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

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.

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 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 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 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 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 evaluate the recognition and uptake of transglutaminase 3 (TG3) by dendritic cell-specific intercellular adhesion molecule 3-grabbing nonintegrin (DC-SIGN) receptors on the membrane surface of DC-SIGN-transfected human embryonic kidney (HEK) 293T cells and monocytederived dendritic cells (MDDCs).Methods The eukaryotic expression vector pGCMV-enhanced green fluorescent protein (EGFP) containing DC-SIGN gene fragments was transfected into HEK293T cells to prepare DC-SIGN-EGFP-HEK293T cells by using liposome transfection method.CD14+ monocytes were isolated from peripheral blood samples by magnetic bead-based negative selection,and then were induced by granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4) to prepare MDDCs.Laser confocal microscopy and flow cytometry were performed to evaluate the recognition and uptake of TG3 protein by DC-SIGN receptors on the surface of HEK293T cells and MDDCs.MDDCs treated without Alexa Fluor 647 dye-tagged TG3 served as blank control group,and those treated with Alexa Fluor 647 dye alone served as negative control group.Results After co-culture with TG3 for 3 hours,laser confocal microscopy and flow cytometry both showed that TG3 could be recognized by and uptaken through DC-SIGN receptors into HEK293T cells and MDDCs.Flow cytometry also revealed that the binding of TG3 to MDDCs could be partially blocked by DC-SIGN blocking antibodies.Neither the negative control group nor the blank control group showed the recognition and binding of TG3 to HEK293T cells and MDDCs.Conclusion TG3 can serve as a kind of autoantigen to be recognized and bound by DC-SIGN receptors,followed by uptake by dendritic cells.

Objective To observe the safety and clinical efficacy of enhanced recovery after surgery in the perioperation period of hepatectomy.Methods 92 patients with primary hepatic cancer who underwent surgical resection in our hospital from December 2014 to May 2016 were divided into two groups,50 patients received well-organized and consecutive clinical interventions guided by ERAS.42 patients underwent traditional perioperative management.Results Compared with traditional group,ERAS group had reduced hospital cost [(40 633.12 ± 6 336.46) RMB vs.(46 139.23 ± 9 605.88) RMB,P ＜ 0.05],shorter postoperative hospital stay[(10.24 ± 1.6) d vs.(13.35 ± 4.86) d,P ＜ 0.05],earlier flatus and defecation [(33.34 ±6.01) h vs.(50.31 ± 3.53) h,P ＜ 0.05],and improved satisfaction rate for pain management[45/50(90％) vs.22/42(52.4％),P ＜ 0.05];while the postoperative adverse events and complications of the two groups showed no difference (P ＞ 0.05).Conclusion The application of ERAS in the perioperation period of hepatectomy is safe and effective,reducing hospital cost,postoperative hospital stay,improving satisfaction rate to pain management,and facilitating recovery in hepatic surgery.