent expansion presented by real-time DSA imaging , 125 I particles were implanted simultaneously or afterwards.Routine biochemical tests and cholangiopancreatography under DSA were conducted in one week , one month and three months after the implantation.Variance analysis was performed with repeated measurements to compare the difference of liver function indexes pre -and post-operation.Meanwhile, 125I particle displacement, falling off and stent patency were observed.After three months, the tumor size was measured by CT.Student t-test was used to compare the tumor sizes of pre-and post-operation.Results The symptoms of jaundice resolved and the general physical conditions improved in 32 patients substantially.The total bilirubin level decreased from preoperative level of (302 ±169)μmol/l to the level of (108 ±50)μmol/l at one week following the surgery , and the indirect bilirubin level decreased from preoperative level of ( 250 ±160 )μmol/l to the level of ( 85 ±43 )μmol/l at one week following the surgery(F=76.32,58.23,P<0.01).The maximal diameters of the tumors decreased from preoperative size of (3.78 ±1.14)cm to the size of (3.14 ±1.28)cm at three months following the surgery, and the minimal diameters of the tumors decreased from preoperative size of ( 2.80 ±0.88 ) cm to the size of ( 1.93 ± 1.00)cm at three months following the surgery, and the differences were statistically significant (t=5.11, 6.73,P<0.05).By using Kaplan-Meier survival curve, the average survival periods were ( 9.9 ± 0.7) months.Conclusions Percutaneous biliary stent placement and 125 I particles intraluminal implanation have definite short-term effects in prolonging survival time , stent patency time and improving the living standard of the patients.The technique is safe and simple.It only needs small incision , has no absolute contraindications and can be applied repeatedly .

Objective To investigate the efficacy of proton pump inhibitors (PPI) combined with flupethixol melitracen in the treatment of non-erosive gastroesophageal reflux disease (NERD) with anxiety and depression.Methods Fifty six NERD patients with anxiety and depression were evenly divided into the positive treatment group and positive control group.Thirty NERD patients without anxiety and depression were set as negative control group.Both flupethixol melitracen (20 mg per day after breakfast) and PPI esomeprazole magnesium (20 mg per day,20 minutes before breakfast) were administrated in positive treatment group.Only esomeprazole magnesium was given in positive control group and negative control group and the dosage was same as that of positive treatment group.The treatment course of three groups was eight weeks.Before and after the treatment,the symptoms of patients were scored according to gastroesophageal reflux disease questionnaire (GERDQ),Hamilton anxiety scale (HAMA),Hamilton depression scale (HAMD) and Pittsburgh sleep quality index (PSQI).Adverse effects were also observed.Variance analysis was performed for the comparison among three groups.Variance analysis or Post-hoc analysis were used for comparison between two groups.Results The differences of different score value before and after treatment of three groups were statistically significant in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (F=6.32,3.93,5.63,49.61,78.69 and 7.07,all P＜ 0.05).The differences of the score value before and after treatment of positive treatment group in total score of GERD Q,score of type A,score of type C,score of HAMA,score of HAMD and PSQI (4.24±2.05,3.16±1.46,1(0,3),9.32±3.21 and 8.88±2.92) were all higher than those of positive control group (2.38±2.22,1.68±1.33,0(0,2),3.72±2.95 and 3.84±1.97) and negative control group (2.32±2.18,2.48±1.34,0(0,1),2.36±1.25 and 2.36±0.79).And the differences were statistically significant (positive treatment group vs positive control group:Post-hoc analysis,P=0.002,0.022,0.003,0.002 and 0.002; positive treatment group vs negative control group:Post-hoc analysis,P=0.001,0.021,0.004,0.001 and 0.001).The difference of the score value before and after treatment of positive treatment group in PSQI (4 (2,6)) was higher than that of negative control group (2 (1,3),Post-hoc analysis,P=0.001).Two cases of positive treatment group had mild dizziness and the symptom relieved after three to four days.Conclusions For NERD patients with anxiety and depression,anti-depression drug flupenthixol melitracen can be used and the effect is superior to using PPI alone.